Factors Influencing the Choice between IUD and Implant among Long-Acting Reversible Contraceptive (LARCs) Users in Burkina Faso

Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. Among these methods, the Implant has gained popularity in sub-Saharan Africa, whereas the utilization of Intrauterine Devices (IUDs) has remained comparatively low, particularly in Burkina Faso. This study aims to evaluate the shifts in IUD and Implant usage from 2010 to 2020 and to pinpoint the factors influencing the choice of IUDs among LARCs users in Burkina Faso. Data and Methods: We conducted an analysis using data from Burkina Faso, drawn from the 2010 Demographic and Health Survey (DHS) and the 2020 PMA Phase 1 data. The 2010 DHS garnered responses from 17,087 women aged 15 - 49, achieving a response rate of 98.4%. The 2020 PMA data collected responses from 6590 women aged 15 - 49, with a response rate of 95.8%. The final sample of Long-Acting Reversible Contraceptives (LARCs) users consisted of 1502 women, including 576 women from the 2010 survey and 926 women from the 2020 survey. Results: The study demonstrates an expansion of IUD usage to include socioeconomically disadvantaged segments among LARC users. However, higher levels of education, older age, and decisions influenced by healthcare providers are correlated with the preference for IUDs over Implants. The choice of IUDs is also connected to a comprehensive understanding of contraceptive methods, suggesting potential biases in the counseling process. Conclusion: Facilitating the broader adoption of IUDs among disadvantaged groups could be achieved by improving the accessibility of IUD products and services in rural areas. Nevertheless, there should be focused initiatives to enhance access to removal services, as this factor could dissuade specific users. Further efforts are required to train healthcare providers, aiming to mitigate biases in delivering Long-Acting Reversible Contraceptives (LARCs). Providers should provide impartial counseling, irrespective of the selected type of LARC.

Efficacy and Tolerability of Long-Acting Injectable Formulation of Nalmefene (Nalmefene Consta 393.1 mg) for Opioid Relapse Prevention: A Multicentre, Open-Label, Randomised Controlled Trial

Objective: To determine the efficacy and tolerability of a long-acting intramuscular formulation of Nalmefene (Nalmefene Consta 393.1 mg) for the treatment of opioid-dependent patients. Design, Setting, and Participants: A 12 weeks, open-label, randomised controlled trial conducted between June 2009-July 2011, at 14 Hospital-based drug clinics, in the 12 countries. Participants were 18 years or older, had Diagnostic and Statistical Manual of Mental Disorders-5 opioid use disorder. Of the 3200 individuals screened, 3000 (93.7%) adults were randomized 1500 participants to receive injections of Long-acting depot formulations ofNalmefene (Nalmefene Consta 393.1 mg) given intramuscularly once in 12 weeks and 1500participants to receive extended-release Naltrexone (Vivitrol 380 mg), administered intramuscularly every fourth week for 12 weeks. Main Outcomes and Measures: The primary endpoints (protocol) were: Confirmed Opioid abstinence (percentage i.e. the number of patients who achieved complete abstinence during week 12). Confirmed abstinence or “opioid-free” was defined as a negative urine drug test for opioids and no self-reported opioid use. Weeks 1 - 4 were omitted from this endpoint to allow for stabilization of abstinence. Secondary end points included a number of days in treatment, treatment retention and craving. The study also investigated, on 275 participants, degree and time course of mu-opioid receptor occupancy following single doses of Nalmefene extended-release injection (Nalmefene Consta 393.1 mg) as well as the plasma concentration of Nalmefene and Nalmefene-3-O-glucuronide. Safety was assessed by adverse event reporting. Results: Of 3000 participants, mean (SD) age was 27.1 (±4.8) years and 831 (27.7%) were women. 