Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence : a feasibility study

Background Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional training. Aims The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM) exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative information regarding patient satisfaction with this new combined training program. Methods Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the participants' rate of participation in and completion of both the PFM/VRR training program and the home exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and participant's satisfaction through a questionnaire. Results Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patientreported symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%). Conclusion A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women with MUI and should be explore through further RCTs

Tunable Superconducting Properties of a-NbSi Thin Films and Application to Detection in Astrophysics

We report on the superconducting properties of amorphous NbxSi1-x thin films. The normal-state resistance and critical temperatures can be separately adjusted to suit the desired application. Notably, the relatively low electron-phonon coupling of these films makes them good candidates for an "all electron bolometer" for Cosmological Microwave Background radiation detection. Moreover, this device can be made to suit both high and low impedance readouts

Incontinence : stress urinary incontinence treatment—surgery first?

A randomized trial involving 460 women with stress urinary incontinence compared physiotherapy with midurethral-sling surgery. We question whether the results, showing higher rates of improvement and cure for surgery than for physiotherapy, should change best practice and clinical practice guideline recommendations

Rejection of randomly coinciding events in Li2_2100^{100}MoO4_4 scintillating bolometers using light detectors based on the Neganov-Luke effect

Random coincidences of nuclear events can be one of the main background sources in low-temperature calorimetric experiments looking for neutrinoless double-beta decay, especially in those searches based on scintillating bolometers embedding the promising double-beta candidate $^{100}$Mo, because of the relatively short half-life of the two-neutrino double-beta decay of this nucleus. We show in this work that randomly coinciding events of the two-neutrino double decay of $^{100}$Mo in enriched Li$_2$$^{100}$MoO$_4$ detectors can be effectively discriminated by pulse-shape analysis in the light channel if the scintillating bolometer is provided with a Neganov-Luke light detector, which can improve the signal-to-noise ratio by a large factor, assumed here at the level of $\sim 750$ on the basis of preliminary experimental results obtained with these devices. The achieved pile-up rejection efficiency results in a very low contribution, of the order of $\sim 6\times10^{-5}$ counts/(keV$\cdot$kg$\cdot$y), to the background counting rate in the region of interest for a large volume ($\sim 90$ cm$^3$) Li$_2$$^{100}$MoO$_4$ detector. This background level is very encouraging in view of a possible use of the Li$_2$$^{100}$MoO$_4$ solution for a bolometric tonne-scale next-generation experiment as that proposed in the CUPID project

Background suppression in massive TeO2_2 bolometers with Neganov-Luke amplified light detectors

Bolometric detectors are excellent devices for the investigation of neutrinoless double-beta decay (0$\nu\beta\beta$). The observation of such decay would demonstrate the violation of lepton number, and at the same time it would necessarily imply that neutrinos have a Majorana character. The sensitivity of cryogenic detectors based on TeO$_2$ is strongly limited by the alpha background in the region of interest for the 0$\nu\beta\beta$ of $^{130}$Te. It has been demonstrated that particle discrimination in TeO$_2$ bolometers is possible measuring the Cherenkov light produced by particle interactions. However an event-by-event discrimination with NTD-based light detectors has to be demonstrated. We will discuss the performance of a highly-sensitive light detector exploiting the Neganov-Luke effect for signal amplification. The detector, being operated with NTD-thermistor and coupled to a 750 g TeO$_2$ crystal, shows the ability for an event-by-event identification of electron/gamma and alpha particles. The extremely low detector baseline noise, RMS 19 eV, demonstrates the possibility to enhance the sensitivity of TeO$_2$-based 0$\nu\beta\beta$ experiment to an unprecedented level

Atypical B cells (CD21-CD27-IgD-) correlate with lack of response to checkpoint inhibitor therapy in NSCLC

