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Pelvic floor dysfunctions (PFD) are prevalent conditions that affect millions of women worldwide, encompassing a range of issues severely affecting women's quality of life. Pelvic floor muscle strength and function are fundamental to the management and prevention of PFD, and pelvic rehabilitation is a non-invasive approach that effectively improves symptoms, restores function, and prevents complications. This study aimed to evaluate the impact of pelvic floor muscle training program using weighted vaginal cones, on pelvic floor muscle function and quality of life in women with pelvic floor dysfunction (PFD). Fifty-four women aged 26-62 years, with different type of urinary incontinence, cystocele, and prolapse participated in this pre-post intervention comparative analysis. Pelvic floor muscle function was assessed using the PC test, which measures strength, endurance and fatigability, while the impact on patients' quality of life was assessed with the Pelvic Floor Impact Questionnaire - Short Form 7 (PFIQ-7). A three-month vaginal cone training regimen was implemented, with as-sessments conducted before the intervention (T0), one month later (T1), and three months later (T2). Data analysis showed a change with significant differences between the PC test score values at the level of each parameter and at each assessment (p<0.05, ES=0.254-511). The scores for bladder and urinary problems Urinary Impact Questionnaire (UIQ-7) significantly de-creased from 38.901 ± 1.268 at T0 to 29.366 ± 2.493 at T2 (W = 1082.000, p < 0.001, ES=0.570). In contrast, the scores for vaginal or pelvic problems (POPIQ-7) showed a slight, insignificant decrease from 12.699 ± 1.128 at T0 to 10.499 ± 2.362 at T2 (W = 278.000, p = 0.800, ES=0.053). fVaginal cone training significantly improves pelvic floor mus-cle function and reduces urynary symptoms in women with PFD [ABSTRACT FROM AUTHOR]

Background: Feedback and biofeedback (BF) are common adjuncts to pelvic floor muscle training (PFMT) for women with stress, urgency, and mixed urinary incontinence (UI). An up to date systematic review of adjunctive feedback or BF was needed to guide practice and further research., Objectives: To determine whether feedback or BF add benefit to PFMT for women with UI., Methods: The Cochrane Incontinence Group Specialised Trials Register was searched (May 2010) for randomised or quasi-randomized trials in women with stress, urgency or mixed UI regardless of cause, which compared PFMT versus PFMT augmented with feedback or BF. Two reviewers independently undertook eligibility screening, risk of bias assessment and data extraction. Analysis was in accordance with the Cochrane Handbook for Systematic Reviews of Intervention (version 5.0.2)., Results: Twenty-four trials were included, and many were at moderate to high risk of bias. Women who received BF were less likely to report they were not improved (RR 0.75, 95% CI: 0.66-0.86), although there was no statistically significant difference for cure (RR 0.92, 95% CI: 0.81-1.05) and marginal statistical significance for leakage episodes (mean difference: -0.12 leaks/day, 95% CI: -0.22 to -0.01). It is possible the results are confounded because women in the BF group commonly had more contact with the health professional than those in the PFMT only arm., Conclusion: BF may add benefit to PFMT but the observed effect could well be related to another variable, such as the amount of health professional contact rather than the BF per se., (Copyright © 2012 Wiley Periodicals, Inc.)

Pelvic floor muscle training (PFMT) is a first-line therapy for women with stress, urgency or mixed urinary incontinence (UI). Supervision and content of PFMT programmes is highly variable. The most effective approach to training is not known. The aim of the review was to compare the effects of different approaches to PFMT for women with UI. This was a systematic review with meta-analysis of randomized or quasi-randomized trials in women with stress, urgency or mixed UI that compared one approach to PFMT with another. The Cochrane Incontinence Group Specialised Trials Register (17 May 2011) was searched. Two reviewers independently assessed trials for eligibility and risk of bias, and extracted data. Data were analyzed as described in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.2.2). From 574 records we included 21 trials (1490 women randomized) that addressed 11 comparisons. Comparisons made included: differences in training supervision (amount, individual versus group), in approach (one versus another, the effect of an additional component) and the exercise training (type of contraction, frequency of training). There were few trials or data in any comparison. In women with stress UI, 10% who received more health professional contact (weekly or twice-weekly group supervision plus individual appointments) did not report improvement compared to 43% who had individual appointments only (risk ratio for no improvement 0.29, 95% confidence interval 0.15 to 0.55, four trials). While women receiving more contact were more likely to report improvement, the confidence interval was wide, and more than half of "controls" reported improvement. This finding, of subjective improvement in both active treatment groups, with more improvement reported by those receiving more health professional contact, was consistent throughout the review. Considerable caution is needed in interpreting the results of the review. Existing evidence is insufficient to make any strong recommendations about the best approach to PFMT. A consistent pattern of more self-reported improvement with more health professional contact was observed; the few data consistently showed that women receiving regular (e.g. weekly) supervision were more likely to report improvement than women doing PFMT with little or no supervision. The clinical rehabilitation impact is to offer women reasonably frequent health professional contact during supervised PFMT.

