Is pre-operative urodynamic bladder function the true predictor of outcome of male sling for post prostatectomy incontinence?

PURPOSE: To investigate pre-operative urodynamic parameters in male sling patients to ascertain whether this might better predict surgical outcomes and facilitate patient selection. METHODS: We performed a retrospective, case notes and video-urodynamics, review of men who underwent AdVanceXP male sling in three London hospitals between 2012 and 2019. Urodynamics were performed in all centres, while retrograde leak point pressure (RLPP) was performed in one centre. RESULTS: Successful outcome was seen in 99/130 (76%) of men who required one pad or less per day. The dry rate was 51%. Pad usage was linked to worse surgical outcomes, mean 2.6 (range 1-6.5) for success vs 3.6 (range 1-10) although the ranges were wide (p = 0.002). 24 h pad weight also reached statistical significance (p = 0.05), with a mean of 181 g for success group versus 475 g for the non-successful group. The incidence of DO in the non-successful group was significantly higher than in successful group (55% versus 29%, p = 0.0009). Bladder capacity less than 250 ml was also associated with worse outcomes (p = 0.003). Reduced compliance was not correlated with outcomes (31% for success groups vs 45% for non-successful group, p = 0.15). Preoperative RLPP was performed in 60/130 patients but did not independently reach statistical significance (p = 0.25). CONCLUSION: Urodynamic parameters related to bladder function-detrusor overactivity and reduced maximum cystometric capacity predict male sling outcomes and may help in patient selection for male sling (or sphincter) surgery; whereas urodynamic parameters of sphincter incompetency (RLPP) were not predictive. Further larger scale studies are required to confirm these findings

Maternal seafood consumption in highly educated women is reduced in pregnancy: A pilot study

Oily fish is a unique natural source to vitamin D and marine n-3 fatty acids. The aim of the present study was to investigate from where pregnant women get dietary advices and whether they eat seafood during pregnancy or not. A self-selected convenience sample (n = 43) of highly educated women responded to a self-administrated web based questionnaire. The women reduced their intake of both lean (p < 0.013) and oily (p < 0.003) fish during pregnancy, indicating that the women were not fully aware of the beneficial effects of seafood intake during pregnancy

Environmental drivers of population-level variation in the migratory and diving ontogeny of an Arctic top predator

This work is an output of the ARISE project (NE/P006035/1 and NE/P00623X/1), part of the Changing Arctic Ocean programme jointly funded by the UKRI Natural Environment Research Council (NERC) and the German Federal Ministry of Education and Research (BMBF). Fieldwork in Canada was carried out under a Canadian Council on Animal Care permit no. NAFC2017–2 and funded by Fisheries and Oceans Canada and a bursary from Department for Business, Energy and Industrial Strategy (BEIS) administered by the NERC Arctic Office. Fieldwork in the Greenland Sea was approved by the Greenland Ministry of Fisheries, Hunting and Agriculture and the Norwegian Food Safety Authority (permit no. 11546) as part of the Northeast Greenland Environmental Study Program 2017–2018 (by the Danish Centre for Environment and Energy at Aarhus University, The Greenland Institute of Natural Resources and the Environmental Agency for Mineral Resource Activities of the Government of Greenland) and financed by oil licence holders in the area.The development of migratory strategies that enable juveniles to survive to sexual maturity is critical for species that exploit seasonal niches. For animals that forage via breath-hold diving, this requires a combination of both physiological and foraging skill development. Here, we assess how migratory and dive behaviour develop over the first year of life for a migratory Arctic top predator, the harp seal Pagophilus groenlandicus, tracked using animal-borne satellite relay data loggers. We reveal similarities in migratory movements and differences in diving behaviour between 38 juveniles tracked from the Greenland Sea and Northwest Atlantic breeding populations. In both regions, periods of resident and transitory behaviour during migration were associated with proxies for food availability: sea ice concentration and bathymetric depth. However, while ontogenetic development of dive behaviour was similar for both populations of juveniles over the first 25 days, after this time Greenland Sea animals performed shorter and shallower dives and were more closely associated with sea ice than Northwest Atlantic animals. Together, these results highlight the role of both intrinsic and extrinsic factors in shaping early life behaviour. Variation in the environmental conditions experienced during early life may shape how different populations respond to the rapid changes occurring in the Arctic ocean ecosystem.Publisher PDFPeer reviewe

