The treatment practices for anterior urethral strictures in China: A case-based survey

ObjectiveTo investigate the treatment concept of Chinese urologists for anterior urethral strictures based on actual cases.MethodsA self-designed case-based questionnaire was distributed to the members of Official WeChat account of Learning Union from March 19, 2020, to April 10, 2020. Questionnaires requested respondents' demographic information and responses to five cases of anterior urethral stricture: short obliterative bulbar urethral stricture caused by straddle injury (Case 1), idiopathic bulbar urethral stricture after failure of multiple endoscopic therapy (Case 2), iatrogenic long penile urethral stricture (Case 3), lichen sclerosis-related urethral stricture (Case 4), and anterior urethral stricture in indwelling catheter after multiple failure of endoscopic surgery (Case 5). Data was described by frequency and percentage.ResultsA total of 1,267 valid anonymous questionnaires were received. Urethroplasty was recommended more frequently than endoscopic surgery (Case 1: 47.8% vs. 32.8%,Case 2: 42.5% vs. 33.8%, Case 3: 36.1% vs. 26.7%). Referrals patients to other urologists engaged in urethral repair and reconstruction account for a high portion of the treatment (Case 1:18.4%, Case 2:23.1%, Case 3:36.5%, Case 4:27.7%,Case 5:9.3%). Excision and primary anastomosis urethroplasty (EPA) was preferred for treatment of Case 1 (42.5%). For Case 2, the most popular choice was EPA (30.6%). Although the patient has a history of failure in endoscopic surgery, 33.8% of urologists continue to choose endoscopic surgery. For Case 3, 20.0% of urologists would perform oral mucosal urethroplasty. Surprisingly, 5.9% chose EPA. For Case 4, 37.3% of urologists selected meatotomy, 30.4% suggested that glans and urethral biopsies should be performed. 21.0% chose to use steroid ointment after surgery. For Case 5, 26.3% of the respondents believed that urethrography should be performed after removing catheter more than one week, if the urine is obstructed during the period, performing cystostomy firstly.ConclusionsIn China, the concept of urethroplasty is more widely accepted than endoscopic surgery for the treatment of anterior urethral strictures. The concept of referral has been widely formed among Chinese urologists. Better understanding of the comprehensive treatment of lichen sclerosis related anterior urethral stricture and the principle of urethral rest should be strengthened

Non-destructive monitoring of maize LAI by fusing UAV spectral and textural features

Leaf area index (LAI) is an essential indicator for crop growth monitoring and yield prediction. Real-time, non-destructive, and accurate monitoring of crop LAI is of great significance for intelligent decision-making on crop fertilization, irrigation, as well as for predicting and warning grain productivity. This study aims to investigate the feasibility of using spectral and texture features from unmanned aerial vehicle (UAV) multispectral imagery combined with machine learning modeling methods to achieve maize LAI estimation. In this study, remote sensing monitoring of maize LAI was carried out based on a UAV high-throughput phenotyping platform using different varieties of maize as the research target. Firstly, the spectral parameters and texture features were extracted from the UAV multispectral images, and the Normalized Difference Texture Index (NDTI), Difference Texture Index (DTI) and Ratio Texture Index (RTI) were constructed by linear calculation of texture features. Then, the correlation between LAI and spectral parameters, texture features and texture indices were analyzed, and the image features with strong correlation were screened out. Finally, combined with machine learning method, LAI estimation models of different types of input variables were constructed, and the effect of image features combination on LAI estimation was evaluated. The results revealed that the vegetation indices based on the red (650 nm), red-edge (705 nm) and NIR (842 nm) bands had high correlation coefficients with LAI. The correlation between the linearly transformed texture features and LAI was significantly improved. Besides, machine learning models combining spectral and texture features have the best performance. Support Vector Machine (SVM) models of vegetation and texture indices are the best in terms of fit, stability and estimation accuracy (R2 = 0.813, RMSE = 0.297, RPD = 2.084). The results of this study were conducive to improving the efficiency of maize variety selection and provide some reference for UAV high-throughput phenotyping technology for fine crop management at the field plot scale. The results give evidence of the breeding efficiency of maize varieties and provide a certain reference for UAV high-throughput phenotypic technology in crop management at the field scale

