Oasis Charitable Trust

Abstract Study question Is the cumulative live birth rate (CLBR) improved by the correction of Cesarean section scar defect (uterine isthmocele) in cases of secondary infertility? Summary answer CLBR in women with isthmocele is not affected by presence of intra-uterine fluid or correction of the defect, in FET cycles. What is known already The recent metanalysis by Busnelli et al 2024 says that LBR is improved following isthmocele repair (either hysteroscopic or laparoscopic)- But CLBR has not been considered in this study and it has a very low quality of evidence. The recent meta-analysis by Vitagliano 2024 and Busnelli 2024 says that isthmocele with intrauterine fluid negatively affects the live birth outcomes in IVF. However CLBR has not been considered in this studies. The retrospective study by Diao et al 2021 says that isthmocele impairs the chances of subsequent pregnancy but the outcomes are unaffected by the presence or absence of intrauterine fluid. Study design, size, duration Retrospective observational single centre study from 2018 to 2024 with a study population of 172. Women with secondary infertility undergoing IVF with uterine isthmocele (n = 72) were the test group and women with previous LSCS without isthmocele undergoing IVF (n = 100) were the control group. Exclusion criteria- Fresh embryo transfer Hydrosalpinx Uterine anamolies Fibroid uterus Endometriosis Previous hysterotomy <22weeks of gestation Patients with no blastocysts available for transfer Participants/materials, setting, methods Controlled ovarian stimulation was done according to hospital’s SOP and freeze all policy adopted. Isthmocele was defined as triangular defect in lower uterine segment of about>/=0.2cm at the site of previous cesarean section scar on transvaginal ultrasonography. When there was persistent intrauterine fluid despite aspiration, isthmocele repair was done. If there was no fluid following aspiration, Frozen embryo transfer (FET) was done. Main results and the role of chance Baseline variables were comparable between both the arms. Endometrial thickness at the time of embryo transfer was more in the control group (9.42+/-1.81 vs 10.55+/-2.20, p = <0.01). The number, grade and day of blastocyst transferred was similar in both groups. Implantation Rate (IR), Clinical Pregnancy Rate (CPR), Miscarriage Rate (MR), Multiple Pregnancy Rate (MPR), Cumulative Live Birth Rate (CLBR) were assessed. Outcomes between Isthmocele(n = 72) and Previous LSCS(n = 100) IR 52(71.2%) VS 67(68.4%)p=0.34 CPR 52(71.2%) VS 67(67.7%)P=0.61 MR 4(5.4%) VS 5(5.1%)P=0.91 MPR 12(16.2%) VS 10(10.1%)P=0.23 CLBR 50(72.5%) VS 63(70.8%) P = 0.07 In women with isthmocele compared to previous LSCS without isthmocele, CLBR was comparable. Outcomes between isthmocele repair done(n = 23) vs not done(n = 49) Intrauterine-fluid– 13(56.4%) VS 22(44.9%)p=0.71 IR-17(73.9%) VS 35(71.4%)p=0.74 CPR-17(73.9%) VS 35(71.4%)p=0.82 MR-1(4.3%) VS 3(6%)p=0.77 MPR-2(8.7%) VS 10(20%)p=0.22 CLBR-16(72.7%) VS 34(72.3%)p=0.97 Therefore, correction of isthmocele did not significantly affect the CLBR and intrauterine-fluid was seen in 56.4% women following repair. Outcomes between isthmocele repair done(n = 23) vs previous LSCS(n = 100) CLBR- 16(72.7%) VS 63(70.8%) P = 0.85 Outcome between isthmocele repair not done(n = 49) vs previous LSCS(n = 100) CLBR-34(72.3%) VS 63(70.8%) P = 0.84 CLBR was not affected whether isthmocele repair has been carried out or not, when compared to women with previous LSCS without isthmocele. Limitations, reasons for caution 1. Relatively smaller sample size. 2. Retrospective design. 3. Details of the cesarean section are not considered. 4. Outcomes were not compared to those with previous normal vaginal delivery but earlier meta-analysis by Vitagliano 2023 says IVF outcomes were unaffected by LSCS when compared to Normal vaginal delivery Wider implications of the findings It is reassuring that isthmocele does not affect the IVF outcomes including CLBR regardless of the presence or absence of intrauterine fluid and correction or non-correction of isthmocele. Further RCTs with larger sample size are warranted to study outcomes of intrauterine fluid in FET cycles with isthmocele. Trial registration number No

Résumé Ouverte en septembre 2017, la Demeure de l’Oasis est un lieu où vivent jusqu’à cinq personnes en situation de handicap psychique. Elle apporte à l’éventail d’hébergements collectifs du secteur une solution innovante qui tente de déjouer les travers de l’institution en s’appuyant sur l’« autogestion accompagnée » du lieu. Les résident(e)s et accompagnant(e)s y sont reconnu(e)s comme acteurs du lieu et décideurs de son fonctionnement.

