Care needs and self-induced measures of women with postpartum pelvic floor disorder- Results of a social media-based survey of 2930 women

INTRODUCTION

Pelvic floor disorders (PFD) occur in about 40% of women after delivery. Less is known about the intervention and care needs of women with postpartum PFD. The aim of this analysis was to analyze care needs and self-initiated measures to strengthen the pelvic floor in postpartum women in relation to incontinence and sexual dysfunction. Furthermore, influencing factors for self-initiated measures were evaluated.

PATIENTS AND METHODS

An anonymous online survey (via LimeSurvey) was conducted between September and October 2022 and distributed via social media (Instagram and Facebook). The survey explicitly addressed mothers with and without pelvic floor disorders up to 5 years postpartum (inclusion criteria). Validated instruments were employed to assess incontinence (ICIQ-SF) and sexual functioning (PISQ-IR: Condition Impact). The questions on the use of services and preventive measures, as well as on the interaction with a gynecologist, were based on self-developed items.

RESULTS

In total, 49.4% of the participants of the survey showed symptoms of urinary incontinence (UI). Furthermore, only 40.3% (n = 241) of women were actively asked by their gynecologists for the occurrence of UI or PFD among those who suffered from PFD. Overall, 79.3% of the participants of the survey with UI underwent measures to deal with the complaints. The ICIQ-SF Score was significantly associated with all self-induced measures. High School diplomas and academic degrees were associated with the use of love balls (p < 0.05).

CONCLUSION

The results of the study show the unmet needs of postpartum women. PFD should be addressed more frequently in the outpatient setting. Furthermore, more systematic information about the treatment of PFD could help to address unmet information needs and improve interventions.

Have you met Angus? Development and evaluation of a social marketing intervention to improve personal flotation device use in commercial fishing

INTRODUCTION

Drowning is the leading cause of death among commercial fishermen in the United States. Approximately 30% of all commercial fishing fatalities are attributed to falls overboard. One of the simplest and most affordable ways to prevent these fatalities is for crewmembers to wear personal flotation devices (PFDs) while on deck. An examination of over 200 fatal falls overboard in the U.S. fishing industry revealed that none of the victims were wearing PFDs when they died. PFDs are not required to be worn by commercial fishermen in the United States, so this study was designed to encourage behavior change using targeted health communication and social marketing.

METHODS

This study developed, implemented, and evaluated a multi-media social marketing campaign featuring a fictitious, culturally-relevant spokesman designed to look, talk, and act like the target audience. The messages were crafted to address common barriers to PFD adoption and misconceptions about fleet-specific risks for fatalities from falls overboard. The campaign was evaluated over two seasons of fishing to look at message retention and intent toward action following exposure to the campaign materials.

RESULTS

Survey respondents indicated overall positive opinions about the spokesman and the messages. Results also show a reported change in behavior related to using PFDs while working on deck.

DISCUSSION

Targeted multi-media messaging can influence behavior of workers in high-risk occupations in remote locations. Safety message development should focus on occupational culture to create valid and authentic communication products for workers in high-risk industries.

Investigating the possible mechanisms of pirfenidone to be targeted as a promising anti-inflammatory, anti-fibrotic, anti-oxidant, anti-apoptotic, anti-tumor, and/or anti-SARS-CoV-2

Pirfenidone (PFD) is a non-peptide synthetic chemical that inhibits the production of transforming growth factor-beta 1 (TGF-β1), tumor necrosis factor-alpha (TNF-α), platelet-derived growth factor (PDGF), Interleukin 1 beta (IL-1β), and collagen 1 (COL1A1), all of which have been linked to the prevention or removal of excessive scar tissue deposition in many organs. PFD has been demonstrated to decrease apoptosis, downregulate angiotensin-converting enzyme (ACE) receptor expression, reduce inflammation through many routes, and alleviate oxidative stress in pneumocytes and other cells while protecting them from COVID-19 invasion and cytokine storm. Based on the mechanism of action of PFD and the known pathophysiology of COVID-19, it was recommended to treat COVID-19 patients. The use of PFD as a treatment for a range of disorders is currently being studied, with an emphasis on outcomes related to reduced inflammation and fibrogenesis. As a result, rather than exploring the molecule's chemical characteristics, this review focuses on innovative PFD efficacy data. Briefly, herein we tried to investigate, discuss, and illustrate the possible mechanisms of actions for PFD to be targeted as a promising anti-inflammatory, anti-fibrotic, anti-oxidant, anti-apoptotic, anti-tumor, and/or anti-SARS-CoV-2 candidate.

