A Four-Way Interaction Model: A Holistic Approach to the Group Decision Support Systems

This study adopts the general systems theory and proposes a four-way interaction model which uses nth logic function to represent interactions of a Group Decision Support System (GDSS) to examine the interaction issues when designing a GDSS. Task type and decision guidance are used to illustrate the application of the proposed model

Localization of Cholecystokinin and Vasoactive Intestinal Peptide in Lower Biliary Tract in Cats Following Electroacupuncture on Right Qimen (LR14) and Riyue (GB 24): an Immunohistochemistry Study

ABSTRACT: Accumulating evidence has shown that control of the motility of the sphincter of Oddi (SO) involves a complex interaction between nerves, neurotransmitters and gastrointestinal hormones such as vasoactive intestinal peptide (VIP) and cholecystokinin (CCK). Our previous studies demonstrated that electroacupuncture (EA) modulated the SO motiiity in cats and rabbits through activation of nonadrenergic non-choiinergic (NANC) pathway. This study was designed to investigate the changes of neurotransmitters such as CCK and VIP in lower biliary tract in cats receiving EA stimulation. After cats were anesthetized with intramuscular injection of ketamine hydrochloride. they were prepared to conduct EA stimulation on right Qimen (LR14) and Riyue (GB 24). The parameters of EA were 6 pulses/ 3 sec and 45 pulses/ 3 sec alternatively in frequency, 1-2 mA in intensity and 20 min in stimulation duration. After the completeness of EA stimulation, visceral organs such as gallbladder, duodenum and the sphincter of Oddi were removed and frozen for immunohistochemistry localization of CCK and VIP, The results showed that the distribution of CCK-Iabeled cells in duodenum, gallbladder and SO were more and distinct after EA than before EA stimulation. Whereas, the VIP-Iabcled cells were significantly more and distinct in duodenum and SO, but not in gall bladder. We conclude that EA regulates the biliary motility though increasing the distribution of CCK-and VIP-containing cells in duodenum and the sphincter of Oddi

Oncologic impact of delay between diagnosis and radical nephroureterectomy

PurposeThis study aimed to evaluate the oncological outcome of delayed surgical wait time from the diagnosis of upper tract urothelial carcinoma (UTUC) to radical nephroureterectomy (RNU).MethodsIn this multicenter retrospective study, medical records were collected between 1988 and 2021 from 18 participating Taiwanese hospitals under the Taiwan UTUC Collaboration Group. Patients were dichotomized into the early (≤90 days) and late (>90 days) surgical wait-time groups. Overall survival, disease-free survival, and bladder recurrence-free survival were calculated using the Kaplan–Meier method and multivariate Cox regression analysis. Multivariate analysis was performed using stepwise linear regression.ResultsOf the 1251 patients, 1181 (94.4%) were classifed into the early surgical wait-time group and 70 (5.6%) into the late surgical wait-time group. The median surgical wait time was 21 days, and the median follow-up was 59.5 months. Our study showed delay-time more than 90 days appeared to be associated with worse overall survival (hazard ratio [HR] 1.974, 95% confidence interval [CI] 1.166−3.343, p = 0.011), and disease-free survival (HR 1.997, 95% CI 1.137−3.507, p = 0.016). This remained as an independent prognostic factor after other confounding factors were adjusted. Age, ECOG performance status, Charlson Comorbidity Index (CCI), surgical margin, tumor location and adjuvant systemic therapy were independent prognostic factors for overall survival. Tumor location and adjuvant systemic therapy were also independent prognostic factors for disease-free survival.ConclusionsFor patients with UTUC undergoing RNU, the surgical wait time should be minimized to less than 90 days. Prolonged delay times may be associated with poor overall and disease-free survival

A comparative study of laparoscopic and robotic assisted radical prostatectomy performed by a single surgeon

Objective: To present the transition from laparoscopic radical prostatectomy (LRP) to robotic-assisted laparoscopic radical prostatectomy (RALP) over 10 years in a medium volume center by a single surgeon. Materials and methods: We retrospectively reviewed 140 prostate cancer patients who underwent LRP (100 patients) or RALP (40 patients) between May 2005 and May 2015. Preoperative parameters included age, body mass index, and serum prostate specific antigen. Operative course parameters included operative time, estimated blood loss, intraoperative blood transfusion, conversion to open surgery, hospitalization days, duration of Foley catheterization, and complications. Pathological stage, surgical margin status, biochemical recurrence (BCR) rate, and continence rate at 12 months after surgery were reviewed and compared between the LRP and RALP groups. Result: The operative outcomes revealed significantly less blood loss (143 mL vs. 306 mL, p<0.001), shorter hospital stay (6.9 days vs. 8.7 days, p=0.006), and shorter duration of Foley catheterization (9.3 days vs. 11.3 days, p<0.001) in patients who underwent RALP. Major perioperative complications occurred in four LRP patients (4%), and none were observed in RALP patients. LRP and RALP had similar positive surgical margin rates (p=0.285) and BCR rates (p=0.88). RALP resulted in better continence recovery than LRP (55% vs. 82.5%, p=0.003). Conclusion: Patients who underwent RALP had better perioperative and functional outcomes. Oncologic outcomes were similar compared to patients who underwent LRP

Green Catalysts Derived from Agricultural and Industrial Waste Products: The Preparation of Phenols from CsOH and Aryl Iodides using CuO on Mesoporous Silica

The synthesis of CuO catalysts supported on mesoporous silica derived from rice husks and semiconductor copper from chemical mechanical planarization (Cu-CMP) wastewater is described. These catalysts are active for the coupling reaction of CsOH with aryl iodides. Low catalyst loading (1 mol-%) without the need for ancillary ligands make these very attractive green catalysts