Cognitive function following surgery for pelvic organ prolapse.

INTRODUCTION AND HYPOTHESIS: Older women are at higher risk for cognitive dysfunction following surgery. We hypothesized that for women undergoing pelvic organ prolapse (POP) surgery, memory function would not be significantly different at delayed postoperative assessment compared to baseline. OBJECTIVE: We sought to compare performance on tests of various neurocognitive domains before and after surgery for POP. METHODS: A prospective cohort study was conducted with women, aged 60 years and older who were undergoing surgery for POP. A battery of highly sensitive neurocognitive tests was administered preoperatively (baseline), on postoperative day 1 (postoperative visit 1, POV1), and at the first postoperative clinic visit 4-6 weeks after surgery (postoperative visit 2, POV2). The test battery included the scene-encoding memory task, the n-back task, the Iowa gambling task, the balloon analogue risk task, and the psychomotor vigilance task. These tests assessed the neurocognitive subdomains of episodic memory, working memory, decision-making, risk-taking, and sustained attention. Two score comparisons were made: between baseline and POV1, and between baseline and POV2. RESULTS: In 29 women, performance on the scene-encoding memory task was worse at POV1 than at baseline (2.22 ± 0.4 vs. 2.45 ± 0.6, p < 0.05) but was better than baseline at POV2 (2.7 ± 0.7 vs. 2.45 ± 0.6, p < 0.05). Similarly, performance on the psychomotor vigilance test was worse at POV1 than at baseline (p < 0.01) but there was no difference at POV2. There was no difference in performance on the Iowa gambling test, n-back test, and balloon analogue risk tasks between baseline and any postoperative visit. CONCLUSION: Cognitive test scores did not worsen significantly between baseline and delayed postoperative assessments in older women undergoing surgery for POP.

Brain activation in response to bladder filling in healthy adults: An activation likelihood estimation meta-analysis of neuroimaging studies.

AIMS: Recent studies have used different neuroimaging techniques and identified various brain regions that are activated during bladder filling. However, there is a lack of consensus regarding which of these brain regions regulate the process of urine storage. The aim of this meta-analysis is to identify brain regions that are commonly activated during bladder filling in healthy adults across different studies. METHODS: PubMed was searched for neuroimaging studies investigating the effects of bladder filling on regional brain activation. Studies were excluded if they did not report brain activation differences from whole-brain group analysis by comparing the state of bladder filling with the state of bladder rest. The current version of the activation likelihood estimation (ALE) approach was used for meta-analysis. RESULTS: We identified 14 neuroimaging studies examining brain activation in response to experimental bladder filling in 181 healthy subjects, which reported 89 foci for ALE analysis. The meta-analysis revealed significant activation in multiple brain regions including thalamus (bilaterally), right insula, cerebellum, and brainstem (bilaterally). CONCLUSIONS: Several key brain regions involved in sensory processing are commonly activated during bladder filling in healthy adults across different studies. Neurourol. Urodynam. 36:960-965, 2017. © 2016 Wiley Periodicals, Inc.

Central control of micturition in women: Brain-bladder pathways in continence and urgency urinary incontinence.

Urinary incontinence disproportionately affects women. Anatomical textbooks typically describe continence mechanisms in women in the context of the pelvic floor support of the urinary bladder and the urethral sphincters. However, the urinary bladder and urethral sphincters are under the central control of the brain through a complex network of neurons that allow storage of urine followed by voiding when socially appropriate. Recent studies suggest that the most common type of urinary incontinence in women, urgency urinary incontinence, involves significant dysfunction of the central control of micturition. In this paper, we review the anatomy and functional connectivity of the nervous system structures involved in the control of micturition. Clinical application of this anatomy in the context of urgency urinary incontinence is also discussed. Understanding the anatomy of the neural structures that control continence will allow clinicians to better understand the underlying pathology of urge incontinence and consider new ways of treating this distressing condition. Clin. Anat. 30:373-384, 2017. © 2017 Wiley Periodicals, Inc.

Deciphering the biochemical and functional characterization of rice straw cultivars for industrial applications.

As an agricultural state, Haryana (India) produces about six million metric tons (mt) of rice straw every year from rice cultivation. Currently, rice straw is either burned or ploughed into the field without being turned into a functional product. Burning of paddy straw release green house gases and particulate matter (2.5 and 10 µm), which leads to air pollution and considerable loss of soil property viz. nutrients, organic matter, productivity and biodiversity, and on and off-farm humans and animals' health. The biochemically and functionally specified potential for optimal alternative use of the rice straw of 13 most widely produced rice varieties from Haryana's eastern and western agro-climate zones was undertaken. Pusa-1401 variety had the highest cellulose (46.55%) and silica content (13.70%), while Pusa-1718 had hemicellulose (28.25%) and lignin (11.60%), respectively. Maximum nitrogen (0.81%), phosphorus (0.32%) and potassium (2.78%) were found in rice variety Pusa-1509, Pusa-1401 and Rice-6129. The findings seemed to be statistically significant (p < 0.05). The biochemical profiles of rice straw cultivars were classified into distinct structural groups (C-H alkalanes, O-H alcohol, C[bond, double bond]O, C-H alkanes) based on the FTIR spectrum in order to find the best alternative possibilities for bioethanol and compost production. According to the study, these rice straw varieties could be used to make lucrative industrial products.

