Adolescents might be susceptible to the effects of the COVID-19 lockdown. We assessed changes in mental wellbeing throughout the first year of the pandemic and compared these with prepandemic levels.
...This five-wave prospective study among Dutch adolescents aged 12–17 years used data collected before the pandemic (n = 224) (T0), in May (T1), July (T2), and October 2020 (T3), and in February 2021 (T4). Generalized estimating equations were used to assess the association between stringency of the lockdown with mental wellbeing.
Adolescents had a lower life satisfaction during the first full lockdown (T1) adjusted β: −0.36, 95% confidence interval (CI): −0.58 to −0.13, during the partial lockdown (T3) (adjusted β: −0.37, 95% CI: −0.63 to −0.12), and during the second full lockdown (T4) (adjusted β: −0.79, 95% CI: −1.07 to −0.52) compared to before the pandemic (T0). Adolescents reported more internalizing symptoms during only the second full lockdown (T4) (adjusted β: 2.58, 95% CI: 0.41–4.75). During the pandemic at T1 (adjusted β: 0.29, 95% CI: 0.20–0.38), T2 (adjusted β: 0.36, 95% CI: 0.26–0.46), T3 (adjusted β: 0.33, 95% CI: 0.22–0.45), and T4 (adjusted β: 0.20, 95% CI: 0.07–0.34), adolescents reported a better psychosomatic health, partly attributable to less trouble falling asleep (p < .01).
The COVID-19 lockdown measures have had both a negative and positive impact on mental wellbeing of Dutch adolescents. However, mental wellbeing was most impacted during the second full lockdown compared to before the pandemic.
Introduction and hypothesis
Surgery for pelvic organ prolapse (POP) has high recurrence rates. Long-term anatomical and patient-reported outcomes after pelvic floor repair are therefore required.
...Methods
This prospective observational cohort study was conducted in a teaching hospital with tertiary referral function for patients with POP. Patients with symptomatic vaginal vault or uterine prolapse (simplified POP Quantification sPOPQ stage ≥2), who underwent robot-assisted sacrocolpopexy (RASC) or supracervical hysterectomy with sacrocervicopexy (RSHS), were included. Follow-up visits with sPOPQ evaluations were planned 4 years after surgery. Patients received pre- and postoperative questionnaires reporting symptoms of vaginal bulge, Urogenital Distress Inventory (UDI-6), and Pelvic Floor Impact Questionnaire (PFIQ-7). Primary outcome was patient self-reported symptoms. Secondary outcome was anatomical cure (sPOPQ stage 1) for all vaginal compartments.
Results
Seventy-seven patients were included. Sixty-one patients (79%) were evaluated after 50 months (physical examination
n
= 51). Symptoms of bulge (95% vs 15%
p
˂ 0.0005), median UDI-6 scores (26.7 vs 22.2,
p
= 0.048), median PFIQ-7 scores (60.0 vs 0,
p
= 0.008), and median sPOPQ stages in all landmarks improved significantly from the pre- to the postoperative visit. Thirty patients (59%) were completely recurrence free and 96% of patients had no apical recurrence. Most recurrences were asymptomatic cystoceles (20%). There was one surgical re-intervention for recurrent prolapse (1.6%).
Conclusions
Robot-assisted sacrocolpopexy and RSHS show sustainable results in the treatment of prolapse. Symptoms of bulge, urinary symptoms, and quality of life improved substantially 50 months postoperatively. Patients should be counseled about the risk of anterior wall recurrence and the small chance of recurrent symptoms that need treatment.
Type 2 diabetes (T2D) is a health concern for both humans and cats, with cases rising over the past decade. Around 70% of patients from either species exhibit pancreatic aggregates of islet amyloid ...polypeptide (IAPP), a protein that proves toxic upon misfolding. These misfolded protein aggregates congregate in the islets of Langerhans of the pancreas, diminishing the capability of β-cells to produce insulin and further perpetuating disease.
Our team's drug discovery program is investigating newly synthesized compounds that could diminish aggregates of both human and feline IAPP, potentially disrupting the progression of T2D.
We prepared 24 compounds derived from diaryl urea, as ureas have previously demonstrated great potential at reducing accumulations of misfolded proteins. Biophysical methods were employed to analyze the anti-aggregation activity of these compounds at inhibiting and/or disrupting IAPP fibril formation in vitro.
The results demonstrate that compounds 12 and 24 were most effective at reducing the fibrillization and aggregation of both human and feline IAPP. When compared with the control for each experiment, samples treated with either compound 12 or 24 exhibited fewer accumulations of amyloid-like fibrils.
Urea-based compounds, such as compounds 12 and 24, may prove crucial in future pre-clinical studies in the search for therapeutics for T2D.
