Low anti-Müllerian hormone level is not a risk factor for early pregnancy loss in IVF/ICSI treatment

STUDY QUESTION: Is a low ( SUMMARY ANSWER: A low or moderately low serum AMH level does not associate with miscarriage, non-visualized pregnancy loss or overall early pregnancy loss rate in the IVF/ICSI treatment. WHAT IS KNOWN ALREADY: Low AMH predicts poor ovarian response and small oocyte yield in IVF/ICSI treatment, but its value in the evaluation of live birth rate (LBR) is modest Little is known about the risk of early pregnancy loss in ART among women with low AMH. STUDY DESIGN, SIZE, DURATION: A retrospective cohort study on 1383 women undergoing their first oocyte retrieval for IVF/ICSI in Helsinki University Hospital in Helsinki, Finland, between 2012 and 2016, with all associated fresh (n = 1315) and frozen-thawed (n = 1418) ET cycles finished by August 2018. AMH was measured within 12 months before the IVF/ICSI stimulation. PARTICIPANTS/MATERIALS, SETTING, METHODS: Of all the women, 235 (17.0%) had low (= 2.0 mu g/L) AMH. The primary outcomes were miscarriage, non-visualized pregnancy loss and early pregnancy loss (miscarriage and non-visualized pregnancy loss combined) after fresh or frozen-thawed ET. The impact of AMH on these outcomes was calculated in three populations: among all women who became pregnant, among women with AMH MAIN RESULTS AND THE ROLE OF CHANCE: Of 1123 pregnancies, 285 (25.4%) ended in non-visualized pregnancy loss and 143 (12.7%) in miscarriage. The LBR was 24.6% per ET (673/2733). Low or moderately low AMH, compared with normal AMH, did not associate with miscarriage or non-visualized pregnancy loss in analyses among all women who became pregnant (adjusted relative risk (RR) for miscarriage vs live birth, 0.70 and 95% CI 0.42-1.17 in low AMH and adjusted RR, 1.00 and 95% CI, 0.68-1.49 in moderately low AMH; adjusted RR for non-visualized pregnancy loss vs live birth, 0.90 and 95% CI, 0.65-1.23 in low AMH and adjusted RR, 1.09 and 95% CI 0.85-1.41 in moderately low AMH), nor did low or moderately low AMH associate with the overall early pregnancy loss rate (adjusted RR for early pregnancy loss vs live birth, 0.86 and 95% CI, 0.68-1.10 in low AMH and adjusted RR, 1.01 and 95% CI, 0.86-1.27 in moderately low AMH). Results remained similar after restricting the analysis to women with AMH LIMITATIONS, REASONS FOR CAUTION: The number of miscarriages in women with low AMH was moderately small, limiting the power of the study. The real-world clinical setting of the study restricted the ability to control for all factors causing selection bias. WIDER IMPLICATIONS OF THE FINDINGS: The cLBR was higher among women with normal AMH than among women with low or moderately low AMH in their first IVF/ICSI treatment because these women had more oocytes and embryos. Women with low or moderately low AMH did not have an increased risk for early pregnancy loss. This information is reassuring for couples and useful in counseling. These results are also valuable when assessing the overall effectiveness of IVF/ICSI treatment.Peer reviewe

The edge of the periphery: situating the ≠Khomani San of the Southern Kalahari in the political economy of Southern Africa

This is an Accepted Manuscript of an article published by Taylor & Francis in African Identities on 14/04/16, available online: http://www.tandfonline.com/10.1080/14725843.2016.1154813In this article, we situate the Southern Kalahari San within the political economy of Southern Africa and within the world system. Here we draw on and critique modernization theory as a model of explanation for the lack of development found locally. In the Southern Kalahari, the ≠Khomani San won a massive land claim that should have empowered and enabled local development. Yet they remain largely impoverished, while seeking out a meaningful life on the edge of the capitalist world system. Within states, contradictions remain as local diversity continues to be reproduced and modernity itself is reproduced as local diversity. The research is premised on empirical fieldwork conducted in the Southern Kalahari in 2013 and supported by a series of earlier field research over the previous five years. The San of the Southern Kalahari are not resisting modernity but drawing on aspects of it selectively for their own vision of meaningful development

Law, Social Norms and Welfare as Means of Public Administration: Case Study of Mahalla Institutions in Uzbekistan

Despite numerous challenges, since its independence, Uzbekistan, with the exception of the May 2005 Andijan events, has enjoyed extraordinary political stability and not recorded any considerable cases of interethnic or interfaith conflict, regime change or civil war, whereas neighboring Kyrgyzstan, labeled an “island of democracy” by the Western world, has experienced numerous conflicts and chaos, ranging from “color revolutions” to ethnic conflict. However, for understanding Uzbekistan’s ability to cope with internal and external challenges, little recourse is made to the post-independence discourse on public administration known as “mahalla reforms”. In spite of the significant existing body of literature on the mahalla, there has been little systematic scholarly investigation of the role of mahalla in maintaining political stability and security in Uzbekistan. Previous studies did not provide an account of how the law, social norms and welfare come to interplay in the mahalla system and how this influences the public administration developments in Uzbekistan. This paper begins to redress this lacuna by analyzing public-administration reforms in post-independence Uzbekistan, namely mahalla reforms, with an effort to show how political and social stability is established through mahalla, and to what extent those reforms have affected the position of individuals vis-à-vis the public-administration system. In undertaking this task, the paper employs three theoretical concepts: the theory of norms, the welfare-pentagon model and the theory of social control. In this paper, I argue that public-administration reforms since 1991 have transformed mahalla into a comprehensive system of social control; and therefore, mahalla can be places of democratic involvement or sites of authoritarianism in Uzbekistan

