Pelvic floor muscle training is the most commonly used physical therapy treatment for women with stress urinary incontinence (SUI). It is sometimes also recommended for mixed and, less commonly, ...urgency urinary incontinence.
To determine the effects of pelvic floor muscle training for women with urinary incontinence in comparison to no treatment, placebo or sham treatments, or other inactive control treatments.
We searched the Cochrane Incontinence Group Specialised Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL) (1999 onwards), MEDLINE (1966 onwards) and MEDLINE In-Process (2001 onwards), and handsearched journals and conference proceedings (searched 15 April 2013) and the reference lists of relevant articles.
Randomised or quasi-randomised trials in women with stress, urgency or mixed urinary incontinence (based on symptoms, signs, or urodynamics). One arm of the trial included pelvic floor muscle training (PFMT). Another arm was a no treatment, placebo, sham, or other inactive control treatment arm.
Trials were independently assessed by two review authors for eligibility and methodological quality. Data were extracted then cross-checked. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook for Systematic Reviews of Interventions. Trials were subgrouped by diagnosis of urinary incontinence. Formal meta-analysis was undertaken when appropriate.
Twenty-one trials involving 1281 women (665 PFMT, 616 controls) met the inclusion criteria; 18 trials (1051 women) contributed data to the forest plots. The trials were generally small to moderate sized, and many were at moderate risk of bias, based on the trial reports. There was considerable variation in the interventions used, study populations, and outcome measures. There were no studies of women with mixed or urgency urinary incontinence alone.Women with SUI who were in the PFMT groups were 8 times more likely than the controls to report that they were cured (46/82 (56.1%) versus 5/83 (6.0%), RR 8.38, 95% CI 3.68 to 19.07) and 17 times more likely to report cure or improvement (32/58 (55%) versus 2/63 (3.2%), RR 17.33, 95% CI 4.31 to 69.64). In trials in women with any type of urinary incontinence, PFMT groups were also more likely to report cure, or more cure and improvement than the women in the control groups, although the effect size was reduced. Women with either SUI or any type of urinary incontinence were also more satisfied with the active treatment, while women in the control groups were more likely to seek further treatment. Women treated with PFMT leaked urine less often, lost smaller amounts on the short office-based pad test, and emptied their bladders less often during the day. Their sexual outcomes were also better. Two trials (one small and one moderate size) reported some evidence of the benefit persisting for up to a year after treatment. Of the few adverse effects reported, none were serious.The findings of the review were largely supported by the summary of findings tables, but most of the evidence was down-graded to moderate on methodological grounds. The exception was 'Participant perceived cure' in women with SUI, which was rated as high quality.
The review provides support for the widespread recommendation that PFMT be included in first-line conservative management programmes for women with stress and any type of urinary incontinence. Long-term effectiveness of PFMT needs to be further researched.
Summary
Besides classic T cell‐derived T‐helper type 2 (Th2) cytokines such as IL‐4, IL‐5 and IL‐13, tissue‐produced cytokines such as thymic stromal lymphopoietin, IL‐25 and IL‐33 are now recognized ...as important contributors to allergic inflammation. IL‐33 is produced by various tissue dwelling cells and broadly enhances allergic inflammation through its effects on hematopoietic cell types. The environmental or endogenous triggers that provoke IL‐33 cellular release may be associated with infection, inflammation or tissue damage. This review summarizes the wide range of documented IL‐33 activities on human cellular mediators of inflammation as well as genetic evidence that IL‐33 contributes to disease. Finally, there will be a discussion of still unanswered questions regarding the mechanisms by which cytokine activity is generated and IL‐33's relationship with other Th2‐associated cytokines.
Cite this as: D. E. Smith, Clinical & Experimental Allergy, 2010 (40) 200–208.
