Low Birth Rate Research Articles

Balancing Pakistan's Population Growth with Climate Change: Charting a Sustainable Path Forward

Pakistan's rapid population growth has a significant impact on its capacity to address climate change. The migration of individuals to urban areas in search of better amenities leads to the expansion of urbanization and a rise in human-induced activities, leading to the formation of urban heat islands and warmer climatic conditions.1,2 This urban development further intensifies the trend of rising temperatures in key cities such as Karachi, Lahore, Islamabad, Peshawar, and Quetta, disturbing the usual climate patterns. Moreover, the demographic dividend, if not effectively utilized, can contribute to environmental deterioration and climate change challenges, thus impeding the achievement of sustainable development objectives. The substantial growth in population strains available resources, escalates emissions, and poses obstacles to the implementation of measures for climate resilience, underscoring the critical necessity of strategic policies to tackle these interconnected issues3. The increase in the population of Pakistan has noteworthy environmental implications on agriculture and food security. Challenges faced by the agricultural sector of the nation include erratic weather patterns, substandard crop yield, and degradation of soil fertility.4 The impact of climate change further complicates these challenges, as elevated temperatures and diminished water availability negatively influence crop output and water efficiency.5 Moreover, insufficient investments, unequal land allocation, and limited water resources impede consistent agricultural development, thereby affecting food security. Projections for the future indicate a necessity for a 40% enhancement in food production by 2025 to fulfill the demands of the growing population, underscoring the critical need for sustainable agricultural methodologies and adaptive measures to alleviate the detrimental consequences of population growth on agriculture and food security in Pakistan.6 Addressing Pakistan's population growth requires a multifaceted approach that encompasses education, healthcare, women's empowerment, and access to family planning services. Education, especially for girls, plays a pivotal role in empowering individuals to make informed choices about family size and reproductive health. By investing in education and promoting gender equality, Pakistan can empower women to participate more fully in the workforce, delay marriage, and make decisions regarding family planning, leading to lower fertility rates and improved maternal and child health outcomes.7,8 Furthermore, access to affordable and high-quality healthcare services, including family planning and reproductive health services, is essential for enabling individuals to plan their families according to their desired family size. Pakistan must prioritize the expansion of healthcare infrastructure, training of healthcare professionals, and dissemination of accurate information about contraception and family planning methods to ensure universal access to reproductive healthcare services.9,10 Pakistan, due to the significant impact of climate change, is confronted with various challenges such as extreme weather events, water scarcity, and food insecurity. It is imperative to prioritize investments in climate-smart infrastructure, sustainable agriculture, and disaster preparedness to bolster climate resilience. The implementation of sustainable strategies such as crop diversification and agroforestry play a vital role in enhancing resilience, ensuring food security, and mitigating greenhouse gas emissions. Given that the agricultural sector serves as a major source of employment, it is crucial for it to embrace climate-resilient practices to effectively adapt to shifting climates and mitigate environmental degradation. Additionally, the allocation of resources towards renewable energy sources like solar and wind power can diminish dependence on fossil fuels, decrease emissions, generate employment opportunities, stimulate economic development, and improve energy accessibility in remote regions.11,12 However, addressing Pakistan's population growth and climate change requires concerted efforts and collaboration among government agencies, civil society organizations, the private sector, and the international community. It demands political will, commitment to sustainable development goals, and long-term planning to achieve meaningful results. By investing in education, healthcare, women's empowerment, sustainable development, and climate resilience, Pakistan can chart a sustainable path forward those balances population dynamics with environmental sustainability. The time to act is now, and Pakistan must seize the opportunity to build a more resilient and prosperous future for its people and the planet.

Reproductive outcomes in women with advanced endometriosis in fresh versus frozen embryo transfer cycles

BackgroundART in women with endometriosis is associated with poor quality of the retrieved oocytes and lower fertilization and pregnancy rates, reflecting that endometriosis may influence fertility by altering the quality of both the oocyte and embryo quality and also by impairing the endometrial receptivity. On comparing endometriosis-affected patients to healthy counterparts, many differences were demonstrated at the endometrial level. Thus, choosing the appropriate method of embryo transfer is of utmost importance, particularly for patients with advanced endometriosis.ObjectiveThe aim of the present study was to compare the reproductive outcomes between fresh and frozen embryo transfer cycles in women with advanced endometriosis.Material and methodsA retrospective cohort study was conducted in the period from January 2018 until December 2021 for patients recruited from two IVF centers, Alexandria, Egypt. Careful review of paper and electronic medical records of infertile women (primary, relative, or secondary infertility) aged 18–37 years who were diagnosed with advanced endometriosis by means of laparoscopy and were scheduled for ICSI followed by either fresh embryo transfer (group I) or freeze-all embryos and deferred embryo transfer (group II) of day 5 embryo(s) was included in the study.ResultsTwo-hundred and eleven women were eligible and included in the study. Women in each study group were matched regarding baseline characteristics. Clinical pregnancy, implantation, and ongoing pregnancy rates were statistically significantly higher in the group of frozen embryo transfer (p < 0.001). Miscarriage rate was found to be higher in the group of fresh transfer compared to FET group but without a statistical significance (20.9% vs 9.2%, p = 0.072).ConclusionIn women with advanced endometriosis, freeze-all policy seems to be associated with better implantation, ongoing pregnancy rates.

