Giving antibiotics to women in labour (whose pregnancies were at least 28 weeks along) probably reduces their risk of developing sepsis – a life-threatening condition that happens when the body overreacts to an infection.
Giving antibiotics in this way makes little or no difference to the number of babies who develop sepsis or die, and probably makes little or no difference to the number of women who die.
The evidence about the adverse (i.e. harmful, unwanted) effects of preventative antibiotics is very uncertain, so we do not know if this treatment contributes to the problem of antimicrobial resistance – when antibiotics stop being effective at fighting bacterial infections.
What is antibiotic prophylaxis, and its benefits and risks?
‘Antibiotic prophylaxis’ means giving antibiotics to prevent infection before any signs appear. This approach has shown some benefit in reducing infections in new mothers and newborn babies. However, routinely giving women preventative antibiotics during labour is controversial due to concerns about unnecessary antibiotic use and antimicrobial resistance.
What did we want to find out?
We wanted to assess the effects of giving preventative (i.e. ‘prophylactic’) antibiotics to women during labour, whose pregnancies were at least 28 weeks along (i.e. 28 weeks’ gestation). We looked at how many women and babies got infections, particularly sepsis, and how many died.
What did we do?
We searched for studies that compared prophylactic antibiotics with a placebo in pregnant women in labour after 28 weeks’ gestation. A placebo is an inactive substance that looks identical to the antibiotic but has no therapeutic effect. This allows researchers to measure the true impact of the intervention.
The studies included women planning a vaginal birth, as long as they did not have a specific medical reason to receive antibiotics (such as a planned caesarean section or a known infection).
We compared and summarised the study results, and rated our confidence in the evidence, based on factors such as study methods and sizes.
What did we find?
We identified four studies involving a total of 42,846 pregnant women. The studies were conducted in 10 countries: Bangladesh, Burkina Faso, Cameroon, the Democratic Republic of Congo, The Gambia, Guatemala, India, Kenya, Zambia, and Pakistan, all low- and middle-income countries.
Roughly half of the women received prophylactic antibiotics (a single dose by mouth), and half received a placebo.
Compared to placebo, prophylactic antibiotics:
probably reduce the number of women who develop sepsis;
probably make little or no difference to the number of women who die;
make little or no difference to the number of newborns who develop sepsis or die;
make little or no difference to the number of women who develop a perineal wound infection (an infection of the tissue between the vagina and anus);
make little or no difference to the number of babies admitted to the neonatal intensive care unit (NICU).
Only one study looked at antimicrobial resistance, and we are not confident in its evidence. The study reported short-term increases in antibiotic-resistant bacteria found in some samples (e.g. of breast milk, nasal or vaginal swabs) from women given antibiotics compared to those given placebo, but these differences disappeared by 13 months. In newborns, antimicrobial resistance was rare.
What are the limitations of the evidence?
We had moderate or high confidence in the evidence about the number of women and babies who developed infections (including sepsis) or died. As noted above, we are not confident in the evidence about antimicrobial resistance. Antimicrobial resistance patterns and antibiotic use practices vary widely, and the studies focused primarily on azithromycin, a broad-spectrum antibiotic, without evaluating other options. The long-term impact on antibiotic resistance remains very uncertain and requires further research.
Washington, D.C. — A multi-institutional team co-led by Carnegie Science’s Michael L. Wong and Caleb Scharf of the NASA Ames Research Center has received a prestigious $5 million, five-year NASA Interdisciplinary Consortia for Astrobiology Research (ICAR) grant to develop A.I. tools for enhancing the search for signs of life on other planets.
The cross-disciplinary project brings together experts in chemistry, geoscience, machine learning, and planetary science to address one of astrobiology’s biggest challenges—reliably distinguishing life from non-life in planetary data.
At the heart of the project is a massive, curated dataset. Carnegie researchers—including Wong, Anirudh Prabhu, Robert Hazen, and George Cody—will lead the effort to generate highly detailed profiles of at least 1,000 samples, ranging from meteorites to fossils to living organisms. They will employ a suite of advanced techniques to analyze the molecular and chemical signatures across this broad sample set.
“A.I. will help us identify patterns in these massive multidimensional datasets that no human, or team of humans, could sift through in one lifetime,” said Wong. “It’s a tool we can use to detect the subtle biosignatures we might otherwise miss in the noise. It may even help us illuminate the fundamental differences between life and non-life.”
Partner institutions across the U.S.—including NASA Ames Research Center, Johns Hopkins University, Rutgers University, Caltech, Howard University, Purdue University, and NASA’s Goddard Space Flight Center—will provide additional instrumentation and laboratory expertise, transforming this effort into a national-scale, data-generation engine. Once the data collection is complete, the team will develop and train machine learning models on this expansive dataset to find patterns that consistently indicate life.