Pirfenidone promotes the levels of exosomal miR-200 to down-regulate ZEB1 and represses the epithelial-mesenchymal transition of non-small cell lung cancer cells

Non-small cell lung cancer (NSCLC) is the malignancy with highest mortality and morbidity. Cancer-associated fibroblasts (CAFs) are the most abundant stromal cells in the tumor microenvironment of NSCLC. This research is performed to explore the biological functions of pirfenidone (PFD) to repress the malignant phenotypes of NSCLC cells, and its regulatory effects on exosomal microRNA-200 (exo-miR-200) derived from CAFs. In the present work, we report that, exo-miR-200 secreted by CAFs restrains the migration, invasion and epithelial-mesenchymal transition (EMT) of NSCLC cells; PFD treatment promotes the secretion of exo-miR-200 from CAFs and enhances the tumor-suppressive properties of exo-miR-200 on NSCLC cells; zinc finger E-box binding homeobox 1 (ZEB1) is identified as a target of miR-200, and PFD treatment repressed the expression of ZEB1 in NSCLC cells via inducing the expression and secretion of miR-200 in CAFs. In conclusion, PFD-induced miR-200 overexpression in CAFs inhibits ZEB1 expression in NSCLC cells, and thus decelerates the migration, invasion and EMT process. Our study may provide clues for the treatment of NSCLC.

Ischial Spinous Fascia Fixation for Dilated Neovaginal Prolapse in Mayer-Rokitansky-Küster-Hauser Syndrome-2 Case Reports

BACKGROUND

Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, as congenital anomaly of the female reproductive tract, is characterized by the congenital absence of uterus and vagina. Dilation maneuver was recommended as the nonsurgical treatment for these patients. However, only several cases were reported depicting the prolapse of the dilated neovagina of patients with MRKH syndrome.

CASE

We report our own experiences in treating 2 patients with neovaginal prolapse MRKH syndrome receiving ischial spinous fascia fixation (ISFF) and reviewed neovaginal prolapse occurrence in MRKH syndrome. In our approach to evaluating the anatomic and functional outcome after operation, we compared the prolapse stage with Pelvic Organ Prolapse Quantification score and analyzed sexual activities by the standardized Female Sexual Function Index¹ (FSFI) and Modified Body Image Scale² (MBIS).

SUMMARY AND CONCLUSION

Both subjective and objective improvement were observed in these 2 patients.

Feeding Problems Including Avoidant Restrictive Food Intake Disorder in Young Children With Autism Spectrum Disorder in a Multiethnic Population

We examined feeding problems, including Avoidant Restrictive Food Intake Disorder (ARFID), in preschool children with Autism Spectrum Disorder (ASD). Data were collected from a prospective longitudinal study of 46 children with ASD in a multiethnic, low resource area in Gothenburg, Sweden. Feeding problems were found in 76% of the children with ASD, and in 28%, the criteria for ARFID were met. The study highlights early onset age, the heterogeneity of feeding problems, and the need for multidisciplinary assessments in ASD as well as in feeding problems, and also the need for further elaboration of feeding disorder classifications in children.

Assessment of the effect of Mulabandha yoga therapy in healthy women, stigmatized for pelvic floor dysfunctions: A randomized controlled trial

Background

In developing countries, women do not reveal their perineum related health issues because most of the time they are stigmatized by the society. Multiparity, mostly found in women of rural areas is one of the major causes of pelvic floor dysfunctions (PFDs) like pelvic organ prolapse, urinary incontinence, rectal incontinence, etc. Usually, they visit health centres in the advanced stage of diseases, and then medical treatment is not the only choice left. Many research studies show that yoga practices promote health conditions, contribute to enhancing endurance, flexibility, and muscular strength, and improving quality of life.

Objective(s)

The study was conducted to assess the impact of Mulabandha yoga therapy (MYT) in healthy woman participants as a preventive measure.

Material and methods

The study was a prospective and randomized controlled trial. Fifty healthy woman participants were allocated in two groups viz., MYT group and No MYT group. Mulabandha yoga was conducted for the MYT group for 12 weeks. No MYT group was advised not to do yoga. Pelvic floor muscle strength was internally evaluated by employing the PERFECT scheme score (P = power, E = endurance, R = repetitions, F = fast contractions, ECT = every contraction timed). For eligible samples, MYT sessions were held for 12 weeks. Data interpretation was done with SPSS software 20.0 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY, USA).