Analysis of assisted reproductive outcomes for gynecologic cancer survivors: a retrospective study

ObjectiveTo examine the reproductive outcomes of assisted reproductive technology (ART) in gynecologic cancer patients and to assess maternal and neonatal complications.MethodsWomen diagnosed with gynecologic cancer who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment between 2013 and 2021 at Shanghai Ji Ai Genetics and IVF Institute were included in this study. Infertile women without any history of cancer were matched to the cancer group. The primary outcome was the cumulative live birth rate. Baseline and follow-up data were compared between groups using Student’s t-tests for normally distributed variables and with Chi-square test for categorical variables. A propensity score-based patient-matching approach was adopted to ensure comparability between individuals with and without specific cancer type.ResultsA total of 136 patients with a history of gynecologic cancer and 241 healthy infertile controls were included in this study. Endometrial cancer constituted 50.70% of the cases and cervical cancer constituted 34.60% of the cases. The cancer group exhibited significantly shorter duration of stimulation, lower levels of estradiol, lower number of retrieved oocytes, day-3 embryos, and blastocysts compared to the control group (P < 0.05). The cumulative live birth rate of the gynecologic cancer group was significantly lower than that of the control group (36.10% vs. 60.50%, P < 0.001). Maternal and neonatal complications did not significantly differ between the groups (P > 0.05). The endometrial cancer and cervical cancer groups showed significantly lower cumulative live birth rates than their matched controls (38.60% vs. 64.50%, P = 0.011 and 24.20% vs. 68.60%, P < 0.001, respectively).ConclusionsThese findings highlight the decreased occurrence of pregnancy and live birth in female gynecologic cancer patients undergoing ART, particularly in endometrial cancers and cervical cancers. These findings have important implications for counseling and managing gynecologic cancer patients undergoing ART.

Investigating Low Birth Rates and High Infant Mortality Rate in Developing Countries: The Rising Infant Mortality Rate

Investigating Low Birth Rates and High Infant Mortality Rate in Developing Countries: The Rising Infant Mortality Rate

Fertility Intentions Among Reproductive-Age Women - Three Provinces, China, 2023.

Low fertility rates have become the most important risk affecting the balanced development of the population in China. About 80.0% of childless women had fertility intentions, 31.9% of women with one child and 11.3% of women with two children intended to have a second and third child, respectively. Women with one child who had an agricultural Hukou, were younger than 30 years old, were remarried, and had received a deduction or reimbursement for childbirth expenses during their first delivery were more willing to have a second child. Women with two children who had an agricultural Hukou and a upper-middle personal income, were self-employed, and had two daughters were more willing to have a third child. In China, women's willingness to have more children is not optimistic. To increase their desire for more children, creating a more favorable fertility environment for reproductive-age women and providing more preferential fertility policies for pregnant women will be necessary.

Research on the Factors Contributing to Low Fertility in South Korea

In 2023, South Korea had a fertility rate of 0.8831, the lowest in the world. Compared to most other east Asian countries, Korea recovered from the Second World War relatively earlier and is home to some of the most influential companies in the world today. Therefore, while other east Asian countries are in the industrial stage characterized by moderate to high rates of population growth, Korea is already a post-industrial society, marked by low population growth. This paper aims to identify the contributing factors to South Koreas low fertility rate by examining previous surveys completed by Koreans, interviews done with Koreans, and statistics about the Korean economy and society. These surveys, interviews, and statistics show the current economic, social, and cultural characteristics of the country and the flaws in them that lead to low fertility rate. The first significant factor related to the low fertility rate in South Korea is the high economic uncertainty due to rising living costs. Many Koreans struggle to achieve financial independence and move out of their parents homes, which is a barrier to starting a family. The second factor is the rising number of women obtaining higher levels of education and subsequently entering the workforce. The last factor is the practice of neo-Confucianism beliefs that are patriarchal in nature. Therefore, the proposed solution is that the Korean government should focus on changing current social and cultural beliefs to minimize the conflict between family and work for Korean women.