“Carnegie has a rich legacy of planetary science and cosmochemistry,” noted Carnegie Science Earth and Planets Laboratory Director Michael Walter. “Few places are better equipped to handle such a wide range of Earth and planetary samples.”
This isn’t just about developing A.I. tools—it’s about putting that intelligence to work. Wong and his team will use their findings to recommend the most effective scientific instruments for future missions, ensuring we send the most promising tools to the most promising extraterrestrial locations in our search for life.
“For NASA, this is incredibly valuable,” says Scharf, “exploring Mars, or an icy moon in the outer Solar System, is hugely challenging and we’re going to need to rely more and more on intelligent machines that carry an optimal collection of tools to seek out other life.”
During data collection, the team aims to create an open-source sample library and data repository. This resource will enable future research by providing scientists with open access to these extremely rich datasets while building a shared foundation for life detection efforts across the planetary science community.
“We’re at the edge of a new era in astrobiology,” Wong concluded. “We’ve never had more data or more computing power. Now is the moment to bring it all together and finally ask—and maybe answer—the biggest question of all: Are we alone?”
Washington, D.C. — A multi-institutional team co-led by Carnegie Science’s Michael L. Wong and Caleb Scharf of the NASA Ames Research Center has received a prestigious $5 million, five-year NASA Interdisciplinary Consortia for Astrobiology Research (ICAR) grant to develop A.I. tools for enhancing the search for signs of life on other planets.
The cross-disciplinary project brings together experts in chemistry, geoscience, machine learning, and planetary science to address one of astrobiology’s biggest challenges—reliably distinguishing life from non-life in planetary data.
At the heart of the project is a massive, curated dataset. Carnegie researchers—including Wong, Anirudh Prabhu, Robert Hazen, and George Cody—will lead the effort to generate highly detailed profiles of at least 1,000 samples, ranging from meteorites to fossils to living organisms. They will employ a suite of advanced techniques to analyze the molecular and chemical signatures across this broad sample set.
“A.I. will help us identify patterns in these massive multidimensional datasets that no human, or team of humans, could sift through in one lifetime,” said Wong. “It’s a tool we can use to detect the subtle biosignatures we might otherwise miss in the noise. It may even help us illuminate the fundamental differences between life and non-life.”
Partner institutions across the U.S.—including NASA Ames Research Center, Johns Hopkins University, Rutgers University, Caltech, Howard University, Purdue University, and NASA’s Goddard Space Flight Center—will provide additional instrumentation and laboratory expertise, transforming this effort into a national-scale, data-generation engine. Once the data collection is complete, the team will develop and train machine learning models on this expansive dataset to find patterns that consistently indicate life.
“Carnegie has a rich legacy of planetary science and cosmochemistry,” noted Carnegie Science Earth and Planets Laboratory Director Michael Walter. “Few places are better equipped to handle such a wide range of Earth and planetary samples.”
This isn’t just about developing A.I. tools—it’s about putting that intelligence to work. Wong and his team will use their findings to recommend the most effective scientific instruments for future missions, ensuring we send the most promising tools to the most promising extraterrestrial locations in our search for life.
“For NASA, this is incredibly valuable,” says Scharf, “exploring Mars, or an icy moon in the outer Solar System, is hugely challenging and we’re going to need to rely more and more on intelligent machines that carry an optimal collection of tools to seek out other life.”
During data collection, the team aims to create an open-source sample library and data repository. This resource will enable future research by providing scientists with open access to these extremely rich datasets while building a shared foundation for life detection efforts across the planetary science community.
“We’re at the edge of a new era in astrobiology,” Wong concluded. “We’ve never had more data or more computing power. Now is the moment to bring it all together and finally ask—and maybe answer—the biggest question of all: Are we alone?”
Sophie Turner has offered advice to the child actors starring in HBO’s new Harry Potter television series, warning them about the impact of social media.
Turner, now 29, was 14 when she joined Game of Thrones and said growing up in the spotlight had a damaging effect on her wellbeing.
“It had such a profound impact on my mental health, like more than I could tell you. It almost destroyed me on numerous occasions,” Turner told Flaunt magazine. She said therapy helped her cope and added, “One of the most important things to me in my life is talking about mental health: it’s vital.”
The actress expressed concern for Dominic McLaughlin, Alastair Stout and Arabella Stanton, who will play Harry Potter, Ron Weasley and Hermione Granger in the forthcoming series. “I look at the kids who are about to be in the new Harry Potter and I just want to give them a hug and say, ‘Look, it’s going to be OK, but don’t go anywhere near [social media],’” Turner said.
She also urged the young stars to maintain stability in their personal lives, “Stay friends with your home friends, keep living at home with your family, make sure your parents are your chaperones — it’s so important to have that grounding adjacent to the big, crazy stuff that you do.”
