A matched case-control study in Taiwan to evaluate potential risk factors for prostate cancer.

The rising incidence rate of prostate cancer (PCa) worldwide has become a public health concern. PCa has a multifactorial etiology, and the link between human papillomavirus (HPV) and PCa has been widely investigated by numerous case-control studies. This age-matched, case-control study included 143 PCa patients and 135 benign prostatic hyperplasia (BPH) patients, with prostatic specimens testing negative for malignancy, as control. Study participants were recruited from four major hospitals in Taoyuan City, Taiwan, period 2018-2020, looking into HPV infection and other PCa risk factors, including dietary habits, family history, personal lifestyle, and sexual behavior. Multiple logistic regression analysis and forward stepwise selection analysis were conducted to identify potential risk factors for PCa. HPV DNA was found in 10 of the 143 PCa cases (7%) and 2 of the 135 BPH controls (1.5%) (OR = 6.02, 95% CI = 1.03-30.3, p = 0.046). This association was slightly significant, and furthermore, high risk HPV was not found to be associated with PCa. Higher body mass index (BMI) (OR = 1.15, 95% CI = 1.05-1.27, p = 0.003), more total meat consumption (OR = 2.74, 95% CI = 1.26-5.94, p = 0.011), exhibited association to PCa. However, PCa family history only presented a statistically significant difference by forward stepwise analysis (OR = 3.91, 95% CI = 1.17-13.12, p = 0.027). While much focus has been on the association between HPV and PCa, the results of this study indicate that more efforts should be directed towards investigating dietary habits, personal lifestyle and family history as factors for PCa. These results could serve as a basis for designing PCa prevention strategies.

Carbon allowance allocation in the shipping industry under EEDI and non-EEDI.

The CO2 emissions targets in this study are based on the Paris Agreement, which aims to cut emissions in 2050 to half of the 2005 levels, with a focus on the shipping industry. This study uses data for various kinds of vessels following the guidelines set in the Energy Efficiency Design Index (EEDI) and examines emission levels and the results of using different strategies during three different business climates. Carbon allowance allocations and cost benefit ratios (CBR) are included. The results show that the minimal free carbon allowances in 2050 for vessels in keeping with EEDI or non-EEDI scenarios should be set so that (1) under prosperous business cycles they are 29% and 14%; (2) under steady business cycles 83% and 42%; (3) under sluggish business cycles 510% and 255%, respectively. In addition, when shipping companies follow the emission cap guidelines, the CBR in 2050 for vessels in both scenarios will be (1) 37.52% and 47.45% during prosperous business cycles; (2) 43.49% and 45.65%during steady business cycles; (3) and 53.60% and 53.83% during sluggish business cycles, respectively. The results indicate that during prosperous business cycles, although the free carbon allowance for shipping companies will be greatly insufficient, their profits will still be higher than during sluggish business cycles.

Complete ureter avulsion causing a long defect as a complication of posterior spine fusion: a rare case treated with nonrobotic laparoscopic repair.

PURPOSE: Ureter avulsion, a challenging urologic complication, has been rarely found in lumbar spine surgeries. Once ignored, the leaked urine usually leads to significant morbidity and also makes further repair more difficult. We present an unusual ureter injury causing a long defect which occurred in posterior spine fusion; immediate repair was performed with minimal invasion. CASE PRESENTATION: A 61-year-old female was receiving microscopic spine fusion (transforaminal lumbar interbody fusion) for her L3-L5 spondylosis. Ureter avulsion with one 3-cm defect occurred unexpectedly. We confirmed urine extravasation promptly, and performed end-to-end ureteroureterostomy with laparoscopy. Retrograde double-J stenting was indwelled. Her postoperative condition was uneventful. CONCLUSION: This rare case with good outcome highlights the importance of early diagnosis and immediate repair for complete ureter avulsion. We prove that reanastomosis for ureter loss as much as 3 cm is feasible with laparoscopy in regional hospitals where a robot is not available. To deal with large gaps between stumps, adequate kidney mobilization is required before anastomosis.

Patient Utility Measurement for Managing Ureteral Stones: A Modified Standard Gamble Approach.

OBJECTIVES: To measure the utility of patients with ureteral stones under various medical regimes and to identify significant factors affecting utility for various health states. METHODS: A cross-sectional survey was conducted to measure the utility of 89 patients on each health state related to the clinical management of ureteral stones. Health states with respect to intervention and treatment modalities were classified into the acute phase (including medication, extracorporeal shock wave lithotripsy, ureterorenoscopic lithotripsy, and surgery) and the chronic phase (no specific intervention, lifestyle modification, maintenance with surveillance, and continued medication). Utility was measured by using the modified standard gamble. Demographic data and relevant history of treatment modalities and interventions for ureteral stones were collected by using a questionnaire. RESULTS: Utility scores of health states in the acute phase (ranging from 0.914 [surgery] to 0.967 [extracorporeal shock wave lithotripsy]) were lower than those in the chronic phase (ranging from 0.955 [maintenance with surveillance] to 0.974 [lifestyle modification]). Utility for surgery was lower than for nonsurgical methods. Utilities for the two lithotripsy modalities were close to that for medication. The utility figures for health states in the chronic phase were the highest for lifestyle modification, but the differences across health states were trivial. Sex, history of ureterorenoscopic lithotripsy, education level, and employment were significant covariates in the final multiple linear regression model. CONCLUSIONS: A modified standard gamble chained method was applied to measure the utility for health states in relation to the clinical management of ureteral stones. Patients preferred nonsurgical treatment over surgical treatment and hemodialysis regardless of health states. We also found that sex, a history of ureterorenoscopic lithotripsy, education level, and employment affected utility for health states related to clinical management. Our findings provide an insight into patient preference for the choice of treatment of ureteral stones.

