bluuebunny/crossref_metadata_2025 huggingface dataset:
Coleção de Vetores de Tripanosomatídeos (Fiocruz/COLVET) held at the institution Fiocruz Minas in Brazil: diversity of Triatominae (Hemiptera, Reduviidae) and relevance for research, education, and entomological surveillance
Authors: Brito Raíssa N. , Souza Rita C. M. , Diotaitui Liléia , Lima Valeria S. , Ferreira Raquel A.
Published: December 2021

The Coleção de Vetores de Tripanosomatídeos (Fiocruz/COLVET), Minas Gerais, Brazil, stands out as one of the most important collections of blood-sucking triatomines, the vectors of Trypanosoma cruzi that causes Chagas disease. The aim is to describe the collection and the services it provides to support scientific research, educational activities, and entomological surveillance between 2013–2019.The data associated with the specimens held in Fiocruz/COLVET is available from the Sistema de Informação sobre a Biodiversidade Brasileira (SiBBr). These specimen metadata were analyzed and either tabulated or plotted on graph and maps. The records of services provided by the collection between 2013–2019 were also categorized and analyzed. There are 12,568 triatomine specimens deposited in the collection that belong to 77 species and 11 genera, from 15 American countries. Of the ~ 65 species of triatomines found in Brazil, 38 (57.6%) are present in the collection, including specimens from all biomes and all but three Brazilian states. The occurrence of Triatoma costalimai, Triatoma lenti, Rhodnius nasutus, and Panstrongylus lenti apparently collected beyond their known distribution ranges are reported and discussed. The collection provided 168 services, supporting educational activities (41.7%), scientific research (35.7%), and regional/national entomological surveillance of triatomines (22.6%). Between the years 2014 and 2020, the number of biological specimens deposited in the Fiocruz/COLVET repository increased from 4,778 to 12,568 triatomine specimens. In addition to its great value to biodiversity conservation, the collection is of great importance because of its support of research and educational activities, and contributions to entomological surveillance, and, therefore, to public health.
Non-Lipschitz heterogeneous reaction with a p-Laplacian operator
Authors: Díaz José L. ,   Escuela Politécnica Superior, Universidad Francisco de Vitoria, Ctra. Pozuelo-Majadahonda Km 1,800, 28223, Pozuelo de Alarcón, Madrid, Spain
Published: December 2021

The intention along this work is to provide analytical approaches for a degenerate parabolic equation formulated with a p-Laplacian operator and heterogeneous non-Lipschitz reaction. Firstly, some results are discussed and presented in relation with uniqueness, existence and regularity of solutions. Due to the degenerate diffusivity induced by the p-Laplacian operator (specially when $ \nabla u = 0 $, or close zero), solutions are studied in a weak sense upon definition of an appropriate test function. The p-Laplacian operator is positive for positive solutions. This positivity condition is employed to show the regularity results along propagation. Afterwards, profiles of solutions are explored specially to characterize the propagating front that exhibits the property known as finite propagation speed. Finally, conditions are shown to the loss of compact support and, hence, to the existence of blow up phenomena in finite time.
Hermite-Hadamard like inequalities for fractional integral operator via convexity and quasi-convexity with their applications
Authors: Nasir Jamshed , Qaisar Shahid , Butt Saad Ihsan , Aydi Hassen , De la Sen Manuel
Published: December 2021

Since the supposed Hermite-Hadamard inequality for a convex function was discussed, its expansions, refinements, and variations, which are called Hermite-Hadamard type inequalities, have been widely explored. The main objective of this article is to acquire new Hermite-Hadamard type inequalities employing the Riemann-Liouville fractional operator for functions whose third derivatives of absolute values are convex and quasi-convex in nature. Some special cases of the newly presented results are discussed as well. As applications, several estimates concerning Bessel functions and special means of real numbers are illustrated.
Editorial: Trabajos de Prehistoria se consolida como revista española de referencia en los indicadores de calidad de revistas científicas
Authors: Rodríguez Yunta Luis , Díaz-del-Río Pedro , Martínez Navarrete M.ª Isabel
Published: December 2021

En los últimos años Trabajos de Prehistoria ha ido mejorando de forma continua su posición en los sistemas de información nacionales e internacionales que certifican la calidad de las publicaciones científicas. En este editorial se presentan datos recogidos en las principales bases de datos y rankings de revistas.
Être mère d’un·e adolescent·e suivi·e pour un cancer : un travail de care genré et socialement différencié
Authors: Rollin Zoé , Sivilotti Lucas
Published: December 2021

À partir de deux terrains de recherche socio-ethnographiques menés auprès d’adolescent·e·s et jeunes adultes ainsi que leurs parents, cet article cherche à investiguer en quoi le contexte de l’irruption d’un évènement grave de santé comme le cancer vient modifier le travail des mères. À partir d’une approche interactionniste, cet article étudie la « gestion sociale de la maladie » (Strauss, 1992) d’un point de vue sociologique, en ajustant la focale sur le versant scolaire de celle-ci en tant que point d’observation heuristique pour saisir certaines dimensions du travail des mères. Le propos principal de cet article est de mettre en évidence le travail des mères d’adolescentes et d’adolescents, dont le quotidien est particulièrement impacté par la survenue de la maladie grave.
Intégrer l’avis de l’enfant dans les décisions de soin : le cas du consentement aux investigations génétiques en oncopédiatrie
Authors: de Montgolfier Sandrine , Hervouet Lucile , Le Tirant Sandra , Rial-Sebbag Emmanuelle
Published: December 2021

Le séquençage du génome humain est de plus en plus utilisé en oncologie pédiatrique afin de diagnostiquer, de sélectionner un traitement ciblé ou un suivi adapté ou d’identifier une transmission héréditaire. Les investigations génétiques soulèvent des enjeux éthiques et juridiques qui se cristallisent autour du consentement des enfants, mais aussi de leurs parents. Il s’agirait notamment de s’assurer que la décision est prise en connaissance de cause, c’est-à-dire en ayant compris les résultats attendus et les incidences pour soi-même et pour ses proches. Dresser un état des lieux du contexte légal et interroger les enfants et leurs parents permet de préciser dans quelle mesure et dans quelles conditions la parole de l’enfant devrait et pourrait être recherchée et entendue lorsqu’un test génétique est envisagé.
La péridurale, un non-choix ? Ethnographie des formes de résistance à une innovation « miracle »
Authors: Quagliariello Chiara , Topçu Sezin
Published: December 2021

En France où l’anesthésie péridurale est très généralisée, une proportion non négligeable de femmes ne souhaitant pas en bénéficier a priori finissent par y recourir. À partir d’un travail ethnographique mené dans une maternité publique de niveau 3 située dans la petite couronne parisienne, cet article se focalise tout d’abord sur les causes des réticences et des refus exprimés par certaines catégories de femmes vis-à-vis de la péridurale. Ensuite, nous examinons les différentes stratégies d’évitement ou de contournement de l’anesthésie péridurale à deux moments-clés du contact des femmes avec le corps médical : les consultations anesthésiques au huitième mois de grossesse et les interactions avec les professionnel·le·s de santé en salle de travail. Enfin, à travers l’étude des stratégies mises en œuvre par les femmes, il s’agit de décrypter les diverses épreuves que les femmes doivent surmonter pour faire valoir leurs choix et intervenir sur leur parcours d’accouchement à l’hôpital.
Encoding processes in five physical sciences research articles: A systemic functional perspective
Authors: Banks David
Published: December 2021

This paper considers the encoding of processes in five physical sciences research articles. Processes may be encoded as finite verbs, non-finite verb forms or as nominalizations. Relational process is the most common process type for finite verbs, followed by mental process as the second most common type, with mathematical processes forming an important subgroup within this type. Mental process is the most common type for non-finite verb forms, and material process the most common type for nominalizations. Viewing this from the point of view of the processes themselves, material processes have a strong chance of being encoded as nominalizations, and relational processes of being encoded as finite verbs. For mental cognitive processes, there is a reasonably strong chance of them being encoded as finite verbs, with non-finite forms being a second preference. For mental mathematical processes, non-finite forms would provide the first preference with finite verbs being a second choice. These findings are important for non-anglophone researchers and students hoping to publish their results in English.
Working with a Family. How a Family-Oriented Welfare System Opens the Border for Migrant Care Workers
Authors: Artero Maurizio , Hajer Minke H. J. , Ambrosini Maurizio
Published: December 2021

