What more comprehensive physiotherapy techniques than pelvic floor muscles training should be investigated in the context of post-prostatectomy? A narrative review.

BACKGROUND: In a previous article, we have underlined the emerging level of evidence for the effectiveness of a more comprehensive functional physical therapy than solely pelvic floor muscles training (PFMT) for men after radical prostatectomy (RP). More and more authors suggest that physiotherapy programs should not focus only on the side effect of continence, but more generally on the interaction of continence disorders with all other side effects related to patient's physical and emotional functioning. RESEARCH QUESTION: The aims of this narrative review are to highlight rehabilitation approaches unrelated to analytical PFMT that would seem relevant to consider in the future for post-RP men. METHOD: Our narrative review sought to map the body of literature relevant to the primary objective (non-PFMT), supplementing the data from our previous review with additional recent articles that were not eligible due to not meeting the inclusion criteria for a systematic review. RESULTS: After full text screening, 13 interventional studies have been selected. Intervention strategies were based on five major type of exercises: flexibility, synergism & co-activation, coordination & movement control, strength & endurance, aerobic & games therapy. Most of the studies of this narrative review focused on synergies, co-activations and movement control techniques that emphasized the deep abdominal muscles and PFMs reflexive activation. The wide variety of countries represented in the 13 studies with consistent results point to the potential effectiveness and replicability across various socio-cultural, ethnical, or religious contexts. CONCLUSION: We found 13 studies from 9 different countries that provide a more complete rehabilitation approach than PFMT alone in men post-RP. Intervention strategies were built around five main types of exercises, with the majority of them emphasizing synergies, co-activations, and movement control techniques. In light of these data, we hope that future research will enable us to offer the most relevant and patient-centered physiotherapy treatment.

A systematic review of supervised comprehensive functional physiotherapy after radical prostatectomy.

INTRODUCTION: Radical prostatectomy (RP) can generate multidimensional physiological changes, like decrease in physical and emotional functioning, as well as Health Related Quality of Life (HRQoL). However, only pelvic floor muscle training (PFMT) is commonly recommended as conservative treatment after RP. More comprehensive interventions than only PFMT, such as physiotherapy promoting general coordination, flexibility, strength, endurance, fitness and functional capacity may seem more relevant and patient-centered. AIM OF THE REVIEW: Our aim was to evaluate whether a more Comprehensive Functional Physical Therapy (CFPT) than PFMT alone, focused on lower limb and lumbo-pelvic exercises, would improve physical capacities and functions (including urinary continence (UI)), emotional functions and HRQoL in patients after RP. EVIDENCE ACQUISITION: A systematic review was performed in accordance with the PRISMA reporting guidelines. A literature search was conducted in PubMed, PEDro, Web of Science and Cochrane Library databases from inception to January 2022. The PICO approach was used to determine the eligibility criteria. According to the quality of selected studies, levels of evidence were given. EVIDENCE SYNTHESIS: Eight clinical trials met the eligibility criteria. Regarding UI, all the studies reported positive outcomes for CFPT between pre- and post-physiotherapy (P<0.05). The selected studies reported positive outcomes for physical capacities as well as for physical and emotional functioning, and for HRQoL (P<0.05). CONCLUSION: Current literature indicates that CFPT was shown to be safe, non-invasive, and particularly effective in terms of UI recovery. CFPT could result in more positive outcomes, including physical capacities, physical and emotional functioning and HRQoL, than PFMT alone. Further standardized, physiotherapist-guided and well-designed clinical trials conducted by experienced multidisciplinary clinicians are still called for.

A frameshift mutation in the gamma E-crystallin gene of the Elo mouse.

The murine Elo (eye lens obsolescence) mutation confers a dominant phenotype characterized by malformation of the eye lens. The mutation maps to chromosome 1, in close proximity to the gamma E-crystallin gene which is the 3'-most member of the gamma-crystallin gene cluster. We have analysed the sequence of this gene from the Elo mouse and identified a single nucleotide deletion which destroys the fourth and last "Greek key" motif of the protein. This mutation is tightly associated with the phenotype, as no recombination was detected in 274 meioses. In addition, the mutant mRNA is present in the affected lens, providing further support for our hypothesis that the deletion is responsible for the dominant Elo phenotype.

