A multi-centre randomised controlled study of pre-IVF outpatient hysteroscopy in women with recurrent IVF implantation failure: Trial of Outpatient Hysteroscopy - [TROPHY] in IVF

<p>Abstract</p> <p>Background</p> <p>The success rate of IVF treatment is low. A recent systematic review and meta-analysis found that the outcome of IVF treatment could be improved in patients who have experienced recurrent implantation failure if an outpatient hysteroscopy (OH) is performed before starting the new treatment cycle. However, the trials were of variable quality, leading to a call for a large and high-quality randomised trial. This protocol describes a multi-centre randomised controlled trial to test the hypothesis that performing an OH prior to starting an IVF cycle improves the live birth rate of the subsequent IVF cycle in women who have experienced two to four failed IVF cycles.</p> <p>Methods and design</p> <p>Eligible and consenting women will be randomised to either OH or no OH using an internet based trial management programme that ensures allocation concealment and employs minimisation for important stratification variables including age, body mass index, basal follicle stimulating hormone level and number of previous failed IVF cycles. The primary outcome is live birth rate per IVF cycle started. Other outcomes include implantation, clinical pregnancy and miscarriage rates.</p> <p>The sample size for this study has been estimated as 758 participants with 379 participants in each arm. Interim analysis will be conducted by an independent Data Monitoring Committee (DMC), and final analysis will be by intention to treat. A favourable ethical opinion has been obtained (REC reference: 09/H0804/32).</p> <p>Trail Registration</p> <p>The trial has been assigned the following ISRCTN number: ISRCTN35859078</p

Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial

Background Non-alcoholic steatohepatitis (NASH) is a common type of chronic liver disease that can lead to cirrhosis. Obeticholic acid, a farnesoid X receptor agonist, has been shown to improve the histological features of NASH. Here we report results from a planned interim analysis of an ongoing, phase 3 study of obeticholic acid for NASH. Methods In this multicentre, randomised, double-blind, placebo-controlled study, adult patients with definite NASH,non-alcoholic fatty liver disease (NAFLD) activity score of at least 4, and fibrosis stages F2–F3, or F1 with at least oneaccompanying comorbidity, were randomly assigned using an interactive web response system in a 1:1:1 ratio to receive oral placebo, obeticholic acid 10 mg, or obeticholic acid 25 mg daily. Patients were excluded if cirrhosis, other chronic liver disease, elevated alcohol consumption, or confounding conditions were present. The primary endpointsfor the month-18 interim analysis were fibrosis improvement (≥1 stage) with no worsening of NASH, or NASH resolution with no worsening of fibrosis, with the study considered successful if either primary endpoint was met. Primary analyses were done by intention to treat, in patients with fibrosis stage F2–F3 who received at least one dose of treatment and reached, or would have reached, the month 18 visit by the prespecified interim analysis cutoff date. The study also evaluated other histological and biochemical markers of NASH and fibrosis, and safety. This study is ongoing, and registered with ClinicalTrials.gov, NCT02548351, and EudraCT, 20150-025601-6. Findings Between Dec 9, 2015, and Oct 26, 2018, 1968 patients with stage F1–F3 fibrosis were enrolled and received at least one dose of study treatment; 931 patients with stage F2–F3 fibrosis were included in the primary analysis (311 in the placebo group, 312 in the obeticholic acid 10 mg group, and 308 in the obeticholic acid 25 mg group). The fibrosis improvement endpoint was achieved by 37 (12%) patients in the placebo group, 55 (18%) in the obeticholic acid 10 mg group (p=0·045), and 71 (23%) in the obeticholic acid 25 mg group (p=0·0002). The NASH resolution endpoint was not met (25 [8%] patients in the placebo group, 35 [11%] in the obeticholic acid 10 mg group [p=0·18], and 36 [12%] in the obeticholic acid 25 mg group [p=0·13]). In the safety population (1968 patients with fibrosis stages F1–F3), the most common adverse event was pruritus (123 [19%] in the placebo group, 183 [28%] in the obeticholic acid 10 mg group, and 336 [51%] in the obeticholic acid 25 mg group); incidence was generally mild to moderate in severity. The overall safety profile was similar to that in previous studies, and incidence of serious adverse events was similar across treatment groups (75 [11%] patients in the placebo group, 72 [11%] in the obeticholic acid 10 mg group, and 93 [14%] in the obeticholic acid 25 mg group). Interpretation Obeticholic acid 25 mg significantly improved fibrosis and key components of NASH disease activity among patients with NASH. The results from this planned interim analysis show clinically significant histological improvement that is reasonably likely to predict clinical benefit. This study is ongoing to assess clinical outcomes

