Women’s pelvic floor muscle strength and urinary and anal incontinence after childbirth: a cross-sectional study

Abstract OBJECTIVE To analyse pelvic floor muscle strength (PFMS) and urinary and anal incontinence (UI and AI) in the postpartum period. METHOD Cross-sectional study carried out with women in their first seven months after child birth. Data were collected through interviews, perineometry (Peritron™), and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). RESULTS 128 women participated in the study. The PFMS mean was 33.1 (SD=16.0) cmH2O and the prevalence of UI and AI was 7.8% and 5.5%, respectively. In the multiple analyses, the variables associated with PFMS were type of birth and cohabitation with a partner. Newborn’s weight, previous pregnancy, UI during pregnancy, and sexual activity showed an association with UI after child birth. Only AI prior to pregnancy was associated with AI after childbirth. CONCLUSION Vaginal birth predisposes to the reduction of PFMS, and caesarean section had a protective effect to its reduction. The occurrence of UI during pregnancy is a predictor of UI after childbirth, and women with previous pregnancies and newborns with higher weights are more likely to have UI after childbirth.AI prior to pregnancy is the only risk factor for its occurrence after childbirth. Associations between PFMS and cohabitation with a partner, and between UI and sexual activity do not make possible to conclude that these variables are directly associated

Interleukin-10 enhances the intestinal epithelial barrier in the presence of corticosteroids through p38 MAPK activity in Caco-2 monolayers : a possible mechanism for steroid responsiveness in ulcerative colitis

Altres ajuts: 2012 Spanish Gastroenterological Association i CIBER G0034Glucocorticosteroids are the first line therapy for moderate-severe flare-ups of ulcerative colitis. Despite that, up to 60% of patients do not respond adequately to steroid treatment. Previously, we reported that low IL-10 mRNA levels in intestine are associated with a poor response to glucocorticoids in active Crohn's disease. Here, we test whether IL-10 can favour the response to glucocorticoids by improving the TNFα-induced intestinal barrier damage (assessed by transepithelial electrical resistance) in Caco-2 monolayers, and their possible implications on glucocorticoid responsiveness in active ulcerative colitis. We show that the association of IL-10 and glucocorticoids improves the integrity of TNFα-treated Caco-2 cells and that p38 MAPK plays a key role. In vitro, IL-10 facilitates the nuclear translocation of p38 MAPK-phosphorylated thereby modulating glucocorticoids-receptor-α, IL-10-receptor-α and desmoglein-2 expression. In glucocorticoids-refractory patients, p38 MAPK phosphorylation and membrane desmoglein-2 expression are reduced in colonic epithelial cells. These results suggest that p38 MAPK-mediated synergism between IL-10 and glucocorticoids improves desmosome straightness contributing to the recovery of intestinal epithelium and reducing luminal antigens contact with lamina propria in ulcerative colitis. This study highlights the link between the intestinal epithelium in glucocorticoids-response in ulcerative colitis

Novel ball head screw and screwdriver design for implant-supported prostheses with angled channels: a finite element analysis

The primary objective of this study was to design the optimal geometry of a novel screwdriver, create the grooves on a ball head screw, and demonstrate its resistance to a torque of up to 40 Ncm at angulations of 0°, 15°, and 30° by using nonlinear finite element analysis. A secondary objective was to create a foolproof, easily recognizable system. The grooved ball head screw and geometry of the screwdriver, functioning from an angulation of 0° to 30°, was generated using Pro-ENGINEER Wildfire 5.0 software. Static structural analyses among bodies in contact were performed at different angles of 0°, 15°, and 30° at a torque of 20 Ncm and 40 Ncm using nonlinear finite element simulation by means of ANSYS 12.0. The maximum stress supported by the ball head screw and screwdriver was similar at 20 Ncm and 40 Ncm. Although greater deformations were found at 40 Ncm, these were small and might not affect the performance of the system. Further, the rupture torque value for the M2 connection was 55 Ncm for 0° and 30°, and 47.5 Ncm for 15°. Numerical simulation showed that the ball head system design can achieve the mechanical strength requirements expected for screws used in implant-supported restorations at an angulation of up to 30°. Finite element analysis showed this novel ball head screw and screwdriver system to be a good solution for angled screw channels in implant-supported prostheses

Two multi-temporal datasets that track the enhanced landsliding after the 2008 Wenchuan earthquake

