Continence Is Not Affected after Sling Revision with Transvaginal Tape Elongation for Post-Sling Voiding Dysfunction.

Voiding dysfunction (VD) after sling operation is not uncommon. Sling revisions by incision/excision are usually effective; however, they may result in recurrent stress urinary incontinence (SUI). We aimed to evaluate continence status after an innovative sling revision procedure that preserves the integrity of the sling. Patients who underwent either a single-incision (AJUST) or a trans-obturator (TVT-O) mid-urethral sling were studied. Transvaginal tape elongation (i.e., sling midline incision and mesh interposition) was performed on patients with post-sling VD. Factors that may affect recurrent SUI were investigated by statistical analyses. Of 119 patients, 90 (75.6%) (45 AJUST and 45 TVT-O) were available for long-term (median 9; 8-10 years) follow-up. A significantly higher rate (17.2% vs. 3.3%, p = 0.014) of VD was noted after AJUST (N = 10) than after TVT-O (N = 2). After sling revision, four (33%) of the 12 cases reported recurrent SUI, which was not significantly different (p = 1.000) from the rate (37%, 29/78) of patients who did not undergo sling revision. Further statistical analyses revealed no significant predisposing factors affecting the recurrence of SUI. Surgical continence did not seem to be affected by having had sling revision with transvaginal tape elongation for post-sling VD.

Spontaneous abdominal wall endometriosis: A Case Report and review of the literature.

OBJECTIVE: We present a case of spontaneous abdominal wall endometriosis presenting as a painless nodular mass in a woman with no prior history of abdominal surgery. CASE REPORT: Abdominal wall endometriosis (AWE) is an uncommon form of endometriosis, usually arising due to a past history of cesarean section or abdominal hysterectomy. However, in rare cases, abdominal wall endometriosis can arise in women with no prior history of abdominal surgery. A 48-year-old woman presented to our obstetrics and gynecology clinic with a painless nodular mass in the right lower quadrant of the abdomen. Abdominal wall ultrasound showed a hypoechoic heterogenous mass under the skin. Wide surgical resection of the mass was conducted and post-operative histopathological report revealed abdominal wall endometriosis. CONCLUSION: Spontaneous abdominal wall endometriosis is an uncommon pathologic condition in which accurate diagnosis is difficult. As an increasing number of obstetrical and gynecological procedures are conducted worldwide, surgeons should keep this clinical entity in the differential diagnosis of any abdominal mass in reproductive-aged females regardless of their past surgical history.

Improved symptoms and signs of refractory interstitial cystitis in women after intravesical Nanofat plus platelet-rich plasma grafting: A pilot study.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by bladder pain accompanied by irritative urinary symptoms, and typical cystoscopic and histological features. In this pilot study, we assessed the impact of lesion-targeted bladder injection therapy using a biocellular regenerative medicine on patients with refractory IC/BPS. The medicine, which was an autologous emulsified fat (Nanofat) and platelet-rich plasma (PRP) combination, was prepared intraoperatively. Six patients (aged 40-54 years), who completed a standard protocol of four consecutive treatments at 3-month intervals, were followed up at 6 months postoperatively. All patients (100%) reported marked (+3; +3 ~ -3) improvement of their overall bladder conditions. Mean bladder pain (from 8.2 to 1.7; range: 0 ~ 10), IC-related symptoms (from 18.5 to 5.7; range: 0 ~ 20), and bother (from 14.8 to 3.8; range: 0 ~ 16) improved significantly (p < 0.01). The normalization of bladder mucosal morphology with treatments was remarkable under cystoscopic examination, and no significant adverse events were found. The cultured mesenchymal stem cells from Nanofat samples of the six patients were verified in vitro. Our preliminary results suggest novel intravesical therapy with autologous Nanofat plus PRP grafting is safe and effective for refractory IC/BPS. Surgical efficacy might be attributed to an in vivo tissue engineering process.

The three-year evolution of overactive bladder syndrome in community-dwelling female residents aged 40 years and above.