SmartSPR sensor: Machine learning approaches to create intelligent surface plasmon based sensors.

Surface plasmon resonance (SPR) based sensors allow the evaluation of aqueous and gaseous solutions from real-time measurements of molecular interactions. The reliability of the response generated by a SPR sensor must be guaranteed, especially in substance detection, diagnoses, and other routine applications since poorly handled samples, instrumentation noise features, or even molecular tampering manipulations can lead to wrong interpretations. This work investigates the use of different machine learning (ML) techniques to deal with these issues, and aim to improve and attest to the quality of the real-time SPR responses so-called sensorgrams. A new strategy to describe a SPR-sensorgram is shown. The results of the proposed ML-approach allow the creation of intelligent SPR sensors to give a safe, reliable, and auditable analysis of sensorgram responses. Our arrangement can be embedded in an Intelligence Module that can classify sensorgrams and identify the substances presents in it. Also made it possible to order and analyze interest areas of sensorgrams, standardizing data, and supporting eventual audit procedures. With those intelligence features, the new generation of SPR-intelligent biosensors is qualifying to perform automated testing. A properly protocol for Leishmaniasis diagnosis with SPR was used to verify this new feature.

Use of the Escherichia coli gene for asparagine synthetase as a selective marker in a shuttle vector capable of dominant transfection and amplification in animal cells.

A new dominant amplifiable selective system for use in bacterium-animal cell shuttle vectors was developed by the insertion of a 2-kilobase genomic fragment containing the cloned Escherichia coli gene for asparagine synthetase (AS) into the pBR322-simian virus 40 recombinant vector pSV2 so as to place the translational initiator codon for the bacterial AS about 1,000 base pairs downstream from the simian virus 40 early promoter. This new construct, pSV2-AS, retains bacterial sequences for transcriptional and translational initiation and so can express AS in bacteria. The construct can also complement AS- mutants of mammalian cells, giving AS+ transfectants capable of growth in medium lacking asparagine, with relatively high efficiency (about 300 colonies per microgram of DNA per 10(6) cells exposed). The vector can be amplified up to 100-fold in such AS+ transfectants by selection in asparagine-free medium containing increasing concentrations of the AS inhibitor beta-aspartyl hydroxamate. AS+ transfectants were found to be much more resistant to a second AS inhibitor, Albizziin, than were normal AS+ animal cell lines. This difference, which may indicate a strong resistance of the bacterial AS enzyme to Albizziin, was exploited to develop an effective selection for bacterial AS transfectants of a number of wild-type AS+ cell lines of rat, Chinese hamster, mouse, and human origin. LR-73 cells, a Chinese hamster AS+ cell line, were transfected with pSV2-AS with an efficiency of about 1,000 colonies per 0.5 microgram of DNA per 10(6) cells. The integrated construct in these cells was amplified by incubation of the transfectants in increasing concentrations of beta-aspartyl hydroxamate. Advantages and disadvantages of this new dominant, selectable, and amplifiable marker over markers commonly used in shuttle vectors are discussed.

Functional studies of a chimeric protein containing portions of the Na(+)/glucose and Na(+)/myo-inositol cotransporters.

We obtained cDNA chimeras between Na/glucose cotransporter (SGLT1) and the homologous Na(+)/myo-inositol cotransporter (SMIT) by creating random chimeras in plasmids. Of 12 chimeras, two were functional when expressed in Xenopus laevis oocytes but, upon sequencing, only one of them (C1) produced an actual chimeric protein. In C1, the first 69 amino acids of SGLT1 were replaced by the corresponding 50 amino acids of SMIT. C1 transports the same sugars as does SGLT1. C1's affinity for all sugar substrates was systematically increased by a factor of 3.3+/-0.4 but the V(max) was diminished by a factor of 15-40. In contrast, the cotransport affinity for Na(+) was unchanged. The surface expression of C1 was one seventh that of SGLT1, which explains part of the reduced V(max) and implies a significant reduction in turnover rate. N-terminal truncated constructs of SGLT1 cDNA showed that deleting amino acids 2-14 does not affect cotransporter activity, but that the pentapeptide T(14)RPVET(19) is important for normal levels of SGLT1 current. The main result of a kinetic analysis of the systematic increase in apparent affinity for sugars, together with the intact Na apparent affinity, suggests enhanced access to the sugar binding site in C1.