A COMPARATIVE MAPPING OF ENZYMES INVOLVED IN HEXOSEMONOPHOSPHATE SHUNT AND CITRIC ACID CYCLE IN THE BRAIN *

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66082/1/j.1471-4159.1963.tb05042.x.pd

Do associations support authoritarian rule? Evidence from Algeria, Mozambique, and Vietnam

Whether associations help to democratize authoritarian rule or support those in power is a contested issue that so far lacks a cross-regional, comparative perspective. In this article we focus on five types of associations in three post-socialist countries, situated in different world regions, that are governed by authoritarian regimes. We first explore how infrastructural and discursive state power impact such associations and vice versa. We then discuss whether these associations support the development of citizens' collective and individual self-determination and autonomy and/or whether they negate such self-determination and autonomy - a state of affairs that is at the core of authoritarianism. Our analysis addresses decision-making in associations and three specific policy areas. We find that most of the covered associations accept or do not openly reject state/ruling party interference in their internal decision-making processes. Moreover, in most of these associations the self-determination and autonomy of members are restricted, if not negated. With respect to HIV/AIDS policy, associations in Algeria and Vietnam toe the official line, and thus contribute, unlike their counterparts in Mozambique, to negating the self-determination and autonomy of affected people and other social minorities. Looking at enterprise promotion policy, we find that the co-optation of business and professionals’ associations in all three countries effectively limits democratizing impulses. Finally, in all three countries many, but not all, of the interviewed associations support state-propagated norms concerning gender and gender relationships, thus contributing to limiting the self-determination and autonomy of women in the private sphere

Using narrative to construct accountability in cases of death after police contact

This paper examines the use of narrative verdicts in the coronial system in England and Wales to record findings in cases of death after police contact. It uses a dataset of 68 verdicts into such cases in the period 2004–2015. The paper considers how regulation is constructed in a way that makes complex cases comprehensible through narrative. The construction of these narratives is affected by legal structures, institutional structures, but also the structures imposed by narrative convention. The paper argues that the relationships between these structures affect what type of narrative is constructed in the aftermath of a death after police contact. It further suggests that devices within narratives enable the construction of a comprehensible narrative verdict in such cases

Assessment of endometrial and ovarian characteristics using three dimensional power Doppler ultrasound to predict response in frozen embryo transfer cycles

<p>Abstract</p> <p>Objective</p> <p>To evaluate whether endometrial or ovarian parameters as measured using 3D power Doppler ultrasound would predict the outcome in frozen embryo transfer (FET) cycles.</p> <p>Methods</p> <p>Thirty women with no known gynecological pathology undergoing FET were recruited. The FET was carried out in the natural menstrual cycle 3-4 days after the first positive LH test result. Blood samples for hormonal analysis were collected, and three-dimensional (3D) ultrasonographic examination was performed on the day of the FET and repeated with analysis of the total hCG one week later.</p> <p>Results</p> <p>The demographic, clinical, and embryological characteristics were similar between the pregnant (15/30) and nonpregnant groups (15/30). There were no differences between the groups in endometrial/subendometrial thickness, volume, or vascularization index (VI). The endometrial triple-line pattern was more often present in the pregnant group on the day of the FET (93.3% vs. 40.0%, 95% CI 25.5-81.2%). No differences in the ovaries were observed on the day of the FET. At the second visit, the triple-line pattern was still more often present in those patients who had conceived (91.7% vs. 42.9%, 95% CI 18.5-79.1%), and their corpus luteum was more active as judged by the rise in 17-hydroxyprogesterone and estradiol levels. No differences were observed in the dominant ovarian vasculature.</p> <p>Conclusions</p> <p>According to our results, measurement of power Doppler indices using 3D ultrasound on the day of the FET does not provide any additional information concerning the outcome of the cycle. The existence of the triple-line pattern on the day of the FET seems to be a prognostic sign of a prosperous outcome after FET. The dominant ovary in the pregnant group seems to be already activated one week after the FET.</p

The thing about pain: The remaking of illness narratives in chronic pain expressions on social media

In this article, we analyse chronic pain narratives on Flickr and Tumblr. We focus on how, by incorporating visual and multimodal elements, chronic pain expressions in social media significantly extend and challenge the logic, function and effects of traditional ‘illness narratives’. We examine a sample of images and blogs related to chronic pain and formulate a typology of chronic pain expressions on these sites. Flickr brings a form of narrative immediacy, making the pain experience visible, eliciting empathy and marking chronicity. Tumblr lends itself to more networked forms of interaction through the circulation of multimodal memes, and support communities are built through humour and social criticism. We argue that new forms of mediation and social media dynamics transform pain narratives. This has implications for our understandings of the forms and formats of pain communication and offers new possibilities for communicating pain within and beyond clinical contexts

Institutional legacies and HRM: similarities and differences in HRM practices in Portugal and Mozambique

This is a study of institutional change and continuity, comparing the trajectories followed by Mozambique and its formal colonial power Portugal in HRM, based on two surveys of firm level practices. The colonial power sought to extend the institutions of the metropole in the closing years of its rule, and despite all the adjustments and shocks that have accompanied Mozambique’s post-independence years, the country continues to retain institutional features and associated practices from the past. This suggests that there is a post-colonial impact on human resource management. The implications for HRM theory are that ambitious attempts at institutional substitution may have less dramatic effects than is commonly assumed. Indeed, we encountered remarkable similarities between the two countries in HRM practices, implying that features of supposedly fluid or less mature institutional frameworks (whether in Africa or the Mediterranean world) may be sustained for protracted periods of time, pressures to reform notwithstanding. This highlights the complexities of continuities which transcend formal rules; as post-colonial theories alert us, informal conventions and embedded discourse may result in the persistence of informal power and subordination, despite political and legal changes