Consideraciones técnico-económicas para la aplicación de la tecnología al desarrollo en el diseño y fabricación de una válvula de apertura y cierre para un punto de agua

Es conocida la importancia del agua como factor clave en el Desarrollo Humano. El agua debe ser suficiente para cubrir las necesidades básicas de las personas (de 50 a 100 litros/persona/día) y con unas condiciones mínimas de calidad (3 litros/persona/día de agua potable). Los problemas principales relacionados con el agua son el acceso, la cantidad y calidad de la misma, y el coste. La falta de calidad da lugar a enfermedades, que en muchos casos son mortales al complicarse con problemas relacionados con una deficiente alimentación y/o con otras enfermedades, falta de medicamentos o de asistencia médica. En otros casos, está relacionada con el acceso incorrecto al saneamiento y la falta higiene. Y en todos los casos, la población afectada es la más pobre. Sin embargo, a pesar que los agentes implicados en las labores de cooperación como ONGs, agencias donantes de ayuda al desarrollo, etc. adoptan el “Modelo de Respuesta a la Demanda”, estudios existentes sobre los puntos de agua (un punto de agua es la parte de la instalación de abastecimiento de agua por donde se accede al agua) y su relación con la tecnología utilizada en los proyectos de instalación de sistemas de abastecimiento de agua, ponen de manifiesto que en los primeros cinco años de funcionamiento, aproximadamente un 30% de los puntos de agua se convierten en no funcionales. En el presente proyecto se estudian las causas del abandono de los sistemas de abastecimiento de agua, presentando una solución de bajo coste a uno de sus problemas técnicos más frecuentes, como es el diseño de la válvula de apertura y cierre de la instalación de abastecimiento de agua, o grifo.

Fabricación y caracterización de wolframio nanoestructurado como material de primera pared en reactores de fusión nuclear

El trabajo que se llevará a cabo se basa en el desarrollo de nuevos materiales que sean capaces de resistir las condiciones extremas a las que estarían expuestos en el interior de un reactor de fusión nuclear, como son los altos choques térmicos y los altos flujos iónicos. Actualmente se está investigando en el potencial del wolframio nanoestructurado como material de primera pared (en inglés PFM: Plasma Facing Material). La principal ventaja de éste frente al wolframio masivo radica en su gran densidad de fronteras de grano que hacen que el material sea más resistente a la irradiación. El objetivo de este trabajo será la búsqueda de las condiciones óptimas para la fabricación de recubrimientos de wolframio nanoestructurado mediante la técnica de pulverización catódica ("sputtering") en diferentes configuraciones, continuo ("Direct Current Magnetron Sputtering" o DCMS) y/o pulsado ("High Power Impulse Magnetron Sputtering" o HiPIMS) y caracterizar sus propiedades como PFM mediante perfilometría, microscopía óptica, microscopía electrónica de barrido ("Scanning Electron Microscope" o SEM) y difracción de rayos X ("X-Ray Diffraction" o XRD). A su vez, se realizará un ensayo de implantación con un plasma pulsado de He para analizar los efectos de la irradiación en uno de los recubrimientos. Abstract: The work that will be carried out is based on the development of new materials capable of withstanding the extreme conditions that they will have to face inside a nuclear fusion reactor, such as high thermal loads and high ion fluxes. Currently, nanostructured tungsten potential is being investigated as a plasma facing material (PFM). The main advantage over coarse grain tungsten is its high density of grain boundaries which make the material more resistant to irradiation. The project´s main objective will be the search of the optimal conditions that will allow us to fabricate nanostructured tungsten thin films by using the sputtering technique in different configurations, such as DCMS (Direct Current Magnetron Sputtering) and/or HiPIMS (High Power Impulse Magetron Sputtering) and characterize their properties as a PFM by perfilometry, optical microscopy, SEM (Scanning Electron Microcopy) and XRD (X-Ray Diffracion) analysis. Moreover, an implantation test with a He pulsed plasma will be carried out to analyze the effects of irradiation on one of the coatings.

