Intravesical botulinum toxin for lower urinary tract dysfunction

Botulinum neurotoxin has achieved substantial clinical benefits in neurogenic detrusor overactivity. More contentious has been its extension to management of refractory idiopathic detrusor overactivity, in which risk of impaired voiding function and consequent need for intermittent catheterisation may counteract the quality-of-life benefits of improved storage function. Several issues remain uncertain for this unlicensed treatment, and clear insights into long-term consequences are needed before it can be regarded as an established mainstream treatment

Cold mix asphalt- an alternative method to pavement rehabilitation

Failure or distress on pavement surface such as pothole, alligator cracking and shear cracking that commonly occurred and required pavement rehabilitation for maintenance proposes. Regarding the cost of reconstruction and the cost of transport and storing removed pavement materials, paying attention to recycling strategies for asphalt pavements has been considered extremely by transportation agencies [1] Pavement rehabilitation is considered as cost efficient instead of reconstruction for new pavement. Pavement rehabilitation is a structural or functional enhancement of a pavement which produces a substantial extension in service life, by substantially improving pavement condition and ride quality. The characteristic of existing pavement conditions is an important component of any rehabilitation design methodology

Where does the time go? An investigation of self-reported time allocation

Depression is recognized as a substantial contributor to the global burden of disease, as well as economic productivity. Behavioral activation has been shown to be an efficacious treatment for depression, drawing on the work of early behavioral theorists and research on the quantitative matching law. Recently, scholars have called for increased theoretical rigor in conceptualizing psychological health, as well as increased conceptual and methodological dialogue between basic and applied researchers. The present study examined the validity of a novel self-report measure of time allocation, an extension of the matching law. A cross-sectional sample of 204 undergraduate psychology students completed measures of behavioral and emotional health in addition to the time allocation task. The task asked participants to report their time spent engaging in meaningful activities, managing life\u27s negatives, and sleeping. It also asked participants to subjectively rate their experience of these life areas on a 1-10 scale. Pearson correlations, multiple regression analyses, and one-way ANOVA were used to evaluate the convergent, discriminant, and predictive validity of the time allocation task. Approximately half of the expected Pearson correlations were significant. Questions related to the quality or effectiveness of allocated time had stronger relationships with conventional and behavioral measures of depression than the time questions, a finding that was not expected. Average time spent managing life\u27s negatives, as well as the subjective quality ratings of all three areas of time, were significant in differentiating depression severity groups. The overall time allocation task demonstrated some predictive validity, but did not show incremental validity when other constructs were controlled for. Strengths and weaknesses of the project, as well as implications for clinical behavioral process research, are discussed in the conclusion

Assessment of the secondary shelf life of Bolognese sauce based on domestic use simulation

Household food waste contributes significantly to global food waste throughout the food supply chain, resulting in a substantial waste of resources. The inability of consumers to utilize food before it spoils generally leads to its disposal, thus representing one of the causes of food waste. The secondary shelf life (SSL) is the period a product should be consumed within once open, specified in the label, which sometimes is extremely short and may lead to a significant amount of discarded food. This study focuses on evaluating the SSL of Bolognese sauce through domestic use simulation and monitoring its microbiological and sensory quality, to explore the potential extension of the SSL, allowing consumers more time to consume the product. Results show that, even under harsh usage conditions, Bolognese sauce can have a SSL longer than 13 days, 2–3 times longer than the current SSL. The results highlight the influence of consumer behavior in determining the SSL, suggesting that improved food management could further reduce household food wast

The state of ambient air quality in Pakistan—a review

Background and purpose: Pakistan, during the last decade, has seen an extensive escalation in population growth, urbanization, and industrialization, together with a great increase in motorization and energy use. As a result, a substantial rise has taken place in the types and number of emission sources of various air pollutants. However, due to the lack of air quality management capabilities, the country is suffering from deterioration of air quality. Evidence from various governmental organizations and international bodies has indicated that air pollution is a significant risk to the environment, quality of life, and health of the population. The Government has taken positive steps toward air quality management in the form of the Pakistan Clean Air Program and has recently established a small number of continuous monitoring stations. However, ambient air quality standards have not yet been established. This paper reviews the data being available on the criteria air pollutants: particulate matter (PM), sulfur dioxide, ozone, carbon monoxide, nitrogen dioxide, and lead. Methods: Air pollution studies in Pakistan published in both scientific journals and by the Government have been reviewed and the reported concentrations of PM, SO2, O3, CO, NO2, and Pb collated. A comparison of the levels of these air pollutants with the World Health Organization air quality guidelines was carried out. Results: Particulate matter was the most serious air pollutant in the country. NO2 has emerged as the second high-risk pollutant. The reported levels of PM, SO2, CO, NO2, and Pb were many times higher than the World Health Organization air quality guidelines. Only O3 concentrations were below the guidelines. Conclusions: The current state of air quality calls for immediate action to tackle the poor air quality. The establishment of ambient air quality standards, an extension of the continuous monitoring sites, and the development of emission control strategies are essential. © Springer-Verlag 2009

