A bioengineered nisin derivative, M21A, in combination with food grade additives eradicates biofilms of Listeria monocytogenes

The burden of foodborne disease has large economic and social consequences worldwide. Despite strict regulations, a number of pathogens persist within the food environment, which is greatly contributed to by a build-up of resistance mechanisms and also through the formation of biofilms. Biofilms have been shown to be highly resistant to a number of antimicrobials and can be extremely difficult to remove once they are established. In parallel, the growing concern of consumers regarding the use of chemically derived antimicrobials within food has led to a drive toward more natural products. As a consequence, the use of naturally derived antimicrobials has become of particular interest. In this study we investigated the efficacy of nisin A and its bioengineered derivative M21A in combination with food grade additives to treat biofilms of a representative foodborne disease isolate of Listeria monocytogenes. Investigations revealed the enhanced antimicrobial effects, in liquid culture, of M21A in combination with citric acid or cinnamaldehyde over its wild type nisin A counterpart. Subsequently, an investigation was conducted into the effects of these combinations on an established biofilm of the same strain. Nisin M21A (0.1 μg/ml) alone or in combination with cinnamaldehyde (35 μg/ml) or citric acid (175 μg/ml) performed significantly better than combinations involving nisin A. All combinations of M21A with either citric acid or cinnamaldehyde eradicated the L. monocytogenes biofilm (in relation to a non-biofilm control). We conclude that M21A in combination with available food additives could further enhance the antimicrobial treatment of biofilms within the food industry, simply by substituting nisin A with M21A in current commercial products such as Nisaplin® (Danisco, DuPont).

Photonic packaging: transforming silicon photonic integrated circuits into photonic devices

Dedicated multi-project wafer (MPW) runs for photonic integrated circuits (PICs) from Si foundries mean that researchers and small-to-medium enterprises (SMEs) can now afford to design and fabricate Si photonic chips. While these bare Si-PICs are adequate for testing new device and circuit designs on a probe-station, they cannot be developed into prototype devices, or tested outside of the laboratory, without first packaging them into a durable module. Photonic packaging of PICs is significantly more challenging, and currently orders of magnitude more expensive, than electronic packaging, because it calls for robust micron-level alignment of optical components, precise real-time temperature control, and often a high degree of vertical and horizontal electrical integration. Photonic packaging is perhaps the most significant bottleneck in the development of commercially relevant integrated photonic devices. This article describes how the key optical, electrical, and thermal requirements of Si-PIC packaging can be met, and what further progress is needed before industrial scale-up can be achieved.

Saccharomyces cerevisiae in the production of whisk(e)y

Whisky is a major global distilled spirit beverage. Whiskies are produced from cereal starches that are saccharified, fermented and distilled prior to spirit maturation. The strain of Saccharomyces cerevisiae employed in whisky fermentations is crucially important not only in terms of ethanol yields, but also for production of minor yeast metabolites which collectively contribute to development of spirit flavour and aroma characteristics. Distillers must therefore pay very careful attention to the strain of yeast exploited to ensure consistency of fermentation performance and spirit congener profiles. In the Scotch whisky industry, initiatives to address sustainability issues facing the industry (for example, reduced energy and water usage) have resulted in a growing awareness regarding criteria for selecting new distilling yeasts with improved efficiency. For example, there is now a desire for Scotch whisky distilling yeasts to perform under more challenging conditions such as high gravity wort fermentations. This article highlights the important roles of S. cerevisiae strains in whisky production and describes key fermentation performance attributes sought in distiller's yeast, such as high alcohol yields, stress tolerance and desirable congener profiles. We hope that the information herein will be useful for whisky producers and yeast suppliers in selecting new distilling strains of S. cerevisiae, and for the scientific community to stimulate further research in this area.

Development of an ecotoxicological protocol for the deep-sea fauna using the hydrothermal vent shrimp Rimicaris exoculata