Effect of prematurely elevated late follicular progesterone on pregnancy outcomes following ovarian stimulation-intrauterine insemination for unexplained infertility: secondary analysis of the AMIGOS trial.

What is the relationship between late follicular phase progesterone levels and clinic pregnancy and live birth rates in couples with unexplained infertility undergoing ovarian stimulation with IUI (OS-IUI)? Late follicular progesterone levels between 1.0 and <1.5 ng/ml were associated with higher live birth and clinical pregnancy rates while the outcomes in groups with higher progesterone levels did not differ appreciably from the <1.0 ng/ml reference group. Elevated late follicular progesterone levels have been associated with lower live birth rates after fresh embryo transfer following controlled ovarian stimulation and egg retrieval, but less is known about whether an association exists with outcomes in OS-IUI cycles. Existing studies are few and have been limited to ovarian stimulation with gonadotrophins, but the use of oral agents, such as clomiphene citrate and letrozole, is common with these treatments and has not been well studied. The study was a prospective cohort analysis of the Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS) randomized controlled trial. Frozen serum was available for evaluation from 2121 cycles in 828 AMIGOS participants. The primary pregnancy outcome was live birth per cycle, and the secondary pregnancy outcome was clinical pregnancy rate per cycle. Couples with unexplained infertility in the AMIGOS trial, for whom female serum from day of trigger with hCG was available in at least one cycle of treatment, were included. Stored frozen serum samples from day of hCG trigger during treatment with OS-IUI were evaluated for serum progesterone level. Progesterone level <1.0 ng/ml was the reference group for comparison with progesterone categorized in increments of 0.5 ng/ml up to ≥3.0 ng/ml. Unadjusted and adjusted risk ratios (RR) and 95% CI were estimated using cluster-weighted generalized estimating equations to estimate modified Poisson regression models with robust standard errors. Compared to the reference group with 110/1363 live births (8.07%), live birth rates were significantly increased in cycles with progesterone 1.0 to <1.5 ng/ml (49/401 live births, 12.22%) in both the unadjusted (RR 1.56, 95% CI 1.14, 2.13) and treatment-adjusted models (RR 1.51, 95% CI 1.10, 2.06). Clinical pregnancy rates were also higher in this group (55/401 clinical pregnancies, 13.72%) compared to reference group with 130/1363 (9.54%) (unadjusted RR 1.46, 95% CI 1.10, 1.94 and adjusted RR 1.42, 95% CI 1.07, 1.89). In cycles with progesterone 1.5 ng/ml and above, there was no evidence of a difference in clinical pregnancy or live birth rates relative to the reference group. This pattern remained when stratified by ovarian stimulation treatment group but was only statistically significant in letrozole cycles. The AMIGOS trial was not designed to answer this clinical question, and with small numbers in some progesterone categories our analyses were underpowered to detect differences between some groups. Inclusion of cycles with progesterone values above 3.0 ng/ml may have included those wherein ovulation had already occurred at the time the IUI was performed. These cycles would be expected to experience a lower success rate but pregnancy may have occurred with intercourse in the same cycle. Compared to previous literature focusing primarily on OS-IUI cycles using gonadotrophins, these data include patients using oral agents and therefore may be generalizable to the wider population of infertility patients undergoing IUI treatments. Because live births were significantly higher when progesterone ranged from 1.0 to <1.5 ng/ml, further study is needed to clarify whether this progesterone range may truly represent a prognostic indicator in OS-IUI cycles. Oklahoma Shared Clinical and Translational Resources (U54GM104938) National Institute of General Medical Sciences (NIGMS). AMIGOS was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development: U10 HD077680, U10 HD39005, U10 HD38992, U10 HD27049, U10 HD38998, U10 HD055942, HD055944, U10 HD055936, and U10HD055925. Research made possible by the funding by American Recovery and Reinvestment Act. Dr Burks has disclosed that she is a member of the Board of Directors of the Pacific Coast Reproductive Society. Dr Hansen has disclosed that he is the recipient of NIH grants unrelated to the present work, and contracts with Ferring International Pharmascience Center US and with May Health unrelated to the present work, as well as consulting fees with May Health also unrelated to the present work. Dr Diamond has disclosed that he is a stockholder and a member of the Board of Directors of Advanced Reproductive Care, Inc., and that he has a patent pending for the administration of progesterone to trigger ovulation. Dr Anderson, Dr Gavrizi, and Dr Peck do not have conflicts of interest to disclose. N/A.