1500 individuals were randomized to receive injections of Long-acting depot formulations of Nalmefene (Nalmefene Consta 393.1 mg) and 1500 to receive injections of extended-release Naltrexone (Vivitrol 380 mg);2088 participants (69.6.0%) completed the trial. Primary endpoints: Confirmed Opioid Abstinence: Complete abstinence was sustained by 86% (n = 1290) of Nalmefene patients (patients treated with Nalmefene Consta 393.1 mg, long-acting depot formulations) compared with 43% (n = 645) of patients treated with extended-release Naltrexone 380 mg (Vivitrol), during weeks 5 - 12 (χ2 = 672.34, P Secondary Endpoint: Craving: A statistically and clinically significant reduction in opioid craving was observed with Nalmefene (Nalmefene Consta 393.1 mg, long-acting depot formulations) vs. Naltrexone (extended-release Naltrexone, Vivitrol 380 mg) by week 4 (P =0.0048), which persisted every week through 12 (P < 0.0001). Patients given Nalmefene (Nalmefene Consta 393.1 mg, long-acting depot formulations) had a 75% decrease in craving from baseline to week 12. Patients given a Naltrexone (extended-release Naltrexone, Vivitrol 380 mg) had a 3% increase in craving from baseline to week 12 (Mean change in self-reporting craving). Secondary Endpoint: Treatment Retention: Long-acting intramuscular formulation of Nalmefene (Nalmefene Consta 393.1 mg) helped significantly more patients complete 12 weeks treatment (n = 1245, 83%) compared with extended-release Naltrexone (Vivitrol 380 mg) (n = 570, 38%) (χ2 = 635.53, P < 0.0001). Patients on long-acting intramuscular formulation of Nalmefene (Nalmefene Consta 393.1 mg) had longer treatment retention than patients on extended-release Naltrexone (Vivitrol 380 mg). Concentrations of Nalmefene and Nalmefene-3-O-Glucuronide in Plasma: Analyses were made of 275 study sample. There was no statistically significant difference for plasma nalmefene concentrations between days 2 and 84 (p = 0.416). The plasma concentration of Nalmefene were 20.3 and 28.5 ng/ml and concentrations of nalmefene-3-O-glucuronide were 2.1 and 4.1 ng/ml, respectively. Plasma levels of Nalmefene remained above 20 ng/ml for approximately 12 weeks after administration of Nalmefene, long-acting depot formulations (Nalmefene Consta 393.1 mg). PET Assessments: Very high mu-opioid receptor occupancy by Nalmefene was detected 1 day after treatments at which time point the occupancy was 100.0% after Nalmefene injection (Nalmefene Consta 393.1 mg). Nalmefene Consta 393.1 mg injection (long-acting intramuscular formulation of Nalmefene) led to a very high occupancy ofmu-opioid receptors in all brain areas examined;the thalamus, caudate nucleus, and frontal cortex. Depending on the brain area mu-opioid receptor occupancy varied between 83.0% and 85.8% 84 days after dosing. Adverse Reactions: Adverse events were similar in opioid-dependent patients treated with long-acting intramuscular formulation of Nalmefene (Nalmefene Consta 393.1 mg) vs. patients treated with extended-release Naltrexone (Vivitrol 380 mg). Conclusions and Relevance: Long-acting depot formulations of Nalmefene (Nalmefene Consta 393.1 mg) was more effective then extended-release Naltrexone (Vivitrol 380 mg) in maintaining short-term abstinence from heroin and should be considered as a treatment option for opioid-dependent individuals.

