A systematic review and meta-analysis of Macroplastique for treating female stress urinary incontinence.

Introduction and hypothesisMacroplastique® (polydimethylsiloxane injection) is a minimally invasive urethral bulking agent with global clinical literature describing its use over 20 years. This study critically assessed the safety and effectiveness outcomes for adult women treated with Macroplastique for stress urinary incontinence (SUI) through a systematic review and meta-analysis.MethodsA systematic review of the scientific literature from 1990 to 2010 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to quantitatively summarize the safety and effectiveness of Macroplastique for female SUI. A total of 958 patients from 23 cohorts were eligible for inclusion and were analyzed. Random-effects models were used to estimate the improvement and cure rates following treatment at three time periods: short-term (<6 months), mid-term (6-18 months), and long-term (>18 months). Expanded models assessed the effect of reinjection rate on successful treatment outcomes. Adverse event rates were aggregated and reported.ResultsImprovement rates were 75 % [95 % confidence interval (CI), 69-81] in the short-term, 73 % (95 % CI, 62-83) in the mid-term, and 64 % (95 % CI, 57-71) long-term. Cure/dry rates were 43 % (95 % CI, 33-54), 37 % (95 % CI, 28-46), and 36 % (95 % CI, 27-46) over the same respective follow-up periods. Higher study reinjection rates were associated with improved long-term SUI outcomes. No serious adverse events were reported.ConclusionsThis quantitative review supports Macroplastique as an effective, durable, and safe treatment option for female SUI. Meta-analytic evidence suggests that long-term therapeutic benefit is frequently maintained, with some patients requiring reinjection

Nonextremal black holes are BPS

Extremal charged black holes are BPS solutions. It is commonly thought that their nonextremal counterparts are not. Further, experience with BPS solutions in flat spacetime suggests that all BPS solutions are supersymmetric; i.e. that they are invariant under some supersymmetry charges of either the original field theory or an appropriately extended version thereof. Using nonextremal Reissner-Nordstr\"om black holes as counterexamples, we show that neither of these expectations is universally valid. These black holes correspond to a one-parameter family of BPS solutions. By showing that, subject to one very plausible assumption, no generalized Killing spinor can be constructed for these, we show that there is no supergravity theory for which these BPS solutions preserve a fraction of the supersymmetry, nor is there an associated Witten-Nester positive energy bound.Comment: LaTeX, 15 pages. v2 Discussion in sec 2.3 amended, small corrections, reference added. v3 (PRD version) Clarifications, corrections and references added. Section 3.2 partly rewritten and expanded, and assumption clarifie

Impact of Vegetative Treatment Systems on Multiple Measures of Antibiotic Resistance in Agricultural Wastewater

Wastewater is an important vector of antibiotic resistant bacteria and antibiotic resistance genes (ARB/G). While there is broad agreement that ARB/G from agricultural (ag) wastewaters can be transported through the environment and may contribute to untreatable infectious disease in humans and animals, there remain large knowledge gaps surrounding applied details on the types and amounts of ARB/G associated with different agricultural wastewater treatment options and different ag production systems. This study evaluates a vegetative treatment system (VTS) built to treat the wastewater from a beef cattle feedlot. Samples were collected for three years, and plated on multiple media types to enumerate tetracycline and cefotaxime-resistant bacteria. Enterobacteriaceae isolates (n = 822) were characterized for carriage of tetracycline resistance genes, and E. coli isolates (n = 673) were phenotyped to determine multi-drug resistance (MDR) profiles. Tetracycline resistance in feedlot runoff wastewater was 2-to-3 orders of magnitude higher compared to rainfall runoff from the VTS fields, indicating efficacy of the VTA for reducing ARB over time following wastewater application. Clear differences in MDR profiles were observed based on the specific media on which a sample was plated. This result highlights the importance of method, especially in the context of isolate-based surveillance and monitoring of ARB in agricultural wastewaters

Toxic Algae Contamination and Demand for Shellfish: A Case Study of Demand for Mussels in Montreal

Toxic algae blooms are a worldwide phenomena, which appear to be increasing in frequency and severity. These natural events cause product contaminations that often have significant economic consequences, including supply interruptions due to closed fishing grounds, losses from human illness, and losses due to a decline in demand for the affected products. This paper evaluates the impacts of a toxic algae bloom contamination event on demand for unaffected shellfish. As an empirical example of the economic losses the shellfish industry experiences for these events, demand for mussels in Montreal is estimated using firm-level data and proxies for consumer information, during and after domoic acid contamination of Prince Edward Island mussels. Sales losses due to decreased demand are calculated. Implications of this issue for seafood safety and management policies are discussed.demand, shellfish, toxic algae, contamination, Demand and Price Analysis, Environmental Economics and Policy, Food Consumption/Nutrition/Food Safety, Resource /Energy Economics and Policy,

In-Situ Colloidal MnO2 Deposition and Ozonation of 2,4-Dinitrotoluene

Laboratory experiments are presented that demonstrate a novel in situ semipassive reactive barrier for the degradation of 2,4 dinitrotoluene created by coating aquifer surfaces by deposition of colloidal MnO2, which catalyzes ozone degradation and enhances contaminant oxidation. Ozone is added to the reactive barrier and is transported through the zone with the contaminants by existing hydraulic gradients. The communication presents the preliminary laboratory investigation demonstrating the viability of this method. Studies were conducted by coating Ottawa sand with colloidal MnO2. Results show that concentrations of MnO2 in the range of 0.2 mg/g can be deposited with no measurable change in hydraulic conductivity, that there is significant coverage of the sand material by MnO2, and the deposition was not reversible under a wide range of chemical conditions. Ozonation of 2,4-dinitrotoluene in the presence of MnO2- coated sand was demonstrated to result in pseudo-first-order degradation kinetics with respect to DNT with half-lives ranging from 28 to 22 min (at pH 6 and 7, respectively), approximately 25% faster than experiments performed in the absence of MnO2