Turner, who shares daughters Willa and Delphine with ex-husband Joe Jonas, said she would not want her own children to start acting at a young age. “Oh God, they’re not acting! Not until they’re at least 25!” she said.
Gears of War is one of the most iconic Xbox series, spawning sequels, spin-offs and books. I fell in love with the series almost 20 years ago when the original landed on the Xbox 360. Microsoft brought the remastered edition of the game, called Gears of War: Reloaded, to Xbox Game Pass, and I can’t wait to play it.
Xbox Game Pass Ultimate, a CNET Editors’ Choice award pick, offers hundreds of games you can play on your Xbox Series X, Xbox Series S, Xbox One, Amazon Fire TV, smart TV and PC or mobile device for $20 a month. A subscription gives you access to a large library of games, with new ones, like Doom: The Dark Ages, added monthly, plus other benefits such as online multiplayer and deals on non-Game Pass titles.
Here are the games Microsoft is adding to Game Pass soon. You can also check out other games the company added to the service recently, like Assassin’s Creed Mirage.
Gears of War: Reloaded
Game Pass Ultimate and PC Game Pass subscribers can play now.
The iconic Gears series is back with a new, remastered edition of the original game. This game maintains the original story of Marcus Fenix and his squad as they take on the alien locust hordes and it includes a bonus campaign act, every multiplayer map and mode, plus characters and cosmetics unlocked through progression.
This game is also on PlayStation 5 and PC, and thanks to cross-play functionality, you can play with and against your friends on those platforms.
Herdling
Game Pass Ultimate and PC Game Pass subscribers can play now.
Get ready for a grand alpine adventure as you shepherd some giant Calicorns — which look like Appa from Avatar: The Last Airbender — up into a mountain pass. You’ll encounter eerie dangers, puzzles and more on your adventure. And before you ask, yes, you can pet these wonderful creatures.
Blacksmith Master (game preview)
Game Pass Ultimate and PC Game Pass subscribers can play now.
Adventuring in a medieval world can be fun and challenging but it can also be difficult work. If you’d rather run and manage a shop in a medieval setting, give Blacksmith Master a try. You run your own forge and have to manage resource acquisition, production and sale of goods. You’ll build your own forge, craft everything from utensils to weapons and become one of the most skilled craftsmen in the kingdom — all without fighting dragons or other dangerous creatures.
Void/Breaker (PC)
Game Pass Ultimate and PC Game Pass subscribers can play now.
You’re trapped by a ruthless AI in an endless loop where you’re forced to fight hostile enemies, die and then repeat. In this roguelite game, each time you die, you’ll face new challenges. Fast gunplay, quick movements and all-out destruction are your friends in this adrenaline-filled adventure. Who knows? Maybe you’ll get out one day.
Goat Simulator Remastered
New for Game Pass Standard subscribers.
Chaos. That’s the best way to describe this game. You play as a goat and your mission is the total destruction of everything in sight. Can’t stand the look of that car? Run it off the road. Don’t like the town hall’s placement? Demolish it. Want that kid’s ice cream? Eat it. Do what you want in this sandbox-style game where anything is possible.
Game Pass Ultimate subscribers got access to this game in November and Game Pass Standard subscribers can get in on the fun soon, too.
Persona 4 Golden
Game Pass Ultimate, PC Game Pass and Game Pass Standard subscribers can play now.
A string of serial murders set this game in motion, where you’ll travel between the real world and the world within TVs as you try and find out who — or what — is behind the murders. You’ll explore your town and carry on daily activities, as well as travel to the TV World to explore different dungeons and battle monsters in this RPG.
Dragon Age: The Veilguard
Game Pass Ultimate and PC Game Pass subscribers can play on Aug. 28.
Step into the enchanted world of Thedas, a land full of untamed wilderness, glittering cities and strife. A pair of corrupt ancient gods has broken out of their hold and is wreaking havoc across the globe. It’s up to you to gather a team and stop them, but that’s just the main quest. You can also embark on side quests and companion quests that shed light on who they are and how the world is changing around you. Veilguard changes the Dragon Age formula with a more action-oriented approach, though it retains familiar aspects like branching dialog choices and skill trees. So get ready to dive into a wild adventure, make new friends and become a legend.
Games leaving Game Pass on Aug. 31
While Microsoft is adding those games to Game Pass soon, the company is also removing five others from the service on Aug. 31. So you still have some time to finish up your campaign or any side quests before you have to buy these games separately.
Ben 10: Power Trip Borderlands 3 Paw Patrol Mighty Pups Save Adventure Bay Sea of Stars This War of Mine: Final Cut
For more on Xbox, discover other games available on Game Pass now, read our hands-on review of the gaming service and learn which Game Pass plan is right for you. You can also check out what to know about upcoming Xbox game price hikes.