In Italy, the strong desire to take care of the elderly at home and within the family opens the border to migrant care workers. Despite an increasing focus on the closure of borders, migrant care workers are considered desirable immigrants and are generally socially accepted in Italian society because they are believed to fulfil an indispensable role in Italian families. Based on ninety-three qualitative interviews with migrant care workers, elderly care recipients, and the family members responsible for the organization of their care, this article considers the favourable position of care workers vis-à-vis the selectivity of immigration governance. Moreover, it discusses the relations established by Italian families with immigrant care workers, in comparison with what the scholarship says about the relationships between immigrant care workers and native families. For this purpose, we propose a typology of domestic elder care relationships, arranging them along a continuum where at one extreme they are asymmetrical and exploitative, whilst at the other they are warm and reciprocal. Finally, we observe a process of “familization” whereby employers and care workers begin to see each other as members of the same “family”. Whilst familialization can be interpreted as genuine affection, it also creates a web of obligations that prioritizes expectations by employers and duties of care workers.
Le demandeur d’asile bénévole, nouvelle figure du « migrant méritant » ?
Authors: Di Cecco Simone
Published: December 2021

À partir de l’analyse des programmes de bénévolat pour demandeur·euse·s d’asile en Italie, cet article s’attache à étudier l’émergence d’une nouvelle figure du « migrant méritant » : le migrant bénévole, reconnaissant et actif, disposé à effectuer gratuitement des activités dites d’intérêt général. Dans le contexte italien, la participation aux programmes de bénévolat s’affirme comme un gage de mérite exigé à certaines populations étrangères, notamment celles gouvernées par les politiques d’asile et insérées dans le système des centres d’hébergement, qui doivent alors faire preuve non seulement de vulnérabilité, mais aussi d’intégration et d’engagement civique. Des écarts et des marges de manœuvre existent néanmoins entre le spectacle de l’intégration et de la valeur civique véhiculé par les programmes de bénévolat, et les pratiques concrètes des demandeur·euse·s d’asile bénévoles. L’étude des tactiques de réappropriation, de mise à distance et de contournement des activités non rémunérées révèle que l’émergence de cette figure de migrant méritant, tout en ayant des effets de mise en concurrence et de distinction entre les demandeur·euse·s d’asile, n’est pas à l’abri de formes plus ou moins visibles de critique et de contestation.
Paris la souricière ? L’organisation de la mobilité étudiante dans la capitale pendant la Seconde Guerre mondiale
Authors: Gillabert Matthieu
Published: December 2021

Alors que Paris figure parmi les premiers pôles d’attraction pour les étudiants à l’échelle mondiale, l’Occupation allemande modifie considérablement la situation de cette mobilité académique. Outre la guerre elle-même qui limite les échanges, les institutions d’accueil sont affaiblies, voire disparaissent. Pourtant, un nombre constant d’étudiants étrangers, souvent dans l’impossibilité de rejoindre leurs proches, demeurent dans la capitale, obligés de s’adapter à cette nouvelle situation. Cet article montre comment la guerre, si elle ne supprime pas totalement cette mobilité académique, transforme en profondeur l’organisation de cette présence étrangère, jusqu’à modifier les catégories sociales de l’étudiant étranger, et rend la vie quotidienne de ces jeunes hommes et de ces jeunes femmes particulièrement difficile.
Blockchain in the Biopharmaceutical Industry
Authors: Volpentesta Tiziano , Miozza Mario , Satwekar Abhijeet
Published: December 2021