Retirement and unemployment as an opportunity for use and social interaction in urban public spaces / Jubilación y desempleo como oportunidad de uso e interacción social en los espacios públicos urbanos

Demographic changes, associated with longer life expectancy and a lower birth rate, have led to population ageing in societies. There is also a high rate of unemployment linked to job insecurity, temporary employment, school drop-out rates and overqualification, among others. These phenomena have generated a new social challenge. This research paper, based on a sample of 259 people, aims to analyse the extent to which socio-occupational status influences the use of public spaces (parks and squares) and users’ perceptions about the possibilities of contact promoted by different public spaces and the quality of relationships with other users. Findings indicate that there are differences depending on socio-occupational status with regard to the perception of social relations and frequency of use. In particular, unemployed and retired people use urban public spaces to a greater extent, and they also show a more positive perception of the possibilities of contact in public spaces and the quality of relationships.

Current Use and Discrepancies in the Adoption of Health-Related Internet of Things and Apps Among Working Women in Japan: Large-Scale, Internet-Based, Cross-Sectional Survey.

Demographic changes and a low birth rate have led to a workforce shortage in Japan. To address this issue, the government has promoted engagement of female employment. However, increased female employment can impact women's health. Using Internet of Things (IoT) and apps to manage women's health has gained attention, but few studies have focused on working women. This study aimed to clarify the current situation of working women and their use of IoT or apps to manage their health. A large-scale, nationwide internet survey was conducted among 10,000 female participants aged from 20 years to 64 years in Japan. Participants were recruited from a marketing research company's active survey panel of 5.24 million members. The survey included questions about health status, sociodemographic factors, psychological characteristics, and the use of IoT or apps for health management. We compared perceived health status and reasons for current IoT use using t tests and assessed participant characteristics that predicted IoT use using the C5.0 decision tree algorithm. Ethical approval was granted by St. Luke's International University. Among participants, 14.6% (1455/10,000) currently used IoT or apps, 7% (695/10,000) used them previously, and 78.5% (7850/10,000) had never used them. Current users (42.7 years old) were older than past users (39.7 years old). Discrepancies were observed between participants' perceived health problems and the purpose for using IoT or apps, with 21.3% (2130/10,000) of all women reporting they experienced menstrual symptoms or disorders but only 3.5% (347/10,000) used IoT or apps to manage the same symptom. On the other hand, current users were more likely to use IoT or apps to manage nutrition-related problems such as underweight or obesity (405/1455, 27.8%). Device use was highest among current users, with 87.3% (1270/1455) using smartphones, 19.7% (287/1455) using smartwatches, and 13.3% (194/1455) using PCs. Decision tree analysis identified 6 clusters, the largest consisting of 81.6% (5323/6523) of non-IoT users who did not exercise regularly, while pregnant women were more likely to use IoT or apps. Our findings highlight the idea that woman with particular health problems (ie, menstrual symptoms or disorders and premenstrual syndrome) have lower use of IoT or apps, suggesting an unmet need for IoT and apps in specific areas.

저출산 시대 모성에 대한 고찰

Today, Korean society is facing a crisis of low birth rate. Conflict between men and women caused by an intense competitive system and conservative familism is cited as a major cause of the low birth rate problem, which has emerged as a national issue. Radical feminism, which is considered an ideological background that influenced the conflict between men and women, emerged as a backlash against the government's reproductive policy that instrumentalizes motherhood, but its argument for liberation from motherhood is becoming a cause of social conflict. At a time like this, discovering a new positive view of motherhood and its value has important implications. Even within feminism, there is not only a perspective that views motherhood as a control mechanism for women and advocates liberation from motherhood. Since the 1980s, efforts have been made to understand motherhood more diversely within feminism, and there is a movement to present motherhood as a social value by discovering the value of care within motherhood. This perspective is believed to have a positive meaning by presenting the area of care as a common area for men and women and highlighting the ‘right to care’ of the vulnerable in a fiercely competitive society. However, in order for care to become an important value for both men and women, it is necessary to properly understand the value of care within motherhood. The personalist perspective, which understands motherhood as an outstanding attribute of women and shows a complementary relationship between men and women, will help men participate more actively in the area of care by learning about fatherhood through motherhood.

