The cognitive effect of anticholinergics for patients with overactive bladder

Overactive bladder (OAB) is often treated with medications that block the cholinergic receptors in the bladder (known as anticholinergics). The effect of this medication class on cognition and risk of dementia has been increasingly studied over the past 40 years after initial studies suggested that the anticholinergic medication class could affect memory. Short-term randomized clinical trials demonstrated that the administration of the anticholinergic oxybutynin leads to impaired memory and attention, and large, population-based studies showed associations between several different anticholinergic medications and dementia. However, trials involving anticholinergics other than oxybutynin have not shown such substantial effects on short-term cognitive function. This discordance in results between short-term cognitive safety of OAB anticholinergics and the long-term increased dementia risk could be explained by the high proportion of patients using oxybutynin in the OAB subgroups of the dementia studies, or a study duration that was too short in the prospective clinical trials on cognition with other OAB anticholinergics. Notably, all studies must be interpreted in the context of potential confounding factors, such as when prodromal urinary symptoms associated with the early stages of dementia lead to an increase in OAB medication use, rather than the use of OAB medication causing dementia. In patients with potential risk factors for cognitive impairment, the cautious use of selected OAB anticholinergic agents with favourable physicochemical and pharmacokinetic properties and clinical trial evidence of cognitive safety might be appropriate

Amoeba Techniques for Shape and Texture Analysis

Morphological amoebas are image-adaptive structuring elements for morphological and other local image filters introduced by Lerallut et al. Their construction is based on combining spatial distance with contrast information into an image-dependent metric. Amoeba filters show interesting parallels to image filtering methods based on partial differential equations (PDEs), which can be confirmed by asymptotic equivalence results. In computing amoebas, graph structures are generated that hold information about local image texture. This paper reviews and summarises the work of the author and his coauthors on morphological amoebas, particularly their relations to PDE filters and texture analysis. It presents some extensions and points out directions for future investigation on the subject.Comment: 38 pages, 19 figures v2: minor corrections and rephrasing, Section 5 (pre-smoothing) extende

Developing a phenomenological equation to predict yield strength from composition and microstructure in β processed Ti-6Al-4V

A constituent-based phenomenological equation to predict yield strength values from quantified measurements of the microstructure and composition of β processed Ti-6Al-4V alloy was developed via the integration of artificial neural networks and genetic algorithms. It is shown that the solid solution strengthening contributes the most to the yield strength (~80% of the value), while the intrinsic yield strength of the two phases and microstructure have lower effects (~10% for both terms). Similarities and differences between the proposed equation and the previously established phenomenological equation for the yield strength prediction of the α+β processed Ti-6Al-4V alloys are discussed. While the two equations are very similar in terms of the intrinsic yield strength of the two constituent phases, the solid solution strengthening terms and the ‘Hall-Petch’-like effect from the alpha lath, there is a pronounced difference in the role of the basketweave factor in strengthening. Finally, Monte Carlo simulations were applied to the proposed phenomenological equation to determine the effect of measurement uncertainties on the estimated yield strength values

Equating Accelerometer Estimates of Moderate-to-Vigorous Physical Activity: In Search of the Rosetta Stone

Purpose - No universally accepted ActiGraph accelerometer cutpoints for quantifying moderate-to-vigorous physical activity (MVPA) exist. Estimates of MVPA from one set of cutpoints cannot be directly compared to MVPA estimates using different cutpoints, even when the same outcome units are reported (MVPA min•d-1). The purpose of this study was to illustrate the utility of an equating system that translates reported MVPA estimates from one set of cutpoints into another, to better inform public health policy. Design - Secondary data analysis. Methods - ActiGraph data from a large preschool project (N=419, 3-6yr-olds, CHAMPS) was used to conduct the analyses. Conversions were made among five different published MVPA cutpoints for children: Pate (PT), Sirard (SR), Puyau (PY), Van Cauwengerghe (VC), and Freedson Equation (FR). A 10 fold cross-validation procedure was used to develop prediction equations using MVPA estimated from each of the five sets of cutpoints as the dependent variable, with estimated MVPA from one of the other four sets of cutpoints (e.g., PT MVPA predicted from FR MVPA). Results - The mean levels of MVPA for the total sample ranged from 22.5 (PY) to 269.0 (FR) min•d-1. Across the prediction models (5 total), the median proportion of variance explained (R2) was 0.76 (range 0.48-0.97). The median absolute percent error was 17.2% (range 6.3%-38.4%). Conclusion - The prediction equations developed here allow for direct comparisons between studies employing different ActiGraph cutpoints in preschool-age children. These prediction equations give public health researchers and policy makers a more concise picture of physical activity levels of preschool-aged children

The Role of Peer Social Network Factors and Physical Activity in Adolescent Girls

Objective: To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls. Methods: Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school. Results: Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses. Conclusions: Frequency of PA with friends was an important correlate of PA among the peer network variables for adolescent girls

Predictors of low urinary quality of life in spinal cord injury patients on clean intermittent catheterization

