Bleeding changes after levonorgestrel 52-mg intrauterine system insertion for contraception in women with self-reported heavy menstrual bleeding.

BackgroundThe levonorgestrel 52-mg intrauterine system has proven efficacy for heavy menstrual bleeding treatment in clinical trials, but few data exist to demonstrate how rapidly the effects occur and the effects in women with self-reported heavy bleeding, as seen commonly in clinical practice.ObjectiveEvaluate changes in bleeding patterns in women with self-reported heavy menstrual bleeding before levonorgestrel 52-mg intrauterine system insertion.Study designA total of 1714 women aged 16-45 years old received a levonorgestrel 52-mg intrauterine system in a multicenter trial evaluating contraceptive efficacy and safety for up to 10 years. At screening, participants described their baseline menstrual bleeding patterns for the previous 3 months. Participants completed daily diaries with subjective evaluation of bleeding information for the first 2 years. For this analysis, we included women with at least 1 complete 28-day cycle of intrauterine system use and excluded women using a hormonal or copper intrauterine contraception in the month prior to study enrollment. We evaluated changes in menstrual bleeding and discontinuation for bleeding complaints per 28-day cycle over 26 cycles (2 years) in women who self-reported their baseline pattern as heavy. We also compared rates of amenorrhea, defined as no bleeding or spotting, within the entire study population in women with subjective heavy menstrual bleeding at baseline compared with those who did not complain of heavy menstrual bleeding.ResultsOf the 1513 women in this analysis, 150 (9.9%) reported baseline heavy menstrual bleeding. The majority of women reported no longer experiencing heavy menstrual bleeding by the end of cycle 1 (112/150, 74.7%) with even greater rates by cycle 2 (124/148, 83.8%). At the end of cycles 6, 13, and 26, 129 of 140 (92.1%; 95% confidence interval, 87.7%-96.6%), 114 of 123 (92.7%; 95% confidence interval, 88.1%-97.3%), and 100 of 103 (97.1%; 95% confidence interval, 93.8%-100%) women reported no heavy menstrual bleeding, respectively. After cycles 13 and 26, 63 of 123 (51.2%; 95% confidence interval, 42.4%-60.1%) and 66 of 103 (64.1%; 95% confidence interval, 54.8%-73.3%), respectively, reported their bleeding as amenorrhea or spotting only. A lower proportion of women with baseline self-reported heavy menstrual bleeding reported amenorrhea as compared with women in the overall study cohort without heavy menstrual bleeding at the end of 6 cycles (319 [25.5%] vs 21 [15.0%], P=.005) and 13 cycles (382 [34.4%] vs 26 [21.1%], P=.003); differences were not significant after 19 cycles (367 [37.2%] vs 36 [31.0%], P=.022) and 26 cycles (383 [43.5%] vs 38 [36.9%], P=.21). Only 4 (2.7%) women with baseline heavy menstrual bleeding discontinued for bleeding complaints (2 for heavy menstrual bleeding and 2 for irregular bleeding), all within the first year.ConclusionMost women who self-report heavy menstrual bleeding experience significant improvement quickly after levonorgestrel 52-mg intrauterine system insertion. Discontinuation for bleeding complaints among women with baseline heavy menstrual bleeding is very low

Glassy states in lattice models with many coexisting crystalline phases

We study the emergence of glassy states after a sudden cooling in lattice models with short range interactions and without any a priori quenched disorder. The glassy state emerges whenever the equilibrium model possesses a sufficient number of coexisting crystalline phases at low temperatures, provided the thermodynamic limit be taken before the infinite time limit. This result is obtained through simulations of the time relaxation of the standard Potts model and some exclusion models equipped with a local stochastic dynamics on a square lattice.Comment: 12 pages, 4 figure

Isoscalar short-range current in the deuteron induced by an intermediate dibaryon

A new model for short-range isoscalar currents in the deuteron and in the NN system is developed; it is based on the generation of an intermediate dibaryon which is the basic ingredient for the medium- and short-range NN interaction which was proposed recently by the present authors.This new current model can very well describe the experimental data for the three basic deuteron observables of isoscalar magnetic type, viz. the magnetic moment, the circular polarization of the photon in the $np\to d\gamma$ process at thermal neutron energies and the structure function B up to Q$^2$=60 fm$^{-2}$.Comment: LaTex, 22 pages with 8 figure

Superparticle Models with Tensorial Central Charges

A generalization of the Ferber-Shirafuji formulation of superparticle mechanics is considered. The generalized model describes the dynamics of a superparticle in a superspace extended by tensorial central charge coordinates and commuting twistor-like spinor variables. The D=4 model contains a continuous real parameter $a\geq 0$ and at a=0 reduces to the SU(2,2|1) supertwistor Ferber-Shirafuji model, while at a=1 one gets an OSp(1|8) supertwistor model of ref. [1] (hep-th/9811022) which describes BPS states with all but one unbroken target space supersymmetries. When 0<a<1 the model admits an OSp(2|8) supertwistor description, and when a>1 the supertwistor group becomes OSp(1,1|8). We quantize the model and find that its quantum spectrum consists of massless states of an arbitrary (half)integer helicity. The independent discrete central charge coordinate describes the helicity spectrum. We also outline the generalization of the a=1 model to higher space-time dimensions and demonstrate that in D=3,4,6 and 10, where the quantum states are massless, the extra degrees of freedom (with respect to those of the standard superparticle) parametrize compact manifolds. These compact manifolds can be associated with higher-dimensional helicity states. In particular, in D=10 the additional ``helicity'' manifold is isomorphic to the seven-sphere.Comment: 32 pages, LATEX, no figure