Watch this: Everything Announced at Gamescom Opening Night Live 2025 in 20 Minutes
Released in 2021, the Zenith Chronomaster Sport has been quite a success for the Le Locle-based brand. A versatile sports chronograph with enough arguments, visually and mechanically, to compete with the heavyweights of the category, it has been made in an array of different versions since its introduction. Ranging from classic to bold, we’ve seen steel editions with tri-colour dials, models in pink, with green accents, with a tri-colour ceramic bezel, in titanium or with a rainbow bezel. Meteorite isn’t new to the collection either, and in fact, the model we’ll be looking at today already existed discreetly, as a Japan-only edition. Well, the steel Zenith Chronomaster Sport Meteorite is now available worldwide, and it looks quite special.
The recipe is pretty straightforward. We’re looking at a classic steel Chronomaster Sport equipped with a different dial and a monochromatic colour scheme – of course, something that speaks to us here, at MONOCHROME (obviously…) The base is known and still as appealing as when it was released in 2021. The watch is a modern, versatile sports chronograph with everything you expect from this category. The steel case, measuring 41mm in diameter, 13.6mm in thickness and a reasonable 47mm lug-to-lug, is sharp and modern, but retains enough classism to not feel too bold – meaning that it will certainly age well. The dial is framed by a glossy black ceramic bezel, engraved with a 1/10th of a second track – a specificity of this collection being its high-frequency movement. The right side is home to two classic pump pushers and water-resistance is rated at 100m.
The main novelty is the dial, which plays on textures first and foremost, and keeps things discreet on the topic of colours. Yes, in classic El Primero fashion, the Chronomaster Sport Meteorite has sub-counters in three different tones, but here these are treated in a gradient of white and grey, not the emblematic version with silver, grey and blue. This actually pairs well with the silver colour of the base dial, made from meteorite, and gives the Widmanstätten pattern, a naturally occurring geometric structure formed by the slow cooling of molten iron in space, all the possibilities to express itself. Hours markers and hands are classic for the collection, as well as the debatable date window at 4:30.
At the core of the Zenith Chronomaster Sport Meteorite beats the El Primero 3600, the latest generation of high-frequency chronograph by Zenith. With its 5Hz (36,000 vibrations/hour) frequency and a silicon escape wheel, it enables the chronograph hand to make a complete rotation every 10 seconds, capturing elapsed time to the nearest tenth of a second. Compared to a classic El Primero, it’s been upgraded with a 60-hour power reserve and a stop seconds mechanism, as well as more modern decoration.
Presented on a steel bracelet with brushed and polished links, fastened by a double-folding clasp, as well as an additional black rubber strap with a matching clasp, the Zenith Chronomaster Sport Meteorite, once a Japan-exclusive model, is now available worldwide, through Zenith boutiques (in-store and online) and authorised retailers. It is priced at CHF 16,900 or EUR 18,300.
For more details, please visit www.zenith-watches.com.
Hasselblad has just launched the X2D II 100C, the first medium format camera capable of taking true HDR photos. Those HDR images can be instantly reviewed on the new 3.6-inch OLED touchscreen at up to 1,400 nits of peak brightness, which Hasselblad says is 75 percent brighter than the original X2D 100C. Other notable upgrades include using LiDAR to assist with autofocus, a 10-stop in-body stabilization system, an additional customizable button, and a new joystick for controlling camera functions instead of using touchscreen commands.
At $7,399, it’s cheaper than its three-year-old predecessor, and still shares some similarities: it takes 100 megapixel photos, comes with 1TB of internal SSD storage, offers similar dynamic range, and the shape is largely unchanged. These don’t overshadow the improvements on the latest model, however, which my colleague Vjeran describes as “one of the greatest cameras I have ever used.”
The highest-resolution images of a solar flare captured at the H-alpha wavelength (656.28 nm) may reshape how we understand the Sun’s magnetic architecture — and improve space weather forecasting. Using the U.S. National Science Foundation (NSF) Daniel K. Inouye Solar Telescope, built and operated by the NSF National Solar Observatory (NSO), astronomers captured dark coronal loop strands with unprecedented clarity during the decay phase of an X1.3-class flare on August 8, 2024, at 20:12 UT. The loops averaged 48.2 km in width — perhaps as thin as 21 km — the smallest coronal loops ever imaged. This marks a potential breakthrough in resolving the fundamental scale of solar coronal loops and pushing the limits of flare modeling into an entirely new realm.
Coronal loops are arches of plasma that follow the Sun’s magnetic field lines, often preceding solar flares that trigger sudden releases of energy associated with some of these magnetic field lines twisting and snapping. This burst of energy fuels solar storms that can impact Earth’s critical infrastructure. Astronomers at the Inouye observe sunlight at the H-alpha wavelength (656.28 nm) to view specific features of the Sun, revealing details not visible in other types of solar observations.
