Changes in urethral resistance in the presence of detrusor activity

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Validation of the Polish version of P-QoL questionnaire

Objective: Pelvic organ prolapse (POP) is a common morbidity that affects many women and significantly decreases quality of life. The severity and the impact of the prolapse on the quality of life are important parameters in the management and follow-up of affected patients. The aim of this validation study was to validate the Polish version of the Prolapse Quality of Life questionnaire (P-QoL). Material and methods: The P-QOL questionnaire was translated into Polish and administered to women recruited from two gynecological outpatient clinics (n = 231). Both symptomatic and asymptomatic women were included in the study and examined in supine position using the Pelvic Organ Prolapse Quantification System (POP-Q). The validity was assessed by comparing symptom scores and quality-of-life scores between symptomatic and asymptomatic women. Results: A total number of 154 symptomatic and 77 asymptomatic women were included. There was a strong correlation between severity of the disease based on physical findings (POP-Q scale) and the P-QoL scores in main prolapse quality-of-life domains. The overall scores for each life domain were significantly different between symptomatic and asymptomatic women (p < 0.001). All the questions regarding symptoms showed significant differences (p < 0.001) between both groups. Conclusions: The Polish version of P-QoL is a valid, reliable, and easily comprehensible instrument to assess quality of life and symptoms in Polish-speaking women suffering from urogenital prolapse

Survival After Sublobar Resection versus Lobectomy for Clinical Stage IA Lung Cancer An Analysis from the National Cancer Data Base

BackgroundRecent data have suggested possible oncologic equivalence of sublobar resection with lobectomy for early-stage non–smallcell lung cancer (NSCLC). Our aim was to evaluate and compare short-term and long-term survival for these surgical approaches.MethodsThis retrospective cohort study utilized the National Cancer Data Base. Patients undergoing lobectomy, segmentectomy, or wedge resection for preoperative clinical T1A N0 NSCLC from 2003 to 2011 were identified. Overall survival (OS) and 30-day mortality were analyzed using multivariable Cox proportional hazards models, logistic regression models, and propensity score matching. Further analysis of survival stratified by tumor size, facility type, number of lymph nodes (LNs) examined, and surgical margins was performed.ResultsA total of 13,606 patients were identified. After propensity score matching, 987 patients remained in each group. Both segmentectomy and wedge resection were associated with significantly worse OS when compared with lobectomy (hazard ratio: 1.70 and 1.45, respectively, both p < 0.001), with no difference in 30-day mortality. Median OS for lobectomy, segmentectomy, and wedge resection were 100, 74, and 68 months, respectively (p < 0.001). Finally, sublobar resection was associated with increased likelihood of positive surgical margins, lower likelihood of having more than three LNs examined, and significantly lower rates of nodal upstaging.ConclusionIn this large national-level, clinically diverse sample of clinical T1A NSCLC patients, wedge and segmental resections were shown to have significantly worse OS compared with lobectomy. Further patients undergoing sublobar resection were more likely to have inadequate lymphadenectomy and positive margins. Ongoing prospective study taking into account LN upstaging and margin status is still needed

The Expression of Inflammatory Mediators in Bladder Pain Syndrome.

Background: Bladder pain syndrome (BPS) pathology is poorly understood. Treatment strategies are empirical, with limited efficacy, and affected patients have diminished quality of life. Objective: We examined the hypothesis that inflammatory mediators within the bladder contribute to BPS pathology. Design, setting, and participants: Fifteen women with BPS and 15 women with stress urinary incontinence without bladder pain were recruited from Cork University Maternity Hospital from October 2011 to October 2012. During cystoscopy, 5-mm bladder biopsies were taken and processed for gene expression analysis. The effect of the identified genes was tested in laboratory animals. Outcome measures and statistical analysis: We studied the expression of 96 inflammation-related genes in diseased and healthy bladders. We measured the correlation between genes and patient clinical profiles using the Pearson correlation coefficient. Results and limitations: Analysis revealed 15 differentially expressed genes, confirmed in a replication study. FGF7 and CCL21 correlated significantly with clinical outcomes. Intravesical CCL21 instillation in rats caused increased bladder excitability and increased c-fos activity in spinal cord neurons. CCL21 atypical receptor knockout mice showed significantly more c-fos upon bladder stimulation with CCL21 than wild-type littermates. There was no change in FGF7-treated animals. The variability in patient samples presented as the main limitation. We used principal component analysis to identify similarities within the patient group. Conclusions: Our study identified two biologically relevant inflammatory mediators in BPS and demonstrated an increase in nociceptive signalling with CCL21. Manipulation of this ligand is a potential new therapeutic strategy for BPS. Patient summary: We compared gene expression in bladder biopsies of patients with bladder pain syndrome (BPS) and controls without pain and identified two genes that were increased in BPS patients and correlated with clinical profiles. We tested the effect of these genes in laboratory animals, confirming their role in bladder pain. Manipulating these genes in BPS is a potential treatment strategy