Postcolonial studies and translation theory

What distinguishes postcolonial approaches to translation is that they examine intercultural encounters in contexts marked by unequal power relations. Herein lie their strengths as well as their weaknesses. Their major contribution has been to illuminate the role of power in the production and reception of translation. But it is not certain that the postcolonial framework can be applied to other interlingual exchanges with minimal inequality of power relations. Moreover, there is a general tendency to underrate the differences among (post)colonial contexts themselves. It is suggested that insufficient attention to the socio-political background of translation has been reflected in postcolonial formulations of resistance, which are typically purely textual. It is argued also that some postcolonial perspectives, rejecting reductive appropriations of other cultures, may have been led to some sort of reification of difference, reflected in a rather pessimistic insistence on the inaccessibility of the position of the Other.La característica diferenciadora que poseen los enfoques postcoloniales en traducción radica en el hecho de que éstos analizan encuentros interculturales que se desarrollan en contextos marcados por desequilibrios en las relaciones de poder y es ahí donde se manifiestan tanto sus virtudes como sus defectos. Su mayor aportación ha sido sacar a la luz el papel del poder en la producción y recepción de traducciones. Sin embargo, se duda de que las teorías postcoloniales puedan aplicarse satisfactoriamente a otros intercambios interlingüísticos en los que las desigualdades en las relaciones de poder sean mínimas. Por otra parte, existe una tendencia generalizada a infravalorar las diferencias existentes entre los contextos (post)coloniales y se sugiere que las expresiones de resistencia propias de este movimiento, por lo general puramente textuales, dan muestra de que se ha prestado una atención insuficiente a las circunstancias sociopolíticas de la traducción. Asimismo se arguye que cabe la posibilidad de que determinadas perspectivas postcoloniales, al rechazar la apropiación reduccionista de otras culturas, hayan fomentado un cierto tipo de cosificación de la diferencia, que se refleja en una insistencia un tanto pesimista sobre el hecho de que es imposible ponerse en el lugar del Otro

Women and Slaves: Gender Politics in the Arabian Nights

I emphasize masculine reflection on female sexuality as the underlying theme of the Arabian Nights. The frame story relates a threat to the marriage institution, uniting the two elements subjugated by the sociopolitical system: women and slaves. The narrative thus exteriorizes repressed patriarchal fears about the oppressed. But because Shahraya¯r’s solution (marrying and killing a woman every night) is equally destructive to the community, a woman intervenes to curb his excesses. Shahraza¯d tells of powerful, promiscuous women but also of virtuous, loyal ones; as stated at the end of the tales, “Not all women are alike.” Hence the effect of the reading experience is one of catharsis: the worst masculine anxieties are expressed to be purged. The denouement is a reconciliation of the patriarchal fear of female sexual empowerment and family law, whereby the role of women is indispensable

فن الشعر)) في ترجمته القديمة : فرصة ضائعة أم تمثّل خلاق؟)) / Early Translations of Aristotle\u27s Poetics : Wasted Opportunity or Creative Adaptation?

[تدرس المقالة ترجمة فن الشعر لأرسطو التي وضعها ﻣﺘّﻰ بن يونس (٩٣٢ م) ، وتلقيها ﻓﻲ التراث العربي . كذلك يبين الكاتب استخدام ابن رشد مفاهيم أرسطو ، بعد مواﺀمتها لمصطلحات الشعر العربي ، لوضع معايير أخلاقية لتقييم الشعر تمثل ﺭﻛﻨﺎً أساسياً من فلسفته الأخلاقية والسياسية ، من خلال تحليل شروح ابن رشد على الترجمة . بذلك جرى تمثل فن الشعر في السياق الثقافي المتلقي ليلعب دوراً فاعلاً في القضايا الفكرية في ذلك العصر بشكل يتخطى معايير الفهم ونقل المعنى وﻳﻔﺘﺢ ﺍﻟﻤﺠﺎﻝ لمقاربات مختلفة لمفاهيم الدقة والإخلاص للنص الأصلي والالتزام الأخلاقي للمترجم في تمثل الآخر ونقل مفاهيمه وقيمه . This article examines the first Arabic translation of Aristotie\u27s Poetics by Matta bin Yunus (932 AD) and its reception in Classical Arabic tradition. Focusing on Ibn Rushd\u27s exegesis of the translation (which adapted Aristotle\u27s literary terms to Arabic ones), the article examines how Ibn Rushd used this commentary to form an ethical view of poetry which he integrated into his political philosophy. Thus, the book, it is argued, was adapted into contemporary debates in a case of creative translation that defies the simple designations of accuracy and faithfulness, offering new perspectives on ethical responsibility, adaptation, and the transformation of the Other.