New postnatal urinary incontinence: obstetric and other risk factors in primparae.

Objective To identify obstetric and other risk factors for urinary incontinence which occurs during pregnancy or after childbirth. Design Questionnaire survey of women. Setting Maternity units in Aberdeen (Scotland), Birmingham (England) and Dunedin (New Zealand). Population 3405 primiparous women with singleton births delivered during one year. Methods Questionnaire responses and obstetric casenote data were analysed using multivariate analysis to identify associations with urinary incontinence. Main outcome measures Urinary incontinence at three months after delivery first starting in pregnancy or after birth. Results The prevalence of urinary incontinence was 29%. New incontinence first beginning after delivery was associated with higher maternal age (oldest versus youngest group, odds ratio, OR 2.02, 95% CI 1.35 to 3.02); and method of delivery (caesarean section versus spontaneous vaginal delivery, OR 0.28, 95% CI 0.19 to 0.41). There were no significant associations with forceps delivery (OR 1.18, 95% CI 0.92 to 1.51) or vacuum delivery (OR 1.16, 95% CI 0.83 to 1.63). Incontinence first occurring during pregnancy and still present at three months was associated with higher maternal body mass index (BMI > 25, OR 1.68, 95% CI 1.16 to 2.43), and heavier babies (birthweight in top quartile, OR 1.56, 95% CI 1.12 to 2.19). In these women, caesarean section was associated with less incontinence (OR 0.39, 95% CI 0.27 to 0.58) but incontinence was not associated with age. Conclusions Women have less urinary incontinence after a first delivery by caesarean section whether or not that first starts during pregnancy. Older maternal age was associated with new postnatal incontinence, and higher body mass index and heavier babies with incontinence first starting during pregnancy. The effect of further deliveries may modify these findings

The association among diet, dietary fiber, and bowel preparation at colonoscopy

BACKGROUND AND AIMS: Pre-colonoscopy dietary restrictions vary widely and lack evidence-based guidance. We investigated whether fiber and various other foods/macronutrients consumed during the 3 days before colonoscopy are associated with bowel preparation quality. METHODS: This was a prospective observational study among patients scheduled for outpatient colonoscopy. Patients received instructions including split-dose polyethylene glycol, avoidance of vegetables/beans 2 days before colonoscopy, and a clear liquid diet the day before colonoscopy. Two 24-hour dietary recall interviews and 1 patient-recorded food log measured dietary intake on the 3 days before colonoscopy. The Nutrition Data System for Research was used to estimate dietary exposures. Our primary outcome was the quality of bowel preparation measured by the Boston Bowel Preparation Scale (BBPS). RESULTS: We enrolled 201 patients from November 2015 to September 2016 with complete data for 168. The mean age was 59 years (standard deviation, 7 years), and 90% of colonoscopies were conducted for screening/surveillance. Only 17% and 77% of patients complied with diet restrictions 2 and 1 day(s) before colonoscopy, respectively. We found no association between foods consumed 2 and 3 days before colonoscopy and BBPS scores. However, BPPS was positively associated with intake of gelatin, and inversely associated with intake of red meat, poultry, and vegetables on the day before colonoscopy. CONCLUSIONS: Our findings support recent guidelines encouraging unrestricted diets >1 day before colonoscopy if using a split-dose bowel regimen. Furthermore, we found no evidence to restrict dietary fiber 1 day before colonoscopy. We also found evidence to promote consumption of gelatin and avoidance of red meat, poultry, and vegetables 1 day before colonoscopy.Dr Jacobson has acted as a consultant for MOTUS GI and Remedy Partners. All other authors disclosed no financial relationships relevant to this publication. Supported by NIH/NIDDK R21DK105476. (R21DK105476 - NIH/NIDDK)Accepted manuscrip