ObjectiveClean intermittent catheterization (CIC) is a preferred method of bladder management for many patients with spinal cord injury (SCI), but long‐term adherence is low. The aim of this study is to identify factors associated with low urinary quality of life (QoL) in SCI adults performing CIC.MethodsOver 1.5 years, 1479 adults with SCI were prospectively enrolled through the Neurogenic Bladder Research Group registry, and 753 on CIC with no prior surgeries were included. Injury characteristics, complications, hand function, and Neurogenic Bladder Symptom Score (NBSS) were analyzed. The NBSS QoL question (overall satisfaction with urinary function) was dichotomized to generate comparative groups (dissatisfied vs neutral/satisfied).ResultsThe cohort was 32.9% female with a median age of 43.2 (18‐86) years, time since the injury of 9.8 (0‐48.2) years, and 69.0% had an injury at T1 or below. Overall 36.1% were dissatisfied with urinary QoL. On multivariable analysis, female gender (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.15‐2.31; P = 0.016), earlier injury (OR, 0.95 per year; 95% CI, 0.93‐0.97; P < 0.001), ≥4 urinary tract infections (UTIs) per year (OR, 2.36; 95% CI, 1.47‐3.81; P = 0.001), and severe bowel dysfunction (OR, 1.42; 95% CI, 1.02‐1.98; P = 0.035) predicted dissatisfaction. Level of injury, fine motor hand function, and caregiver dependence for CIC were not associated with dissatisfaction.ConclusionsIn a mature SCI cohort, physical disability does not predict dissatisfaction with urinary QoL but severe bowel dysfunction and recurrent UTIs have a significant negative impact. With time the rates of dissatisfaction decline but women continue to be highly dissatisfied on CIC and may benefit from early intervention to minimize the burden of CIC on urinary QoL.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149763/1/nau23983.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149763/2/nau23983_am.pd

Treatment of Candida albicans biofilms with low-temperature plasma induced by dielectric barrier discharge and atmospheric pressure plasma jet

Because of some disadvantages of chemical disinfection in dental practice (especially denture cleaning), we investigated the effects of physical methods on Candida albicans biofilms. For this purpose, the antifungal efficacy of three different low-temperature plasma devices (an atmospheric pressure plasma jet and two different dielectric barrier discharges (DBDs)) on Candida albicans biofilms grown on titanium discs in vitro was investigated. As positive treatment controls, we used 0.1% Chlorhexidine digluconate (CHX) and 0.6% sodium hypochlorite (NaOCl). The corresponding gas streams without plasma ignition served as negative treatment controls. The efficacy of the plasma treatment was determined evaluating the number of colony-forming units (CFU) recovered from titanium discs. The plasma treatment reduced the CFU significantly compared to chemical disinfectants. While 10 min CHX or NaOCl exposure led to a CFU log 10 reduction factor of 1.5, the log10 reduction factor of DBD plasma was up to 5. In conclusion, the use of low-temperature plasma is a promising physical alternative to chemical antiseptics for dental practice. © IOP Publishing Ltd and Deutsche Physikalische Gesellschaft

Reasons for cessation of clean intermittent catheterization after spinal cord injury: Results from the Neurogenic Bladder Research Group spinal cord injury registry

IntroductionClean intermittent catheterization (CIC) is recommended for bladder management after spinal cord injury (SCI) since it has the lowest complication rate. However, transitions from CIC to other less optimal strategies, such as indwelling catheters (IDCs) are common. In individuals with SCI who stopped CIC, we sought to determine how individual characteristics affect the bladder‐related quality of life (QoL) and the reasons for CIC cessation.MethodsThe Neurogenic Bladder Research Group registry is an observational study, evaluating neurogenic bladder‐related QoL after SCI. From 1479 participants, those using IDC or urinary conduit were asked if they had ever performed CIC, for how long, and why they stopped CIC. Multivariable regression, among participants discontinuing CIC, established associations between demographics, injury characteristics, and SCI complications with bladder‐related QoL.ResultsThere were 176 participants who had discontinued CIC; 66 (38%) were paraplegic and 110 (63%) were male. The most common reasons for CIC cessation among all participants were inconvenience, urinary leakage, and too many urine infections. Paraplegic participants who discontinued CIC had higher mean age, better fine motor scores, and lower educational attainment and employment. Multivariable regression revealed years since SCI was associated with worse bladder symptoms (neurogenic bladder symptom score), ≥4 urinary tract infections (UTIs) in a year was associated with worse satisfaction and feelings about bladder symptoms (SCI‐QoL difficulties), while tetraplegia was associated better satisfaction and feelings about bladder symptoms (SCI‐QoL difficulties).ConclusionsTetraplegics who have discontinued CIC have an improved QoL compared with paraplegics. SCI individuals who have discontinued CIC and have recurrent UTIs have worse QoL.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153674/1/nau24172_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153674/2/nau24172.pd

Self-Management Strategies Mediate Self-Efficacy and Physical Activity

Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested