Introduction and hypothesis
The objective was to identify the prevalence and risk factors for urinary incontinence (UI) in healthy midlife Singaporean women.
Methods
Healthy women, aged 45–69 years, ...were assessed for UI and sociodemographic characteristics, including ethnicity, menopausal status, parity, and body mass index (BMI). UI subtypes corresponding to stress (SUI) alone, urge (UUI) alone, mixed (MUI), and leakage (drops only) incontinence were classified using the Urinary Distress Inventory 6 (UDI-6). Risk factors were examined using Chi-squared tests, followed by sequential multivariate logistic regression to estimate adjusted odds ratios (aOR and 95% confidence intervals).
Results
A total of 1,119 women (mean age 56.2 ± 5.2) completed the UDI-6. 52.3% reported any UI; MUI and SUI were the most common, each affecting 20% of women. Post-menopausal women had a lower risk (aOR 0.5 0.3–0.9) of SUI, but a higher risk (aOR 4.4 1.0–19.9) of UUI compared with premenopausal women. Higher education was negatively associated (aOR 0.3 0.2–0.7) with UUI, but positively associated with MUI (aOR 2.3 1.3–4.0). Parity (1–2 children) increased the risk of SUI (aOR 1.8 1.0–3.1), but reduced the risk of UUI (aOR 0.4 0.2–0.9). Obesity was associated with increased risk for MUI (aOR 2.2 1.4–3.4) and leakage (aOR 2.0 1.0–4.1). Malays and Indians had a higher risk of MUI, having (aOR 2.1 (1.2–3.7) and 1.7 (1.1–2.7) respectively compared with Chinese, a difference mediated by higher BMI.
Conclusion
Urinary incontinence is a major morbidity prevalent in healthy midlife Asian women. Post-menopausal status, education level, parity, BMI (and its link with ethnicity) are independent risk factors in this population, and should be incorporated into counseling and targeted interventions.
H19 is an imprinted oncofetal non-coding RNA recently shown to be the precursor of miR-675. The pathophysiological roles of H19 and its mature product miR-675 to carcinogenesis have, however, not ...been defined. By quantitative reverse transcription–polymerase chain reaction, both H19 and miR-675 were found to be upregulated in human colon cancer cell lines and primary human colorectal cancer (CRC) tissues compared with adjacent non-cancerous tissues. Subsequently, the tumor suppressor retinoblastoma (RB) was confirmed to be a direct target of miR-675 as the microRNA suppressed the activity of the luciferase reporter carrying the 3′-untranslated region of RB messenger RNA that contains the miR-675-binding site. Suppression of miR-675 by transfection with anti-miR-675 increased RB expression and at the same time, decreased cell growth and soft agar colony formation in human colon cancer cells. Reciprocally, enhanced miR-675 expression by transfection with miR-675 precursor decreased RB expression, increased tumor cell growth and soft agar colony formation. Moreover, the inverse relationship between the expressions of RB and H19/miR-675 was also revealed in human CRC tissues and colon cancer cell lines. Our findings demonstrate that H19-derived miR-675, through downregulation of its target RB, regulates the CRC development and thus may serve as a potential target for CRC therapy.
Background
Femoroacetabular impingement (FAI) represents a constellation of anatomical and clinical features, but definitive diagnosis is often difficult. The high prevalence of cam deformity of the ...femoral head in the asymptomatic population as well as clinical factors leading to the onset of symptoms raises questions as to what other factors increase the risk of cartilage damage and hip pain.
Questions/purposes
The purpose was to identify any differences in anatomical parameters and squat kinematics among symptomatic, asymptomatic, and control individuals and if these parameters can determine individuals at risk of developing symptoms of cam FAI.