Results

Fifty healthy woman participants were allocated for analysis. There was no statistically significant difference in between the groups comparison in terms of age, socio-economic status, occupation, education, parity and mode of delivery. PERFECT scheme score significantly improved in participants after 12 weeks of regular MYT. No statistically significant differences were observed between the groups comparison in terms of PERFECT scheme score.

Conclusion

The current study shows that regular practice of MYT for 12 weeks is a better means to reinforce the strength of pelvic floor muscles in women. This MYT procedure will establish evidence for women who are reluctant towards their pelvic organ-related issues. Women must incorporate the MYT practice in their routine life as a preventive measure to refrain from pelvic floor dysfunctions.

Comparative Evaluation of 15 Laser and Perfluorodecalin Combinations for Tattoo Removal

BACKGROUND AND OBJECTIVES

We present a case of laser tattoo removal treated with 15 different combinations using picosecond 1064 nm, picosecond 755 nm, nanosecond 755 nm, and a fractionated CO₂ laser, both with and without a perfluorodecalin (PFD) patch to ascertain the most effective approach. STUDY DESIGN/MATERIALS AND METHODS: A single lower extremity black tattoo was divided into 15 treatment sections allowing for testing of various laser and PFD combinations. Sectioned treatment was conducted until a treatment superiority was noted.

RESULTS

After two sessions using sectioned combination treatments with a 4-week interval clinically significant results were produced.

CONCLUSIONS

The combination of picosecond 1064 nm, picosecond 755 nm, and a fractionated CO₂ laser without the PFD patch showed superior clinical improvement over the other combinations. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Accelerometers: Assessing their potential for measuring personal flotation device use on commercial fishing vessels

BACKGROUND

Falls overboard are the most common cause of fatalities in commercial fishing. As a result, interventions aimed at increasing and measuring the use of personal flotation devices (PFDs) are a high priority. The focus of this study was to explore the use of accelerometers as a means for objectively measuring PFD use on lobster fishing vessels.

METHODS

For participating vessels, researchers attached an accelerometer to a PFD worn by a crewmember and another to the vessel's wheelhouse. GoPro videos were also employed to record crewmember activities so these could be synchronized with accelerometer outputs. Accelerometer outputs included two distinct measures, the proportional integration mode (PIM) and zero crossing mode (ZCM). Data were fitted to various equations to identify the best method for predicting PFD use.

RESULTS

Seven lobster fishing vessels participated in the trial. Data indicated that accelerometers could predict PFD use with a fairly high degree of accuracy. In particular, a logistic equation incorporating PIM values from the PFD and the absolute value of the difference between the PFD PIM readings and the PIM readings from the stationary accelerometer demonstrated the highest degree of accuracy, with correct classifications for 73.3% to 77.6% of the 10-second data intervals. Accuracy was highest when crew members were moving versus stationary. The predictive value of ZCM was comparatively limited.

CONCLUSIONS

PIM accelerometer readings can be used to measure PFD use with a considerably high degree of accuracy, especially for sternmen who are moving regularly and have the highest risk for falling overboard.

How sensitive is Melissa officinalis to realistic ozone concentrations?

Lemon balm (Melissa officinalis, L.; Lamiaceae) was exposed to realistic ozone (O3) dosages (80 ppb for 5 h), because high background levels of O3 are considered to be as harmful as episodic O3 regimes. Temporal alterations of different ecophysiological, biochemical and structural parameters were investigated in order to test if this species can be considered as an O3-bioindicator regarding changes in background concentrations. At the end of ozone exposure, the plants did not exhibit any visible foliar symptoms, as only at microscopic level a small number of dead cells were found. Photosynthetic processes, however, were significantly affected. During and after the treatment, ozone induced a reduction in CO2 fixation capacity (up to 52% after 12 h from the beginning of the treatment) due to mesophyllic limitations. Intercellular CO2 concentration significantly increased in comparison to controls (+90% at the end of the post-fumigation period). Furthermore impairment of carboxylation efficiency (-71% at the end of the post-fumigation period compared to controls in filtered air) and membrane damage in terms of integrity (as demonstrated by a significant rise in solute leakage) were observed. A regulatory adjustment of photosynthetic processes was highlighted during the post-fumigation period by the higher values of qNP and (1-q(P)) and therefore suggests a tendency to reduce the light energy used in photochemistry at the expense of the capacity to dissipate the excess as excitation energy. In addition, the chlorophyll a/b ratio and the de-epoxidation index increased, showing a rearrangement of the pigment composition of the photosynthetic apparatus and a marked activation of photoprotective mechanisms.

