Is there a link between overactive bladder and the metabolic syndrome in women? : A systematic review of observational studies

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.To conduct a systematic review to determine whether there is an association between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) or overactive bladder (OAB) in women. We systematically reviewed English language observational studies on the effect of MetS (or component factors) on the presence of OAB or LUTS in women. We searched PubMed, Web of Science and The Cochrane Library with no date restrictions, checked reference lists and undertook citation searches in PubMed and Google Scholar. Studies were assessed for risk of bias. Because of heterogeneity, results were not pooled, but are reported narrativelyPeer reviewe

The Impacts of Juniper Removal on Native Herbaceous Vegetation and Surface-Dwelling Invertebrates in the Sagebrush Steppe

Understanding the effects of disturbance and restoration on a species’ habitat is essential for understanding the demographic rates and population trends observed in a species. Sufficient habitat provides the space and resources required for survival and successful reproduction, such as food availability, access to water, protection from predators, protection from harsh weather, and adequate habitat for reproduction and raising of offspring. When these components are not provided by habitat, species can be impacted adversely, which is particularly important for species of conservation concern such as greater sage-grouse (Centrocercus urophasianus, hereafter sage-grouse). Sage-grouse are a gallinaceous gamebird species that are sagebrush (Artemisia spp.) obligates due to their reliance on sagebrush for every phase of their life history cycle. Currently, the species occupies only 56% of its pre-European settlement distribution in North America, with negative population trends observed across their range. Declines in populations and range contractions have been driven by a variety of factors, including encroachment of previously intact sagebrush by native woody conifer species such as western juniper (Juniperus occidentalis, hereafter juniper). The expansion of woody plants is a global phenomenon with large-scale ecological consequences. These expansions have largely been driven by altered fire regimes and favorable climatic conditions arising from climate change. Conifer encroachment has been shown to decrease sage-grouse productivity, increase predation risk, and suppress the herbaceous understory, which sage-grouse rely on for food, cover, thermoregulation, and nesting. Because of these negative consequences, management agencies and private landowners have attempted to restore sagebrush habitat through the removal of encroached conifer. The literature on the response of sage-grouse to these broad-scale management actions has focused primarily on impacts to lekking behavior, nest success, and brood success, with less consideration given to the impact of these restoration practices on food availability. Adequate access to food is essential for individual fitness and contributes substantially to reproductive success. Sage-grouse diet changes with the season, with exclusive reliance on sagebrush in the winter, a shift to forbs and invertebrates during nesting and brood-rearing, and a transition back to sagebrush in the fall once forbs and invertebrates are no longer available. With extensive root networks and dense stands, conifers are highly competitive with understory vegetation for water and nutrients, which can adversely impact the vegetation and associated invertebrate communities that sage-grouse rely on to meet their nutritional needs. From the context of food availability, my research aimed to elucidate the benefits observed from landscape-scale removal of encroached juniper in sagebrush ecosystems. Chapter one focuses on the impact of juniper removal on native herbaceous vegetation, including shrubs, forbs, and grass. A temporal frame of time since juniper removal was used to assess differences in forage quantity, forage quality, plant species richness, and plant cover for herbaceous vegetation. Data collection occurred at four strata based on time since treatment for juniper removal: old cuts (completed 2008 – 2013), mid cuts (completed 2014 – 2016), recent cuts (completed 2017 – 2020), and controls (encroached juniper areas with no cuts). A mixture of biomass sampling, vegetation surveying, and remotely sensed data were used to model differences in forage metrics between juniper treatments. Results revealed increased mean forage quantity across functional groups between controls and treatments. Comparison of forage quality metrics revealed that removal of juniper increased the crude protein of forage by 1.8% between controls and mid cuts, however, no other ecologically meaningful differences in forage quality were observed. I also documented increased plant species richness, increased shrub and grass cover, and inconclusive changes in forb cover between treatments and controls. These findings indicate that removal of encroached juniper can benefit sage-grouse by increasing the herbaceous vegetation they rely on for food and other habitat needs. Chapter two focuses on the impact of juniper removal on the surface-dwelling invertebrate community, including invertebrate taxa that are commonly consumed by sage-grouse. A temporal frame of time since juniper removal was used to assess differences in invertebrate abundance, family diversity, and community composition. Data collection occurred at four strata based on time since treatment for juniper removal: old cuts (completed 2008 – 2013), mid cuts (completed 2014 – 2016), recent cuts (completed 2017 – 2020), and controls (encroached juniper areas with no cuts). Pitfall trapping was used to sample invertebrate communities, with the resulting data used to model differences in invertebrate metrics between juniper treatments. Results revealed increased invertebrate abundance, including increased sage-grouse food invertebrate abundance, between controls and treatments, however, this trend was not sustained through the entire post-treatment recovery period. Analysis of invertebrate family diversity response to juniper removal revealed a sharp decrease in family diversity between controls and recent cuts for overall and food invertebrate diversity. Analysis of invertebrate community composition revealed distinct invertebrate communities between treatments, with few specific families likely driving the observed differentiation in composition. These findings indicate that removal of encroached juniper can benefit sage-grouse by increasing consumable invertebrate matter, which comprises a key component of sage-grouse diet, despite decreased invertebrate diversity. Management that seeks to improve sage-grouse habitat through the removal of encroached juniper should consider the underlying factors that benefit sage-grouse following juniper removal, including the impact of treatment on the native herbaceous understory and surface-dwelling invertebrate community. Understanding the abiotic and biotic changes brought about by juniper removal, especially in the context of multi-year, long-term habitat restoration, is key to future restoration success. I sought to evaluate the impact of juniper removal on sage-grouse habitat through the lens of food availability. Collectively, I demonstrated increased quantity and cover of herbaceous vegetation and increased invertebrate abundance resulting from juniper removal. While the extent of sagebrush ecosystems affected by juniper expansion is immense, these findings indicate that wide-scale juniper removal is an effective management tool to improve sage-grouse habitat and sagebrush systems as a whole

