The clinical guidelines for interstitial cystitis and related symptomatic conditions were revised by updating our previous guidelines. The current guidelines define interstitial cystitis/bladder pain ...syndrome as a condition with chronic pelvic pain, pressure or discomfort perceived to be related to the urinary bladder accompanied by other urinary symptoms, such as persistent urge to void or urinary frequency in the absence of confusable diseases. The characteristic symptom complex is collectively referred as hypersensitive bladder symptoms. Interstitial cystitis/bladder pain syndrome is divided into Hunner‐type interstitial cystitis and bladder pain syndrome; Hunner‐type interstitial cystitis and bladder pain syndrome represent interstitial cystitis/bladder pain syndrome with Hunner lesions and interstitial cystitis/bladder pain syndrome without Hunner lesions, respectively. So‐called non‐Hunner‐type interstitial cystitis featured by glomerulations or bladder bleeding after distension is included in bladder pain syndrome. The symptoms are virtually indistinguishable between Hunner‐type interstitial cystitis and bladder pain syndrome; however, Hunner‐type interstitial cystitis and bladder pain syndrome should be considered as a separate entity of disorder. Histopathology totally differs between Hunner‐type interstitial cystitis and bladder pain syndrome; Hunner‐type interstitial cystitis is associated with severe inflammation of the urinary bladder accompanied by lymphoplasmacytic infiltration and urothelial denudation, whereas bladder pain syndrome shows little pathological changes in the bladder. Pathophysiology would also differ between Hunner‐type interstitial cystitis and bladder pain syndrome, involving interaction of multiple factors, such as inflammation, autoimmunity, infection, exogenous substances, urothelial dysfunction, neural hyperactivity and extrabladder disorders. The patients should be treated differently based on the diagnosis of Hunner‐type interstitial cystitis or bladder pain syndrome, which requires cystoscopy to determine the presence or absence Hunner lesions. Clinical studies are to be designed to analyze outcomes separately for Hunner‐type interstitial cystitis and bladder pain syndrome.
Foamed concrete (FC) is a high-quality building material with densities from 300 to 1850 kg/m3, which can have potential use in civil engineering, both as insulation from heat and sound, and for ...load-bearing structures. However, due to the nature of the cement material and its high porosity, FC is very weak in withstanding tensile loads; therefore, it often cracks in a plastic state, during shrinkage while drying, and also in a solid state. This paper is the first comprehensive review of the use of man-made and natural fibres to produce fibre-reinforced foamed concrete (FRFC). For this purpose, various foaming agents, fibres and other components that can serve as a basis for FRFC are reviewed and discussed in detail. Several factors have been found to affect the mechanical properties of FRFC, namely: fresh and hardened densities, particle size distribution, percentage of pozzolanic material used and volume of chemical foam agent. It was found that the rheological properties of the FRFC mix are influenced by the properties of both fibres and foam; therefore, it is necessary to apply an additional dosage of a foam agent to enhance the adhesion and cohesion between the foam agent and the cementitious filler in comparison with materials without fibres. Various types of fibres allow the reduction of by autogenous shrinkage a factor of 1.2–1.8 and drying shrinkage by a factor of 1.3–1.8. Incorporation of fibres leads to only a slight increase in the compressive strength of foamed concrete; however, it can significantly improve the flexural strength (up to 4 times), tensile strength (up to 3 times) and impact strength (up to 6 times). At the same time, the addition of fibres leads to practically no change in the heat and sound insulation characteristics of foamed concrete and this is basically depended on the type of fibres used such as Nylon and aramid fibres. Thus, FRFC having the presented set of properties has applications in various areas of construction, both in the construction of load-bearing and enclosing structures.
Clinical guidelines for interstitial cystitis and hypersensitive bladder have been updated as of 2015. The guidelines define interstitial cystitis by the presence of hypersensitive bladder symptoms ...(discomfort, pressure or pain in the bladder usually associated with urinary frequency and nocturia) and bladder pathology, after excluding other diseases explaining symptoms. Interstitial cystitis is further classified by bladder pathology; either Hunner type interstitial cystitis with Hunner lesions or non‐Hunner type interstitial cystitis with mucosal bleeding after distension in the absence of Hunner lesions. Hypersensitive bladder refers to a condition, where hypersensitive bladder symptoms are present, but bladder pathology or other explainable diseases are unproven. Interstitial cystitis and hypersensitive bladder severely affect patients' quality of life as a result of disabling symptoms and/or comorbidities. Reported prevalence suggestive of these disorders varies greatly from 0.01% to >6%. Pathophysiology would be an interaction of multiple factors including urothelial dysfunction, inflammation, neural hyperactivity, exogenous substances and extrabladder disorders. Definite diagnosis of interstitial cystitis and hypersensitive bladder requires cystoscopy with or without hydrodistension. Most of the therapeutic options lack a high level of evidence, leaving a few as recommended therapeutic options.