Systematic Review of the Performance of Noninvasive Tests in Diagnosing Bladder Outlet Obstruction in Men with Lower Urinary Tract Symptoms

Context: Several noninvasive tests have been developed for diagnosing bladder outlet obstruction (BOO) in men to avoid the burden and morbidity associated with invasive urodynamics. The diagnostic accuracy of these tests, however, remains uncertain. Objective: To systematically review available evidence regarding the diagnostic accuracy of noninvasive tests in diagnosing BOO in men with lower urinary tract symptoms (LUTS) using a pressure-flow study as the reference standard. Evidence acquisition: The EMBASE, MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central, Google Scholar, and WHO International Clinical Trials Registry Platform Search Portal databases were searched up to May 18, 2016. All studies reporting diagnostic accuracy for noninvasive tests for BOO or detrusor underactivity in men with LUTS compared to pressure-flow studies were included. Two reviewers independently screened all articles, searched the reference lists of retrieved articles, and performed the data extraction. The quality of evidence and risk of bias were assessed using the QUADAS-2 tool. Evidence synthesis: The search yielded 2774 potentially relevant reports. After screening titles and abstracts, 53 reports were retrieved for full-text screening, of which 42 (recruiting a total of 4444 patients) were eligible. Overall, the results were predominantly based on findings from nonrandomised experimental studies and, within the limits of such study designs, the quality of evidence was typically moderate across the literature. Differences in noninvasive test threshold values and variations in the urodynamic definition of BOO between studies limited the comparability of the data. Detrusor wall thickness (median sensitivity 82%, specificity 92%), near- infrared spectroscopy (median sensitivity 85%, specificity 87%), and the penile cuff test (median sensitivity 88%, specificity 75%) were all found to have high sensitivity and specificity in diagnosing BOO. Uroflowmetry with a maximum flow rate of 10 mm was reported to have similar diagnostic accuracy, with median sensitivity of 68% and specificity of 75%. Conclusions: According to the literature, a number of noninvasive tests have high sensitivity and specificity in diagnosing BOO in men. However, although the majority of studies have a low overall risk of bias, the available evidence is limited by heterogeneity. While several tests have shown promising results regarding noninvasive assessment of BOO, invasive urodynamics remain the gold standard. Patient summary: Urodynamics is an accurate but potentially uncomfortable test for patients in diagnosing bladder problems such as obstruction. We performed a thorough and comprehensive review of the literature to determine if there were less uncomfortable but equally effective alternatives to urodynamics for diagnosing bladder problems. We found that some simple tests appear to be promising, although they are not as accurate. Further research is needed before these tests are routinely used in place of urodynamics. (C) 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.Peer reviewe

Studies of the decays D^0 \rightarrow K_S^0K^-\pi^+ and D^0 \rightarrow K_S^0K^+\pi^-