Halo mass function and the free streaming scale Schneider, Aurel; Smith, Robert E; Reed, Darren
Monthly notices of the Royal Astronomical Society,
08/2013, Letnik:
433, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The nature of structure formation around the particle free streaming scale is still far from understood. Many attempts to simulate hot, warm and cold dark matter cosmologies with a free streaming ...cut-off have been performed with cosmological particle-based simulations, but they all suffer from spurious structure formation at scales below their respective free streaming scales - i.e. where the physics of halo formation is most affected by free streaming. We perform a series of high-resolution numerical simulations of different warm dark matter (WDM) models, and develop an approximate method to subtract artificial structures in the measured halo mass function. The corrected measurements are then used to construct and calibrate an extended Press-Schechter (EPS) model with sharp-k window function and adequate mass assignment. The EPS model gives accurate predictions for the low-redshift halo mass function of cold dark matter (CDM) and WDM models, but it significantly underpredicts the halo abundance at high redshifts. By taking into account the ellipticity of the initial patches and connecting the characteristic filter scale to the smallest ellipsoidal axis, we are able to eliminate this inconsistency and obtain an accurate mass function over all redshifts and all dark matter particle masses covered by the simulations. As an additional application we use our model to predict the microhalo abundance of the standard neutralino-CDM scenario and we give the first quantitative prediction of the mass function over the full range of scales of CDM structure formation.
In the fungal kingdom, the ectomycorrhizal (EcM) symbiosis has evolved independently in multiple groups that are referred to as lineages. A growing number of molecular studies in the fields of ...mycology, ecology, soil science, and microbiology generate vast amounts of sequence data from fungi in their natural habitats, particularly from soil and roots. However, as the number and diversity of sequences has increased, it has become increasingly difficult to accurately identify the fungal species in these samples and to determine their trophic modes. In particular, there has been significant controversy regarding which fungal groups form ectomycorrhizas, the morphological “exploration types” that these fungi form on roots, and the ecological strategies that they use to obtain nutrients. To address this problem, we have synthesized the phylogenetic and taxonomic breadth of EcM fungi by using the wealth of accumulated sequence data. We also compile available information about exploration types of 143 genera of EcM fungi (including 67 new reports) that can be tentatively used to help infer the ecological strategies of different fungal groups. Phylogenetic analyses of ribosomal DNA ITS and LSU sequences enabled us to recognize 20 novel lineages of EcM fungi. Most of these are rare and have a limited distribution. Five new lineages occur exclusively in tropical and subtropical habitats. Altogether 46 fungal genera were added to the list of EcM fungal taxa and we anticipate that this number will continue to grow rapidly as taxonomic works segregate species-rich genera into smaller, monophyletic units. Three genera were removed from the list of EcM groups due to refined taxonomic and phylogenetic information. In all, we suggest that EcM symbiosis has arisen independently in 78–82 fungal lineages that comprise 251–256 genera. The EcM fungal diversity of tropical and southern temperate ecosystems remains significantly understudied and we expect that these regions are most likely to reveal additional EcM taxa.
•We synthesized the phylogenetic and taxonomic breadth of ectomycorrhizal (EcM) fungi.•We compiled information about exploration types of 143 genera of EcM fungi.•EcM symbiosis has arisen independently in 78–82 fungal lineages.•EcM symbiosis comprises 251–256 genera of fungi.
The ability to change an organism's DNA through gene editing is of great importance for the prevention and treatment of genetic and acquired diseases. Rapid progress has been made during the last ...decade due to the discovery and refinement of CRISPR/Cas9 as an accurate, fast, and reliable genome editing technique. In this issue of the JCI, Lebek et al. present the culmination from a line of work in the Olson laboratory focused on in vivo gene editing of CAMK2D. The paper presents a combined state-of-the-art gene therapy approach that demonstrates how gene therapy can yield cardioprotection in a mouse model and takes notable steps toward potential applicability in patients.
Immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine is recommended in the United States during weeks 27 through 36 of pregnancy to prevent life-threatening infant pertussis. ...The optimal gestation for immunization to maximize concentrations of neonatal pertussis toxin antibodies is unknown.
To determine pertussis toxin antibody concentrations in cord blood from neonates born to women immunized and unimmunized with Tdap vaccine in pregnancy and optimal gestational age for immunization to maximize concentrations of neonatal antibodies.
Prospective, observational, cohort study of term neonates in Houston, Texas (December 2013-March 2014).
Tdap immunization during weeks 27 through 36 of pregnancy or no Tdap immunization.
