Adnexal torsion in a patient with Müllerian agenesis undergoing ovarian stimulation: a case report

Background: As assisted reproductive technologies become increasingly available to patients, more women with Müllerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments. Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary. Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort may be at an especially high risk for ovarian torsion. Physicians should recognize this risk and counsel their patients on this risk when discussing fertility options in patients with Müllerian agenesis

China neemt (Volvo) over

De gebeurtenissen sinds de overname van Volvo Cars door het Chinese Geely in 2010 tarten soms de verbeelding, alleszins voor de gemiddelde leek. In dit artikel zal worden aangetoond dat de Chinezen echter een zeer doordachte strategie gebruiken om hun geopolitieke en –economische doelen te verwezenlijken

The PI Launchpad: Expanding the base of potential Principal Investigators across space sciences

The PI Launchpad attempts to provide an entry level explanation of the process of space mission development for new Principal Investigators (PIs). In particular, PI launchpad has a focus on building teams, making partnerships, and science concept maturity for a space mission concept, not necessarily technical or engineering practices. Here we briefly summarize the goals of the PI Launchpad workshops and present some results from the workshops held in 2019 and 2021. The workshop attempts to describe the current process of space mission development (i.e. space-based telescopes and instrument platforms, planetary missions of all types, etc.), covering a wide range of topics that a new PI may need to successfully develop a team and write a proposal. It is not designed to replace real experience but to provide an easily accessible resource for potential PIs who seek to learn more about what it takes to submit a space mission proposal, and what the first steps to take can be. The PI Launchpad was created in response to the high barrier to entry for early career or any scientist who is unfamiliar with mission design. These barriers have been outlined in several recent papers and reports, and are called out in recent space science Decadal reports.Comment: 7 Pages, 2 Figure, Accepted to Frontier

Une étude sémiologique, sociolinguistique et pragmatique de l’épidiscours des utilisateurs de Doctissimo sur les émoticônes

La Cémo (Communication Ecrite Médiée par Ordinateur) constitue un contexte énonciatif issu des nouveaux médias et abordé comme une combinaison de formes de communication nouvelles et diversifiées possédant leurs caractéristiques propres (Cougnon, 2015). Parmi celles-ci se trouve l’émoticône, que nous définirons comme un agencement « de signes graphiques imitant des mimiques faciales ou d’autres objets, indiquant une émotion du locuteur, qui interagissent avec des énoncés pour produire un sens qui dépasse celui, littéral, de la proposition logique énoncée » (Halté, 2016 : 227). Les chercheurs qui se sont penchés sur le rôle des émoticônes dans la Cémo (Fersini, Messina, & Pozzi, 2016 ; Marcoccia, Gauducheau & Gauducheau, 2007 ; McIntyre, 2016) ont observé qu’elles diminuent l’ambiguïté, sont un indice du ton et de l’humeur du locuteur, constituent un mode de prévention contre une mauvaise interprétation, aident à structurer les échanges et renforcent la valeur expressive de l’énoncé. Selon qu’elles abordent l’interprétation des émoticônes en production ou en réception, ces études présentent des résultats contradictoires. Cette ambivalence est liée à la complexité des questions de l’interprétation des émoticônes et de leur valeur discursive (Gauducheau, 2012). Dans cette communication, nous présentons les résultats de l’étude d’un corpus original portant sur la représentation que les usagers se font de ces émoticônes. Le corpus est composé de discussions issues du forum de Santé Doctissimo (site comprenant 2.600.000 inscrits, 6 millions de discussions et 300 millions de messages). Ce « métadiscours » spontané des membres du forum a été causé par l’événement suivant : en novembre 2015, Doctissimo décide de changer son jeu d’émoticônes afin de moderniser son site. Ce sont dorénavant des « smileys bleus » qui apparaissent lorsque l’utilisateur insère son code typographique habituel. Ce changement, impactant également les messages archivés, engendrera 14 fils de discussions réclamant le retour des « anciens smileys ». Nous avons sélectionné manuellement 506 messages – en fonction de leur intérêt métadiscursif et sociologique - et décortiqué les arguments mis en avant sur la base d’une grille d’analyse croisant des critères communicationnels, psychologiques et sociologiques. Il en ressort que les émoticônes représentent un enjeu affectif réel que l’on retrouve parmi les considérations avancées pour le retour des anciennes émoticônes, aux côtés d’arguments relatifs à l’esthétique, la taille, la variété, la nuance et l’insertion discursive. Cette recherche adopte une double démarche sociolinguistique et sémio-discursive. D’une part, elle se penche sur les normes et les règles d’expressivité dans la Cémo (Gauducheau, 2012). Ainsi, avec Baym (1998), nous postulons que des formes expressives spécifiques – dont les émoticônes – peuvent naître au sein d’une communauté, participant dès lors à la construction des normes et à la codification des échanges. D'autre part, cette recherche analyse les représentations des utilisateurs à travers leur métadiscours. Nous tentons ainsi de définir un référentiel des émoticônes dans la communauté des forums de Doctissimo et de catégoriser les fonctions qui leur sont attribuées

Use of low dose vaginal misoprostol in office hysteroscopy: a pre–post interventional study