Biostimulation of Anaerobic Digestion Using Iron Oxide Nanoparticles (IONPs) for Increasing Biogas Production from Cattle Manure.

The effect of synthesised IONPs employing a nontoxic leaf extract of Azadirachta indica as a reducing, capping, and stabilizing agent for increasing biogas and methane output from cattle manure during anaerobic digestion (AD) was investigated in this study. Furthermore, the UV-visible spectra examination of the synthesized nanoparticles revealed a high peak at 432 nm. Using a transmission electron microscope, the average particle size of IONPs observed was 30-80 nm, with irregular, ultra-small, semi-spherical shapes that were slightly aggregated and well-distributed. IONPs had a polydisparity index (PDI) of 219 nm and a zeta potential of -27.0 mV. A set of six bio-digesters were fabricated and tested to see how varying concentrations of IONPs (9, 12, 15, 18, and 21 mg/L) influenced biogas, methane output, and effluent chemical composition from AD at mesophilic temperatures (35 ± 2 °C). With 18 mg/L IONPs, the maximum specific biogas and methane production were 136.74 L/g of volatile solids (VS) and 64.5%, respectively, compared to the control (p < 0.05), which provided only 107.09 L/g and 51.4%, respectively. Biogas and methane production increased by 27.6% and 25.4%, respectively using 18 mg/L IONPs as compared to control. In all treatments, the pH of the effluent was increased, while total volatile fatty acids, total solids, volatile solids, organic carbon content, and dehydrogenase activity decreased. Total solid degradation was highest (43.1%) in cattle manure + 18 mg/L IONPs (T5). According to the results, the IONPs enhanced the yield of biogas and methane when compared with controls.

Neural Mechanisms Underlying Breast Cancer Related Fatigue: A Systematic Review of Neuroimaging Studies.

Introduction: Fatigue and cognitive dysfunction commonly co-occur in breast cancer patients and survivors. However, the underlying neural mechanism is not clear. We performed a systematic review of studies that used neuroimaging methods to investigate structural and functional changes in the brain associated with fatigue in breast cancer patients and survivors. Methods: We searched PubMed, Scopus, EmBase, and Cochrane CENTRAL from January 2009 to May 2021 for studies that reported brain neuroimaging findings in relationship to fatigue in breast cancer patients or survivors. Neuroimaging methods included magnetic resonance imaging (MRI), positron emission tomography (PET), and electroencephalogram (EEG). We summarized structural and functional neuroimaging changes associated with fatigue. Results: Of the 176 articles retrieved, ten MRI studies reported neuroimaging findings in relationship to fatigue. Together these studies compared 385 breast cancer patients or survivors to 205 controls. Fatigue was associated with reduced white matter integrity and increased glutamate in the insula but changes in gray matter volume were not associated with fatigue score. Nine of the ten studies found significant associations between fatigue and functional changes in the frontoparietal cortex. In response to memory and planning tasks, fatigue was associated with increased activations in several regions of the frontoparietal cortex, however, overall performance on tasks was not reduced. Fatigue was also associated with extensive changes in the connectivity of brain networks that filter endogenous signals (salience network), internal attention (default mode network), and external attention (dorsal attention network). Subcortical regions associated with fatigue included insula (interoception), superior colliculus (sleep regulation), and thalamus (alertness). Functional brain changes before initiation of chemotherapy were a better predictor of post-treatment fatigue than chemotherapy itself. Conclusions: Fatigue in breast cancer is associated with widespread functional changes of brain regions and networks that affect executive function including memory, planning, internal and external attention. Observed changes likely represent a compensatory mechanism through which breast cancer patients and survivors try to maintain adequate executive function. Breast cancer patients scheduled to undergo chemotherapy are at high risk for developing fatigue even before the start of treatment.

Quantitative Changes in Cerebral Perfusion during Urinary Urgency in Women with Overactive Bladder.

PURPOSE: To quantitatively measure changes in cerebral perfusion in select regions of interest in the brain during urinary urgency in women with overactive bladder (OAB) using arterial spin labeling (ASL). METHODS: Twelve women with OAB and 10 controls underwent bladder filling and rated urinary urgency (scale 0-10). ASL fMRI scans were performed (1) in the low urgency state after voiding and (2) high urgency state after drinking oral fluids. Absolute regional cerebral blood flow (rCBF) in select regions of interest was compared between the low and high urgency states. RESULTS: There were no significant differences in rCBF between the low and high urgency states in the control group. In the OAB group, rCBF (mean ± SE, ml/100 g/min) increased by 10-14% from the low to the high urgency state in the right anterior cingulate cortex (ACC) (44.56 ± 0.59 versus 49.52 ± 1.49, p < 0.05), left ACC (49.29 ± 0.85 versus 54.02 ± 1.46, p < 0.05), and left insula (50.46 ± 1.72 versus 54.99 ± 1.09, p < 0.05). Whole-brain analysis identified additional areas of activation in the right insula, right dorsolateral prefrontal cortex, and pons/midbrain area. CONCLUSIONS: Urinary urgency is associated with quantitative increase in cerebral perfusion in regions of the brain associated with processing emotional response to discomfort.