Methods
Forty-three participants (n = 43) were recruited and divided into three groups: symptomatic (12), asymptomatic (17), and control (14). Symptomatic participants presented a cam deformity (identified by an elevated alpha angle on CT images), pain symptoms, clinical signs, and were scheduled for surgery. The other recruited volunteers were blinded and unaware whether they had a cam deformity. After the CT data were assessed for an elevated alpha angle, participants with a cam deformity but who did not demonstrate any clinical signs or symptoms were considered asymptomatic, whereas participants without a cam deformity and without clinical signs or symptoms were considered healthy control subjects. For each participant, anatomical CT parameters (axial alpha angle, radial alpha angle, femoral head-neck offset, femoral neck-shaft angle, medial proximal femoral angle, femoral torsion, acetabular version) were evaluated. Functional squat parameters (maximal squat depth, pelvic range of motion) were determined using a motion capture system. A stepwise discriminant function analysis was used to determine which of the parameters were most suitable to classify each participant with their respective subgroup.
Results
The symptomatic group showed elevated alpha angles and lower femoral neck-shaft angles, whereas the asymptomatic group showed elevated alpha angles in comparison with the control group. The best discriminating parameters to determine symptoms were radial alpha angle, femoral neck-shaft angle, and pelvic range of motion (p < 0.001).
Conclusions
In the presence of a cam deformity, indications of a decreased femoral neck-shaft angle and reduced pelvic range of motion can identify those at risk of symptomatic FAI.
Level of Evidence
Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
The problem of multilabel classification has attracted great interest in the last decade, where each instance can be assigned with a set of multiple class labels simultaneously. It has a wide variety ...of real-world applications, e.g., automatic image annotations and gene function analysis. Current research on multilabel classification focuses on supervised settings which assume existence of large amounts of labeled training data. However, in many applications, the labeling of multilabeled data is extremely expensive and time consuming, while there are often abundant unlabeled data available. In this paper, we study the problem of transductive multilabel learning and propose a novel solution, called Trasductive Multilabel Classification (TraM), to effectively assign a set of multiple labels to each instance. Different from supervised multilabel learning methods, we estimate the label sets of the unlabeled instances effectively by utilizing the information from both labeled and unlabeled data. We first formulate the transductive multilabel learning as an optimization problem of estimating label concept compositions. Then, we derive a closed-form solution to this optimization problem and propose an effective algorithm to assign label sets to the unlabeled instances. Empirical studies on several real-world multilabel learning tasks demonstrate that our TraM method can effectively boost the performance of multilabel classification by using both labeled and unlabeled data.
Prevalence of total hip arthroplasty (THA) has trended upwards over past decades and is projected to increase further. Optimizing outcomes after surgery is essential to avoid surgical revision and ...maximize outcomes. Low back pain is reported as a problem post THA. Patient-reported outcome measures (PROMs) are commonly used to evaluate THA outcomes but have limitations (e.g., ceiling effects). It is therefore important to assess a comprehensive range of outcomes. Physical outcome measures of spinopelvic alignment and physical functioning demonstrate potential value, but no evidence synthesis has investigated their association with PROMs. The objectives of this systematic review are to evaluate the association between spinopelvic alignment and physical outcome measures of physical functioning with PROMs and characteristics of low back pain after THA.
This protocol is aligned with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Cross-sectional and longitudinal cohort studies evaluating the association between the physical outcome measures and PROMs (any outcome measures reported) following THA by any approach/implant will be included except surface replacement and revision THA. Studies investigating THA for developmental pathology and inflammatory conditions will be excluded. A systematic search in MEDLINE (Ovid), Embase (Ovid), Scopus, Web of Science, CINAHL, and the grey literature will be carried out from inception to July 31, 2023. Two independent reviewers will evaluate eligibility of retrieved articles, extract data and assess risk of bias (NIH quality assessment tool) of included studies. A third reviewer will mediate disagreements. Random-effects meta-analyses will be conducted if studies are sufficiently homogeneous in design, population, physical measures and PROMs; reporting odds ratios and 95% confidence intervals. Where meta-analyses are not possible, a narrative synthesis will be conducted. Confidence in cumulative evidence will be assessed using a modified GRADE (Grading of Recommendations Assessment, Development, and Evaluation).
PROSPERO Registration number CRD42023412744.
