Women Candidate Research Articles

Drug and biomarker tissue levels in a randomized presurgical trial on exemestane alternative schedules.

The drug's activity at the target tissue could help to define the minimal effective dose to promote cancer preventive therapy. Here we present exemestane and sex hormone concentrations within breast tissue from a pre-surgical study of alternative exemestane schedules. Postmenopausal women candidate for breast surgery for estrogen receptor-positive breast cancer were randomized to exemestane 25 mg once daily (QD), 25 mg three times/week (TIW), or 25 mg per/week (QW) for 4-6 weeks before surgery. Drug and sex hormones were analyzed from homogenized frozen tissue using a QTRAP 6500+ LC-MS/MS System. Tissue drug concentrations were detectable only in the QD arm with higher concentrations in non-malignant tissue. Estradiol was nearly suppressed in all groups in the non-malignant tissue (QD vs TIW p = .364 and QD vs QW p = .693). In contrast, a dose-response trend was observed in cancer tissue. Based on estradiol suppression in non-malignant tissue, lower exemestane schedules should be explored for breast cancer preventive therapy.

Human papillomavirus infection in women undergoing in-vitro fertilization: effects on embryo development kinetics and live birth rate

BackgroudSeveral studies showed that human papillomavirus (HPV) affects male fertility, but its impact on female fertility and in vitro fertilization (IVF) outcome is not yet clear.MethodsObjective of this observational, prospective, cohort study was to evaluate the prevalence of HPV infection in women candidate to IVF, and the effects of HPV infection on the kinetic of embryonic development and on IVF outcome. A total number of 457 women candidate to IVF were submitted to HR-HPV test; among them, 326 underwent their first IVF cycle and were included in the analysis on IVF results.Results8.9% of women candidate to IVF were HPV-positive, HPV16 being the most prevalent genotype. Among the infertility causes, endometriosis was significantly more frequent in HPV-positive than in negative women (31.6% vs. 10.1%; p < 0.01). Granulosa and endometrial cells resulted HPV-positive in 61% and 48% of the women having HPV-positive cervical swab, respectively. Comparing HPV-positive and negative women at their first IVF cycle, no significant difference was observed in the responsiveness to controlled ovarian stimulation (COS) in terms of number and maturity of retrieved oocytes, and of fertilization rate. The mean morphological embryo score was comparable in the two groups; embryos of HPV-positive women showed a quicker development in the early stages, with a significantly shorter interval between the appearance of pronuclei and their fusion. In the following days, embryo kinetic was comparable in the two groups until the early blastocyst stage, when embryos of HPV-positive women became significantly slower than those of HPV-negative women. Overall, these differences did not affect live birth rate/started cycle, that was comparable in HPV-positive and negative women (22.2 and 28.1%, respectively).Conclusions(a) the prevalence of HPV infection in women candidate to IVF is similar to that observed in the general female population of the same age range; (b) HPV infection migrates along the female genital apparatus, involving also the endometrium and the ovary, and perhaps participates in the genesis of pelvic endometriosis; (c) HPV slightly affects the developmental kinetic of in vitro-produced embryos, but does not exert an effect on live birth rate.

Voting for a woman: ideology and gendered candidate choice in Finland

ABSTRACT This study contributes to the literature on gendered candidate choice by investigating how voters’ ideological positions on both the socioeconomic left–right and the cultural GAL–TAN dimensions are associated with support for women candidates, and how these associations play out among women and men voters. The study is situated in the open-list proportional electoral system (OLPR) of Finland, where voters are obliged to cast a vote for a single candidate from a large selection of nominees and where women have a strong presence in the political sphere. We use unique data on voters’ self-reported candidate choice from two Finnish post-election studies in 2011 and 2019. The results show that a majority of both men and women voters tend to engage in same-gender voting, meaning that women voters are more inclined to cast a vote for women candidate than men voters are. We further show that the two ideological dimensions have different connections for men and women voters. While women voters’ propensity to support women candidates is connected to their position on the left–right dimension, but not to the GAL–TAN dimension, the opposite holds for men voters.