Modeling studies examining the effect of lakes on regional and global climate, as well as studies on the influence of climate variability and change on aquatic ecosystems, are surveyed. Fully coupled ...atmosphere—land surface—lake climate models that could be used for both of these types of study simultaneously do not presently exist, though there are many applications that would benefit from such models. It is argued here that current understanding of physical and biogeochemical processes in freshwater systems is sufficient to begin to construct such models, and a path forward is proposed. The largest impediment to fully representing lakes in the climate system lies in the handling of lakes that are too small to be explicitly resolved by the climate model, and that make up the majority of the lake-covered area at the resolutions currently used by global and regional climate models. Ongoing development within the hydrological sciences community and continual improvements in model resolution should help ameliorate this issue.
Introduction and hypothesis
The use of synthetic mesh in transvaginal pelvic floor surgery has been subject to debate internationally. Although mesh erosion appears to be less associated with an ...abdominal approach, the long-term outcome has not been studied intensively. This study was set up to determine the long-term mesh erosion rate following abdominal pelvic reconstructive surgery.
Methods
A prospective, observational cohort study was conducted in a tertiary care setting. All consecutive female patients who underwent robot-assisted laparoscopic sacrocolpopexy and sacrocolporectopexy in 2011 and 2012 were included. Primary outcome was mesh erosion. Preoperative and postoperative evaluation (6 weeks, 1 year, 5 years) with a clinical examination and questionnaire regarding pelvic floor symptoms was performed. Mesh-related complications were assessed using a transparent vaginal speculum, proctoscopy, and digital vaginal and rectal examination. Kaplan–Meier estimates were calculated for mesh erosion. A review of the literature on mesh exposure after minimally invasive sacrocolpopexy was performed (≥12 months’ follow-up).
Results
Ninety-six of the 130 patients included (73.8%) were clinically examined. Median follow-up time was 48.1 months (range 36.0–62.1). Three mesh erosions were diagnosed (3.1%; Kaplan–Meier 4.9%, 95% confidence interval 0–11.0): one bladder erosion for which mesh resection and an omental patch interposition were performed, and two asymptomatic vaginal erosions (at 42.7 and 42.3 months) treated with estrogen cream in one. Additionally, 22 patients responded solely by questionnaire and/or telephone; none reported mesh-related complaints. The literature, mostly based on retrospective studies, described a median mesh erosion rate of 1.9% (range 0–13.3%).
Conclusions
The long-term rate of mesh erosion following an abdominally placed synthetic graft is low.
•Effects of P. australis on evapotranspiration were studied for a riparian wetland.•Energy/water balance measurements were made before and after vegetation removal.•Agro-IBIS model simulations were ...performed to supplement observations of H and LE.•Removal of P. australis resulted in 32% lower ET and 245mm of net “water savings”.•Sensible heat fluxes more than doubled due to warmer, drier, windier conditions.
The energy and water balance of a Phragmites australis dominated wetland in south central Nebraska was analyzed to assess consumptive water use and the potential for “water savings” as a result of vegetation eradication via herbicide treatment. Energy balance measurements were made at the field site for two growing seasons (treated and untreated), including observations of net radiation, heat storage, and sensible heat flux, which was measured using a large-aperture scintillometer. Latent heat flux was calculated as a residual of the energy balance, and comparisons were made between the two growing seasons and with model simulations to examine the relative impacts of vegetation removal and climate variability.
Observed ET rates dropped by roughly 32% between the two growing seasons, from a mean of 4.4±0.7mmday−1 in 2009 (with live vegetation) to 3.0±0.8mmday−1 in 2010 (with dead P. australis). These results are corroborated by the Agro-IBIS model simulations, and the reduction in ET implies a total “water savings” of 245mm over the course of the growing season. The significant decreases in ET were accompanied by a more-than-doubling of sensible heat flux, as well as a ∼60% increase in heat storage due to decreased LAI. Removal of P. australis was also found to cause measurable changes in the local micrometeorology at the wetland. Consistent with the observed increase in sensible heat flux during 2010, warmer, drier, windier conditions were observed in the dead, P. australis section of the wetland, compared to an undisturbed section of live, native vegetation. Modeling results suggest that the elimination of transpiration in 2010 was partially offset by an increase in surface evaporation, thereby reducing the subsequent water savings by roughly 60%. Thus, the impact of vegetation removal depends on the local climate, depth to groundwater, and management decisions related to regrowth of vegetation.
The export of nitrate by the Mississippi River to the Gulf of Mexico has tripled since the 1950s primarily due to an increase in agricultural fertilizer application and hydrological changes. Here we ...have adapted two physically based models, the Integrated Biosphere Simulator (IBIS) terrestrial ecosystem model and the Hydrological Routing Algorithm (HYDRA) hydrological transport model, to simulate the nitrate export in the Mississippi River system and isolate the role of hydrological processes in the observed increase and interannual variability in nitrate export. Using an empirical nitrate input algorithm based on constant land cover and variability in runoff, the modeling system is able to represent much of the spatial and interannual variability in aquatic nitrate export. The results indicate that about a quarter of the sharp increase in nitrate export from 1966 to 1994 was due to an increase in runoff across the basin. This illustrates the pivotal role of hydrology and climate in the balance between storage of nitrate in the terrestrial system and leaching.
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