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Background: The prevalence and the psychosocial impact of urinary incontinence in older people of a rural population were investigated.Methods: A cross-sectional study was made by means of a home health interview in a representative sample of people aged 65 years and older in the Basic Health Zone of Cabra (Córdoba). A questionnaire was used with two questions to detect urinary incontinence and further questions regarding its duration, frequency, volume, severity and psychosocial impact. Data were analyzed with basic statistics. A logistic regression model was created to identify which factors affect people's lifestyles.Results: Among the 827 respondents the prevalence of incontinence reached 36% [95% confidence interval (CI): 34%-38%] and was higher (p < .001) in women (42%; 95% CI: 39%-45%) than in men (29%; 95% CI: 25%-38%). The most frequent duration of incontinence was from 1 to 5 years (16.8%). Fifteen percent had daily episodes and 10.6% estimated the volume of urine loss as high. Incontinence was severe in 9% of the affected subjects. Half the incontinent subjects expressed social limitations and negative feelings related to incontinence, and 21% admitted that incontinence negatively affected their lives. In the logistic regression model, both volume of urine loss [odds ratio (OR) = 5.61; 95% CI: 2.76-11.42] and being married (OR = 2.34; 95% CI: 1.03-5.33) were the factors statistically associated with a negative influence of incontinence on lifestyle.Conclusions: Urinary incontinence is a very frequent symptom in our population. Half the incontinent subjects suffer from some degree of psychosocial limitation. The volume of urine loss and being married are the most important factors with psychosocial impact. [ABSTRACT FROM AUTHOR]

The early-science observations made by the James Webb Space Telescope (JWST) have revealed an excess of ultramassive galaxy candidates that appear to challenge the standard cosmological model (ΛCDM). Here, we argue that any modifications to ΛCDM that can produce such ultramassive galaxies in the early Universe would also affect the UV galaxy luminosity function (UV LF) inferred from the Hubble Space Telescope (HST). The UV LF covers the same redshifts (z≈7-10) and host-halo masses (M&#95;{h}≈10^{10}-10^{12}M&#95;{⊙}) as the JWST candidates, but tracks star-formation rate rather than stellar mass. We consider beyond-ΛCDM power-spectrum enhancements and show that any departure large enough to reproduce the abundance of ultramassive JWST candidates is in conflict with the HST data. Our analysis, therefore, severely disfavors a cosmological explanation for the JWST abundance problem. Looking ahead, we determine the maximum allowable stellar-mass function and provide projections for the high-z UV LF given our constraints on cosmology from current HST data.

Iontophoresis, a non-invasive application of a constant low-intensity electric current, is a promising strategy to accelerate wound healing. Although its mechanisms are not yet fully elucidated, part of its action seems related to inhibiting bacteria growth. This work aimed to investigate the antimicrobial effect of iontophoresis using Staphylococcus epidermidis and Escherichia coli strains, Gram-positive and Gram-negative bacteria, respectively. Anodic iontophoresis was applied to each bacterial suspension using Ag/AgCl electrodes, and bacteria viability was evaluated after 24 h incubation by counting colony-forming units. A Quality-by-Design approach was performed to assess the influence of the iontophoresis' intensity and application time on bacterial viability. Cell morphology was evaluated by scanning electron microscopy. Iontophoresis showed antimicrobial effects on the Gram-positive bacteria only at 5 mA and 60 min application. However, a linear relationship was observed between intensity and application time for the Gram-negative one, causing drastic morphological changes and up to 98 % death. The cell wall of Gram-negative bacteria seems more susceptible to disorganization triggered by iontophoresis-induced ion transport than Gram-positive ones. Therefore, anodic iontophoresis can be a powerful ally in controlling Gram-negative bacteria proliferation in wounds., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Health related quality of life (HRQoL) is a relevant result when assessing the course of different pathologies and the efficacy of their treatments. HRQoL has been studied previously on adults born small for gestational age (SGA), both in the general population and in patients who had received recombinant human growth hormone (rhGH) treatment, with disparate results. Our study included 50 adults who had received rhGH treatment for the SGA indication in 4 Spanish hospitals. Data have been gathered retrospectively from their clinical records, current weight and height were measured, and patients have been asked to fill out SF-36 and QoLAGHDA quality of life forms, and the Graffar test to evaluate their socio-economical status. Patient's adult height was - 1.2 ± 0.9 SD, lower than their target height of 1 ± 0.8 SD, but gaining 1.7 ± 1 SD from the beginning of the treatment. SF-36 test results showed lower scoring on Mental Health domains than on those related to Physical Health. No correlation was found between HRQoL results and final height, rhGH treatment duration or puberty. Correlation was indeed found between QoLAGHDA and several domains of SF-36, but QoLAGHDA detected fewer patients with low HRQoL than SF-36. Thus, it is concluded that SGA patient's follow-up should include a HRQoL, neuro-cognitive and psychiatric assessment in their transition to adult age. Adult SGA patients without catch up growth have impaired HRQoL, especially in mental health domains., (© 2023. The Author(s).)