OBJECTIVE: In this 3-year longitudinal cohort study, we aimed to evaluate the evolution of overactive bladder in female community residents aged 40 years and above in central Taiwan and identify its risk factors. MATERIALS AND METHODS: Female community residents aged 40 years and above were invited to participate in this study and fill out a yearly Overactive Bladder Symptom Score (OABSS) questionnaire over a 3-year period. A woman was defined to have OAB if the total OABSS was ≧4 and urgency score was ≧2. At the end of the third year, the incidence, remission, persistence, and relapse of OAB in these community residents were calculated. A novel statistical analysis technique, machine learning with data mining, was applied to examine its use in this field. Five machine learning models were used to predict the risk factors associated with persistent OAB and the results were compared with the conventional logistic regression model. RESULTS: In total, 1469 female residents were included in the first year and 1290 (87.8%) women completed the questionnaires for all 3 years. The prevalence of OAB was 20.2% (n = 260). The second- and third-year incidence rates of OAB were 13.5% and 7.1%. The remission rates were 39.6% and 44.3%. Twenty-two percent of the women reported relapse of OAB in the third year. The two-year OAB persistence rate was 43.8%. For the prediction of risk factors for persistent OAB, the multivariable logistic regression model had better predictive accuracy (AUC = 0.664) than the five machine learning models. Age â‰§ 60 was associated with persistent OAB (OR 2.8; 95% CI: 1.34-5.89, P = 0.002). CONCLUSION: The yearly incidence, remission, and persistence rates of OAB were high in female community residents aged 40 years and above in central Taiwan. Older women had a higher risk of persistent OAB symptoms in this 3-year longitudinal cohort study.

Development of a Longitudinal Diagnosis and Prognosis in Patients with Chronic Kidney Disease: Intelligent Clinical Decision-Making Scheme.

Previous studies on CKD patients have mostly been retrospective, cross-sectional studies. Few studies have assessed the longitudinal assessment of patients over an extended period. In consideration of the heterogeneity of CKD progression. It's critical to develop a longitudinal diagnosis and prognosis for CKD patients. We proposed an auto Machine Learning (ML) scheme in this study. It consists of four main parts: classification pipeline, cross-validation (CV), Taguchi method and improve strategies. This study includes datasets from 50,174 patients, data were collected from 32 chain clinics and three special physical examination centers, between 2015 and 2019. The proposed auto-ML scheme can auto-select the level of each strategy to associate with a classifier which finally shows an acceptable testing accuracy of 86.17%, balanced accuracy of 84.08%, sensitivity of 90.90% and specificity of 77.26%, precision of 88.27%, and F1 score of 89.57%. In addition, the experimental results showed that age, creatinine, high blood pressure, smoking are important risk factors, and has been proven in previous studies. Our auto-ML scheme light on the possibility of evaluation for the effectiveness of one or a combination of those risk factors. This methodology may provide essential information and longitudinal change for personalized treatment in the future.

A 3-year longitudinal survey of overactive bladder in community-dwelling male residents aged 40 years and above.

OBJECTIVES: To evaluate the short-term evolution and risk factors of overactive bladder (OAB) in community-dwelling male residents aged 40 years and above in central Taiwan. METHODS: This was a 3-year longitudinal cohort study. From January 2012 to December 2012, community residents aged 40 years and above, living in central Taiwan, were invited to participate in this study. A yearly Overactive Bladder Symptom Score (OABSS) questionnaire was used to assess the prevalence, incidence, remission, persistence, and relapse of OAB for three consecutive years. OAB was defined as total OABSS ≧4 and urgency score ≧2. RESULTS: Nine hundred forty-one male residents aged ≧40 years were recruited. The prevalence of OAB was 15%. The male residents with OAB were older, had a history of urological surgery, were unemployed, had lower educational levels, and lower yearly incomes compared with male residents without OAB. The prevalence increased with age when stratified into different age cohorts (40-49, 7%; 50-59, 12.7%; 60-69, 18.2%; ≧70, 32%; P < .001). Age ≧60 (odds ratio [OR] 2.58; 95% CI, 1.62-4.11) and history of urological surgery (OR 2.85; 95% CI, 1.29-6.30) were the major risk factors after multivariable logistic regression analysis. Eight hundred participants completed all the 3 years' questionnaires. The second- and third-year incidence rates of OAB were 10% (69/691) and 6.2% (42/674), respectively. The remission rates were 47.7% (52/109) and 46% (58/126), respectively. The two-year OAB persistence rate was 30.3% (33/109). CONCLUSIONS: The prevalence and yearly incidence of OAB are high in community-dwelling male residents aged ≧40 years in central Taiwan. Age is an important risk factor.

Early postpartum biofeedback assisted pelvic floor muscle training in primiparous women with second degree perineal laceration: Effect on sexual function and lower urinary tract symptoms.