In light of deep-sea mining industry development, particularly interested in massive-sulphide deposits enriched in metals with high commercial value, efforts are increasing to better understand potential environmental impacts to local fauna. The aim of this study was to assess the natural background levels of biomarkers in the hydrothermal vent shrimp Rimicaris exoculata and their responses to copper exposure at in situ pressure (30MPa) as well as the effects of depressurization and pressurization of the high-pressure aquarium IPOCAMP. R. exoculata were collected from the chimney walls of the hydrothermal vent site TAG (Mid Atlantic Ridge) at 3630m depth during the BICOSE cruise in 2014. Tissue metal accumulation was quantified in different tissues (gills, hepatopancreas and muscle) and a battery of biomarkers was measured: metal exposure (metallothioneins), oxidative stress (catalase, superoxide dismutase, glutathione-S-transferase and glutathione peroxidase) and oxidative damage (lipid peroxidation). Data show a higher concentration of Cu in the hepatopancreas and a slight increase in the gills after incubations (for both exposed groups). Significant induction of metallothioneins was observed in the gills of shrimps exposed to 4μM of Cu compared to the control group. Moreover, activities of enzymes were detected for the in situ group, showing a background protection against metal toxicity. Results suggest that the proposed method, including a physiologically critical step of pressurizing and depressurizing the test chamber to enable the seawater exchange during exposure to contaminants, is not affecting metal accumulation and biomarkers response and may prove a useful method to assess toxicity of contaminants in deep-sea species.

Criteri e strumenti per l'applicazione dell'H-BIM. La gestione digitalizzata dei processi tra teoria e prassi

La ricerca si pone l’obiettivo di analizzare strumenti e metodi per l’applicazione dell’H-BIM comprendendone le criticità e fornendo soluzioni utili in questo campo. Al contempo la finalità non è circoscrivibile alla semplice produzione di modelli 3D semanticamente strutturati e parametrici a partire da una nuvola di punti ottenuta con un rilievo digitale, ma si propone di definire i criteri e le metodiche di applicazione delle H-BIM all’interno dell’intero processo. L’impostazione metodologica scelta prevede un processo che parte dalla conoscenza dello stato dell’arte in tema di H-BIM con lo studio dell’attuale normativa in materia e i casi studio di maggior rilevanza. Si è condotta una revisione critica completa della letteratura in merito alla tecnologia BIM e H-BIM, analizzando esperienze di utilizzo della tecnologia BIM nel settore edile globale. Inoltre, al fine di promuovere soluzioni intelligenti all’interno del Facility Management è stato necessario analizzare le criticità presenti nelle procedure, rivedere i processi e i metodi per raccogliere e gestire i dati, nonché individuare le procedure adeguate per garantire il successo dell’implementazione. Sono state evidenziate le potenzialità procedurali e operative legate all’uso sistematico delle innovazioni digitali nell’ottica del Facility Management, oltre che allo studio degli strumenti di acquisizione ed elaborazione dei dati e di post-produzione. Si è proceduto al testing su casi specifici per l’analisi della fase di Scan-to-BIM, differenziati per tipologia di utilizzo, data di costruzione, proprietà e localizzazione. Il percorso seguito ha permesso di porre in luce il significato e le implicazioni dell’utilizzo del BIM nell’ambito del Facility Management, sulla base di una differenziazione delle applicazioni del modello BIM al variare delle condizioni in essere. Infine, sono state definite le conclusioni e formulate raccomandazioni riguardo al futuro utilizzo della tecnologia H-BIM nel settore delle costruzioni. In particolare, definendo l’emergente frontiera del Digital Twin, quale veicolo necessario nel futuro della Costruzione 4.0.

Applicazione di un modello bi-obiettivo per la progettazione sostenibile di sistemi produttivi riconfigurabili

Negli ultimi anni la competitività nei mercati è notevolmente cresciuta, la complessità dei prodotti industriali è considerevolmente aumentata e quest’ultimi devono ora essere accuratamente ottimizzati sotto ogni aspetto. I prodotti, oltre ad avere dei cicli di vita più brevi, sono soggetti a un’alta personalizzazione e a una domanda variabile. Per rimanere competitive, le aziende manifatturiere devono possedere nuovi tipi di sistemi di produzione che siano convenienti e molto reattivi a tutti questi cambiamenti del mercato, quali i Sistemi di produzione riconfigurabili (Reconfigurable Manufacturing System - RMS). La particolarità di tali sistemi risiede nella capacità di cambiare rapidamente le loro strutture hardware e software, aspetto che li renda idonei a soddisfare la produzione moderna. Oltre agli aspetti produttivi, l’attenzione odierna è incentrata anche sulle tematiche ambientali legate al risparmio energetico durante i processi produttivi, alla riduzione delle quantità di CO2 emesse e alla sostenibilità ambientale. L’obiettivo di questa tesi è quello di proporre un modello di ottimizzazione multi-obiettivo che tenga conto sia della minimizzazione del tempo complessivo necessario alla movimentazione dei prodotti e alla riconfigurazione delle macchine, e sia della minimizzazione del consumo energetico. Tale modello è stato applicato ad un caso studio realistico che ha permesso di individuare un trade-off tecnico-ambientale individuando la frontiera di Pareto con punto di ottimo (134.6 min; 9346.3 kWh) che si discosta del 57% dal valore trovato ottimizzando la funzione tempo, e dello 0.76% dal valore ottenuto ottimizzando la funzione energia.

