Latest news with #MUI
Sinar Daily
08-05-2025
- Health
- Sinar Daily
Governor proposes sterilising poor men to cut birth rates
JAKARTA – A proposal by West Java Governor Dedi Mulyadi to make vasectomy a condition for social aid to poor men has drawn widespread criticism from Indonesians. The measure, proposed on April 29, aims to control birth rates among impoverished families as a long-term strategy to reduce extreme poverty in the region. "If someone cannot afford pregnancy and their child's education, it's better not to rush into parenthood,' he was reported as saying by local media. However, his statement ignited heated debates involving religious leaders, community figures, academics, human rights organisations and ordinary citizens, who deemed the proposal excessive, inhumane and a violation of basic rights. A vasectomy is a permanent male contraceptive method involving a minor surgical procedure to cut and seal the tubes carrying sperm from the testes. This procedure prevents sperm from mixing with semen, effectively preventing pregnancy. While it does not impair male sexual function, it is typically irreversible. Dedi's proposal offers men who agree to undergo a vasectomy an incentive of IDR 500,000 (RM 130). Even more controversially, other aid programmes, such as food subsidies, healthcare, scholarships and housing, would also be tied to the willingness of men to undergo the procedure. "I want men to take more responsibility in family planning, not just leave it to women,' Dedi asserted. Indonesia's Social Affairs Minister, Saifullah Yusuf, warned against arbitrarily linking any form of assistance to medical conditions that involve bodily autonomy. 'When it comes to bodily rights and health, every aspect must be carefully considered. This is not a simple matter,' he said. Meanwhile, Community Empowerment Coordinating Minister Muhaimin Iskandar emphasised that such conditions contradict existing regulations. 'No legal provision allows states to impose such conditions on social assistance,' he said. The West Java branch of the Indonesian Ulema Council (MUI) declared that vasectomy is forbidden in Islam if performed permanently without urgent medical necessity. 'Permanent sterilisation procedures like vasectomy are not allowed unless in cases of medical emergencies. This is not about money but about Islamic law,' stated its chairman, KH Rahmat Syafei. The Indonesian Human Rights Commission (Komnas HAM) condemned the proposal, calling it a violation of individual bodily rights and undue pressure on the poor. 'The human body is an individual's absolute right. Tying aid to medical procedures is a form of coercion,' said its chairperson, Atnike Nova Sigiro. Amid mounting criticism, Dedi Mulyadi clarified that his proposal was not coercive but rather an incentive-based voluntary programme. 'I'm merely encouraging, not forcing. If they don't want to, there's no compulsion. But we must think about the long-term future of impoverished families,' he explained. In a public opinion poll conducted by local media, most Indonesians viewed the proposal as inhumane, degrading to the poor and inappropriate for a diverse, multicultural and religious country like Indonesia. Many social media users also accused Dedi of exploiting the sensitive issue as 'cheap political capital' ahead of the upcoming elections. – AGENCY
Medscape
07-05-2025
- Health
- Medscape
Sling and Botox Comparable for Mixed Urinary Incontinence
OnabotulinumtoxinA (Botox) injection and midurethral sling surgery yielded comparable symptom improvement in women with mixed stress-urgency urinary incontinence (MUI) at 6 months, a multicenter randomized study found. Surgery led to insignificantly better outcomes in the Mid-urethral Sling vs Botox A (MUSA) trial conducted by Heidi Harvie, MD, MBA, MSCE, associate professor of obstetrics and gynecology at Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues. Heidi Harvie, MD, MBA, MSCE '[Stress-urinary incontinence] SUI is most common, followed by MUI and [urgency urinary incontinence] UUI,' said Harvie. 