Background: Pelvic floor muscle training is the most commonly recommended physical therapy treatment for women with stress urinary incontinence. It is also sometimes recommended for mixed and, less commonly, urge urinary incontinence. The supervision and content of pelvic floor muscle training programmes are highly variable, and some programmes use additional strategies in an effort to increase adherence or training effects., Objectives: To compare the effects of different approaches to pelvic floor muscle training for women with urinary incontinence., Search Methods: We searched the Cochrane Incontinence Group Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and CINAHL, and handsearching of journals and conference proceedings (searched 17 May 2011), and the reference lists of relevant articles., Selection Criteria: Randomised trials or quasi-randomised trials in women with stress, urge or mixed urinary incontinence (based on symptoms, signs or urodynamics). One arm of the study included pelvic floor muscle training. Another arm was an alternative approach to pelvic floor muscle training, such as a different way of teaching, supervising or performing pelvic floor muscle training., Data Collection and Analysis: We independently assessed trials for eligibility and methodological quality. We extracted then cross-checked data. We resolved disagreements by discussion. We processed data as described in the Cochrane Handbook for Systematic Reviews of Interventions (version 5.2.2). We subgrouped trials by intervention., Main Results: We screened 574 records for eligibility and included 21 trials in the review. The 21 trials randomised 1490 women and addressed 11 comparisons. These were: differences in training supervision (amount, individual versus group), in approach (one versus another, the effect of an additional component) and the exercise training (type of contraction, frequency of training). In women with stress urinary incontinence, 10% of those who received weekly or twice-weekly group supervision in addition to individual appointments with the therapist did not report improvement post-treatment compared to 43% of the group who had individual appointments only (risk ratio (RR) for no improvement 0.29, 95% confidence interval (CI) 0.15 to 0.55, four trials). Looking at this another way, 90% of those who had combined group and individual supervision reported improvement versus 57% of women receiving individual supervision only. While women receiving the combination of frequent group supervision and individual supervision of pelvic floor muscle training were more likely to report improvement, the confidence interval was wide, and more than half of the 'control' group (the women who did not get the additional weekly or twice-weekly group supervision) reported improvement. This finding, of subjective improvement in both active treatment groups, with more improvement reported by those receiving more health professional contact, was consistent throughout the review.We feel there are several reasons why caution is needed when interpreting the results of the review: there were few data in any comparison; a number of trials were confounded by comparing two arms with multiple differences in the approaches to pelvic floor muscle training; there was a likelihood of a relationship between attention and reporting of more improvement in women who were not blind to treatment allocation; some trials chose interventions that were unlikely to have a muscle training effect; and some trials did not adequately describe their intervention., Authors' Conclusions: This review found that the existing evidence was insufficient to make any strong recommendations about the best approach to pelvic floor muscle training. We suggest that women are offered reasonably frequent appointments during the training period, because the few data consistently showed that women receiving regular (e.g. weekly) supervision were more likely to report improvement than women doing pelvic floor muscle training with little or no supervision.

Background: Pelvic floor muscle training (PFMT) is an effective treatment for stress urinary incontinence in women. Whilst most of the PFMT trials have been done in women with stress urinary incontinence, there is also some trial evidence that PFMT is effective for urgency urinary incontinence and mixed urinary incontinence. Feedback or biofeedback are common adjuncts used along with PFMT to help teach a voluntary pelvic floor muscle contraction or to improve training performance., Objectives: To determine whether feedback or biofeedback adds further benefit to PFMT for women with urinary incontinence.To compare the effectiveness of different forms of feedback or biofeedback., Search Strategy: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 13 May 2010) and the reference lists of relevant articles., Selection Criteria: Randomised or quasi-randomised trials in women with stress, urgency or mixed urinary incontinence (based on symptoms, signs or urodynamics). At least two arms of the trials included PFMT. In addition, at least one arm included verbal feedback or device-mediated biofeedback., Data Collection and Analysis: Trials were independently assessed for eligibility and risk of bias. Data were extracted by two reviewers and cross-checked. Disagreements were resolved by discussion or the opinion of a third reviewer. Data analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Intervention (version 5.1.0). Analysis within subgroups was based on whether there was a difference in PFMT between the two arms that had been compared., Main Results: Twenty four trials involving 1583 women met the inclusion criteria; 17 trials contributed data to analysis for one of the primary outcomes. All trials contributed data to one or more of the secondary outcomes. Women who received biofeedback were significantly more likely to report that their urinary incontinence was cured or improved compared to those who received PFMT alone (risk ratio 0.75 , 95% confidence interval 0.66 to 0.86). However, it was common for women in the biofeedback arms to have more contact with the health professional than those in the non-biofeedback arms. Many trials were at moderate to high risk of bias, based on trial reports. There was much variety in the regimens proposed for adding feedback or biofeedback to PFMT alone, and it was often not clear what the actual intervention comprised or what the purpose of the intervention was., Authors' Conclusions: Feedback or biofeedback may provide benefit in addition to pelvic floor muscle training in women with urinary incontinence. However, further research is needed to differentiate whether it is the feedback or biofeedback that causes the beneficial effect or some other difference between the trial arms (such as more contact with health professionals).

We establish and develop a novel methodology to treat higher-order non-linear effects of gravitational radiation that is scattered from binary inspirals, which employs modern scattering-amplitudes methods on the effective picture of the binary as a composite particle. We spell out our procedure to study such effects: assembling tree amplitudes via generalized-unitarity methods and employing the closed-time-path formalism to derive the causal effective actions, which encompass the full conservative and dissipative dynamics. We push through to a new state of the art for these higher-order effects, up to the third subleading tail effect, at order G N 5 and the 5-loop level, which corresponds to the 8.5PN order. We formulate the consequent dissipated energy for these higher-order corrections, and carry out a renormalization analysis, where we uncover new subleading RG flow of the quadrupole coupling. For all higher-order tail effects we find perfect agreement with partial observable results in PN and self-force theories, where available. [ABSTRACT FROM AUTHOR]

Introduction: Expanding the use of surface electromyography-biofeedback (EMG-BF) devices in different therapeutic settings highlights the gradually evolving role of visualizing muscle activity in the rehabilitation process. This review evaluates their concepts, uses, and trends, combining evidence-based research. Areas covered: This review dissects the anatomy of EMG-BF systems, emphasizing their transformative integration with machine-learning (ML) and deep-learning (DL) paradigms. Advances such as the application of sophisticated DL architectures for high-density EMG data interpretation, optimization techniques for heightened DL model performance, and the fusion of EMG with electroencephalogram (EEG) signals have been spotlighted for enhancing biomechanical analyses in rehabilitation. The literature survey also categorizes EMG-BF devices based on functionality and clinical usage, supported by insights from commercial sectors. Expert opinion: The current landscape of EMG-BF is rapidly evolving, chiefly propelled by innovations in artificial intelligence (AI). The incorporation of ML and DL into EMG-BF systems augments their accuracy, reliability, and scope, marking a leap in patient care. Despite challenges in model interpretability and signal noise, ongoing research promises to address these complexities, refining biofeedback modalities. The integration of AI not only predicts patient-specific recovery timelines but also tailors therapeutic interventions, heralding a new era of personalized medicine in rehabilitation and emotional detection. [ABSTRACT FROM AUTHOR]