A Multicenter, Randomized, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Long-Acting Injectable Formulation of Vanoxerine (Vanoxerine Consta 394.2 mg) for Cocaine Relapse Prevention

Objective: To determine the efficacy and tolerability of a long-acting intramuscular formulation of Vanoxerine (Vanoxerine Consta 394.2 mg) for treatment of cocaine-dependent patients. Design, Setting, and Participants: A 12-week, A multicenter, randomized, placebo-controlled trial conducted between June 2009-July 2011, at 17 Hospital-based drug clinics, in the 15 countries. Participants were 18 years or older, had Diagnostic and Statistical Manual of Mental Disorders-5 cocaine use disorder. Of the 2800 patients who were assessed between March 10, 2009 to August 10, 2010, 2600 (93%) were eligible and willing to take part in the trial and were enrolled: 1300 were randomly assigned to receive injections of Long-acting depot formulations of Vanoxerine (Vanoxerine Consta 394.2 mg) given intramuscularly once in 12 weeks and 1300 to receive Placebo injections, given intramuscularly once in 12 weeks. Only 100 of 2800 patients (3.6%) did not meet the inclusion criteria. Main Outcomes and Measures: The primary endpoints (protocol) were: Confirmed Cocaine abstinence (percentage i.e. the number of patients who achieved complete abstinence during 12 weeks). Confirmed abstinence or “cocaine-free” was defined as a negative urine drug test for cocaines and no self-reported cocaine use. Secondary end points included a number of days in treatment, treatment retention and craving. The study also investigated, on 275 participants, degree and time course of Central Dopamine transporter receptor occupancy following single doses of long-acting intramuscular formulation of Vanoxerine (Vanoxerine Consta 394.2 mg) as well as the plasma concentration of Vanoxerine and 17-hydroxyl Vanoxerine. Safety was assessed by adverse event reporting. Results: Of 2600 participants, mean (SD) age was 28.5 (±5.5) years and 598 (23%) were women. 1300 individuals were randomized to receive injections of Long-acting depot formulations of Vanoxerine (Vanoxerine Consta 394.2 mg) and 1300 to receive injections of Placebo. 1417 participants (54.5.0%) completed the trial. Primary Endpoints: Confirmed Cocaine Abstinence: Complete abstinence was sustained by 72% (n = 936) of Vanoxerine patients (patients treated with Vanoxerine Consta 394.2 mg, long-acting depot formulations) compared with 37% (n = 481) of patients treated with Placebo, during weeks 5 - 12. The difference was significant as evaluated using a Chi-square test (χ2 = 672.34, P < 0.0001). Secondary Endpoint: Craving: A statistically and clinically significant reduction in cocaine craving was observed with Vanoxerine (Vanoxerine Consta 394.2 mg, long-acting depot formulations) vs. Placeboby week 4 (P = 0.0048), which persisted every week through 12 (P < 0.0001). Patients given Vanoxerine (Vanoxerine Consta 394.2 mg, long-acting depot formulations) had a 87% decrease in craving from baseline to 12th week. Patients given a Placebo had a 2% increase in craving from baseline to 12th week. Secondary Endpoint: Treatment Retention: Long-acting intramuscular formulation of Vanoxerine (Vanoxerine Consta 394.2 mg) helped significantly more patients complete 12 weeks treatment (n = 936, 72%) compared with Placebo (n = 481, 37%) (χ2 = 635.53, P < 0.0001). Patients on the long-acting intramuscular formulation of Vanoxerine (Vanoxerine Consta 394.2 mg) had longer treatment retention than patients on Placebo. Concentrations of Vanoxerine and 17-Hydroxyl Vanoxerinein Plasma: Analyses were made of 275 study samples. There was no statistically significant difference for plasma Vanoxerine concentrations between days 2 and 84 (p = 0.416). The plasma concentration of Vanoxerine were 70.4 and 94.3 ng/ml and concentrations of 17-hydroxyl Vanoxerine were 10.5 and 13.2 ng/ml, respectively. Plasma levels of Vanoxerine remained above 70 ng/ml for approximately 12 weeks after administration of Vanoxerine, long-acting depot formulations (Vanoxerine Consta 394.2 mg). PET Assessments: Very high central dopamine transporter receptor occupancy by Vanoxerine was detected 1 day after treatments, at which time point the occupancy was 100.0% after Vanoxerine injection (Vanoxerine Consta 394.2 mg). At days 7, 28, 56 and 84 post-Vanoxerine Consta 394.2 mg administration, occupancies were 95% to 79%. Vanoxerine Consta 394.2 mg injection (long-acting intramuscular formulation of Vanoxerine) led to very high occupancy of Central Dopamine transporter receptors in all brain areas examined;nucleus accumbens, caudate nucleus and putamen. Depending on the brain area Central Dopamine transporter receptor occupancy varied between 95.0% and 79% at days 7, 28, 56 and 84 after dosing. High Vanoxerine occupancy (77%) persisted at 12 weeks after the dosings. Adverse Reactions: Adverse events were similar in cocaine-dependent patients treated with the long-acting intramuscular formulation of Vanoxerine (Vanoxerine Consta 394.2 mg) vs. patients treated with Placebo. Conclusions and Relevance: Long-acting depot formulations of Vanoxerine (Vanoxerine Consta 394.2 mg) were more effective than Placebo injection in maintaining short-term abstinence from cocaine and should be considered as a treatment option for cocaine-dependent individuals.

Westinghouse Electric Corp.plans long-term investment in China

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THE NINTH FIVE-YEAR PLAN AND LONG-TERM TARGET BY 2010 FOR CHINA'S FOOD INDUSTRY

The"Ninth Five-Year Plan for theNational Economy and SocialDevelopment and the Long-TermTarget by the Year 2010" adopted at theFourth Session of the Eighth National People’sCongress have opened up a vast new worldfor the development of China’s food industry.The food industry should seize the opportunityto strengthen itself and speed up itsdevelopment for meeting the needs ofimproving the people’s living standards andperform well in modernized socialistconstruction.

Power generation expansion planning approach considering carbon emission constraints

Decarbonization of the power sector in China is an essential aspect of the energy transition process to achieve carbon neutrality.The power sector accounts for approximately 40%of China’s total CO_(2) emissions.Accordingly,collaborative optimization in power generation expansion planning(GEP)simultaneously considering economic,environmental,and technological concerns as carbon emissions is necessary.This paper proposes a collaborative mixedinteger linear programming optimization approach for GEP.This minimizes the power system’s operating cost to resolve emission concerns considering energy development strategies,flexible generation,and resource limitations constraints.This research further analyzes the advantages and disadvantages of current GEP techniques.Results show that the main determinants of new investment decisions are carbon emissions,reserve margins,resource availability,fuel consumption,and fuel price.The proposed optimization method is simulated and validated based on China’s power system data.Finally,this study provides policy recommendations on the flexible management of traditional power sources,the market-oriented mechanism of new energy sources,and the integration of new technology to support the attainment of carbon-neutral targets in the current energy transition process.