Stable, high-level expression of a carcinoembryonic antigen-encoding cDNA after transfection and amplification with the dominant and selectable asparagine synthetase marker.

The introduction and expression of cloned genes in a wide variety of animal cells requires the convenient use of dominant selectable markers. Very few of these markers can be amplified in copy number, a necessary feature if variable and high-level expression of the gene of interest is required. We describe the successful dominant transfection and amplification of a vector containing the Escherichia coli asparagine synthetase (AS)-encoding gene, asnA, transfected into a variety of human and rodent cell lines. An unlinked co-transfected expression vector containing the CEA cDNA, encoding human carcinoembryonic antigen, can be co-amplified with the asnA marker leading to extremely high levels of CEA synthesis. In addition, we show that the expression of both the asnA marker and the co-transfected CEA construct are stable in normal and amplified transfectants after prolonged culture in the absence of selective pressure.

Cardiac output in a fetus with erythroblastosis fetalis: assessment using pulsed Doppler.

Pulsed Doppler studies of left and right ventricular outputs were obtained over time in a hydropic fetus with erythroblastosis fetalis. Despite severe anemia, cardiac outputs were within the normal range and remained normal after in utero percutaneous intravascular transfusions, which reversed the hydrops. The measurement of cardiac output in utero provides direct evidence that high-output failure due to anemia is not the mechanism for hydrops in erythroblastosis fetalis.

Accelerated stability studies of heparin.

The objective of this study was to extend our understanding of the stability of heparin. Sodium heparin, derived from porcine intestinal mucosa, was first incubated in 0.1 N hydrochloric acid and 0.1 N sodium hydroxide at 30 and 60 degrees C and sampled at times ranging from 0 to 1000 h. The absorbance spectra of the products formed under basic conditions showed an ultraviolet maxima at 232 nm associated with chemically catalyzed beta-elimination at the uronic acid residues. The products formed under acidic conditions showed a decreased staining intensity consistent with desulfation and a decrease in molecular weight corresponding to hydrolysis of glycosidic linkages when analyzed by gradient polyacrylamide gel electrophoresis. Heparin samples were next prepared in 10 mM sodium phosphate buffer at pH 7.0 in sealed ampules that had been flushed with nitrogen and incubated at 100 degrees C. Samples taken at times ranging from 0 to 4000 h were then analyzed. Heparin was relatively stable over the first 500 h, after which it rapidly degraded. Heparin, assayed using both anti-factor Xa and anti-factor IIa amidolytic methods retained 80-90% of its activity over the first 500 h, but these activities dropped precipitously, to approximately 6% and approximately 0.5% of the initial activity at 1000 h and 2000 h, respectively. This rapid decomposition began only after the buffering capacity of the solution was overwhelmed by acidic degradants, which caused the pH to decrease. Decomposition processes observed under these conditions included the endolytic hydrolysis of glycosidic linkages and loss of sulfation, particularly N-sulfate groups, and were similar to the degradation processes observed in 0.1 N hydrochloric acid. This study provides initial observations on heparin degradation pathways. More complete, quantitative studies and studies leading to the isolation and characterization of specific degradants are still required.

[French validation of a Minor Morphologic Anomalies Scale in schizophrenic patients and their parents]. / Validation française d'une échelle d'Anomalies Morphologiques Mineures appliquée à des patients schizophrènes et à leurs parents.