We combine the observable-based formalism (KMOC), the analytic properties of the scattering amplitude, generalised unitarity and the heavy-mass expansion with a newly introduced IBP reduction for Fourier integrals, to provide an efficient framework for computing scattering waveforms. We apply this framework to the scattering of two charged massive bodies in classical electrodynamics. Our work paves the way for the computation of the analytic one-loop waveform in General Relativity. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the incidence of urinary incontinence (UI) during pregnancy and after delivery, perceptions of UI, effectiveness of pelvic floor muscle exercise (PFME) on UI, and risk factors for UI among pregnant women. Methods: Chinese women aged =18 years at 35 to 37 weeks of gestation were invited to participate. Perceptions of UI were assessed using a questionnaire that comprises seven statements. Urinary symptoms were assessed using the self-report six-item Urogenital Distress Inventory (UDI-6). Women were considered to have UI when they had positive scores on any of the incontinence items. Women who reported to have UI symptoms were assessed by a physiotherapist in the postnatal ward and were taught PFME. UI impact on quality of life was assessed using the self-report seven-item Incontinence Impact Questionnaire. Participants with UI during pregnancy who delivered in our hospital were followed up at 6 weeks postnatally through telephone. Their adherence to PFME was assessed in terms of the mean number of contractions performed per day. Results: Of 1134 participants, the incidence of UI was 73.0% during pregnancy and 21.9% after delivery. Predictors for UI during pregnancy were a history of UI before pregnancy (odds ratio [OR]=14.40, p<0.001), higher pre-pregnancy body mass index (OR=1.04, p=0.034), and previous vaginal delivery (OR=2.06, p=0.001), whereas predictors for UI after delivery were vaginal delivery in the index pregnancy (OR=3.86, p<0.001), older age (OR=1.12, p<0.001), a history of UI before pregnancy (OR=1.86, p=0.028), and total score of items 2 to 4 on the UDI-6 during pregnancy (OR=1.20, p=0.015). 86.4% of participants reported poor or no adherence to PFME. Adherence to postnatal PFME was not associated with UI after delivery (p=0.477). Women with higher education levels adhered more to PFME (p=0.008). Perceptions of UI were not associated with adherence to postnatal PFME. Conclusion: A history of pre-pregnancy UI is the main predictor for UI during pregnancy, whereas vaginal delivery is the main predictor for UI after delivery. The effect of postpartum PFME on UI after delivery is not significant, probably owing to the low rate of adherence to PFME. [ABSTRACT FROM AUTHOR]

We study classical radiation fields at next-to-leading order using the methods of scattering amplitudes. The fields of interest to us are sourced when two massive, point-like objects scatter inelastically, and can be computed from one-loop amplitudes. The real and imaginary parts of the amplitudes play important but physically distinct roles in the radiation field. We argue that the imaginary part captures the effects of radiation reaction. This aspect of radiation reaction is directly linked to cuts of one-loop amplitudes which expose Compton trees. We also discuss the fascinating interplay between renormalisation, radiation reaction and classical field theory from this perspective. [ABSTRACT FROM AUTHOR]

In this paper, we explore correlators of a series of theories in anti-de Sitter space: we present comprehensive results for interactions involving scalars, gluons, and gravitons in multiple dimensions. One aspect of our investigation is the establishment of an intriguing connection between the kinematic factors of these theories; indeed, such a connection directly relates these theories among themselves and with other theories of higher spin fields. Besides providing several explicit results throughout the paper, we also highlight the interconnections and relationships between these different theories, providing valuable insights into their similarities and distinctions. [ABSTRACT FROM AUTHOR]

Objectives: Pelvic floor disorders (PFDs) such as stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can be managed through conservative treatments, such as conservative management involving biofeedback (BF) and electrostimulation. This study aimed to investigate the therapeutic effects of conservative treatments on PFDs. Materials and Methods: A retrospective cohort study was conducted. Women with PFD who underwent 1-3 months of BF and electrostimulation between January 1, 2020, and January 31, 2021, were included in the study. BF treatment was administered using three sensors to monitor pelvic floor muscle activity, providing patients with immediate feedback and guidance on muscle exercises. One session lasted for 5-10 min. Electrostimulation treatment utilized a specially made pelvic belt with electrode sheets to stimulate and contract pelvic floor muscles passively. One session lasted for 15 min. Six therapies in 1 month were prescribed. Pre- and post-treatment Pelvic Floor Distress Inventory (PFDI-20) scores, including POP distress inventory 6 (POPDI-6), colorectal-anal distress inventory (CRAD-8), and urinary distress inventory 6 (UDI-6) scores, were compared. Subgroup analysis by age, menopause, body mass index (BMI), and child delivery mode was performed. Results: The study included 51 women with PFDs (SUI, POP, frequency or urgency or nocturia, and pain) treated with BF and electrostimulation, with a mean age of 49.94 ± 13.63 years. Sixteen patients (37.1%) were menopausal, with a mean menopause age of 50 ± 5.20 years. Twenty-six patients (68.4%) had a history of normal vaginal delivery. The mean PFDI-20 scores before and after treatment were 32.67 (standard deviation [SD] 10.05) and 25.99 (SD 9.61), respectively (P < 0.001). This decrease in scores reflected an improvement in subjective perceptions of symptoms and quality of life. The POPDI-6, CRAD-8, and UDI-6 scores significantly decreased after treatment. Subgroup analysis of scores change regarding age, menopause, BMI, and child delivery mode was not statistically significant. Conclusion: The study demonstrated the effectiveness of BF and electrostimulation for treating women with PFDs. The findings contributed to the understanding of treatment duration, patient characteristics, and the potential benefits of a multimodal approach. Moreover, the study's diverse participant population and the use of validated outcome measures enhance the generalizability and scientific rigor of the findings. [ABSTRACT FROM AUTHOR]

