Outcomes and prognostic factors of simple partial cystectomy for localized bladder urothelial cell carcinoma

AbstractRadical cystectomy has remained the gold standard for recurrent superficial or muscle invasive bladder tumor. However, partial cystectomy still has a role in those who reject or have contraindications for radical cystectomy. In this study, we sought to identify predictors of bladder recurrence and overall survival after simple partial cystectomy. We included 27 patients with bladder tumor who received simple partial cystectomy without pelvic lymph node dissection between March 2000 and September 2013. Adjuvant chemotherapy or radiation therapy was prescribed according to the pathological results. Parameters were compared on the basis of bladder recurrence and overall survival. During a mean follow-up time of 39 months, five patients (18.5%) experienced bladder recurrence. An older age, a higher pathological stage, positive surgical margins, and distant metastases were significant predictors of overall survival (p = 0.031, p = 0.001, p = 0.001, and p = 0.011, respectively). Meanwhile, previous bladder instillation and positive surgical margins were significant predictors of bladder recurrence (p = 0.026 and p = 0.027, respectively). The rate of consecutive distant metastases (33.3%) was almost twice the rate of bladder recurrence (18.5%), and six patients developed consecutive distant metastases without first experiencing bladder recurrence. In patients who received a simple partial cystectomy as an alternative treatment, previous bladder instillation and positive surgical margins were significant predictors of bladder recurrence. Patients with an older age, positive surgical margins, and consecutive distant metastases had worse overall survival. Partial cystectomy with routine lymph node dissection may be a better option for achieving favorable long-term outcomes

Electron Paramagnetic Resonance Studies of Succinate:Ubiquinone Oxidoreductase from Paracoccus denitrificans

Electron paramagnetic resonance (EPR) studies of succinate:ubiquinone oxidoreductase (SQR) from Paracoccus denitrificans have been undertaken in the purified and membrane-bound states. Spectroscopic “signatures” accounting for the three iron-sulfur clusters (2Fe-2S, 3Fe-4S, and 4Fe-4S), cytochromeb, flavin, and protein-bound ubisemiquinone radicals have been obtained in air-oxidized, succinate-reduced, and dithionite-reduced preparations at 4–10 K. Spectra obtained at 170 K in the presence of excess succinate showed a signal typical of that of a flavin radical, but superimposed with another signal. The superimposed signal originated from two bound ubisemiquinones, as shown by spectral simulations. Power saturation measurements performed on the air-oxidized enzyme provided evidence for a weak magnetic dipolar interaction operating between the oxidized 3Fe-4S cluster and the oxidized cytochrome b. Power saturation experiments performed on the succinate- and dithionite-reduced forms of the enzyme demonstrated that the 4Fe-4S cluster is coupled weakly to both the 2Fe-2S and the 3Fe-4S clusters. Quantitative interpretation of these power saturation experiments has been achieved through redox calculations. They revealed that a spin-spin interaction between the reduced 3Fe-4S cluster and the cytochrome b (oxidized) may also exist. These findings form the first direct EPR evidence for a close proximity (≤2 nm) of the high potential 3Fe-4S cluster, situated in the succinate dehydrogenase part of the enzyme, and the low potential, low spin b-heme in the membrane anchor of the enzyme

Gender Difference in Statin Intervention on Blood Lipid Control among Patients with Coronary Heart Disease

SummaryBackgroundThe aim of this study was to clarify the current status in the effective control of dyslipidemia in Taiwanese women and men with coronary heart disease (CHD).Materials and methodsA total 1584 patients with CHD (1188 men, aged 64.8 ± 11.6 years and 396 women, aged 69.0 ± 9.8 years) from 3486 patients who had atherosclerotic vascular disease and complete lipids measured values [total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C)] were used for analysis.ResultsThe waist, height, weight, and creatinine levels were higher in men than in women. The systolic blood pressure, TC, HDL-C, LDL-C, fasting blood glucose, and platelet were lower in men than in women. Men were more likely to achieve the target goal than women in TC < 160 mg/dL, LDL-C < 100 mg/dL, and TG < 150 mg/dL as well as to achieve HDL-C goal.ConclusionA significant gap was found between the guidelines and clinical practice in statin intervention among these CHD patients, particularly for women. The strategy in control of dyslipidemia should consider gender difference

Location-Aware Visual Question Generation with Lightweight Models

This work introduces a novel task, location-aware visual question generation (LocaVQG), which aims to generate engaging questions from data relevant to a particular geographical location. Specifically, we represent such location-aware information with surrounding images and a GPS coordinate. To tackle this task, we present a dataset generation pipeline that leverages GPT-4 to produce diverse and sophisticated questions. Then, we aim to learn a lightweight model that can address the LocaVQG task and fit on an edge device, such as a mobile phone. To this end, we propose a method which can reliably generate engaging questions from location-aware information. Our proposed method outperforms baselines regarding human evaluation (e.g., engagement, grounding, coherence) and automatic evaluation metrics (e.g., BERTScore, ROUGE-2). Moreover, we conduct extensive ablation studies to justify our proposed techniques for both generating the dataset and solving the task.Comment: EMNLP 202

Using Capacitance Sensor to Extract Characteristic Signals of Dozing from Skin Surface

Skin is the largest organ of the human body and a physiological structure that is directly exposed to the environment. From a theoretical perspective, numerous physiological and psychological signals use the skin as a medium for input and output with the outside world. Therefore, the skin is considered an optimal signal interception point when developing noninvasive, direct, and rapid signal exploration devices. To date, skin signal interceptions are predominantly performed by measuring skin impedance. However, this method is prone to interference such as sweat secretion, salt accumulation on the skin, and muscle contractions, which may result in a substantial amount of interference and erroneous results. The present study proposes novel and effective methods for skin signal interception, such as using a nested probe as a sensor to measure capacitance to be further processed as physiological and psychological signals. The experimental results indicate that the capacitance curve for the transition between wakefulness and dozing exhibits significant changes. This change in the curve can be analyzed by computer programs to clearly and rapidly determine whether the subject has entered the initial phases of sleep

Molecular Dynamics Simulation of Nanoindentation-induced Mechanical Deformation and Phase Transformation in Monocrystalline Silicon

This work presents the molecular dynamics approach toward mechanical deformation and phase transformation mechanisms of monocrystalline Si(100) subjected to nanoindentation. We demonstrate phase distributions during loading and unloading stages of both spherical and Berkovich nanoindentations. By searching the presence of the fifth neighboring atom within a non-bonding length, Si-III and Si-XII have been successfully distinguished from Si-I. Crystallinity of this mixed-phase was further identified by radial distribution functions

A systematic review and meta-analysis comparing the efficacy and safety of ciprofol (HSK3486) versus propofol for anesthetic induction and non-ICU sedation

Background: Ciprofol (HSK3486) is a novel intravenous anesthetic agent that bears structural similarity to propofol and displays favorable pharmacodynamic characteristics such as rapid onset and offset. The meta-analysis aimed at comparing the efficacy and safety of ciprofol versus propofol in clinical practice.Methods: Medline, EMBASE, Google Scholar, Cochrane Library were searched from inception to April 2023. The primary outcome was success rate of sedation/anesthetic induction and differences in sedation/induction time. The secondary outcomes included risks of hemodynamic instability, respiratory complications, and pain on injection, as well as recovery profiles, satisfaction score, and top-up dose requirement.Results: Twelve RCTs (sedation: n = 6, anesthetic induction, n = 6, all conducted in China) involving 1,793 patients (age: 34–58 years) published from 2021 to 2023 were analyzed. Pooled results revealed no differences in success rate [risk ratio (RR) = 1, 95% confidence interval (CI): 0.99 to 1.01, I2 = 0%, 1,106 patients, p = 1] and time required for successful anesthetic induction/sedation [mean difference (MD) = 7.95 s, 95% CI: −1.09 to 16.99, I2 = 97%, 1,594 patients, p = 0.08]. The risks of top-up dose requirement (RR = 0.94, p = 0.48), cardiopulmonary complications [i.e., bradycardia (RR = 0.94, p = 0.67), tachycardia (RR = 0.83, p = 0.68), hypertension (RR = 1.28, p = 0.2), hypoxemia/pulmonary depression (RR = 0.78, p = 0.24)], and postoperative nausea/vomiting (RR = 0.85, p = 0.72), as well as discharge time (MD = 1.39 min, p = 0.14) and satisfaction score (standardized MD = 0.23, p = 0.16) did not differ significantly between the two groups. However, the ciprofol group had lower risks of hypotension (RR = 0.85, p = 0.02) and pain on injection (RR = 0.17, p &lt; 0.00001) than the propofol group. The time to full alertness was statistically shorter in the propofol group (i.e., 0.66 min), but without clinical significance.Conclusion: Our results demonstrated similar efficacy between ciprofol and propofol for sedation and anesthetic induction, while ciprofol was associated with lower risks of hypotension and pain on injection. Future studies are warranted to evaluate the efficacy and safety of ciprofol in pediatric or the elderly populations.Systematic Review Registration: (https://www.crd.york.ac.uk/prospero/), identifier (CRD42023421278)

Blockchain-Based Medical Record Management with Biofeedback Information

Blockchain is a new emerging technology of distributed databases, which guarantees the integrity, security and incorruptibility of data by means of the cryptography. Such features are suitable for secure and reliable data storage. This chapter investigates the blockchain-based architecture with applications to medical health record or biofeedback information management. This framework employs the smart contract to establish a medical record management system to ensure the privacy of patients. Moreover, the blockchain technique accelerates the medical record or information exchange such that the cost of human resource is significant reduced. All patients can manage their individual medical records and information easily in the different hospitals and clinics. They also have the privilege to deal with and authorize personal medical records in the proposed management framework