M31's Heavy Element Distribution and Outer Disk

Hubble Space Telescope imaging of 11 fields in M31 were reduced to color-magnitude diagrams. The fields were chosen to sample all galactocentric radii to 50 kpc. Assuming that the bulk of the sampled stellar populations are older than a few Gyr, the colors of the red giants map to an abundance distribution with errors of order 0.1 dex in abundance. The radially sampled abundance distributions are all about the same width, but show a mild abundance gradient that flattens outside ~20 kpc. The various distributions were weighted and summed with the aid of new surface brightness profile fits to obtain an abundance distribution representative of the entirety of M31. M31 is a system near chemical maturity. This ``observed closed box'' is compared to analytical closed box models. M31 suffers from a lack of metal-poor stars and metal-rich stars relative to the simplest closed-box model in the same way as the solar neighborhood.Comparing to several simple chemical evolution models, neither complete mixing of gas at all times nor zero mixing, inhomogeneous models give the most convincing match to the data. As noted elsewhere, the outer disk of M31 is a factor of ten more metal-rich than the Milky Way halo, ten times more metal-rich than the dwarf spheroidals cospatial with it, and more metal-rich than most of the globular clusters at the same galactocentric radius. Difficulties of interpretation are greatly eased if we posit that the M31 disk dominates over the halo at all radii out to 50 kpc. In fact, scaling from current density models of the Milky Way, one should not expect to see halo stars dominating over disk stars until beyond our 50 kpc limit. A corollary conclusion is that most published studies of the M31 "halo" are actually studies of its disk.Comment: 28 pages, 11 black-and-white figures, in press, Astrophysical Journa

Chandra X-Ray Spectroscopy Of The Very Early O Supergiant HD 93129A: Constraints On Wind Shocks And The Mass-Loss Rate

We present an analysis of both the resolved X-ray emission-line profiles and the broad-band X-ray spectrum of the O-2 If* star HD 93129A, measured with the Chandra High Energy Transmission Grating Spectrometer ( HETGS). This star is among the earliest and most massive stars in the Galaxy, and provides a test of the embedded wind-shock scenario in a very dense and powerful wind. A major new result is that continuum absorption by the dense wind is the primary cause of the hardness of the observed X-ray spectrum, while intrinsically hard emission from colliding wind shocks contributes less than 10 per cent of the X-ray flux. We find results consistent with the predictions of numerical simulations of the line-driving instability, including line broadening indicating an onset radius of X-ray emission of several tenths of R-*. Helium-like forbidden-to-intercombination line ratios are consistent with this onset radius, and inconsistent with being formed in a wind-collision interface with the star\u27s closest visual companion at a distance of 100 au. The broad-band X-ray spectrum is fitted with a dominant emission temperature of just kT = 0.6 keV along with significant wind absorption. The broad-band wind absorption and the line profiles provide two independent measurements of the wind mass-loss rate:. M = 5.2(-1.5)(+1.8) x 10(-6) and 6.8(-2.2)(+2.8) x 10(-6) M-circle dot yr(-1), respectively. This is the first consistent modelling of the X-ray line-profile shapes and broad-band X-ray spectral energy distribution in a massive star, and represents a reduction of a factor of 3-4 compared to the standard H alpha mass-loss rate that assumes a smooth wind

The Dynamical Distinction between Elliptical and Lenticular Galaxies in Distant Clusters: Further Evidence for the Recent Origin of S0 Galaxies