Microstructural and mechanical characterization of tungsten based materials for fusion reactors

El wolframio (W) y sus aleaciones se consideran los mejores candidatos para la construcción del divertor en la nueva generación de reactores de fusión nuclear. Este componente va a recibir las cargas térmicas más elevadas durante el funcionamiento del reactor ya que estará en contacto directo con el plasma. En los últimos años, después de un profundo análisis y siguiendo una estrategia de reducción de costes, la Organización de ITER tomó la decisión de construir el divertor integramente de wolframio desde el principio. Por ello, el wolframio no sólo actuará como material en contacto con el plasma (PFM), sino que también tendría aplicaciones estructurales. El wolframio, debido a sus excelentes propiedades termo-físicas, cumple todos los requerimientos para ser utilizado como PFM, sin embargo, su inherente fragilidad pone en peligro su uso estructural. Por tanto, uno de los principales objetivos de esta tesis es encontrar una aleación de wolframio con menor fragilidad. Durante éste trabajo, se realizó la caracterización microstructural y mecánica de diferentes materiales basados en wolframio. Sin embargo, ésta tarea es un reto debido a la pequeña cantidad de material suministrado, su reducido tamaño de grano y fragilidad. Por ello, para una correcta medida de todas las propiedades físicas y mecánicas se utilizaron diversas técnicas experimentales. Algunas de ellas se emplean habitualmente como la nanoindentación o los ensayos de flexión en tres puntos (TPB). Sin embargo, otras fueron especificamente desarrolladas e implementadas durante el desarrollo de esta tesis como es el caso de la medida real de la tenacidad de fractura en los materiales masivos, o de las medidas in situ de la tenacidad de fractura en las láminas delgadas de wolframio. Diversas composiciones de aleaciones de wolframio masivas (W-1% Y2O3, W-2% V-0.5% Y2O3, W-4% V-0.5% Y2O3, W-2% Ti-1% La2O3 y W-4% Ti-1% La2O3) se han estudiado y comparado con un wolframio puro producido en las mismas condiciones. Estas aleaciones, producidas por ruta pulvimetalúrgica de aleado mecánico (MA) y compactación isostática en caliente (HIP), fueron microstructural y mecánicamente caracterizadas desde 77 hasta 1473 K en aire y en alto vacío. Entre otras propiedades físicas y mecánicas se midieron la dureza, el módulo elástico, la resistencia a flexión y la tenacidad de fractura para todas las aleaciones. Finalmente se analizaron las superficies de fractura después de los ensayos de TPB para relacionar los micromecanismos de fallo con el comportamiento macroscópico a rotura. Los resultados obtenidos mostraron un comportamiento mecánico frágil en casi todo el intervalo de temperaturas y para casi todas las aleaciones sin mejoría de la temperatura de transición dúctil-frágil (DBTT). Con el fin de encontrar un material base wolframio con una DBTT más baja se realizó también un estudio, aún preliminar, de láminas delgadas de wolframio puro y wolframio dopado con 0.005wt.