The first measurements of the coherence factor R_{K_S^0K\pi} and the average strong--phase difference \delta^{K_S^0K\pi} in D^0 \to K_S^0 K^\mp\pi^\pm decays are reported. These parameters can be used to improve the determination of the unitary triangle angle \gamma\ in B^- \rightarrow $\widetilde{D}K^-$ decays, where $\widetilde{D}$ is either a D^0 or a D^0-bar meson decaying to the same final state, and also in studies of charm mixing. The measurements of the coherence factor and strong-phase difference are made using quantum-correlated, fully-reconstructed D^0D^0-bar pairs produced in e^+e^- collisions at the \psi(3770) resonance. The measured values are R_{K_S^0K\pi} = 0.70 \pm 0.08 and \delta^{K_S^0K\pi} = (0.1 \pm 15.7)$^\circ$ for an unrestricted kinematic region and R_{K*K} = 0.94 \pm 0.12 and \delta^{K*K} = (-16.6 \pm 18.4)$^\circ$ for a region where the combined K_S^0 \pi^\pm invariant mass is within 100 MeV/c^2 of the K^{*}(892)^\pm mass. These results indicate a significant level of coherence in the decay. In addition, isobar models are presented for the two decays, which show the dominance of the K^*(892)^\pm resonance. The branching ratio {B}(D^0 \rightarrow K_S^0K^+\pi^-)/{B}(D^0 \rightarrow K_S^0K^-\pi^+) is determined to be 0.592 \pm 0.044 (stat.) \pm 0.018 (syst.), which is more precise than previous measurements.Comment: 38 pages. Version 3 updated to include the erratum information. Errors corrected in Eqs (25), (26), 28). Fit results updated accordingly, and external inputs updated to latest best known values. Typo corrected in Eq(3)- no other consequence

Evaluation of the nutritional embedding evaluation programme

Undernutrition among children remains a significant challenge in Kenya with 26% of children under the age of five registering low height-for-age ratios or, in other words, experiencing stunted growth. The problem is often attributed to parents’ scant knowledge of optimal feeding practices. Augmenting this knowledge by providing caregivers with information on nutrition has proven to be effective - inducing positive changes in caregivers’ behavior and, in turn, improving health outcomes among children. Designed to supply this critically needed information, NEEP was tested as a potentially impactful, cost-effective and scalable innovation to reduce undernutrition and improve growth outcomes among children

Search for the decay J/ψ→γ+invisibleJ/\psi\to\gamma + \rm {invisible}

We search for $J/\psi$ radiative decays into a weakly interacting neutral particle, namely an invisible particle, using the $J/\psi$ produced through the process $\psi(3686)\to\pi^+\pi^-J/\psi$ in a data sample of $(448.1\pm2.9)\times 10^6$ $\psi(3686)$ decays collected by the BESIII detector at BEPCII. No significant signal is observed. Using a modified frequentist method, upper limits on the branching fractions are set under different assumptions of invisible particle masses up to 1.2 $\mathrm{\ Ge\kern -0.1em V}/c^2$. The upper limit corresponding to an invisible particle with zero mass is 7.0$\times 10^{-7}$ at the 90\% confidence level

Selection and integration of earth observation-based data for an operational disease forecasting system

The current increase in the volume and quality of Earth Observation (EO) data being collected by satellites offers the potential to contribute to applications across a wide range of scientific domains. It is well established that there are correlations between characteristics that can be derived from EO satellite data, such as land surface temperature or land cover, and the incidence of some diseases. Thanks to the reliable frequent acquisition and rapid distribution of EO data it is now possible for this field to progress from using EO in retrospective analyses of historical disease case counts to using it in operational forecasting systems. However, bringing together EO-based and non-EO-based datasets, as is required for disease forecasting and many other fields, requires carefully designed data selection, formatting and integration processes. Similarly, it requires careful communication between collaborators to ensure that the priorities of that design process match the requirements of the application. Here we will present work from the D-MOSS (Dengue forecasting MOdel Satellite-based System) project. D-MOSS is a dengue fever early warning system for South and South East Asia that will allow public health authorities to identify areas at high risk of disease epidemics before an outbreak occurs in order to target resources to reduce spreading of epidemics and improve disease control. The D-MOSS system uses EO, meteorological and seasonal weather forecast data, combined with disease statistics and static layers such as land cover, as the inputs into a dengue fever model and a water availability model. Water availability directly impacts dengue epidemics due to the provision of mosquito breeding sites. The datasets are regularly updated with the latest data and run through the models to produce a new monthly forecast. For this we have designed a system to reliably feed standardised data to the models. The project has involved a close collaboration between remote sensing scientists, geospatial scientists, hydrologists and disease modelling experts. We will discuss our approach to the selection of data sources, data source quality assessment, and design of a processing and ingestion system to produce analysis-ready data for input to the disease and water availability models