“This is the first time the Inouye Solar Telescope has ever observed an X-class flare,” says Cole Tamburri, the study’s lead author who is supported by the Inouye Solar Telescope Ambassador Program while completing his Ph.D. at the University of Colorado Boulder (CU). The program is funded by the NSF and is designed to support Ph.D. students as they create a well-networked cohort of early-career scientists at U.S. Universities, who will bring their expertise in Inouye data reduction and analysis to the broader solar community. “These flares are among the most energetic events our star produces, and we were fortunate to catch this one under perfect observing conditions.”
The team — which includes scientists from the NSO, the Laboratory for Atmospheric and Space Physics (LASP), the Cooperative Institute for Research in Environmental Sciences (CIRES), and CU — focused on the razor-thin magnetic field loops (hundreds of them) woven above the flare ribbons. On average, the loops measured about 48 km across, but some were right at the telescope’s resolution limit. “Before Inouye, we could only imagine what this scale looked like,” Tamburri explains. “Now we can see it directly. These are the smallest coronal loops ever imaged on the Sun.”
The Inouye’s Visible Broadband Imager (VBI) instrument, tuned to the H-alpha filter, can resolve features down to ~24 km. That is over two and a half times sharper than the next-best solar telescope, and it is that leap in resolution that made this discovery possible. “Knowing a telescope can theoretically do something is one thing,” Maria Kazachenko, a co-author in the study and NSO scientist, notes. “Actually watching it perform at that limit is exhilarating.”
While the original research plan involved studying chromospheric spectral line dynamics with the Inouye’s Visible Spectropolarimeter (ViSP) instrument, the VBI data revealed something unexpected treasures — ultra-fine coronal structures that can directly inform flare models built with complex radiative-hydrodynamic codes. “We went in looking for one thing and stumbled across something even more intriguing,” Kazachenko admits.
Theories have long suggested coronal loops could be anywhere from 10 to 100 km in width, but confirming this range observationally has been impossible — until now. “We’re finally peering into the spatial scales we’ve been speculating about for years,” says Tamburri. “This opens the door to studying not just their size, but their shapes, their evolution, and even the scales where magnetic reconnection — the engine behind flares — occurs.”
Perhaps most tantalizing is the idea that these loops might be elementary structures — the fundamental building blocks of flare architecture. “If that’s the case, we’re not just resolving bundles of loops; we’re resolving individual loops for the first time,” Tamburri adds. “It’s like going from seeing a forest to suddenly seeing every single tree.”
The imagery itself is breathtaking: dark, threadlike loops arching in a glowing arcade, bright flare ribbons etched in almost impossibly sharp relief — a compact triangular one near the center, and a sweeping arc-shaped one across the top. Even a casual viewer, Tamburri suggests, would immediately recognize the complexity. “It’s a landmark moment in solar science,” he concludes. “We’re finally seeing the Sun at the scales it works on.” Something made only possible by the NSF Daniel K. Inouye Solar Telescope’s unprecedented capabilities.
The paper describing this study, titled “Unveiling Unprecedented Fine Structure in Coronal Flare Loops with the DKIST,” is now available in The Astrophysical Journal Letters.
Fast radio bursts (FRBs) are some of the most powerful signals in the universe. They can emit as much power in a few milliseconds as our Sun does in several days. Despite their strength, we still don’t have a definitive answer to what causes them. That is partly because, at least for the ones that only happen once, they are really hard to point down. But a new extension to the Canadian Hydrogen Intensity Mapping Experiment (CHIME) might provide the resolution needed to determine where non-repeating FRBs come from – and its first discovery was one of the brightest FRBs of all time, which helped researchers track it with an unprecedented level of precision, as described in a new paper in The Astrophysical Journal Letters.
CHIME has been in operation since 2018, but it only recently completed it’s new “Outrigger” extension earlier this year. The Outriggers, in this case, are miniaturized versions of the main telescope in British Columbia (about 66 km away from the main array), West Virginia, and California. These distances allow the system to create a very long baseline interferometer (VLBI), which is capable of analyzing differences in the signals received between the four stations to localize the sources of the FRBs they’re searching for.
In March, CHIME was able to capture a dream test case. A FRB named FRB20250316A, but colloquially named “radio-brightest flash of all time” (RBFLOAT), assumedly because the researchers were thirsty while trying to come up with a catchy name for their discovery, legitimately lived up to its name of being one of the brightest FRBs of all time. It also happened to come from a galaxy in our galactic neighborhood – NGC 4141, about 130 million light years away.
Fraser discusses FRBs, and what makes them so puzzling.
Given the new location information afforded by the CHIME’s new VLBI features, the researchers were able to narrow down this single burst to a more specific area than just a galaxy. They found it just outside of a star forming region on one of the galaxy’s spiral arms. Even more impressively, they narrowed it down to an accuracy of just 42 light years. That level of accuracy, given the 130 million light year distance, is impressive for any signal, but even more impressive for one that only lasted for a few milliseconds.