Modellazione e progettazione di un sistema di tracciabilità blockchain nell’industria agroalimentare: Il caso Moncaro

Industria 4.0 ha coinvolto il settore agroalimentare introducendo nuove strategie di tracciabilità, a favore della sostenibilità e della sicurezza alimentare. L’Organizzazione Internazionale della Vigna e del Vino pone tra gli obiettivi per il 2024 la transizione digitale della filiera, così da avere una tracciabilità trasparente e affidabile. Questo fornisce un vantaggio ai produttori e ai consumatori che dispongono di maggiori informazioni quantitative e qualitative del prodotto. I sistemi di tracciabilità sono integrati nella supply chain aumentandone la resilienza; tuttavia, la maggior parte degli ERP in commercio ricostruiscono la tracciabilità a posteriori: dal codice lotto finale si ricompone tutto il processo. Per monitorare costantemente la filiera ed incrementarne la trasparenza si stanno integrando nuove tecnologie alla tracciabilità, come l’intelligenza artificiale e la blockchain. Obiettivo di questa tesi è la progettazione di un sistema di tracciabilità blockchain. Pertanto, si introduce alla tracciabilità e alla blockchain descrivendo i principali contributi in letteratura che propongono approcci e strategie, evidenziando vantaggi e sfide future. Poi, si presenta il caso Moncaro, cooperativa agricola che ha cantine e vigneti nel territorio marchigiano, analizzando il processo di vinificazione in bianco dal punto di vista del flusso fisico e informativo, rispettivamente tramite BPMN e Relationship chart. Ai fini della modellazione e della scelta dei dati da inserire in tracciabilità, si analizzano le informazioni registrate negli ERP sviluppati da Apra s.p.a., software house, di cui Moncaro fruisce. Quindi, si propone la formulazione di un algoritmo in pseudocodice che permette di collegare sequenzialmente le attività, così, da ottenere la tracciabilità real time e un’architettura che può gestire tutte le informazioni della supply chain. Infine, si è implementato uno scenario produttivo reale, mediante l’architettura di database a grafo di Neo4j AuraDB

Continual learning on nano drones

Miniaturized flying robotic platforms, called nano-drones, have the potential to revolutionize the autonomous robots industry sector thanks to their very small form factor. The nano-drones’ limited payload only allows for a sub-100mW microcontroller unit for the on-board computations. Therefore, traditional computer vision and control algorithms are too computationally expensive to be executed on board these palm-sized robots, and we are forced to rely on artificial intelligence to trade off accuracy in favor of lightweight pipelines for autonomous tasks. However, relying on deep learning exposes us to the problem of generalization since the deployment scenario of a convolutional neural network (CNN) is often composed by different visual cues and different features from those learned during training, leading to poor inference performances. Our objective is to develop and deploy and adaptation algorithm, based on the concept of latent replays, that would allow us to fine-tune a CNN to work in new and diverse deployment scenarios. To do so we start from an existing model for visual human pose estimation, called PULPFrontnet, which is used to identify the pose of a human subject in space through its 4 output variables, and we present the design of our novel adaptation algorithm, which features automatic data gathering and labeling and on-device deployment. We therefore showcase the ability of our algorithm to adapt PULP-Frontnet to new deployment scenarios, improving the R2 scores of the four network outputs, with respect to an unknown environment, from approximately [−0.2, 0.4, 0.0,−0.7] to [0.25, 0.45, 0.2, 0.1]. Finally we demonstrate how it is possible to fine-tune our neural network in real time (i.e., under 76 seconds), using the target parallel ultra-low power GAP 8 System-on-Chip on board the nano-drone, and we show how all adaptation operations can take place using less than 2mWh of energy, a small fraction of the available battery power.

Antioxidant And Antiproliferative Activities Of Methanolic Extract From A Neglected Agricultural Product: Corn Cobs.