폐교대학 구성원 보호를 위한 정부 지원방안 고찰

South Korea has a declining school-age population due to a low birth rate of 0.78, which is causing major changes in the university environment. Meanwhile, the government is evaluating the management and operation status of universities through structural reforms and inducing autonomous development of universities through financial support. However, the survival of universities is becoming a serious issue due to the lack of freshman enrollment, which started from local universities, and there are cases of universities closing down because of difficulties to operate due to decreased funding. Therefore, this study reviews the existing cases of closed universities, the government's university structural reform policies, and examines the problems of the school-age population that may appear in Korea in the future. Then, the negative effects of university closure on students, faculty, and school corporations are examined. Based on this, the purpose of this study is to propose government support measures to protect students, faculty and staff, and school corporations by examining system improvement measures related to school corporations.

Straw incorporation and nitrogen fertilization regulate soil quality, enzyme activities and maize crop productivity in dual maize cropping system

BackgroundStraw incorporation serves as an effective strategy to enhance soil fertility and soil microbial biomass carbon (SMBC), which in turn improves maize yield and agricultural sustainability. However, our understanding of nitrogen (N) fertilization and straw incorporation into soil microenvironment is still evolving. This study explored the impact of six N fertilization rates (N0, N100, N150, N200, N250, and N300) with and without straw incorporation on soil fertility, SMBC, enzyme activities, and maize yield.ResultsResults showed that both straw management and N fertilization significantly affected soil organic carbon (SOC), total N, SMBC, soil enzyme activities, and maize yield. Specifically, the N250 treatment combined with straw incorporation significantly increased SOC, total N, and SMBC compared to lower fertilization rates. Additionally, enzyme activities such as urease, cellulase, sucrose, catalase, and acid phosphatase reached their peak during the V6 growth stage in the N200 treatment under for both straw management conditions. Compared to N250 and N300 treatments of traditional planting, the N200 treatment with residue incorporation significantly increased yield by 8.30 and 4.22%, respectively. All measured parameters, except for cellulase activity, were significantly higher in spring than in the autumn across both study years, with notable increases observed in 2021.ConclusionsThese findings suggest that optimal levels of SOC, soil total N (STN), and SMBC, along with increased soil enzyme activities, is crucial for sustaining soil fertility and enhancing maize grain yield under straw incorporation and N200 treatments.

Lowering Chemical Fertilizers Rate in ‘Black Amber’ Plum Orchard for Improving Sustainable Resource Management: Effect on Soil Health and Fruit Quality

ABSTRACT The combined application of chemical fertilizers and organic material is a transitional approach toward more sustainable and productive farming. This study aimed to investigate the response of low chemical fertilizer rates and supplementing with organic materials on soil health and fruit quality. In plum orchard, combination of reduced chemical fertilizer rates (R80; R70; R60) with organic manures (F; V) at varying levels based the loss in nitrogen requirement and microbial inoculants (Bf; J) were studied over the conventional approach (R100) on soil health and fruit quality in a 2-year experiment. Soil analysis showed soil physico-chemical properties and enzymes activity with application of R70+V10+Bf. Compared to integrated treatments R100 saw highest availability of soil potassium and calcium. Application of R70+V10+J resulted in maximum improvement in fruit weight, TSS and soluble sugar content. Fruit set percentage was higher in treatment R70+V10+Bf. Fruit yield showed significant changes with treatments R70+V10+Bf and R70+V10+J having similar yield to R100. Our results suggest that by reducing the amount of chemical fertilizer by 30% and partially replacing it with organic materials had a positive effect on soil health without affecting the fruit production and quality.

Changes in online public opinions associated with various three-child supportive policies in China: Observational study using social media data over time.

According to the Seventh National Census, China's fertility rate is less than 1.5, marking a significant national issue with potential risks. To counter this low birth rate, the Chinese government has relaxed family planning policies and introduced supportive measures. Changes in birth policy have attracted considerable attention from the people of China. This article aims to study the public's response to the three-child support policy using Weibo as a window. The goal is to provide a more balanced evaluation of current perspectives, enabling policymakers to formulate better fertility information, particularly when anticipating a poor public response to controversial policies. This research uses a crawler to gather data from Sina Weibo. Through opinion mining of Weibo posts on the three-child policy, Weibo users' online opinions on the three-child policy are analyzed from two perspectives: their attention content and sentiment tendency. Using an interrupted time series, it examines changes in online views on the policy, matching policy documents to the time nodes of Weibo posts. The public has shown great interest in and provided short-term positive feedback on policies related to improving maternity insurance, birth rewards, and housing subsidies. In contrast, there has been a continuous negative response to policies such as extending maternity leave, which has particularly sparked concerns among women regarding future employment and marital rights protection. On social media, the public's attention to the three-child birth policy has focused mainly on the protection of women's rights, especially legal rights after childbirth, and issues related to physical and mental health. Child-rearing support and economic pressure are also hot topics, involving the daily expenses of multichild families, childcare services, and housing pressure. However, this study also revealed that infertile or single women express a strong desire to have children, but due to limitations in the personal medical insurance system, this desire has not been fully satisfied. Our study demonstrates the feasibility of a rapid and flexible method for evaluating the public response to various three-child supportive policies in China using near real-time social media data. This information can help policy makers anticipate public responses to future pandemic three-child policies and ensure that adequate resources are dedicated to addressing increases in negative sentiment and levels of disagreement in the face of scientifically informed but controversial, restrictions.

Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach.

The exclusive breastfeeding (EBF) rate in Indonesia is lower than expected. Among the key factors affecting breastfeeding practices, paternal support has been suggested. To explore the role of paternal support in EBF failure among 3-month-old infants. This sequential mixed-methods study, part of an ongoing cohort study in West Java in early 2022, included 225 infants. The parents of 3-month-old infants were interviewed. Paternal support was assessed using a 15-point validated questionnaire for a total score of 15-60 points. Multivariate binary regression was used to determine adjusted odds ratios (aORs). The qualitative exploration was based on in-depth interviews (IDIs) and forum group discussions (FGDs) following the quantitative survey. Of the 225 infants, 52.2% were no longer EBF. High paternal support (greater than the mean score) of breastfeeding was determined in 52.9% of cases (mean± standard deviation, 38.7±6.7 for the overall population vs. 37.5±6.3 and 40.2±6.8 for infants who were and were not EBF at 3 months of age, respectively). Low paternal support was associated with an increased EBF failure rate (aOR, 2.84; 95% confidence interval [CI], 1.46-5.54). Other variables that remained as predictors in the final model were a low birth rate (aOR, 7.35; 95% CI, 1.73-31.20), negative maternal attitude (aOR, 3.31; 95% CI, 1.63-6.75), lower self-efficacy (aOR, 4.82; 95% CI, 2.43-9.57), and lower maternal education level (aOR, 2.87; 95% CI, 1.03- 8.03). The IDIs and FGD observed the importance of the father's support of the mother and EBF. The qualitative exploration revealed a lack of knowledge about EBF as a parental support barrier. Paternal support is important for EBF. Paternal involvement in EBF planning encouraged themother to continue. Plans that include fathers in breastfeeding education may help increase paternal support.

교권침해에 대한 예비교사들의 인식 분석

Objectives The purposes of this study is to analyze the view of pre-service teachers about teachers rights paying attention to the seriousness of the educational crisis caused by the infringement of teachers rights. Methods For this, reflective writing was used for 85 pre-service teachers who were enrolled D university located in Daejeon metropolitan city. Results Pre-service teachers defined teaching rights as a legal right for educational practice and an ethical right socially granted for teaching given to teachers. They recognized that infringement of teachers rights occurred by lack of legal regulations to protect teachers when the teachers rights is violated, distrust of the coercive teachers experienced in school education in the past, intensifying dependence on private education for children’s college entrance, excessive protection of children due to low birth rate and the change in the social perception of the role of teachers. They suggested that teachers rights could be restored through establishing the legal supplementation for teachers rights and strengthening the status of public education, strengthening the role of principal as a teacher's guardian, supporting the formation of the educational community throughout society and trying to have a sense of vocation for teaching by teachers themselves. Conclusions Frist, Pre-service teachers paid more attention to an ethical right arising from the nature of teaching as a personality cultivation than to a legal right given because of being a professional. Second, They recognized teachers as subjective beings in the teaching rights by emphasizing the responsibility of their teaching themselves. Third, They emphasized that teaching rights and student human rights should maintain mutual harmony and balance In light of the inseparable relationship between teaching and learning in education. Forth, It shows that the perception of pre-service teachers about teachers rights is being formed through internal reflection on the nature of education in that they find the cause of the infringement of teachers rights in terms of social structure, while the solution is a formation of an educational community based on mutual respect.

