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Objective: To investigate the extent of persistent urinary incontinence (UI) 12 years after birth, and association with delivery-mode history and other factors.Design: Twelve-year longitudinal cohort study.Setting: Maternity units in Aberdeen, Birmingham, and Dunedin.Population: Women who returned questionnaires 3 months and 12 years after index birth.Methods: Data on all births over a period of 12 months were obtained from the units and then women were contacted by post.Main Outcome Measure: Persistent UI reported at 12 years, with one or more previous contact.Results: Of 7879 women recruited at 3 months, 3763 (48%) responded at 12 years, with 2944 also having responded at 6 years; non-responders had similar obstetric characteristics. The prevalence of persistent UI was 37.9% (1429/3763). Among those who had reported UI at 3 months, 76.4% reported it at 12 years. Women with persistent UI had lower SF12 quality of life scores. Compared with having only spontaneous vaginal deliveries (SVDs), women who delivered exclusively by caesarean section were less likely to have persistent UI (odds ratio, OR 0.42, 95% CI 0.33-0.54). This was not the case in women who had a combination of caesarean section and SVD births (OR 1.01, 95% CI 0.78-1.30). Older age at first birth, greater parity, and overweight/obesity were associated with persistent UI. Of 54 index primiparae with UI before pregnancy, 46 (85.2%) had persistent UI.Conclusions: This study, demonstrating that UI persists to 12 years in about three-quarters of women, and that risk was only reduced with caesarean section if women had no other delivery mode, has practice implications.Tweetable Abstract: A longitudinal study of 3763 women showed a prevalence of persistent UI 12 years after birth of 37.9%. [ABSTRACT FROM AUTHOR]

Predicting airbag deployment geometries is an important task for airbag and vehicle designers to meet safety standards based on biomechanical injury risk functions. This prediction is also an extraordinarily complex problem given the number of disciplines and their interactions. State-of-the-art airbag deployment geometry simulations (including time history) entail large, computationally expensive numerical methods such as finite element analysis (FEA) and computational fluid dynamics (CFD), among others. This complexity results in exceptionally large simulation times, making thorough exploration of the design space prohibitive. This paper proposes new parametric simulation models which drastically accelerate airbag deployment geometry predictions while maintaining the accuracy of the airbag deployment geometry at reasonable levels; these models, called herein machine learning (ML)-accelerated models, blend physical system modes with data-driven techniques to accomplish fast predictions within a design space defined by airbag and impactor parameters. These ML-accelerated models are evaluated with virtual test cases of increasing complexity: from airbag deployments against a locked deformable obstacle to airbag deployments against free rigid obstacles; the dimension of the tested design spaces is up to six variables. ML training times are documented for completeness; thus, airbag design explorers or optimization engineers can assess the full budget for ML-accelerated approaches including training. In these test cases, the ML-accelerated simulation models run three orders of magnitude faster than the high-fidelity multi-physics methods, while accuracies are kept within reasonable levels within the design space.

Objective: To investigate the extent of persistent urinary incontinence (UI) 12 years after birth, and association with delivery-mode history and other factors., Design: Twelve-year longitudinal cohort study., Setting: Maternity units in Aberdeen, Birmingham, and Dunedin., Population: Women who returned questionnaires 3 months and 12 years after index birth., Methods: Data on all births over a period of 12 months were obtained from the units and then women were contacted by post., Main Outcome Measure: Persistent UI reported at 12 years, with one or more previous contact., Results: Of 7879 women recruited at 3 months, 3763 (48%) responded at 12 years, with 2944 also having responded at 6 years; non-responders had similar obstetric characteristics. The prevalence of persistent UI was 37.9% (1429/3763). Among those who had reported UI at 3 months, 76.4% reported it at 12 years. Women with persistent UI had lower SF12 quality of life scores. Compared with having only spontaneous vaginal deliveries (SVDs), women who delivered exclusively by caesarean section were less likely to have persistent UI (odds ratio, OR 0.42, 95% CI 0.33-0.54). This was not the case in women who had a combination of caesarean section and SVD births (OR 1.01, 95% CI 0.78-1.30). Older age at first birth, greater parity, and overweight/obesity were associated with persistent UI. Of 54 index primiparae with UI before pregnancy, 46 (85.2%) had persistent UI., Conclusions: This study, demonstrating that UI persists to 12 years in about three-quarters of women, and that risk was only reduced with caesarean section if women had no other delivery mode, has practice implications., Tweetable Abstract: A longitudinal study of 3763 women showed a prevalence of persistent UI 12 years after birth of 37.9%., (© 2015 Royal College of Obstetricians and Gynaecologists.)

Objectives: To develop and validate a clinical risk score to identify patients at risk of chronic obstructive pulmonary disease (COPD) using clinical factors routinely recorded in primary care., Design: Case-control study of patients containing one incident COPD case to two controls matched on age, sex and general practice. Candidate risk factors were included in a conditional logistic regression model to produce a clinical score. Accuracy of the score was estimated on a separate external validation sample derived from 20 purposively selected practices., Setting: UK general practices enrolled in the Clinical Practice Research Datalink (1 January 2000 to 31 March 2006)., Participants: Development sample included 340 practices containing 15 159 newly diagnosed COPD cases and 28 296 controls (mean age 70 years, 52% male). Validation sample included 2259 cases and 4196 controls (mean age 70 years, 50% male)., Main Outcome Measures: Area under the receiver operator characteristic curve (c statistic), sensitivity and specificity in the validation practices., Results: The model included four variables including smoking status, history of asthma, and lower respiratory tract infections and prescription of salbutamol in the previous 3 years. It had a high average c statistic of 0.85 (95% CI 0.83 to 0.86) and yielded a sensitivity of 63.2% (95% CI 63.1 to 63.3) and specificity 87.4% (95% CI 87.3 to 87.5)., Conclusions: Risk factors associated with COPD and routinely recorded in primary care have been used to develop and externally validate a new COPD risk score. This could be used to target patients for case finding.