Vibrational Coupling Infrared Nanocrystallography.

Coupling between molecular vibrations leads to collective vibrational states with spectral features sensitive to local molecular order. This provides spectroscopic access to the low-frequency intermolecular energy landscape. In its nanospectroscopic implementation, this technique of vibrational coupling nanocrystallography (VCNC) offers information on molecular disorder and domain formation with nanometer spatial resolution. However, deriving local molecular order relies on prior knowledge of the transition dipole magnitude and crystal structure of the underlying ordered phase. Here we develop a quantitative model for VCNC by relating nano-FTIR collective vibrational spectra to the molecular crystal structure from X-ray crystallography. We experimentally validate our approach at the example of a metal organic porphyrin complex with a carbonyl ligand as the probe vibration. This framework establishes VCNC as a powerful tool for measuring low-energy molecular interactions, wave function delocalization, nanoscale disorder, and domain formation in a wide range of molecular systems.

Long Excited-State Lifetimes in Three-Coordinate Copper(I) Complexes via Triplet-Triplet Energy Transfer to Pyrene-Decorated Isocyanides.

There has been much effort to improve excited-state lifetimes in photosensitizers based on earth-abundant first-row transition metals. Copper(I) complexes have gained significant attention in this field, and in most cases, sterically driven approaches are used to optimize their lifetimes. This study presents a series of three-coordinate copper(I) complexes (Cu1-Cu3) where the excited-state lifetime is extended by triplet-triplet energy transfer. The heteroleptic compounds feature a cyclohexyl-substituted ß-diketiminate (CyNacNacMe) paired with aryl isocyanide ligands, giving the general formula Cu(CyNacNacMe)(CN-Ar) (CN-dmp = 2,6-dimethylphenyl isocyanide for Cu1; CN-pyr = 1-pyrenyl isocyanide for Cu2; CN-dmp-pyr = 2,6-dimethyl-4-(1-pyrenyl)phenyl isocyanide for Cu3). The nature, energies, and dynamics of the low-energy triplet excited states are assessed with a combination of photoluminescence measurements at room temperature and 77 K, ultrafast transient absorption (UFTA) spectroscopy, and DFT calculations. The complexes with the pyrene-decorated isocyanides (Cu2 and Cu3) exhibit extended excited-state lifetimes resulting from triplet-triplet energy transfer (TTET) between the short-lived charge-transfer excited state (3CT) and the long-lived pyrene-centered triplet state (3pyr). This TTET process is irreversible in Cu3, producing exclusively the 3pyr state, and in Cu2, the 3CT and 3pyr states are nearly isoenergetic, enabling reversible TTET and long-lived 3CT luminescence. The improved photophysical properties in Cu2 and Cu3 result in improvements in activity for both photocatalytic stilbene E/Z isomerization via triplet energy transfer and photoredox transformations involving hydrodebromination and C-O bond activation. These results illustrate that the extended excited-state lifetimes achieved through TTET result in newly conceived photosynthetically relevant earth-abundant transition metal complexes.

Early events in the mechanism of single-source chemical vapor deposition of zirconium and hafnium diboride: a computational investigation.

Chemical vapor deposition (CVD) of group 4 metal-diboride ceramics from a single source is a versatile technique that finds many applications from hypersonic flight to microelectronics. Though the kinetics of CVD have been studied extensively-allowing significant process improvements-a mechanistic understanding of the process has yet to be attained. Computations suggest two plausible reaction pathways-one higher-energy and the second lower-that correlate well with experimental results reported in the literature, explaining phenomena such as high-temperature deposition resulting in films overstoichiometric in boron. These insights offer a new perspective that may be instrumental in the rational design of new precursors for single-source CVD.

Enhanced Deep-Red Phosphorescence in Cyclometalated Iridium Complexes with Quinoline-Based Ancillary Ligands.

Compounds with good photoluminescence quantum yields (ΦPL) in the deep-red to near-infrared parts of the spectrum are desired for a variety of applications in optoelectronics, imaging, and sensing. However, in this region of the spectrum, quantum yields are usually modest, which is explained by the energy gap law and the inherently slower radiative decay rates for low-energy emitters according to the second-order perturbation theory. In this work, we outline a new direction in deep-red luminescence, introducing a new suite of bis-cyclometalated iridium complexes with efficient luminescence beyond 650 nm. Seven new complexes are prepared using two different cyclometalating (C^N) ligands with four quinoline-derived ancillary ligands (L^X). The chosen cyclometalating ligands are well-established to produce deep-red phosphorescence and include a metalated phenyl ring appended to a conjugated heterocycle. The ancillary ligands combine a rigid quinoline or benzoquinoline "L" donor with a variable anionic "X" donor comprised of an O-donor aryloxy or carboxylate or an N-donor amidate. These complexes phosphoresce in the deep-red region with wavelengths between 650 and 700 nm and solution quantum yields between 0.018 and 0.42.

Vibrational exciton nanoimaging of phases and domains in porphyrin nanocrystals.

Much of the electronic transport, photophysical, or biological functions of molecular materials emerge from intermolecular interactions and associated nanoscale structure and morphology. However, competing phases, defects, and disorder give rise to confinement and many-body localization of the associated wavefunction, disturbing the performance of the material. Here, we employ vibrational excitons as a sensitive local probe of intermolecular coupling in hyperspectral infrared scattering scanning near-field optical microscopy (IR s-SNOM) with complementary small-angle X-ray scattering to map multiscale structure from molecular coupling to long-range order. In the model organic electronic material octaethyl porphyrin ruthenium(II) carbonyl (RuOEP), we observe the evolution of competing ordered and disordered phases, in nucleation, growth, and ripening of porphyrin nanocrystals. From measurement of vibrational exciton delocalization, we identify coexistence of ordered and disordered phases in RuOEP that extend down to the molecular scale. Even when reaching a high degree of macroscopic crystallinity, identify significant local disorder with correlation lengths of only a few nanometers. This minimally invasive approach of vibrational exciton nanospectroscopy and -imaging is generally applicable to provide the molecular-level insight into photoresponse and energy transport in organic photovoltaics, electronics, or proteins.

Three-Electron Nickel(I)/Nickel(0) Half-Bond.

An (N-heterocyclic carbene)nickel(I) cation precursor reacts with the corresponding nickel(0) complex to form a dinickel(I,0) monocation. The Ni···Ni distance in this cation is 0.93 Å shorter than in the analogous dinickel(0) complex. Although the solid-state structure shows equivalent Ni centers, density functional theory calculations indicate significant electronic localization. Reactions with CO and NO form mononuclear carbonyl and nitrosyl complexes. Oxidative addition of an aryl bromide results in C-arylation of the carbene ligands.

Synthetically Tunable White-, Green-, and Yellow-Green-Light Emission in Dual-Luminescent Gold(I) Complexes Bearing a Diphenylamino-2,7-fluorenyl Moiety.

The syntheses and photophysical characterization of five new gold(I) complexes bearing diphenylamine-substituted fluorenyl moieties are reported; four are characterized by X-ray diffraction crystallography. Ancillary ligation on gold(I) is provided by organophosphine and N-heterocyclic carbene ligands. Two complexes, Au-DPA0 and Au-DPA1, are σ-aryls, two, Au-ADPA0 and Au-ADPA1, are σ-alkynyls, and one, Au-TDPA1, is a σ-triazolyl bound through carbon. All complexes show vibronically structured absorption and luminescence bands that are assignable to π-π* transitions localized on the diphenylamine-substituted fluorenyl π system. The excited-state dynamics of all five chromophores are governed by selection of the ancillary ligand and σ attachment of the diphenylamine-substituted fluorenyl moiety. All of these chromophores are dual luminescent in a toluene solution at 298 K. The luminescence from the aryl derivatives, Au-ADPA0 and Au-DPA1, appears green. The alkynyl derivative containing a phosphine ancillary ligand, Au-ADPA0, is a white-light emitter, while the alkynyl derivative containing an N-heterocyclic carbene ancillary ligand, Au-ADPA1, is a yellow-light emitter. The luminescence from the triazolyl-linked chromophore, Au-TDPA1, appears as yellow-green. Spin-restricted density functional theory calculations support the assignments of ligand-centric optical transitions but with contributions of ligand-to-metal charge transfer involving the vacant Au 6p orbital.

2D Vibrational Exciton Nanoimaging of Domain Formation in Self-Assembled Monolayers.

Order, disorder, and domains affect many of the functional properties in self-assembled monolayers (SAMs). However, carrier transport, wettability, and chemical reactivity are often associated with collective effects, where conventional imaging techniques have limited sensitivity to the underlying intermolecular coupling. Here we demonstrate vibrational excitons as a molecular ruler of intermolecular wave function delocalization and nanodomain size in SAMs. In the model system of a 4-nitrothiophenol (4-NTP) SAM on gold, we resolve coupling-induced peak shifts of the nitro symmetric stretch mode with full spatio-spectral infrared scattering scanning near-field optical microscopy. From modeling of the underlying 2D Hamiltonian, we infer domain sizes and their distribution ranging from 3 to 12 nm across a field of view on the micrometer scale. This approach of vibrational exciton nanoimaging is generally applicable to study structural phases and domains in SAMs and other molecular interfaces.

Phylogenetics Identifies Two Eumetazoan TRPM Clades and an Eighth TRP Family, TRP Soromelastatin (TRPS).

Transient receptor potential melastatins (TRPMs) are most well known as cold and menthol sensors, but are in fact broadly critical for life, from ion homeostasis to reproduction. Yet, the evolutionary relationship between TRPM channels remains largely unresolved, particularly with respect to the placement of several highly divergent members. To characterize the evolution of TRPM and like channels, we performed a large-scale phylogenetic analysis of >1,300 TRPM-like sequences from 14 phyla (Annelida, Arthropoda, Brachiopoda, Chordata, Cnidaria, Echinodermata, Hemichordata, Mollusca, Nematoda, Nemertea, Phoronida, Priapulida, Tardigrada, and Xenacoelomorpha), including sequences from a variety of recently sequenced genomes that fill what would otherwise be substantial taxonomic gaps. These findings suggest: 1) the previously recognized TRPM family is in fact two distinct families, including canonical TRPM channels and an eighth major previously undescribed family of animal TRP channel, TRP soromelastatin; 2) two TRPM clades predate the last bilaterian-cnidarian ancestor; and 3) the vertebrate-centric trend of categorizing TRPM channels as 1-8 is inappropriate for most phyla, including other chordates.

An effective one-dimensional approach to calculating mean first passage time in multi-dimensional potentials.

Thermally activated escape processes in multi-dimensional potentials are of interest to a variety of fields, so being able to calculate the rate of escape-or the mean first-passage time (MFPT)-is important. Unlike in one dimension, there is no general, exact formula for the MFPT. However, Langer's formula, a multi-dimensional generalization of Kramers's one-dimensional formula, provides an approximate result when the barrier to escape is large. Kramers's and Langer's formulas are related to one another by the potential of mean force (PMF): when calculated along a particular direction (the unstable mode at the saddle point) and substituted into Kramers's formula, the result is Langer's formula. We build on this result by using the PMF in the exact, one-dimensional expression for the MFPT. Our model offers better agreement with Brownian dynamics simulations than Langer's formula, although discrepancies arise when the potential becomes less confining along the direction of escape. When the energy barrier is small our model offers significant improvements upon Langer's theory. Finally, the optimal direction along which to evaluate the PMF no longer corresponds to the unstable mode at the saddle point.

A systematic review of English language patient-reported outcome measures for use in urogynaecology and female pelvic medicine.

