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Importance Physical health and psychological health represent modifiable factors in the causal pathway of lower urinary tract symptoms (LUTS). Objectives Understand the relationship between physical and psychological factors and LUTS over... more
Importance Physical health and psychological health represent modifiable factors in the causal pathway of lower urinary tract symptoms (LUTS). Objectives Understand the relationship between physical and psychological factors and LUTS over time. Study Design Adult women enrolled in the Symptoms of Lower Urinary Tract Dysfunction Research Network observational cohort study completed the LUTS Tool and Pelvic Floor Distress Inventory, including urinary (Urinary Distress Inventory), prolapse (Pelvic Organ Prolapse Distress Inventory), and colorectal anal (Colorectal-Anal Distress Inventory) subscales at baseline, 3 months, and 12 months. Physical functioning, depression, and sleep disturbance were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires; relationships were assessed using multivariable linear mixed models. Results Of 545 women enrolled, 472 had follow-up. Median age was 57 years; 61% and 78% reported stress urinary incontinence and overactive bladder, respectively; and 81% reported obstructive symptoms. The PROMIS depression scores were positively associated with all urinary outcomes (range, 2.5- to 4.8-unit increase per 10-unit increase in depression score; P < 0.01 for all). Higher sleep disturbance scores were associated with higher urgency, obstruction, LUTS Total Severity, Urinary Distress Inventory, and Pelvic Floor Distress Inventory (1.9- to 3.4-point increase per 10-unit increase, all P < 0.02). Better physical functioning was associated with less severe urinary symptoms except stress urinary incontinence (2.3- to 5.2-point decrease per 10-unit increase, all P < 0.01). All symptoms decreased over time; however, no association was detected between baseline PROMIS scores and trajectories of LUTS over time. Conclusions Nonurologic factors demonstrated small to medium cross-sectional associations with urinary symptom domains, but no significant association was detected with changes in LUTS. Further work is needed to determine whether interventions targeting nonurologic factors reduce LUTS in women.
Objectives:To describe the distribution of post-void residual (PVR) volumes across patients with and without lower urinary tract symptoms (LUTS) and examine relationships between self-reported voiding symptoms, storage symptoms, and... more
Objectives:To describe the distribution of post-void residual (PVR) volumes across patients with and without lower urinary tract symptoms (LUTS) and examine relationships between self-reported voiding symptoms, storage symptoms, and PVR.Methods:PVR and demographic data were obtained from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) observational cohort study. Selfreported symptoms were collected using the American Urological Association Symptom Index (AUA-SI) and the LUTS Tool. PVR values were obtained from two other cohorts:living kidney donors with unknown LUTS from the Renal and Lung Living Donors Evaluation Study (RELIVE), and continent women in the Establishing the Prevalence of Incontinence (EPI) study, a population-based study of racial differences in urinary incontinence prevalence.Results:Across the three studies, median PVRs were similar: 26mL in LURN (n=880, range 0–932mL), 20mL in EPI (n=166, range 0–400mL), and 14mL in RELIVE (n=191, range 0–352mL). In LURN, males had 3.6 times higher odds of having PVR>200mL (95% CI=1.72–7.48). In RELIVE, median PVR was significantly higher for males (20mL vs. 0mL, p=0.004). Among women, only the intermittency severity rating was associated with a probability of an elevated PVR. Among men, incomplete emptying and burning severity rating were associated with a higher odds of elevated PVR, but urgency severity ratings were associated with lower odds of elevated PVR.Conclusions:Care-seeking patients have PVRs similar to those in people with unknown history of LUTS (RELIVE) and without self-reported LUTS (EPI). Although PVR was correlated with voiding symptoms, the mean differences only explain ~2% of the variance.
INTRODUCTION AND OBJECTIVE:Lower urinary tract symptoms (LUTS) are highly prevalent, decrease health-related quality of life (QOL), and are costly to treat. It is useful to consider storage symptom...