% potasio (K). Éstas láminas fueron fabricadas industrialmente mediante sinterizado y laminación en caliente y en frío y se sometieron posteriormente a un tratamiento térmico de recocido desde 1073 hasta 2673 K. Se ha analizado la evolución de su microestructura y las propiedades mecánicas al aumentar la temperatura de recocido. Los resultados mostraron la estabilización de los granos de wolframio con el incremento de la temperatura de recocido en las láminas delgadas de wolframio dopado con potasio. Sin embargo, es necesario realizar estudios adicionales para entender mejor la microstructura y algunas propiedades mecánicas de estos materiales, como la tenacidad de fractura. Tungsten (W) and tungsten-based alloys are considered to be the best candidate materials for fabricating the divertor in the next-generation nuclear fusion reactors. This component will experience the highest thermal loads during the operation of a reactor since it directly faces the plasma. In recent years, after thorough analysis that followed a strategy of cost reduction, the ITER Organization decided to built a full-tunsgten divertor before the first nuclear campaigns. Therefore, tungsten will be used not only as a plasma-facing material (PFM) but also in structural applications. Tungsten, due to its the excellent thermo-physical properties fulfils the requirements of a PFM, however, its use in structural applications is compromised due to its inherent brittleness. One of the objectives of this phD thesis is therefore, to find a material with improved brittleness behaviour. The microstructural and mechanical characterisation of different tunsgten-based materials was performed. However, this is a challenging task because of the reduced laboratory-scale size of the specimens provided, their _ne microstructure and their brittleness. Consequently, many techniques are required to ensure an accurate measurement of all the mechanical and physical properties. Some of the applied methods have been widely used such as nanoindentation or three-point bending (TPB) tests. However, other methods were specifically developed and implemented during this work such as the measurement of the real fracture toughness of bulk-tunsgten alloys or the in situ fracture toughness measurements of very thin tungsten foils. Bulk-tunsgten materials with different compositions (W-1% Y2O3, W-2% V- 0.5% Y2O3, W-4% V-0.5% Y2O3, W-2% Ti-1% La2O3 and W-4% Ti-1% La2O3) were studied and compared with pure tungsten processed under the same conditions. These alloys, produced by a powder metallurgical route of mechanical alloying (MA) and hot isostatic pressing (HIP), were microstructural and mechanically characterised from 77 to 1473 K in air and under high vacuum conditions. Hardness, elastic modulus, flexural strength and fracture toughness for all of the alloys were measured in addition to other physical and mechanical properties. Finally, the fracture surfaces after the TPB tests were analysed to correlate the micromechanisms of failure with the macroscopic behaviour. The results reveal brittle mechanical behaviour in almost the entire temperature range for the alloys and micromechanisms of failure with no improvement in the ductile-brittle transition temperature (DBTT). To continue the search of a tungsten material with lowered DBTT, a preliminary study of pure tunsgten and 0.005 wt.% potassium (K)-doped tungsten foils was also performed. These foils were industrially produced by sintering and hot and cold rolling. After that, they were annealed from 1073 to 2673 K to analyse the evolution of the microstructural and mechanical properties with increasing annealing temperature. The results revealed the stabilisation of the tungsten grains with increasing annealing temperature in the potassium-doped tungsten foil. However, additional studies need to be performed to gain a better understanding of the microstructure and mechanical properties of these materials such as fracture toughness.

(Table 1) Chemical composition and bulk densities of dolerites from ODP Hole 504B lower dikes

Chemical interactions between seawater and the oceanic crust have been widely investigated during recent years. However, most of these studies concern the uppermost volcanic part of the crust. The contribution of the underlying sheeted dike complex to the global budget of the oceans is inferred solely from some ophiolite studies and from the 500-m high-level dike section of DSDP/ODP 504B which was drilled in 1981. Hole 504B is the only place where a continuous and long (1260 m) section in the sheeted dike complex has been cored, and it is now regarded as a reference section for the upper oceanic crust. Many petrological and chemical data from these dolerites are available, including the relative proportions of veins, extensively altered adjacent rocks, and less altered 'host-rocks'. For these three reasons, considering the entire dike section penetrated by Hole 504B is a unique chance to study chemical fluxes related to hydrothermal alteration of this part of the oceanic crust. The calculation of any chemical flux implies knowledge of the chemical composition of the fresh precursor (protolith). Previously, mean compositions of glasses (=P1a) or basalts from the Hole 504B volcanics have been used as protoliths. In this paper, we calculate and discuss the use of various protoliths based on dolerites from Hole 504B. We show that the most adequate and realistic protolith is the mean of individual protoliths that we calculated from the acquisition, by automatic mode, of about 1000 microprobe analyses in each thin-section of dolerite from the Hole 504B lower dikes. Consequently, PFm is further used to calculate chemical fluxes in the dike section of Hole 504B. The chemical compositions of the host-rocks adjacent to alteration halos tend to converge to that of PFm with depth, except for Fe2O3t and TiO2. Because the volume percent of alteration halos increases with depth, the total fluxes related to these halos increase with depth. This explains why the mean flux (host-rocks+halos+veins) of the upper dikes is roughly similar to the mean flux of the lower dikes. During the alteration of the entire Hole 504B dike section, the dolerites gained relatively large quantities of Fe2O3t (+4.0 g/100 cm**3) and released much SiO2 (-6.8 g/100 cm**3), CaO (-5.8 g/100 cm**3), and TiO2 (1.6 g/100 cm**3), and minor Al2O3 (-0.7 g/100 cm**3) and MgO (-0.7 g/100 cm**3). We show the importance of the choice of the protolith in the calculation of chemical budget, particularly for elements showing low flux values. In Hole 504B, the Mg uptake by the volcanics during low temperature alteration added to the Mg release by the dikes gives a net flux of -0.07x10**14 g/year. We propose that part of the Mg uptake by the oceanic crust, which is necessary to compensate the rivers input (-1.33x10**14 g/year), occurs in the underlying gabbros and/or in sections which are altered such as Trinity and Troodos ophiolites. Compared with ophiolites, fluxes calculated for elements other than Mg for the entire crust are generally similar (in tendency, if not in absolute value) to that we obtained from Hole 504B.

Rehabilitation of pelvic floor muscles utilizing trunk stabilization

The pelvic floor muscles (PFM) are part of the trunk stability mechanism. Their function is interdependent with other muscles of this system. They also contribute to continence, elimination, sexual arousal and intra-abdominal pressure. This paper outlines some aspects of function and dysfunction of the PFM complex and describes the contribution of other trunk muscles to these processes. Muscle pathophysiology of stress urinary incontinence (SUI) is described in detail. The innovative rehabilitation programme for SUI presented here utilizes abdominal muscle action to initiate tonic PFM activity. Abdominal muscle activity is then used in PFM strengthening, motor relearning for functional expiratory actions and finally impact training. (C) 2003 Elsevier Ltd. All rights reserved.

Application of a new method in the study of pelvic floor muscle passive properties in continent women

The aim of this study was to present a new methodology for evaluating the pelvic floor muscle (PFM) passive properties. The properties were assessed in 13 continent women using an intra-vaginal dynamometric speculum and EMG (to ensure the subjects were relaxed) in four different conditions: (1) forces recorded at minimal aperture (initial passive resistance); (2) passive resistance at maximal aperture; (3) forces and passive elastic stiffness (PES) evaluated during five lengthening and shortening cycles; and (4) percentage loss of resistance after 1 min of sustained stretch. The PFMs and surrounding tissues were stretched, at constant speed, by increasing the vaginal antero-posterior diameter; different apertures were considered. Hysteresis was also calculated. The procedure was deemed acceptable by all participants. The median passive forces recorded ranged from 0.54 N (interquartile range 1.52) for minimal aperture to 8.45 N (interquartile range 7.10) for maximal aperture while the corresponding median PES values were 0.17 N/mm (interquartile range 0.28) and 0.67 N/mm (interquartile range 0.60). Median hysteresis was 17.24 N∗mm (interquartile range 35.60) and the median percentage of force losses was 11.17% (interquartile range 13.33). This original approach to evaluating the PFM passive properties is very promising for providing better insight into the patho-physiology of stress urinary incontinence and pinpointing conservative treatment mechanisms.