'In the United States, MUI affects an estimated 30% of women by 60 years of age. Women with urinary incontinence typically report that UUI is more bothersome than SUI, and the combination of both is more bothersome than either UUI or SUI alone.' Of the two, MUI is the more challenging to treat. Published online in JAMA , the MUSA trial recruited 150 women (age, 27-87 [mean, 59] years; about 55% White) from seven clinical centers in the Pelvic Floor Disorders Network, National Institute of Child Health and Human Development (NICHD). All had moderate to severe MUI with an average of seven leakage episodes per day and had not responded to conservative treatments, such as lifestyle changes and exercise, or oral medications. From July 2020 to September 2022, participants were randomly assigned to receive either an intradetrusor injection of onabotulinumtoxinA 100 U (focusing on the urgency component) or midurethral sling (focusing on the stress urgency component). Of these, 137 received treatment, with last follow-up in December 2023. OnabotulinumtoxinA recipients could receive an additional injection between 3 and 6 months, and all participants could receive additional treatment (including crossover to the alternative intervention) between 6 and 12 months. The primary outcome was a change from baseline in Urogenital Distress Inventory (UDI) scores (range, 0-300) at 6 months. Secondary outcomes included a UDI change at 3 and 12 months, irritative and stress subscores of the UDI, urinary incontinence episodes, predictors of poor treatment response, quality of life, and global impression outcomes. In addition, adverse events, use of additional treatments, and cost-effectiveness were evaluated. Both groups showed mean improvement in the UDI total score at 6 months with no significant difference in scores between groups. OnabotulinumtoxinA: −66.8 (95% CI, −84.9 to −48). Sling: −84.9 (95% CI, −100.5 to −69.3) for a mean difference of 18.1 points (95% CI, −4.6 to 40.7; P = .12). = .12). In secondary outcomes, there was a greater improvement in the UDI stress incontinence score with the sling at −45.2 (95% CI, −53.7 to −36.8) vs with onabotulinumtoxinA at −25.1 (95% CI, −34.1 to −16.1; P < .001). < .001). No significant difference emerged in the UDI irritative score with onabotulinumtoxinA at −32.9 (95% CI, −40.3 to −25.6) vs with the sling at −27.4 (95% CI, −34.6 to −20.3; P = .27). = .27). In the medication group, 12.7% and 28.2% received a second injection by 6 or 12 months, respectively. By 12 months, 30.3% in the sling group received onabotulinumtoxinA, and 15.5% in the onabotulinumtoxinA group received a sling. Overall adverse events did not differ between groups, but recurrent urinary tract infections were more common in the sling group at 17.6% vs in the onabotulinumtoxinA group at 6.9%. Rates of surgical revision (1.5%), vaginal mesh exposure (2.9%), and short-term postprocedural urinary catheter use (11.8%) in the sling group were similar to those reported in other studies. In the onabotulinumtoxinA group, 2.8% required intermittent self-catheterization 2 weeks post-procedure. 'Midurethral sling surgery and onabotulinumtoxinA are both good options for improving MUI symptoms. However, these patients can be difficult to treat with one therapy,' Harvie told Medscape Medical News . She hopes the findings will potentially help inform treatment decisions and shared decision-making based on patient preference in partnership with clinician recommendations. As for the economic side, her group is currently planning a cost-effectiveness analysis of the two approaches. Brittany L. Roberts, MD In an accompanying editorial on the study, obstetrician-gynecologist Brittany L. Roberts, MD, and colleagues at the Albany Medical Center in Albany, New York, agreed that shared decision-making should ultimately guide therapeutic strategy. 'Because 45% of patients had another therapy within a year, it underlines that mixed urinary incontinence is a chronic disease and may require new treatments over time,' they wrote. 'Future studies should explore this concept and examine the impact on the utilization of healthcare resources and patient satisfaction.' Roberts' group pointed out that the 'clinical conundrum' of this mixed condition affects 1 in 4 women older than 65 years. 'The personal and societal costs of incontinence are significant,' they wrote. By age 80, 20% will undergo surgery for SUI or MUI. While physical and behavioral therapies improve both types, medications are standard treatment for urgency. 'When conservative treatment fails, conventional guidance has been to treat the urgency before the stress component because anti-incontinence surgical procedures can worsen urgency incontinence and many urgency treatments are medical rather than surgical,' they wrote. Another strategy has been to treat whichever symptom is dominant. Results from the Effects of Surgical Treatment Enhanced with Exercise for Mixed Urinary Incontinence (ESTEEM) trial revealed that both groups, surgery with or without behavioral and physical therapy, reported improved urgency symptoms, findings substantiated in prior cohort studies. 