Compromised autophagy and mitochondrial dysfunction downregulate chondrocytic activity, accelerating the development of osteoarthritis (OA). Irisin, a cleaved form of fibronectin type III domain ...containing 5 (FNDC5), regulates bone turnover and muscle homeostasis. Little is known about the effect of Irisin on chondrocytes and the development of osteoarthritis. This study revealed that human osteoarthritic articular chondrocytes express decreased level of FNDC5 and autophagosome marker LC3-II but upregulated levels of oxidative DNA damage marker 8-hydroxydeoxyguanosine (8-OHdG) and apoptosis. Intra-articular administration of Irisin further alleviated symptoms of medial meniscus destabilization, like cartilage erosion and synovitis, while improved the gait profiles of the injured legs. Irisin treatment upregulated autophagy, 8-OHdG and apoptosis in chondrocytes of the injured cartilage. In vitro, Irisin improved IL-1β-mediated growth inhibition, loss of specific cartilage markers and glycosaminoglycan production by chondrocytes. Irisin also reversed Sirt3 and UCP-1 pathways, thereby improving mitochondrial membrane potential, ATP production, and catalase to attenuated IL-1β-mediated reactive oxygen radical production, mitochondrial fusion, mitophagy, and autophagosome formation. Taken together, FNDC5 loss in chondrocytes is correlated with human knee OA. Irisin repressed inflammation-mediated oxidative stress and extracellular matrix underproduction through retaining mitochondrial biogenesis, dynamics and autophagic program. Our analyses shed new light on the chondroprotective actions of this myokine, and highlight the remedial effects of Irisin on OA development.
Assimilation of the Moderate Resolution Imaging Spectroradiometer (MODIS) total aerosol optical depth (AOD) retrieval products (at 550 nm wavelength) from both Terra and Aqua satellites have been ...developed within the National Centers for Environmental Prediction (NCEP) Gridpoint Statistical Interpolation (GSI) three‐dimensional variational (3DVAR) data assimilation system. This newly developed algorithm allows, in a one‐step procedure, the analysis of 3‐D mass concentration of 14 aerosol variables from the Goddard Chemistry Aerosol Radiation and Transport (GOCART) module. The Community Radiative Transfer Model (CRTM) was extended to calculate AOD using GOCART aerosol variables as input. Both the AOD forward model and corresponding Jacobian model were developed within the CRTM and used in the 3DVAR minimization algorithm to compute the AOD cost function and its gradient with respect to 3‐D aerosol mass concentration. The impact of MODIS AOD data assimilation was demonstrated by application to a dust storm from 17 to 24 March 2010 over East Asia. The aerosol analyses initialized Weather Research and Forecasting/Chemistry (WRF/Chem) model forecasts. Results indicate that assimilating MODIS AOD substantially improves aerosol analyses and subsequent forecasts when compared to MODIS AOD, independent AOD observations from the Aerosol Robotic Network (AERONET) and Cloud‐Aerosol Lidar with Orthogonal Polarization (CALIOP) instrument, and surface PM10 (particulate matter with diameters less than 10 μm) observations. The newly developed AOD data assimilation system can serve as a tool to improve simulations of dust storms and general air quality analyses and forecasts.
Key Points
Assimilating MODIS AOD with a 3DVAR method coupled with WRF/Chem model
Using individual aerosol species as analysis variables in 3DVAR
AOD data assimilation substantially improved aerosol analysis and forecast
Few studies have presented a holistic approach to evaluating complex national tourism policies, successfully quantified the dynamics at play, or proposed an improvement model. The corresponding ...purpose of this study is to address this problem, using the method of hybrid MCDM (multiple criteria decision-making) to examine the dependent relationships among various dimensions and criteria of tourism policies and, ultimately, to suggest an optimal improvement plan for Taiwan tourism policy. A decision-making trial and evaluation laboratory (DEMATEL) is employed to construct a network relationship map (NRM), which then is used to illustrate the influential network of the tourism policy improvement model. The DEMATEL-based analytic network process (DANP) and VIKOR are adopted to evaluate the weights and the gaps to the aspired level of implementation. The model is useful in identifying both an influential network and a priority sequence of dimensions/criteria related to tourism policies and, thus, is helpful to tourism policy management.