Glycogene Expression Alterations Associated with Pancreatic Cancer Epithelial-Mesenchymal Transition in Complementary Model Systems

The ability to selectively detect and target cancer cells that have undergone an epithelial-mesenchymal transition (EMT) may lead to improved methods to treat cancers such as pancreatic cancer. The remodeling of cellular glycosylation previously has been associated with cell differentiation and may represent a valuable class of molecular targets for EMT.As a first step toward investigating the nature of glycosylation alterations in EMT, we characterized the expression of glycan-related genes in three in-vitro model systems that each represented a complementary aspect of pancreatic cancer EMT. These models included: 1) TGFβ-induced EMT, which provided a look at the active transition between states; 2) a panel of 22 pancreatic cancer cell lines, which represented terminal differentiation states of either epithelial-like or mesenchymal-like; and 3) actively-migrating and stationary cells, which provided a look at the mechanism of migration. We analyzed expression data from a list of 587 genes involved in glycosylation (biosynthesis, sugar transport, glycan-binding, etc.) or EMT. Glycogenes were altered at a higher prevalence than all other genes in the first two models (p<0.05 and <0.005, respectively) but not in the migration model. Several functional themes were shared between the induced-EMT model and the cell line panel, including alterations to matrix components and proteoglycans, the sulfation of glycosaminoglycans; mannose receptor family members; initiation of O-glycosylation; and certain forms of sialylation. Protein-level changes were confirmed by Western blot for the mannose receptor MRC2 and the O-glycosylation enzyme GALNT3, and cell-surface sulfation changes were confirmed using Alcian Blue staining.Alterations to glycogenes are a major component of cancer EMT and are characterized by changes to matrix components, the sulfation of GAGs, mannose receptors, O-glycosylation, and specific sialylated structures. These results provide leads for targeting aggressive and drug resistant forms of pancreatic cancer cells

The Marker State Space (MSS) Method for Classifying Clinical Samples

The development of accurate clinical biomarkers has been challenging in part due to the diversity between patients and diseases. One approach to account for the diversity is to use multiple markers to classify patients, based on the concept that each individual marker contributes information from its respective subclass of patients. Here we present a new strategy for developing biomarker panels that accounts for completely distinct patient subclasses. Marker State Space (MSS) defines "marker states" based on all possible patterns of high and low values among a panel of markers. Each marker state is defined as either a case state or a control state, and a sample is classified as case or control based on the state it occupies. MSS was used to define multi-marker panels that were robust in cross validation and training-set/test-set analyses and that yielded similar classification accuracy to several other classification algorithms. A three-marker panel for discriminating pancreatic cancer patients from control subjects revealed subclasses of patients based on distinct marker states. MSS provides a straightforward approach for modeling highly divergent subclasses of patients, which may be adaptable for diverse applications. © 2013 Fallon et al

Enhanced Discrimination of Malignant from Benign Pancreatic Disease by Measuring the CA 19-9 Antigen on Specific Protein Carriers

The CA 19-9 assay detects a carbohydrate antigen on multiple protein carriers, some of which may be preferential carriers of the antigen in cancer. We tested the hypothesis that the measurement of the CA 19-9 antigen on individual proteins could improve performance over the standard CA 19-9 assay. We used antibody arrays to measure the levels of the CA 19-9 antigen on multiple proteins in serum or plasma samples from patients with pancreatic adenocarcinoma or pancreatitis. Sample sets from three different institutions were examined, comprising 531 individual samples. The measurement of the CA 19-9 antigen on any individual protein did not improve upon the performance of the standard CA 19-9 assay (82% sensitivity at 75% specificity for early-stage cancer), owing to diversity among patients in their CA 19-9 protein carriers. However, a subset of cancer patients with no elevation in the standard CA 19-9 assay showed elevations of the CA 19-9 antigen specifically on the proteins MUC5AC or MUC16 in all sample sets. By combining measurements of the standard CA 19-9 assay with detection of CA 19-9 on MUC5AC and MUC16, the sensitivity of cancer detection was improved relative to CA 19-9 alone in each sample set, achieving 67–80% sensitivity at 98% specificity. This finding demonstrates the value of measuring glycans on specific proteins for improving biomarker performance. Diagnostic tests with improved sensitivity for detecting pancreatic cancer could have important applications for improving the treatment and management of patients suffering from this disease