Biopharmaceutical companies and health authorities continuously exchange information to provide safe and effective therapeutics. The interactions between the two require transparency and extensive documentation exchange concerning the processes which extend from the development through the manufacturing phase. The current processes rely on paper documentation, notebooks, and point-to-point electronic data interchange (EDI) for the storage of data. Thereby, generating challenges of data integrity within the internal siloed structures and the traceability of the medicinal products in the pursuit to avoid counterfeiting. With Industry 4.0 and blockchain, the authors envisioned a reinvented workflow that helps to 1) manage data integrity with decentralized trust and 2) improve the track and trace capabilities. Hence, biopharmaceutical companies can manage data in a more trustable manner while maintaining security and privacy, further enabling the external ecosystem with track and trace to ensure complete transparency until the therapeutics reach patients.
Application of Machine Learning Techniques in Additive Manufacturing: A Review
Authors: Gajakosh Amithkumar , Suresh Kumar R. , Mohanavel V. , Shanmugam Ragavanantham , Ramoni Monsuru
Published: December 2021

This chapter provides an analysis of the state-of-the-art in ML applications for optimizing the additive manufacturing process. This chapter primarily presents a review of the literature on the use of machine learning (ML) in optimizing the additive manufacturing process at various stages. The chapter identifies ML-researched areas in which ML can be used to optimize processes such as process design, process plan and control, process monitoring, quality enhancement of additively manufactured products, and so on. In addition, general literature on the intersection of additive manufacturing and machine learning will be presented. The benefits and drawbacks of ML for additive manufacturing will be discussed, as well as existing obstacles that are currently limiting applications.
Assessment of Intrapelvic Blood Flow with the Penile Brachial Index Using a Toe Blood Pressure Cuff in Japanese Patients with Lower Urinary Tract Symptoms
Authors: Hayashi Keiichiro , Sasaki Haruaki , Fuji Kohzo , Hiramatsu Aya , Yamagishi Motoki , Matsumoto Yuki , Matsubara Eiji , Saito Katsuyuki , Ishikawa Kimiyasu , Fukagai Takashi , Ogawa Yoshio
Published: December 2021

Purpose:

We aim at investigating the relationship between lower urinary tract symptoms (LUTSs) and intrapelvic blood flow. Conventionally, intrapelvic blood flow is assessed using a Doppler blood flowmeter. In this study, the penile brachial pressure index (PBI), which is a simpler tool, was used.

Materials and Methods:

The participants of this study were 103 male outpatients with LUTS whose PBI was measured using the form pulse wave velocity/ankle-brachial index with a toe blood pressure cuff. Data including age, body mass index (BMI), penile blood pressure, PBI, complications (hypertension, dyslipidemia, and diabetes mellitus), International Prostate Symptom Score (IPSS), and Erection Hardness Score (EHS) were retrospectively examined. LUTS positivity was defined as an IPSS score ≥8 and LUTS negativity as an IPSS score <8.

Results:

The PBI and EHS scores were significantly higher in the LUTS-negative participants than in the LUTS-positive participants. Furthermore, a multivariate analysis showed a significant difference only in PBI. However, age, BMI, EHS, or previous history of complications did not significantly differ.

Conclusion:

PBI was found to be an independent factor of LUTS. Recent studies have shown that LUTS and erectile dysfunction are associated with lifestyle-related diseases, and that these conditions are caused due to impaired blood flow in the intrapelvic arteries due to arteriosclerosis. Therefore, LUTS should be treated as a vascular disease.
Differentiating Tower from Bell Curves in Smooth Continuous Uroflowmetry Curves of Healthy Adolescents
Authors: Yang Stephen Shei-Dei , Chang Shang-Jen
Published: December 2021

Introduction:

The definition of each uroflow pattern is vague, and therefore, interpreting uroflowmetry curves is associated with low inter-rater agreement. The aim of the study is to evaluate whether subjective or objective parameters could better differentiate tower from bell curves.

Materials and Methods:

Uroflow curves of community healthy adolescents with smooth continuous curves and minimal fluctuations within optimal bladder volume were independent reviewed by two experienced pediatric urodynamists and classified as bell or tower. The objective parameters generated from uroflow curves including Franco-Yang (F-Y) index (≧80) and angle at peak flow rate (A_Qmax ≧80°) were also used to differentiate tower from bell. The participants were asked to complete dysfunctional voiding symptom score (10 items, score 0–3).

Results:

A total of 287 adolescents with a mean age of 15.3 ± 1.7 years were enrolled and 150 curves were eligible for analysis. The inter-rater agreement was low (kappa = 0.27). Adolescents with uroflow curves classified as tower though F-Y index and A_Qmax were associated with higher urgency score than those with bell curves. However, adolescents with the tower curves defined by interpreters did not have higher urgency scores.