OBJECTIVE: To evaluate the short-term effect of routine early postpartum electromyographic biofeedback assisted pelvic floor muscle training on sexual function and lower urinary tract symptoms. MATERIALS AND METHODS: From December 2016 to November 2017, primiparous women with vaginal delivery, who experienced non-extended second-degree perineal laceration were invited to participate. Seventy-five participants were assigned into a pelvic floor muscle training (PFMT) group or control group. Women in the PFMT group received supervised biofeedback-assisted pelvic floor muscle training at the 1st week and 4th week postpartum. Exercises were performed at home with the same protocol until 6 weeks postpartum. The Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Urinary Distress Inventory short form questionnaire (UDI-6) were used to evaluate sexual function and lower urinary tract symptoms respectively at immediate postpartum, 6 weeks, 3 months, and 6 months postpartum. RESULTS: Forty-five women (23 in PFMT group,22 in control group) completed all questionnaires at 6 months postpartum. For overall sexual function and the three sexual functional domains, no statistically significant difference was found in PISQ scores from baseline to 6 weeks, 3 months, and 6 months postpartum between the PFMT and control groups. For postpartum lower urinary tract symptoms, all symptoms gradually improved over time for both groups without a statistically significant difference between groups. CONCLUSION: Our study showed that supervised biofeedback-assisted pelvic floor muscle training started routinely at one week postpartum did not provide additional improvement in postpartum sexual function and lower urinary tract symptoms.

Correlation of severity of pelvic organ prolapse with lower urinary tract symptoms.

OBJECTIVE: Relationships between pelvic organ prolapse (POP) staging and lower urinary tract symptoms (LUTS) are controversial. In this study, we evaluated correlations of POP staging with LUTS in different compartments. MATERIALS AND METHODS: From January 2016 to December 2017, 250 consecutive patients with urogynecologic complaints who were referred to our urodynamic unit were recruited into this study. Different stages of different compartments (anterior, central and posterior) of POPs according to IUGA and ICS terminology were re-grouped into four categories as stage 0, 1, 2, and 3 (including stage 4 because of a limited number of patients in stage 4). Pearson correlation coefficient and general linear regression were used for correlations of POP staging in different compartments and LUTS (stress urinary incontinence, overactive bladder and voiding symptoms) as well as their associated factors. RESULTS: Only OAB had a moderate correlation with different compartments of POP (anterior vaginal wall: -0.3116; cervix: -0.2954 and posterior vaginal wall: -0.3779; all p < 0.05). Stage 1 AVWP significantly increased (39.6%) the occurrence of OAB compared to no prolapse. Posterior compartment (stage 1-3) prolapse reduced the occurrence of OAB. CONCLUSION: Only stage 1 AVWP is associated with an increase in OAB, and posterior compartment prolapse may reduce the occurrence of OAB.

Blocking the Spinal Fbxo3/CARM1/K+ Channel Epigenetic Silencing Pathway as a Strategy for Neuropathic Pain Relief.

Many epigenetic regulators are involved in pain-associated spinal plasticity. Coactivator-associated arginine methyltransferase 1 (CARM1), an epigenetic regulator of histone arginine methylation, is a highly interesting target in neuroplasticity. However, its potential contribution to spinal plasticity-associated neuropathic pain development remains poorly explored. Here, we report that nerve injury decreased the expression of spinal CARM1 and induced allodynia. Moreover, decreasing spinal CARM1 expression by Fbxo3-mediated CARM1 ubiquitination promoted H3R17me2 decrement at the K+ channel promoter, thereby causing K+ channel epigenetic silencing and the development of neuropathic pain. Remarkably, in naïve rats, decreasing spinal CARM1 using CARM1 siRNA or a CARM1 inhibitor resulted in similar epigenetic signaling and allodynia. Furthermore, intrathecal administration of BC-1215 (a novel Fbxo3 inhibitor) prevented CARM1 ubiquitination to block K+ channel gene silencing and ameliorate allodynia after nerve injury. Collectively, the results reveal that this newly identified spinal Fbxo3-CARM1-K+ channel gene functional axis promotes neuropathic pain. These findings provide essential insights that will aid in the development of more efficient and specific therapies against neuropathic pain.

Correlations between severity of anterior vaginal wall prolapse and parameters of urethral pressure profile.