That precise localization allowed the researchers to take a look at the area using other observational resources both prior to the burst and after it. The Katzman Automatic Imaging Telescope (KAIT) and the Coddenham Observatory didn’t see any signs of a optical signal before the RBFLOAT signal, nor were any signals found after the event by Keck, Gemini, or MMT. CHIME itself also didn’t find another signal, despite monitoring the area for over 200 hours.
Since RBFLOAT lacked a repeating signal, it puts it into a category of single-burst FRBs, that might have a distinct cause from the less common repeating one that have typically been located with such precision. While single-burst FRBs are more common, given their transient nature it has been difficult to determine where precisely they came from, and therefore narrow down what might be causing them.
Video talking about Chime and it’s Outriggers and how they can revolutionize FRB astronomy. Credit – Caltech Astro Seminars YouTube Channel
Magnetars are a typical suggested cause, according to one theory at least. However, the RBFLOAT signal very clearly came from outside of an active star-forming region, where most magnetars would be expected. This could have been caused by the magnetar being gravitationally flung out of the nearby region or it could have formed there itself. Or this particular FRB could have been caused by something completely different.
Ultimately, even the researchers aren’t sure yet. But this particular discovery is a case study in how CHIME’s new Outrigger extensions will help locate and isolate even one-off FRBs. As the number of detections increases, patterns are more likely to emerge, and that’s when researchers might finally be able to answer the question of what causes the most powerful signals in the universe.
Learn More:
Eureka Alert / Northwestern University – ‘Root beer FLOAT’ burst’s home is located with extraordinary precision
The Chime / FRB Collaboration et al – FRB 20250316A: A Brilliant and Nearby One-off Fast Radio Burst Localized to 13 pc Precision
UT – Astronomers Detect Most Distant Fast Radio Burst Ever
UT – Fast Radio Bursts are Helping to Locate the Universe’s Missing Matter
Participants were aged between 32 and 49 years and had received a diagnosis of breast cancer between the years 2016 and 2023 (Table 1).
Table 1 Basic sociodemographic characteristics of participants
Three (3) predominant themes emerged from the analysis of the data: (1) limited knowledge and awareness regarding FP options; (2) barriers to effective FP discussions and uptake and (3) promoting factors for FP (Table 2). In the paragraphs below, each principal theme is further explained by a set of subthemes to enhance the understanding of the overarching concepts.
Table 2 Themes and subthemes
Theme 1: limited knowledge and awareness regarding FP options
Most women 10 out of 15 in this study indicated a lack of awareness regarding FP, although they were receiving cancer treatment at a tertiary healthcare facility, some of whom had been diagnosed as far back as 2016. FP did not seem to be a well-recognized medical procedure among this sub-group of women. Two participants had only gained knowledge about FP for the first time, through interacting with the study research assistants during the cross-sectional phase of the research:
If not for you guys [researchers] educating me on the topic, I wouldn’t have had a fair idea of what it was. (Participant 11)
The last time I came to Korle Bu it was explained to me by your research, I wouldn’t have known anything about it (Participant 8).
Three participants as illustrated below, pointed out that their knowledge of FP originated from non-medical sources including via reading a book or hearsay.
Um, I know that they can freeze your eggs. Yeah. That I know. I read it. (Participant 13)
There is a madam, it seems she is a survivor. She was saying that there is another lady who told her of something like that. But as for me I haven’t heard of anybody talking about it. (Participant 3)
I don’t know if it was a movie I heard it from. I just know I’ve heard people have that conversation. (Patient participant)
While the above discussion highlights a potential lack of awareness of FP among women receiving treatment, two participants explained that as part of standard medical procedure the attending healthcare professional had discussed FP, prior to breast cancer treatment.
Before treatment, they (health professionals) lay these issues before you, either they have injections and medications … that will protect your eggs (Participantt 2).
They told me that before chemo, they can remove and store some of a woman’s eggs and then put it back after treatment. And if that’s not what you want, they have some injections they will be giving you for you to get pregnant (Participantt 12).
It emerged that patient education on fertility preservation was not standard or routine practice. What’s more is that in some cases there appeared to be no clarity about the discussions and the decisions that followed FP education. Two patient’s highlight this communication gap:
When I was in Korle-Bu, they came round and said they can help you get pregnant after treatment but I haven’t heard anything else (Participantt 14).
Before I started treatment, one guy explained all that (FP) to me. But I didn’t see that happen so I wouldn’t know if my eggs were taken or if I was injected … but I don’t know (Participantt 15).
