The effects of childbirth on the pelvic-floor

Basically, vaginal delivery is associated with the risk of pelvic floor damage. The pelvic floor sequelae of childbirth includes anal incontinence, urinary incontinence and pelvic organ prolapse. Pathophysiology, incidence and risk factors for the development of the respective problems are reviewed. Where possible, recommendations for reducing the risk of pelvic floor damage are given

Ten Million Degree Gas in M 17 and the Rosette Nebula: X-ray Flows in Galactic H II Regions

We present the first high-spatial-resolution X-ray images of two high-mass star forming regions, the Omega Nebula (M 17) and the Rosette Nebula (NGC 2237--2246), obtained with the Chandra X-ray Observatory Advanced CCD Imaging Spectrometer (ACIS) instrument. The massive clusters powering these H II regions are resolved at the arcsecond level into >900 (M 17) and >300 (Rosette) stellar sources similar to those seen in closer young stellar clusters. However, we also detect soft diffuse X-ray emission on parsec scales that is spatially and spectrally distinct from the point source population. The diffuse emission has luminosity L_x ~ 3.4e33 ergs/s in M~17 with plasma energy components at kT ~0.13 and ~0.6 keV (1.5 and 7 MK), while in Rosette it has L_x \~6e32 ergs/s with plasma energy components at kT ~0.06 and ~0.8 keV (0.7 and 9 MK). This extended emission most likely arises from the fast O-star winds thermalized either by wind-wind collisions or by a termination shock against the surrounding media. We establish that only a small portion of the wind energy and mass appears in the observed diffuse X-ray plasma; in these blister H II regions, we suspect that most of it flows without cooling into the low-density interstellar medium. These data provide compelling observational evidence that strong wind shocks are present in H II regions.Comment: 35 pages, including 11 figures; to appear in ApJ, August 20, 2003. A version with high-resolution figures is available at ftp://ftp.astro.psu.edu/pub/townsley/diffuse.ps.g

The formation of broad emission line regions in supernova-QSO wind interactions: II. 2D calculations

One aspect of supernova remnant evolution that is relatively unstudied is the influence of an AGN environment. A high density ambient medium and a nearby powerful continuum source will assist the cooling of shocked ejecta and swept-up gas. Motion of the surrounding medium relative to the remnant will also affect the remnant morphology. In an extension to previous work we have performed 2D hydrodynamical calculations of SNR evolution in an AGN environment, and have determined the evolutionary behaviour of cold gas in the remnant. The cold gas will contribute to the observed broad line emission in AGNs, and we present preliminary theoretical line profiles from our calculations. A more detailed comparison with observations will be performed in future work. The SNR-AGN interaction may be also useful as a diagnostic of AGN winds

EUROSPEC : at the interface between remote-sensing and ecosystem CO2 flux measurements in Europe

Resolving the spatial and temporal dynamics of gross primary productivity (GPP) of terrestrial ecosystems across different scales remains a challenge. Remote sensing is regarded as the solution to upscale point observations conducted at the ecosystem level, using the eddy covariance (EC) technique, to the landscape and global levels. In addition to traditional vegetation indices, the photochemical reflectance index (PRI) and the emission of solar-induced chlorophyll fluorescence (SIF), now measurable from space, provide a new range of opportunities to monitor the global carbon cycle using remote sensing. However, the scale mismatch between EC observations and the much coarser satellite-derived data complicate the integration of the two sources of data. The solution is to establish a network of in situ spectral measurements that can act as a bridge between EC measurements and remote-sensing data. In situ spectral measurements have already been conducted for many years at EC sites, but using variable instrumentation, setups, and measurement standards. In Europe in particular, in situ spectral measurements remain highly heterogeneous. The goal of EUROSPEC Cost Action ES0930 was to promote the development of common measuring protocols and new instruments towards establishing best practices and standardization of these measurements. In this review we describe the background and main tradeoffs of in situ spectral measurements, review the main results of EUROSPEC Cost Action, and discuss the future challenges and opportunities of in situ spectral measurements for improved estimation of local and global estimates of GPP over terrestrial ecosystems.Peer reviewe