Common Molecular Etiologies Are Rare in Nonsyndromic Tibetan Chinese Patients with Hearing Impairment

Background: Thirty thousand infants are born every year with congenital hearing impairment in mainland China. Racial and regional factors are important in clinical diagnosis of genetic deafness. However, molecular etiology of hearing impairment in the Tibetan Chinese population living in the Tibetan Plateau has not been investigated. To provide appropriate genetic testing and counseling to Tibetan families, we investigated molecular etiology of nonsyndromic deafness in this population. Methods: A total of 114 unrelated deaf Tibetan children from the Tibet Autonomous Region were enrolled. Five prominent deafness-related genes, GJB2, SLC26A4, GJB6, POU3F4, and mtDNA 12S rRNA, were analyzed. Inner ear development was evaluated by temporal CT. A total of 106 Tibetan hearing normal individuals were included as genetic controls. For radiological comparison, 120 patients, mainly of Han ethnicity, with sensorineural hearing loss were analyzed by temporal CT. Results: None of the Tibetan patients carried diallelic GJB2 or SLC26A4 mutations. Two patients with a history of aminoglycoside usage carried homogeneous mtDNA 12S rRNA A1555G mutation. Two controls were homozygous for 12S rRNA A1555G. There were no mutations in GJB6 or POU3F4. A diagnosis of inner ear malformation was made in 20.18 % of the Tibetan patients and 21.67 % of the Han deaf group. Enlarged vestibular aqueduct, the most common inner ear deformity, was not found in theTibetan patients, but was seen in 18.33 % of the Han patients. Common molecular etiologies

Factors to Consider in Augmentation Urethroplasty with Oral Mucosa Graft or Penile Skin Flap for Anterior Urethral Stricture: A Systematic Review and Meta-analysis

Context: Oral mucosa graft (OMG) and penile skin flap (PSF) are common substitutions in urethroplasty; however, the recommended substitution for anterior urethral strictures remains uncertain. Objective: To compare the efficacy of OMG and PSF in anterior urethral strictures in terms of success rate and prevalence of postvoid dribbling based on current studies. Evidence acquisition: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and registered at PROSPERO (ID: CRD42022313879). All publications until March 1, 2022, were searched in the PubMed, EMBASE, and Cochrane Library databases without any restriction. Studies that focused on patients with anterior urethral strictures undergoing single-stage augmentation urethroplasty with OMG and PSF, and reported comparable success rates between the two substitutions were included. Evidence synthesis: Thirteen studies involving a total of 1216 patients were included in the screening procedures, and 12 studies were eventually included in the meta-analysis. No significant difference in success rates was identified between OMG and PSF (odds ratio [OR]: 1.41, 95% confidence interval [CI]: 0.96–2.07, p = 0.08). No significant difference was observed in the comparison of success rates in penile urethral strictures (OR: 0.95, 95% CI: 0.53–1.70, p = 0.86) and in the comparison of postvoid dribbling (OR: 0.59, 95% CI: 0.31–1.11, p = 0.10). However, a subgroup analysis suggested that OMG had a higher success rate than PSF in studies with the top 50% sample size (six studies, OR: 1.678, 95% CI: 1.055–2.668, p = 0.029) and the top 50% follow-up period (five studies, OR: 2.279, 95% CI: 1.193–4.352, p = 0.013). Conclusions: OMG provides the same success rate and postvoid dribbling as PSF. However, based on the existing evidence, OMG is more likely to perform better in a cohort with long-term follow-up and a relatively large sample size. More studies on the two substitutions are necessary to evaluate the factors of urethroplasty success rate, performance of substitutions in penile urethral strictures, and indicators of quality of life. Patient summary: In this research, we compared the outcomes of oral mucosa graft (OMG) and penile skin flap for urethroplasty in anterior urethral stricture patients in 13 studies. We found that these were similar in terms of success rate and postvoid dribbling. However, OMG could probably provide a higher success rate when the studies had more patients or a longer follow-up period