Theme 2: barriers to effective FP discussions and uptake
Participant accounts reveal several barriers to effective FP discussions and uptake, these are discussed in more detail in the sections below:
Subtheme 2.1: Doctors non-disclosure of FP options
A significant barrier to FP uptake was the failure of healthcare providers to communicate information or sufficient information regarding FP options. As already described above, the discussions of FP were not held or were conducted in a poor manner. Expressing displeasure about not being informed about reproductive choices, two women said:
None of this (FP) was mentioned to me before my treatment began oh…They didn’t inform us so we know our options and the decisions to take, they waited for us to undergo treatment first (Participant 12).
If I knew that there was a way to solve that … like the issue of freezing your eggs before you go for the chemotherapy, I would have gone for that. Um, I haven’t spoken with anybody who has actually said anything concerning that (Participant 13).
Inferring from the narratives above, failing to communicate FP options did a disservice to participants who may have been willing to explore FP options.
Subtheme 2.2: Patients fertility history or parity
Patients attempted to reason why FP was not discussed by the medical provider, after a diagnosis of breast cancer. They recalled their interaction with the attending health professional:
The doctor first asked me how many children I had, to which I answered four. If I had told him I had no children, maybe he would have taken time to explain that to me, but because I told him I had children, he did not say anything else. (Participant 9)
I think if I had said no, I am not done, I’m not yet done having children, they would have probably introduced the subject. But the question was, are you, you know, how many children do you intend to have anymore? No. Okay. Then they move on to the next thing. (Participantt 10)
Having a satisfying number of children seemed good reason for why some women lacked interest in pursuing FP options:
As for me I have some children that’s why I didn’t give it much thought. (Patient 4)
If the person is also old and doesn’t need more children, then it may not be necessary for the person to do it. (Participant 8)
It is important to recognize that fertility-related concerns may vary, at the time of diagnosis. For one participant who was pregnant, fertility concerns were centred on the potential outcome of a current pregnancy rather than future reproductive choices, “ I was pregnant during diagnosis, so the conversation did not focus so much on how would you give birth. I was more concerned if the pregnancy will still hold” (Participant 1).
Subtheme 2.3: The burden of cancer care versus fertility needs
As illustrated above, for majority of the (9 out of 15) women, the immediate health concerns of cancer seemed to overshadow considerations for future fertility. Participants indicated that oncological care consumed their entire focus, against this backdrop FP seemed secondary. Describing the overwhelming nature of living with a breast cancer diagnosis and concerns about survival, one participant explained “It affects you, you don’t know your chances of survival (Patient 1, Another explained further “When you are diagnosed with the cancer, all you are thinking about is to cure, you know, to save your life, sort of. Uh-huh. So, that one (FP) becomes a secondary matter” (Participant 4).
Ongoing treatment of cancer seems intense, on this account the women in this study projected and feared that FP procedures would add an additional layer of stress and thus discourage patronage. Weary of their own histories of cancer surgery and the burden experienced, two participants reflected:
Just like my reason for saying that I am tired of surgery, there may be others who may also be afraid like that. (Participant 3)
There are too many surgeries involved. Do you think some women will agree if you tell somebody that aside the surgery they’ll undergo as part of the cancer treatment, there are other surgeries they would have to undergo if they wish to have children after the treatment? (Participant 9)
Viewing the introduction of FP as burdensome, one patient shares how it could potentially affect adherence to treatment:
It’s a lot dealing with cancer from my perspective, it’s a lot it’s heavy so if we have to add fertility and it has to be done in a way ahh, it won’t… it won’t burden the person. You see, some people are there, immediately they hear all these things then, a lot of people stop coming for treatment because the things to are too much. (Participant 10)
Finding balance between cancer care treatment and fertility needs seemed crucial for women to accept FP treatment.
Subtheme 4: Financial cost or affordability
The cost of FP was viewed as a limiting factor to FP uptake, by women in this study:
Someone may want to do it but because there is no money the person may say that I won’t do it because I do not have money. (Participant 3)
If I had that money, I would have made them take all my eggs. But that procedure involves money (Participant).
The participants in this study viewed that the financial burden of undergoing an extra procedure, in addition to what is already required for breast cancer treatment, may deter patients from considering FP.
You just imagine paying for chemo and then paying for the preservation process after. It’ll be too expensive. (Participant 15)
You also know how costly the cancer treatment itself is. And so, I believe a lot of women would want to go through the egg freezing process if it weren’t for how expensive the entire procedure is. (Participant 11)
Subtheme 5: Little awareness and evidence in support of FP success
The women indicated they had no previous encounter with someone who had undergone the FP process:
I haven’t heard anyone say they’ve been through FP before. (Participant 15)
I don’t know anyone with breast cancer who has done this procedure. (Participant 2)
The narrative was the same for patient 3 who added that personal success stories about FP could significantly influence decision-making for those contemplating FP.