INTRODUCTION: Patient-reported outcome measures (PROMs) are widely used in clinical practice and research in urogynaecology. There is no consensus on which PROMs should be used. No unifying document identifies all available PROMs and compares the psychometric properties of these. METHODS: Systematic review of the literature following PRISMA guidelines. Studies where women had been administered an English-language PROM which assessed pelvic-floor symptomatology and psychometric properties had been reported were included. RESULTS: 85 PROMs assessing pelvic-floor symptoms in a urogynaecology population were identified. 43 PROMs assessed lower urinary tract symptoms in 95 studies, four PROMS assessed vaginal symptoms in seven studies, 20 PROMs assessed bowel symptoms in 27 studies and three PROMs assessed sexual symptoms in seven studies. 15 PROMs assessed two or more of these symptom areas in 60 studies. PROMs with the with the best available psychometric evidence within these five areas were (urinary symptoms) the Incontinence Quality-of-Life questionnaire (I-QOL aka ICIQ-UIqol) and International Consultation on Incontinence Questionnaire (ICIQ-UI-SF), (bowel symptoms) the Accidental Bowel Leakage Evaluation (ABLE) questionnaire and the International Consultation on Incontinence Bowel questionnaire (ICIQ-B), (vaginal symptoms) the Pelvic Organ Prolapse Symptom Score (POPSS), (sexual symptoms) the Pelvic organ prolapse- urinary Incontinence Sexual function Questionnaire- IUGA revised (PISQ-IR) and (comprehensive PROMs) the Australian Pelvic Floor Questionnaire and the Electronic Personal Assessment Questionnaire-Pelvic-Floor (ePAQ-PF). CONCLUSIONS: Multiple PROMs with robust psychometric properties are available. Some widely used PROMs have weak evidence. Formal recommendations on which English-language PROMs to use within clinical practice and research in urogynaecology are required.

Two-photon absorption characterization and comparison of Au(I) fluorenyl benzothiazole complexes in the visible wavelength regime.

We use the two-photon excited fluorescence method to determine the two-photon absorption (2PA) cross sections of three series of (fluorenyl benzothiazole) gold(I) complexes in the visible wavelength range from 570 to 700 nm. We compare the effect of ancillary ligand substitutions on the 2PA magnitudes and find that the ancillary ligand does not drastically affect either the magnitude or the shape of 2PA. Even so, moderate 2PA cross sections were measured that ranged from 10 to 1000 s of GM (Göppert-Mayer, =10-50cm4s/photon), making these types of complexes nonlinear optical materials for two-photon absorbing applications.

Room-Temperature Phosphorescent Platinum(II) Alkynyls with Microsecond Lifetimes Bearing a Strong-Field Pincer Ligand.

The use of organometallic triplet emitters in organic light emitting diodes (OLEDs) is motivated by the premise of efficient intersystem crossing leading to unit internal quantum efficiencies. However, since most devices are based on solid-state components, an inherent limitation to square-planar platinum(II) phosphors is their tendency toward aggregation-based quenching. Here, a new class of emissive, four-coordinate PtII species based on the bisimidazolyl carbazolide (BIMCA) ligand is introduced, which displays highly efficient, long-lived solid-state phosphorescence at room temperature. A set of four BIMCAPt phenyl acetylides were synthesized that emit in the green (λmax =507-540 nm) with >60 % quantum yield and millisecond lifetimes. The structures of the resulting species reveal a non-planar structure imposed by steric clashes between BIMCA and the iodo or alkynyl co-ligand. Ground-state and photophysical characterization are presented. Density functional theory calculations indicate that the BIMCA ligand dominates the frontier orbitals along with the first Franck-Condon singlet and triplet excited states.

Synthesis and photophysics of gold(i) alkynyls bearing a benzothiazole-2,7-fluorenyl moiety: a comparative study analyzing influence of ancillary ligand, bridging moiety, and number of metal centers on photophysical properties.