We examine resolved spectroscopic data obtained with the Keck II telescope for 44 spheroidal galaxies in the fields of two rich clusters, Cl0024+16 (z=0.40) and MS0451-03 (z=0.54), and contrast this with similar data for 23 galaxies within the redshift interval 0.3<z<0.65 in the GOODS northern field. For each galaxy we examine the case for systemic rotation, derive central stellar velocity dispersions sigma and photometric ellipticities, epsilon. Using morphological classifications obtained via Hubble Space Telescope imaging as the basis, we explore the utility of our kinematic quantities in distinguishing between pressure-supported ellipticals and rotationally-supported lenticulars (S0s). We demonstrate the reliability of using the v/(1-epsilon) vs sigma and v/sigma vs epsilon distributions as discriminators, finding that the two criteria correctly identify 63%+-3% and 80%+-2% of S0s at z~0.5, respectively, along with 76%+8-3% and 79%+-2% of ellipticals. We test these diagnostics using equivalent local data in the Coma cluster, and find that the diagnostics are similarly accurate at z=0. Our measured accuracies are comparable to the accuracy of visual classification of morphologies, but avoid the band-shifting and surface brightness effects that hinder visual classification at high redshifts. As an example application of our kinematic discriminators, we then examine the morphology-density relation for elliptical and S0 galaxies separately at z~0.5. We confirm, from kinematic data alone, the recent growth of rotationally-supported spheroidals. We discuss the feasibility of extending the method to a more comprehensive study of cluster and field galaxies to z~1, in order to verify in detail the recent density-dependent growth of S0 galaxies.Comment: 7 pages, 4 figures, updated with version accepted to Ap

Faecal incontinence persisting after childbirth : a 12 year longitudinal study

© 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.Peer reviewedPostprin

The Stellar Phase Density of the Local Universe and its Implications for Galaxy Evolution

This paper introduces the idea that the general mixing inequality obeyed by evolving stellar phase densities may place useful constraints on the possible history of the over-all galaxy population. We construct simple models for the full stellar phase space distributions of galaxies' disk and spheroidal components, and reproduce the well-known result that the maximum phase density of an elliptical galaxy is too high to be produced collisionlessly from a disk system, although we also show that the inclusion of a bulge component in the disk removes this evolutionary impediment. In order to draw more general conclusions about the evolution of the galaxy population, we use the Millennium Galaxy Catalogue to construct a model of the entire phase density distribution of stars in a representative sample of the local Universe. In such a composite population, we show that the mixing inequality rules out some evolutionary paths that are not prohibited by consideration of the maximum phase density alone, and thus show that the massive ellipticals in this population could not have formed purely from collisionless mergers of a low mass galaxy population like that found in the local Universe. Although the violation of the mixing inequality is in this case quite minor, and hence avoidable with a modest amount of non-collisionless star formation in the merger process, it does confirm the potential of this approach. The future measurement of stellar phase densities at higher redshift will allow this potential to be fully exploited, offering a new way to look at the possible pathways for galaxy evolution, and to learn about the environment of star formation through the way that this phase space becomes populated over time.Comment: 6 pages, 4 figures, accepted for publication in Astronomy & Astrophysic

The Tully-Fisher Relation of Barred Galaxies

We present new data exploring the scaling relations, such as the Tully-Fisher relation (TFR), of bright barred and unbarred galaxies. A primary motivation for this study is to establish whether barredness correlates with, and is a consequence of, virial properties of galaxies. Various lines of evidence suggest that dark matter is dominant in disks of bright unbarred galaxies at 2.2 disk scale lengths, the point of peak rotation for a pure exponential disk. We test the hypothesis that the TF plane of barred high surface brightness galaxies is offset from the mean TFR of unbarred galaxies, as might be expected if barred galaxies are ``maximal'' in their inner parts. We use existing and new TF data to search for basic structural differences between barred and unbarred galaxies. Our new data consist of 2-dimensional Halpha velocity fields derived from SparsePak integral field spectroscopy (IFS) and V,I-band CCD images collected at the WIYN Observatory for 14 strongly barred galaxies. We use WIYN/SparsePak (2-D) velocity fields to show that long-slit (1-D) spectra yield reliable circular speed measurements at or beyond 2.2 disk scale lengths, far from any influence of the bar. This enables us to consider line width measurements from extensive TF surveys which include barred and nonbarred disks and derive detailed scaling relation comparisons. We find that for a given luminosity, barred and unbarred galaxies have comparable structural and dynamical parameters, such as peak velocities, scale lengths, or colors. In particular, the location of a galaxy in the TF plane is independent of barredness. In a global dynamical sense, barred and unbarred galaxies behave similarly and are likely to have, on average, comparable fractions of luminous and dark matter at a given radius. (abridged)Comment: Accepted for publication in the ApJ (September 1, 2003 issue, v594). Appendix figures with I-band image and superimposed 2-D velocity field plus rotation curves must be downloaded separately (due to size constraints) from http://www.astro.ubc.ca/people/courteau/public/courteau03_TFbars.ps.g