We release two datasets that track the enhanced landsliding induced by the 2008 Mw 7.9 Wenchuan earthquake over a portion of the Longmen Mountains, at the eastern margin of the Tibetan Plateau (Sichuan, China). The first dataset is a geo-referenced multi-temporal polygon-based inventory of pre- and coseismic landslides, post-seismic remobilisations of coseismic landslide debris and post-seismic landslides (new failures). It covers 471&thinsp;km2 in the earthquake's epicentral area, from 2005 to 2018. The second dataset records the debris flows that occurred from 2008 to 2017 in a larger area (∼17 000&thinsp;km2), together with information on their triggering rainfall as recorded by a network of rain gauges. For some well-monitored events, we provide more detailed data on rainfall, discharge, flow depth and density. The datasets can be used to analyse, on various scales, the patterns of landsliding caused by the earthquake. They can be compared to inventories of landslides triggered by past or new earthquakes or by other triggers to reveal common or distinctive controlling factors. To our knowledge, no other inventories that track the temporal evolution of earthquake-induced mass wasting have been made freely available thus far. Our datasets can be accessed from https://doi.org/10.5281/zenodo.1405489. We also encourage other researchers to share their datasets to facilitate research on post-seismic geological hazards.</p

Rewinding the invasion history of monk parakeets in Barcelona city: 1976-2022

Predicting the future abundance and distribution of introduced alien species is crucial to mitigate their impact on ecosystems, but this has been shown to be highly challenging. A good approach to obtain crucial clues to the root causes behind dynamic changes over time and space of invasive species is historical resurveys. Barcelona holds one of the largest densities in Europe of monk parakeets Myiopsitta monachus, a highly successful invasive avian alien species. In this study, we evaluate population size, population growth rates and range expansion across the city, performing periodic nest and chamber counts from detection of the first nest in 1976 to 2022. Population estimates of monk parakeets during the study period showed a steady increase, reaching 6,444 ± 449 individuals in 2022. The population exhibited exponential growth with a mean population growth rate of r = 0.19 per year, which means a population doubling time of 3.7 years. Furthermore, two phases were evident: the first from 1976 to 1994 with a growth rate of 0.37 and a population doubling time of 1.9 years; and the second from 1999 to 2022 with a growth rate of 0.08 and a time to double the population of nine years. Moreover, we document the expansion of the range during our study through the colonisation of new areas, which fitted to a diffusion model for the whole period. Currently, the growth rate of the invasive monk parakeet population does not appear to be limited by resources, nest availability, disease, or predators and we expect them to continue increasing and expanding their range if no control measures are take

Disease severity in familial cases of IBD

Background: Phenotypic traits of familial IBD relative to sporadic cases are controversial, probably related to limited statistical power of published evidence. Aim: To know if there are phenotype differences between familial and sporadic IBD, evaluating the prospective Spanish registry (ENEIDA) with 11,983 cases. Methods: 5783 patients (48.3%) had ulcerative colitis (UC) and 6200 (51.7%) Crohn's disease (CD). Cases with one or more 1st, 2nd or 3rd degree relatives affected by UC/CD were defined as familial case. Results: In UC and CD, familial cases compared with sporadic cases had an earlier disease onset (UC: 33 years [IQR 25–44] vs 37 years [IQR 27–49]; p b 0.0001); (CD: 27 years [IQR 21–35] vs 29 years [IQR 22–40]; p b 0.0001), higher prevalence of extraintestinal immune-related manifestations (EIMs) (UC: 17.2% vs 14%; p = 0.04); (CD: 30.1% vs 23.6%; p b 0.0001). Familial CD had higher percentage of ileocolic location (42.7% vs 51.8%; p = 0.0001), penetrating behavior (21% vs 17.6%; p = 0.01) and perianal disease (32% vs 27.1%; p = 0.003). Differences are not influenced by degree of consanguinity. Conclusion: When a sufficiently powered cohort is evaluated, familial aggregation in IBD is associated to an earlier disease onset, more EIMs and more severe phenotype in CD. This feature should be taken into account at establishing predictors of disease course

The reproductive capacity of Monk Parakeets Myiopsitta monachus is higher in their invasive range

Breeding parameters for Monk Parakeets Myiopsitta monachus nesting in Barcelona, Spain, were collected for 651 nests over five breeding seasons. This invasive population has a high reproductive capacity compared with the species in the native range: fledging success was double, the percentage of pairs attempting second broods three times higher and 55% of first-year birds bred compared with almost zero in South America

Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients with Inflammatory Bowel Disease: Results from the Eneida Registry

Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn''s disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response

Squeezed tensor non-Gaussianity in non-attractor inflation

We investigate primordial tensor non-Gaussianity in single field inflation, during a phase of non-attractor evolution when the spectrum of primordial tensor modes can be enhanced to a level detectable at interferometer scales. Making use of a tensor duality we introduced in arXiv:1808.10475, we analytically compute the full bispectrum of primordial tensor fluctuations during the non-attractor era. During this epoch the shape of the tensor bispectrum is enhanced in the squeezed limit, its amplitude can be amplified with respect to slow-roll models, and tensor non-Gaussianity can exhibit a scale dependence distinctive of our set-up. We prove that our results do not depend on the frame used for the calculations. Squeezed tensor non-Gaussianity induces a characteristic quadrupolar anisotropy on the power spectrum of the stochastic background of primordial tensor perturbations. As a step to make contact with gravitational wave experiments, we discuss the response function of a ground based Michelson interferometer to a gravitational wave background with such a feature.Comment: 34 pages, 4 figure