Results of these studies showed that the vaccine to be immunogeni

Results of these studies showed that the vaccine to be immunogenic and safe. The NADFC therefore issued marketing authorization and Bio Farma’s seasonal influenza vaccine Flubio® became the first licensed product of the WHO technology transfer initiative in June 2009. Some 165,000 doses were produced for commercial

distribution Selleck ERK inhibitor focusing principally on mass immunization of Hajj pilgrims. Until such time as Bio Farma is able to produce its own seasonal (and ultimately pandemic) antigen, bulk seasonal vaccine supplies will continue to be imported from Biken Institute in Japan, for which a commercial agreement has been signed. The majority of the critical equipment for the preparation of seed lots, upstream process and quality control in pilot scale has been received. In 2008, Bio Farma started the preliminary development of the upstream process for seasonal influenza vaccine, and by April 2009 had produced three batches of seasonal bulk antigen derived from A/Solomon Islands/3/2006 IVR-145 seed strain at 1 000 egg scale. A Technical

Collaboration and License Agreement was signed between Bio Farma and Biken Institute MAPK inhibitor of Japan in December 2009 for the transfer of influenza vaccine upstream production process. This was implemented through the training of Bio Farma staff at the Biken campus and follow-up training in Indonesia (see Section 4 below). Technology transfer of concentrated bulk preparation comprises the upstream process technology and quality control of seasonal influenza vaccine, i.e. seed preparation and virus cultivation up to the inactivation processes. In July 2009, following the onset of the A(H1N1) influenza pandemic, Bio Farma switched its attention to the development of a vaccine against this novel strain and by November 2010 a total of 20 lots had been

produced (Table 1). Of the latest nine batches of A(H1N1) derived from A/California/7/2009 (H1N1)v-like NYMC 179A, the first three were used to familiarize Bio Farma operators with the process. Thanks to this experience and hands-on guidance from Biken experts, the next batches showed increasing consistency (Table 2), and it is expected that by early 2011, three consecutive and consistent batches will have been produced to be formulated as monovalent Sitaxentan pandemic ready-filled bulk. Within its overall influenza pandemic preparedness plan, the Indonesian Ministry of Health decided to set up a manufacturing facility for egg-based influenza vaccines against wild-type influenza virus strains. The project comprises the whole manufacturing process including bulk antigen production, formulation, filling, laboratory quality control facilities, as well as an independent chicken farm to produce embryonated eggs. Significant progress had made in the physical execution of the BSL3+ building within the Bio Farma complex in Bandung.

The authors wish to thank Prof Giuseppe Novelli for the provisio

The authors wish to thank Prof. Giuseppe Novelli for the provision of plasmids containing the cDNA of LOX-1 and LOXIN. The authors would also like to thank Dr. Chris Rogers for statistical analysis and Dr. Ray Bush, Paul Savage, and Yvonne Johnson for technical assistance. “
“Since becoming clinically available in late 2011, cell-free DNA (cfDNA)-based noninvasive prenatal testing (NIPT) for fetal aneuploidy has seen an unprecedented rapid adoption into clinical care.1 This followed multiple publications on methodologies, validation, and test performance,2, 3, 4, 5, 6, 7, Selleckchem Dorsomorphin 8, 9, 10, 11, 12, 13 and 14 all demonstrating

improved sensitivities and lower false-positive Protease Inhibitor Library molecular weight (FP) rates than current screening methods. Opinion statements by national and international professional societies support the clinical use of NIPT in pregnant women, with most recommending use restricted to women at high risk for fetal aneuploidy.15, 16 and 17 Two approaches to NIPT have been developed and commercialized. In the first approach, fetal chromosome copy number is determined by comparing the number of sequence reads from the chromosome(s) of interest to those from reference chromosomes.7, 8, 11, 12, 13, 18, 19, 20, 21 and 22 The second approach entails

targeted amplification and sequencing of single-nucleotide polymorphisms (SNPs).2, 3, 4, 5, 23 and 24 This approach requires a sophisticated informatics-based method to compute aneuploidy risk through SNP distribution. Validation of the SNP-based NIPT method at 11-13 weeks’ gestation was recently reported, demonstrating high sensitivity and specificity for detection of trisomy 21, trisomy 18, trisomy 13, Turner syndrome (monosomy X), and triploidy.2 and 3 Despite hundreds of thousands of tests already having been performed worldwide, there are few large-scale TCL reports describing performance of NIPT in actual clinical settings,22 and 25 with most studies reporting on <1000 total patients.26, 27, 28 and 29