Simultaneous multi-band detection of Low Surface Brightness galaxies with Markovian modelling

We present an algorithm for the detection of Low Surface Brightness (LSB) galaxies in images, called MARSIAA (MARkovian Software for Image Analysis in Astronomy), which is based on multi-scale Markovian modeling. MARSIAA can be applied simultaneously to different bands. It segments an image into a user-defined number of classes, according to their surface brightness and surroundings - typically, one or two classes contain the LSB structures. We have developed an algorithm, called DetectLSB, which allows the efficient identification of LSB galaxies from among the candidate sources selected by MARSIAA. To assess the robustness of our method, the method was applied to a set of 18 B and I band images (covering 1.3 square degrees in total) of the Virgo cluster. To further assess the completeness of the results of our method, both MARSIAA, SExtractor, and DetectLSB were applied to search for (i) mock Virgo LSB galaxies inserted into a set of deep Next Generation Virgo Survey (NGVS) gri-band subimages and (ii) Virgo LSB galaxies identified by eye in a full set of NGVS square degree gri images. MARSIAA/DetectLSB recovered ~20% more mock LSB galaxies and ~40% more LSB galaxies identified by eye than SExtractor/DetectLSB. With a 90% fraction of false positives from an entirely unsupervised pipeline, a completeness of 90% is reached for sources with r_e > 3" at a mean surface brightness level of mu_g=27.7 mag/arcsec^2 and a central surface brightness of mu^0 g=26.7 mag/arcsec^2. About 10% of the false positives are artifacts, the rest being background galaxies. We have found our method to be complementary to the application of matched filters and an optimized use of SExtractor, and to have the following advantages: it is scale-free, can be applied simultaneously to several bands, and is well adapted for crowded regions on the sky.Comment: 39 pages, 18 figures, accepted for publication in A

The Next Generation Virgo Cluster Survey. XII. Stellar Populations and Kinematics of Compact, Low-Mass Early-Type Galaxies from Gemini GMOS-IFU Spectroscopy

We present Gemini GMOS-IFU data of eight compact low-mass early-type galaxies (ETGs) in the Virgo cluster. We analyse their stellar kinematics, stellar population, and present two-dimensional maps of these properties covering the central 5"x 7" region. We find a large variety of kinematics: from non- to highly-rotating objects, often associated with underlying disky isophotes revealed by deep images from the Next Generation Virgo Cluster Survey. In half of our objects, we find a centrally-concentrated younger and more metal-rich stellar population. We analyze the specific stellar angular momentum through the lambdaR parameter and find six fast-rotators and two slow-rotators, one having a thin counter-rotating disk. We compare the local galaxy density and stellar populations of our objects with those of 39 more extended low-mass Virgo ETGs from the SMAKCED survey and 260 massive ($M>10^{10}$\Msun) ETGs from the A3D sample. The compact low-mass ETGs in our sample are located in high density regions, often close to a massive galaxy and have, on average, older and more metal-rich stellar populations than less compact low-mass galaxies. We find that the stellar population parameters follow lines of constant velocity dispersion in the mass-size plane, smoothly extending the comparable trends found for massive ETGs. Our study supports a scenario where low-mass compact ETGs have experienced long-lived interactions with their environment, including ram-pressure stripping and gravitational tidal forces, that may be responsible for their compact nature.Comment: Accepted in ApJ, 19 pages, 10 figure