Diagnostic Differences for Anterior Knee Pain between Sexes in Adolescent Basketball Players

BACKGROUND

The purpose of this study was to determine if there is a sex difference in the prevalence of specific patellofemoral disorders that cause anterior knee pain in adolescent basketball players undergoing pre-participation screening.

METHODS: SETTING

Biomechanical Laboratory.

METHODS: PARTICIPANTS

A total of 810 (688 female and 122 male) basketball players from a single county public school district.

METHODS: MAIN OUTCOME MEASURES

Prior to the start of three consecutive basketball seasons, participants were evaluated for anterior knee pain. Testing consisted of completion of the Anterior Knee Pain Scale. Those with positive findings completed an IKDC form, a standardized history and a physician-administered physical examination.

RESULTS

Anterior knee pain was noted in 410 of 1620 knees (25.3%). 26.6% of female knees and 18.0% of male knees were affected (p<0.05). Patellofemoral dysfunction (PFD) was the most common diagnosis with an overall prevalence of 6.4% (7.3% females; 1.2% males). Less common were Sinding-Larsen-Johanssen disease (SLJ), 4.8% (5.0% females; 3.7% males), Osgood-Schlatter Disease (OSD) 2.5% (2.3% females; 4.1% males); and plica syndrome 2.3% (2.1% females; 3.3% males). The remaining diagnoses (trauma, fat pad syndrome, IT band and pes anserine bursitis) had a combined prevalence of 1.7% (1.9% females; 1.6% males).

CONCLUSIONS

PFD was significantly more common in females (p<0.05). Anterior knee pain was more common in adolescent female basketball players than in adolescent male basketball players.

LEVEL OF EVIDENCE

Descriptive Laboratory Study. Level 1.

A novel tomato MYC-type ICE1-like transcription factor, SlICE1a, confers cold, osmotic and salt tolerance in transgenic tobacco

ICE1 (inducer of CBF expression 1), a MYC-type bHLH transcription factor, is an important activator of CBF3/DREB1A for regulating cold signaling and stress tolerance. In this study, we isolated the novel ICE1-like gene SlICE1a from tomato which contains the conserved bHLH domain, an S-rich motif, and ACT-domain. It is localized in the nucleus and harbors transcription-activating activity in the N-terminal. In addition, the SlICE1a transcript is slightly upregulated by cold stress, salt stress, and osmotic stress. SlICE1a overexpression in tobacco enhances the induction of CBF/DREB and their target genes, consequently increasing the levels of proline, soluble sugars, and late embryogenesis abundant (LEA) proteins, and enhancing tolerance to cold stress, osmotic stress, and salt stress. SlICE1a functions in abiotic stress responses by regulating the expression of stress-tolerant genes, and is thus beneficial for crop improvement.

Overexpression of tomato enhancer of SOS3-1 (LeENH1) in tobacco enhanced salinity tolerance by excluding Na+ from the cytosol

The salt overly sensitive pathway has an important function in plant salinity tolerance. The enhancer of SOS3-1 (ENH1) participates in a new salinity stress pathway with SOS2 but without SOS3. To investigate the physiological effects and functional mechanism of ENH1 under salt stress, ENH1 was isolated from tomato and overexpressed in tobacco. Under salt stress, the sprouting percentage, fresh weight, and dry weight of transgenic plants were higher than those of wild-type (WT) plants. Under salt stress, the chlorophyll content, net photosynthetic rate, and maximal photochemical efficiency of PSII in transgenic plants decreased more slowly than those in WT plants. The overexpression of LeENH1 in tobacco excluded Na(+) from the cytosol and retained high K(+) levels in the cytosol to reestablish ion homeostasis. Higher thylakoid-bound ascorbate peroxidase activity and lower reactive oxygen species levels were found in transgenic plants under salt stress.