Here, laboratory and clinical experience of >31,000 women who received prenatal screening with a SNP-based NIPT is reported. This is a retrospective analysis of prospectively collected data on 31,030 cases received for commercial testing from March through September 2013. This study received a notification of exempt determination from an institutional review board (Albert Einstein College of Medicine Institutional Review Board: no. 2014-3307). Samples were classified as out of specification and excluded in cases of gestational age <9 weeks, multiple gestation, donor egg pregnancy, surrogate carrier, missing patient information, sample received >6 days after collection, insufficient blood volume (<13 mL), wrong collection tube used, or if the sample was damaged.

Animal experiments were approved by the Ethical committee of Utre

Animal experiments were approved by the Ethical committee of Utrecht University, and performed according to its regulations. The following antigens were used for vaccination and determination of specificity of monoclonal antibodies (mAb):

recombinant MAP Hsp 65 kD (rMAP Hsp60) and Hsp 70 kD (rMAP Hsp70). These antigens were produced as described earlier [6] and [17]. A recombinant C-terminal deletion mutant protein of the Hsp70 molecule was constructed, comprising the receptor binding part. It consisted of N-terminal amino acids 1–359 of wildtype Hsp70, had a molecular weight of approximately 45 kD and was designated RBS70. RBS70 was constructed by restriction endonuclease digestion of the original MAPK inhibitor recombinant MAP Hsp70 pTrcHis expression vector with AflII (NE Biolabs, USA) and HindIII (Gibco-Invitrogen, the Netherlands) using 5 units of each enzyme CX 5461 per μg DNA. The digested fragment was separated from the vector DNA by agarose gel (1%) electroforesis and isolated from the gel using a QIAEXII

kit (Promega, the Netherlands). The vector DNA was blunted by using T4 DNA polymerase (Fermentas, Germany) subsequently purified using a DNA cleaning kit (Zymo Research, USA), religated using T4 DNA ligase (Quick Ligation kit, NE Biolabs, USA) and purified using the DNA cleaning kit. Finally, chemically competent Top10 bacteria (Invitrogen, the Netherlands) were transformed with the vector DNA using a heat shock protocol provided by the manufacturer. Transformed bacteria were selected and protein expression and purification was performed similar to the procedure described for recombinant MAP Hsp70 [6]. In addition, the following antigens were used: recombinant M. tuberculosis Hsp70 (MTb), recombinant Escherichia coli (E. coli) Hsp70 and bovine Hsc70 purified from bovine brain (generous gifts from Stressgen, Canada). Purified

protein derivatives (PPDs) were produced at CVI (Lelystad, the Netherlands) as previously described [18], from MAP strain 3+5/C (PPDP), M. bovis (MB) strain AN5 (PPDB), and M. avium ssp. avium (MAA) strain D4 (PPDA). MAP strain and 316F was grown at the CVI (generous gifts from D. Bakker). To define peptides for the screening of monoclonal antibodies and sera from cattle and goats the following HSP70 Genbank-derived sequences were used: Q00488 (MAP Hsp70); A0QLZ6 (MAA Hsp70); P0A5C0 (MB Hsp70); P0A5B9 (MTb Hsp70); P04475 (E. coli Hsp70); NP776975 (Bos taurus Hsp70-1A). A first set of 124 synthetic 14-mer peptides, with an aminoterminal cysteine, a 5 amino acids (aa) shift and an overlap of 9 aa, covering the MAP Hsp70 molecule, was synthesized using the simultaneous multiple peptide synthesis (SMPS) technique described previously [19]. To enable di-sulphate binding of peptides to the solid phase ELISA plate, an amino-terminal cysteine residue was coupled to each peptide during synthesis. For primary screening peptides were pooled in 11 groups of sequential peptides.