► The research demonstrated a holistic approach, a hybrid MCDM models, for evaluating complex national tourism policies. ► The DEMATEL is employed to construct NRM to illustrate the influential network of the tourism policy improvement model. ► The DANP and VIKOR are adopted to evaluate the weights and the gaps to the aspired level of implementation. ► The models are helpful to tourism policy management.
Each example in a multi-label dataset is associated with multiple labels, which are often correlated. Learning from this data can be improved when dimensionality reduction tasks, such as feature ...selection, are applied. The standard approach for multi-label feature selection transforms the multi-label dataset into single-label datasets before using traditional feature selection algorithms. However, this approach often ignores label dependence. In this work, we propose an alternative method, LCFS, that constructs new labels based on relations between the original labels. By doing so, the label set from the data is augmented with second-order information before applying the standard approach. To assess LCFS, an experimental evaluation using Information Gain as a measure to estimate the importance of features was carried out on 10 benchmark multi-label datasets. This evaluation compared four LCFS settings with the standard approach, using random feature selection as a reference. For each dataset, the performance of a feature selection method is estimated by the quality of the classifiers built from the data described by the features selected by the method. The results show that a simple LCFS setting gave rise to classifiers similar to, or better than, the ones built using the standard approach. Furthermore, this work also pioneers the use of the systematic review method to survey the related work on multi-label feature selection. The summary of the 99 papers found promotes the idea that exploring label dependence during feature selection can lead to good results.
•By constructing new labels, LCFS considers label relations from a multi-label dataset.•A LCFS setting achieved performance competitive with the standard approach.•LCFS contributed to outperform classifiers based on experimental references.•We also pioneer the systematic review use on multi-label feature selection literature.•The summary of 99 papers found evidence that agrees with LCFS achievements.
Objectives
To assess temporal patterns and regional differences in the incidence rate, and factors associated with survival of urinary tract urothelial carcinoma.
Methods
The medical records of 8830 ...patients with new diagnoses of urinary tract urothelial carcinoma in the years 2001–2010 were retrieved from Taiwan National databases. Temporal trends, regional disparity and related survival factors were evaluated using the Cochran–Armitage trend test, local Moran’s I statistic and log‐rank test, respectively.
Results
The annual urinary tract urothelial carcinoma incidence rates (standardized by age) were steady at approximately 3.14–3.41 per 100 000 person‐years. Notably, women had a significantly higher annual urinary tract urothelial carcinoma incidence than men in most of the years studied (range of female‐to‐male annual standardized rate ratio: 2.08–3.25), and diabetes prevalence in urinary tract urothelial carcinoma increased significantly from 12.3% to 23.4% per year over the 10 years. High urinary tract urothelial carcinoma incidence cluster areas other than the latest endemic area of “blackfoot disease” were newly identified by local Moran’s I statistic (P < 0.05). Furthermore, older age, male sex, end‐stage kidney disease and more advanced tumor grade were associated with lower 5‐year overall survival probabilities in the 2001–2015 cohort.
Conclusions
The incidence and survival of urinary tract urothelial carcinoma over the decade 2001–2010 were different according to population and regional features. Various urinary tract urothelial carcinoma screening, prevention, treatment and care plans should be developed depending on age, sex, comorbidity and area of residence.
Blood culture is viewed as the golden standard for the diagnosis of sepsis but suffers from low sensitivity and long turnaround time. LightCycler SeptiFast (LC-SF) is a real-time multiplex polymerase ...chain reaction test able to detect 25 common pathogens responsible for bloodstream infections within hours. We aim to assess the accuracy of LC-SF by systematically reviewing the published studies.
Related literature on Medline, Embase, and Cochrane databases was searched up to October 2012 for studies utilizing LC-SF to diagnose suspected sepsis and that provided sufficient data to construct two-by-two tables.