Impact of low-dose dexamethasone on pregnancy outcome in type A PCOS women candidate for IVF/ICSI using the gonadotropinreleasing hormone antagonist protocol

Objective. Evaluation of the efficacy of low-dose dexamethasone on ovarian response and pregnancy outcome in infertile patients with type A polycystic ovarian syndrome (PCOS). Patients and methods. The study included infertile patients with type A PCOS who were candidates for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) using a fixed GnRH antagonist protocol. The patients were randomized into two groups: a low-dose steroid group of 80 women with type A PCOS undergoing a trial of IVF/ICSI who received two tablets of 0.5 mg dexamethasone every evening from the first day of gonadotropin administration till the night before oocyte retrieval with a GnRH antagonist controlled ovarian hyperstimulation (COH), and a placebo group of 80 women with type A PCOS undergoing IVF/ICSI who received two tablets of placebo from the first day of gonadotropin administration until the night of oocyte retrieval. Results. In the low-dose dexamethasone group, the duration of stimulation was statistically significantly shorter, and there were significantly fewer stimulation ampoules; however, E2 levels on the day of ovulation induction, fertilization rate, and the number of retrieved M2 and fertilized oocytes were significantly higher compared to the placebo group. On the other hand, there was no significant difference between both groups regarding the incidence of ovarian hyperstimulation syndrome (OHSS) and the rate of embryo transfer. Conclusion. Dexamethasone improves embryo quality and pregnancy rate; additionally, it minimizes the number of gonadotropin ampoules used for stimulation. Thus, we suggest the use of dexamethasone in women with PCOS undergoing IVF/ICSI treatment. Key words: low-dose dexamethasone; type A PCOS; IVF/ICSI; antagonist protocol

The utero-tonic effects of low dose intravenous ketamine in cesarean section under spinal anesthesia; A randomized double-blind clinical trial.

Recently, the prevalence of cesarean section (CS) has been on the rise and the proper uterine tone is an important issue. We investigated the effects of intravenous (IV) ketamine on intraoperative bleeding and the need for oxytocin in CS under spinal anesthesia (SA). This study, took place at Alzahra hospital during 2020. Pregnant women candidate for elective CS under SA were divided into two groups of ketamine and placebo. In group K, after umbilical cord clamping, 0.25 mg/kg ketamine and in group P 2ccs normal saline was injected. Mean arterial pressure and heart rate were recorded at baseline, before and 5 minutes after cord clamping and at the end of the surgery. The drop in hemoglobin values, the administrated units of oxytocin and side effects were also recorded. No significant difference was found in terms of patients' demographic data (P ≥ 0.05). The mean units of administrated oxytocin in group K was 34.61±6.63 and in group P; 48.47±12.15, which was significantly different (P=0.0001). The drop in Hb was less in group K, however not statistically significant (P=0.094). The need for methergine was significantly higher in group P (P=0.0001). The mean HR was significantly higher in group P (P=0.027), however, no significant difference was observed regarding the MAP (P=0.064). The incidence of hallucination (4.8%) and nystagmus (21%) was significantly higher in group K (P= 0.0001), but nausea and vomiting were more significant in group P (P= 0.027). Prophylactic administration of low-dose ketamine in CS under S.A could significantly reduce the administrated oxytocin units and the need for additional utero-tonics and was associated with less drop in Hb values.

The impact of letrozole on oocyte quality in assisted reproductive technology (ART); a randomized double-blind clinical trial

Objective To examine the effect of letrozole on oocyte quality and pregnancy outcome in assisted reproductive technology (ART). Methods This double blind placebo controlled clinical trial was conducted in Vali-Asr Infertility Center. Infertile women candidate for IVF that underwent antagonist protocol were selected. Eligible women randomly allocated into treatment (letrozole/Let group) and control (placebo) group. Participants received letrozole 5 mg/day or placebo at the time of gonadotropin start until trigger day in the same manner. Number of oocyte retrieved, metaphase II oocyte number, high grade oocyte number (G1), high quality embryo, Chemical and clinical pregnancy rate and OHSS (ovarian hyperstimulation syndrome) rate was recorded. 216 infertile women (104 in letrozole and 112 in the control group) were evaluated. Results In the Let group estradiol level was significantly lower (p_value < .001) and testosterone significantly higher than in the control group (p_value = .02). The number of retrieved oocytes, MII oocytes, G1 oocytes, and 2PN was significantly lower in the Let group (p < .05). No significant difference was found in the day of stimulation, total gonadotropin dose, OHSS rate, and clinical pregnancy rate between the two groups (p > 0.05). Conclusions According to the results, letrozole may reduce oocyte quality and cause poor IVF outcomes as well.