Conclusions:

Objective classification of tower curves with may be more reliable than subjective classification by the urodynamists. However, a significant proportion of participants with tower curves did not have urgency symptoms.
Safety and Efficacy of Percutaneous Nephrolithotomy in Patients with Large Stones
Authors: Hsiao Shu-Chuan , Jou Yeong-Chin , Cheng Ming-Chin , Shen Cheng-Huang , Lin Chang-Te , Chen Pi-Che , Lai Wei-Hong , Chen Pei-Yi
Published: December 2021

Aims:

The aim of the study is to evaluate the safety and efficacy of tubeless percutaneous nephrolithotomy (PCNL) in patients with large stones.

Subjects and Methods:

From January 2011 to June 2016, 425 tubeless PCNLs were performed at our hospital. All patients underwent a single-stage procedure with a metal dilator. Of the 425 patients, 93 had stone sizes ≥5 cm (mean: 7.77 cm, Group 1) and 332 patients had stone sizes <5 cm (mean: 2.75 cm, Group 2). Data analysis was performed using Statistical Package for the Social Sciences, V. 21.0. Numerical variables were compared by independent-samples t-test. Categorical variables were compared by Chi-square or Fisher's exact test as appropriate. P < 0.05 was deemed statistically significant.

Results:

The duration of surgery was longer in Group 1 than in Group 2 (93.6 vs. 70.4 min, P < 0.001). There were no significant differences between the two groups in the incidence of postoperative fever (8% vs. 7%) or sepsis (both 1%). In addition, no significant difference was observed in the length of postoperative hospital stays (3.05 vs. 3.2 days) although the transfusion rate was higher in Group 1 (6/93 vs. 4/332, P = 0.003). No other major complications or conversion to open surgery occurred in either group.

Conclusions:

Tubeless PCNL performed in patients with stones ≥5 cm in size has a reasonable and acceptably higher transfusion rate, with no other associated major complications.
Can Cavernous Nerves be Spared after Radical Prostatectomy? Evidence from Animal Studies
Authors: Chiang Han-Sun , Chang Meng-Lin , Wu Yi-No
Published: December 2021

Purpose:

The current study aims at evaluating penile erectile function after nerve-sparing radical prostatectomy (RP) based on evidence from a reliable animal model. The previous model in which the cavernous nerve (CN) is temporarily crushed is reviewed and compared to the present method of prostate lobes removal near the CN to determine which is more relevant to the clinical situation.

Materials and Methods:

Twenty-four rats were divided into three groups. One group was subjected to temporary CN crushing, one group was subject to prostate lobes removal near the CN, and the last group was preserved (sham group). All rats were re-examined at 4 weeks after the first surgical procedure. The pathological changes of the CNs were evaluated by their gross appearance and immunohistochemistry. Intracavernosal pressure (ICP) was measured as a parameter of male erectile function.

Results:

The results of the current study demonstrate that the removal of the prostate lobes near the CN led to the degeneration of CN, even with careful sparing techniques. Four weeks after the first surgical procedure, the rats' abdomens were reopened, and CNs were identified in only 60% of the rats with prostate lobes removal near the CN. Furthermore, the remaining CNs in this group were found to be histologically degenerated, with poorer erectile function presented by ICP. In contrast, the CNs after temporary crush were only mildly injured and demyelinated, with evidence of regeneration. The changes in the rats with prostate lobes removal near the CN are much more similar to those in rats with clinical RP with CN sparing.

Conclusion:

The current study concluded that, in the rat model, CNs will be injured, degenerated, and eventually disappear after prostate lobes removal near the CN; this is very similar to what is observed in clinical RP. Protection of the CNs for erectile function preservation should be investigated further using this animal model.
Early Penile Rehabilitation with a Vacuum Erectile Device in Patients Undergoing Robotic-Assisted Radical Prostatectomy
Authors: Rujinithiwat Supichamon , Usawachintachit Manint , Panumatrassamee Kamol , Santingamkun Apirak , Tantiwongse Kavirach
Published: December 2021

Purpose:

This aim was to study the efficacy of a vacuum erectile device (VED) in rehabilitating the erectile function of patients undergoing nerve-sparing robotic-assisted radical prostatectomy.