A total of 34 studies enrolling 6012 patients of suspected sepsis were included. The overall sensitivity and specificity for LC-SF to detect bacteremia or fungemia was 0·75 (95% CI: 0·65-0·83) and 0·92 (95%CI:0·90-0·95), respectively. LC-SF had a high positive likelihood ratio (10·10) and a moderate negative likelihood ratio (0·27). Specifically, LC-SF had a sensitivity of 0·80 (95%CI: 0·70-0·88) and a specificity of 0·95(95%CI: 0·93-0·97) for the bacteremia outcome, and a sensitivity of 0·61 (95%CI: 0·48-0·72) and a specificity of 0·99 (95%CI: 0·99-0·99) for the fungemia outcome. High heterogeneity was found in the bacteremia outcome subgroup but not in the fungemia outcome subgroup.
LC-SF is of high rule-in value for early detection of septic patients. In a population with low pretest probability, LC-SF test can still provide valuable information for ruling out bacteremia or fungemia.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Prior research has highlighted the synergistic impact of protein supplementation on muscle function post‐exercise in adults; however, evidence supporting the combined effects were less ...robust and inconsistent on those with protein insufficiency. This investigation aims to explore efficacy of protein‐enriched soup coupled with exercise on muscle health and metabolism in middle‐aged and older adults with suboptimal protein intake.
Methods
An open‐label, 12‐week, randomized controlled trial involving participants with insufficient protein intake (<1.0 g/kg/day) was done. The intervention group consumed protein‐enriched soup (24–30 g protein daily) and 1‐h weekly exercise, while controls received health education. Assessments included laboratory tests, functional assessments, and body composition.
Results
In this trial, 97 out of 100 randomized participants (mean age: 64.65 ± 4.84 years, 81.8% female) completed the study (47 in intervention group and 50 in control group). Compared results of baselines, at 1 and 3 months of intervention, significant improvements in waist circumference (83.48 ± 10.22 vs. 82.5 ± 9.88 vs. 82.37 ± 9.42 cm, P for trend = 0.046), 6‐min walking distance (525.65 ± 58.46 vs. 534.47 ± 51.87 vs. 552.02 ± 57.66 m, P for trend = 0.001), five‐time sit‐to‐stand time (7.63 ± 1.63 vs. 6.81 ± 1.8 vs. 6.4 ± 1.42 s, P for trend <0.001), grip strength (26.74 ± 6.54 vs. 27.53 ± 6.99 vs. 28.52 ± 7.09 kg, P for trend <0.001), and MNA score (26.8 ± 2.14 vs. 27.73 ± 1.74 vs. 27.55 ± 1.72, P for trend <0.001) were discerned within the intervention group. The intervention demonstrated a significant reduction in serum triglyceride (105.32 ± 49.84 vs. 101.36 ± 42.58 vs. 93.43 ± 41.49 mg/dL, P for trend = 0.023), increased HDL‐C (60.04 ± 16.21 vs. 60 ± 17.37 vs. 62.55 ± 18.27 mg/dL, P for trend = 0.02), and DHEA‐S levels (97.11 ± 54.39 vs. 103.39 ± 56.75 vs. 106.83 ± 60.56 μg/dL, P for trend = 0.002). Serum myostatin did not differ in both groups, but serum leptin levels significantly increased (9118.88 ± 5811.68 vs. 11508.97 ± 7151.08 vs. 11220.80 ± 7190.71 pg/mL, P for trend = 0.016) in controls. The intervention group showed greater improvements in 6 min walking distance (β = 0.71, 95% CI: 6.88 to 40.79, P = 0.006), five‐time sit‐to‐stand test (β = −0.87, 95% CI: −1.59 to −0.15, P = 0.017), MNA score (β = 0.96, 95% CI: 0.20 to 1.71, P = 0.013), serum triglycerides (β = −15.01, 95% CI: −27.83 to −2.20, P = 0.022), LDL‐C (β = −9.23, 95% CI: −16.98 to −1.47, P = 0.020), and DHEA‐S levels (β = 9.98, 95% CI: 0.45 to 19.51, P = 0.04) than controls.
Conclusions
Protein‐enriched soup with weekly exercise over 12 weeks significantly improved physical performance, lipid profile, and DHEA‐S levels among middle‐aged and older adults with inadequate protein intake, while studies assessing long‐term benefits of the intervention are needed.
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