This is something that isn’t already in existence, so it won’t be easy for people to do it. But for others as well, unless someone has experienced it and tells them how it is like. Then maybe the person may be able to convince them to accept. But for someone who hasn’t done it before or someone who hasn’t witnessed it, it will be very difficult for them to accept. (Participant 3)
For such interested women, patient 3 believed first-hand accounts would be crucial in encouraging their acceptance of FP.
Subtheme 6: Religious barriers
Highlighting the importance of religion, Participant 3 perceived that one’s religious beliefs could serve as a deterrent to FP uptake, she noted:
Someone’s belief can prevent them because you know that in Ghana, we have a lot of religions, so someone’s beliefs can prevent them. (Participant 3)
Someone’s church, maybe the person may say that this is the church I go to and so I cannot do such a thing. (Participant 4)
Conversely, participants 13 and 12 opined that religion was not a barrier to the uptake of FP
I don’t see culture coming in. Maybe religion, some of the religions, yeah, might not, I don’t see too much of it coming in. (Participant13)
Since it’s something that can help women, I don’t think religion would really cause a hindrance. (Participant 12)
Theme 3: promoting factors for FP
Factors proposed to promote the uptake for FP were awareness creation, talking about its benefit, and the provision of financial support.
Subtheme 3.1: Awarenesscreation
The patients’ suggested public health and patient educative counselling were the best ways to create awareness about FP. Participant 1 suggested this education should be done right before breast cancer treatment is started perhaps to give the women a chance to fully consider all the resources available to them.
During the time that erm, we are going to start treatment, it should be something spoken of and we should be open to them that you know chemo can do so – so and so to your system. So, these are the things we think would increase your chances of having children by preserving your eggs. These must be said to patients before they start treatment. I think, with this, they will have an option to choose whether to preserve their eggs or not to. (Participant 1)
Education is key. Like they should make us aware that these options are there. (Participant 5)
The doctor can inform them that their eggs can be removed and stored so that they can later be fertilized with their husband’s sperm and implanted in them. If they agree to it, fine. And if they don’t agree to it, they should be left alone. (Participants 9)
Participants advised that FP awareness should be created, and accurate and reliable information about FP provided. They also cautioned that the information should be communicated in a way that is not overwhelming:
So, it hasn’t been,… err there hasn’t been a lot of education on the FP. So, I think it’s good if it’s introduced well you know, but you know,… slowly and not; go and do it!, it seems a lot for them….(Participant 10).
Erm I suggest that someone going through cancer treatment should be given the right information and educated on this topic. Because someone might have no problem financing the procedure but they may not have been educated on that so they would not get the chance to make that decision. At least with me, I got educated on it by you guys. So, I think more education on the preservation would really help. (Participant 11)
I think it should be emphasized more, you know, for people to be aware of so many options they can have during or after treatment, so, it should be popular but it’s not popular. It’s not something out there. (Participant 1).
Patient 13 hinted that there should be a professional on the medical team solely responsible for FP counselling:
Adding a reproductive person as part of the team for the chemo treatment session such that, if someone comes and the person is still in the reproductive age, maybe the person can go through some counselling with the person, you know.
Subtheme 3.2: The perceived benefit of future fertility
As revealed in the patients’ narratives, education that lays emphasis on the perceived benefits of FP would be key for successful uptake.
If I am told these are the things you can do to increase your chances of having children after treatment, of course I’ll go for it. (Participant 1)
Also, 10 out of 15 believed that FP held a lot of promise for women diagnosed with breast cancer, particularly young ones who have no child.
I think it is good… if you will be treated and can be given medication that will protect your eggs. For example, maybe the person is young … if this option is here … then I think that it is good. (Participant 2)
As for me I have some children that’s why I didn’t give it much thought. But for those who have the illness but do not have children, that procedure will have been good for them (Participant 4).
Someone may be young, hasn’t given birth before or married before and this befalls the person, then it is advisable for that the person so that the person can get children when she marries. So, it is very good. (Participant 8)
Subtheme 3.3: Financial relief
Women suggested that the government could assist by providing financial aid to support women going through breast cancer treatment. As illustrated below participants believed that women would accept FP if they are supported financially. Others also requested that the government reduce the cost instead of absolving all of it.
Ok. For me, I think financial because if they make it less expensive or erm the government can help_ let me say government – either make it less expensive or the government can help by subsidizing the fees they have to pay. If it’s possible, they can put it on health insurance for those who want to give birth after treatment, because the treatment itself is expensive. (Participant 5)
If the National Health Insurance Scheme can cover some of the cost of the FP process women wouldn’t have to pay so much for the process. (Participant 11)
I don’t know if the government or hospital can help with that. I think the government should help us out with that. (Participant 12)
What I can say is that, the government should help with the cost of the process. Because it’s not easy at all, the cost involved in chemo and the FP process as well. (Participant 15)
According to the participants’ narratives, FP awareness creation, support from government and highlighting the benefits of FP from previous beneficiaries may promote the uptake of FP in Ghana.