Neglected agricultural products (NAPs) are defined as discarded material in agricultural production. Corn cobs are a major waste of agriculture maize. Here, a methanolic extract from corn cobs (MEC) was obtained. MEC contains phenolic compounds, protein, carbohydrates (1.4:0.001:0.001). We evaluated the in vitro and in vivo antioxidant potential of MEC. Furthermore, its antiproliferative property against tumor cells was assessed through MTT assays and proteins related to apoptosis in tumor cells were examined by western blot. MEC showed no hydroxyl radical scavenger capacity, but it showed antioxidant activity in Total Antioxidant Capacity and DPPH scavenger ability assays. MEC showed higher Reducing Power than ascorbic acid and exhibited high Superoxide Scavenging activity. In tumor cell culture, MEC increased catalase, metallothionein and superoxide dismutase expression in accordance with the antioxidant tests. In vivo antioxidant test, MEC restored SOD and CAT, decreased malondialdehyde activities and showed high Trolox Equivalent Antioxidant Capacity in animals treated with CCl4. Furthermore, MEC decreased HeLa cells viability by apoptosis due an increase of Bax/Bcl-2 ratio, caspase 3 active. Protein kinase C expression increased was also detected in treated tumor cells. Thus, our findings pointed out the biotechnological potential of corn cobs as a source of molecules with pharmacological activity.

What Is The Best Indication For Single-incision Ophira Mini Sling? Insights From A 2-year Follow-up International Multicentric Study.

The Ophira Mini Sling System involves anchoring a midurethral, low-tension tape to the obturator internus muscles bilaterally at the level of the tendinous arc. Success rates in different subsets of patients are still to be defined. This work aims to identify which factors influence the 2-year outcomes of this treatment. Analysis was based on data from a multicenter study. Endpoints for analysis included objective measurements: 1-h pad-weight (PWT), and cough stress test (CST), and questionnaires: International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and Urinary Distress Inventory (UDI)-6. A logistic regression analysis evaluated possible risk factors for failure. In all, 124 female patients with stress urinary incontinence (SUI) underwent treatment with the Ophira procedure. All patients completed 1 year of follow-up, and 95 complied with the 2-year evaluation. Longitudinal analysis showed no significant differences between results at 1 and 2 years. The 2-year overall objective results were 81 (85.3%) patients dry, six (6.3%) improved, and eight (8.4%) incontinent. A multivariate analysis revealed that previous anti-incontinence surgery was the only factor that significantly influenced surgical outcomes. Two years after treatment, women with previous failed surgeries had an odds ratio (OR) for treatment failure (based on PWT) of 4.0 [95% confidence interval (CI) 1.02-15.57). The Ophira procedure is an effective option for SUI treatment, with durable good results. Previous surgeries were identified as the only significant risk factor, though previously operated patients showed an acceptable success rate.

Effects Of Therapeutic Approach On The Neonatal Evolution Of Very Low Birth Weight Infants With Patent Ductus Arteriosus.

To analyze the effects of treatment approach on the outcomes of newborns (birth weight [BW] < 1,000 g) with patent ductus arteriosus (PDA), from the Brazilian Neonatal Research Network (BNRN) on: death, bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH III/IV), retinopathy of prematurity requiring surgical (ROPsur), necrotizing enterocolitis requiring surgery (NECsur), and death/BPD. This was a multicentric, cohort study, retrospective data collection, including newborns (BW < 1000 g) with gestational age (GA) < 33 weeks and echocardiographic diagnosis of PDA, from 16 neonatal units of the BNRN from January 1, 2010 to Dec 31, 2011. Newborns who died or were transferred until the third day of life, and those with presence of congenital malformation or infection were excluded. Groups: G1 - conservative approach (without treatment), G2 - pharmacologic (indomethacin or ibuprofen), G3 - surgical ligation (independent of previous treatment). Factors analyzed: antenatal corticosteroid, cesarean section, BW, GA, 5 min. Apgar score < 4, male gender, Score for Neonatal Acute Physiology Perinatal Extension (SNAPPE II), respiratory distress syndrome (RDS), late sepsis (LS), mechanical ventilation (MV), surfactant (< 2 h of life), and time of MV. death, O2 dependence at 36 weeks (BPD36wks), IVH III/IV, ROPsur, NECsur, and death/BPD36wks. Student's t-test, chi-squared test, or Fisher's exact test; Odds ratio (95% CI); logistic binary regression and backward stepwise multiple regression. Software: MedCalc (Medical Calculator) software, version 12.1.4.0. p-values < 0.05 were considered statistically significant. 1,097 newborns were selected and 494 newborns were included: G1 - 187 (37.8%), G2 - 205 (41.5%), and G3 - 102 (20.6%). The highest mortality was observed in G1 (51.3%) and the lowest in G3 (14.7%). The highest frequencies of BPD36wks (70.6%) and ROPsur were observed in G3 (23.5%). The lowest occurrence of death/BPD36wks occurred in G2 (58.0%). Pharmacological (OR 0.29; 95% CI: 0.14-0.62) and conservative (OR 0.34; 95% CI: 0.14-0.79) treatments were protective for the outcome death/BPD36wks. The conservative approach of PDA was associated to high mortality, the surgical approach to the occurrence of BPD36wks and ROPsur, and the pharmacological treatment was protective for the outcome death/BPD36wks.