Materials and Methods:

This prospective randomized study enrolled 35 prostate cancer patients from Thailand who had intact baseline erectile function and underwent nerve-sparing robotic-assisted radical prostatectomy. These patients were randomly assigned into either a study group which applied the VED for 10 min daily for 6 months or a control group which received no additional interventions. A 5-item version of the International Index of Erectile Function (IIEF-5) score, stretched penile length, and midshaft circumference were measured at 1, 3, and 7 months after surgery, respectively.

Results:

The mean patient age was 65.6 years, and the mean baseline IIEF-5 score was 22.91, which were comparable between the two groups. Three patients in the study group did not follow the VED protocol due to postoperative urinary incontinence. A per-protocol analysis revealed that the mean IIEF-5 score at 7 months was significantly higher in the study group compared to the control group (11.29 ± 7.47 vs. 6.61 ± 5.33, P = 0.047). The mean midshaft circumference was also higher in the study group (9.24 ± 1.43 cm vs. 7.91 ± 0.37 cm, P = 0.002). No statistically significant difference in the mean stretched penile length between the two groups was found.

Conclusion:

Early VED usage for penile rehabilitation following radical prostatectomy significantly improves IIEF-5 score and better preserves penile circumference but not penile length. A larger-scale multi-institutional study is required to validate these findings.
Rational Combination with an Immunotherapy Backbone in Genitourinary Cancers
Authors: Guo Jhe-Cyuan , Lin Chia-Chi
Published: December 2021

Immunotherapy, especially immune checkpoint blockade treatment, has changed the landscape of anticancer therapy. In genitourinary (GU) cancer, the programmed cell death-1 (PD-1)/programmed cell death-ligand 1 (PD-L1) blockade alone has resulted in improved outcomes compared with conventional therapies, such as chemotherapy and targeted therapy in advanced urothelial carcinoma and renal cell carcinoma (RCC), respectively. To improve the efficacy of the PD-1/PD-L1 blockade, a combination of this blockade with other therapeutic modalities has been explored in the earnest. In a recent study, ipilimumab, an anticytotoxic T-lymphocyte-associated protein 4 (CTLA-4) monoclonal antibody, combined with nivolumab, an anti-PD-1 monoclonal antibody as the first-line therapy, has demonstrated superior efficacy to sunitinib in advanced RCC patients with International Metastatic RCC Database Consortium intermediate and poor risk. This mini-review article focuses on the rational combination with the PD-1/PD-L1 blockade in GU cancers.
Conservative Management of Vesicoureteral Reflux
Authors: Siregar Safendra , Kurniawan Andri Pratama , Mustafa Akhmad
Published: December 2021

Vesicoureteral reflux (VUR) is defined as the retrograde flow of urine from the bladder to the upper urinary tract (the ureters and kidneys), caused by ureterovesical junction dysfunction. VUR is the most common congenital urinary tract abnormality; nevertheless, the conservative treatment for VUR remains controversial. In addition, the limited data availability made it difficult to establish a widely accepted treatment protocol. This study aimed to review available treatment modalities and recommendations with regard to the conservative management for VUR. An online literature search was performed on PubMed, PubMed Central, and Google Scholar. Studies were compared with several available guidelines. Based on literature search, the conservative management of VUR involves a multimodality approach, including the bladder-bowel dysfunction management through bladder training, anticholinergics and alpha-blockers, continuous antibiotic prophylaxis, and circumcision in male patients. Operative and other invasive treatment modalities may be considered in treatment failure or breakthrough urinary tract infection and should not be used as a first-line treatment.
Thyrotoxic Goiter and Asymptomatic Thyroid Nodule as an Initial Presentation of Clear Cell Renal Cell Carcinoma
Authors: Khairul-Asri Mohd Ghani , Sidhu Simran , Raja Gopal Navarasi S , Azli Saiful , Badawi Mohamed Abdelwahab , Hadi S.H.M , Fahmy Omar
Published: December 2021