OBJECTIVE: Previous studies have shown that anterior vaginal wall prolapse (AVWP) results in reduction of pressure in the proximal urethra. However, the effect of severity of AVWP on urethral pressure is controversial. This study aimed to evaluate parameters of the urethral pressure profile in different stages of AVWP. MATERIALS AND METHODS: From 2016 to 2017, 286 consecutive patients with urogynecologic complaints who were referred to our urodynamic unit were enrolled in this study to analyze their urethral pressure profiles. Stages of AVWP were regrouped into three groups ranging from mild to severe stages (groups 1-3). Maximal urethral pressure, urethral closure pressure, functional urethral length, length of continence zone, as well as area of continence zone were compared among these three groups. RESULTS: Distribution of age, parity, and menopausal women were significantly different among these three groups. Maximal urethral pressure (pressures for groups 1, 2, and 3 were 74.6∼75.9cmH2O, 69.7∼73.4cmH2O, and 58.3∼60.5cmH2O, respectively; all P<.05) and stress urethral closure pressure (pressures for groups 1, 2, and 3 were 69.3cmH2O, 62.3cmH2O, and 52.2cmH2O, respectively; all P<.05) gradually and significantly decreased, consistent with the severity of AVWP. However, the attenuated maximal urethral pressure and stress urethral closure pressure in accordance with severity did not show any significant difference after controlling for age, body mass index, parity, menopause, and stress urinary incontinence symptoms. CONCLUSION: Our results showed that AVWP significantly attenuated urethral pressure. However, patient age, menopausal status, and number of parities seem to be more influential in compromising urethral function than just AVWP alone.

Risk Prediction for Early Chronic Kidney Disease: Results from an Adult Health Examination Program of 19,270 Individuals.

Developing effective risk prediction models is a cost-effective approach to predicting complications of chronic kidney disease (CKD) and mortality rates; however, there is inadequate evidence to support screening for CKD. In this study, four data mining algorithms, including a classification and regression tree, a C4.5 decision tree, a linear discriminant analysis, and an extreme learning machine, are used to predict early CKD. The study includes datasets from 19,270 patients, provided by an adult health examination program from 32 chain clinics and three special physical examination centers, between 2015 and 2019. There were 11 independent variables, and the glomerular filtration rate (GFR) was used as the predictive variable. The C4.5 decision tree algorithm outperformed the three comparison models for predicting early CKD based on accuracy, sensitivity, specificity, and area under the curve metrics. It is, therefore, a promising method for early CKD prediction. The experimental results showed that Urine protein and creatinine ratio (UPCR), Proteinuria (PRO), Red blood cells (RBC), Glucose Fasting (GLU), Triglycerides (TG), Total Cholesterol (T-CHO), age, and gender are important risk factors. CKD care is closely related to primary care level and is recognized as a healthcare priority in national strategy. The proposed risk prediction models can support the important influence of personality and health examination representations in predicting early CKD.

Inhibiting MLL1-WDR5 interaction ameliorates neuropathic allodynia by attenuating histone H3 lysine 4 trimethylation-dependent spinal mGluR5 transcription.

ABSTRACT: Mixed lineage leukemia 1 (MLL1)-mediated histone H3 lysine 4 trimethylation (H3K4me3) of a subset of genes has been linked to the transcriptional activation critical for synaptic plasticity, but its potential contribution to neuropathic allodynia development remains poorly explored. Here, we show that MLL1, which is induced in dorsal horn neuron after spinal nerve ligation (SNL), is responsible for mechanical allodynia and increased H3K4me3 at metabotropic glutamate receptor subtype 5 (mGluR5) promoter. Moreover, SNL induced WD (Trp-Asp) repeat domain 5 subunit (WDR5) expression as well as the MLL1-WDR5 interaction accompany with H3K4me3 enrichment and transcription of mGluR5 gene in the dorsal horn in neuropathic allodynia progression. Conversely, WDR5-0103, a novel inhibitor of the MLL1-WDR5 interaction, reversed SNL-induced allodynia and inhibited SNL-enhanced mGluR5 transcription/expression as well as MLL1, WDR5, and H3K4me3 at the mGluR5 promoter in the dorsal horn. Furthermore, disrupting the expression of MLL1 or WDR5 using small interfering RNA attenuated mechanical allodynia and reversed protein transcription/expression and complex localizing at mGluR5 promoter in the dorsal horn induced by SNL. This finding revealed that MLL1-WDR5 complex integrity regulates MLL1 and WDR5 recruitment to H3K4me3 enrichment at mGluR5 promoter in the dorsal horn underlying neuropathic allodynia. Collectively, our findings indicated that SNL enhances the MLL1-WDR5 complex, which facilitates MLL1 and WDR5 recruitment to H3K4me3 enrichment at mGluR5 promoter in spinal plasticity contributing to neuropathic allodynia pathogenesis.