an RCT

Physical inactivity leads to a deconditioning of the skeletal, neuromuscular and cardiovascular system. It can lead to impaired quality of life, loss of autonomy, falls and fractures. Regular exercise would be a logical remedy, but the generally recommended high-volume endurance and strength training programs require a lot of time and equipment. In this randomized controlled study with 23 healthy participants, we established that a short, intensive jump training program can prevent the large musculoskeletal and cardiovascular deconditioning effects caused by two months of physical inactivity during bed rest, particularly the loss of bone mineral mass and density, lean muscle mass, maximal leg strength and peak oxygen uptake. The jump training group showed no significant changes with respect to these indicators of musculoskeletal and cardiovascular health after 60 days of bed rest, whereas the control group exhibited substantial losses: up to −2.6% in tibial bone mineral content and density, −5% in leg lean mass, −40% in maximal knee extension torque and −29% in peak oxygen uptake. Consequently, we recommend jump training as a very time-efficient and effective type of exercise for astronauts on long-term space missions, the elderly and sedentary populations in general

Are life-extending treatments for terminal illnesses a special case? Exploring choices and societal viewpoints

Criteria used by the National Institute for Health and Care Excellence (NICE) to assess life-extending, end-of-life (EoL) treatments imply that health gains from such treatments are valued more than other health gains. Despite claims that the policy is supported by societal values, evidence from preference elicitation studies is mixed and in-depth research has shown there are different societal viewpoints. Few studies elicit preferences for policies directly or combine different approaches to understand preferences.Survey questions were designed to investigate support for NICE EoL guidance at national and regional levels. These ‘Decision Rule’ and ‘Treatment Choice’ questions were administered to an online sample of 1496 UK respondents in May 2014. The same respondents answered questions designed to elicit their agreement with three viewpoints (previously identified and described) in relation to provision of EoL treatments for terminally ill patients. We report the findings of these choice questions and examine how they relate to each other and respondents' viewpoints.The Decision Rule questions described three policies: DA – a standard ‘value for money’ test, applied to all health technologies; DB – giving special consideration to all treatments for terminal illnesses; and DC – giving special consideration to specific categories of treatments for terminal illnesses e.g. life extension (as in NICE EoL guidance) or those that improve quality-of-life (QoL). Three Treatment Choices were presented: TA – improving QoL for patients with a non-terminal illness; TB – extending life for EoL patients; and TC – improving QoL at the EoL.DC received most support (45%) with most respondents giving special consideration to EoL only when treatments improved QoL. The most commonly preferred treatment choices were TA (51%) and TC (43%). Overall, this study challenges claims about public support for NICE's EoL guidance and the focus on life extension at EoL and substantiates existing evidence of plurality in societal values

Aerobic capacity and skeletal muscle characteristics in glycogen storage disease IIIa: an observational study

Background: Individuals with glycogen storage disease IIIa (GSD IIIa) (OMIM #232400) experience muscle weakness and exercise limitation that worsen through adulthood. However, normative data for markers of physical capacity, such as strength and cardiovascular fitness, are limited. Furthermore, the impact of the disease on muscle size and quality is unstudied in weight bearing skeletal muscle, a key predictor of physical function. We aim to produce normative reference values of aerobic capacity and strength in individuals with GSD IIIa, and to investigate the role of muscle size and quality on exercise impairment. Results: Peak oxygen uptake (V̇O2peak) was lower in the individuals with GSD IIIa than predicted based on demographic data (17.0 (9.0) ml/kg/min, 53 (24)% of predicted, p = 0.001). Knee extension maximum voluntary contraction (MVC) was also substantially lower than age matched predicted values (MVC: 146 (116) Nm, 57% predicted, p = 0.045), though no difference was found in MVC relative to body mass (1.88 (2.74) Nm/kg, 61% of predicted, p = 0.263). There was a strong association between aerobic capacity and maximal leg strength (r = 0.920; p = 0.003). Substantial inter-individual variation was present, with a high physical capacity group that had normal leg strength (MVC), and relatively high V̇O2peak, and a low physical capacity that display impaired strength and substantially lower V̇O2peak. The higher physical capacity sub-group were younger, had larger Vastus Lateralis (VL) muscles, greater muscle quality, undertook more physical activity (PA), and reported higher health-related quality of life. Conclusions: V̇O2peak and knee extension strength are lower in individuals with GSD IIIa than predicted based on their demographic data. Patients with higher physical capacity have superior muscle size and structure characteristics and higher health-related quality of life, than those with lower physical capacity. This study provides normative values of these important markers of physical capacity

'Smart' design: greening the Total Product System

About the book: Since the Rio summit in 1992, the paradigm of corporate environmental responsibility has gradually and consistently extended beyond complying with increasingly stringent environmental regulation and taking up the proactive initiatives of a few world-class companies. Research indicates that the business and financial performance of companies may depend directly on socially and environmentally responsible business practices. Many world-class companies now realize that customers and other stakeholders do not distinguish between a company and its suppliers. As a result, greening the supply chain is an innovative idea which is fast gaining attention in the industry. Greening the Supply Chain is a compilation of important chapters written by a diverse set of international authors which incorporates a broad variety of perspectives. Note: Smart car refers to Smart City coupe and Fortwo, and all terms are registered trademarks of MCC (micro compact car)