'While the original hypothesis of ESTEEM was that treating both components of mixed urinary incontinence with behavioral and physical therapy plus sling would result in better patient outcomes, ESTEEM revealed that urgency symptoms can improve with the midurethral sling alone, challenging previously held beliefs about the impact of anti-incontinence surgeries worsening the urgency component of mixed incontinence,' Roberts and associates wrote. They further pointed out that combined findings from MUSA and ESTEEM revealed that the pathophysiology of stress and urge incontinence are likely intertwined. 'For example, both patients and clinicians have difficulty discerning which type of leakage patients have, particularly when the incontinence is severe.' With better diagnostic clarity on urgency and stress incontinence phenotypes, more specific advice maybe offered to individuals on what to treat first. While the MUSA trial positioned both interventions in equipoise, they have significant differences. OnabotulinumtoxinA can be administered in the clinic or operating room and requires no incision but insertion of a cystoscope. Sling surgery is performed in the operating room and typically requires three small incisions. Slings are meant to be a permanent intervention, while onabotulinumtoxinA injection must be repeated as its effects wear off. So why not perform a sling surgery and give onabotulinumtoxinA at the same time? A randomized trial of 78 patients posing this question found that compared with sling alone, combined therapy did not show greater symptom improvement at 3 months. Additionally, the combined therapy group engaged in more self-catheterization and had more urinary tract infections.
Yahoo
14-02-2025
- Business
- Yahoo
BlackRock Municipal Income Fund, Inc. (MUI) Delists from the NYSE in Connection with the Conversion to an Unlisted Interval Fund Structure
NEW YORK, February 14, 2025--(BUSINESS WIRE)--BlackRock Municipal Income Fund, Inc. (NYSE: MUI, the "Fund") has delisted from the New York Stock Exchange (NYSE). Please note that, effective as of the Delisting Date, the MUI Shares will no longer trade on the NYSE or any other securities exchange. The Fund is in the process of converting from an exchange-listed closed-end fund to an unlisted continuously-offered closed-end fund that conducts quarterly repurchases of its shares (the "Conversion") and will operate under the name BlackRock Municipal Credit Alpha Portfolio, Inc. (the "Interval Fund"). It is currently anticipated that the Conversion will take place after the close of business on March 21, 2025, and be effective on March 24, 2025 (the "Conversion Date"). The Interval Fund currently intends to commence the initial repurchase offer in the second quarter of 2025. Conversion and First Periodic Repurchase MUI Shares held on the Conversion Date will be redesignated as Institutional Shares of the Interval Fund ("Interval Fund Shares"). The Interval Fund Shares will not be listed for trading on any securities exchange and a secondary market is not expected to develop for the Interval Fund Shares. As a result, an investment in the Interval Fund is not a liquid investment. Shareholders will generally only be able to sell their Interval Fund Shares through the Interval Fund's quarterly offers to repurchase between 5% and 25% of the outstanding Interval Fund Shares. The Interval Fund currently intends to commence the initial repurchase offer in the second quarter of 2025. Although the Interval Fund intends to conduct quarterly repurchase offers, such repurchase offers may be oversubscribed. If a repurchase offer is oversubscribed, the Interval Fund will repurchase the shares tendered on a pro rata basis, and shareholders will have to wait until the next repurchase offer to make another repurchase request. As a result, shareholders may be unable to liquidate all or a given percentage of their investment in the Interval Fund through a particular repurchase offer. Shareholders will be subject to the risk of NAV fluctuations and other investment-related risks during that period. Important Notice to Shareholders Who Hold Shares Through a Financial Intermediary Following the Conversion, the Interval Fund will offer one or more classes of shares through select financial intermediaries. Shareholders should be aware that not all financial intermediaries will offer to sell shares of the Interval Fund or support quarterly repurchase offers by the Interval Fund. SHAREHOLDERS SHOULD CONTACT THEIR FINANCIAL INTERMEDIARY AS SOON AS POSSIBLE TO CONFIRM WHETHER THEIR INTERMEDIARY WILL SUPPORT QUARTERLY REPURCHASE OFFERS AND WHAT, IF ANY, EFFECT THE CONVERSION WILL HAVE ON THE SHAREHOLDER'S ACCOUNT. Additional Resources Regarding the Conversion: PRESS RELEASE – December 23, 2024:BlackRock Municipal Income