Preliminary outcome of non-ablative vaginal Erbium laser treatment for female stress and mixed urinary incontinence.

OBJECTIVE: This prospective study presents a preliminary result to compare the clinical efficacy of patients with stress urinary incontinence and mixed urinary incontinence using minimal invasive Er:YAG vaginal laser. MATERIALS AND METHODS: A total of 20 patients were included, in which were 10 patients with SUI and 10 patients with MUI (stress and urge incontinence), and underwent a 2940 nm Er:YAG laser with a special SMOOTH mode in an outpatient office without anesthesia or postoperative medications. All patients completed two sessions of treatment with an interval time of 28 days. At three months after treatment, all patients were asked to a clinical visit for evaluate the clinical outcome by pre-treatment and post-treatment ICIQ-SF questionnaire. At pretreatment and 3 months after the completion of two therapy sessions, patients were asked to answer the ICIQ-SF questionnaire. The questionnaire consists of three scales for assessment of the treatment outcome of urinary incontinence as: no change (no change score), improvement (decrease score 1-5), and strong improvement (decrease score >5) for two groups of patients with SUI and MUI. All the results were compared by Student's t test with two way analysis of variance between the two groups. RESULTS: A total of 20 patients presented with SUI symptom relief and improvement with treatment satisfaction. All 10 patients with SUI reported improvement after vaginal laser treatment, 70% with marked improvement and 30% with improvement. All 10 patients with MUI also had improvement, 40% with marked improvement and 60% with improvement. There was no statistically significant difference in the treatment outcome between the two groups. CONCLUSIONS: Vaginal Erbium laser produce provides vaginal collagen remodeling and synthesis that may repair and restore the pelvic floor function. Despite of sample limitation and short follow up, this treating procedure presented a good and a safe clinical outcome in patients with SUI and with MUI by assessment of ICIQ-SF questionnaire.

Transcription Repressor Hes1 Contributes to Neuropathic Pain Development by Modifying CDK9/RNAPII-Dependent Spinal mGluR5 Transcription.

Diverse transcriptional controls in the dorsal horn have been observed in pain hypersensitivity. However, the understanding of the exact causes and mechanisms of neuropathic pain development is still fragmentary. Here, the results demonstrated nerve injury decreased the expression of spinal hairy and enhancer of split 1 (Hes1), a transcriptional repressor, and enhanced metabotropic glutamate receptor subtype 5 (mGluR5) transcription/expression, which was accompanied with behavioral allodynia. Moreover, nerve injury decreased Hes1 levels and reciprocally increased cyclin dependent kinase-9 (CDK9) levels and recruited CDK9 to phosphorylate RNA polymerase II (RNAPII) in the promoter fragments of mGluR5, thereby enhancing mGluR5 transcription/expression in the dorsal horn. These effects were also induced by intrathecally administering naïve rats with Hes1 small interfering RNA (siRNA). Conversely, Hes1 overexpression using intrathecal lentiviral vectors in nerve injury rats produced reversal of pain behavior and reversed protein expressions, phosphorylation, and coupling to the promoter segments in the dorsal horn. Collectively, the results in this study indicated nerve injury diminishes spinal Hes1-dependent suppression of CDK9-dependent RNAPII phosphorylation on the mGluR5 promoter that possibly enhances mGluR5 transcription/expression for neuropathic pain development.

Effects of uterine preservation on long-term subjective outcomes of sacrospinous ligament fixation for the treatment of pelvic organ prolapse.

OBJECTIVE: To evaluate the long-term subjective outcomes in women who underwent sacrospinous ligament fixation with and without uterine preservation for treatment of uterovaginal prolapse. STUDY DESIGN: Two hundred and ten women with POP-Q≧stage III uterovaginal prolapse, who underwent sacrospinous ligament fixation from January 1994 to December 2007 were included. Patient Global Impression of Improvement was used to assess the surgical outcome in July 2016. Primary outcome measures were subjective success rate and current satisfaction. Kaplan-Meier method and Cox proportional hazard model were used for analysis. RESULTS: The mean follow-up was 13.3 years (range 8.5-22.6 years). One hundred and thirty-nine patients were successfully interviewed and analyzed. The cumulative subjective success rate was 88.5% and current satisfaction was 77.7%. The repeat surgery rate was 2.9%. There were no significant differences in subjective success (89% vs. 88%) or current satisfaction (78.1% vs. 77.3%) between uterine preservation (n = 64) and concomitant hysterectomy (n = 75). Kaplan-Meier analysis showed that sacrospinous ligament fixation with uterine preservation had a better subjective outcome at mid-term follow-up but was not significantly different compared with concomitant hysterectomy after long-term follow-up (P = 0.63). The adjusted HR of uterine preservation was 0.75 (95%CI: 0.22-2.12, P = 0.59). CONCLUSION: Sacrospinous ligament fixation with or without uterine preservation in the treatment of women with uterovaginal prolapse has no significant difference in long-term subjective outcomes and patient satisfaction.