UNLABELLED: Minor Physical Anomalies represent valuable indices of disturbance in early neurodevelopment. They are frequently observed in individuals with various brain disorders, including mental retardation, autism, epilepsy, hyperactivity, foetal alcohol syndrome and schizophrenia. The high prevalence of Minor Physical Anomalies in schizophrenia provides considerable support for a neurodevelopmental model in this disorder. However, studies in large sample using standardised scale are lacking. Such studies are needed in order to confirm their actual frequency and study the clinical correlates or morphological anomalies. OBJECTIVE: The aim of this study was to revise and validate a French version of a scale designed for the evaluation of Minor Physical Anomalies in adult psychiatric patients and notably in patients with schizophrenia. METHODOLOGY: The scale was revised from the Waldrop scale. The choice of items was done on the basis of frequency, reliability in the adult, reliability of rating. Some new items, related to know syndroms with comportmental symptoms were added. Both raters had previously had a short initiation to the rating of the scale. Interrater reliability between two examiners, blind with regards to the diagnosis was evaluated. RESULTS: The interrater reliability was good, with an intraclass correlation coefficient at 0.97. Patients had significantly more minor physical anomalies than comparison subjects, and also more Minor Physical Anomalies than their parents. Fathers and mothers of these schizophrenic patients had significantly more Minor Physical Anomalies than normal comparison subjects. CONCLUSION: Although the evaluation of physical anomalies relies on subjective appreciation of normal vs abnormal, the revised version of minor physical anomalies scale (French version) was found to be a reliable tool, provided that a short initiation to the rating is performed. The scale differentiated schizophrenic patients from their parents, and the latter from the normal controls. A lot of questions remains unanswered concerning the neurodevelopmental hypothesis of schizophrenia. This scale appeared as a useful complementary tool to help in the determination of the developmental phenotypic status of the patients enrolled in pathophysiological studies aiming the identification of developmental factors in schizophrenia.

The challenge of PACS in a small hospital.

Memorial Hospital is located in-North Conway, New Hampshire. Year round, the 35-bed hospital serves mainly tourists and retirees to the area. The imaging department wanted to integrate its services within an existing community network, meet the needs of a transient population and resolve staff utilization and storage problems. Conversion from film to digital in the radiology department took advantage of digital x-ray and PACS. Since the hospital was already using digital technology for CT, MR, ultrasound and fluoroscopy, it made sense to include plain film imaging in the digitization process Memorial Hospital faced a number of challenges. Those in decision-making positions lacked a general knowledge about PACS, and, in particular, about PACS in similarly sized facilities. The hospital also lacked experience working with vendors. A timeline was critical as Memorial Hospital prepared for winter, its busiest season. The facility decided on a phased-in project with no immediate HIS/RIS interface, and computerized radiography with hard-copy films was implemented immediately. The facility has made the transition from a conventional imaging department to a PACS environment. It attributes its success to the way it involved those who would be affected by any future changes in the planning and decision-making processes. Memorial Hospital expects to expand its services and streamline its archival capabilities in the near future.

Pilot study: Gelafundin (polygeline) 4% plus antibiotics in the treatment of high-risk cirrhotic patients with spontaneous bacterial peritonitis.

BACKGROUND: Cirrhotic patients with spontaneous bacterial peritonitis (SBP) have elevated rates of renal impairment and mortality. It has been shown that cefotaxime plus albumin infusion decrease renal impairment compared with antibiotic treatment alone, in patients with serum bilirubin >4 mg/dL or creatinine >1 mg/dL. AIM: To assess clinical outcomes of high-risk cirrhotic patients with SBP who were treated with antibiotics associated with Gelafundin (polygeline) 4%. METHODS: Twenty nine cirrhotic patients with SBP and serum bilirubin >4 mg/dL or creatinine >1 mg/dL were enrolled. Ceftriaxone was administered in doses of 2 g/day and Gelafundin 4% was given intravenously at 1.5 g/kg of body weight at the time of the diagnosis, followed by 1 g/kg on day 3. Renal impairment was defined as nonreversible deterioration of renal function during hospitalization. RESULTS: Eight patients (27.5%) had basal renal failure. Infection resolved in 28 (96.6%) patients. Renal impairment occurred in four patients (13.8%), and three patients (10.4%) died during hospitalization. Mortality within 90 days after discharge was 34.5% (10 patients). CONCLUSION: The rates of renal impairment and mortality in high-risk patients with SBP suggest that Gelafundin 4% administration given with ceftriaxone may be a less expensive therapeutic alternative to albumin.

