Should corifollitropin alfa be offered to patients with "genuine" poor response to controlled ovarian hyperstimulation?

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Stereotype and skew: Quantifying gender bias in pre-trained and fine-tuned language models

This paper proposes two intuitive metrics, skew and stereotype, that quantify and analyse the gender bias present in contextual language models when tackling the WinoBias pronoun resolution task. We find evidence that gender stereotype correlates approximately negatively with gender skew in out-of-the-box models, suggesting that there is a trade-off between these two forms of bias. We investigate two methods to mitigate bias. The first approach is an online method which is effective at removing skew at the expense of stereotype. The second, inspired by previous work on ELMo, involves the fine-tuning of BERT using an augmented gender-balanced dataset. We show that this reduces both skew and stereotype relative to its unaugmented fine-tuned counterpart. However, we find that existing gender bias benchmarks do not fully probe professional bias as pronoun resolution may be obfuscated by cross-correlations from other manifestations of gender prejudice. Our code is available online

Observation of 2nd band vortex solitons in 2D photonic lattices

We demonstrate second-band bright vortex-array solitons in photonic lattices. This constitutes the first experimental observation of higher-band solitons in any 2D periodic system. These solitons possess complex intensity and phase structures, yet they can be excited by a simple highly-localized vortex-ring beam. Finally, we show that the linear diffraction of such beams exhibits preferential transport along the lattice axes

Robust optical delay lines via topological protection

Phenomena associated with topological properties of physical systems are naturally robust against perturbations. This robustness is exemplified by quantized conductance and edge state transport in the quantum Hall and quantum spin Hall effects. Here we show how exploiting topological properties of optical systems can be used to implement robust photonic devices. We demonstrate how quantum spin Hall Hamiltonians can be created with linear optical elements using a network of coupled resonator optical waveguides (CROW) in two dimensions. We find that key features of quantum Hall systems, including the characteristic Hofstadter butterfly and robust edge state transport, can be obtained in such systems. As a specific application, we show that the topological protection can be used to dramatically improve the performance of optical delay lines and to overcome limitations related to disorder in photonic technologies.Comment: 9 pages, 5 figures + 12 pages of supplementary informatio

Clinical and cost-effectiveness of DREAMS START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives) for people living with dementia and their carers: a study protocol for a parallel multicentre randomised controlled trial

Introduction: Many people living with dementia experience sleep disturbance and there are no known effective treatments. Non-pharmacological treatment options should be the first-line sleep management. For family carers, relatives’ sleep disturbance leads to interruption of their sleep, low mood and breakdown of care. Our team developed and delivered DREAMS START (Dementia RElAted Manual for Sleep; STrAtegies for RelaTives), a multimodal non-pharmacological intervention, showing it to be feasible and acceptable. The aim of this randomised controlled trial is to establish whether DREAMS START is clinically cost-effective in reducing sleep disturbances in people living with dementia living at home compared with usual care. // Methods and analysis: We will recruit 370 participant dyads (people living with dementia and family carers) from memory services, community mental health teams and the Join Dementia Research Website in England. Those meeting inclusion criteria will be randomised (1:1) either to DREAMS START or to usual treatment. DREAMS START is a six-session (1 hour/session), manualised intervention delivered every 1–2 weeks by supervised, non-clinically trained graduates. Outcomes will be collected at baseline, 4 months and 8 months with the primary outcome being the Sleep Disorders Inventory score at 8 months. Secondary outcomes for the person with dementia (all proxy) include quality of life, daytime sleepiness, neuropsychiatric symptoms and cost-effectiveness. Secondary outcomes for the family carer include quality of life, sleep disturbance, mood, burden and service use and caring/work activity. Analyses will be intention-to-treat and we will conduct a process evaluation. // Ethics and dissemination: London—Camden & Kings Cross Ethics Committee (20/LO/0894) approved the study. We will disseminate our findings in high-impact peer-reviewed journals and at national and international conferences. This research has the potential to improve sleep and quality of life for people living with dementia and their carers, in a feasible and scalable intervention. // Trial registration number: ISRCTN13072268

Tretinoin-based formulations - influence of concentration and vehicles on skin penetration

Tretinoin is used in the management of acne and it is part of a gold standard treatment for photoaging. It has also been reported as an agent for superficial chemical peeling in highly concentrated formulations with few considerations about skin penetration. The aim of this study was to evaluate the influence of drug concentration and vehicles currently used on skin penetration of tretinoin. In vitro permeation tests were carried out using Franz diffusion cells fitted with porcine ear skin and 10% aqueous methanol in the receptor compartment. Formulations studied, cream or hydroalcoholic dispersion, containing 0.25%, 1% and 5% of tretinoin were placed in the donor compartment for six hours. Tretinoin concentration in skin layers was measured by high performance liquid chromatography. The largest amount of tretinoin from both vehicles was detected in stratum corneum with significant differences among the three concentrations. The hydroalcoholic dispersion was the best vehicle. Significant amounts of tretinoin were found even in deep layers of epidermis. The formulation with 0.25% tretinoin showed better results when considered the amount of tretinoin on skin in terms of percentage. Finally, skin penetration of tretinoin was influenced by vehicle and concentration of this drug used in formulation

Toward a geography of black internationalism: Bayard Rustin, nonviolence and the promise of Africa

This article charts the trip made by civil rights leader Bayard Rustin to West Africa in 1952, and examines the unpublished ‘Africa Program’ which he subsequently presented to leading American pacifists. I situate Rustin’s writings within the burgeoning literature on black internationalism which, despite its clear geographical registers, geographers themselves have as yet made only a modest contribution towards. The article argues that within this literature there remains a tendency to romanticize cross-cultural connections in lieu of critically interrogating their basic, and often competing, claims. I argue that closer attention to the geographies of black internationalism, however, allows us to shape a more diverse and practiced sense of internationalist encounter and exchange. The article reconstructs the multiplicity of Rustin’s black internationalist geographies which drew eclectically from a range of Pan-African, American and pacifist traditions. Though each of these was profoundly racialized, they conceptualized race in distinctive ways and thereby had differing understandings of what constituted the international as a geographical arena. By blending these forms of internationalism Rustin was able to promote a particular model of civil rights which was characteristically internationalist in outlook, nonviolent in principle and institutional in composition; a model which in selective and uneven ways continues to shape our understanding of the period

Mechanisms of Intragastric pH Sensing

Luminal amino acids and lack of luminal acidity as a result of acid neutralization by intragastric foodstuffs are powerful signals for acid secretion. Although the hormonal and neural pathways underlying this regulatory mechanism are well understood, the nature of the gastric luminal pH sensor has been enigmatic. In clinical studies, high pH, tryptic peptides, and luminal divalent metals (Ca2+ and Mg2+) increase gastrin release and acid production. The calcium-sensing receptor (CaSR), first described in the parathyroid gland but expressed on gastric G cells, is a logical candidate for the gastric acid sensor. Because CaSR ligands include amino acids and divalent metals, and because extracellular pH affects ligand binding in the pH range of the gastric content, its pH, metal, and nutrient-sensing functions are consistent with physiologic observations. The CaSR is thus an attractive candidate for the gastric luminal sensor that is part of the neuroendocrine negative regulatory loop for acid secretion