Numerical heat conduction in hydrodynamical models of colliding hypersonic flows

Hydrodynamical models of colliding hypersonic flows are presented which explore the dependence of the resulting dynamics and the characteristics of the derived X-ray emission on numerical conduction and viscosity. For the purpose of our investigation we present models of colliding flow with plane-parallel and cylindrical divergence. Numerical conduction causes erroneous heating of gas across the contact discontinuity which has implications for the rate at which the gas cools. We find that the dynamics of the shocked gas and the resulting X-ray emission are strongly dependent on the contrast in the density and temperature either side of the contact discontinuity, these effects being strongest where the postshock gas of one flow behaves quasi-adiabatically while the postshock gas of the other flow is strongly radiative. Introducing additional numerical viscosity into the simulations has the effect of damping the growth of instabilities, which in some cases act to increase the volume of shocked gas and can re-heat gas via sub-shocks as it flows downstream. The resulting reduction in the surface area between adjacent flows, and therefore of the amount of numerical conduction, leads to a commensurate reduction in spurious X-ray emission, though the dynamics of the collision are compromised. The simulation resolution also affects the degree of numerical conduction. A finer resolution better resolves the interfaces of high density and temperature contrast and although numerical conduction still exists the volume of affected gas is considerably reduced. However, since it is not always practical to increase the resolution, it is imperative that the degree of numerical conduction is understood so that inaccurate interpretations can be avoided. This work has implications for the dynamics and emission from astrophysical phenomena which involve high Mach number shocks.Comment: 14 pages, 10 figures, accepted for publication in MNRA

Is HIV Infection a Risk Factor for Multi-Drug Resistant Tuberculosis? A Systematic Review

BACKGROUND:Tuberculosis (TB) is an important cause of human suffering and death. Human immunodeficiency virus (HIV), multi-drug resistant TB (MDR-TB), and extensive drug resistant tuberculosis (XDR-TB) have emerged as threats to TB control. The association between MDR-TB and HIV infection has not yet been fully investigated. We conducted a systematic review and meta-analysis to summarize the evidence on the association between HIV infection and MDR-TB. METHODS AND RESULTS:Original studies providing Mycobacterium tuberculosis resistance data stratified by HIV status were identified using MEDLINE and ISI Web of Science. Crude MDR-TB prevalence ratios were calculated and analyzed by type of TB (primary or acquired), region and study period. Heterogeneity across studies was assessed, and pooled prevalence ratios were generated if appropriate. No clear association was found between MDR-TB and HIV infection across time and geographic locations. MDR-TB prevalence ratios in the 32 eligible studies, comparing MDR-TB prevalence by HIV status, ranged from 0.21 to 41.45. Assessment by geographical region or study period did not reveal noticeable patterns. The summary prevalence ratios for acquired and primary MDR-TB were 1.17 (95% CI 0.86, 1.6) and 2.72 (95% CI 2.03, 3.66), respectively. Studies eligible for review were few considering the size of the epidemics. Most studies were not adjusted for confounders and the heterogeneity across studies precluded the calculation of a meaningful overall summary measure. CONCLUSIONS:We could not demonstrate an overall association between MDR-TB and HIV or acquired MDR-TB and HIV, but our results suggest that HIV infection is associated with primary MDR-TB. Future well-designed studies and surveillance in all regions of the world are needed to better clarify the relationship between HIV infection and MDR-TB

Human immunodeficiency virus: 25 years of diagnostic and therapeutic strategies and their impact on hepatitis B and C virus

The human immunodeficiency virus (HIV) had spread unrecognized in the human population as sexually transmitted disease and was finally identified by its disease AIDS in 1981. Even after the isolation of the causative agent in 1983, the burden and death rate of AIDS accelerated worldwide especially in young people despite the confection of new drugs capable to inhibit virus replication since 1997. However, at least in industrialised countries, this trend could be reversed by the introduction of combination therapy strategies. The design of new drugs is on going; besides the inhibition of the three enzymes of HIV for replication and maturation (reverse transcriptase, integrase and protease), further drugs inhibits fusion of viral and cellular membranes and virus maturation. On the other hand, viral diagnostics had been considerably improved since the emergence of HIV. There was a need to identify infected people correctly, to follow up the course of immune reconstitution of patients by measuring viral load and CD4 cells, and to analyse drug escape mutations leading to drug resistance. Both the development of drugs and the refined diagnostics have been transferred to the treatment of patients infected with hepatitis B virus (HBV) and hepatitis C virus (HCV). This progress is not completed; there are beneficial aspects in the response of the scientific community to the HIV burden for the management of other viral diseases. These aspects are described in this contribution. Further aspects as handling a stigmatising disease, education of self-responsiveness within sexual relationships, and ways for confection of a protective vaccine are not covered

