Objective
To determine the safety and effectiveness of female sterilisation in the Finnish population.
Design
A national register‐based study using record linkage.
Setting
National data from Finland.
...Sample
A total of 16 272 female sterilisations performed in 2009–2014.
Methods
The Register of Sterilisations was linked with the Hospital Discharge Register, Termination of Pregnancy Register, and the Medical Birth Register in order to investigate the occurrence of re‐sterilisations, other surgical operations, and unwanted pregnancies after sterilisation, per method.
Main outcome measures
Outcome measures included all pregnancies after sterilisation (births, miscarriages, terminations of pregnancy, and ectopic pregnancies) and operations (repeat sterilisations, other hysteroscopic and laparoscopic procedures, hysterectomies, and re‐operations for a complication). The outcomes were presented by method as risk ratio (RR) with 95% confidence intervals (95% CIs).
Results
There was no significant difference in all spontaneous pregnancies between the groups. The risk ratio for any pregnancy was 1.27 (95% Cl 0.80–2.02) for Filshie® versus Essure® and 1.35 (95% Cl 0.92–1.96) for Pomeroy versus Essure®. In total, 1394 (8.6%) selected operations were identified after primary sterilisation. Re‐sterilisations and hysteroscopies were most frequent among Essure® patients.
Conclusions
Patients undergoing hysteroscopic or laparoscopic sterilisation have a similar risk of unintended pregnancy. All sterilisations are safe, and the risk of re‐operations because of complications is low. Women with Essure® have a higher risk of undergoing re‐sterilisation compared with patients undergoing laparoscopic sterilisation.
Tweetable
Essure®, Filshie®, and Pomeroy sterilisations are equally effective and safe.
Tweetable
Essure®, Filshie®, and Pomeroy sterilisations are equally effective and safe.
The physiological barriers of the eye pose challenges to the delivery of the array of therapeutics for ocular diseases. Hydrogels have been widely explored for medical applications and introduce ...possible solutions to overcoming the medication challenges of the ocular environment. While the innovations in drug encapsulation and release mechanisms, biocompatibility, and treatment duration have become highly sophisticated, the challenge of widespread application of hydrogel formulations in the clinic is still apparent. This article reviews the latest hydrogel formulations and their associated chemistries for use in ocular therapies, spanning from external anterior to internal posterior regions of the eye in order to evaluate the state of recent research. This article discusses the utility of hydrogels in soft contact lens, wound dressings, intraocular lens, vitreous substitutes, vitreous drug release hydrogels, and cell-based therapies for regeneration. Additional focus is placed on the pre-formulation, formulation, and manufacturing considerations of the hydrogels based on individual components (polymer chains, linkers, and therapeutics), final hydrogel product, and required preparations for clinical/commercial applications, respectively.
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Female sterilisation is usually performed on an elective basis at perceived family completion, however, around 1-3% of women who have undergone sterilisation elect to undergo sterilisation reversal ...(SR) at a later stage. The trends in SR rates in Western Australia (WA), proportions of SR procedures between hospital types (public and private), and the effects of Federal Government policies on these trends are unknown.
Using records from statutory state-wide data collections of hospital separations and births, we conducted a retrospective descriptive study of all women aged 15-49 years who underwent a SR procedure during the period 1st January 1990 to 31st December 2008 (n = 1868 procedures).
From 1991 to 2007 the annual incidence rate of SR procedures per 10,000 women declined from 47.0 to 3.6. Logistic regression modelling showed that from 1997 to 2001 the odds of women undergoing SR in a private hospital as opposed to all other hospitals were 1.39 times higher (95% CI 1.07-1.81) and 7.51 times higher (95% CI 5.46-10.31) from 2002 to 2008. There were significant decreases in SR rates overall and among different age groups after the Federal Government interventions.
Rates of SR procedures in WA have declined from 1990 to 2008, particularly following policy changes such as the introduction of private health insurance (PHI) policies. This suggests decisions to undergo SR may be influenced by Federal Government interventions.
Background
Female sterilisation remains a common contraceptive method in many countries.
Aims
The aim is to analyse the recent changes in the incidence of female sterilisation in New South Wales ...(NSW).
Methods
Data were obtained from the NSW Admitted Patients Data Collection for all female patients who had undergone one of the five sterilisation procedures in a public or private hospitals in NSW during 2010 and 2019. Denominators for calculating sterilisation rates were estimated using census and other population data.