The effect of androgen administration on in vitro fertilization outcome in poor responders undergoing ovarian stimulation with microdose protocol: A randomized clinical trial

Objective(s)Patients with poor ovarian response who have reduced ovarian reserve sometimes despite the maximum dose of gonadotropins do not respond properly. Androgens have been shown to play an important role in the early follicular development and proliferation of granulosa cells. This study aimed to evaluate the effect of androgen administration on IVF outcome in poor responders. Study DesignIn this randomized clinical trial, 60 poor responder women candidate for controlled ovarian stimulation were randomly enrolled in two groups (n = 30/each). In the intervention group testosterone gel added to the interrupted microdose flare protocol. The control group received the conventional microdose flare protocol. ResultsThe main outcome was clinical and chemical pregnancy; and the second outcomes were the number of mature oocytes, duration of cycle and total dose of gonadotropins. Basic clinical and demographic features were comparable between the groups. The total gonadotropin consumption were significantly higher in the control group than the intervention group (p = 0.047). In addition, the number of MII oocytes was higher (but not significant) in the intervention group than the control group (p = 0.16). The mean total duration of the cycle was equal in both groups. There were no significant differences in chemical and clinical pregnancy rates between the two groups (p = 0.41, p = 0.67). Conclusion(s)The results of the current study showed that androgen administration in poor responders in in vitro fertilization reduces the total dose of gonadotropin, but it does not improve the pregnancy outcomes.

Effects of Misoprostol and Evening Primrose Extracts on Cervix Preparation for Labor Induction in Term Pregnancies

Background: Ripening is the process of preparing the cervix for induction of labor and is crucial to identify a low-complication, low-cost, and safe method of inducing labor before spontaneous labor begins. Therefore, this study aimed to demonstrate the impact of the evening primrose capsule on inducing labor, as well as to compare its effect to that of misoprostol. Methods: This prospective clinical trial study was performed on 200 low-risk pregnant women candidate for delivery in an academic hospital in Tehran from 2018 to 2020. Patients were randomly divided into two groups to receive 25 µg misoprostol vaginally or 500 mg evening primrose vaginal capsule to induce labor and repeated every three hours until reaching the bishop score &gt; 4 in case of no effective up to three doses. The total drug dose, as well as maternal and neonatal outcomes evaluated and compared between groups. Results: Although misoprostol was significantly more effective than evening primrose in increasing cervical bishop score in the inactive phase of labor, the active phase and delivery time were not different between the groups. Also, there was no significant difference between the two groups in the cesarean section rate. Maternal complications, including uterine hyperstimulation, headache, or gastrointestinal complications in the group receiving misoprostol were significantly higher in misoprostol group, but fetal complications, including Apgar score, pH, hospitalization, and meconium excretion, were not significantly different between the two groups. Conclusions: Evening primrose capsules are safe and can be used to induce labor because of the lower risk of hyperstimulation of the uterus and the higher tolerance. There should be more research done to see if this medicine can be used alone or in conjunction with misoprostol or mechanical dilators or if it can be administered at home rather than in the hospital.

Candidate emergence as movement mobilization: An analysis of Women's post‐2016 electoral engagement

AbstractPolitical science scholarship argues that women's underrepresentation in American politics stems from a persistent shortage of female candidates. Women are less likely to run because they often perceive individual and structural obstacles that negatively impact their electoral interest. Such barriers remain intact, yet thousands of women have signaled their interest in running for office since the 2016 election by participating in candidate training programs (CTPs). Though running for office is not commonly defined as an activist activity, this article argues that theories of collective action and movement mobilization, rather than those focusing on the psychological aspects of candidate emergence, are better equipped to explain the recent increase of electoral interest. Using EMILY's List—an elite political entity that began as a grassroots social movement organization—as a case, this article integrates scholarship from sociology and political science to examine how feminist activist organizing can impact women's interest in running for public office. I first review the research on women's candidate emergence and CTPs before discussing the electoral movement strategies and the mobilizing impact of the media and collective action frames. The article reviews recent scholarship on the Women's March and the Resistance, then synthesizes the literature to examine EMILY's List and their electoral movement strategies leading up to the 2018 midterm elections. I conclude by suggesting avenues for future research that can bridge the relationship between movements and electoral politics and advance scholarly understanding of how, when, and why women run for office.

