A comparison of MRI-based pelvic floor support measures between young and old women with prolapse

INTRODUCTION AND HYPOTHESIS

We sought to 1) test the hypothesis that young women (≤45 years) with pelvic organ prolapse have a higher prevalence of major levator ani muscle (LAM) defects than old women (≥70 years) with prolapse and 2) compare level II/III measurements between young and old women with prolapse and age-matched controls to evaluate age-related mechanistic differences in the disease process.

METHODS

A secondary analysis examined four groups of parous women: young prolapse (YPOP, n = 17); old prolapse (OPOP, n = 17); young controls (YC, n = 15); old controls, (OC, n = 13). Prolapse was defined as any compartment at or beyond the hymen with vaginal bulge symptoms. Genital hiatus (GH) was measured on clinical exam. Major LAM defects and level II/III measurements (UGH: urogenital hiatus, LA: levator area, and apex location) were assessed on MRI at rest and strain, and the difference (Δ) between measurements calculated. Principal component analysis was used to evaluate levator plate (LP) shape.

RESULTS

Major LAM defects occurred in 42% of YPOP and 47% of OPOP (p > .99). GHrest was 1.5 cm larger in OPOP versus YPOP (p < .001) and 2 cm larger in OPOP versus OC (p < .001). Regardless of prolapse status, LArest and UGHrest on MRI increased with age. YPOP had larger ΔLA (p = .04), ΔUGH (p = .03), and Δapex than OPOP (p = .01). Resting LP shape was more dorsally oriented in OPOP versus YPOP (p = .02) and OC versus YC (p = .004).

CONCLUSIONS

Prolapse in young women cannot be solely explained by a higher LAM defect prevalence. GH size and other measures of level II/III pelvic support worsen with age regardless of prolapse status.

Field reconnaissance and structural assessment of the October 30, 2020, Samos, Aegean Sea earthquake: an example of severe damage due to the basin effect

An earthquake with a magnitude ranging from Mw = 6.9 (KOERI) to Mw = 7.0 (USGS) struck Samos Island in the Aegean Sea on October 30, 2020, with an epicentre 70 kms from the İzmir city centre in Turkey. The earthquake took place at 14:51 local time (11:51 UTC). The peak ground acceleration (PGA) of this earthquake was recorded to be 0.179 g at the epicentre of the earthquake. This earthquake occurred at a depth of 17.26 km (AFAD (2020) İzmir Earthquake Report, (In Turkish)) and lasted 16 s. The main shock from the earthquake triggered a tsunami that hit the building stocks built near the coast. During the gradual deregulation of COVID-19 pandemic regulations, various events caused considerable damage to the building stock, particularly in the Izmir Seferihisar and Bayraklı regions and resulted in a massive disruption of daily habits. The main shock caused 117 deaths in both Turkey and Greece, and 1632 people were also injured in Turkey. Moreover, several injuries occurred in Greece. A total of 103 buildings collapsed, 700 were severely damaged, 814 buildings were moderately damaged, and 7889 were slightly damaged. The basic aim of this paper is to briefly present the past and present seismotectonic characteristics of the region, present building stock, and former structural conditions before the earthquake, assess structural performance and classify distinguished earthquake-induced failures and damage due to the basin effect.

Collective effect of damage prevention in taenioglossan radular teeth is related to the ecological niche in Paludomidae (Gastropoda: Cerithioidea)

The molluscan radula, a thin membrane with embedded rows of teeth, is the structure for food processing and gathering. For proper functioning, radular failures must be either avoided or reduced when interacting with the preferred food, as this might be of high significance for the individual fitness. Thus, the analysis of structural failure in radular teeth could be included in studies on trophic specializations. Here, we tested the failure of non-mineralized, chitinous radular teeth from taxa, belonging to an African paludomid species flock from Lake Tanganyika and surrounding river systems. These species are of high interest for evolutionary biologists since they represent a potential result of an adaptive radiation including trophic specialisations to distinct substrates, the food is attached to. In a biomechanical experiment a shear load was applied to tooth cusps with a force transducer connected to a motorized stage until structural failure occurred. Subsequently broken areas were measured and breaking stress was calculated. As the experiments were carried out under dry and wet conditions, the high influence of the water content on the forces, teeth were capable to resist, could be documented. Wet teeth were able to resist higher forces, because of their increased flexibility and the flexibility of the embedding membrane, which enabled them either to slip away or to gain support from adjacent teeth. This mechanism can be understood as collective effect reducing structural failure without the mineralisation with wear-minimizing elements, as described for Polyplacophora and Patellogastropoda. Since the documented mechanical behaviour of radular teeth and the maximal forces, teeth resist, can directly be related to the gastropod ecological niche, both are here identified as an adaptation to preferred feeding substrates. STATEMENT OF SIGNIFICANCE: The radula, a chitinous membrane with teeth, is the molluscan feeding structure. Here we add onto existing knowledge about the relationship between tooth's mechanical properties and species' ecology by determining the tooth failure resistance. Six paludomid species (Gastropoda) of a prominent species flock from Lake Tanganyika, foraging on distinct feeding substrates, were tested. With a force transducer wet and dry teeth were broken, revealing the high influence of water content on mechanical behaviour and force resistance of teeth. Higher forces were needed to break wet radulae due to an increased flexibility of teeth and membrane, which resulted in an interlocking or twisting of teeth. Mechanical behaviour and force resistance were both identified as trophic adaptations to feeding substrate.