Results
The number of sterilisation cases dropped from 3407 in 2010 to 2561 in 2019, and the sterilisation rate declined from 22.6 per 10 000 females aged 20–49 in 2010 to 15.4 in 2019. Incidence was at its peak in the 35–39 age group in both years. Indigenous females had higher sterilisation rates than non‐Indigenous females born in Australia or overseas. While some foreign‐born females had higher sterilisation rates than for those who were in Australia or overseas on average their rates were lower than those who were born in Australia or overseas. There was a clear socio‐economic gradient such that females living in the most disadvantaged areas had much higher sterilisation rates than those living in the least disadvantaged areas. The Indigenous, ethnic and socio‐economic differences in sterilisation rates persisted in both years of this study.
Conclusion
Although fertility rates in NSW changed little over the 10‐year interval a steady decline in sterilisation occurred, consistent with other forms of contraception (particularly long‐acting reversible types) increasing concurrently in popularity.
There is a growing body of literature that recognizes the importance of plasma treated water (PTW) for inactivation of microorganism. However, very little attention has been paid to the role of ...reactive nitrogen species (RNS) in deactivation of bacteria. The aim of this study is to explore the role of RNS in bacterial killing, and to develop a plasma system with increased sterilization efficiency. To increase the concentration of reactive oxygen and nitrogen species (RONS) in solution, we have used vapor systems (DI water/HNO
at different wt%) combined with plasma using N
as working gas. The results show that the addition of the vapor system yields higher RONS contents. Furthermore, PTW produced by N
+ 0.5 wt% HNO
vapor comprises a large amount of both RNS and ROS, while PTW created by N
+ H
O vapor consists of a large amount of ROS, but much less RNS. Interestingly, we observed more deactivation of E. Coli with PTW created by N
+ 0.5 wt% HNO
vapor plasma as compared to PTW generated by the other plasma systems. This work provides new insight into the role of RNS along with ROS for deactivation of bacteria.
Plasma treated water (PTW), produced by atmospheric-pressure plasma treatment of water, usually contains various reactive oxygen and nitrogen species (RONS). This study aimed at evaluating the ...effectiveness of different types of PTW on seed germination, seedling growth and microbial sterilization during the germinated mung bean processing. Results showed that air-PTW possessed outstanding abilities in improving seed germination and seedling growth with a germination index of 95.50% and a vigor index of 1146.64, and in microbial decontamination. The physicochemical properties of the PTW were analyzed to better understand the PTW stressed germination. Some physiological parameters like the activity of superoxide dismutase (SOD), the contents of malondialdehyde (MDA) and phytohormone (indole acetic acid (IAA) and abscisic acid (ABA)) during germination were also evaluated. This study suggested that air-PTW treatment could indeed provide a green and effective mean of stimulating seed germination and plant growth, and thus accelerate the growth cycle.
Increasing the production of food by using both economical and environmentally friendly means has been deemed as an urgent matter to sustain the food demand of rapidly growing world population. The results of this study suggest that PTW presents a great opportunity to address this need by increasing seedling growth and viability. PTW treatment is an environment-friendly and low-cost mean of stimulating seed germination and plant growth, which possesses the potential of scale up or industrial applications in relevant fields.
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•Plasma-treated water (PTW) was applied into mung bean germination for the first time.•The effects of PTW on seed germination, seedling growth, and sprout sterilization were studied.•Air-PTW has the potential for use as a green and effective mean for improving seed germination.
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•D-WO3@C exhibited a faster photocatalytic sterilization compared to most catalysts.•7 log inactivation of E. coli or S. aureus was obtained after treating samples.•The generation of ...ROS enabled the bacteria deformed, ruptured, and ultimately died.
Defect WO3-carbon hybrid nanosheets (D-WO3@C), synthesized by a facile hydrothermal method, is utilized as an effective visible-light driven photocatalyst for sustainable inactivation of bacteria. Detailed characterization through SEM-EDS, XRD, FT-IR, HRTEM, and XPS confirmed the formation of the nanohybrids. As a result, the as-synthesized D-WO3@C exhibited the best sterilization efficiency among all of the WO3 photocatalysts, and 7 log inactivation of E. coli or S. aureus was obtained after treating samples for 45 min with 1000 μg/mL D-WO3@C. It was found that D-WO3@C exhibited enhanced visible-light-driven photocatalytic sterilization in killing bacteria compared with D-WO3 and P-WO3. The results show that the oxygen vacancies and carbon matrix were able to promote photocatalytic performance by triggering a faster interfacial transfer and a higher efficient separation of electron-hole pairs, which most likely is the reason behind the improved bactericidal effect. Furthermore, fluorescent-based cell viability/death tests and SEM technology were employed to demonstrate the lethal effect as well as the integrity of bacterial membranes during photocatalytic process. Photoelectrochemical techniques and UV–visible diffuse reflectance revealed the efficient separation of electron-hole pairs between D-WO3 and carbon matrix. More importantly, after being tested in four cycles, D-WO3@C showed good photocatalytic performance due to its chemical stability. The excellent properties associated with the novel D-WO3/C indicated that they could be considered as a promising light-visible driven photocatalyst to remove, in practice, microbial contamination of water.