The JPEG compression method is among the most successful compression schemes since it readily provides good compressed results at a rather high compression ratio. However, the decompressed result of ...the standard JPEG decompression scheme usually contains some visible artifacts, such as blocking artifacts and Gibbs artifacts (ringing), especially when the compression ratio is rather high. In this paper, a novel artifact reducing approach for the JPEG decompression is proposed via sparse and redundant representations over a learned dictionary. Indeed, an effective two-step algorithm is developed. The first step involves dictionary learning and the second step involves the total variation regularization for decompressed images. Numerical experiments are performed to demonstrate that the proposed method outperforms the total variation and weighted total variation decompression methods in the measure of peak of signal to noise ratio, and structural similarity.
Previous biomechanical studies have identified capsular closure, labral repair or reconstruction, and osteochondroplasty as important surgical interventions to improve hip stability.
To investigate ...the outcome metrics used to quantify hip stability and assess and measure the relative contributions of the labrum, capsule, and bone to hip stability through a quantitative analysis.
Systematic review and meta-analysis; Level of evidence, 4.
PubMed and Embase databases were searched using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included studies evaluated cadaveric hip biomechanics related to capsular, labral, and bony management during hip arthroscopy. Studies were assessed for distraction force and distance, fluid measures, and contact forces used to quantify the suction seal. Exclusion criteria included open surgery, arthroplasty, reorientation osteotomy, or traumatic dislocation.
A total of 33 biomechanical studies comprising 322 hips that evaluated 1 or more of the following were included: distraction force or distance (24 studies), fluid measures (10 studies), and contact forces (6 studies). Compared with a capsulotomy or capsulectomy, capsular repair or reconstruction demonstrated greater resistance to distraction (standardized mean difference SMD, 1.13; 95% CI, 0.46-1.80;
= .0009). Compared with a labral tear, a labral repair or reconstruction demonstrated less resistance to distraction (SMD, -0.67; 95% CI, -1.25 to -0.09;
= .02). Compared with a labral debridement, repair or reconstruction demonstrated greater resistance to distraction (SMD, 1.74; 95% CI, 1.23 to 2.26;
< .00001). No quantitative analysis was feasible from studies evaluating the effect of osseous resection due to the heterogeneity in methodology and outcome metrics assessed.
Most biomechanical evidence supports capsulotomy repair or reconstruction to improve hip distractive stability at the end of hip arthroscopic surgery. While the repair of a torn labrum does not improve distractive resistance, it is superior to labral debridement in most biomechanical studies.
Perioperative stroke is a major complication for patients undergoing surgery. Patent foramen ovale (PFO) represents a possible anatomical link between venous thrombosis and stroke.
To determine ...whether a preoperatively diagnosed PFO is associated with increased risk of perioperative ischemic stroke.
Retrospective cohort study from Massachusetts General Hospital and 2 affiliated community hospitals between January 1, 2007, and December 31, 2015. Participants were 182 393 consecutive adults undergoing noncardiac surgery with general anesthesia.
Preoperatively diagnosed PFO.
Perioperative ischemic stroke occurring within 30 days of surgery; stroke subtype by Oxfordshire Community Stroke Project classification and stroke severity by National Institute of Health Stroke Scale (NIHSS).
Among the 150 198 patient cases analyzed (median SD age, 55 16 years), 1540 (1.0%) had a diagnosis of PFO before surgery. A total of 850 (0.6%) ischemic strokes occurred within 30 days of surgery (49 3.2% among patients with PFO and 801 0.5% among patients without PFO). In adjusted analyses, patients with PFO had an increased risk of ischemic stroke compared with patients without PFO (odds ratio, 2.66 95% CI, 1.96-3.63; P < .001). The estimated risks of stroke were 5.9 for every 1000 patients with PFO and 2.2 for every 1000 patients without PFO (adjusted absolute risk difference, 0.4% 95% CI, 0.2%-0.6%). Patients with PFO also had an increased risk of large vessel territory stroke (relative risk ratio, 3.14 95% CI, 2.21-4.48; P < .001) and a more severe stroke-related neurologic deficit measured by NIHSS (median, 4 interquartile range {IQR}, 2-10 vs median, 3 IQR, 1-6 for those without PFO; P = .02).
Among adult patients undergoing noncardiac surgery at 3 hospitals, having a preoperatively diagnosed PFO was significantly associated with increased risk of perioperative ischemic stroke within 30 days after surgery. Further research is needed to confirm these findings and to determine whether interventions would decrease this risk.
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