Directive 02-14: Tax Obligations of Persons Purchasing Cigarettes in Interstate Commerce for which the Massachusetts Cigarette Excise Has Not Been Paid

The development of accurate clinical biomarkers has been challenging in part due to the diversity between patients and diseases. One approach to account for the diversity is to use multiple markers to classify patients, based on the concept that each individual marker contributes information from its respective subclass of patients. Here we present a new strategy for developing biomarker panels that accounts for completely distinct patient subclasses. Marker State Space (MSS) defines "marker states" based on all possible patterns of high and low values among a panel of markers. Each marker state is defined as either a case state or a control state, and a sample is classified as case or control based on the state it occupies. MSS was used to define multi-marker panels that were robust in cross validation and training-set/test-set analyses and that yielded similar classification accuracy to several other classification algorithms. A three-marker panel for discriminating pancreatic cancer patients from control subjects revealed subclasses of patients based on distinct marker states. MSS provides a straightforward approach for modeling highly divergent subclasses of patients, which may be adaptable for diverse applications.</p

Recommandations pour l’utilisation de la toxine botulinique de type A (Botox®) dans l’hyperactivité vésicale réfractaire idiopathique

RésuméObjectifsDéfinir des recommandations pour l’utilisation pratique de la toxine botulinique de type A (BoNTA) dans l’hyperactivité vésicale réfractaire idiopathique (HAVRI).MéthodeÉlaboration de recommandations de bonne pratique par consensus formalisé, validées par un groupe de 13 experts puis par un groupe de lecture indépendant.RésultatsEn cas d’infection urinaire celle-ci doit être traitée et l’injection reportée. Avant l’injection, il est recommandé de s’assurer de la faisabilité et de l’acceptabilité de l’auto-sondage. L’injection peut être réalisée après une anesthésie locale urétro-vésicale (lidocaïne), éventuellement complétée par l’inhalation de protoxyde d’azote et parfois sous anesthésie générale. L’injection sera réalisée au bloc opératoire ou en salle d’endoscopie. La vessie ne doit pas être trop remplie (risque de perforation). Le traitement doit être appliqué en 10 à 20 injections de 0,5 à 1mL réparties de manière homogène dans la vessie en restant à distance des méats urétéraux. Il n’est pas recommandé de laisser en place une sonde vésicale sauf en cas d’hématurie importante. Le patient doit être surveillé jusqu’à la reprise mictionnelle. Une note d’information sur les effets indésirables éventuels doit lui être remise à sa sortie. Une consultation doit être prévue 3 mois après la première injection (calendrier mictionnel, débitmétrie, résidu post-mictionnel et examen cytobactériologique des urines). Un résidu >200mL et/ou symptomatique doit faire discuter des auto-sondages. Une nouvelle injection pourra être envisagée lorsque le bénéfice clinique de la précédente s’estompe (entre 6 et 9 mois).ConclusionsLe respect de ces recommandations devrait permettre une utilisation optimale de la BoNTA.Niveau de preuve3.SummaryObjectivesProvide guidelines for practical usage of botulinum toxin type A (BoNTA) for refractory idiopathic Overactive Bladder management.Patients and methodsGuidelines using formalized consensus guidelines method. These guidelines have been validated by a group of 13 experts quoting proposals, subsequently reviewed by an independent group of experts.ResultsIn the case of patients with urinary tract infection, it must be treated and injection postponed. Before proposing an injection, it is recommended to ensure the feasibility and acceptability of self-catheterisation by patient. The injection can be performed after local anesthesia of the bladder and urethra (lidocaine), supplemented where necessary by nitrous oxide inhalation and sometimes under general anesthesia. Injection is performed in the operating room or endoscopy suite. The bladder should not be too filled (increased risk of perforation). Treatment should be applied in 10 to 20 injections of 0.5 to 1mL homogeneously distributed in the bladder at a distance from the urethral orifices. It is not recommended to leave a urinary catheter in place except in cases of severe hematuria. The patient should be monitored until resumption of micturition. After the first injection, an appointment must be scheduled within 3 months (micturition diary, uroflowmetry, measurement of residual urine and urine culture). Performance of self-catheterisation should be questioned in the case of a symptomatic post-void residual and/or a residue>200mL. A new injection may be considered when the clinical benefit of the previous injection diminishes (between 6 and 9 months). A period of three months must elapse between each injection.ConclusionsImplementation of these guidelines may promote best practice usage of BoNTA with optimal risk/benefit ratio