Management of women with uterine fibroids in reproductive center: retrospective analysis of clinical and reproductive outcomes.

Uterine fibroids are the most common benign tumor in women. According to literature, submucosal myomas have a negative effect on reproductive outcomes in women undergoing assisted reproductive techniques (ART) but there are fewer data concerning intramural fibroids. During last years, ulipristal acetate (UPA) 5 mg was widely used as medical option of fibroid's treatment, but from 2020, the Pharmacovigilance Risk Assessment Committee (PRAC) has revoked the marketing authorization after some cases of liver toxicity. In this observational, retrospective study we collected data from a sample of 23 women affected by symptomatic uterine fibroids (from type 1 to type 7 according FIGO classification) followed in our center for assisted reproduction from 2016-2019. All patients received 5 mg/day UPA for three months, followed by two months of wash-out therapy. A group of 13 women treated with UPA, with intramural fibroid not distorting the uterine cavity, after wash-out therapy, affected by tubal or idiopathic factors of infertility too, underwent ART. We also evaluated a control group of women, not affected by fibroids, randomly selected from a general group of our ART patients, similar by age, BMI, and cause of infertility only idiopathic or tubal factors. We evaluated the impact of UPA on reduction of fibroid volume, symptomatology and distortion of the cavity in all the women treated, and the IVF (in-vitro fertilization) outcome between the fibroid group of women affected by intramural fibroids who underwent ART, and the control group. In all the women treated with UPA the overall median fibroid volume pretreatment was 45.168±35.360 mm3, that decreased to a mean value of 22.592±22.116 mm3 post one cycle of UPA, with an overall mean decrease of -22.586 mm3 (of 49%) statistically significant (P=0.00001). After treatment, the distortion of the uterine cavity reduced in high percentage of cases: 85,71% (type 1-2), χ2 difference in respect to the value pretreatment of 0.3941, and 86.96% of patients subjectively referred an improvement in the symptomatology. In the group of 13 women that undergone ART, after one IVF cycle for each patient, we obtained 61% of positivity of dosage of beta human chorionic gonadotropin (hCG) after UPA treatment, and we obtained a similar value in the control group. In our little sample we have observed that UPA represented a valid non-invasive medical treatment strategy for fibroids in women candidate for (IVF, not only in women affected by sub-mucosal, but also by intramural fibroids not distorting uterine cavity. After a single, three months course of treatment, we obtained good results in terms of reduction of fibroid's volume and improvement of symptomatology, without side effects, preparing a more favorable environment for ART.

Prevention of postpartum haemorrhage in patients with severe preeclampsia using Carbetocin versus Misoprostol

ABSTRACT Background: A significant reason of maternal deaths is postpartum hemorrhage (PPH) that accounted for one-quarter of all maternal mortality globally. Primary postpartum hemorrhage (PPH) is conventionally described as a loss of blood of ≥ 500 ml within the first 24 hours following childbirth. AIM OF THE WORK using carbetocin versus misoprostol in postpartum hemorrhage prevention in sufferers with intense preeclampsia. Patients and Methods: A randomized prospective study is done to compare use carbetocin vs misoprostol in postpartum hemorrhage prevention with severe preeclampsia. In the present research a total of 100 patients who attended Sohag general Hospital included. First group was formed of 50 pregnant women candidate for cesarean section delivery with intense preeclampsia obtained carbetocin (IV injection (100 ug ,one ampoule pabal) following baby delivery. While the second group is formed of another 50 pregnant women that are also candidate for cesarean section delivery with intense preeclampsia but obtained Sublingual 600 ug misoprostol following baby delivery. Results: The findings revealed that there was a highly substantial statistical variation among the baseline & post-partum Hb & HCT in both Misoprostol group and carbitocin group. Conclusion: Carbetocin is more effective than Misoprostol in preventing incidence of atonic postpartum hemorrhage in patients performing elective caesarean delivery with severe preeclampsia. Keywords: Postpartum Haemorrhage; Preeclampsi; Carbetocin; Misoprostol

Serum macrophage migration inhibition factor for diagnosing endometriosis and its severity: case-control study