The differential representation is a novel formalism for studying boundary correlators in (d + 1)-dimensional anti-de Sitter space. In this letter, we generalize the differential representation beyond tree level using the notion of operator-valued integrals. We use the differential representation to compute three-point bubble and triangle Witten diagrams with external states of conformal dimension ∆ = d. We compare the former to a position space computation. [ABSTRACT FROM AUTHOR]

Following a recent proposal to describe inelastic eikonal scattering processes in terms of gravitationally dressed elastic eikonal amplitudes, we motivate a collinear double graviton dressing and investigate its properties. This is derived from a generalized Wilson line operator in the worldline formalism by integrating over fluctuations of the eikonal trajectories of external particles in gravitationally interacting theories. The dressing can be expressed as a product of exponential terms — a coherent piece with contributions to all odd orders in the gravitational coupling constant and a term quadratic in graviton modes, with the former providing classical gravitational wave observables. In particular, the coherent dressing involves O κ 3 subleading double graviton corrections to the Weinberg soft factor. We use this dressing to derive expressions for the waveform, radiative momentum spectrum and angular momentum. In a limiting case of the waveform, we derive the nonlinear memory effect resulting from the emission of nearly soft gravitons from a scattering process. [ABSTRACT FROM AUTHOR]

The quantum off-shell recursion provides an efficient and universal computational tool for loop-level scattering amplitudes. In this work, we present a new comprehensive computational framework based on the quantum off-shell recursion for binary black hole systems. Using the quantum perturbiner method, we derive the recursions and solve them explicitly up to two-loop order. We introduce an indicator that enables straightforward distinguishing diagrams and deriving integral families in the context of off-shell recursions. By employing the soft expansion technique, we remove irrelevant terms from the loop integrands and express them in terms of master integrals. We classify the one-loop and the two-loop classical diagrams, and their loop integrands are represented by linear combinations of the master integrals. Finally, we explicitly calculate the classical scalar 2 → 2 amplitudes in the potential region up to the 3PM order and reproduce the known results. [ABSTRACT FROM AUTHOR]

With the aim of computing bound waveforms from scattering amplitudes, we explore gravitational two-body dynamics using the Schwinger-Dyson equations and Bethe-Salpeter recursion. We show that the tree-level scattering waveform admits a natural analytic continuation, in rapidity, to the bound waveform, which we confirm from an independent calculation, in the Post-Newtonian expansion, of the time-domain multipoles at large eccentricity. We demonstrate consistency of this scattering-to-bound map with the Damour-Deruelle prescription for orbital elements in the quasi-Keplerian parametrization (which enters into the evaluation of the multipoles) and with the analytic continuation, in the binding energy, of radiated energy and angular momentum at 3PM. [ABSTRACT FROM AUTHOR]

The double copy is a remarkable relationship between gauge theory and gravity that has been explored in a number of contexts, most notably scattering amplitudes and classical solutions. The convolutional double copy provides a straightforward method to bridge the two theories via a precise map for the fields and symmetries at the linearised level. This method has been thoroughly investigated in flat space, offering a comprehensive dictionary both with and without fixing the gauge degrees of freedom. In this paper, we extend this to curved space with an (anti) de Sitter background metric. We work in the temporal gauge, and employ a modified convolution that involves the Mellin transformation in the time direction. As an example, we show that the point-like charge in gauge theory double copies to the (dS-) Schwarzschild black hole solution. [ABSTRACT FROM AUTHOR]

We find that different asymptotic measurements in quantum field theory can be related to one another through new versions of crossing symmetry. Assuming analyticity, we conjecture generalized crossing relations for multi-particle processes and the corresponding paths of analytic continuation. We prove them to all multiplicity at tree-level in quantum field theory and string theory. We illustrate how to practically perform analytic continuations on loop-level examples using different methods, including unitarity cuts and differential equations. We study the extent to which anomalous thresholds away from the usual physical region can cause an analytic obstruction to crossing when massless particles are involved. In an appendix, we review and streamline historical proofs of four-particle crossing symmetry in gapped theories. [ABSTRACT FROM AUTHOR]

We present a classification of conformally-invariant three-point tensor structures in d dimensions that parallels the classification of three-particle scattering amplitudes in d + 1 dimensions. Using a set of canonically-normalized weight-shifting operators, we construct a basis of three-point structures involving conserved currents or stress tensors and non-conserved spinning operators, directly from their amplitude counterparts. As an application, we also examine the conformal block expansion of the four-point functions of external currents and stress tensors in this amplitude basis. Our results can be useful for conformal bootstrap applications involving spinning correlators as well as Witten diagram computations in anti-de Sitter space. [ABSTRACT FROM AUTHOR]

We revisit the amplitude-based derivation of gravitational waveform for the scattering of two scalar black holes at subleading post-Minkowskian (PM) order. We take an eikonal-inspired approach to the two-massive-particle cut needed in the KMOC framework, as highlighted in [1], and show that its effect is to implement a simple change of frame. This clarifies one of the points raised in [2] when comparing with the post-Newtonian (PN) results. We then provide an explicit PM expression for the waveform in the soft limit, ω → 0, including the first non-universal, ω log ω, contribution. Focusing on this regime, we show that the small-velocity limit of our result agrees with the soft limit of the PN waveform of [2], provided that the two quantities are written in the same asymptotic frame. Performing the BMS supertranslation that, as discussed in [3], is responsible for the (G) static contribution to the asymptotic field employed in the PN literature, we find agreement between the amplitude-based and the PN soft waveform up to and including G3/c5 order. [ABSTRACT FROM AUTHOR]

Background: Overactive bladder (OAB) is a common clinical presentation in patients with multiple sclerosis., Objectives: The purpose of this study was to compare the effects of transcranial magnetic stimulation (TMS) and biofeedback on overactive bladder in patients with multiple sclerosis., Methods: This research included 45 individuals with multiple sclerosis of both sexes. We randomly divided them into three equal groups (A, B, and C). Patients in group A got biofeedback training and pelvic floor exercise (PFME); patients in group B had transcranial magnetic treatment and PFME; and patients in group C had PFME. Urodynamic measurements were utilized to determine bladder parameters (detrusor pressure at maximum flow rate, bladder volume at initial desire to empty, maximum cystometric capacity, detrusor pressure, and maximum flow rate) for all groups before and after a six-week training interval (the end of therapy)., Results: There was a statistically significant improvement in all urodynamic measurement parameters within the groups (Groups A, B and C). Except for the maximal cystometric capacity and detrusor pressure were non-significant improvement in B before and after therapy. However, there was no significant difference between the three groups following therapy., Conclusion: Transcranial magnetic stimulation and biofeedback improved bladder function in patients with multiple sclerosis. These approaches have a high level of safety and effectiveness, but EMG biofeedback has superiority., (© 2024. The Author(s).)

Introduction: Pelvic floor muscle training (PFMT) for urinary incontinence (UI) is recommended in combination with biofeedback to visualize pelvic floor muscles. The focus is on non-invasive hand-held ultrasound (US) measurement methods for PFMT, which can be performed at home. Recently, self-performed US measurements in which the patient applies the US to themself have gradually spreading. This study aimed to develop an educational program for the biofeedback method using self-performed US and to evaluate its feasibility., Methods: This study was an observational study. The ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) was utilized to create an e-learning program for women aged ≥40 years with UI. Participants self-performed bladder US via e-learning, using a hand-held US device with a convex probe. The primary outcome was the number of times the bladder area was successfully extracted using an existing automatic bladder area extraction system. The secondary outcome was the total score of the technical evaluation of the self-performed US, which was evaluated across three proficiency levels. Descriptive statistics were conducted for participant characteristics, presenting categorical variables as percentages and continuous variables as means ± SD., Results: We included 11 participants with a mean age of 56.2 years. Nine participants were able to record US videos, and two were unable to record bladder videos. Regarding the technical evaluation scores, all participants scored ≥80%; four had perfect scores., Conclusions: This study showed that transabdominal self-performed bladder US can be performed in 81.8% of women with UI in their 40-60s by using an e-learning program., (© 2024 The Author(s). Japan Journal of Nursing Science published by John Wiley & Sons Australia, Ltd on behalf of Japan Academy of Nursing Science.)

Recently it has been shown that Bern-Carrasco-Johansson (BCJ) numerators of colour-kinematic duality for tree-level scattering amplitudes in Yang-Mills theory (coupled with scalars) can be determined using a quasi-shuffle Hopf algebra. In this paper we consider the same theory, but with higher-derivative corrections of the forms α′F3 and α′2F4, where F is the field strength. In the heavy mass limit of the scalars, we show that the BCJ numerators of these higher-derivative theories are governed by the same Hopf algebra. In particular, the kinematic algebraic structure is unaltered and the derivative corrections only arise when mapping the abstract algebraic generators to physical BCJ numerators. The underlying kinematic Hopf algebra enables us to obtain a compact expression for the BCJ numerators of any number of gluons and two heavy scalars for amplitudes with higher-derivative operators. The pure gluon BCJ numerators can also be obtained from our results by a simple factorisation limit where the massive particles decouple. [ABSTRACT FROM AUTHOR]

We compute the classical tree-level five-point amplitude for the two-to-two scattering of spinning celestial objects with the emission of a graviton. Using this five-point amplitude, we then turn to the computation of the leading-order time-domain gravitational waveform. The method we describe is suitable for arbitrary values of classical spin of Kerr black holes and does not require any expansion in powers of the spin. In this paper we illustrate it in the simpler case of the scattering of one Kerr and one Schwarzschild black hole. An important ingredient of our calculation is a novel form of the Compton amplitude with spinning particles including contact terms derived from matching to black-hole perturbation theory calculations. This ensures that our waveform is valid up to at least fourth order in the spin. Our method can be applied immediately to generate improved waveforms once higher-order contact terms in the Compton amplitude become available. Finally, we show the formula for the gravitational memory to all orders in the spin, which is in agreement with our results. [ABSTRACT FROM AUTHOR]

Both the Bern, Carrasco, and Johansson (BCJ) and the Kawai, Lewellen, and Tye (KLT) double-copy formalisms have been recently generalized to a class of scattering matrix elements (so-called form factors) that involve local gauge-invariant operators. In this paper, we continue the study of double copy for form factors. First, we generalize the double-copy prescription to form factors of higher-length operators tr(ϕm) with m ≥ 3. These higher-length operators introduce new non-trivial color identities, but the double-copy prescription works perfectly well. The closed formulae for the CK-dual numerators are also provided. Next, we discuss the υ → vectors which are central ingredients appearing in the factorization relations of both the KLT kernels and the gauge form factors. We present a general construction rule for the υ → vectors and discuss their universal properties. Finally, we consider the double copy for the form factor of the tr(F2) operator in pure Yang-Mills theory. In this case, we propose a new prescription which involves a gauge invariant decomposition for the form factor and a mixture of different CK-dual numerators appearing in the expansion. The new prescription for the more complicated double copy has been verified up to five external gluons. [ABSTRACT FROM AUTHOR]