Randomized controlled trial of physiotherapy for postpartum stress incontinence : 7-year follow-up

Objective To estimate the long-term effect of intensive, 6-week physiotherapy programs, with and without deep abdominal muscle (TrA) training, on persistent postpartum stress urinary incontinence (SUI). Methods The study was a single-blind randomized controlled trial. Fifty-seven postnatal women with clinically demonstrated persistent SUI 3 months after delivery participated in 8 weeks of either pelvic floor muscle training (PFMT) (28) or PFMT with deep abdominal muscle training (PFMT + TrA) (29). Seven years post-treatment, 35 (61.4%) participants agreed to the follow-up; they were asked to complete a 20-min pad test and three incontinence-specific questionnaires with an assessor blinded to each participant's group assignment. Results: Of the 35 (61.4%) who agreed to the follow-up: 26 (45.6%) took the 20-min pad test (12 PFMT and 14 PFMT + TrA) and 35 (61.4%) completed the questionnaires (18 PFMT and 17 PFMT + TrA). The baseline clinical characteristics of the follow-up and non-follow-up participants were not significantly different; nor did they differ between PFMT and PFMT + TrA participants enrolled in the follow-up study. At 7 years, the pad test scores for the PFMT group did not differ statistically from those of the PFMT + TrA group. When combining both treatment groups, a total of 14/26 (53%) follow-up participants were still continent according to the pad test. Conclusion The addition of deep abdominal training does not appear to further improve the outcome of PFM training in the long term. However, benefits of physiotherapy for postpartum SUI, although not as pronounced as immediately after the initial intervention, is still present 7 years post-treatment.

Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence : a feasibility study

Background Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional training. Aims The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM) exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative information regarding patient satisfaction with this new combined training program. Methods Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the participants' rate of participation in and completion of both the PFM/VRR training program and the home exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and participant's satisfaction through a questionnaire. Results Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patientreported symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%). Conclusion A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women with MUI and should be explore through further RCTs.

Room temperature ferroelectric and magnetic investigations and detailed phase analysis of Aurivillius phase Bi 5Ti 3Fe 0.7Co 0.3O 15 thin films

Aurivillius phase Bi 5Ti 3Fe 0.7Co 0.3O 15 (BTF7C3O) thin films on α-quartz substrates were fabricated by a chemical solution deposition method and the room temperature ferroelectric and magnetic properties of this candidate multiferroic were compared with those of thin films of Mn 3 substituted, Bi 5Ti 3Fe 0.7Mn 0.3O 15 (BTF7M3O). Vertical and lateral piezoresponse force microscopy (PFM) measurements of the films conclusively demonstrate that BTF7C3O and BTF7M3O thin films are piezoelectric and ferroelectric at room temperature, with the major polarization vector in the lateral plane of the films. No net magnetization was observed for the in-plane superconducting quantum interference device (SQUID) magnetometry measurements of BTF7M3O thin films. In contrast, SQUID measurements of the BTF7C3O films clearly demonstrated ferromagnetic behavior, with a remanent magnetization, B r, of 6.37 emu/cm 3 (or 804 memu/g), remanent moment 4.99 × 10 -5 emu. The BTF7C3O films were scrutinized by x-ray diffraction, high resolution transmission electron microscopy, scanning transmission electron microscopy, and energy dispersive x-ray analysis mapping to assess the prospect of the observed multiferroic properties being intrinsic to the main phase. The results of extensive micro-structural phase analysis demonstrated that the BTF7C3O films comprised of a 3.95 Fe/Co-rich spinel phase, likely CoFe 2 - xTi xO 4, which would account for the observed magnetic moment in the films. Additionally, x-ray magnetic circular dichroism photoemission electron microscopy (XMCD-PEEM) imaging confirmed that the majority of magnetic response arises from the Fe sites of Fe/Co-rich spinel phase inclusions. While the magnetic contribution from the main phase could not be determined by the XMCD-PEEM images, these data however imply that the Bi 5Ti 3Fe 0.7Co 0.3O 15 thin films are likely not single phase multiferroics at room temperature. The PFM results presented demonstrate that the naturally 2D nanostructured Bi 5Ti 3Fe 0.7Co 0.3O 15 phase is a novel ferroelectric and has potential commercial applications in high temperature piezoelectric and ferroelectric memory technologies. The implications for the conclusive demonstration of ferroelectric and ferromagnetic properties in single-phase materials of this type are discussed.