Fund, Inc. (MUI) Provides De-Listing and Conversion Dates for Upcoming Conversion to Unlisted Continuously-Offered Closed-End Fund PRESS RELEASE - June 7, 2024:BlackRock Municipal Income Fund, Inc. (MUI) Approves Conversion to Unlisted Closed-End Interval Fund Structure October 16, 2024 SEC Filing:SEC Registration Filing for BlackRock Municipal Credit Alpha Portfolio (MUNEX) PRESS RELEASE - November 18, 2024:BlackRock Municipal Income Fund, Inc. (MUI) Announces Final Results of Tender Offer Important Notice This press release is for informational purposes only and shall not constitute a recommendation, an offer to purchase or a solicitation of an offer to sell any common shares of the Fund. About BlackRock BlackRock's purpose is to help more and more people experience financial well-being. As a fiduciary to investors and a leading provider of financial technology, we help millions of people build savings that serve them throughout their lives by making investing easier and more affordable. For additional information on BlackRock, please visit Availability of Fund Updates BlackRock will update performance and certain other data for the Fund on a monthly basis on its website in the "Closed-end Funds" section of as well as certain other material information as necessary from time to time. Investors and others are advised to check the website for updated performance information and the release of other material information about the Fund. This reference to BlackRock's website is intended to allow investors public access to information regarding the Fund and does not, and is not intended to, incorporate BlackRock's website in this release. Forward-Looking Statements This press release, and other statements that BlackRock or the Fund may make, may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act, with respect to the Fund's or BlackRock's future financial or business performance, strategies or expectations. Forward-looking statements are typically identified by words or phrases such as "trend," "potential," "opportunity," "pipeline," "believe," "comfortable," "expect," "anticipate," "current," "intention," "estimate," "position," "assume," "outlook," "continue," "remain," "maintain," "sustain," "seek," "achieve," and similar expressions, or future or conditional verbs such as "will," "would," "should," "could," "may" or similar expressions. BlackRock cautions that forward-looking statements are subject to numerous assumptions, risks and uncertainties, which change over time. Forward-looking statements speak only as of the date they are made, and BlackRock assumes no duty to and does not undertake to update forward-looking statements. Actual results could differ materially from those anticipated in forward-looking statements and future results could differ materially from historical performance. With respect to the Fund, the following factors, among others, could cause actual events to differ materially from forward-looking statements or historical performance: (1) changes and volatility in political, economic or industry conditions, the interest rate environment, foreign exchange rates or financial and capital markets, which could result in changes in demand for the Fund or in the Fund's net asset value; (2) the relative and absolute investment performance of the Fund and its investments; (3) the impact of increased competition; (4) the unfavorable resolution of any legal proceedings; (5) the extent and timing of any distributions or share repurchases; (6) the impact, extent and timing of technological changes; (7) the impact of legislative and regulatory actions and reforms, and regulatory, supervisory or enforcement actions of government agencies relating to the Fund or BlackRock, as applicable; (8) terrorist activities, international hostilities, health epidemics and/or pandemics and natural disasters, which may adversely affect the general economy, domestic and local financial and capital markets, specific industries or BlackRock; (9) BlackRock's ability to attract and retain highly talented professionals; (10) the impact of BlackRock electing to provide support to its products from time to time; and (11) the impact of problems at other financial institutions or the failure or negative performance of products at other financial institutions. Annual and Semi-Annual Reports and other regulatory filings of the Fund with the SEC are accessible on the SEC's website at and on BlackRock's website at and may discuss these or other factors that affect the Fund. The information contained on BlackRock's website is not a part of this press release. View source version on Contacts 1-800-882-0052 Sign in to access your portfolio