Assiut University Farm, in El-Kharga

AimLike many urban boroughs, since 2007, there has been a rise in serious gang and youth violence. An innovative partnership project has been launched between the local district general hospital, borough council (A) and local youth charity tackling youth-on-youth and gang related violence. Vulnerable young people, under the age of 18, have been identified and offered dedicated support from the youth worker team. This has only been instigated for borough A and young people from the adjacent borough B have no such provision.The aim of this project was to quantify the scale of youth-on-youth violence resulting in Emergency Deparment (ED) attendance and to subsequently evaluate the number of young people who have access to youth worker services.MethodAll ED attendances for young people aged 12–24 were identified from 11/9/14–5/12/14. This data was further analysed to compare attendances for borough A and B. Patients younger than 18, eligible for youth worker input, attending the ED secondary to youth-on-youth violence from 1/10/14 to 1/12/14 were identified.ResultsFrom 11/9/14–5/12/14:× 42,306 casualty (CAS) cards manually searched4% (1,522 cards) – secondary to injury10% (156 cards) – injuries categorised as assault, in patients aged 12–24From 1/10/14 to 1/12/14:× 52 attendances secondary to youth-on-youth violence, aged under 1841 male: 11 female× See graph:1 for age breakdown2 for attendance by borough3 for outline cost of attendancesMany of this cohort attended multiple times with previous injuries, up to 11 attendances in preceding years, suggesting that gang violence was a significant part of their lives. G302(P) Figure 1ConclusionsThe burden of youth-on-youth violence is evident. As highlighted, 52% from borough B had no available youth support. On presentation of this data, the local mayor ‘Policing and Crime Office’ have awarded a grant for the commissioning of a youth worker for borough B, enabling them to work 3 days a week to meet the needs of these vulnerable young people. G302(P) Figure 2 G302(P) Figure 3

To determine the seroprevalence of selected orthobunyaviruses in livestock in the Yucatan Peninsula of Mexico, a serologic investigation was performed using serum samples from 256 domestic animals (182 horses, 31 sheep, 1 dog, 37 chickens, and 5 turkeys). All serum samples were examined by plaque reduction neutralization test using Cache Valley virus (CVV), Cholul virus (CHLV), South River virus (SOURV), Kairi virus, Maguari virus, and Wyeomyia virus. Of the 182 horses, 60 (33.0%) were seropositive for CHLV, 48 (26.4%) were seropositive for CVV, 1 (0.5%) was seropositive for SOURV, 60 (33.0%) had antibodies to an undetermined orthobunyavirus, and 13 (7.1%) were negative for orthobunyavirus-specific antibody. Of the 31 sheep, 6 (19.3%) were seropositive for CHLV, 3 (9.7%) were seropositive for CVV, 4 (12.9%) were seropositive for SOURV, 16 (51.6%) had antibodies to an undetermined orthobunyavirus, and 2 (6.5%) were negative for orthobunyavirus-specific antibody. The single dog was seropositive for SOURV. Four (11%) chickens had antibodies to an undetermined orthobunyavirus, and 1 (20%) turkey was seropositive for CHLV. These data indicate that orthobunyaviruses commonly infect livestock in the Yucatan Peninsula.

. This means, in effect, in the way of the Gospel, for it was there that , Gandhi found the ultimate source of his inspiration. Since then others have attempted to follow this way, such as Martin Luther King and Lech Wal'<rsa. On the basis of their experience and the freedom movements which they inspired, we can speak of a of liberation. This has nothing to do with a theology of liberation in the terms of the well-known developments in Latin America, where the attempt is made to justify the use of violence in the struggle for social and political freedom by appealing to the Gospel. It is rather the theology of liberation of which Pope John Paul 11 spoke during the general audience on 21 February 1979 after his return from Mexico: