Good urodynamic practice: Pressure signal quality immediately after catheter insertion for cystometry with a water-filled pressure transducer system and its relevance for the ICS zero procedure

AIM: This study aims to evaluate the intracorporeal pressures immediately after the insertion of the catheters for urodynamic testing with a water-filled urodynamic pressure transducer system to determine the relevance of the International Continence Society (ICS) zeroing principles. METHODS: Here, a retrospective analysis of a random series of urodynamic recordings is performed. The initial pressures, immediately after the insertion of the catheters, have been compared with the pressures after some milliliters of filling and flushing away of the gel, used with insertion, and/or the mucus and debris from the inserted catheters. Differences of initially recorded intravesical and intrarectal pressures from those after flushing and filling are analyzed and associated with the ICS standard practice of zeroing. RESULTS: Statistically and clinically significant differences between the initial pressures and the pressures after filling and flushing are observed, with nonphysiological initial pressures in 62% of the studies. Some filling (20 ml or more in the bladder) and flushing of the pressure channels resulted in the registration of physiological pressures and synchronous response from both lines on abdominal pressure increases. CONCLUSIONS: The pressure signal quality of a water-filled urodynamic system immediately after catheter insertion is low with inaccurately displayed pressure values, but it changes to normal after flushing the pressure channels and some filling. Rezeroing of the intracorporeal pressures immediately after catheter insertion for cystometry is the inappropriate correction procedure that misleadingly modifies the false initial pressures, resulting in ongoing unrealistic urodynamic study pressures

Head-to-head comparison of pressures during full cystometry, with clinical as well as in-depth signal-analysis, of air-filled catheters versus the ICS-standard water-filled catheters

Aims: To compare in vivo differences of two catheter systems for urodynamics to further discover their measurement properties. Methods: Side-by-side catheterization with two catheters for intravesical and abdominal pressure during full cystometry in 36 prospectively recruited patients with analysis of mean and absolute differences at urodynamic events and post hoc in-depth signal analysis comparing the full pressure traces of both systems. Results: The mean pressure differences at urodynamic events between air-filled and water-filled systems are small, however, with a large variation, without a systematic difference. The majority of the intersystem differences are significantly larger than 5 cmH 2O. Further analysis showed that urodynamic event pressure differences of both systems at the start of the test were carried forward throughout the remainder of the test without subsequent or additional tendency to differ. Post hoc whole test signal analysis with pressures equalized from the first sample shows high cross-correlation (>0.981) between the pressure signals per location (rectum and bladder) per test and almost zero-time shift (<0.05 s) of all cystometry pressure samples. Conclusions: We confirm earlier studies that showed random differences at events between air-filled and water-filled pressures during clinical urodynamic testing and confirm that these are intrinsic but not systematic—and still incompletely explained—offset-baseline differences. We determined on closer full measurement analysis after equalizing, that both systems are similar in displaying urodynamic pressure variations and amplitudes. We also confirm that both systems require awareness of intrinsic measurement properties during urodynamic testing and especially may necessitate adjustment of pressure offsets into a quantitative diagnosis of a urodynamic test

K0s K0s Final State in Two-Photon Collisions and Implications for Glueballs

The K0s K0s final state in two-photon collisions is studied with the L3 detector at LEP. The mass spectrum is dominated by the formation of the f_2'(1525) tensor meson in the helicity-two state with a two-photon width times the branching ratio into K Kbar of 76 +- 6 +- 11 eV. A clear signal for the formation of the f_J(1710) is observed and it is found to be dominated by the spin-two helicity-two state. No resonance is observed in the mass region around 2.2 GeV and an upper limit of 1.4 eV at 95% C.L. is derived for the two-photon width times the branching ratio into K0s K0s for the glueball candidate xi(2230)

Explaining Extreme Events of 2012 from a Climate Perspective

Attribution of extreme events is a challenging science and one that is currently undergoing considerable evolution. In this paper are 19 analyses by 18 different research groups, often using quite different methodologies, of 12 extreme events that occurred in 2012. In addition to investigating the causes of these extreme events, the multiple analyses of four of the events, the high temperatures in the United States, the record low levels of Arctic sea ice, and the heavy rain in northern Europe and eastern Australia, provide an opportunity to compare and contrast the strengths and weaknesses of the various methodologies. The differences also provide insights into the structural uncertainty of event attribution, that is, the uncertainty that arises directly from the differences in analysis methodology. In these cases, there was considerable agreement between the different assessments of the same event. However, different events had very different causes. Approximately half the analyses found some evidence that anthropogenically caused climate change was a contributing factor to the extreme event examined, though the effects of natural fluctuations of weather and climate on the evolution of many of the extreme events played key roles as well.Peer Reviewe

Measurement of the W-Pair Production Cross Section and W-Decay Branching Fractions in e+e−e^{+}e^{-} Interactions at s\sqrt{s}= 189 GeV

The data collected by the L3 experiment at LEP at a centre-of-mass energy of $188.6~\rm{Ge\kern -0.1em V}$ are used to measure the W-pair production cross section and the W-boson decay branching fractions. These data correspond to an integrated luminosity of 176.8~pb$^{-1}$. The total cross section for W-pair production, combining all final states, is measured to be $\sigma_{\rm{WW}}= 16.24 \pm 0.37~(stat.) \pm 0.22~(syst.)$~pb. Including our data collected at lower centre-of-mass energies, the hadronic branching fraction of the W-boson is determined to be $B(\rm{W} \rightarrow \rm{qq})= \left[ 68.20 \pm 0.68~(stat.) \pm 0.33~(syst.)\right]~\%$. The results agree with the Standard Model predictions.The data collected by the L3 experiment at LEP at a centre-of-mass energy of 188.6 GeV are used to measure the W-pair production cross section and the W-boson decay branching fractions. These data correspond to an integrated luminosity of 176.8pb^-1. The total cross section for W-pair production, combining all final states, is measured to be sigma_WW = 16.24 +/- 0.37(stat.) +/- 0.22(syst.) pb. Including our data collected at lower centre-of-mass energies, the hadronic branching fraction of the W-boson is determined to be B(W ->qq) = [68.20 +/- 0.68 (stat.) +/- 0.33 (syst.) ] %. The results agree with the Standard Model predictions.The data collected by the L3 experiment at LEP at a centre-of-mass energy of 188.6 GeV are used to measure the W-pair production cross section and the W-boson decay branching fractions. These data correspond to an integrated luminosity of 176.8 pb −1 . The total cross section for W-pair production, combining all final states, is measured to be σ WW =16.24±0.37 (stat.)±0.22 (syst.) pb. Including our data collected at lower centre-of-mass energies, the hadronic branching fraction of the W-boson is determined to be B (W→qq)=[68.20±0.68 (stat.)±0.33 (syst.)]%. The results agree with the Standard Model predictions

Light resonances in Ks K pi and eta pi pi final states in gamma gamma collisions at LEP

The e+e- -> e+e- Ks K+- pi-+ e+e- -> e+e- eta pi+ pi- and final states are studied with the L3 detector at LEP using data collected at centre-of-mass energies from 183 GeV up to 202 GeV. The mass spectrum of the Ks K+- pi-+ final state shows an enhancement around 1470MeV, which is identified with the pseudoscalar meson eta(1440). This state is observed in gamma gamma collisions for the first time and its two-photon width is measured to be Gamma_gamma gamma(eta(1440))x BR(eta(1440)->KK pi)= 212 +/- 50(stat) +/- 23(sys)eV. Clear evidence is also obtained for the formation of the axial vector mesons f1(1420) and f1(1285). In the eta pi+ pi- channel the f1(1285) is observed, and upper limits for the formation of eta(1440) and eta(1295) are obtained

Relative effectiveness and adverse effects of cervical manipulation, mobilisation and the activator instrument in patients with sub-acute non-specific neck pain: results from a stopped randomised trial

<p>Abstract</p> <p>Background</p> <p>Neck pain of a mechanical nature is a common complaint seen by practitioners of manual medicine, who use a multitude of methods to treat the condition. It is not known, however, if any of these methods are superior in treatment effectiveness. This trial was stopped due to poor recruitment. The purposes of this report are (1) to describe the trial protocol, (2) to report on the data obtained from subjects who completed the study, (3) to discuss the problems we encountered in conducting this study.</p> <p>Methods</p> <p>A pragmatic randomised clinical trial was undertaken. Patients who met eligibility criteria were randomised into three groups. One group was treated using specific segmental high velocity low amplitude manipulation (diversified), another by specific segmental mobilisation, and a third group by the Activator instrument. All three groups were also treated for any myofascial distortions and given appropriate exercises and advice. Participants were treated six times over a three-week period or until they reported being pain free. The primary outcome measure for the study was Patient Global Impression of Change (PGIC); secondary outcome measures included the Short-Form Health Survey (SF-36v₂), the neck Bournemouth Questionnaire, and the numerical rating scale for pain intensity. Participants also kept a diary of any pain medication taken and noted any perceived adverse effects of treatment. Outcomes were measured at four points: end of treatment, and 3, 6, and 12 months thereafter.</p> <p>Results</p> <p>Between January 2007 and March 2008, 123 patients were assessed for eligibility, of these 47 were considered eligible, of which 16 were allocated to manipulation, 16 to the Activator instrument and 15 to the mobilisation group. Comparison between the groups on the PGIC adjusted for baseline covariants did not show a significant difference for any of the endpoints. Within group analyses for change from baseline to the 12-month follow up for secondary outcomes were significant for all groups on the Bournemouth Questionnaire and for pain, while the mobilisation group had a significant improvement on the PCS and MCS subscales of the SF-36_v2. Finally, there were no moderate, severe, or long-lasting adverse effects reported by any participant in any group.</p> <p>Conclusions</p> <p>Although the small sample size must be taken into consideration, it appears that all three methods of treating mechanical neck pain had a long-term benefit for subacute neck pain, without moderate or serious adverse events associated with any of the treatment methods. There were difficulties in recruiting subjects to this trial. This pragmatic trial should be repeated with a larger sample size.</p

Carbon disulfide. Just toxic or also bioregulatory and/or therapeutic?

The overview presented here has the goal of examining whether carbon disulfide (CS2) may play a role as an endogenously generated bioregulator and/or has therapeutic value. The neuro- and reproductive system toxicity of CS2 has been documented from its long-term use in the viscose rayon industry. CS2 is also used in the production of dithiocarbamates (DTCs), which are potent fungicides and pesticides, thus raising concern that CS2 may be an environmental toxin. However, DTCs also have recognized medicinal use in the treatment of heavy metal poisonings as well as having potency for reducing inflammation. Three known small molecule bioregulators (SMBs) nitric oxide, carbon monoxide, and hydrogen sulfide were initially viewed as environmental toxins. Yet each is now recognized as having intricate, though not fully elucidated, biological functions at concentration regimes far lower than the toxic doses. The literature also implies that the mammalian chemical biology of CS2 has broader implications from inflammatory states to the gut microbiome. On these bases, we suggest that the very nature of CS2 poisoning may be related to interrupting or overwhelming relevant regulatory or signaling process(es), much like other SMBs