Background & Aims:Detailed investigation of the biological pathways leading to hepatic fibrosis and identification of liver fibrosis biomarkers may facilitate early interventions for pediatric cholestasis.Approach &... more
Background & Aims:Detailed investigation of the biological pathways leading to hepatic fibrosis and identification of liver fibrosis biomarkers may facilitate early interventions for pediatric cholestasis.Approach & Results:A targeted ELISA-based panel of 9 biomarkers (lysyl oxidase (LOX), tissue inhibitor matrix metalloproteinase 1 (TIMP1), connective tissue growth factor (CTGF), interleukin-8 (IL-8), endoglin, periostin, mac-2-binding protein (mac2-BP), matrix metalloproteinase-3 and −7 (MMP-3, MMP-7) was examined in children with biliary atresia (BA, n=187), alpha-1 antitrypsin deficiency (A1AT, n=78) and Alagille syndrome (ALGS, n=65) and correlated with liver stiffness (LSM) and biochemical measures of liver disease. Median age and LSM were 9 years and 9.5 kPa. After adjusting for covariates, there were positive correlations between LSM and endoglin (p=0.04), IL-8 (p<0.001) and MMP-7 (p<0.001) in BA. The best prediction model for LSM in BA using clinical and lab measurements had an R2=0.437; adding IL-8 and MMP7 improved R2 to 0.523 and 0.526 (both p<0.0001). In A1AT, CTGF and LSM were negatively correlated (p=0.004); adding CTGF to a LSM prediction model improved R2 from 0.524 to 0.577 (p=0.0033). Biomarkers did not correlate with LSM in ALGS. A significant number of biomarker/lab correlations were found in BA but not A1AT or ALGS.Conclusions:Endoglin, IL-8, and MMP-7 significantly correlate with increased LSM in children with BA, while CTGF inversely correlates with LSM in A1AT; these biomarkers appear to enhance prediction of LSM beyond clinical tests. Future disease-specific investigations of change in these biomarkers over time and as predictors of clinical outcomes will be important.
... Barry L. Karger,; Frank J. Yang,; Michel Martin,; Jerry W. King,; Gary H. Thompson,; Hyung Kyu Shin,; Edward N. Fuller,; Karl-Gustav Wahlund,; Joseph A. Gardella Jr.,; Pierluigi Reschiglian,; Victor P. Andreev,; Joe Davis. Article... more
... Barry L. Karger,; Frank J. Yang,; Michel Martin,; Jerry W. King,; Gary H. Thompson,; Hyung Kyu Shin,; Edward N. Fuller,; Karl-Gustav Wahlund,; Joseph A. Gardella Jr.,; Pierluigi Reschiglian,; Victor P. Andreev,; Joe Davis. Article first published online: 7 DEC 1998. ...
<p>Results of the computer simulation of electric potential, electric field and electroosmotic flow velocity in the axisymmetric model of the cell (cylinder of 10 µm radius and 10 µm height, nucleus–sphere of 3 µm radius, located in... more
<p>Results of the computer simulation of electric potential, electric field and electroosmotic flow velocity in the axisymmetric model of the cell (cylinder of 10 µm radius and 10 µm height, nucleus–sphere of 3 µm radius, located in the center of the cylinder). Mathematical model is described by eqs. (1–6); parameters are presented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-t001" target="_blank">Table 1</a>. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g001" target="_blank">Figure 1A</a> represents electric potential (color map) and electric field strength (arrows) in the model of the polarized cell; inward current enters through the top of the cylinder and leaves the cell through the bottom of the cylinder (eq. 2). Electric potential is in the range −0.007÷−0.059 V; strong component of electric field parallel to the cylindrical surface is present. For comparison, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g001" target="_blank">Figure 1B</a> presents electric potential and field in the non-polarized cell (zero inward and outward current); here the component of electric field parallel to the surface is practically absent. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g001" target="_blank">Figure 1C</a> demonstrates electroosmotic flow circulation (color represents magnitude of the velocity, arrows represent direction) caused by electric field distribution in the polarized cell (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g001" target="_blank">Fig. 1A</a>), maximum value of fluid velocity 120 µm/s is in the vicinity of the cylindrical wall, while the average magnitude of the fluid velocity across the cytoplasm is 20 µm/s. Fluid circulates, moving downwards near the cylindrical wall and upwards near the nucleus. For comparison, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g001" target="_blank">Figure 1D</a> demonstrates that electroosmotic flow is practically absent (except the filleted corners) in the model of a non-polarized cylindrical cell, where electric field parallel to the surface is absent.</p
<p>Concentration of the fluorescently labeled protein averaged over the small cylinder near the top of the cell presented in <a... more
<p>Concentration of the fluorescently labeled protein averaged over the small cylinder near the top of the cell presented in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g005" target="_blank">Fig. 5</a>. Blue, red, and magenta curves represent recovery of the fluorescence due to pure diffusion for central (blue), biased b = 5 µm (red), and biased b = 7 µm (magenta) locations of the bleaching spot. In case of pure diffusion the time of 50% recovery does not depend on the position of the bleaching spot. On the contrary, in case of electroosmosis and diffusion, the recovery curves differ substantially for the different locations of the bleach spot: central-green, b = 5 µm -cyan, b = 7 µm-yellow. The 50% recovery time differs for these locations: 0.12 s, 0.058 s, and 0.04 s. Therefore diffusion coefficients determined from these values of recovery time might differ 3-fold as well. See text for more detailed discussion.</p
<p>The flux of the messenger proteins normal to the surface of the nucleus is integrated over this surface. Red curves present the total flux due to electroosmosis, electromigration, and diffusion. For comparison, blue curves... more