The matter in our Universe comes in two flavors: dark and baryonic. Of these, only the latter couples to photons, giving rise to the well-known baryon acoustic oscillations and, in the process, generating supersonic relative velocities between dark matter and baryons. These velocities-imprinted with the acoustic scale in their genesis-impede the formation of the first stars during cosmic dawn (z∼20), modulating the expected 21-cm signal from this era. In a companion paper we showed, combining numerical simulations and analytic models, that this modulation takes the form of robust velocity-induced acoustic oscillations (VAOs), with a well-understood shape that is frozen at recombination, and unaffected by the unknown astrophysics of star formation. Here we propose using these VAOs as a standard ruler at cosmic dawn. We find that three years of 21-cm power-spectrum data from the upcoming HERA interferometer should be able to measure the Hubble expansion rate H(z) at z=15-20 to percent-level precision, ranging from 0.3% to 11% depending on the strength of astrophysical feedback processes and foregrounds. This would provide a new handle on the expansion rate of our Universe during an otherwise unprobed epoch, opening a window to the mysterious cosmic-dawn era.

The epoch of the formation of the first stars, known as the cosmic dawn, has emerged as a new arena in the search for dark matter. In particular, the first claimed 21-cm detection exhibits a deeper global absorption feature than expected, which could be caused by a low baryonic temperature, and has been interpreted as a sign for electromagnetic interactions between baryons and dark matter. This hypothesis has a striking prediction: large temperature anisotropies sourced by the velocity-dependent cooling of the baryons. However, in order to remain consistent with the rest of cosmological observations, only part of the dark matter is allowed to be charged and thus interactive. Here we compute, for the first time, the 21-cm fluctuations caused by a charged subcomponent of the dark matter, including both the pre- and postrecombination evolution of all fluids. We find that, for the same parameters that can explain the anomalous 21-cm absorption signal, any percent-level fraction of charged dark matter would source novel 21-cm fluctuations with a unique acoustic spectrum, and with an amplitude above any other known effects. These fluctuations are uncorrelated with the usual adiabatic anisotropies, and would be observable at high significance with interferometers such as the Low-Frequency Array and the Hydrogen Epoch of Reionization Array, thus providing a novel probe of dark matter at cosmic dawn.

The dynamics of our Universe is strongly influenced by pervasive-albeit elusive-dark matter, with a total mass about five times the mass of all the baryons 1,2 . Despite this, its origin and composition remain a mystery. All evidence for dark matter relies on its gravitational pull on baryons, and thus such evidence does not require any non-gravitational coupling between baryons and dark matter. Nonetheless, some small coupling would explain the comparable cosmic abundances of dark matter and baryons 3 , as well as solving structure-formation puzzles in the pure cold-dark-matter models 4 . A vast array of observations has been unable to find conclusive evidence for any non-gravitational interactions of baryons with dark matter 5-9 . Recent observations by the EDGES collaboration, however, suggest that during the cosmic dawn, roughly 200 million years after the Big Bang, the baryonic temperature was half of its expected value 10 . This observation is difficult to reconcile with the standard cosmological model but could be explained if baryons are cooled down by interactions with dark matter, as expected if their interaction rate grows steeply at low velocities 11 . Here we report that if a small fraction-less than one per cent-of the dark matter has a mini-charge, a million times smaller than the charge on the electron, and a mass in the range of 1-100 times the electron mass, then the data 10 from the EDGES experiment can be explained while remaining consistent with all other observations. We also show that the entirety of the dark matter cannot have a mini-charge.