Magnetic field-induced ferroelectric switching in multiferroic aurivillius phase thin films at room temperature

Single-phase multiferroic materials are of considerable interest for future memory and sensing applications. Thin films of Aurivillius phase Bi 7Ti3Fe3O21 and Bi6Ti 2.8Fe1.52Mn0.68O18 (possessing six and five perovskite units per half-cell, respectively) have been prepared by chemical solution deposition on c-plane sapphire. Superconducting quantum interference device magnetometry reveal Bi7Ti3Fe 3O21 to be antiferromagnetic (TN = 190 K) and weakly ferromagnetic below 35 K, however, Bi6Ti2.8Fe 1.52Mn0.68O18 gives a distinct room-temperature in-plane ferromagnetic signature (Ms = 0.74 emu/g, μ0Hc =7 mT). Microstructural analysis, coupled with the use of a statistical analysis of the data, allows us to conclude that ferromagnetism does not originate from second phase inclusions, with a confidence level of 99.5%. Piezoresponse force microscopy (PFM) demonstrates room-temperature ferroelectricity in both films, whereas PFM observations on Bi6Ti2.8Fe1.52Mn0.68O18 show Aurivillius grains undergo ferroelectric domain polarization switching induced by an applied magnetic field. Here, we show for the first time that Bi6Ti2.8Fe1.52Mn0.68O18 thin films are both ferroelectric and ferromagnetic and, demonstrate magnetic field-induced switching of ferroelectric polarization in individual Aurivillius phase grains at room temperature.

Application of a new method in the study of pelvic floor muscle passive properties in continent women

The aim of this study was to present a new methodology for evaluating the pelvic floor muscle (PFM) passive properties. The properties were assessed in 13 continent women using an intra-vaginal dynamometric speculum and EMG (to ensure the subjects were relaxed) in four different conditions: (1) forces recorded at minimal aperture (initial passive resistance); (2) passive resistance at maximal aperture; (3) forces and passive elastic stiffness (PES) evaluated during five lengthening and shortening cycles; and (4) percentage loss of resistance after 1 min of sustained stretch. The PFMs and surrounding tissues were stretched, at constant speed, by increasing the vaginal antero-posterior diameter; different apertures were considered. Hysteresis was also calculated. The procedure was deemed acceptable by all participants. The median passive forces recorded ranged from 0.54 N (interquartile range 1.52) for minimal aperture to 8.45 N (interquartile range 7.10) for maximal aperture while the corresponding median PES values were 0.17 N/mm (interquartile range 0.28) and 0.67 N/mm (interquartile range 0.60). Median hysteresis was 17.24 N∗mm (interquartile range 35.60) and the median percentage of force losses was 11.17% (interquartile range 13.33). This original approach to evaluating the PFM passive properties is very promising for providing better insight into the patho-physiology of stress urinary incontinence and pinpointing conservative treatment mechanisms.

Randomized controlled trial of physiotherapy for postpartum stress incontinence : 7-year follow-up

Objective To estimate the long-term effect of intensive, 6-week physiotherapy programs, with and without deep abdominal muscle (TrA) training, on persistent postpartum stress urinary incontinence (SUI). Methods The study was a single-blind randomized controlled trial. Fifty-seven postnatal women with clinically demonstrated persistent SUI 3 months after delivery participated in 8 weeks of either pelvic floor muscle training (PFMT) (28) or PFMT with deep abdominal muscle training (PFMT + TrA) (29). Seven years post-treatment, 35 (61.4%) participants agreed to the follow-up; they were asked to complete a 20-min pad test and three incontinence-specific questionnaires with an assessor blinded to each participant's group assignment. Results: Of the 35 (61.4%) who agreed to the follow-up: 26 (45.6%) took the 20-min pad test (12 PFMT and 14 PFMT + TrA) and 35 (61.4%) completed the questionnaires (18 PFMT and 17 PFMT + TrA). The baseline clinical characteristics of the follow-up and non-follow-up participants were not significantly different; nor did they differ between PFMT and PFMT + TrA participants enrolled in the follow-up study. At 7 years, the pad test scores for the PFMT group did not differ statistically from those of the PFMT + TrA group. When combining both treatment groups, a total of 14/26 (53%) follow-up participants were still continent according to the pad test. Conclusion The addition of deep abdominal training does not appear to further improve the outcome of PFM training in the long term. However, benefits of physiotherapy for postpartum SUI, although not as pronounced as immediately after the initial intervention, is still present 7 years post-treatment.