How to move ionized gas: an introduction to the dynamics of HII regions

This review covers the dynamic processes that are important in the evolution and structure of galactic HII regions, concentrating on an elementary presentation of the physical concepts and recent numerical simulations of HII region evolution in a non-uniform medium. The contents are as follows: (1) The equations (Euler equations; Radiative transfer; Rate equations; How to avoid the dynamics; How to avoid the atomic physics). (2) Physical concepts (Static photoionization equilibrium; Ionization front propagation; Structure of a D-type front; Photoablation flows; Other ingredients - Stellar winds, Radiation pressure, Magnetic fields, Instabilities). (3) HII region evolution (Early phases: hypercompact and ultracompact regions; Later phases: compact and extended regions; Clumps and turbulence).Comment: To be published as a chapter in 'Diffuse Matter from Star Forming Regions to Active Galaxies' - A volume Honouring John Dyson. Eds. T. W. Harquist, J. M. Pittard and S. A. E. G. Falle. 25 pages, 7 figures. Some figures degraded to meet size restriction. Full-resolution version available at http://www.ifront.org/wiki/Dyson_Festschrift_Chapte

Solution Structures of the Acyl Carrier Protein Domain from the Highly Reducing Type I Iterative Polyketide Synthase CalE8

Biosynthesis of the enediyne natural product calicheamicins γ1I in Micromonospora echinospora ssp. calichensis is initiated by the iterative polyketide synthase (PKS) CalE8. Recent studies showed that CalE8 produces highly conjugated polyenes as potential biosynthetic intermediates and thus belongs to a family of highly-reducing (HR) type I iterative PKSs. We have determined the NMR structure of the ACP domain (meACP) of CalE8, which represents the first structure of a HR type I iterative PKS ACP domain. Featured by a distinct hydrophobic patch and a glutamate-residue rich acidic patch, meACP adopts a twisted three-helix bundle structure rather than the canonical four-helix bundle structure. The so-called ‘recognition helix’ (α2) of meACP is less negatively charged than the typical type II ACPs. Although loop-2 exhibits greater conformational mobility than other regions of the protein with a missing short helix that can be observed in most ACPs, two bulky non-polar residues (Met992, Phe996) from loop-2 packed against the hydrophobic protein core seem to restrict large movement of the loop and impede the opening of the hydrophobic pocket for sequestering the acyl chains. NMR studies of the hydroxybutyryl- and octanoyl-meACP confirm that meACP is unable to sequester the hydrophobic chains in a well-defined central cavity. Instead, meACP seems to interact with the octanoyl tail through a distinct hydrophobic patch without involving large conformational change of loop-2. NMR titration study of the interaction between meACP and the cognate thioesterase partner CalE7 further suggests that their interaction is likely through the binding of CalE7 to the meACP-tethered polyene moiety rather than direct specific protein-protein interaction

Island survivors: population genetic structure and demography of the critically endangered giant lizard of La Gomera, Gallotia bravoana

Background: The giant lizard of La Gomera (Gallotia bravoana), is an endemic lacertid of this Canary Island that lives confined to a very restricted area of occupancy in a steep cliff, and is catalogued as Critically Endangered by IUCN. We present the first population genetic analysis of the wild population as well as of captive-born individuals (for which paternity data are available) from a recovery center. Current genetic variability, and inferred past demographic changes were determined in order to discern the relative contribution of natural versus human-mediated effects on the observed decline in population size. Results: Genetic analyses indicate that the only known natural population of the species shows low genetic diversity and acts as a single evolutionary unit. Demographic analyses inferred a prolonged decline of the species for at least 230 generations. Depending on the assumed generation time, the onset of the decline was dated between 1200-13000 years ago. Pedigree analyses of captive individuals suggest that reproductive behavior of the giant lizard of La Gomera may include polyandry, multiple paternity and female long-term sperm retention. Conclusions: The current low genetic diversity of G. bravoana is the result of a long-term gradual decline. Because generation time is unknown in this lizard and estimates had large credibility intervals, it is not possible to determine the relative contribution of humans in the collapse of the population. Shorter generation times would favor a stronger influence of human pressure whereas longer generation times would favor a climate-induced origin of the decline. In any case, our analyses show that the wild population has survived for a long period of time with low levels of genetic diversity and a small effective population size. Reproductive behavior may have acted as an important inbreeding avoidance mechanism allowing the species to elude extinction. Overall, our results suggest that the species retains its adaptive potential and could restore its ancient genetic diversity under favorable conditions. Therefore, management of the giant lizard of La Gomera should concentrate efforts on enhancing population growth rates through captive breeding of the species as well as on restoring the carrying capacity of its natural habitat.Spanish Ministry of Education; European Life Project [LIFE 02 NAT-E-008614]; Ministerio de Ciencia e Innovacion [REN 2001- 1514/GLO, CGL 2010-18216]info:eu-repo/semantics/publishedVersio