Dynamics of Some Medical and Demographic Indicators in St. Petersburg During the Period from 2018 to 2023

Background. There have been negative trends in the birth rate and population growth decline in recent years. Forecasts from demographers are also not so encouraging as the next generation of childbearing age is one from the end of the last century which is characterized by low birth rate. Population mortality exceeded the birth rate during the years of challenging and questionable economic reforms. Moreover, there was a high level of chronic morbidity in child population, and physical development had the trend to retardation. Meanwhile under these circumstances, the President of Russian Federation and the Government adopted regulatory documents (decrees, dedicated programs) that determined the directions of state social policy on improving the situation with children in Russian Federation until 2000.Objective. The aim of the study is to evaluate the dynamics of several medical and social indicators of 2018–2023 characterizing demographic trends direction, with proposals on improving medical care in the maternal and child health care system.Methods. The study has covered reporting form No. 19 of Russian Federal State Statistics Service (Rosstat) for children’s outpatient clinics, form No. 14 for children’s hospitals, form No. 030/у “Check-list of dispensary observation”. The study has used the materials of the Presidential Coordination board meeting from November 15, 2016. Statistical data was obtained from the “Office of the Federal State Statistics Service for St. Petersburg and the Leningrad Region” (Petrostat) and the Center for Analysis and Forecast of Mother and Child Health at Health Committee of St. Petersburg, Medical Information and Analytical Center (“Major results in the field of health care in St. Petersburg”, 2019, 2020, 2021, 2022). Statistical processing was carried out via variational statistics methods (Pearson’s criterion, Fisher’s angular transformation criterion) and data from the automated system of prophylactic medical examination, registration certificate FSR No. 2009/05279, corresponding to the order of the Ministry of Health of Russian Federation No. 514н dated August 10, 2017.Results. The analysis of study results confirms the negative demographic patterns in St. Petersburg like the all-Russian. Increase assisted reproductive technologies was noted alongside with birth rate decrease. There are still high rates of stillbirth and perinatal mortality, as well as increased infant mortality rate. The correlation of depopulation processes with children’s health worsening and increasing disability is emphasized.Conclusion. The problems raised in this paper do not have an straightforward solution and require multimodal approach.

Exploring uterine contractility frequency in infertile population: A comparative study among different control groups with and without a C-section defect.

Women undergoing IVF who have had a previous c-section (CS) have a lower live birth rate than those with a previous vaginal delivery. However, the precise underlying mechanisms need clarification. Does a previous CS affect the pattern of uterine contractility?. Prospective evaluation in patients undergoing frozen blastocyst embryo transfer in medicated endometrial preparation cycles. Twenty patients were included in groups: A/nulliparous. B/previous vaginal delivery. C/ previous CS without a niche, whereas fifteen patients were recruited in group D (CS and a niche). Patients employed estradiol compounds and 800 mg vaginal progesterone. A 3D-scan was performed the transfer-day where uterine contractility/minute was recorded. Baseline characteristics (age, BMI, smoking, endometrial thickness) were similar. Mean frequency of uterine contractions/minute was similar between groups (1.15, 1.01, 0.92, and 1.21 for groups A, B, C, and D, respectively). There was a slight increase in the number of contractions in patients with a sonographic niche versus controls, not reaching statistical significance (p=0.48). No differences were observed when comparing patients with a previous C-section (regardless of the presence of a niche) to those without a C-section, either nulliparous (p=0.78) or with a previous vaginal delivery (p=0.80). The frequency of uterine contractions was similar between patients who achieved a clinical pregnancy and those who did not (1.19 vs. 1.02 UC/min, p=0.219, respectively). Our study found no significant difference in the frequency of uterine contractility between patients with or without a previous C-section or sonographic diagnosed niche. Further investigation is necessary to understand the physiological mechanisms affecting implantation in patients with isthmocele.

Clinical data-based modeling of IVF live birth outcome and its application

BackgroundThe low live birth rate and difficult decision-making of the in vitro fertilization (IVF) treatment regimen bring great trouble to patients and clinicians. Based on the retrospective clinical data of patients undergoing the IVF cycle, this study aims to establish classification models for predicting live birth outcome (LBO) with machine learning methods.MethodsThe historical data of a total of 1405 patients undergoing IVF cycle were first collected and then analyzed by univariate and multivariate analysis. The statistically significant factors were identified and taken as input to build the artificial neural network (ANN) model and supporting vector machine (SVM) model for predicting the LBO. By comparing the model performance, the one with better results was selected as the final prediction model and applied in real clinical applications.ResultsUnivariate and multivariate analysis shows that 7 factors were closely related to the LBO (with P < 0.05): Age, ovarian sensitivity index (OSI), controlled ovarian stimulation (COS) treatment regimen, Gn starting dose, endometrial thickness on human chorionic gonadotrophin (HCG) day, Progesterone (P) value on HCG day, and embryo transfer strategy. By taking the 7 factors as input, the ANN-based and SVM-based LBO models were established, yielding good prediction performance. Compared with the ANN model, the SVM model performs much better and was selected as the final model for the LBO prediction. In real clinical applications, the proposed ANN-based LBO model can predict the LBO with good performance and recommend the embryo transfer strategy of potential good LBO.ConclusionsThe proposed model involving all essential IVF treatment factors can accurately predict LBO. It can provide objective and scientific assistance to clinicians for customizing the IVF treatment strategy like the embryo transfer strategy.

