Practice makes the expert: The importance of training volunteers in the generation of phenological data from photographs of biodiversity observation platforms.

Phenology studies the time at which events in the life cycle of a species occur sand how they are related to environmental cues. Patterns of change in phenology at different scales can be used as an indicator of ecosystem changes and climate change, but the data necessary to detect these changes can be difficult to obtain due to their temporal and regional dimensions. Citizen science can contribute to generate large amounts of data on phenological changes at wide geographical scales that would be almost impossible for professional scientists to generate, but the quality and reliability of these data are often questioned. The objective of this study was to evaluate the use of a biodiversity observation citizen science platform based on photographic information as a potential source of large-scale phenological information, and to identify the key benefits and limitations of this type of information source. We used the Naturalista photographic databases for two invasive species in a tropical region: Leonotis nepetifolia and Nicotiana glauca. The photographs were classified into different phenophases (initial growth, immature flower, mature flower, dry fruit) by three groups of volunteers: a group of experts, a trained group with information on the biology and phenology of both species, and an untrained group. The degree of reliability of the phenological classifications was estimated for each group of volunteers and each phenophase. The degree of reliability of the phenological classification of the untrained group was generally very low for all phenophases. The group of trained volunteers showed accuracy levels for the reproductive phenophases that equaled the degree of reliability among the expert group, regardless of species, and was consistent across phenophases. We conclude that volunteer classification of photographic information contained in biodiversity observation platforms can provide phenological information with high geographic coverage and an increasing temporal coverage on general phenological patterns of species with wide distributions but has limited applicability in the identification of exact start and end dates. and peaks of the different phenophases.

The Rationale for Photobiomodulation Therapy of Vaginal Tissue for Treatment of Genitourinary Syndrome of Menopause: An Analysis of Its Mechanism of Action, and Current Clinical Outcomes.

Objective: Light, particularly in the visible to far-infrared spectrum, has been applied to the female genital tract with lasers and other devices for nearly 50 years. These have included procedures on both normal and neoplastic tissues, management of condylomata, endometriosis, and menometrorrhagia, and, more recently, a number of fractional laser devices have been applied for the management of genitourinary syndrome of menopause (GSM) and stress urinary incontinence (SUI), and to achieve so-called vaginal rejuvenation. Photobiomodulation therapy (PBMT) has been proposed as an alternative for use in managing GSM and SUI. Methods: This article reviews the biological basis, symptoms, and management of GSM, and investigates the current status and rationale for the use of PBMT. Results and conclusions: Based on the preliminary evidence available, PBMT is safe and appears to be efficacious in treating GSM.

Multimodal vaginal toning for bladder symptoms and quality of life in stress urinary incontinence.

INTRODUCTION AND HYPOTHESIS: Treatment options for women with stress urinary incontinence (SUI) have limitations. We hypothesized that multimodal vaginal toning therapy would improve bladder symptoms and quality of life in women with postpartum SUI and sexual function complaints. METHODS: Patients self-administered 24 sessions of multimodal vaginal toning therapy lasting 10 min each over 50 days. Outcomes included 1-h pad weight test, Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Female Sexual Distress Scale-Revised 2005 (FSDS-R), Female Sexual Function Index (FSFI), pelvic floor muscle strength, patient satisfaction, and adverse events. RESULTS: Of the 55 patients enrolled (safety population), 48 completed the study per-protocol (PP population). A total of 38 (79%) patients had a positive 1-h pad weight test at baseline. In this group, urine leakage was moderate or severe in 82% of patients at baseline, but in only 18% after treatment. Treatment success was 84%, defined as >50% improvement in pad weight relative to baseline. In the PP population, mean UDI-6 score improved by 50% (p < 0.001) and IIQ-7 score improved by 69% (p < 0.001). Sexual function quality of life improved by 54% for FSDS-R and 15% for FSFI (both p < 0.001). Pelvic floor muscle strength significantly improved (p < 0.001). Patient satisfaction with therapy was reported in 83% of patients. In the safety population, 2 (3.6%) adverse events were reported-1 urinary tract infection and 1 report of discomfort due to excessive warmth. CONCLUSIONS: Multimodal vaginal toning therapy yields clinically meaningful improvements in bladder symptoms, pelvic floor muscle strength, and quality of life in women with SUI.

Evaluation of postoperative fever: usefulness and cost-effectiveness of routine workup.

OBJECTIVE: This study was undertaken to determine which investigative tools are of most clinical benefit in a routine postoperative fever workup and to describe which postoperative patients require closer investigation at the time of fever. STUDY DESIGN: We performed a retrospective analysis of 676 patients undergoing exploratory laparotomy for a gynecologic condition who had a fever of 38.0 degrees C (100.4 degrees F) or higher. Charts were reviewed for independent variables related to their diagnosis and surgery in addition to any workup for fever. An estimate of the total charge of a routine workup was performed. Statistical analysis was performed with SPSS for Windows, version 10.1. RESULTS: We found 194 patients (29%) had a postoperative temperature of 38.0 degrees C or higher. A laboratory/radiographic workup for the fever was performed in 119 women (61%). Only 15% of urinalyses, 14% of urine cultures, 7% of blood cultures, 14% of chest radiographs, and 17% of sputum cultures were positive. There were several significant differences between those with and without serious infections that can guide management of postoperative patients. The total charge for laboratory/radiographic workup was 48,432 US dollars or 2201 US dollars per serious infection diagnosed. CONCLUSION: Approximately 29% of women undergoing laparotomy by gynecologists have a fever of 38.0 degrees C (100.4 degrees F) or higher. We found the majority of fever workups were of low clinical yield and added moderate cost. Significant infection is associated with surgery for malignancy, bowel resection, number of febrile days, higher fever, and moderately increased white blood cell count. Only patients with these characteristics are most likely to benefit from laboratory and/or radiographic workup of fever.