Individualised pelvic floor muscle training in women with pelvic organ prolapse: a multicentre randomised controlled trial

<br>Background: Pelvic organ prolapse is common and is strongly associated with childbirth and increasing age. Women with prolapsed are often advised to do pelvic floor muscle exercises, but supporting evidence is limited. Our aim was to establish if one-to-one individualised pelvic floor muscle training (PFMT) is effective in reducing prolapse symptoms.</br> <br>Methods: A parallel‐group multicentre randomised controlled trial (ISRCTN35911035) in female outpatients with newly-diagnosed, symptomatic stage I, II or III prolapse, comparing five PFMT appointments over 16 weeks (n=225) versus a lifestyle advice leaflet (n=222). Treatment allocation was by remote computer allocation using minimisation. Our primary endpoint was participants’ self-report of prolapsed symptoms at 12 months. Group assignment was masked from outcome assessors. We compared outcomes between trial groups in an intention-to-treat analysis. The cost of PFMT and savings on subsequent treatments were calculated to estimate cost-effectiveness.</br> <br>Findings: Compared to the control group, the intervention group reported fewer prolapse symptoms at 12 months (mean difference between groups in change score 1.52, 95% CI [0.46, 2.59], p=0.0053); reported their prolapse to be “better” more often (57.2% versus 44.7%, difference 12.6%, 95% CI [1.1%, 24.1%], p=0.0336); and had an increased but non-significant odds of having less severe stage of prolapse at their 6-month clinical examination, (OR 1.47, 95% CI [0.97, 2.27], p=0.07). The control group had a greater uptake of other prolapse treatment (49.6% versus 24.1%, difference 25.5%, 95% CI [14.5%, 36.0%], p <0.0001). Findings were robust to missing data. The net cost of the 25 intervention was £131.61 per woman and the cost per one-point reduction in the symptom score was £86.59, 95% CI [£50.81, £286.11]. </br&gt

A closer look at creativity as search

Publisher PD

Water sources for root water uptake : Using stable isotopes of hydrogen and oxygen as a research tool in agricultural and agroforestry systems

DP was supported by the autonomous Province of Bozen-Bolzano and Free University of Bozen-Bolzano, Italy [grant number B83G13000420003]; JG was supported by the Carnegie Trust for the Universities of Scotland [grant reference: RIG008284] and the UK Natural Environment Research Council [grant numbers: NE/N007611/1 and NE/S009167/1].Peer reviewedPostprin

The impact of subsidies on the ecological sustainability and future profits from North Sea fisheries

Background: This study examines the impact of subsidies on the profitability and ecological stability of the North Sea fisheries over the past 20 years. It shows the negative impact that subsidies can have on both the biomass of important fish species and the possible profit from fisheries. The study includes subsidies in an ecosystem model of the North Sea and examines the possible effects of eliminating fishery subsidies.Methodology/Principal Findings: Hindcast analysis between 1991 and 2003 indicates that subsidies reduced the profitability of the fishery even though gross revenue might have been high for specific fisheries sectors. Simulations seeking to maximise the total revenue between 2004 and 2010 suggest that this can be achieved by increasing the effort of Nephrops trawlers, beam trawlers, and the pelagic trawl-and-seine fleet, while reducing the effort of demersal trawlers. Simulations show that ecological stability can be realised by reducing the effort of the beam trawlers, Nephrops trawlers, pelagic- and demersal trawl-and-seine fleets. This analysis also shows that when subsidies are included, effort will always be higher for all fleets, because it effectively reduces the cost of fishing.Conclusions/Significance: The study found that while removing subsidies might reduce the total catch and revenue, it increases the overall profitability of the fishery and the total biomass of commercially important species. For example, cod, haddock, herring and plaice biomass increased over the simulation when optimising for profit, and when optimising for ecological stability, the biomass for cod, plaice and sole also increased. When subsidies are eliminated, the study shows that rather than forcing those involved in the fishery into the red, fisheries become more profitable, despite a decrease in total revenue due to a loss of subsidies from the government

Social complexification and pig (Sus scrofa) husbandry in ancient China : a combined geometric morphometric and isotopic approach

Funding: This work was supported by the CNRSCASS program for the training of Chinese PhD students.Peer reviewedPublisher PD

Scientific opinion on the tolerable upper intake level for folate

© 2023 European Food Safety Authority. EFSA Journal published by Wiley‐VCH GmbH on behalf of European Food Safety Authority.Peer reviewedPublisher PD

Ideologies and their points of view

© Springer International Publishing Switzerland 2016. It is well known that different arguments appeal to different people. We all process information in ways that are adapted to be consistent with our underlying ideologies. These ideologies can sometimes be framed in terms of particular axes or dimensions, which makes it possible to represent some aspects of an ideology as a region in the kind of vector space that is typical of many generalised quantum models. Such models can then be used to explain and predict, in broad strokes, whether a particular argument or proposal is likely to appeal to an individual with a particular ideology. The choice of suitable arguments to bring about desired actions is traditionally part of the art or science of rhetoric, and today’s highly polarised society means that this skill is becoming more important than ever. This paper presents a basic model for understanding how different goals will appeal to people with different ideologies, and thus how different rhetorical positions can be adopted to promote the same desired outcome. As an example, we consider different narratives and hence actions with respect to the environment and climate change, an important but currently highly controversial topic

Mitigation potential and environmental impact of centralized versus distributed BECCS with domestic biomass production in Great Britain

ACKNOWLEDGEMENTS This work was carried out under the UK Energy Research Council (UKERC)‐funded project ‘Assessing potential, feasibility and impacts of Bioenergy with CCS (BECCS) in the UK (Access‐BECCS)’. We thank Dr Ajay Gambhir for valuable comments and discussion.Peer reviewedPublisher PD

Glutamatergic transmission and receptor expression in the synucleinopathy h-α-synL62 mouse model : Effects of hydromethylthionine

Acknowledgements The authors acknowledge Dr. Dilyara Lauer and Heide Lueck for the excellent technical support with the administration of drugs, collection of brains and sectioning of brain tissue for immunohistochemistry. Funding This work was funded by TauRx Therapeutics Ltd., Singapore. Z. C. was funded by the Erasmus+ programme of the European Union.Peer reviewedPublisher PD