INTRINSIC MECHANISM FOR ENTROPY CHANGE IN CLASSICAL AND QUANTUM EVOLUTION

It is shown that the existence of a time operator in the Liouville space representation of both classical and quantum evolution provides a mechanism for effective entropy change of physical states. In particular, an initially effectively pure state can evolve under the usual unitary evolution to an effectively mixed state.Comment: 20 pages. For more information or comments contact E. Eisenberg at [email protected] (internet)

Deformation Energy Minima at Finite Mass Asymmetry

A very general saddle point nuclear shape may be found as a solution of an integro-differential equation without giving apriori any shape parametrization. By introducing phenomenological shell corrections one obtains minima of deformation energy for binary fission of parent nuclei at a finite (non-zero) mass asymmetry. Results are presented for reflection asymmetric saddle point shapes of thorium and uranium even-mass isotopes with A=226-238 and A=230-238 respectively.Comment: 5 pages, 2 Postscript figures, REVTeX, Version 4.

Calculation of dephasing times in closed quantum dots

Dephasing of one-particle states in closed quantum dots is analyzed within the framework of random matrix theory and Master equation. Combination of this analysis with recent experiments on the magnetoconductance allows for the first time to evaluate the dephasing times of closed quantum dots. These dephasing times turn out to depend on the mean level spacing and to be significantly enhanced as compared with the case of open dots. Moreover, the experimental data available are consistent with the prediction that the dephasing of one-particle states in finite closed systems disappears at low enough energies and temperatures.Comment: 4 pages, 3 figure

Study of the one-dimensional off-lattice hot-monomer reaction model

Hot monomers are particles having a transient mobility (a ballistic flight) prior to being definitely absorbed on a surface. After arriving at a surface, the excess energy coming from the kinetic energy in the gas phase is dissipated through degrees of freedom parallel to the surface plane. In this paper we study the hot monomer-monomer adsorption-reaction process on a continuum (off-lattice) one-dimensional space by means of Monte Carlo simulations. The system exhibits second-order irreversible phase transition between a reactive and saturated (absorbing) phases which belong to the directed percolation (DP) universality class. This result is interpreted by means of a coarse-grained Langevin description which allows as to extend the DP conjecture to transitions occurring in continuous media.Comment: 13 pages, 5 figures, final version to appear in J. Phys.

Problems and Aspects of Energy-Driven Wavefunction Collapse Models

Four problematic circumstances are considered, involving models which describe dynamical wavefunction collapse toward energy eigenstates, for which it is shown that wavefunction collapse of macroscopic objects does not work properly. In one case, a common particle position measuring situation, the apparatus evolves to a superposition of macroscopically distinguishable states (does not collapse to one of them as it should) because each such particle/apparatus/environment state has precisely the same energy spectrum. Second, assuming an experiment takes place involving collapse to one of two possible outcomes which is permanently recorded, it is shown in general that this can only happen in the unlikely case that the two apparatus states corresponding to the two outcomes have disjoint energy spectra. Next, the progressive narrowing of the energy spectrum due to the collapse mechanism is considered. This has the effect of broadening the time evolution of objects as the universe evolves. Two examples, one involving a precessing spin, the other involving creation of an excited state followed by its decay, are presented in the form of paradoxes. In both examples, the microscopic behavior predicted by standard quantum theory is significantly altered under energy-driven collapse, but this alteration is not observed by an apparatus when it is included in the quantum description. The resolution involves recognition that the statevector describing the apparatus does not collapse, but evolves to a superposition of macroscopically different states.Comment: 17 page

Antiresonance and Localization in Quantum Dynamics

The phenomenon of quantum antiresonance (QAR), i.e., exactly periodic recurrences in quantum dynamics, is studied in a large class of nonintegrable systems, the modulated kicked rotors (MKRs). It is shown that asymptotic exponential localization generally occurs for $\eta$ (a scaled $\hbar$) in the infinitesimal vicinity of QAR points $\eta_0$. The localization length $\xi_0$ is determined from the analytical properties of the kicking potential. This ``QAR-localization" is associated in some cases with an integrable limit of the corresponding classical systems. The MKR dynamical problem is mapped into pseudorandom tight-binding models, exhibiting dynamical localization (DL). By considering exactly-solvable cases, numerical evidence is given that QAR-localization is an excellent approximation to DL sufficiently close to QAR. The transition from QAR-localization to DL in a semiclassical regime, as $\eta$ is varied, is studied. It is shown that this transition takes place via a gradual reduction of the influence of the analyticity of the potential on the analyticity of the eigenstates, as the level of chaos is increased.Comment: To appear in Physical Review E. 51 pre-print pages + 9 postscript figure