Anisotropic outputs of a nanogenerator from oblique-aligned ZnO nanowire arrays.

We studied the dependence of the output of the piezoelectric nanogenerator (NG) on the inclining orientation of the ZnO nanowire arrays (NWAs). The oblique-aligned NWAs were grown by combing a modified oblique-angle sputtering technique for preparing the seed layer and hydrothermal growth. The piezoelectric output of the NWAs was studied by scanning the tip of an atomic force microscope along four different directions in reference to the inclining direction of the NWs. The statistical outputs were analyzed in reference to the theoretically calculated piezopotential distribution in the NWs. Our study provides in-depth understanding about the performance of NGs.

High incidence of and risk factors for metachronous bilateral upper tract urothelial carcinoma in Taiwan.

AIM: Urothelial carcinoma (UC) can occur multifocally in the whole urothelium. A higher rate of bilateral metachronous upper tract (UT) UC was noted in Taiwan. The incidence and risk factors were largely unknown and hence were explored in the study. METHODS: From January 1977 through June 2003, 462 patients with unilateral UT-UC were studied retrospectively. The cumulative incidence of contralateral recurrence was analysed with the Kaplan-Meier analysis. Potential risk factors for contralateral recurrence including age, smoking, bladder cancer, renal function, diagnostic year etc. were evaluated with the log-rank test. Independent risk factors were identified by using the Cox regression analysis. RESULTS: The median follow-up time was 34 months (6-337). Among the 462 patients, 52 (11.3%) developed metachronous contralateral UC. The 2, 5, and 10-year contralateral disease-free survivals were 93.5%, 84.0%, and 75.7%, respectively. The median time to contralateral recurrence was 31.0 months. With the univariate analysis, only poor renal function (serum creatinine < or > OR =2.0 mg/dL, P < 0.001) and late diagnostic year (before or after 1990, P < 0.001) were risk factors for contralateral recurrence. In the multivariate analysis, poor renal function (hazard ratio: 2.98; 95% confidence interval: 1.67-5.33; P < 0.001) and late diagnostic year (hazard ratio: 4.27; 95% confidence interval: 1.71-10.65; P = 0.002) remained independent risk factors. CONCLUSIONS: The incidence of metachronous UT-UC is high in Taiwan. Patients who had either chronic renal insufficiency or a disease diagnosed after 1990 had a higher risk of contralateral recurrence.

Impact of nocturia on symptom-specific quality of life among community-dwelling adults aged 40 years and older.

OBJECTIVES: To evaluate factors predicting the effect of nocturia in a community-based cohort of adults using a nocturia-specific quality-of-life (N-QOL) questionnaire. METHODS: From October 2004 to February 2005, adults aged 40 years old or older living in Matsu, Taiwan and reporting nocturia of one episode or more per night were interviewed with a 12-item N-QOL questionnaire consisting of Sleep/Energy and Bother/Concern subscales. Univariate analyses were used to analyze the effects of demographic characteristics, frequency and duration of nocturia, and sleeping characteristics on the N-QOL score. Multiple linear regression analysis was used to identify factors predicting the N-QOL score. RESULTS: A total of 663 adults completed this study (mean age 59.4 years). The average N-QOL scores (a lower score indicates worse QOL) were 91.4 +/- 11.2, 83.7 +/- 13.2, 77.6 +/- 16.8, and 67.6 +/- 21.2 for nocturia episodes of 1, 2, 3, and 4 or more per night, respectively (P < 0.001). Men reported significantly lower N-QOL (85.6 +/- 15.1 versus 88.9 +/- 13.1, P = 0.003) and Bother/Concern subscale scores (42.0 +/- 8.4 versus 44.0 +/- 7.4, P < 0.001), but not Energy/Sleep subscale scores (43.6 +/- 7.8 versus 44.4 +/- 7.3, P = 0.158) than women. On multiple linear regression analysis, increasing nocturia episodes (regression coefficient -6.2, 95% confidence interval -7.4 to -5.0), male sex (regression coefficient -3.5, 95% confidence interval -5.4 to -1.5), and degree of sleeping disturbance after nocturia (regression coefficient -4.5, 95% confidence interval -5.6 to -3.4) independently predicted a significantly lower N-QOL score. CONCLUSIONS: The results of our study have confirmed that nocturia has a more significant QOL impact when the patient has two or more episodes per night. Moreover, men experienced a greater impact from nocturia than women, particularly in the Bother/Concern domain.