Steam sterilisation is a commonly used method in the sterilisation of surgical instruments. To ensure the sterility of the sterilised goods an evaluation of the sterilisation process is required. ...This might be achieved either through physical measurements or indicators. Optimal sterilisation results are achieved by removing the air from the sterilisation chamber. In this paper a new computational fluid dynamics (CFD) based approach is presented, which allows to calculate the steam distribution within a sterilisation chamber with focusing on hollow loads. Additional measurements were performed using a self-developed measurement chamber to validate the CFD model. A modified process challenge device (PCD) with different tube lengths in combination with a chemical indicator (CI) was tested, to identify the volumetric influence of the lumen on the resulting air-steam mixture therein. A numerically efficient model was developed to determine a steam volume fraction threshold leading to a response of the CI. This study aims to predict the volumetric amount of steam which is necessary in order to pass a PCD test fitted with a CI. Both the CFD model and the measurements showed that often an insufficient steam penetration is indicated by PCDs which can lead to an insufficient sterilisation of hollow loads.
•CFD simulation of a process challenge device used in type B steam sterilisers.•Self-developed measurement steriliser for validation purposes.•Impact of different PCD tube lengths on chemical indicators.•Determination of a steam threshold range leading to a chemical indicator response.•100+ chemical indicator measurements.
The color stability of mulberry juice is affected during its processing and storage. This study investigates changes in the color of mulberry juice processed by four different sterilization ...treatments during 30 days of storage at 4 °C: high pressure processing (HPP at 400 MPa/5 min, 400 MPa/10 min, 500 MPa/5 min, and 500 MPa/10 min), thermal processing (TP at 70 °C/10 min, and 75 °C/10 min), high temperature short time (HTST), and membrane filtration (MF). After 30 days of storage, the retention rates of total anthocyanin, cyanidin-3-glucoside and cyanidin-3-rutinoside in juice samples treated by different sterilization methods were found to be significantly higher than those of the control group. Among these treatments, the retention rates of total anthocyanin, cyanidin-3-glucoside and cyanidin-3-rutinoside were highest in HPP (400 MPa/5 min) at 84.70%, 80.20% and 98.61%, respectively. Both TP (70 °C/10 min) and HTST treatments also showed significantly higher anthocyanin retention rates, at 83.19% and 84.27%, respectively. These results indicate that HPP (400 MPa/5 min), TP (70 °C/10 min) and HTST treatments are most suitable for the sterilization of mulberry juice.
The distinct color of mulberry juice is one of the foremost qualities that imprints on consumers' senses, but it is extremely unstable in processing and storage. However, the color protection of mulberry juice was not studied previously. In this study, the protective effects of different sterilization treatments on the color-preservation and anthocyanin contents of mulberry juice were investigated for the first time. We found that the high-pressure processing treatment (HPP, 400 MPa/5 min) had the most powerful color-preserving effect. The study is of great significance as a guide to improving the color stability of mulberry juice, thereby also improving and promoting the development of the mulberry deep processing industry.
•HPP treatment was sufficient to provide microbial safety and acceptable color for mulberry juice with 30 days at 4 °C.•HPP treatment (400 MPa/5 min) increased the stability of anthocyanins in mulberry juice.•HPP treatment (400 MPa/5 min) markedly enhanced the content of C3G and C3R in mulberry juice.•HPP treatment (400 MPa/5 min) is the best method to sterilize mulberry juice.
A patient requesting sterilization envisages an easy to perform, safe cheap and reversible method. Despite best efforts of researchers and pharma companies, such a device has not been produced yet. ...Female sterilization is one of the most common procedures and encompasses tubal ligation, laparoscopic salpingectomy or hysteroscopic sterilization. This short review focuses on role of hysteroscopy on sterilization and informed consent as sterilization is a legacy for the rest of a woman life.
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