[The 1990 Chinese Census: initial results]. / Le recensement chinois de 1990: premier bilan.

PIP: Preliminary results of a 10% sample from the 4th census of the People's Republic of China, conducted between April and July 1990, began to be published outside China in mid-1992. Comparison of results of the 3rd census in 1982 with the 1990 data make possible an assessment of China's demographic situation over the past decade. To help determine whether the 1990 data are reliable and take into account the "mobile population" of persons residing in districts other than those of their registration and unregistered children born in defiance of the 1-child policy. the 1990 age structure was compared with that of 1982. The 1990 population corresponded in general terms to that enumerated in 1982, but allowing for mortality it included nearly 4 million children born around the beginning of the one child policy who were not included in the 1982 census. A second anomaly was the apparent omission of around 2 million persons in the 28-37 year cohort in 1990 who may have been part of the "mobile population." The 1990 census data indicate that fertility for 1982-90 was 8.8% higher on average than reflected in vital statistics of survey data. The annual number of births would have fluctuated between 20 and 25 million. If this reconstruction is correct, the 176.4 million children aged 0-7 years enumerated in 1990 would be the survivors of around 184 million infants born between the 2 censuses. A population movement characterized by an average of 7 million deaths and 23 million births annually can be inferred. The number of persons aged 65 and over increased from 49 to 63 million between the censuses. The proportion 65 and over increased from 4.9 to 5.6%, while that of children under 15 declined from 33.4% in 1982 to 27.6% in 1990. The overall sex ratio increased slightly from 106.3 to 106.5 between 1982 and 1990. The persisting excess of males is a result of the 1-child policy. The excess of males aged 0-7 born during the intercensal period was over 9 million, instead of the 5 million that should be expected according to the laws of biology. One of the principal findings of the 1990 census was the vigorous nuptiality increase, the apparent result of a decline i the average age at first marriage from 25 to 24 years for men and of slightly less than a year for women, who continue to marry in their 23rd year on average. The combination of a declining age at marriage and the arrival at marriageable age of the last cohorts born in the 1960s produced noneligible effects on fertility. Between 1981 and 1989, the average maternal age at first birth declined from 24 to 23 years. The total fertility rate declined from 2.6 in 1982 to 2.2 in 1990. In 1982 and 1990, respectively, 47.25% and 49.5% of births were first order, 25.6% and 31.7% were second order, and 27.15% and 19.74% were third or higher order. 12 years after the launching of the 1-child policy, the 2-child family appears to predominate. If this level of fertility persists, the Chinese population will probably reach 1.3 billion before 2000.^ieng

[Family and population in China from the sixteenth to the eighteenth century in the light of a recent work by Liu Ts'ui-Jung]. / Famille et population en Chine du XVIe au XVIIIe siècle à la lumière d'un ouvrage récent de Liu Ts'ui-Jung.

Taking as its starting point the huge sample of 260,000 people born in China between the 13th and the 19th century used by Liu Ts'ui-Jung in her recent study on Lineage population, our study aims at assessing the premodern demographic evolution of China. Inasmuch the method of family reconstruction actually limited the scope of her book, Liu Ts'ui-Jung was not able to go beyond the description of a specific demographic regime defined by three elements: 1) universal marriage; 2) a moderate level of masculine fertility; and 3) a life expectation at 15 comprised between 30 and 40. These conditions would not allow the constitution of many extended households, whereas the annual rate of growth would be somewhere around 1%, a situation having little in common with the present day "population explosion". Using data included in the book, but not considered for the demonstration, we have been able to establish a dramatic deterioration of the mortality pattern from the middle of the 18th century onwards. Accordingly, the proportion of widows increases whereas population which would be characterized with a long period of growth followed by a crisis generated by a surge of the mortality rate.

[Population registration and censuses. The Chinese tradition]. / Enregistrement de la population et recensements. La tradition chinoise.