Three new gold(i) alkynyl complexes (Au-ABTF(0-2)) containing a benzothiazole fluorenyl moiety, with either an organic phosphine or N-heterocyclic carbene as ancillary ligand, have been synthesized and photophysically characterized. All three complexes display highly structured ground-state absorption and luminescence spectra. Dual-luminescence is observed in all three complexes at room temperature in toluene after three freeze-pump-thaw cycles. The phosphine complexes (Au-ABTF(0-1)) exhibit similar photophysics with fluorescent quantum yields ∼0.40, triplet-state quantum yields ∼0.50, and fluorescent lifetimes ∼300 ps. The carbene complex Au-ABTF2 displays different behavior; having a fluorescent quantum yield of 0.23, a triplet-state quantum yield of 0.61, and a fluorescent lifetime near 200 ps, demonstrating that the ancillary ligand alters excited-state dynamics. The compounds exhibit strong (on the order of 105 M-1 cm-1) and positive excited-state absorption in both their singlet and triplet excited states spanning the visible region. Delayed fluorescence resulting from triplet-triplet annihilation is also observed in freeze-pump-thaw deaerated samples of all the complexes in toluene. DFT calculations (both static and time-resolved) agree with the photophysical data where phosphine complexes have slightly larger S1-T2 energy gaps (0.28 eV and 0.26 eV) relative to the carbene complex (0.21 eV). Comparison of the photophysical properties of Au-ABTF(0-2) to previously published dinuclear gold(i) complexes and mononuclear gold(i) aryl complexes bearing the same benzothiazole-2,7-fluorenyl moiety are made. Structure-property relationships regarding ancillary ligand, bridging moiety, and number of metal centers are drawn.

Development and initial psychometric testing of a body-image domain within an electronic pelvic floor questionnaire (ePAQ-pelvic floor).

INTRODUCTION: Urogynaecological conditions have been shown to negatively impact on body image in a number of previous studies. ePAQ-Pelvic Floor (ePAQ-PF) is a patient-reported outcome measure used in clinical practice to assess urogynaecological conditions and their impact on quality of life. This study aimed to develop and undertake initial psychometric testing of a new domain to assess urogynaecological body image within ePAQ-PF. METHODS: A patient involvement group, analysis of free-text data from ePAQ-PF and a systematic review of existing PROMs assessing urogynaecological body image informed the content of a new body-image domain within ePAQ-PF. This was administered to 208 patients who consented to the use of their anonymised ePAQ-PF responses for research purposes. These data underwent factor analysis, internal consistency reliability and item-total correlation testing. Evidence-based hypotheses were formulated to test construct validity. Criterion validity was assessed against the Body-image Scale (BIS). Patients completed a separate questionnaire (QQ-11) to measure the face validity of ePAQ-PF. RESULTS: Factor analysis revealed a four-item body-image domain with good internal consistency reliability (Cronbach's α = 0.899) and item-total correlation (Spearman's rank r > 0.40). ePAQ-PF body-image domain scores correlated significantly with the BIS scores (r = 0.501). Age, prolapse, sexual dysfunction, pelvic pain and urinary incontinence scores correlated significantly with body-image domain score. QQ-11 value scores demonstrated good acceptability. CONCLUSIONS: Body-image assessment should form part of routine care in urogynaecology. Preliminary results support the validity, reliability and functionality of the body-image domain in ePAQ-PF. Further psychometric testing of this is required, including tests of responsiveness and stability.

Evidence for the urogynaecology multidisciplinary team meeting: evaluation from a secondary care perspective.

INTRODUCTION: Urogynaecology multidisciplinary team (MDT) meetings to discuss management plans prior to invasive treatments for urinary incontinence have been recommended by guidelines in the UK since 2013. Evidence for MDT discussion in urogynaecology is lacking, with only two published studies. The aim of this study was to evaluate the cases discussed at a secondary care urogynaecology MDT meeting, to establish types of clinical problems discussed, assess the outcomes of the MDT meeting and compare this with existing evidence for MDT meetings in urogynaecology. METHODS: A retrospective review of meeting minutes and all case notes for patients discussed at 12 MDT meetings over 13 months was carried out. Data collected included attendance from different staff groups, reasons for referral, outcome of discussions, and changes to management plans. RESULTS: A total of 123 cases were discussed over 12 meetings, 7 members of staff attended each meeting on average. 63% of cases were referred for discussion of a primary problem. The majority of patients were referred for discussion of management of urinary incontinence prior to invasive procedures (57%). The agreed MDT plan corresponded with proposed management in 67% of cases, with changes to management plan in 31% of cases. CONCLUSION: Refinements to management plans in this study highlight the importance of MDT input in urogynaecology care and mirror the findings of two previous studies. Evidence for improved outcomes and the cost-effectiveness of MDTs is lacking and is an area for future research. Expanded national guidance for urogynaecology MDTs is likely to require local and regional restructuring of these in the UK.