The possibility that part of the dark matter is made of massive compact halo objects (MACHOs) remains poorly constrained over a wide range of masses, and especially in the 20-100  M&#95;{⊙} window. We show that strong gravitational lensing of extragalactic fast radio bursts (FRBs) by MACHOs of masses larger than ∼20  M&#95;{⊙} would result in repeated FRBs with an observable time delay. Strong lensing of a FRB by a lens of mass M&#95;{L} induces two images, separated by a typical time delay ∼few×(M&#95;{L}/30  M&#95;{⊙})  msec. Considering the expected FRB detection rate by upcoming experiments, such as canadian hydrogen intensity mapping experiment (CHIME), of 10^{4} FRBs per year, we should observe from tens to hundreds of repeated bursts yearly, if MACHOs in this window make up all the dark matter. A null search for echoes with just 10^{4} FRBs would constrain the fraction f&#95;{DM} of dark matter in MACHOs to f&#95;{DM}≲0.08 for M&#95;{L}≳20  M&#95;{⊙}.

We consider the possibility that the black-hole (BH) binary detected by LIGO may be a signature of dark matter. Interestingly enough, there remains a window for masses 20M&#95;{⊙}≲M&#95;{bh}≲100M&#95;{⊙} where primordial black holes (PBHs) may constitute the dark matter. If two BHs in a galactic halo pass sufficiently close, they radiate enough energy in gravitational waves to become gravitationally bound. The bound BHs will rapidly spiral inward due to the emission of gravitational radiation and ultimately will merge. Uncertainties in the rate for such events arise from our imprecise knowledge of the phase-space structure of galactic halos on the smallest scales. Still, reasonable estimates span a range that overlaps the 2-53  Gpc^{-3} yr^{-1} rate estimated from GW150914, thus raising the possibility that LIGO has detected PBH dark matter. PBH mergers are likely to be distributed spatially more like dark matter than luminous matter and have neither optical nor neutrino counterparts. They may be distinguished from mergers of BHs from more traditional astrophysical sources through the observed mass spectrum, their high ellipticities, or their stochastic gravitational wave background. Next-generation experiments will be invaluable in performing these tests.

Background: Single-incision laparoscopic surgery has sparked a great deal of interest in the surgical community in recent years, including bariatric surgery. However, we still do not definitively know if this type of surgical approach provides benefits over conventional techniques without increasing morbidity and mortality., Objective: To evaluate the safety and efficacy of single-incision laparoscopic bariatric surgery (SILBS) compared with conventional laparoscopic bariatric surgery (CLBS)., Materials and Methods: We searched the most important databases. Randomized clinical trials and observational studies comparing SILBS with CLBS were included. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations., Results: Fourteen studies complied with the inclusion criteria for our analysis, which included 2357 patients (1179 SILBS group versus 1178 CLBS group). The duration of surgery was longer in the SILBS group and no major intraoperative complications were observed in these series. A small improvement in postoperative pain was indicated in the SILBS group. The overall morbidity rate was 5% in the SILBS group and 4.8% in the CLBS. There was 1 perioperative death in 1 study, which occurred in an adjustable gastric banding (AGB) group, at .1% of all cases of AGB and .005% of all SILBS cases. When cosmesis was evaluated, patients in the SILBS group were more satisfied with the scar outcome., Conclusion: SILBS is a feasible technique to use in selected patients. However, there is insufficient evidence to recommend its widespread use compared with a conventional approach. More studies are needed to analyze the safety of this technique and its possible benefits., (Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Organic farming conserves natural resources, promotes biodiversity, guarantees animal welfare and obtains healthy products from raw materials through natural processes. In order to evaluate possibilities of increasing organic animal production, this study proposes a farm-scale multicriteria method for assessing the conversion of dairy goat systems to the organic model. In addition, a case study in the Northern Sierra of Seville, southern Spain, is analysed. A consensus of expert opinions and a field survey are used to validate a list of potential indicators and issues for assessing the conversion, which consider not only the European Community regulations for organic livestock farming, but also agroecological principles. As a result, the method includes 56 variables integrated in nine indicators: Nutritional management, Sustainable pasture management, Soil fertility and contamination, Weed and pest control, Disease prevention, Breeds and reproduction, Animal welfare, Food safety and Marketing and management. The nine indicators are finally integrated in a global index named OLPI (Organic Livestock Proximity Index). Application of the method to a case study with 24 goat farms reveals an OLPI value of 46.5% for dairy goat farms located in mountain areas of southern Spain. The aspects that differ most from the agroecological model include soil management, animal nutrition and product marketing. Results of the case study indicate that the proposed method is easy to implement and is useful for quantifying the approximation of conventional farms to an organic model.