Improving assessment capability for accounts receivable pool financiers An empirical investigation

Purpose The accounts receivable pool (ARP) is an e-invoice management system that provides suppliers with easy access to financial service. The purpose of this paper is to focus on the strength and weakness of ARP mechanism and suggest efficient methods to identify creditworthy borrowers. Design/methodology/approach By decomposing the sales records of 348 ARP borrowers and predicting the occurrence of overdue incidences, this study first portrays the creditworthy borrowers by sales features. Then, content analysis was applied to measure the loadings of soft and hard information, and examined the effectiveness of different information structures in creditworthiness assessment. Findings For ARP borrowers, upward trend and low volatility reveal their creditworthiness. In order to identify creditworthy borrowers beforehand, ARP financiers who have elaborated more soft information and less hard information can perform better. Originality/value This study first discussed ARP finance from a critical perspective and underlines borrower assessment to eliminate the defect of loose recourse. The empirical evidence presents the sales features of creditworthy borrowers. Moreover, the results suggest an efficient approach for ARP financiers to conduct better assessment

The neutrophil percentage-to-albumin ratio is an independent risk factor for poor prognosis in peritoneal dialysis patients

AbstractAim This study aimed to investigate the predictive ability of the neutrophil percentage-to-albumin Ratio (NPAR) concerning all-cause mortality and cardio-cerebrovascular mortality in patients undergoing peritoneal dialysis (PD).Methods We included a total of 807 PD patients from the Peritoneal Dialysis Center of the Second Affiliated Hospital of Soochow University between January 2009 and December 2019 in this study. Patients were categorized into three groups based on their baseline NPAR. The Kaplan-Meier method, multivariate Cox proportional hazard model, and Fine-Gray competing risk model were employed to examine the relationship between NPAR level and all-cause mortality and cardio-cerebrovascular mortality among PD patients. Furthermore, the ROC curve and calibration plots were utilized to compare the performance between NPAR and other conventional indicators.Results The mean follow-up period was 38.2 months. A total of 243 (30.1%) patients passed away, with 128 (52.7%) succumbing to cardio-cerebrovascular diseases. The mortality rates of the Middle and High NPAR groups were significantly greater than that of the Low NPAR group (p < 0.001), and NPAR was independently associated with all-cause mortality and cardio-cerebrovascular mortality. Receiver Operating Characteristic (ROC) analysis indicated that the Area Under the Curve (AUC) of NPAR (0.714) was significantly superior to those of C-reactive protein (CRP) (0.597), neutrophil to lymphocyte ratio (NLR) (0.589), C-reactive protein to albumin ratio (CAR) (0.698) and platelet to lymphocyte ratio (PLR) (0.533).Conclusion NPAR served as an independent predictive marker for all-cause mortality and cardio-cerebrovascular mortality in PD patients. Moreover, NPAR demonstrated superior predictive potential compared to CRP, CAR, NLR, and PLR

Super-resolution imaging of urethral vasculature in healthy pre- and post-menopausal females

Summary: Previous studies have postulated that the urethral vasculature (UV) might play an important role in urinary continence for women. The goal of this research was to compare the UV in pre- and post-menopausal women using a super-resolution ultrasound imaging method called Super Ultrasound for Greater Accuracy and Resolution (SUGAR). We found that post-menopausal women exhibited decreased UV parameters such as fractal dimension, vessel proportion, and mean blood vessel diameter than pre-menopausal women. We also discriminated the vascular pattern in several layers of the urethra and its surrounding in vivo, including the urethral mucosa and submucosa, urethral muscle, and anterior vaginal wall. Besides, the statistical analysis of the vasculature pattern showed that most of the UV parameters peaked at mid-urethra. Ultimately, the UV parameters exhibited a tendency of first increasing, then reducing, and finally decreasing with age