A Preliminary Analysis of Software Metrics in Decentralised Applications

This study examines software metrics in decentralized applications (dApps) to analyze their structural and behavioral characteristics as they grow in complexity. Sixty dApps were categorized into Small (3 to 29 contracts), Medium (30 to 46 contracts), and Large (47 to 206 contracts) based on their contract count. Initial analysis showed a non-normal data distribution, leading to the use of Spearman's correlation method. Findings revealed that Medium dApps have strong correlations between metrics like 'Average Local Variables' and 'Maximum Local Variables', while Large dApps show higher correlations between 'Number of Functions' and 'State Variable Count', indicating more complex contract structures. The higher Coupling Between Objects (CBO) in large dApps suggests increased interactions with other contracts or libraries, potentially elevating security risks. These insights are valuable for developers and stakeholders in the blockchain and IoT sectors, aiding in understanding how dApps evolve with increasing complexity and the implications on software metric relationships.Ethereum Foundation grant FY23-1048

Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)) : Part B

In 2014 the International Endohernia Society (IEHS) published the first international "Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias". Guidelines reflect the currently best available evidence in diagnostics and therapy and give recommendations to help surgeons to standardize their techniques and to improve their results. However, science is a dynamic field which is continuously developing. Therefore, guidelines require regular updates to keep pace with the evolving literature. Methods For the development of the original guidelines all relevant literature published up to year 2012 was analyzed using the ranking of the Oxford Centre for Evidence-Based-Medicine. For the present update all of the previous authors were asked to evaluate the literature published during the recent years from 2012 to 2017 and revise their statements and recommendations given in the initial guidelines accordingly. In two Consensus Conferences (October 2017 Beijing, March 2018 Cologne) the updates were presented, discussed, and confirmed. To avoid redundancy, only new statements or recommendations are included in this paper. Therefore, for full understanding both of the guidelines, the original and the current, must be read. In addition, the new developments in repair of abdominal wall hernias like surgical techniques within the abdominal wall, release operations (transversus muscle release, component separation), Botox application, and robot-assisted repair methods were included. Results Due to an increase of the number of patients and further development of surgical techniques, repair of primary and secondary abdominal wall hernias attracts increasing interests of many surgeons. Whereas up to three decades ago hernia-related publications did not exceed 20 per year, currently this number is about 10-fold higher. Recent years are characterized by the advent of new techniques-minimal invasive techniques using robotics and laparoscopy, totally extraperitoneal repairs, novel myofascial release techniques for optimal closure of large defects, and Botox for relaxing the abdominal wall. Furthermore, a concomitant rectus diastasis was recognized as a significant risk factor for recurrence. Despite still insufficient evidence with respect to these new techniques it seemed to us necessary to include them in the update to stimulate surgeons to do research in these fields. Conclusion Guidelines are recommendations based on best available evidence intended to help the surgeon to improve the quality of his daily work. However, science is a continuously evolving process, and as such guidelines should be updated about every 3 years. For a comprehensive reference, however, it is suggested to read both the initially guidelines published in 2014 together with the update. Moreover, the presented update includes also techniques which were not known 3 years before

Synthesizing Stellar Populations in South Pole Telescope Galaxy Clusters. I. Ages of Quiescent Member Galaxies at 0.3 < z < 1.4

Using stellar population synthesis models to infer star formation histories (SFHs), we analyze photometry and spectroscopy of a large sample of quiescent galaxies that are members of Sunyaev-Zel’dovich (SZ)-selected galaxy clusters across a wide range of redshifts. We calculate stellar masses and mass-weighted ages for 837 quiescent cluster members at 0.3 < z < 1.4 using rest-frame optical spectra and the Python-based Prospector framework, from 61 clusters in the SPT-GMOS Spectroscopic Survey (0.3 < z < 0.9) and three clusters in the SPT Hi-z cluster sample (1.25 < z < 1.4). We analyze spectra of subpopulations divided into bins of redshift, stellar mass, cluster mass, and velocity-radius phase-space location, as well as by creating composite spectra of quiescent member galaxies. We find that quiescent galaxies in our data set sample a diversity of SFHs, with a median formation redshift (corresponding to the lookback time from the redshift of observation to when a galaxy forms 50% of its mass, t 50) of z = 2.8 ± 0.5, which is similar to or marginally higher than that of massive quiescent field and cluster galaxy studies. We also report median age-stellar mass relations for the full sample (age of the universe at t 50 (Gyr) = 2.52 (±0.04)-1.66 (±0.12) log10(M/1011 M ⊙)) and recover downsizing trends across stellar mass; we find that massive galaxies in our cluster sample form on aggregate ∼0.75 Gyr earlier than lower-mass galaxies. We also find marginally steeper age-mass relations at high redshifts, and report a bigger difference in formation redshifts across stellar mass for fixed environment, relative to formation redshifts across environment for fixed stellar mass