Managing voiding dysfunction in young men

AbstractVoiding dysfunction is an uncommon condition in young men. With increased understanding of the etiology of chronic lower urinary tract dysfunction, there has been significant improvement in the management of the condition. We have reviewed the current literature and make suggestions about diagnosis, treatment, and further research on this topic. We searched the PubMed database for the management of voiding dysfunction in young men using the following terms: voiding dysfunction, lower urinary tract symptoms, young men, risk factor, urodynamics study, uroflowmetry, magnetic resonance imaging, primary bladder neck obstruction/bladder neck dysfunction, dysfunctional voiding/pseudodyssynergia, impaired detrusor contractility/detrusor underactivity, adrenergic antagonist, transurethral incision, urotherapy, baclofen, and botulinum toxin. Uroflowmetry is an important noninvasive examination for screening young men for possible voiding dysfunction. A videourodynamic study is recommended for patients with low urine flow. Primary bladder neck obstruction and dysfunctional voiding are the two most common diagnoses. α-Adrenergic antagonists and urotherapy are widely used for treating bladder neck obstruction and dysfunctional voiding, respectively. Botulinum toxin A may become a potential therapeutic option in the future. Although the published reports usually included a small number of patients and lacked randomization and a placebo-controlled group, these clinical studies still provide great advances in managing voiding dysfunction in young men. Further well-designed studies are warranted to support optimal management of these conditions

An asymmetrical synchrotron model for knots in the 3C 273 jet

To interpret the emission of knots in the 3C 273 jet from radio to X-rays, we propose a synchrotron model in which, owing to the shock compression effect, the injection spectra from a shock into the upstream and downstream emission regions are asymmetric. Our model could well explain the spectral energy distributions of knots in the 3C 273 jet, and predictions regarding the knots spectra could be tested by future observations.Comment: 9 pages, 1 figure, 1 table, new version accepted for publication in Ap

Efficiency and Returns to Scale Measurements with Shared Inputs in Multi-Activity Data Envelopment Analysis: An Application to Farmers' Organizations in Taiwan

This paper addresses the question how team production promotes efficiency of a firm when some inputs can be rewarded on the basis of outputs but some cannot because they are shared among outputs and non-separable. A multi-activity DEA model with variable returns to scale is proposed to provide information on the efficiency performance for organizations with inputs shared among several closely related activities. The model is applied to study the case of 279 farmers' associations in Taiwan. The result suggests that it is important to improve the efficiency of the non-profit oriented activities to improve their overall performances. Three out of four departments of TFAs can gain from economies of scale through expansion, while the remaining one gains through contraction. Thus, policies promoting structural adjustment and consolidations of TFAs would not be inconsistent with public interests.multi-activity DEA, shared inputs, efficiency measure, directional distance function, Productivity Analysis,

SK channels and ventricular arrhythmias in heart failure

Small-conductance Ca2+-activated K+ (SK) currents are important in the repolarization of normal atrial (but not ventricular) cardiomyocytes. However, recent studies showed that the SK currents are upregulated in failing ventricular cardiomyocytes, along with increased SK channel protein expression and enhanced sensitivity to intracellular Ca2+. The SK channel activation may be either antiarrhythmic or proarrhythmic, depending on the underlying clinical situations. While the SK channel is a new target of antiarrhythmic therapy, drug safety is still one of the major concerns

Productivity Change in Taiwan's Farmers' Credit Unions: A Nonparametric Risk-Adjusted Malmquist Approach

This article proposes an extended three-stage DEA methodology similar to Fried et al. (2002) to improve the measurement of productivity growth then the assumption of free disposability of undesirable outpu t does not apply. A directional distance function is used to construct adjusted Malmquist-Luenberger productivity indexes which simultaneously account for the impacts of undesirable outputs, environmental variables, and statistical noise. Panel data for 264 farmers' credit unions (FCUs) in Taiwan covering the 1998-2000 period are employed to illustrate the advantages of this method. On average, the productivity of Taiwan's FCUs is found to have deteriorated over the 1998-2000 period. Although an improvement in efficiency has been observed, the major reason for the deterioration is found to be due to the regression of techno logy.Malmquist-Luenberger productivity index, three-stage DEA, undesirable outputs, directional distance function, Agricultural Finance, Productivity Analysis,

Q-enhanced fold-and-bond MEMS inductors

This work presents a novel coil fabrication technology to enhance quality factor (Q factor) of microfabricated inductors for implanted medical wireless sensing and data/power transfer applications. Using parylene as a flexible thin-film device substrate, a post-microfabrication substrate folding-and-bonding method is developed to effectively increase the metal thickness of the surface-micromachined inductors, resulting in their lower self-resistance so their higher quality factor. One-fold-and-bond coils are successfully demonstrated as an example to verify the feasibility of the fabrication technology with measurement results in good agreements with device simulation. Depending on target specifications, multiple substrate folding-and-bonding can be extensively implemented to facilitate further improved electrical characteristics of the coils from single fabrication batch. Such Q-enhanced inductors can be broadly utilized with great potentials in flexible integrated wireless devices/systems for intraocular prostheses and other biomedical implants

An hourglass model for the flare of HST-1 in M87

To explain the multi-wavelength light curves (from radio to X-ray) of HST-1 in the M87 jet, we propose an hourglass model that is a modified two-zone system of Tavecchio & Ghisellini (hereafter TG08): a slow hourglass-shaped or Laval nozzle-shaped layer connected by two revolving exponential surfaces surrounding a fast spine, through which plasma blobs flow. Based on the conservation of magnetic flux, the magnetic field changes along the axis of the hourglass. We adopt the result of TG08---the high-energy emission from GeV to TeV can be produced through inverse Compton by the two-zone system, and the photons from radio to X-ray are mainly radiated by the fast inner zone system. Here, we only discuss the light curves of the fast inner blob from radio to X-ray. When a compressible blob travels down the axis of the first bulb in the hourglass, because of magnetic flux conservation, its cross section experiences an adiabatic compression process, which results in particle acceleration and the brightening of HST-1. When the blob moves into the second bulb of the hourglass, because of magnetic flux conservation, the dimming of the knot occurs along with an adiabatic expansion of its cross section. A similar broken exponential function could fit the TeV peaks in M87, which may imply a correlation between the TeV flares of M87 and the light curves from radio to X-ray in HST-1. The Very Large Array (VLA) 22 GHz radio light curve of HST-1 verifies our prediction based on the model fit to the main peak of the VLA 15 GHz radio light curve.Comment: 14 pages, 2 figures, accepted for publication in A