Comparison of two methods for measuring the pubococcygeal line from sagittal-plane magnetic resonance imaging

Aims The pubococcygeal line (PCL) is an important reference line for determining measures of pelvic organ support on sagittal-plane magnetic resonance imaging (MRI); however, there is no consensus on where to place the posterior point of the PCL. As coccyx movement produced during pelvic floor muscle (PFM) contractions may affect other measures, optimal placement of the posterior point is important. This study compared two methods for measuring the PCL, with different posterior points, on T2-weighted sagittal MRI to determine the effect of coccygeal movement on measures of pelvic organ support in older women. Methods MRI of the pelvis was performed in the midsagittal plane, at rest and during PFM contractions, on 47 community-dwelling women 60 and over. The first PCL was measured to the tip of the coccyx (PCLtip) and the second to the sacrococcygeal joint (PCLjnt). Four measures of pelvic organ support were made using each PCL as the reference line: urethrovesical junction height, uterovaginal junction height, M-line and levator plate angle. Results During the PFM contraction the PCLtip shortened and lifted (P < 0.001); the PCLjnt did not change (P > 0.05). The changes in the four measures of pelvic organ support were smaller when measured relative to the PCLtip as compared to those to the PCLjnt (P < 0.001). Conclusions Coccyx movement affected the length and position of the PCLtip, which resulted in underestimates of the pelvic-organ lift produced by the PFM contraction. Therefore, we recommend that the PCL be measured to the sacrococcygeal joint and not to the tip of the coccyx

Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence : a feasibility study

Background Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional training. Aims The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM) exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative information regarding patient satisfaction with this new combined training program. Methods Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the participants' rate of participation in and completion of both the PFM/VRR training program and the home exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and participant's satisfaction through a questionnaire. Results Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patientreported symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%). Conclusion A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women with MUI and should be explore through further RCTs.

Ordered arrays of multiferroic epitaxial nanostructures

Epitaxial heterostructures combining ferroelectric (FE) and ferromagnetic (FiM) oxides are a possible route to explore coupling mechanisms between the two independent order parameters, polarization and magnetization of the component phases. We report on the fabrication and properties of arrays of hybrid epitaxial nanostructures of FiM NiFe(2)O(4) (NFO) and FE PbZr(0.52)Ti(0.48)O(3) or PbZr(0.2)Ti(0.8)O(3), with large range order and lateral dimensions from 200 nm to 1 micron. METHODS: The structures were fabricated by pulsed-laser deposition. High resolution transmission electron microscopy and high angle annular dark-field scanning transmission electron microscopy were employed to investigate the microstructure and the epitaxial growth of the structures. Room temperature ferroelectric and ferrimagnetic domains of the heterostructures were imaged by piezoresponse force microscopy (PFM) and magnetic force microscopy (MFM), respectively. RESULTS: PFM and MFM investigations proved that the hybrid epitaxial nanostructures show ferroelectric and magnetic order at room temperature. Dielectric effects occurring after repeated switching of the polarization in large planar capacitors, comprising ferrimagnetic NiFe2O4 dots embedded in ferroelectric PbZr0.52Ti0.48O3 matrix, were studied. CONCLUSION: These hybrid multiferroic structures with clean and well defined epitaxial interfaces hold promise for reliable investigations of magnetoelectric coupling between the ferrimagnetic / magnetostrictive and ferroelectric / piezoelectric phases.