Overexpression of a tomato carotenoid ε-hydroxylase gene alleviates sensitivity to chilling stress in transgenic tobacco

Chilling is one of the most serious environmental stresses that disrupt the metabolic balance of cells and enhance the production of reactive oxygen species (ROS). Lutein plays important roles in dissipating excess excitation energy and eliminating ROS to maintain the normal physiological function of cells. A tomato carotenoid epsilon-ring hydroxylase gene (LeLUT1) was isolated, and the LeLUT1-GFP fusion protein was localized in the chloroplast of Arabidopsis mesophyll protoplast. Quantitative real-time polymerase chain reaction (qRT-PCR) analysis indicated that the expression of LeLUT1 was the highest in the leaves and was down-regulated by various abiotic stresses in tomato. The transgenic tobacco plants overexpressing LeLUT1 had higher lutein content, which was decreased in cold condition. Under chilling stress, the non-photochemical quenching (NPQ) values were higher in the transgenic plants than in the wild type (WT) plants. Compared with the WT plants, the transgenic plants showed lower levels of hydrogen peroxide (H2O2), superoxide radical (O2(·-)), relative electrical conductivity, and malondialdehyde content (MDA), and relatively higher values of maximal photochemical efficiency of photosystem II (Fv/Fm), oxidizable P700 of PSI, and net photosynthetic rate (Pn). Therefore, the transgenic seedlings were less suppressed in growth and lost less cotyledon chlorophyll than the WT seedlings. These results suggested that the overexpression of LeLUT1 had a key function in alleviating photoinhibition and photooxidation, and decreased the sensitivity of photosynthesis to chilling stress.

Chloroembryos: a unique photosynthesis system

The embryos of some angiosperm taxa contain chlorophyll and this chlorophyllous stage is persisting until the embryo matures (further referred as chloroembryos). Besides being chlorophyllous, these embryos seem to have the ability to photosynthesize. This suggests that the chlorophyllous state of the embryo has an important role in seed development. The photosynthesis of chloroembryos is highly shade adaptive in nature as it is embedded within the supporting tissues (several layers of pod wall, seed coat and endosperm). Moreover, these chloroembryos are developing in a highly osmotic environment, and contain various components of the photosynthetic machinery. Detailed studies were performed in these chloroembryos in order to elucidate the structure of the chloroplasts, pigment composition, the photochemical activities, the rate of carbon assimilation and also the shade adaptive features. It has been shown that the respired CO2 within these chloroembryos is recycled by the efficient photosynthetic components of the chloroembryos and thus potentially influences the seed's carbon economy. Thus, the major role of embryonic photosynthesis is to produce both energy-rich molecules and oxygen, of which the former can be directly used for biosynthesis. During embryogenesis oxygen production is especially important, in a situation wherein the oxygen is limited within the enclosed seed. As these chloroembryos grow in an environment of a sugar rich endosperm, it requires some adaptive mechanisms in this high osmotic environment. The additional polypeptides found in the thylakoids of chloroembryo chloroplasts in comparison to the thylakoids of leaf chloroplast have been suggested to have a role in protecting the photosynthetic components in the chloroembryos in an environment of high osmotic strength. An attempt to understand osmotic stress tolerance existing in these chloroembryos may lead to a better understanding of tolerance of photosynthesis to osmotic stress.

Modeling of grid cell activity demonstrates in vivo entorhinal 'look-ahead' properties

Recent in vivo data show ensemble activity in medial entorhinal neurons that demonstrates 'look-ahead' activity, decoding spatially to reward locations ahead of a rat deliberating at a choice point while performing a cued, appetitive T-Maze task. To model this experiment's look-ahead results, we adapted previous work that produced a model where scans along equally probable directions activated place cells, associated reward cells, grid cells, and persistent spiking cells along those trajectories. Such look-ahead activity may be a function of animals performing scans to reduce ambiguity while making decisions. In our updated model, look-ahead scans at the choice point can activate goal-associated reward and place cells, which indicate the direction the virtual rat should turn at the choice point. Hebbian associations between stimulus and reward cell layers are learned during training trials, and the reward and place layers are then used during testing to retrieve goal-associated cells based on cue presentation. This system creates representations of location and associated reward information based on only two inputs of heading and speed information which activate grid cell and place cell layers. We present spatial and temporal decoding of grid cell ensembles as rats are tested with perfect and imperfect stimuli. Here, the virtual rat reliably learns goal locations through training sessions and performs both biased and unbiased look-ahead scans at the choice point. Spatial and temporal decoding of simulated medial entorhinal activity indicates that ensembles are representing forward reward locations when the animal deliberates at the choice point, emulating in vivo results.