Primary outcome was geometric mean concentrations (GMCs) of pertussis toxin antibodies in cord blood of Tdap-exposed and Tdap-unexposed neonates and proportions of Tdap-exposed and Tdap-unexposed neonates with pertussis toxin antibody concentrations of 15 IU/mL or higher, 30 IU/mL or higher, and 40 IU/mL or higher, cutoffs representing quantifiable antibodies or levels that may be protective until the infant immunization series begins. Secondary outcome was the optimal gestation for immunization to achieve maximum pertussis toxin antibodies.
Six hundred twenty-six pregnancies (mean maternal age, 29.7 years; 41% white, 27% Hispanic, 26% black, 5% Asian, 1% other; mean gestation, 39.4 weeks) were included. Three hundred twelve women received Tdap vaccine at a mean gestation of 31.2 weeks (range, 27.3-36.4); 314 were unimmunized. GMC of neonatal cord pertussis toxin antibodies from the Tdap-exposed group was 47.3 IU/mL (95% CI, 42.1-53.2) compared with 12.9 IU/mL (95% CI, 11.7-14.3) in the Tdap-unexposed group, for a GMC ratio of 3.6 (95% CI, 3.1-4.2; P < .001). More Tdap-exposed than Tdap-unexposed neonates had pertussis toxin antibody concentrations of 15 IU/mL or higher (86% vs 37%; difference, 49% 95% CI, 42%-55%), 30 IU/mL or higher (72% vs 17%; difference, 55% 95% CI, 49%-61%), and 40 IU/mL or higher (59% vs 12%; difference, 47% 95% CI, 41%-54%); P < .001 for each analysis. GMCs of pertussis toxin antibodies were highest when Tdap vaccine was administered during weeks 27 through 30 and declined thereafter, reaching a peak at week 30 (57.3 IU/mL 95% CI, 44.0-74.6).
Immunization with Tdap vaccine during the third trimester of pregnancy, compared with no immunization, was associated with higher neonatal concentrations of pertussis toxin antibodies. Immunization early in the third trimester was associated with the highest concentrations.
Recent scholarship has thoroughly documented climate change attitudes within the majority of the English-speaking countries of the USA, the UK, Canada, and Australia. In these nations, political ...identity is widely recognized as a uniquely powerful predictor of climate change attitudes and, at least in the USA, several studies have found that education moderates the effect of political identity. The cross-national dynamics of climate change attitudes and political identity are not well-characterized, particularly in nations with a history of state socialism. In this manuscript, we consider the role of political and free market ideological polarization around climate change within Anglophone, Western European, and post-Communist states. Further, we investigate education as a moderator of political and ideological factors cross-nationally. We suggest that, in comparison to Western European and post-Communist states, the role of political and ideological polarization in Anglophone states is exceptional in shaping climate change attitudes. Using data for 20 countries in the 2010 ISSP Environmental Module, we find that the effect of party affiliation and free market ideology on the perception of climate change’s danger and importance is strongest in Anglophone states, more modest in Western European countries, and limited within post-Communist states. Further, education moderates most intensely in Anglophone states. Our results suggest that there is something exceptional occurring within Anglophone states with regard to political polarization and climate change attitudes.
Diffusion MRI allows the structural connectivity of the whole brain (the ‘tractogram’) to be estimated in vivo non-invasively using streamline tractography. The biological accuracy of these data sets ...is however limited by the inherent biases associated with the reconstruction method. Here we propose a method to retrospectively improve the accuracy of these reconstructions, by selectively filtering out streamlines from the tractogram in a manner that improves the fit between the streamline reconstruction and the underlying diffusion images. This filtering is guided by the results of spherical deconvolution of the diffusion signal, hence the acronym SIFT: spherical-deconvolution informed filtering of tractograms. Data sets processed by this algorithm show a marked reduction in known reconstruction biases, and improved biological plausibility. Emerging methods in diffusion MRI, particularly those that aim to characterise and compare the structural connectivity of the brain, should benefit from the improved accuracy of the reconstruction.
► Novel method for selective filtering of whole-brain fibre-tracking data ► Reduces reconstruction biases of streamline tractography ► Improved biological plausibility of connectome reconstruction ► Better interpretability of structural connectivity between regions
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