P-745 effectiveness and safety of consecutive single embryo transfer compared to double embryo transfer: results from UK HFEA registry

Abstract Study question How does two-consecutive single embryo transfer (2xSET) affect reproductive outcomes of in-vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) compared to double embryo transfer (DET)? Summary answer 2xSET may provide greater or comparable live birth rates with lower multiple birth, preterm birth, and pregnancy loss or neonatal death rates compared to DET. What is known already Elective single embryo transfer (SET) in IVF/ICSI is widely encouraged over DET to minimise the risk of multiple birth and associated morbidities. Despite this, UK multiple birth rates following IVF remain higher than spontaneous conception, with 5% of IVF pregnancies resulting in multiple birth compared to 0.4%-1.2% multiple gestation rates following spontaneous conception. Owing to advancements in cryopreservation techniques, live birth and ongoing pregnancy rates are now comparable between fresh and frozen embryo transfer. Consequently, 2xSET has been suggested as an alternate technique to achieve comparable live birth rates with fewer multiple gestation pregnancies compared to DET. Study design, size, duration This retrospective cohort study was conducted using Human Fertilisation and Embryology Authority (HFEA) register data, which encompasses national data from all IVF clinics in the UK. Within this analysis, all women who underwent their first oocyte collection and IVF or ICSI treatment cycle with subsequent SET, DET or 2xSET between 2010 and 2019 using either blastocyst or cleavage stage embryos were included (N = 125,149). Participants/materials, setting, methods This national retrospective cohort study utilised UK HFEA register data from 2010-2019, including all women who underwent their first oocyte collection and subsequent embryo transfer (N = 125,149). The rate of live birth, multiple birth, preterm birth, and pregnancy loss or neonatal death was compared between SET, DET, and 2xSET IVF/ICSI pregnancies using either blastocyst or cleavage stage embryos, and was stratified by maternal age. Data analysis was conducted in RStudio v4.2, alpha equals 0.05. Main results and the role of chance 2xSET pregnancies following blastocyst-stage transfer achieved a greater live birth occurrence rate of 0.47 (0.13) (median (interquartile range)) than SET, 0.41 (0.13), and DET, 0.38 (0.13) (P &amp;lt; 0.05). When using SET as a reference standard, 2xSET achieved a lower multiple birth rate, odds ratio (OR) of 6.87 (95%CI 6.14-7.68), than DET, OR 28.20 (95%CI 25.20-31.57), and lower preterm birth rate; OR 1.11 (95%CI 1.06-1.15) in 2xSET, and OR 2.80 (95%CI 2.67-2.94) in DET. Pregnancy loss or neonatal death rate was also lower in 2xSET, OR 1.14 (95%CI 1.08-1.21), compared to DET, OR 2.11 (95%CI 1.98-2.24). Conversely, in cleavage-stage embryo transfer pregnancies, no significant difference in live birth occurrence rate was observed, achieving rates of 0.27 (0.21) for SET, 0.26 (0.13) for DET, and 0.29 (0.18) for 2xSET. 2xSET was less likely to result in multiple birth than DET, OR 0.14 (95%CI 0.11-0.19). Moreover, when using SET as a reference standard, 2xSET was less likely to result in preterm birth than DET, OR 1.02 (95%CI 0.87-1.23) and 2.48 (95%CI 2.17-2.82) respectively, as well as pregnancy loss or neonatal death, OR 1.07 (95%CI 0.85-1.35) and 2.03 (95%CI 1.70-2.42) respectively. Limitations, reasons for caution Certain confounders are not recorded within HFEA registry data, including patient body mass index (BMI), evaluation of embryo quality, and endometrial thickness at embryo transfer. Consequently, while our analysis identifies broad trends in embryo transfer success and morbidity, results may differ within certain patient populations. Wider implications of the findings 2xSET may provide greater or comparable live birth rates with lower multiple birth and morbidity than DET. Promotion of 2xSET where appropriate for maternal age and embryo quality should be implemented to enhance reproductive outcomes and reduce the risk of morbidity in IVF/ICSI pregnancies. Trial registration number Not Applicable