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Samples were analyzed for specific MHC isoform (I, IIa, and IIx) content via mixed homogenate SDS-PAGE, and creatine analogues (MTC, muscle creatine transporter [SLC6A8], serum total creatine [STC], and serum creatinine [CRT]). Furthermore, MHC IIa and MTC content were compared with Wilks coefficient using Pearson correlation coefficients. Male PL MHC content was 50 ± 6% I, 45 ± 6% IIa, and 5 ± 11% IIx, versus 46 ± 6% I, 53 ± 6 IIa, and 0% IIx in female PL. Conversely, male CON MHC content was 33 ± 5% I, 38 ± 7% IIa, and 30 ± 8% IIx, vs. 35 ± 9% I, 44 ± 8% IIa, and 21 ± 17% IIx in female CON. Muscle total creatine, SLC6A8, STC, and CRT did not significantly differ between groups nor sexes. Finally, neither MHC IIa content (r = -0.288; p = 0.364) nor MTC (r = 0.488; p = 0.108) significantly predicted Wilks coefficient, suggesting these characteristics alone do not determine powerlifting skill variation.Miller, JD, Lippman, JD, Trevino, MA, and Herda, TJ. Larger motor units are recruited for high-intensity contractions than for fatiguing moderate-intensity contractions. J Strength Cond Res 34(11) 3013-3021, 2020-The purpose of this study was to investigate whether moderate-intensity contractions performed to fatigue activate the motor unit (MU) pool to the same extent as a higher-intensity contraction. #link# Subjects (7 men, 2 women, age = 22.78 ± 4.15 years, height = 173.78 ± 14.19 cm, mass = 87.39 ± 21.19 kg) performed 3 isometric maximum voluntary contractions (MVCs), an isometric trapezoidal contraction at 90% MVC (REP90), and repetitive isometric trapezoidal contractions at 50% MVC performed to failure with the first (REP1) and final repetition (REPL) used for analysis. Surface EMG was recorded from the vastus lateralis. Action potentials were extracted into firing events of single MUs with recruitment thresholds (RTs), MU action potential amplitudes (MUAPAMP), and mean firing rates (MFRs) recorded. Linear MFR and MUAPAMP vs. RT and exponential MFR vs. MUAPAMP relationships were calculated for each subject. The level of significance was set at p ≤ 0.05. B terms for the MFR vs. MUAPAMP relationships (p = 0.001, REPL = -4.77 ± 1.82 pps·mV, REP90 = -2.63 ± 1.00 pps·mV) and predicted MFRs for MUs recruited at 40% MVC (p less then 0.001, REPL = 11.14 ± 3.48 pps, REP90 = 18.38 ± 2.60 pps) were greater for REP90 than REPL indicating firing rates were greater during REP90. In addition, larger mean (p = 0.038, REPL = 0.178 ± 0.0668 mV, REP90 = 0.263 ± 0.128 mV) and maximum (p = 0.008, REPL = 0.320 ± 0.127 mV, Rep90 = 0.520 ± 0.234 mV) MUAPAMPS were recorded during REP90 than REPL. Larger MUs were recruited and similar sized MUs maintained greater firing rates during a high-intensity contraction in comparison to a moderate-intensity contraction performed at fatigue. Individuals seeking maximized activation of the MU pool should use high-intensity resistance training paradigms rather than moderate-intensity to fatigue.

The association between hypertrophic cervical elongation and pelvic organ prolapse (POP) has been observed, but causation has not been determined. This study assessed the relationship of POP with hypertrophic cervical elongation according to menopausal status and the pelvic compartment involved in prolapse.

This retrospective single-center case-control study was conducted at Shengjing Hospital of China Medical University between January 2017 and May 2019. Transverse and anteroposterior diameter of the cervix and cervical length were obtained by manual intravaginal measurement for 508 patients with POP and 510 patients without POP. Data were analyzed based on POP compartment and menopausal status.

In the premenopausal group, there was a statistically significant difference in the proportion of patients with hypertrophic cervical elongation in the non-POP and POP groups (P < 0.05); However, among postmenopausal patients, there was no statistical significance between these groups (P > 0.05). Patients with apical compartment POP had a higher proportion of occurrence of hypertrophic cervical elongation than those with nonapical compartment POP (P < 0.05).

Hypertrophic cervical elongation in premenopausal patients is significantly associated with POP; in particular, there is a significant correlation between apical compartment POP and hypertrophic cervical elongation.

Hypertrophic cervical elongation in premenopausal patients is significantly associated with POP; in particular, there is a significant correlation between apical compartment POP and hypertrophic cervical elongation.

The aim of this study was to determine if preoperative medication administration is associated with postoperative urinary retention (PUR) after urogynecologic procedures and identify preoperative and intraoperative factors that are predictive of PUR.

A retrospective review of patients who underwent prolapse and/or incontinence surgery was performed. The primary outcome was PUR, defined as postoperative retrograde void trial with postvoid residuals of greater than 100 mL. 2-D08 was performed to compare demographics and preoperative and intraoperative characteristics of women with and without PUR, and multivariable logistic regression modeling was used to identify independent predictors of PUR.