Escalating utilization of inpatient surgery for pelvic floor dysfunction in the elderly in Taiwan.

AIMS: The direct cost of operations and health care expenditure for treating pelvic floor dysfunction are substantial. In this study, we evaluate the number of inpatient surgical procedures and direct expenditures for treating pelvic organ prolapse and urinary incontinence under the coverage of National Health Insurance (NHI) in Taiwan. METHODS: Thirteen years of population-based NHI inpatient claims were used in this study. The number of surgical procedures and the average direct cost of inpatient fees for treating pelvic floor dysfunction for each patient from 1999 to 2011 were calculated. The patients were stratified based on age into a younger than 65 years group and 65 years or older group for comparisons. RESULTS: The number of patients per year increased by 27%, increasing from 5278 patients in 1999 to 6706 patients in 2011. The total direct cost of inpatient (surgical and admission) fees for pelvic floor dysfunction increased by 57.2%, increasing from $6 674 968 USD in 1999 to $10 494 894 USD in 2011. However, while the expenditures for women 65 years or older increased by 102.2% from 1999 to 2011, there was only a 38.3% increase for those younger than 65 years when we stratified the patients by age. CONCLUSION: The increasing expenditures for inpatient surgery for pelvic floor dysfunction are mainly due to the escalating utilization of inpatient surgical procedures, especially those for pelvic organ prolapse in women aged 65 or older.

Hyaluronic acid improves pain symptoms more than bladder storage symptoms in women with interstitial cystitis.

OBJECTIVE: Intravesical hyaluronic acid (HA) therapy is one of acceptable methods to treat bladder pain and storage symptoms (i.e., urgency, frequency and nocturia) of interstitial cystitis/bladder pain syndrome (IC/BPS). We aim to assess the impacts of intravesical HA on bladder pain and storage symptoms, respectively, and to investigate their associated factors in patients with IC/BPS. MATERIALS AND METHODS: In this prospective, multicenter study, 103 women with refractory IC/BPS undergoing a standard protocol of intravesical HA therapy were enrolled. A pain Visual Analog Scale (VAS) and the Interstitial Cystitis Symptom and Problem Index (ICSI & ICPI) were used to assess symptoms and bother associated with IC/BPS. The Scaled Global Response Assessment (GRA) was used to evaluate patients' perception of overall changes in bladder pain and storage symptoms, respectively, after treatment. RESULTS: Mean age of participants was 43.6 ± 11.8 years. The average duration of symptoms was 5.1 ± 5.0 years. Significant improvements in pain VAS, ICSI and ICPI scores were observed after treatment. However, patients reported significantly different rates of moderate/marked improvement in bladder pain and storage symptoms (73.8% vs. 47.6%; P < 0.001) on the GRA, respectively. "Lower pain VAS score" and "reduced functional bladder capacity" were found to be the factors that adversely affected the treatment responses of bladder pain and storage symptoms, respectively, after repeated statistical analyses. CONCLUSION: Bladder instillation of HA seemed more efficient in improving bladder pain than storage symptoms associated with IC/BPS. The persistence of bladder storage symptoms after treatment might result from a reduced functional bladder capacity.

k-Skip-n-Gram-RF: A Random Forest Based Method for Alzheimer's Disease Protein Identification.

In this paper, a computational method based on machine learning technique for identifying Alzheimer's disease genes is proposed. Compared with most existing machine learning based methods, existing methods predict Alzheimer's disease genes by using structural magnetic resonance imaging (MRI) technique. Most methods have attained acceptable results, but the cost is expensive and time consuming. Thus, we proposed a computational method for identifying Alzheimer disease genes by use of the sequence information of proteins, and classify the feature vectors by random forest. In the proposed method, the gene protein information is extracted by adaptive k-skip-n-gram features. The proposed method can attain the accuracy to 85.5% on the selected UniProt dataset, which has been demonstrated by the experimental results.