Development of ToSPACE for Pipe Wall Thinning Management in Nuclear Power Plants

A number of piping components in the secondary system of nuclear power plants are exposed to aging mechanisms such as FAC (Flow-Accelerated Corrosion), cavitation, flashing, SPE (Solid Particle Erosion), LDIE (Liquid Droplet Impingement Erosion), etc. Those mechanisms may lead to thinning, leak, or rupture of the components. Due to the pipe ruptures caused by wall thinning in Surry unit 2 of USA in 1986 and in Mihama unit 3 of Japan in 1994, the pipe wall thinning management has emerged as one of the most important issues in nuclear power plants. To manage the pipe wall thinning in the secondary system, Korea has used a foreign program since 1996. As using the foreign country’s program for long term, it was necessary to improve from the perspective of the users. Accordingly, KEPCO-E & C has started to develop the 3D-based pipe wall thinning management program (ToSPACE, Total Solution for Piping And Component Engineering management) from eight years ago, and the development was successful. This paper describes the major functions included in ToSPACE program, such as 3D-based DB (Database) buildup, development of FAC and erosion evaluation theories, UT (Ultra-sonic Test) data reliability analysis, field connection with 3D, automatic establishment of long-term inspection plan, etc. ToSPACE program was developed to allow site engineers performing the selection of inspection quantity at each refueling outage, UT data reliability analysis, UT evaluation, determination of next inspection timing, identification of the inspecting and replacing components in 3D drawings, etc., to access easily.

Market-Based Transmission Expansion Planning

The paper presents the main features of transmission expansion problem (TEP). In accord with review the aims and influencing factors are defined. The competitive behaviors of market participants, transmission losses, discrete investment costs, various operating conditions are considered in the model. The model is a mixed-integer linear programming formulation for a static TEP in the competitive environment. The presented methodology is applied to six-node system. In order to point out efficiency of the model the results obtained are compared with traditional problem solution.

Long-term Coordination of Transmission and Storage to Integrate Wind Power

A power system with a high wind power integration requires extra transmission capacity to accommodate the intermittency inherent to wind power production.Storage can smooth out this intermittency and reduce transmission requirements.This paper proposes a stochastic optimization model to coordinate the long-term planning of both transmission and storage facilities to efficiently integrate wind power.Both longterm and short-term uncertainties are considered in this model.Long-term uncertainty is described via scenarios,while shortterm uncertainty is described via operating conditions.Garver’s 6-node system and a system representing Northwest China in 2030 are used to illustrate the proposed model.Results indicate that storage reduces transmission requirement and the overall investment,and allows the efficient integration of wind power.

The long-term impact on the Chinese economy of an aging population

Rapid fertility decline and rising life expectancy are leading to a fast and profound aging of China＇s population. This paper will attempt to analyze the long-term economic impact of population aging. After discussing its impact on employment, domestic consumption, social security programs and public finance, rural-urban migration and urbanization, the Chinese economy＇s comparative advantage in international markets and structural change in industry, we suggest alternative policies of gradually relaxing the fertility control policy, assigning higher priority to the development of human capital, raising the compulsory retirement age, and improving the equity and efficiency of social security programs.

Application of Mathematial-Simulated Model Setup for Eudcational Planning

In this paper, the principle and methods of system engineering are applied to studying the problem of educational long-term development planning. a complete mathematical-simulated model setup is adopted to describe the internal regularity between educational system and social economic macrosystem. and then. a set of effective methods are put forward to carry out educational planning. This model has been actually appliedcation in the project of educational planning research in Chongqing region,

Multifactor-influenced Reliability-constrained Reserve Expansion of Integrated Electricity-gas Systems Considering Failure Propagation

With the increasing interactions between natural gas systems(NGS)and power systems,component failures in one system may propagate to the other one,threatening reliable operation of the whole system.Due to neglect of such cross-sectorial failure propagation in integrated electricity-gas systems(IEGSs),traditional economy-oriented reserve expansion models may lead to unreasonable planning results.In order to address this,an innovative reserve expansion model is proposed to determine the allocation of energy production components through the harmonization between costs and reliability.First,novel multifactor-influenced reliability indices are defined con-sidering synthetic effects of multiple uncertainties,including failure propagation,load uncertainties and generation failures.In reliability index formulation,contribution of failure propagation on system reliability is analytically expressed.To avoid high computational complexity,the fuzzy set theory is combined with conventional methods,e.g.,Monte-Carlo simulation technique to reduce numerous contingency states.Sampled contingency states are aggregated into several clusters represented by a fuzzy number.To effectively solve the planning model,a decomposition approach is introduced and applied to decompose the original problem into a master problem and two correlated reliability sub-problems.Numerical studies show the proposed model can plan reasonable reserves to guarantee reliability levels of IEGSs considering failure propagation.