Of women in this cohort, 44.8% (364/813) had PUR. There were no significant differences in preoperative medication administration in women with and without PUR. Age older than 60 years (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.09-2.02), combined prolapse and incontinence surgerystoperative counseling regarding PUR after urogynecologic surgery.

Although the impact of stigma is known for women with urinary incontinence, it has not been well studied among the full spectrum of pelvic floor disorders. This study quantifies the level of stigma among women presenting for urogynecologic care and tests the hypothesis that stigma related to pelvic floor disorders results in a delay in care seeking for these problems.

Women presenting for new patient visits (N = 523) in university medical center-based urogynecology clinics completed 2 anonymous questionnaires (Stigma Scale for Chronic Illnesses 8-item version and Pelvic Floor Bother Questionnaire) before their visit. The Kruskal-Wallis test was used to compare the distributions of stigma scores. link2 Logistic regression was used to model factors associated with a delay in seeking care. Spearman correlation was used to determine whether there was an association between stigma and bother scores.

Median stigma score was significantly higher for those presenting with complaints of urine leakage (P = 0.015), accidental bowel leakage (P < 0.001), and constipation (P < 0.001) compared with women without these symptoms. Women presenting with accidental bowel leakage had the highest median stigma score, and those presenting with pelvic organ prolapse had the lowest. Total stigma score had a moderately positive correlation (r = 0.5, P < 0.001) with bother score. In a logistic regression model, higher stigma score was associated with a decreased likelihood of waiting 1 year or more to seek care (odds ratio = 0.92, 95% confidence interval = 0.86-0.98).

Pelvic floor disorders carry varying levels of stigma. Women who feel more stigmatized by pelvic floor disorders seem to seek care earlier.

Pelvic floor disorders carry varying levels of stigma. Women who feel more stigmatized by pelvic floor disorders seem to seek care earlier.

To estimate the risk of mesh complications in women with and without subsequent pelvic and abdominal radiation therapy (RT).

We identified women within a large health care organization who underwent mesh-augmented surgery for pelvic floor disorders between 2008 and 2014 and subsequently received RT prior to 2018. We compared them to a randomly selected group of women who underwent similar mesh-augmented pelvic reconstructive surgery without RT in a 14 ratio. Mesh complications were identified through chart review corroborated with the ninth and tenth revisions of the International Classification of Diseases and Current Procedural Terminology codes for mesh complications. Mesh complications between groups were compared using survival analysis and Cox proportional hazards models.

We identified 36 women with RT and compared them with 144 women without RT. Indications for mesh implantation and concomitant vaginal procedures were similar between the groups. link3 The majority of mesh implants (94.4%) were midurethrinary incontinence. The need for future RT may only be a minor factor in counseling patients on the risks of mesh implants for pelvic floor disorders.

Polycarbonate urethane (PCU) is a new biomaterial, and its mechanical properties can be tailored to match that of vaginal tissue. We aimed to determine whether vaginal host immune and extracellular matrix responses differ after PCU versus lightweight polypropylene (PP) mesh implantation.

Hysterectomy and ovariectomy were performed on 24 Sprague-Dawley rats. Animals were divided into 3 groups (1) PCU vaginal mesh, (2) PP vaginal mesh, and (3) sham controls. Vagina-mesh complexes or vaginas (controls) were excised 90 days after surgery. We quantified responses by comparing (1) histomorphologic scoring of hematoxylin and eosin- and Masson trichrome-stained slides, (2) macrophage subsets (immunolabeling), (3) pro-inflammatory and anti-inflammatory cytokines (Luminex panel), (4) matrix metalloproteinase (MMP)-2 and -9 using an enzyme-linked immunosorbent assay, and (5) type I/III collagen using picrosirius red staining.

There was no difference in histomorphologic score between PCU and PP (P = 0.211). Althougth larger animal models.

To evaluate barriers to care for patients presenting to urogynecologists and determine how these barriers differ in private and public/county health care settings.

Standardized anonymous questionnaires were distributed from May 2018 to July 2018 to new patients presenting to a urogynecologist at three institutions two private health care clinics (sites A and B) and one public/county hospital clinic (site C). Patients identified symptom duration, symptom severity, and factors inhibiting presentation to care from a list of barriers. Patients then identified the primary barrier to care.

One hundred nine questionnaires were distributed, and 88 were submitted, resulting in an 81% response rate (31 from site A, 30 from site B, 27 from site C). In analysis of the private versus public setting, there was no statistical difference between age (58 years vs 57 years, P = 0.69), body mass index (28 vs 30, P = 0.301), symptom duration (24 months vs 16 months, P = 0.28), or severity respectively. When asked to identify the primary barrier to presentation, patients in the private setting stated they did not know to see a specialist (26.2%, P = 0.002), while patients in the public setting could not obtain a closer appointment time (22.2% vs 13.1%, P = 0.35. Additionally, patients in the public setting were more likely to cite lack of health care coverage as a barrier to care (18.5% vs 1.6%, P = 0.01).

This study highlights barriers that can contribute to the disparity of care seen in our patient population. Efforts should be made to acknowledge and mitigate hindrances impacting access to care.

This study highlights barriers that can contribute to the disparity of care seen in our patient population. Efforts should be made to acknowledge and mitigate hindrances impacting access to care.