Introduction: In this document the Small for Gestational Age (SGA) Child Working Group of the Spanish Society for Paediatric Endocrinology proposes the guidelines for the management and follow-up of SGA children, highlighting the potential morbidity arising from the SGA condition and its consequences in adulthood., Material and Methods: There is currently a wide variability in the management of the SGA child between health centres and health professionals. The diagnostic criteria for SGA according to the last international consensus guidelines are defined, which also include preterm SGA patients but excluding those patients in whom low birthweigh is associated with specific syndromes. We also outline the potential abnormalities associated with the SGA condition and recommend specific therapeutic and preventative measures., Conclusions: Low birth weight remains a major cause of morbidity in childhood and is associated with an increased risk of health problems later in life. Childhood is a critical window during which some of the risk factors accounting for this sequence are potentially reversible, with healthy lifestyle measures and environmental intervention. Accordingly, these guidelines should be useful not only for Primary Care Paediatricians but also for Neonatologists, Paediatric Endocrinologists, Neuropaediatricians and Pediatric Gastroenterologists, and also for the parents., (Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

Background: The study of the severity of occupational injuries is very important for the establishment of prevention plans. The aim of this paper is to analyze the distribution of occupational injuries by a) individual factors b) work place characteristics and c) working conditions and to analyze the severity of occupational injuries by this characteristics in men and women in Andalusia., Methods: Injury data came from the accident registry of the Ministry of Labor and social issues in 2003. Dependent variable: the severity of the injury: slight, serious, very serious and fatal; the independent variables: the characteristics of the worker, company data, and the accident itself. Bivariate and multivariate analysis were done to estimate the probability of serious, very serious and fatal injury, related to other variables, through odds ratio (OR), and using a 95% confidence interval (CI 95%)., Results: The 82.4% of the records were men and 17.6% were women, of whom the 78,1% are unskilled manual workers, compared to 44.9% of men. The men belonging to class I have a higher probability of more severe lesions (OR = 1.67, 95% CI = 1.17-2.38)., Conclusions: The severity of the injury is associated with sex, age and type of injury. In men it is also related with the professional situation, the place where the accident happened, an unusual job, the size and the characteristics of the company and the social class, and in women with the sector.

The precise etiology of neural tube defects (NTDs) is not known. There is some evidence that mutations in MTHFR gene provide susceptibility to NTDs in some populations; however, other studies have not found this association. One of the problems with previous studies is that they treat NTDs as a homogeneous group, when specific defects could have different etiologies. We conducted a case-control study specifically for anencephaly, based on the Mexican Epidemiological Surveillance System of Neural Tube Defects to evaluate its association with maternal MTHFR 677C > T and 1298A > C polymorphisms, in three states with high frequencies of NTDs: Puebla, Estado de México and Guerrero. We interviewed and collected blood samples from 118 case mothers and 112 control mothers. The questionnaire included information on their reproductive history, socioeconomic characteristics, prenatal care, tobacco and alcohol use, presence of chronic diseases, acute illnesses and fever, consumption of multivitamins and drugs during the periconceptional period. After adjusting for potential confounders, the risk from the mutated homozygous mothers (677TT genotype) was significantly higher than that from mothers with 677CC genotype (OR 3.16, 95% CI 1.29-7.73); in the case of the heterozygous mothers, an increased risk of anencephaly was observed, even though this was not statistically significant (OR 1.81 95% CI 0.78-4.25). The association found between maternal 677TT genotype and anencephaly and the elevated presence of the 677T allele among Mexican women of fertile age urges intensifying folic acid supplementation which has proved to modify this genetic risk in other populations.

Aims: To study the proportion and characteristics of elderly people who use aids for urinary incontinence, and the economic cost of pads., Design: Cross-sectional study., Interventions: A specific questionnaire on urinary incontinence and Barthel and Lawton indexes; and economic analysis of the number of pads used., Location: Basic Health Zone of Cabra (Córdoba)., Patients: 827, among a total of 5139 > or = 65 years-old subjects, by means of a random sampling, classified in age groups., Measurements: Two sources of data were used: a home health interview gathering information about the use of aids; the register which controls the prescription of pads in the Basic Health Zone of Cabra., Main Results: Urinary incontinence was detected in 36% of elderly people. Sixty-three percent of the incontinent people used some sort of aid, 8.1% used pads and 2.9% used an urethral catheter. The use of aids was related to advanced age, female gender and functional dependence. In 1996, the cost of the pads was 19,416,298 pesetas and 51,659 pesetas per incontinent person., Conclusions: The overall prevalence of the use of aids was greater than or similar to that of other studies whereas the use of pads was less. During 1996 the average cost of the pads per elderly person amounted to 49% of the theoretical maximum cost permitted by the health authority.