The Impact of Re-tear on the Clinical Outcome after Rotator Cuff Repair Using Open or Arthroscopic Techniques - A Systematic Review

Background:

It is generally accepted that rotator cuff repair gives satisfactory results in the long term, although most studies have so far shown a fairly high rate of structural failure or re-tear. The purpose of this review study is to assess whether failure of the repaired cuff to heal could negatively affect the functional outcome.

Methods:

This article includes an extensive Internet PubMed based research in the current English-language literature including level I to level V studies as well as systematic reviews.

Results:

According to this extended study research, the results are mixed; certain reports show that patients with a healed rotator cuff repair have improved function and strength compared to those with structural failure, whereas other studies support the generally perceived concept that tendon re-tear does not lead to inferior clinical outcome.

Conclusion:

Further high-level prospective studies with larger numbers of patients and longer follow up are needed to overcome the current debate over function between healed and failed rotator cuff repairs.

A global analysis approach for investigating structural resilience in urban drainage systems

Building resilience in urban drainage systems requires consideration of a wide range of threats that contribute to urban flooding. Existing hydraulic reliability based approaches have focused on quantifying functional failure caused by extreme rainfall or increase in dry weather flows that lead to hydraulic overloading of the system. Such approaches however, do not fully explore the full system failure scenario space due to exclusion of crucial threats such as equipment malfunction, pipe collapse and blockage that can also lead to urban flooding. In this research, a new analytical approach based on global resilience analysis is investigated and applied to systematically evaluate the performance of an urban drainage system when subjected to a wide range of structural failure scenarios resulting from random cumulative link failure. Link failure envelopes, which represent the resulting loss of system functionality (impacts) are determined by computing the upper and lower limits of the simulation results for total flood volume (failure magnitude) and average flood duration (failure duration) at each link failure level. A new resilience index that combines the failure magnitude and duration into a single metric is applied to quantify system residual functionality at each considered link failure level. With this approach, resilience has been tested and characterised for an existing urban drainage system in Kampala city, Uganda. In addition, the effectiveness of potential adaptation strategies in enhancing its resilience to cumulative link failure has been tested.

Mechanical failure modes of chronically implanted planar silicon-based neural probes for laminar recording

Penetrating intracortical electrode arrays that record brain activity longitudinally are powerful tools for basic neuroscience research and emerging clinical applications. However, regardless of the technology used, signals recorded by these electrodes degrade over time. The failure mechanisms of these electrodes are understood to be a complex combination of the biological reactive tissue response and material failure of the device over time. While mechanical mismatch between the brain tissue and implanted neural electrodes have been studied as a source of chronic inflammation and performance degradation, the electrode failure caused by mechanical mismatch between different material properties and different structural components within a device have remained poorly characterized. Using Finite Element Model (FEM) we simulate the mechanical strain on a planar silicon electrode. The results presented here demonstrate that mechanical mismatch between iridium and silicon leads to concentrated strain along the border of the two materials. This strain is further focused on small protrusions such as the electrical traces in planar silicon electrodes. These findings are confirmed with chronic in vivo data (133-189 days) in mice by correlating a combination of single-unit electrophysiology, evoked multi-unit recordings, electrochemical impedance spectroscopy, and scanning electron microscopy from traces and electrode sites with our modeling data. Several modes of mechanical failure of chronically implanted planar silicon electrodes are found that result in degradation and/or loss of recording. These findings highlight the importance of strains and material properties of various subcomponents within an electrode array.

Structural failures of the blood-gas barrier and the epithelial-epithelial cell connections in the different vascular regions of the lung of the domestic fowl, Gallus gallus variant domesticus, at rest and during exercise

Structural failure of blood–gas barrier (BGB) and epithelial–epithelial cell connections (EECCs) in different vascular regions of the exchange tissue of the lung was studied in rested and exercised chickens. The number of red blood cells (nRBCs) was counted and protein concentration (PC) measured after lavaging the respiratory system, and blood was sampled to determine the blood lactate levels (BLLs). The numbers of complete BGB breaks (nBGBBs) and those of the EECCs (nEECCBs) were counted in the different vascular territories of the lung. The nRBCs and the PCs increased with increasing exercise intensities but the rate of increase decreased at higher workloads. From rest to the fastest experimental treadmill speed of 2.95 m.sec⁻¹, BLLs increased 4-fold. In all cases, the nEECCBs exceeded those of the BGB, showing that structurally the BGB is relatively weaker than the EECC. The increase in the number of breaks with increasing exercise can be attributed to increase in the pulmonary capillary blood pressure (PCBP) from faster heart rates and higher cardiac outputs, while the leveling out of the measurements made at higher workloads may have arisen from hemodynamic changes that initially ensued from exudation of blood plasma and then flow of blood into the air capillaries on failure of the BGB. The relative differences in the nBGBBs and the nEECCBs in the different vascular regions of the lung were ascribed to diameters of the branches and their points of origin and angles of bifurcation from the pulmonary artery. Presence of RBCs in the air capillaries of the lungs of rested chickens showed that failure of the BGB commonly occurs even in healthy and unstressed birds. Rapid repair and/or defense responses, which were observed, may explain how birds cope with mechanical injuries of the BGB.