4 The oral mucosa represents a barrier to drug permeation and it

4. The oral mucosa represents a barrier to drug permeation and it is intermediate between skin epidermis and the gut in its permeability characteristics. The effectiveness of the buccal barrier and whether buccal absorption could provide means for Amiloride hydrochloride administration can be

determined by ex vivo permeation studies. Permeation studies were carried BTK inhibitors out on optimized formulation. Histological examination was performed to evaluate the pathological changes in cell morphology and tissue organization during administration of buccoadhesive tablets. The administration site of buccal tablet over the buccal mucosa did not cause any irritation, ulceration, inflammation and redness, and it resembles to controlled buccal mucosa. In vivo buccal diffusion studies were conducted for optimized formulations of both films and tablets in the rabbits showed zero order release pattern. The in vivo studies of buccal films of Amiloride hydrochloride

in rabbits did not show any inflammation or any other sensitization reactions at the administration site. In vitro and in vivo correlations were carried out for the therapeutic efficacy of pharmaceutical formulations and are governed check details by the factors related to both in vitro and in vivo characteristics of the drug. A graph was plotted by taking cumulative % in vitro release and cumulative % in vivo drug release for the same period of time and the release rate followed zero order, showing the correlation co efficient value to be 0.994. In vivo kinetic parameters were listed in Table 5, already and Fig. 5 are representing the in vivo data. Buccal films and tablets of Amiloride hydrochloride were prepared and evaluated in the present work. Films and tablets were prepared by solvent casting technique and compression method respectively, by employing

the various polymers alone and in combinations. All the physicochemical characteristics were evaluated, which showed satisfactory results with good buccoadhesive strength. The formulations were showing good stability in natural human saliva. Good correlation was observed between in-vitro and in-vivo profile, revealed the ability of the formulations to reproduce the in-vitro release pattern through the biological membrane. Hence Amiloride hydrochloride oral mucoadhesive buccal formulations which can be used mainly in minimizing dose and mainly help to improve the patient compliance and Amiloride hydrochloride is a drug of choice for delivery through the control release via buccal route. All authors have none to declare. The authors express sincere thanks to Management of Annamacharya college of Pharmacy and School of Pharmaceutical Sciences, JNTU-K, Kakinada for their cooperation in the present research work. “
“Among various approaches, preparation of drug embedded matrix tablets is one of the least complicated methods for obtaining controlled release and is widely applied in industry.

1 M Na2CO3/NaHCO3, pH 9 2, 50 μL/well) at 4 °C overnight Plates

1 M Na2CO3/NaHCO3, pH 9.2, 50 μL/well) at 4 °C overnight. Plates were blocked with PBST and 3% (w/v) non-fat dry milk for

2 h at room temperature. Plates were incubated with 3-fold dilutions to endpoint titre of pooled serum samples (100 μL per well in PBST with 1% non-fat dry milk (starting concentration: 1:50 dilution) for 2 h at room temperature. Following three washes with 100 μL PBST, plates were incubated with horseradish-peroxidase-conjugated anti-mouse IgG (Santa Cruz Biotechnology, Dallas, TX) at a dilution of 1:3000 in PBST and non-fat dry milk (1%, v/v) for 1 h at room temperature. Unbound antibody was removed by three washes with 100 μL PBST and plates were developed using SigmaFAST OPD substrate (Sigma, St. Louis, MO) (100 μL/well) and stopped with 3 M HCl (50 μL/well). The colorimetric change was measured as the optical density (OD 490 nm) on a Synergy 4 (BioTek, Winooski, VT) microplate reader. The endpoint titre was defined as the reciprocal of the highest dilution that yields an OD-value above the mean plus three standard deviations of blank wells. The hemagglutination inhibition (HI) assay was used to assess functional antibodies to the HA able to inhibit agglutination of turkey red blood cells (tRBCs). Serum samples were treated with 4 volumes of a receptor-destroying enzyme of Vibrio cholera filtrate

(Sigma, St. Louis, MO) for 18 h at 37 °C. After addition of 3 volumes of 2.5% Selleckchem Buparlisib (v/v) sodium citrate, the serum samples were incubated at 56 °C for 30 min and diluted with PBS unless to yield a 1:10 dilution of the original serum sample. Serum samples were 2-fold serially diluted in PBS (25 μL sample volume) in Nunc® 96-well polystyrene V-bottom microwell plates (Thermo Fisher Scientific, Waltham, MA) and then incubated with recombinant reassortant virus (PR8:AH1, PR8:SH1, PR8:malNL00, PR8:malAlb01 or PR8:chickJal12) at 4 HAU/25 μL in PBS for 30 min at room