BackgroundEndometriosis is a long-standing progressive disease that affects women of reproductive age. Macrophage migration inhibitory factor (MIF) is one of non-invasive blood biomarker that was detected in sera of endometriotic patients. The present study aimed to determine the accuracy of serum MIF in diagnosing endometriosis in women with infertility and chronic pelvic pain, and correlate its level to the stage of the disease.MethodsObservational case-control study conducted at Fayoum University hospital from March 2016 till September 2018. Three hundred women candidate for diagnostic laparoscopy for either infertility or gynecologic chronic pelvic pain were included. The study group included patients with symptoms suggestive of endometriosis or chocolate cyst by ultrasound and proved by laparoscopy and histopathology. The control group included other causes of infertility or pelvic pain. All patients undergone either diagnostic or operative laparoscopy, and before laparoscopy blood sampling for quantitative measurement of macrophage migration inhibitory factor (MIF) protein in serum by ELISA technique.ResultsThe level of serum MIF was significantly higher in endometriosis group compared to control group (1.75 ± 1.48 pg/ml and 0.51 ± 0.45 pg/ ml, respectively, P = < 0.001), with a progressive increase with advancing stage (stage I, 1.3 ± 1.03 pg/ml, stage II, 1.7 ± 1.57 pg/ml, stage III, 2.1 ± 1.19 pg/ml and in stage IV, 3.2 ± 2.6 pg/ml). Moreover, in patients presented with pain and infertile patients showed significantly higher levels of serum MIF (1.92 ± 1.13 vs 1.21 ± 1.17 and 1.82 ± 1.13 vs 1.32 ± 0.91 respectively with p-value < 0.001). ROC curve of serum MIF with a cut off value of 0.85 pg/ml or more achieves a sensitivity of 80.6%, specificity of 83.3%, positive predictive value of 82.9% and negative predictive value of 81.2%.ConclusionSerum MIF might be a promising marker not only for noninvasive diagnosis of endometriosis but as a target for detecting severity as well.

Effect of adding letrozole to gonadotropin on in vitro fertilization outcomes: An RCT.

BackgroundAromatase inhibitors prevent the aromatization of androgens into estrogens, which reduces the negative feedback of estrogen on the hypothalamic-pituitary axis. It is clear that increasing the secretion of follicle-stimulating hormones results in an increased follicular growth.ObjectiveThis study aimed to evaluate the effect of adding letrozole to gonadotropin on in vitro fertilization outcomes in normal responders.Materials and MethodsIn this randomized clinical trial, 100 normal responder women candidate for controlled ovarian stimulation were randomly enrolled in two groups (n = 50/each). In the case group letrozole was added to gonadotropin in the antagonist protocol. The control group received the conventional antagonist protocol. The main outcome was clinical and chemical pregnancy; and the second outcomes were the number of mature oocytes, the fertilization rate, estradiol level, and the total dose of gonadotropins.ResultsBasic clinical and demographic features were comparable between the groups. Estradiol level on the day of human-chorionic-gonadotropin administration and the total gonadotropin consumption were significantly higher in the control group than the case group (p = 0.045). In addition, the number of MII oocytes was higher (but not significantl) in the case group than the control group (p = 0.09). Moreover, the endometrial thickness was significantly lower in the case group. There were no significant differences in fertilization rate and chemical and clinical pregnancy rates between the two groups.ConclusionAlthough adding letrozole to gonadotropin in normal responders reduces the total dose of gonadotropin, it does not improve the pregnancy outcomes.

Why is There Zero Women Candidate for Governor Election in West Java, Indonesia?

Democracy requires active public political participation. Sustainability of general elections is vitally important in democracy. As a developing country, Indonesia is still struggling to implement its democracy. Interesting phenomena in Indonesian democracy, the number of women who run their candidacy in an election is still limited. For instance, in West Java Province Regional Election, there are no women candidates for governor or vice governor. The political sociology perspective sees these phenomena as the patriarchal culture that the community prefers male leader to women. This research aims at understanding causes of why there are no female candidates in the general election in West Java. This research makes use of quantitative approach with survey method aimed to explain political views of West Java society about female candidates in a gubernatorial election. The area of the research covers West Java province, involving 500 respondents. The data was collected by using the questionnaire distributed by Google Form to people living in this area. The data were then analyzed by inferential statistics. This study indicates that West Java residents still hold strong ideology on gender differences, believing that a good leader should be male. Even in the smallest scope of institution, men is suppossed be a leader. In addition, there is a dichotomy between the public and the personal space for male and female duty. Women are suggested to stay at the private space, while male has a duty at the public sphere. It is also evidenced in the research that women voters have little tendency to elect the female candidates. This occurs not just because of their patriarchal cultural background, but also due to their education. It is indicated that even female voters had higher education, their tendency to elect the women candidate was still low. Â

The Effect of Phenylephrine Infusion on Maternal Hemodynamic Changes During Spinal Anesthesia for Cesarean Delivery.