Female urinary incontinence (UI) is highly prevalent in the US (>60%). Pelvic floor muscle training (PFMT) represents first-line care for UI; however, access and adherence challenges urge new care delivery models. This prospective cohort study investigates the feasibility and safety of a remote digital care program (DCP) combining education and PFMT with real-time biofeedback with an average duration of 10 weeks. The primary outcome was the change in the Urinary Impact Questionnaire—short form (UIQ-7) from baseline to program-end, calculated through latent growth curve analysis (LGCA). Secondary outcomes included the impact of pelvic conditions (PFIQ-7), depression (PHQ-9), anxiety (GAD-7), productivity impairment (WPAI), intention to seek additional healthcare, engagement, and satisfaction. Of the 326 participants who started the program, 264 (81.0%) completed the intervention. Significant improvement on UIQ-7 (8.8, 95%CI 4.7; 12.9, p < 0.001) was observed, corresponding to a response rate of 57.3%, together with improvements in all other outcomes and high satisfaction (8.9/10, SD 1.8). This study shows the feasibility and safety of a completely remote DCP with biofeedback managed asynchronously by a physical therapist to reduce UI-related symptoms in a real-world setting. Together, these findings may advocate for the exploration of this care delivery option to escalate access to proper and timely UI care. [ABSTRACT FROM AUTHOR]

We consider asymptotic observables in quantum field theories in which the S-matrix makes sense. We argue that in addition to scattering amplitudes, a whole compendium of inclusive observables exists where the time-ordering is relaxed. These include expectation values of electromagnetic or gravitational radiation fields as well as out-of-time-order amplitudes. We explain how to calculate them in two ways: by relating them to amplitudes and products of amplitudes, and by using a generalization of the LSZ reduction formula. As an application, we discuss one-loop master integrals contributing to gravitational radiation in the post-Minkowski expansion, emphasizing the role of classical cut contributions and highlighting the different infrared physics of in-in observables. [ABSTRACT FROM AUTHOR]

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Introduction and Hypothesis: The objective was to evaluate the clinically beneficial effect of adding transvaginal monopolar non-ablative radiofrequency (RF) to pelvic floor muscle training (PFMT) on leakage severity, quality of life and urinary incontinence-related symptoms in women with stress urinary incontinence (SUI)., Methods: A double-blind randomised controlled trial was conducted, with a 6-week intervention and a 6-month follow-up. Participants were randomly assigned to the experimental group (PFMT plus RF; n = 18) or the control group (PFMT plus placebo; n = 20). The primary outcome was the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Secondary outcomes included the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7), self-efficacy, female sexual function, pelvic floor muscle dynamometry, 1-h pad test and number of SUI episodes per week. Inferential analyses of the data were performed using a two-factor analysis of variance., Results: Both groups achieved a statistically significant improvement in ICIQ-SF over time. However, the differences observed in the experimental group exceeded the minimal clinically important differences by 4 points (MD = -9.4, 95% CI = -12.6 to -6.3), which was not observed in the control group (MD = -3.9, 95% CI = -6.9 to -1.0). This was maintained at the 6-month follow-up with a significant time*group interaction (p < 0.001, ηp 2  = 0.150). There was no time*group interaction in the other variables (p > 0.05). Additionally, a significant difference in favour of the experimental group was observed in the 1-h pad test and episodes of SUI per week (p < 0.05)., Conclusions: This study highlights the beneficial effects of adding transvaginal RF to PFMT on the severity and amount of leakage, as well as on the quality of life and urinary incontinence-related symptoms in women with moderate SUI. Future trials are needed to assess the effects of this intervention in women with severe SUI., (© 2024. The International Urogynecological Association.)

We consider the scattering of charged particles on particular electromagnetic fields which have properties analogous to gravitational horizons. Classically, particles become causally excluded from regions of spacetime beyond a null surface which we identify as the 'electromagnetic horizon'. In the quantum theory there is pair production at the horizon via the Schwinger effect, but only one particle from the pair escapes the field. Furthermore, unitarity appears to be violated when crossing the horizon, suggesting there is no well-defined S-matrix. Despite this, we show how to use the perturbiner method to construct 'amplitudes' which contain all the dynamical information required to construct observables related to pair creation, and to radiation from particles scattering on the background. [ABSTRACT FROM AUTHOR]

Urinary incontinence affects approximately 200 million people worldwide. The objective of this study was to investigate the effect of pelvic floor muscle (PFM) training with biofeedback (BF) in women with urinary incontinence in comparison to PFM training alone. The primary outcome was PFM strength with secondary outcomes being the severity of incontinence, other PFM parameters, quality of life (QoL), social life, satisfaction and adherence to treatment. Randomized controlled trials (RCTs) published from 2005 to 2023 in PubMed, MEDLINE, Scopus and Google Scholar were searched and evaluated with the PEDro scale. Nine moderate and two high methodological quality RCTs were selected. There was a statistically significant improvement in all parameters. In five studies, muscle strength and the severity of incontinence were statistically better in the BF group compared to the non-BF group. In most studies, no differences were found for QoL and social life between the groups. For adherence to treatment, the results were ambiguous. Τhe remaining variables (endurance, precontraction, function, adherence and satisfaction) had few studies to support the results. There was moderate level evidence that the group utilizing PFM exercises with BF showed significant improvements in the management of urinary incontinence. Concerning muscle strength and the severity of incontinence, findings were inconclusive, as only in some studies the results were statistically better in the BF group compared to the non-BF group. [ABSTRACT FROM AUTHOR]