temperature. Then, 50 μL 0.5% tRBCs (Lampire Biological Laboratory, Pipersville, PA) were added and the mixture was incubated for 45 min at 4 °C. Sera from all groups were assayed individually for the challenge strain PR8:SH1 for HI activity. Divergent H7 strains were assayed with pooled sera. The HI titre was calculated from the reciprocal of the highest dilution that completely inhibited hemagglutination of red blood cells and the geometric mean titre (GMT) of two independent assays was reported as the final titre. Two negative HI readings were assigned <10, single negative results were scored a value of 5 for the calculation of geometric means. In preparedness for a potential H7N9 pandemic, it is highly desirable, not only for vaccine manufacturers, but also for health care providers, to develop an influenza vaccine that at low vaccine dose, most preferably with a single administration, stimulates good immune responses.

This booklet provided detailed shoulder and thoracic exercises th

This booklet provided detailed shoulder and thoracic exercises that incorporated all functional and anatomical shoulder movements and advice regarding progression of ambulation after discharge. The physiotherapist coached each experimental

group participant individually regarding post-discharge exercise frequency, duration, and progression. At discharge, an exercise diary was given to experimental group participants with instructions to complete it daily and return it at their final assessment three months postoperatively. In order to maintain concealment Luminespib datasheet of group allocation, the exercise diary was returned to the principal investigator (JR) in a reply-paid envelope. Control group participants received no postoperative physiotherapy intervention. Participant-rated outcomes (pain, shoulder

function, and health-related quality of life) were measured on all participants up to three months postoperatively. Following hospital discharge, the scales and INCB018424 questionnaires with which these were measured were mailed to participants for completion and return in a reply-paid envelope. Therapistrated outcomes (shoulder range of motion, muscle strength) were assessed in participants who lived within 60 kilometres of the hospital and indicated that they would be able to attend outpatient assessments after hospital discharge. All outcome measures were recorded at baseline, 1, and 3 months postoperatively. Additionally, pain and

range of motion were measured at discharge from hospital. Pain was measured by asking participants to shade areas on a body chart where they had experienced pain or discomfort on the day of assessment and to rate the intensity of their pain in each area using a numerical rating scale (from 0 = no pain to 10 = pain as bad as you can imagine). Three pain regions were identified: incisional (along the incision or within two intercostal spaces above or below), thoracic cage (apart from Dipeptidyl peptidase incisional), and the shoulder joint complex (upper limb proximal to the mid-humerus, including the clavicular and scapular areas and the trapezius muscle). Pain that was superior to the cervical spine, inferior to the umbilicus, or distal to the mid-humerus was excluded from analysis. The pain scores reported were for the shoulder region (out of 10) and for total pain (out of 30, calculated by adding together the pain scores for the three regions). Active shoulder range of motion was measured with digital inclinometrya using a standard protocol. Total shoulder motion allowing movement of all joints in the shoulder complex was measured, not isolated glenohumeral movement. Shoulder flexion, elevation through abduction, and external rotation were measured as these movements elongate the muscles divided during open thoracotomy.

But probably more important is the value and confidence that such

But probably more important is the value and confidence that such reviews give to the local employees working on the projects, as most reviews have been supportive of the development plans submitted by the applicants. Certainly there have been recommendations for some changes, but often the WHO/TAG teams have given support to “carry on as planned”. This gives recipients additional reassurance to proceed and confirms for the executive management that their teams know what they are doing. This is important because of the unique complexities of influenza

vaccine manufacture. Large egg-based production facilities are a new concept for most applicants. To support such production, many recipients have even had to develop their own egg supply facilities. Moreover, most of the countries involved have not had established influenza vaccine delivery programmes and have therefore had to make plans for vaccine delivery in parallel ABT-888 in vivo to building their own indigenous production facilities. Interestingly, only 3 of the 11 grant recipients are developing influenza production facilities in partnership with large international pharmaceutical companies (Instituto Butantan, Brazil and Birmex, Mexico with sanofi pasteur and Bio Farma, Indonesia with Biken). Independent of WHO, these recipients have made their own business arrangements with their technology transfer partner either

