An animal experimental study on pubourethral ligament restoration with platelet rich plasma for the treatment of stress urinary incontinence.

Introduction: Minimally invasive methods for injured ligament and tendon restoration have been developed and gained popularity in recent years. Injury and relaxation of the pubourethral ligament (PUL) can lead to stress urinary incontinence (SUI). The aim of this study was to investigate the impact of injecting platelet rich plasma (PRP) into the PUL following its surgical transection resulting in SUI, confirmed by leak point pressure (LPP) measurements pre- and post-intervention in an experimental animal model. Material and methods: Twenty female adult Sprague-Dawley rats were assigned in 2 groups: 1) treatment group with transection of the PUL and application of PRP at the time of transection and at one month follow-up and 2) a control group, with transection of the PUL only. Leak point pressures (LPPs) were measured prior to transection, immediately following the transection and at 1 and 2 months in both groups. Results: The median LPPs for the control group were: LPP - preT: 35.6 (29.8-44.8) cmH2O, LPP - postT: 14.6 (5.8-19.0) cmH2O, LPP - 1 month: 27.3 (19.2-33.8) cmH2O, LPP - 2 months: 29.0 (27.0-34.0) cmH2O, whereas for the PRP group were: LPP-preT: 40.5 (33.2-46.3) cmH2O, LPP - postT: 15.7 (3.0-24.0) cmH2O, LPP - 1month: 31.6 (24.8-37.4) cmH2O, LPP - 2 months: 36.8 (32.5-45.4) cmH2O. PRP injections on transected PULs significantly increased LPPs at one month follow-up [31.6 cmH2O vs. 27.3 cmH2O, p = .043]. This effect was confirmed at two months [36.8 cmH2O vs. 29.0 cmH2O, p <.001]. Conclusions: Injection of PRP into transected PULs significantly improved LPPs at one and two months' follow-up. However, further experimental and clinical research is needed to evaluate the safety and efficacy of this treatment, in clinical practice

Focused Attention vs. Open Monitoring: An Event-Related Potential Study of Emotion Regulation by Two Distinct Forms of Mindfulness Meditation

This study investigated the effects of two novel forms of 8-week mindfulness meditation training, focused attention (FA) and open monitoring (OM), relative to an established training, mindfulness-based cognitive therapy (MBCT), on early emotional reactivity to negative emotional images as assessed by electroencephalography (EEG). Data on the late-positive potential (LPP) were analyzed to address whether the three mindfulness interventions attenuated the LPP from pre- to post-intervention, and if significant differences existed between groups in LPP at post-intervention. Rather than an attenuation, results indicated an average increase in LPP amplitude from pre- to post-intervention. No significant differences were found in the LPP between the training conditions at post-intervention. These results provide preliminary evidence that mindfulness training in novice practitioners may heighten initial emotional reactivity. Further, well-designed research is needed to examine a wider range of neural responses to better understand emotion regulation process effects of different forms of mindfulness training

Women’s use of Preventive Primary Care in the Late Postpartum Period

The literature has limited data on how women access health care after the traditional postpartum period (postpartum). Modeled after a paper by Bryant (2016), this project assesses the prevalence of primary care visits in the late postpartum period (LPP)(60- 730 days postpartum). Study objectives included (1) Identify demographics of general delivering population at UVMMC compared to patients with UVM-affiliated primary care provider (UVMPCP). (2) Understand how the general delivering population uses the UVMHN LPP (3) Among women with a UVM-affiliated PCP, identify the prevalence of preventive care visits in the LPP. (4) Identify characteristics associated with LPP visit attendance. Hypothesis: Women with an established PCP prior to pregnancy are more likely to attend preventive PCP LPP visits. This was a retrospective cohort study for all women who delivered at UVMMC between 7/1/2015-6/30/2017. Data was extracted from Epic EMR. During the study period, 4169 women had one singleton pregnancy, 3413 (82%) had a known PCP, and 1279 (31%) had UVMPCP. 2535 (61%) of all delivering singleton women and 1112 (87%) of UVMPCP women had at least one clinical visit within UVMHN in the LPP. 959 (75%) of UVMPCP women had a LPP PCP visit, and 382 patients (30%) had preventative PCP LPP visits. Our hypothesis was rejected (OR 0.930), but attending any LPP PCP visit was associated with having a PCP established prior to pregnancy (OR 1.684). Attending preventive PCP visit was associated with having the same delivering provider as PCP (OR 1.742), a pre-pregnancy PCP visit (OR 1.460), a PCP visit during prenatal time (OR 1.459), ED visit early postpartum period (OR 0.402), a fetal or neonatal demise (OR 0.445), being single (0.601), and with public insurance (OR 0.489). Further work in understanding these associations will be important in developing improved transition of care models and increasing overall engagement in women’s preventive medicine

A systematic review of randomised controlled trials on the effectiveness of exercise programs on lumbo pelvic pain among postnatal women

Background: A substantial number of women tend to be affected by Lumbo Pelvic Pain (LPP) following child birth. Physical exercise is indicated as a beneficial method to relieve LPP, but individual studies appear to suggest mixed findings about its effectiveness. This systematic review aimed to synthesise evidence from randomised controlled trials on the effectiveness of exercise on LPP among postnatal women to inform policy, practice and future research. Methods: A systematic review was conducted of all randomised controlled trials published between January 1990 and July 2014, identified through a comprehensive search of following databases: PubMed, PEDro, Embase, Cinahl, Medline, SPORTDiscus, Cochrane Pregnancy and Childbirth Group’s Trials Register, and electronic libraries of authors’institutions. Randomised controlled trials were eligible for inclusion if the intervention comprised of postnatal exercise for women with LPP onset during pregnancy or within 3 months after delivery and the outcome measures included changes in LPP. Selected articles were assessed using the PEDro Scale for methodological quality and findings were synthesised narratively as meta-analysis was found to be inappropriate due to heterogeneity among included studies. Results: Four randomised controlled trials were included, involving 251 postnatal women. Three trials were rated as of ‘good’ methodological quality. All trials, except one, were at low risk of bias. The trials included physical exercise programs with varying components, differing modes of delivery, follow up times and outcome measures. Intervention in one trial, involving physical therapy with specific stabilising exercises, proved to be effective in reducing LPP intensity. An improvement in gluteal pain on the right side was reported in another trial and a significant difference in pain frequency in another. Conclusion: Our review indicates that only few randomised controlled trials have evaluated the effectiveness of exercise on LPP among postnatal women. There is also a great amount of variability across existing trials in the components of exercise programs, modes of delivery, follow up times and outcome measures. While there is some evidence to indicate the effectiveness of exercise for relieving LPP, further good quality trials are needed to ascertain the most effective elements of postnatal exercise programs suited for LPP treatment

Fluctuations of the competition interface in presence of shocks

We consider last passage percolation (LPP) models with exponentially distributed random variables, which are linked to the totally asymmetric simple exclusion process (TASEP). The competition interface for LPP was introduced and studied by Ferrari and Pimentel in [Ann. Probab. 33 (2005), 1235-1254] for cases where the corresponding exclusion process had a rarefaction fan. Here we consider situations with a shock and determine the law of the fluctuations of the competition interface around its deterministic law of large number position. We also study the multipoint distribution of the LPP around the shock, extending our one-point result of [Probab. Theory Relat. Fields 61 (2015), 61-109].Comment: 33 pages, 4 figures, LaTe

Reduced kinetic mechanisms for modelling LPP combustión in gas turbines

Reduced kinetic mechanisms for modelling LPP combustión in gas turbine