A pre-post interventional study of patients undergoing office hysteroscopy alone and in combination with endometrial biopsy was performed during October 2015–March 2018 to evaluate the effect of low dose vaginal misoprostol on patient’s pain. Pain scores were assessed using the visual analog scale at the completion of the procedure. There were 646 patients included in the study. Of these, 462 had office hysteroscopy alone; 206 (44.6%) received 50 mcg of vaginal misoprostol the night prior to the procedure and the remaining 256 (55.4%) patients had no cervical ripening. The reported pain score following hysteroscopy was significantly lower among patients who received misoprostol [4(0–10) vs. 5(0–10); p=.001]. Most patients (78.2%) did not report any misoprostol related side effects. Of the 184 patients who underwent a combination of office hysteroscopy and endometrial biopsy, 97 (52.7%) received pre-procedure vaginal misoprostol while 87 (47.3%) did not. Post procedure pain was independent of pre-treatment with vaginal misoprostol (6.3 ± 2.7 vs. 6.6 ± 2.7; p = .54).Impact statement What is already known on this subject? Office hysteroscopy and endometrial biopsy is increasingly performed for evaluation of various gynaecologic conditions, however, patients’ perceived pain at the time of procedure may lead to incomplete procedures. Various doses of misoprostol have been tested to reduce patients’ pain, however none lower than 200 mcg vaginally, and at these doses, side effects are reported. What the results of this study add? To date, there is a scarcity of published data on the use of low dose misoprostol (50 mcg) in gynaecologic procedures. Our study found that the use of low dose vaginal misoprostol prior to office hysteroscopy is associated with lower reported pain and tenaculum utilisation during the procedure. However, vaginal misoprostol prior to successive office hysteroscopy and endometrial biopsy failed to decrease the reported pain, and the overall pain score was higher than hysteroscopy alone. What the implications are of these findings for clinical practice and/or further research? The use of low dose vaginal misoprostol (50 mcg) the evening prior to office hysteroscopy is associated with lower reported pain and tenaculum utilisation and is not associated with significant side effects. Therefore, 50 mcg of misoprostol could be used in clinical practice as a method to reduce patients’ reported pain during office hysteroscopy

Adnexal Torsion in a Patient with Müllerian Agenesis Undergoing Ovarian Stimulation: A Case Report

Background: As assisted reproductive technologies become increasingly available to patients, more women with Müllerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments. Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary. Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort may be at an especially high risk for ovarian torsion. Physicians should recognize this risk and counsel their patients on this risk when discussing fertility options in patients with Müllerian agenesis

Adnexal Torsion in a Patient with Müllerian Agenesis Undergoing Ovarian Stimulation: A Case Report

Background: As assisted reproductive technologies become increasingly available to patients, more women with Müllerian agenesis may undergo ovarian stimulation and oocyte retrieval to have genetically-related offspring. The risk of ovarian torsion is increased in patients utilizing assisted reproductive technologies compared to patients who do not undergo these treatments. Case: A 25-year-old G0 with Mayer-Rokitansky-Kuster-Hauser syndrome presented to the emergency room two days after oocyte retrieval with an acute abdomen. During laparoscopy, she was found to have torsion of her left ovary. Summary and Conclusion: As more young women with Müllerian agenesis present for fertility treatment, this anatomically unique patient cohort may be at an especially high risk for ovarian torsion. Physicians should recognize this risk and counsel their patients on this risk when discussing fertility options in patients with Müllerian agenesis

Structured approaches to promote patient and family engagement in treatment in acute care hospital settings: protocol for a systematic scoping review

Abstract Background While effective engagement of patients and families in treatment is increasingly viewed as a priority for many healthcare systems, much remains to be learned about the nature and outcomes of approaches that seek to accomplish this goal in the acute care hospital setting. Wide variability in the implementation of practices designed to promote patient and family engagement in hospitals has been noted. Approaches aimed at promoting patient and family engagement in treatment share the over-arching goal of changing behaviors of patients, families, and healthcare providers and possibly administrators. Behavior change techniques (BCTs) can be a key element of patient and family engagement approaches. This scoping review will contribute to the development of an evidence base detailing that the BCTs have potential to be effective in patient and family engagement interventions. The specific objectives of this review are to (a) identify and classify approaches used in acute care hospitals to engage patient and families in treatment according to the behavior change technique taxonomy; and (b) evaluate and synthesize the outcomes for these approaches for patients and families, healthcare providers, and health administrators/funders. Methods This systematic scoping review will allow us to determine the extent, range, and nature of research activity related to initiatives designed to promote patient and family engagement in care. A comprehensive electronic literature search will be conducted in MEDLINE, EMBASE, and CINAHL. Studies will be included if they report on outcomes of a structured or systematic approach to the promotion of adult inpatient and family engagement in treatment in acute care settings. Studies will be selected in a two-stage screening process (title and abstract; full text) and quality will be assessed using the mixed methods assessment tool. Data extraction will include narrative descriptions of the intervention and classification of the behavior change techniques employed. Discussion This review aims to identify and classify the specific behavior change techniques underpinning patient and family engagement interventions used in acute care hospital settings. By identifying the “active ingredients” in these interventions, our findings will be transferable to a wide range of acute care hospital contexts and populations

Additional file 1: of Structured approaches to promote patient and family engagement in treatment in acute care hospital settings: protocol for a systematic scoping review

PRISMA-P Checklist. The data provided shows a completed copy of the PRISMA-P Checklist to guide readers in assessing the quality of the current protocol. (DOCX 29 kb