Estimated Disability-adjusted Life Years Averted By Long-term Provision Of Long Acting Contraceptive Methods In A Brazilian Clinic.

What is the contribution of the provision, at no cost for users, of long acting reversible contraceptive methods (LARC; copper intrauterine device [IUD], the levonorgestrel-releasing intrauterine system [LNG-IUS], contraceptive implants and depot-medroxyprogesterone [DMPA] injection) towards the disability-adjusted life years (DALY) averted through a Brazilian university-based clinic established over 30 years ago. Over the last 10 years of evaluation, provision of LARC methods and DMPA by the clinic are estimated to have contributed to DALY averted by between 37 and 60 maternal deaths, 315-424 child mortalities, 634-853 combined maternal morbidity and mortality and child mortality, and 1056-1412 unsafe abortions averted. LARC methods are associated with a high contraceptive effectiveness when compared with contraceptive methods which need frequent attention; perhaps because LARC methods are independent of individual or couple compliance. However, in general previous studies have evaluated contraceptive methods during clinical studies over a short period of time, or not more than 10 years. Furthermore, information regarding the estimation of the DALY averted is scarce. We reviewed 50 004 medical charts from women who consulted for the first time looking for a contraceptive method over the period from 2 January 1980 through 31 December 2012. Women who consulted at the Department of Obstetrics and Gynaecology, University of Campinas, Brazil were new users and users switching contraceptive, including the copper IUD (n = 13 826), the LNG-IUS (n = 1525), implants (n = 277) and DMPA (n = 9387). Estimation of the DALY averted included maternal morbidity and mortality, child mortality and unsafe abortions averted. We obtained 29 416 contraceptive segments of use including 25 009 contraceptive segments of use from 20 821 new users or switchers to any LARC method or DMPA with at least 1 year of follow-up. The mean (± SD) age of the women at first consultation ranged from 25.3 ± 5.7 (range 12-47) years in the 1980s, to 31.9 ± 7.4 (range 16-50) years in 2010-2011. The most common contraceptive chosen at the first consultation was copper IUD (48.3, 74.5 and 64.7% in the 1980s, 1990s and 2000s, respectively). For an evaluation over 20 years, the cumulative pregnancy rates (SEM) were 0.4 (0.2), 2.8 (2.1), 4.0 (0.4) and 1.3 (0.4) for the LNG-IUS, the implants, copper IUD and DMPA, respectively and cumulative continuation rates (SEM) were 15.1 (3.7), 3.9 (1.4), 14.1 (0.6) and 7.3 (1.7) for the LNG-IUS, implants, copper IUD and DMPA, respectively (P < 0.001). Over the last 10 years of evaluation, the estimation of the contribution of the clinic through the provision of LARC methods and DMPA to DALY averted was 37-60 maternal deaths; between 315 and 424 child mortalities; combined maternal morbidity and mortality and child mortality of between 634 and 853, and 1056-1412 unsafe abortions averted. The main limitations are the number of women who never returned to the clinic (overall 14% among the four methods under evaluation); consequently the pregnancy rate could be different. Other limitations include the analysis of two kinds of copper IUD and two kinds of contraceptive implants as the same IUD or implant, and the low number of users of implants. In addition, the DALY calculation relies on a number of estimates, which may vary in different parts of the world. LARC methods and DMPA are highly effective and women who were well-counselled used these methods for a long time. The benefit of averting maternal morbidity and mortality, child mortality, and unsafe abortions is an example to health policy makers to implement more family planning programmes and to offer contraceptive methods, mainly LARC and DMPA, at no cost or at affordable cost for the underprivileged population. This study received partial financial support from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), grant # 2012/12810-4 and from the National Research Council (CNPq), grant #573747/2008-3. B.F.B., M.P.G., and V.M.C. were fellows from the scientific initiation programme from FAPESP. Since the year 2001, all the TCu380A IUD were donated by Injeflex, São Paulo, Brazil, and from the year 2006 all the LNG-IUS were donated by the International Contraceptive Access Foundation (ICA), Turku, Finland. Both donations are as unrestricted grants. The authors declare that there are no conflicts of interest associated with this study.