Background: Childbirth is one of the biggest risk factors for incontinence. Urinary and anal incontinence can cause pain and social limitations that affect social life, cohabitation, and work. There is currently no up-to-date literature study on the effect of pelvic floor muscle training with feedback from a physiotherapist, which involves verbal instructions based on vaginal and anal digital palpation, compared to treatment without feedback (e.g., recommendations for pelvic floor muscle training). Aim: The objective of this systematic review was to examine the scientific evidence regarding the impact of pelvic floor muscle training (PFMT) with feedback from a physiotherapist and/or biofeedback on urinary and anal incontinence in women during the first six months following vaginal delivery, compared to treatment without feedback. Methods: The literature search was conducted in the databases PubMed, Cochrane, and CINAHL. In addition, a manual search was conducted. The search terms consisted of MeSH terms and synonyms in the respective search block including population, intervention, and study design, as well as the terms pelvic floor and postpartum. An evaluation of each included study was conducted for methodological quality, evidence value, and clinical relevance. Results: Eight studies were included, three of which showed a significant difference between groups, in favor of the intervention group that received pelvic floor muscle training with feedback from a physiotherapist and/or biofeedback. Due to the varying results and insufficient quality for the majority of the studies, the scientific basis was considered insufficient. Conclusion: The scientific evidence for pelvic floor muscle training with feedback from a physiotherapist or biofeedback on postpartum urinary and anal incontinence compared to treatment without feedback is considered insufficient. Further research on the subject is needed. The study is registered in PROSPERO CRD42022361296. [ABSTRACT FROM AUTHOR]

In [1], logarithmic correction to subleading soft photon and soft graviton theorems have been derived in four spacetime dimensions from the ratio of IR-finite S-matrices. This has been achieved after factoring out IR-divergent components from the traditional electromagnetic and gravitational S-matrices using Grammer-Yennie prescription. Although the loop corrected subleading soft theorems are derived from one-loop scattering amplitudes involving scalar particles in a minimally coupled theory with scalar contact interaction, it has been conjectured that the soft factors are universal (theory independent) and one-loop exact (don't receive corrections from higher loops). This paper extends the analysis conducted in [1] to encompass general spinning particle scattering with non-minimal couplings permitted by gauge invariance and general coordinate invariance. By re-deriving the ln ω soft factors in this generic setup, we establish their universal nature. Furthermore, we summarize the results of loop corrected soft photon and graviton theorems up to sub-subleading order, which follows from the analysis of one and two loop QED and quantum gravity S-matrices. While the classical versions of these soft factors have already been derived in the literature, we put forth conjectures regarding the quantum soft factors and outline potential strategies for their derivation. [ABSTRACT FROM AUTHOR]

We study the space and properties of global and local observables for radiation emitted in the scattering of a massive scalar field in gauge and gravitational plane-wave backgrounds, in both the quantum and classical theory. We first compute the radiated momentum and angular momentum flow, demonstrating that they are good local observables determined by the amplitude and phase of the waveform. We then focus on the corresponding global observables, which in the gravitational case requires dealing with the collinear divergence of the gravitational Compton cross-section. We show using the KLN theorem that we can obtain an infrared-finite cross-section only by summing over forward scattering diagrams; this suggests dressing the initial state in the direction collinear to the plane wave in order to be able to compute observables integrated over the celestial sphere. Finally, we explore the high-energy behaviour of our observables. We find that classical global observables generically exhibit a power-law mass divergence in electrodynamics and a logarithmic mass divergence in gravity, even when radiation reaction is included. We then show explicitly how this is consistently resolved in the full quantum theory. [ABSTRACT FROM AUTHOR]

Introduction Pelvic floor muscle training (PFMT) is suggested for women with stress urinary incontinence (SUI). The aim of our study is to examine the effectiveness of PFMT on urodynamic (UDS) parameters. Material and methods This is a prospective observational study enrolling women with SUI. Pelvic surgery, prolapse, body mass index >30, and cognitive disability were exclusion criteria. Patients had baseline UDS, then PFMT only (Group A) or PFMT plus biofeedback (BFD) (Group B) for 6 months and UDS 3 months after treatment. The primary investigated parameters were the number of pads used per day and Valsalva leak point pressure (VLPP). Results Forty-six women completed the study, 22 in Group A and 24 in Group B. At baseline, all patients documented SUI with 3 median pads used per day. Urodynamic SUI was documented with a median Valsalva leak point pressure (mVLPP) of 45 cmH2O. At the re-evaluation, 12 women (26.1%) had SUI in BDs with median number pads per day of 1, which was statistically different to baseline (p = 0.02). Urodynamic SUI was reported in 8 (17.4%) women with a mVLPP of 88 cmH2O. Six patients were from Group A and 6 from Group B. In Group A, the median number of pads per day was 1, and urodynamic SUI was found in 3 women. In Group B, the median number of pads per day was 1, and urodynamic SUI was found in 5 women. Thirty-four women (73.9%) were dry - 16 (47.1%) from Group A and 18 (52.9%) from Group B. Conclusions PFMT improves urodynamic parameters among women with SUI. [ABSTRACT FROM AUTHOR]

By combining the KMOC-formalism with the exponential representation of the scattering matrix we show that the two-body scattering angle is given by the corresponding matrix element of the exponential representation. This holds to all orders in the Post-Minkowskian expansion of gravity when restricted to the conservative sector. Once gravitational radiation is taken into account new terms correcting this relationship appear starting at fourth Post-Minkowskian order. A systematic expansion of the momentum kick is provided to any order, thus illustrating the iterative structure that partly recycles terms from lower orders in the Post-Minkowskian expansion. We provide explicit results for this computation to fourth Post-Minkowskian order, the first complete calculation at this order based on scattering amplitudes. [ABSTRACT FROM AUTHOR]

The tree-level wavefunction coefficient for four gravitons in de Sitter space was recently bootstrapped using the Cosmological Optical Theorem, flat space limit, and Manifestly Local Test [1]. Inspired by the double copy for scattering amplitudes, we derive a compact new expression for this quantity starting from the wavefunction coefficient for gluons. [ABSTRACT FROM AUTHOR]