LY294002 nmr to construct production facilities or to share the production, fill finish or other components of the larger production process. Given that few of the grantees had previous experience of influenza vaccine development and manufacture, they all required training, although the extent of the training varies by grantee. For this purpose, WHO has established a centre of excellence and training at the Netherlands Vaccine Institute in Bilthoven, the all Netherlands [2]. Feedback from the grantees indicates

that the training courses carried out here and/or at the National Institute for Biological Standards and Control in the United Kingdom have been instrumental for the successful implementation of the projects. The hope that the WHO grants will also stimulate new non-egg production methodologies remains. Although the recent H1N1 epidemic forced some recipients to go straight into egg-based pandemic influenza vaccine production, there is continued interest from several companies to invest in alternative production techniques. In summary, as viewed from the vantage of the TAG, the WHO influenza technology transfer initiative has been successful. Clearly the relatively small WHO investments made in these companies to develop their own influenza vaccine production facilities have had quite dramatic results. A few companies are already producing large amounts of influenza vaccine. Others will soon follow. Whether they are developing egg-based or planning non-egg based influenza vaccine production, all companies are optimistic that their efforts will come to fruition.

11 The best characterized

microdomain to date is the lipi

11 The best characterized

microdomain to date is the lipid raft that is enriched in cholesterol and saturated lipids such as sphingolipids. Another microdomain is the caveolae that are specialized uncoated cell surface invaginations. Caveolae are generally viewed as a specialized subtype of lipid rafts. These lipid raft microdomains are organized by the lipid constituents, namely, cholesterol and sphingolipids. Nonlipid raft microdomains have been reported and these appeared to be organized by proteins eg, the actin cytoskeleton, galectin-1, K- and H-ras. The compartmentalization of the plasma membrane into microdomains with specialized structures beta-catenin inhibitor and functions suggest that the biogenesis

of each class of membrane vesicles from the plasma membrane is microdomain-specific. Therefore, the membrane lipids of circulating vesicles could reflect the microdomain from which they were derived and may determine their composition and functions. Indeed, membrane of exosomes that originated from endosomes is reportedly enriched in cholesterol and GM1 gangliosides, and this enrichment appears to distinguish exosomes from other membrane vesicles.8 Cholesterol- and GM1 ganglioside-rich membranes are reflective Selleck Quizartinib of lipid rafts that represent the major sites of endocytosis. Exposed phosphatidylserine has been reported to be present on membrane of several extracellular vesicles including exosomes.8

Although monocytes and macrophages Mephenoxalone endothelial cells are known to secrete vesicles with exposed phosphatidylserines during inflammation, circulating vesicles with exposed phosphatidylserine in a healthy individual is thought to originate primarily from platelets.12 Together, the studies on membrane lipids of circulating vesicles suggest that circulating vesicles could be differentiated by their membrane phospholipid composition, specifically GM1 gangliosides and phosphatidylserines. As these 2 phospholipids are known to bind cholera toxin B chain (CTB) and annexin V (AV), respectively, CTB and AV are potentially ligands for extracting different populations of circulating vesicles. In this study, we tested if circulating plasma membrane vesicles could be fractionated according to their affinity for CTB and AV, and if these fractionated vesicles could be used for discovery of PE biomarkers. The recruitment and enrollment of third trimester PE and matched healthy pregnant women by KK Women’s & Children’s Hospital were approved by the Singhealth Centralized Institutional Review Board (ref no: CIRB 2011/476/D).

A schematic of the final analytical scheme is given in Fig 1 Al

A schematic of the final analytical scheme is given in Fig. 1. All common chemicals were commercial analytical grade. Lysozyme selleck from chicken egg white, albumin from bovine serum (BSA), l-arabinose, glycogen from oyster, chondroitin sulfate

A sodium salt from bovine trachea, α-lactose monohydrate, glucose, N-acetyl neuraminic acid from Escherichia coli, Type II ι-carrageenan, 3-(N-morpholino)propanesulfonic acid (MOPS), and dextran were obtained from Sigma-Aldrich (United Kingdom). Deoxyribonucleic acid (DNA) sodium salt from salmon sperm was purchased from Fisher Bioreagents (United Kingdom). Sodium alginate from Laminaria hyperborea came from BDH (United Kingdom). Lonza Walkersville (Maryland, USA) provided endotoxin derived from E. coli. Gellan gum was produced by Applichem Biochemica (United Kingdom). High molecular weight hyaluronan (HA) was purchased from R&D Systems (United Kingdom). Endotoxin standards and stocks were purchased from Lonza Walkersville (Maryland, USA). All reagents were used as purchased. All sugars are D isomers except where noted otherwise. Solutions were filtered with 0.22 μm filters (GV PVDF, PES Express, Millipore, Massachusetts, USA) where appropriate. Polystyrene microtitre plates (Corning Costar #3596, Massachusetts, USA) were used with all assays, except where noted otherwise. All spectroscopic measurements were made with a Safire II spectrophotometer (Tecan,