"The case of China is in many ways exemplary, due to both its extremely long history and the fact that the Chinese approach influenced other countries over the course of the centuries, and can thus be viewed as a model. The first ¿censuses' were intended as an administrative tool, to manage lists of those subject to the corvee. As administrative regulations evolved, these lists were made obsolete and replaced, with the change of dynasty in 1644, by fiscal records. From 1740 to 1780, in order to link economic knowledge--especially grain prices--to the demographic situation, the central government urged local authorities to produce nominative records. Genealogies, rich in information, were another source of knowledge. With certain alterations, the Chinese model spread into the surrounding region, including Japan, Vietnam and Korea." (SUMMARY IN ENG AND SPA)

[Chinese demographic prospects up to the year 2000]. / Perspectives demographiques chinoises a l'horizon 2000.

PIP: This paper tries to reconstruct the demographic evolution of China during the past 30 years, in the light of new data recently published by Chinese sources. At the end of 1979 China had a population of 1970 million, a birth rate of 18/1000, a mortality rate of 6/1000, and a growth rate of 12/1000; the Chinese population which was 540 million in 1949, the year of the Liberation, was already 642 million by the end of 1957. The demographic evolution of the past 30 years can be summed up in 5 phases: 1) 1950-57, marked by a natural growth rate of 10-24/1000, due mainly to a significant decrease in mortality; fecundity was about 5 children/woman; 2) 1958-61; very little is known about those years, the period of the "great leap forward"; there was undoubtedly a marked decrease in birth rate due to starvation-caused amenorrhea, and a marked decrease in mortality rate, resulting in a natural growth rate of only 5/1000; 3) 1963-64, with a natural growth rate of 33.5/1000, and mortality decreases again; 4) 1965-70, with a birth rate of 35/1000 and a mortality rate down to 7-8/1000; these are the years of the Cultural Revolution and the demographic problem is underrated in comparison to the political situation; 5) 1970-on; fertility rate is at its lowest, 2.3, and the slogan is "2 children/couple". The characteristics of China's population in 1979 are not very different from those of 1953; 38.5% of the population is in the age group 0-15, and there are 410 million dependent young people as compared to 60 million dependent old people; survival rate is 65.7% and infant mortality has fallen to the level of that in developed countries. The Communist Party made public its directives in 1979: 1 child/couple, reduction of natural growth rate to 5/1000 by 1985 and zero population growth by the year 2000; should these directives become real, China will have a population of 1050 million inhabitants by the year 2000. The level of education in China is still low despite the doubling and tripling of the number of schools at every level; the current reduction in birth rate will show in the classrooms only in about 12 years' time. The active population includes almost the totality of the population over 17, with the majority employed in the agricultural section; the internal gross product has increased 60 times in the past 26 years; still, unemployment exists and it becoming a serious problem. Demographic aging is still much below the level of developed countries. The real problem will become apparent in 1982-93, when the mass of the people born between 1962-73, about 300 million people, will become adults and will be looking for jobs.^ieng

[The lessons from the third Chinese census]. / Les lecons du troisieme recensement chinois

PIP: A review of the main results of the 1982 census of China is presented. Topics considered include the underestimation of fertility and mortality, nuptiality and fertility, sex ratio of infants, illiteracy, employment, and regional differences.^ieng

[In China, defusing a time bomb]. / En Chine, desamorcer une bombe a retardement.

PIP: China's recent successes in reducing fertility are first described. Some of the problems related to this rapid fertility decline are then reviewed, including labor force developments. The possibilities for a new population surge in China are also considered.^ieng

[Demographic constraints]. / Les contraintes demographiques.

PIP: This is a comparative analysis of China and India's policies and programs designed to reduce the rate of population growth. The authors note that these two countries also differ with regard to the emphasis given to primary, secondary, or higher education and to levels of female labor force participation. They conclude that over the next 10 years both will face a growing population, an excess of manpower over available jobs, and regional disparities in development that could threaten internal stability.^ieng

China and India: a comparison of demographic constraints.

PIP: The authors compare demographic trends in China and India and policies and programs developed to slow population growth. Particular attention is given to regional differences within both countries and to problems of providing employment opportunities to a rapidly growing population.^ieng