Introduction: Checkpoint inhibitor (CI) therapy has revolutionized treatment for non-small cell lung cancer (NSCLC). However, a proportion of patients do not respond to CI therapy for unknown reasons. Although the current paradigm in anti-tumor immunity evolves around T cells, the presence of tertiary lymphoid structures and memory B cells has been positively correlated with response to CI therapy in NSCLC. In addition, double negative (DN) (CD27- IgD-) B cells have been shown to be abundant in NSCLC compared to healthy lung tissue and inversely correlate with the intratumoral presence of memory B cells. Nonetheless, no study has correlated DN B cells to survival in NSCLC. Methods: In this study, we evaluated the presence and phenotype of B cells in peripheral blood with flow cytometry of patients with NSCLC and mesothelioma before receiving CI therapy and correlated these with clinical outcome. Results: Non-responding patients showed decreased frequencies of B cells, yet increased frequencies of antigen-experienced CD21- DN (Atypical) B cells compared to responding patients and HC, which was confirmed in patients with mesothelioma treated with CI therapy. Conclusions: These data show that the frequency of CD21- DN B cells correlates with lack of response to CI therapy in thoracic malignancies. The mechanism by which CD21- DN B cells hamper CI therapy remains unknown. Our findings support the hypothesis that CD21- DN B cells resemble phenotypically identical exhausted B cells that are seen in chronic infection or function as antigen presenting cells that induce regulatory T cells.</p

Therapeutic Hypothermia for Neonatal Encephalopathy Results in Improved Microstructure and Metabolism in the Deep Gray Nuclei

BACKGROUND AND PURPOSE: Therapeutic hypothermia has reduced morbidity and mortality and is associated with a lower burden of lesions on conventional imaging in NE. However, its effects on brain microstructure and metabolism have not been fully characterized. We hypothesized that therapeutic hypothermia improves measures of brain microstructure and metabolism. MATERIALS AND METHODS: Forty-one neonates with moderate/severe NE (29 treated with hypothermia, 12 nontreated) and 12 healthy neonates underwent MR imaging, DTI, and (1)H-MR spectroscopy. MR imaging scans were scored by the predominant pattern of brain injury: normal, watershed, and BG/thalamus. ADC, FA, Lac:NAA, and NAA:Cho values from bilateral BG and thalamus ROIs were averaged. T test and linear regression analysis were used to determine the association between hypothermia and MR imaging quantitative measures. RESULTS: Conventional MR imaging findings were normal in 41% of treated neonates; all nontreated neonates had brain injury. Values of MR imaging metrics were closer to normal in treated neonates compared with nontreated neonates: ADC was 63% higher in the BG and 116% higher in the thalamus (both P < .05), and Lac:NAA was 76% lower (P = .04) in the BG. Treated neonates with normal MR imaging findings had normal (1)H-MR spectroscopy metabolites, and ADC was higher by 35% in the thalamus (P = .03) compared with healthy neonates. CONCLUSIONS: Therapeutic hypothermia may reduce disturbances of brain metabolism and preserve its microstructure in the setting of NE, possibly by minimizing cytotoxic edema and cell death. Long-term follow-up studies are required to determine whether early post-treatment DTI and (1)H-MR spectroscopy will be useful biomarkers of treatment response

Renal toxicity from platinum/pemetrexed and pembrolizumab in the era of combination therapy

Background: Recently, the phase 3 keynote-189 trial showed that in previously untreated patients with advanced non-squamous NSCLC without targetable mutations, the progression-free and overall survival were significantly longer with addition of pembrolizumab to chemotherapy than with chemotherapy alone. Both chemotherapy and pembrolizumab can give renal toxicity, which can be a major challenge in the clinical setting. Methods: In a prospective multicenter observational real-life cohort study [Visser Eur Respir J 2018], we evaluated the incidence of acute/chronic kidney disease (AKD/ CKD), its related treatment discontinuation frequency and associated clinical variables with AKD in patients with stage IIIB/IV NSCLC treated with platinum/pemetrexed. In addition, the Keynote 189 toxicity data was used for the combination treatment. We thereafter reviewed literature to generate an algorithm for diagnosis and treatment in increased creatinine levels. Results: 149 patients received pemetrexed platinum, of whom 44 patients (30%) continued maintenance. During induction therapy 48 patients (50%) treated with cisplatinum/pemetrexed developed AKD and 15 patients (29%) treated with carboplatin/pemetrexed. During maintenance 13 patients (30%) developed AKD, leading to CKD and treatment discontinuation in eight patients (62%). In the Keynote 189 trial combining pembrolizumab with chemotherapy, nephritis has been reported in 1,7% of patients in any grade (1,5% grade 3-4). However, when looking at an increased blood creatinine in the group that was treated with carboplatin, a total of 12,2% of patients showed any increase (0,7% grade 3-4). Conclusions: Increased blood creatinine levels from pemetrexed and pembrolizumab is a common entity, probably more common in a real-life setting. This elevation is clinically challenging in a population that receives three agents that can cause a creatinine increase. Currently, there are no markers to distinguish between renal failure due to chemotherapy of immunothera