Switzerland). Standard abbreviations this website for l-arabinose (Ara), ribose (Rib), glucose (Glc), galactose (Gal), glucuronic

acid (GlcA), guluronic acid (GulA), N-acetyl neuraminic acid (NeuNAc), mannose (Man) were selectively used to reduce graphical clutter. Absorbance spectra of pure carbohydrates and proteins were measured in solutions buffered with 20 mM MOPS, pH 7.2. Spectral measurements were also recorded following reaction in several colorimetric assays. Absorbance spectra were measured from 230 to 1000 nm in ≤3 nm increments using the microplate reader. The Bio-Rad protein assay (California, USA) based on Bradford’s method was employed to measure protein concentration [36] and [37]. The instructions provided by the reagent manufacturer (version: Lit 33 Rev C) were followed. Samples were diluted most in 20 mM MOPS, pH 7.0. Absorbance measurements were made at 595 nm and 990 nm. Blank-corrected standard curves were run in triplicate with absorbance at 990 nm subtracted from absorbance at 595 nm. Linear regression was used to fit the standard curve. The BCA assay kit (Pierce Thermo Scientific, Illinois, USA, version: 1296.7) was employed to measure protein concentration [40]. The microplate instructions provided by the assay kit manufacturer were followed. Samples were diluted into 20 mM MOPS, pH 7.0. Absorbance was measured at 562 nm and 990 nm. Blank-corrected standard curves were run in triplicate with a second order polynomial fit employed.

Evidence is required to guide some key areas of physiotherapy man

Evidence is required to guide some key areas of physiotherapy management. The role of exercise selleck kinase inhibitor in managing hip osteoarthritis should be clarified including comparisons of the effects of different exercise modalities (land-based, aquatic) and dosages. Manual therapy requires further investigation given the seemingly different results when it is delivered in isolation versus in combination with exercise. Randomised controlled trials are also needed to evaluate other interventions such as gait aids, heel wedges, and self-management programs. In parallel with this, investigation into the biomechanical, neuromuscular, and psychological mechanisms underpinning treatment effects will help to better understand outcomes and refine treatments.

In addition to assessing clinical effectiveness, economic evaluations should be included to establish the cost-effectiveness of treatments. This is important in today’s health care landscape to assist health policy makers in their decision-making regarding funding. A recent systematic review found few studies documenting cost-effectiveness for conservative non-drug interventions in hip or knee osteoarthritis (Pinto et al 2012b). Given the heterogeneity in clinical presentation, it would also be useful to identify prognostic factors that predict which people with hip osteoarthritis are likely to demonstrate a favourable Perifosine response

to which physiotherapy intervention. In a recent study, five baseline variables were found to predict treatment responders to a physiotherapy program for hip osteoarthritis (Wright et al 2011) – unilateral hip pain, age ≤ 58 years, pain ≥ 6/10 on a numeric pain rating scale, 40 m self-paced walk test time of ≤ 26 sec, and duration of symptoms

of ≤ 1 year. Having three or more of the five predictor variables increased the post-test probability of success to 99% or higher. While the results need to be validated in replication studies, they suggest that early referral for physiotherapy is preferable. Development of clinical prediction rules will assist clinicians in ascertaining the likelihood that their intervention will be effective for a particular patient. There have been considerable advances at the knee in understanding the role of biomechanical factors in influencing knee osteoarthritis disease progression as well as investigating biomechanical interventions to reduce knee load first such as footwear, bracing and gait retraining. This area could be extended to hip osteoarthritis to develop and evaluate potential disease-modifying treatments. In order to do this, better knowledge of the biomechanical and neuromuscular contributors to disease progression is also needed. Kim Bennell is partly supported by an Australian Research Council Future Fellowship. The contribution of A/Professor Haxby Abbott and Dr Fiona Dobson in assisting with the exercise study data extraction is gratefully appreciated. “
“Urinary incontinence is a common complaint in women.