BackgroundSpinal anesthesia is used as a common anesthetic technique in many routine and outpatient surgeries.ObjectivesThe aim of this study was to determine the effect of phenylephrine on maternal hemodynamic changes during spinal anesthesia for cesarean delivery.MethodsThis double-blind randomized controlled trial was conducted on 116 pregnant women candidate for the elective cesarean section through spinal anesthesia in the Shahid Akbarabadi Hospital, Tehran in 2019. The eligible women were randomly divided into the intervention (phenylephrine; n = 58) and control (normal saline; n = 58) groups. The data collection tool was a checklist, including the demographic and clinical variables, such as age, height, weight, body mass index, gravid, gestational age, Apgar score of 1 and 5, systolic blood pressure, diastolic blood pressure, heart rate, mean arterial pressure, SPO2, PH of the umbilical cord, PCO2, HCO3, base excess, nausea, and vomiting. Data were analyzed using SPSS 24 software and P value < 0.05 was considered as significant.ResultsThe intervention and control groups showed a significant difference in terms of the PH of the umbilical cord, PCO2, and nausea and vomiting (P value < 0.05). The results of the repeated measure ANOVA test showed a significant statistical difference between the intervention and control groups at different time points in terms of arterial pressure, systolic and diastolic blood pressures (P value < 0.05).ConclusionsPhenylephrine is effective in the prevention of some complications, like reducing mean arterial pressure, systolic and diastolic blood pressures, nausea, and vomiting during spinal anesthesia for cesarean delivery. Therefore, these drugs can be used based on maternal hemodynamic status during spinal anesthesia for cesarean delivery.

Urgency and ambition: the influence of political environment and emotion in spurring US women’s candidacies in 2018

This article analyses publicly reported statements of motivation by non-incumbent women US House candidates in 2018 to assess the role of negative emotions, particularly those cued by catalysing events like the 2016 presidential election, in women candidate emergence. Findings reveal that Democratic non-incumbent women candidates were most likely to describe negative inducements, including feelings of urgency, anger and/or threat, as motivating candidacy, with these emotions slightly more evident in white women’s statements. This indicates that women’s candidacies can emerge, at least in part, from perceptions that the costs of not running are too high to stay on the sidelines.

OPPORTUNITIES AND CHALLENGES OF WOMEN LEGISLATIVE CANDIDATES ON ELECTIONS IN BANDA ACEH

Purpose: This research is focused on the public space in the field of politics that explains how women candidates legislative from political parties and local political parties national participate in contestation with the men in the legislative election in 2019 the level of the city Banda Aceh.&#x0D; Methodology: This paper uses qualitative research methods with an ethnographic approach contemporary feminist and collection of data through observation, documentation and semi-structured interviews were conducted with fifteen legislative women candidates of local political parties and national political parties from the electoral districts of Banda Aceh were scattered on 9 districts in Banda Aceh.&#x0D; Main Findings: The findings of this study indicate that there are three forces of elected women candidate to continue to increase each election period: (1) The full support of the family, (2) Grassroots women's community (Balee Inong), (3) The presence of government support through Musrena and Musrenbang forum which became the strength of women's bargaining position in planning and budgeting. Although on the other hand patriarchy culture is still a separate constraint for women working in the public arena.&#x0D; Implications/Applications: The results showed that the dominance of men who are members of local and national political parties in Aceh making space for women in the general election is getting narrower, plus a serial number of women in a legislative candidate sequence that is in the last number makes women, not the candidates featured in his political party. But the election of women in the legislature is much better than the previous period.&#x0D; Novelty: The political arena became a force for women of Banda Aceh in scraping patriarchy culture that has been very inherent to Acehnese people wrapped in a religious culture or the habit of Acehnese people who put women into numbers two in development.

A randomized controlled trial of a new technique for laparoscopic management of ovarian endometriosis preventing recurrence and keeping ovarian reserve

IntroductionLaparoscopic cystectomy provides more favourable outcomes as regards the recurrence and subsequent clinical pregnancy rates. It is associated with significant reduction in the ovarian reserve due to the inevitable removal of unaffected ovarian tissue. The aim of our study was to evaluate the efficiency of Surgicel in preventing recurrence of endometriomas after their laparoscopic conservative management (cystectomy or drainage).Material and methodsA randomized controlled trial included two hundred women (candidate for conservative laparoscopic management of ovarian endometriomas). They were randomized into four groups; group D in which patients underwent laparoscopic drainage of the endometrioma, group C in which patients underwent laparoscopic cystectomy of the endometrioma, group DS in which patients underwent laparoscopic drainage followed by insertion of Surgicel inside the cyst cavity & group CS in which patients underwent laparoscopic cystectomy of the endometrioma followed by insertion of Surgicel inside the remaining ovarian tissues. All patients were followed up for 2 years & the primary outcome was the recurrence of endometriomas in the ipsilateral ovary & the postoperative ovarian reserve was reassessed as a secondary outcome.ResultsThe Surgicel-treated groups had significantly lower hazard of recurrence compared to untreated groups (p = 0.004). Group CS had significantly lower hazard of recurrence compared to Group D & C (p = 0.014, 0.046 respectively). Group DS had significantly lower hazard of recurrence compared to Group D (p = 0.039) but it not significantly different from Group C (p = 0.112). Group DS had the lowest drop of AMH and was significantly lower than the other three groups.ConclusionSurgicel reduces effectively the recurrence risk of endometriomas and its use during laparoscopic drainage is an effective alternative for traditional laparoscopic cystectomy with minimal affection of the patient ovarian reserve.Trial registrationName of the registry: clinicaltrials.gov. Trial registration number NCT02947724. Date of registration October 28, 2016.

The 2017 Election in Papua New Guinea

This paper draws on the Papua New Guinea Election Results Database alongside other data to study the 2017 General Election in Papua New Guinea. The paper shows that the 2017 elections suffered significant problems, even by the standards of other countries of similar levels of development. Amongst other issues, the paper finds worrying patterns of roll inflation in parts of the Highlands. In terms of election outcomes, we find some evidence that women candidates are becoming more competitive, although improvements are modest and trends uncertain. We also demonstrate that the relationship between candidate numbers and incumbent re-election, first found by David Hegarty in the 1980s still exists and is statistically robust. Finally, we conduct an in-depth study into the Limited Preferential Voting (LPV) system. We find LPV brought an increase in invalid ballots and a boost in women candidate competitiveness, but that many other anticipated changes appear not to have eventuated. However, importantly, in 2017 it appears some voters cast their second and third preferences along national lines as a protest vote against the Prime Minister’s party. Voting on national issues is thought to be rare in Papua New Guinea, and if LPV is facilitating it, the system may ultimately bring larger political changes, although this is far from guaranteed.

The measurement of endometrial volume and sub-endometrial vascularity to replace the traditional endometrial thickness as predictors of in-vitro fertilization success

To assess the value of endometrial thickness, volume, and sub-endometrial perfusion in women undergoing IVF. In 82 women candidate for ICSI, endometrial thickness and sub-endometrial perfusion were measured with a trans-vaginal 2 D ultrasound and 3 D power Doppler respectively on day of hCG trigger and Embryo transfer (ET). The primary outcome was the clinical pregnancy rate. Endometrial volume showing a statistically significant difference between pregnant and nonpregnant women (4.11 ± 1.19 vs. 3.4 ± 1.1 p = .019) on day of triggering and at ET (4.02 ± 1.15 vs. 3.45 ± 0.90, p = .022). VFI was significantly higher in pregnant group at both days of triggering and ET (0.54 ± 0.48 vs. 0.33 ± 0.31 and 0.47 ± 0.22 vs. 0.34 ± 0.2, p = .02). At cutoff values of 3.265 and 2.95 cm3 (70 & 80% sensitivity, specificity 64.5 & 51.6%, a positive predictive value 38.9 & 34.8%, and negative predictive value 87.0 & 88.9%) to predict pregnancy on the day of hCG trigger & ET respectively. Cutoff value for Endometrial VFI on the day of ET was 0.674 (sensitivity of 70%, specificity of 80.6%, PPV 53.8%, and NPV 89.3%). Higher endometrial volume and VFI were associated with pregnancy.