<p>The flux of the messenger proteins normal to the surface of the nucleus is integrated over this surface. Red curves present the total flux due to electroosmosis, electromigration, and diffusion. For comparison, blue curves present the flux due to pure diffusion, and green curves present the flux due to diffusion and electromigration. In <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g004" target="_blank">Figure 4A</a> messengers are initially located near the upper corner of the cell (as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g002" target="_blank">Fig. 2</a>), in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g004" target="_blank">Figure 4B</a> near the center of the cylindrical surface, in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g004" target="_blank">Figure 4C</a> at the bottom of the cylinder (as in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g003" target="_blank">Fig. 3</a>), and in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g004" target="_blank">Figure 4D</a> at the top of the cylinder. Note that everywhere, except <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0061884#pone-0061884-g004" target="_blank">Fig. 4D</a>, electroosmosis facilitates faster and more intense transport of messengers onto the surface of the nucleus. See text for more detailed discussion.</p
Research Interests:
The goal of this study was to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder... more
The goal of this study was to perform an in-depth dynamic analysis of individual bladder diaries to inform which behavioral modifications would best reduce lower urinary tract symptoms, such as frequency and urgency. Three-day bladder diaries containing data on timing, volumes, and types of fluid intake, as well as timing, volumes, and bladder sensation at voids were analyzed for 197 participants with lower urinary tract symptoms. A novel dynamic analytic approach to bladder diary time series data was proposed and developed, including intra-subject correlations between time-varying variables: rates of intake, bladder filling rate, and urge growth rate. Grey-box models of bladder filling rate and multivariable linear regression models of urge growth rate were developed for individual diaries. These models revealed that bladder filling rate, rather than urine volume, was the primary determinant of urinary frequency and urgency growth rate in the majority of participants. Simulations p...
Our hypothesis is that changes in gene and protein expression are crucial to the development of late-onset Alzheimer’s disease. Previously we examined how DNA alleles control downstream expression of RNA transcripts and how those... more
Our hypothesis is that changes in gene and protein expression are crucial to the development of late-onset Alzheimer’s disease. Previously we examined how DNA alleles control downstream expression of RNA transcripts and how those relationships are changed in late-onset Alzheimer’s disease. We have now examined how proteins are incorporated into networks in two separate series and evaluated our outputs in two different cell lines. Our pipeline included the following steps: (i) predicting expression quantitative trait loci; (ii) determining differential expression; (iii) analysing networks of transcript and peptide relationships; and (iv) validating effects in two separate cell lines. We performed all our analysis in two separate brain series to validate effects. Our two series included 345 samples in the first set (177 controls, 168 cases; age range 65–105; 58% female; KRONOSII cohort) and 409 samples in the replicate set (153 controls, 141 cases, 115 mild cognitive impairment; age r...
Women with lower urinary tract symptoms are often diagnosed based on a predefined symptom complex or a predominant symptom. There are many limitations to this paradigm as often patients present with multiple urinary symptoms which do not... more
Women with lower urinary tract symptoms are often diagnosed based on a predefined symptom complex or a predominant symptom. There are many limitations to this paradigm as often patients present with multiple urinary symptoms which do not perfectly fit the preestablished diagnoses. We used cluster analysis to identify novel, symptom based subtypes of women with lower urinary tract symptoms. We analyzed baseline urinary symptom questionnaire data obtained from 545 care seeking female participants enrolled in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network) Observational Cohort Study. Symptoms were measured with the LUTS (lower urinary tract symptoms) Tool and the AUA SI (American Urological Association Symptom Index), and analyzed using a probability based consensus clustering algorithm. Four clusters were identified. The 138 women in cluster F1 did not report incontinence but experienced post-void dribbling, frequency and voiding symptoms. The 80 women in clust...
Our hypothesis is that changes in gene and protein expression are crucial to the development of late-onset Alzheimer's disease. Previously we examined how DNA alleles control downstream expression of RNA transcripts and how those... more
Our hypothesis is that changes in gene and protein expression are crucial to the development of late-onset Alzheimer's disease. Previously we examined how DNA alleles control downstream expression of RNA transcripts and how those relationships are changed in late-onset Alzheimer's disease. We have now examined how proteins are incorporated into networks in two separate series and evaluated our outputs in two different cell lines. Our pipeline included the following steps: (i) predicting expression quantitative trait loci; (ii) determining differential expression; (iii) analysing networks of transcript and peptide relationships; and (iv) validating effects in two separate cell lines. We performed all our analysis in two separate brain series to validate effects. Our two series included 345 samples in the first set (177 controls, 168 cases; age range 65-105; 58% female; KRONOSII cohort) and 409 samples in the replicate set (153 controls, 141 cases, 115 mild cognitive impairmen...

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