MethodologyThe following guidelines were based on MEDLINE and PUBMED searches of English language literature, in addition to consensus conference proceedings. Levels of evidence and grades of recommendation were assigned for each investigation and treatment, as per the modified Oxford Centre for Evidence-Based Medicine grading system. Where the literature was inconsistent or scarce, a consensus expert opinion was generated to provide treatment guidelines.
Complexes formed between phi29 DNA polymerase (DNAP) and DNA fluctuate discretely between the pre-translocation and post-translocation states on the millisecond time scale. The translocation fluctuations can be observed in ionic current traces when individual complexes are captured atop the α-hemolysin nanopore in an electric field. The presence of complementary 2′-deoxynucleoside triphosphate (dNTP) shifts the equilibrium across the translocation step toward the post-translocation state. Here we have determined quantitatively the kinetic relationship between the phi29 DNAP translocation step and dNTP binding. We demonstrate that dNTP binds to phi29 DNAP-DNA complexes only after the transition from the pre-translocation state to the post-translocation state; dNTP binding rectifies the translocation but it does not directly drive the translocation. Based on the measured time traces of current amplitude, we developed a method for determining the forward and reverse translocation rates, and the dNTP association and dissociation rates, individually at each dNTP concentration and each voltage. The translocation rates, and their response to force, match those determined for phi29 DNAP-DNA binary complexes and are unaffected by dNTP. The dNTP association and dissociation rates do not vary as a function of voltage, indicating that force does not distort the polymerase active site, and that dNTP binding does not directly involve a displacement in the translocation direction. This combined experimental and theoretical approach, and the results obtained, provide a framework for separately evaluating the effects of biological variables on the translocation transitions and their effects on dNTP binding.
The Joint SIU-ICUD (Société Internationale d'Urologie) (International Consultation on Urological Diseases) International Consultation reviewed the available presented data and provided specific conclusions and recommendations for each non-surgical urologic method to address neurogenic bladder after SCI.
The term 'neurogenic bladder' describes lower urinary tract dysfunction that has occurred likely as a result of a neurological injury or disease (1) . The International Continence Society (ICS) defines 'neurogenic lower urinary tract dysfunction' (NLUTD) as 'lower urinary tract dysfunction due to disturbance of the neurologic control mechanism.' This broad definition is used to describe a multitude of conditions of varying severity.Common causes of NLUTD include: spinal cord injury (SCI), multiple sclerosis (MS) and myelomeningocele (MMC). Other causes of NLUTD include: Parkinson's disease, cerebrovascular accidents, traumatic brain injury, brain or spinal cord tumor, cauda equina syndrome, transverse myelitis, multisystem atrophy, pelvic nerve injury and diabetes.It is well described that neurological disorders can lead to urologic complications including: urinary incontinence, UTIs, urolithiasis, sepsis, ureteric obstruction, vesicoureteric reflux (VUR) and renal failure (2) . Due to the potential morbidity, and even mortality, initial investigation, ongoing management and surveillance is warranted in this patient population. Despite the frequency and potential severity of NLUTD, there are few high-quality studies in the literature to guide urological practices. CUAJ -CUA Guideline Kavanagh et al Guideline: Neurogenic bladderPrior neurogenic guidelines vary in their clinical assessment, investigations utilized and surveillance strategies (2)(3)(4)(5)(6) . The primary reason is that there is limited evidence to support a common strategy. The purpose of this guideline is to help urologists to identify high-risk patients with NLUTD and to provide an approach to the management and surveillance of patients with NLUTD. ClassificationThe etiology of a NLUTD is often classified based on whether the primary lesion is suprapontine, suprasacral, sacral or infrasacral (7) . A complementary system was developed by Madersbacher et al. based on the function of the detrusor muscle and of the external sphincter (8) . These systems allow a physician to have a general idea of how the lower urinary tract is likely to behave in SCI patients with more complete injuries. (Figure 1). Newer systems using MR urography in combination with urodynamics (UDS) have also been proposed. (9) MethodologyThis review was performed according to the methodology recommended by the Canadian Urologic Association (10) . EmBASE and Medline databases were used to identify literature relevant to the early urological care of NLUTD patients. Recommendations were developed by consensus and graded using a modified Oxford system which identifies level of evidence (LOE) and grade of recommendation (GOR). This complete version includes the full text of the guidelines (including the sections in the executive summary). Canadian epidemiology of neurogenic bladderThere are 3.7 million Canadians living with a neurologic condition, (11,12) three common types of neurologic conditions are Multiple Sclerosis (MS), Spina Bifida (SB) and Spinal Cord Injury (SCI). In ...
Background-Researchers must identify strategies to optimize the persuasiveness of messages used in public education campaigns encouraging fruit and vegetable (FV) intake.
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