Simultaneous-count models to estimate abundance from counts of unmarked individuals with imperfect detection.

We developed a method to estimate population abundance from simultaneous counts of unmarked individuals over multiple sites. We considered that at each sampling occasion, individuals in a population could be detected at 1 of the survey sites or remain undetected and used either multinomial or binomial simultaneous-count models to estimate abundance, the latter being equivalent to an N-mixture model with one site. We tested model performance with simulations over a range of detection probabilities, population sizes, growth rates, number of years, sampling occasions, and sites. We then applied our method to 3 critically endangered vulture species in Cambodia to demonstrate the real-world applicability of the model and to provide the first abundance estimates for these species in Cambodia. Our new approach works best when existing methods are expected to perform poorly (i.e., few sites and large variation in abundance among sites) and if individuals may move among sites between sampling occasions. The approach performed better when there were >8 sampling occasions and net probability of detection was high (>0.5). We believe our approach will be useful in particular for simultaneous surveys at aggregation sites, such as roosts. The method complements existing approaches for estimating abundance of unmarked individuals and is the first method designed specifically for simultaneous counts.

Modelos de Conteo Simultáneo para Estimar la Abundancia a partir de Conteos de Individuos No Marcados con Detección Imperfecta Resumen Desarrollamos un método para estimar la abundancia poblacional a partir de conteos simultáneos de individuos sin marcaje en múltiples sitios. Consideramos que en cada ocasión de muestreo los individuos de una población podrían ser detectados en uno de los sitios de censos o podrían permanecer sin ser detectados y usamos modelos de conteo simultáneo multinomial o binomial para estimar la abundancia, con el binomial como equivalente a un modelo de mezcla N con un solo sitio. Probamos el desempeño del modelo con simulaciones en un rango de probabilidades de detección, tamaños poblacionales, tasas de crecimiento, número de años, ocasiones de muestreo, y sitios. Después aplicamos nuestro método a tres especies de buitre que se encuentran en peligro crítico en Camboya para demostrar cuán aplicable es el modelo en el mundo real y para proporcionar las primeras estimaciones de abundancia para estas especies en Camboya. Nuestra nueva estrategia trabaja de mejor manera cuando se espera que los modelos existentes tengan un desempeño pobre (es decir, pocos sitios y una gran variación en la abundancia entre sitios) y si los individuos podrían moverse de un sitio a otro entre cada ocasión de muestreo. La estrategia tuvo un mejor desempeñó cuando hubo >8 ocasiones de muestreo y la probabilidad neta de detección fue alta (>0.5). Creemos que nuestra estrategia será especialmente útil para censos simultáneos en sitios de agregación, como los nidos. El método complementa las estrategias existentes para estimar la abundancia de individuos sin marcaje y es el primer método diseñado específicamente para conteos simultáneos.

What are the concerns and goals of women attending a urogynaecology clinic? Content analysis of free-text data from an electronic pelvic floor assessment questionnaire (ePAQ-PF).