Atomic Charge Transfer-counter Polarization Effects Determine Infrared Ch Intensities Of Hydrocarbons: A Quantum Theory Of Atoms In Molecules Model.

Atomic charge transfer-counter polarization effects determine most of the infrared fundamental CH intensities of simple hydrocarbons, methane, ethylene, ethane, propyne, cyclopropane and allene. The quantum theory of atoms in molecules/charge-charge flux-dipole flux model predicted the values of 30 CH intensities ranging from 0 to 123 km mol(-1) with a root mean square (rms) error of only 4.2 km mol(-1) without including a specific equilibrium atomic charge term. Sums of the contributions from terms involving charge flux and/or dipole flux averaged 20.3 km mol(-1), about ten times larger than the average charge contribution of 2.0 km mol(-1). The only notable exceptions are the CH stretching and bending intensities of acetylene and two of the propyne vibrations for hydrogens bound to sp hybridized carbon atoms. Calculations were carried out at four quantum levels, MP2/6-311++G(3d,3p), MP2/cc-pVTZ, QCISD/6-311++G(3d,3p) and QCISD/cc-pVTZ. The results calculated at the QCISD level are the most accurate among the four with root mean square errors of 4.7 and 5.0 km mol(-1) for the 6-311++G(3d,3p) and cc-pVTZ basis sets. These values are close to the estimated aggregate experimental error of the hydrocarbon intensities, 4.0 km mol(-1). The atomic charge transfer-counter polarization effect is much larger than the charge effect for the results of all four quantum levels. Charge transfer-counter polarization effects are expected to also be important in vibrations of more polar molecules for which equilibrium charge contributions can be large.

Onset Of Hypertension During Pregnancy Is Associated With Long-term Worse Blood Pressure Control And Adverse Cardiac Remodeling.

Up to 20% of women with hypertensive pregnancy disorders might persist with chronic hypertension. This study compared clinical and echocardiographic features between women whose hypertension began as hypertensive pregnancy disorders (PH group) and women whose diagnosis of hypertension did not occur during pregnancy (NPH group). Fifty PH and 100 NPH women were cross-sectionally evaluated by clinical, laboratory, and echocardiography analysis, and the groups were matched by duration of hypertension. PH exhibited lower age (46.6 ± 1.4 vs. 65.3 ± 1.1 years; P < .001), but higher systolic (159.8 ± 3.9 vs. 148.0 ± 2.5 mm Hg; P = .009) and diastolic (97.1 ± 2.4 vs. 80.9 ± 1.3 mm Hg; P < .001) blood pressure than NPH, although used more antihypertensive classes (3.4 ± 0.2 vs. 2.6 ± 0.1; P < .001). Furthermore, PH showed higher left ventricular wall thickness and increased prevalence of concentric hypertrophy than NPH after adjusting for age and blood pressure. In conclusion, this study showed that PH may exhibit worse blood pressure control and adverse left ventricular remodeling compared with NPH.

Weight Variation In Users Of Depot-medroxyprogesterone Acetate, The Levonorgestrel-releasing Intrauterine System And A Copper Intrauterine Device For Up To Ten Years Of Use.

Data on record regarding weight variation in depot-medroxyprogesterone acetate (DMPA) and levonorgestrel-releasing intrauterine system (LNG-IUS) users are controversial. To date, no studies have yet evaluated weight variation in DMPA and LNG-IUS users in up to ten years of use compared to non-hormonal contraceptive users. A retrospective study analysed weight variations in 2138 women using uninterruptedly DMPA (150 mg intramuscularly, three-monthly; n = 714), the LNG-IUS (n = 701) or a copper-intrauterine device (Cu-IUD; n = 723). At the end of the first year of use, there was a mean weight increase of 1.3 kg, 0.7 kg and 0.2 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively, compared to weight at baseline (p < 0.0001). After ten years of use, the mean weight had risen by 6.6 kg, 4.0 and 4.9 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively. DMPA-users had gained more weight than LNG-IUS- (p = 0.0197) and than Cu-IUD users (p = 0.0294), with the latter two groups not differing significantly from each other in this respect (p = 0.5532). Users of hormonal and non-hormonal contraceptive methods gained a significant amount of weight over the years. DMPA users gained more weight over the treatment period of up to ten years than women fitted with either a LNG-IUS or a Cu-IUD.