Background/aim: Surface electromyography (surface EMG) is a primary technique to detect the electrical activities of muscles through surface electrodes. In recent years, surface EMG applications have grown from conventional fields into new fields. However, there is a gap between the progress in the research of surface EMG and its clinical acceptance, characterized by the translational knowledge and skills in the widespread use of surface EMG among the clinician community. To reduce this gap, it is necessary to translate the updated surface EMG applications and technological advances into clinical research. Therefore, we aimed to present a perspective on recent developments in the application of surface EMG and signal processing methods. Materials and methods: We conducted this scoping review following the Joanna Briggs Institute (JBI) method. We conducted a general search of PubMed and Web of Science to identify key search terms. Following the search, we uploaded selected articles into Rayyan and removed duplicates. After prescreening 133 titles and abstracts, we assessed 91 full texts according to the inclusion criteria. Results: We concluded that surface EMG has made innovative technological progress and has research potential for routine clinical applications and a wide range of applications, such as neurophysiology, sports and art performances, biofeedback, physical therapy and rehabilitation, assessment of physical exercises, muscle strength, fatigue, posture and postural control, movement analysis, muscle coordination, motor synergies, modelling, and more. Novel methods have been applied for surface EMG signals in terms of time domain, frequency domain, time-frequency domain, statistical methods, and nonlinear methods. Conclusion: Translating innovations in surface EMG and signal analysis methods into routine clinical applications can be a helpful tool with a growing and valuable role in muscle activation measurement in clinical practices. Thus, researchers must build many more interfaces that give opportunities for continuing education and research with more contemporary techniques and devices. [ABSTRACT FROM AUTHOR]

Copyright of Fisioterapia Brasil is the property of Atlantica Editora and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To investigate the clinical efficacy of acupuncture combined with biofeedback electrical stimulation on female stress urinary incontinence. Ninety patients diagnosed in a hospital between January 2020 and January 2021 were randomly divided into three groups (A, B and C). Group A was treated with biofeedback electrical stimulation, 3 times a week for 30 min for 15 times. Group B used acupuncture treatment, including Guanyuan, Qihai, Zhongji, Zusanli, Sanyinjiao and Yinlingquan, once a day, Monday-Friday, 30 min each, for a total of 10 times. Group C was treated with acupuncture combined with biofeedback electrical stimulation. All three groups were combined with pelvic floor muscle training. Following treatment, the changes in class I and II muscle fibre strength, ICI-Q-SF score and urine leakage in the 1-hour pad test were compared. Prior to treatment, there was no significant difference in the general data of the three patient groups, as well as class I and II muscle fibre strength, ICI-Q-SF score and 1-hour urinary pad test (P > 0.05). Following treatment, class I and II muscle fibre strength in groups A and C improved compared with before, with statistical significance (P < 0.05); there was no significant difference in group B (P > 0.05). In the three groups, ICI-Q-SF scores and 1-hour urinary pad test results were lower compared with before (P < 0.05), with those in group C better than those in groups A and B (P < 0.05). The treatment efficiency of the three patient groups was 86.7%, 83.3% and 96.7%, respectively. Combined acupuncture and biofeedback electrical stimulation can improve pelvic floor muscle strength, urine leakage and quality of life, and can be superior to biofeedback and acupuncture treatment alone., (© 2024. The Author(s).)

Introduction and Hypothesis: The Choosing Wisely campaign is an international initiative that is aimed at promoting a dialog between professionals, helping the population to choose an evidence-based, truly necessary and risk-free care. The aim of the study was to develop the Choosing Wisely Brazil list on Women's Health Physiotherapy in the area of the pelvic floor., Methods: A observational study was carried out between January 2022 and July 2023, proposed by the Brazilian Association of Physiotherapy in Women's Health, and developed by researchers working in the area of the pelvic floor. The development of the list consisted of six stages: a panel of experts, consensus building, national research, a review by the Choosing Wisely Brazil team, preparation of the list, and publication of the recommendations. Descriptive and content analyses were carried out in order to include evidence-based recommendations with over 80% agreement by physiotherapists in Brazil., Results: The expert panel was made up of 25 physiotherapists who submitted 63 recommendations. Seven physiotherapists/researchers carried out a critical analysis of the literature and refined the recommendations, resulting in 11 recommendations that were put to a national vote, in which 222 physiotherapists took part. After a review by the Choosing Wisely Brazil team, five recommendations with an average agreement of 88.2% agreement were chosen for publication., Conclusions: The Choosing Wisely Brazil team in Physiotherapy in Women's Health/Pelvic Floor proposed a list of five recommendations that showed a high agreement among Brazilian physiotherapists working in the area., (© 2024. The International Urogynecological Association.)

Introduction and Hypothesis: Self-efficacy for pelvic floor exercises, i.e. confidence in achieving pelvic floor contractions, may predict adherence to treatment. However, there is a paucity of literature investigating the clinical relevance of this outcome. The aim was to determine the relationship between self-efficacy for pelvic floor exercise and symptom severity, pelvic floor distress and impact on quality of life, as well as sociodemographic characteristics and pelvic floor muscle strength in women with stress urinary incontinence (SUI)., Methods: A cross-sectional study was conducted in women with SUI. The Spanish version of the Broome Pelvic Muscle Self-Efficacy Scale was used to assess self-efficacy for pelvic floor exercise. The dependent variables were: urinary incontinence symptoms using the International Consultation on Incontinence Questionnaire, short form (ICIQ-SF), pelvic floor distress symptoms using the Urogenital Distress Inventory-6, impact on quality of life using the Incontinence Impact Questionnaire (IIQ-7), leakage using the 1-h pad test, number of SUI episodes per week and pelvic floor muscle strength., Results: A total of 56 women with a median age of 44.5 years were included. Self-efficacy for pelvic floor exercise correlated negatively and moderately with the ICIQ-SF (r = -0.529; p < 0.001), IIQ-7 (r = -0.442; p = 0.001), 1-h pad test (r s  = -0.467; p < 0.001); and number of SUI episodes/week (r s  = -0.489; p < 0.001). Correlation with the other outcomes was weak or non-existent. Linear regression with forward selection showed that the ICIQ-SF was the variable most related to self-efficacy (β: -3.01, 95% CI: -4.03 to -1.69)., Conclusions: These findings highlight the importance of assessing self-efficacy for pelvic floor exercise in the treatment of women with SUI. Future prospective studies are needed to confirm these findings., (© 2024. The International Urogynecological Association.)