INTRODUCTION AND HYPOTHESIS: Understanding patients' concerns and goals is essential for providing individualised care in urogynaecology. The study objectives were to undertake a content analysis of free-text concerns and goals recorded by patients using an electronic pelvic-floor questionnaire (ePAQ-PF) and measure how these related to self-reported symptom and health-related quality-of-life (HRQOL) data also recorded using ePAQ-PF. METHODS: A total of 1996 consenting patients completed ePAQ-PF. Content analysis was undertaken of free-text responses to the item: 'Considering the issues that currently concern you the most, what do you hope to achieve from any help, advice or treatment?' Key content themes were identified by the lead researcher, and three researchers read and coded all recorded responses. Student's t test was used to compare ePAQ-PF domain scores for patients reporting concerns in the relevant domain with those who did not. RESULTS: In total, 63% of participants who completed the questionnaire, recorded at least one free-text item. Content analysis identified 1560 individual concerns coding into the 19 ePAQ-PF domains. Symptom scores were significantly higher for patients reporting free-text concerns in 18 domains (p < 0.05). Additional concerns relating specifically to body image were recorded by 11% of patients. Key areas of importance emerging for personal goals included cure/improvement, better understanding, incontinence pad use, sexual function and surgery. CONCLUSIONS: Free-text reporting in ePAQ-PF is utilised by patients and facilitates self-expression and discussion of issues impacting on HRQOL. The significant relationship between recorded free-text concerns and ePAQ-PF domain scores suggests convergent validity for the instrument. Development and psychometric testing of a domain to assess body image is proposed.

Patient-reported outcome measures which assess body image in urogynaecology patients: a systematic review.

AIM: Urogynaecological conditions can have a significant impact on body image. Patient-reported outcome measures (PROMs) are widely used in urogynaecology to assess symptoms and their impact on quality of life. This systematic review aimed to identify currently available PROMs used to assess body image within a urogynaecological population and to identify the most psychometrically robust and appropriate PROM tools to use in this context. METHODS: Ovid Medline, AMED, CINAHL, Cochrane Collaboration, EMBASE and Web of Science databases were searched from January 1966 to November 2018 to identify studies that had administered a PROM to assess body image to patients diagnosed with a urogynaecological condition. The information extracted and critically appraised included study setting, PROM instrument used and the reported psychometric properties of the PROM. RESULTS: Seventeen studies were included from 3207 screened articles. Seven different PROMs used to assess body image in a urogynaecological population were identified. Two of these PROMs (Genital Self-Image Scale-20 and Body Image in Pelvic Organ Prolapse questionnaire) had good psychometric evidence for use, but this was only in the context of women with prolapse. Evidence for validity and reliability was limited for the other five PROMs identified. CONCLUSION: Further development and psychometric testing of PROMs to assess body image in urogynaecology, for both research purposes and clinical practice, are required. Further research is also required to investigate the relationship between body image and urogynaecological symptomatology, and developing valid, reliable and functional PROMs will be integral to this.

A systematic review of non-invasive modalities used to identify women with anal incontinence symptoms after childbirth.

INTRODUCTION AND HYPOTHESIS: Anal incontinence following childbirth is prevalent and has a significant impact upon quality of life (QoL). Currently, there is no standard assessment for women after childbirth to identify these symptoms. This systematic review aimed to identify non-invasive modalities used to identify women with anal incontinence following childbirth and assess response and reporting rates of anal incontinence for these modalities. METHODS: Ovid Medline, Allied and Complementary Medicine Database (AMED), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Collaboration, EMBASE and Web of Science databases were searched for studies using non-invasive modalities published from January 1966 to May 2018 to identify women with anal incontinence following childbirth. Study data including type of modality, response rates and reported prevalence of anal incontinence were extracted and critically appraised. RESULTS: One hundred and nine studies were included from 1602 screened articles. Three types of non-invasive modalities were identified: validated questionnaires/symptom scales (n = 36 studies using 15 different instruments), non-validated questionnaires (n = 50 studies) and patient interviews (n = 23 studies). Mean response rates were 92% up to 6 weeks after childbirth. Non-personalised assessment modalities (validated and non-validated questionnaires) were associated with reporting of higher rates of anal incontinence compared with patient interview at all periods of follow-up after childbirth, which was statistically significant between 6 weeks and 1 year after childbirth (p < 0.05). CONCLUSIONS: This systematic review confirms that questionnaires can be used effectively after childbirth to identify women with anal incontinence. Given the methodological limitations associated with non-validated questionnaires, assessing all women following childbirth for pelvic-floor symptomatology, including anal incontinence, using validated questionnaires should be considered.