Thyroid nodule as a metastasis to renal cell carcinoma (RCC) is rarely found. We present two cases – presented with thyroid nodules and diagnosed as metastatic RCC; one patient had thyrotoxic goiter, whereas the second patient presented with asymptomatic thyroid nodule. Subsequently, hemithyroidectomy and total thyroidectomy were performed, respectively. Then, both patients underwent radical nephrectomy for the primary tumor. At present, patients are under regular oncology follow-up, with no evidence of disease recurrence.
Bladder Calculi in Taiwan
Authors: Laih Chun-Yo , Chang Chao-Hsiang , Chen Wen-Chi
Published: December 2021

In Taiwan, the reported admission rate for bladder calculi was 7.5% of all patients with urolithiasis. The admission rate for bladder calculi was 12.9/100,000 in 2010, with elderly males constituting 91.8% of these patients. Pediatric bladder calculi are rare in Taiwan with a reported prevalence of only 0.047%. There are four possible causes of secondary bladder calculi, namely bladder outlet obstruction (BOO), neurogenic bladder, intravesical foreign bodies, and renal transplant. The biggest reported bladder stone in Taiwan was approximately 7 cm × 4.8 cm in size, with a weight of 320 g. Several pathogenic factors contribute to the formation of bladder calculi, including intravesical foreign bodies, BOO, neurogenic bladder, and metabolic abnormalities. Contemporary treatment of bladder calculi includes endoscopic cystolithotripsy or cystolitholapaxy with laser or LithoClast lithotripters. Some studies from Taiwan have reported that bladder calculi may increase the risk of cancer. An association between bladder calculi and chronic kidney disease has been reported in serial reports. In conclusion, most bladder calculi can be treated by endoscopic surgery and attention to associated comorbidities is warranted.
Clear Renal Cell Carcinoma with Angioleiomyomatous Stroma in a Noninherited Renal Cancer Syndrome
Authors: Rajaian Shanmugasundaram , Krishnamurthy Karrthik , Murugasen Lakshman , Narasimhachar Srinivas Chakravathy
Published: December 2021

Renal cell carcinoma (RCC) comprises only 3% of adult cancer cases. In most cases, patient is asymptomatic and the tumor mass is incidentally detected during radiological imaging for other medical conditions. Only one-third of patients with RCC present with hematuria, palpable tumor mass, or flank pain. Most of the cases of RCC are with clear or papillary cells, but a small subset of cases have demonstrated clear cell RCC with leiomyomatous stroma. The World Health Organization classification of tumors of the urinary system and male genital organs 2016 and the International Society Urological Pathology 2012 Vancouver classification have identified RCC with leiomyomatous stroma (RCCLMS) as an emerging entity of RCC. RCCLMS has been seen with inherited renal cancer syndromes such as tuberous sclerosis complex and von Hippel-Lindau disease. Here, we present a rare case of RCC with morphological and histopathological findings of the RCCLMS subset but showed noninherited mutational traits.
Metabolic Profiling Based on Nuclear Magnetic Resonance Spectroscopy and Mass Spectrometry as a Tool for Clinical Application
Authors: Garcia-Perdomo Herney Andrés , Vallejo Felipe García , Sanchez Adalberto
Published: December 2021

Metabolomics provides an abundance of information with the potential to accurately describe the physiological state of an organism. It aims to identify small molecules under physiological conditions that might serve as biomarkers and aid in the identification and treatment of health problems. Combining nuclear magnetic resonance (NMR) with mass spectrometry (MS) yields better identification and quantification of compounds, especially in mixtures, as well as the ability to cross-analyze data from both techniques and thereby increase the number of compounds identified. Metabolomic profiling using NMR and/or MS provides an important diagnostic tool for identifying metabolites under different conditions. This also requires a valid and reliable way to standardize the way we use it to identify biomarkers. Regarding the clinical application of metabolomics, for bladder cancer, threonine, phenylalanine, valine, isoleucine, lysine, methionine, leucine, glutamate, histidine, arginine, aspartic acid, tyrosine, glutamine, and serine were found discriminative in diagnosing this entity. On the other side, sarcosine, choline, phosphocholines, phosphorylcholines, carnitines, citrate, amino acids (lysine, glutamine, and ornithine), arachidonoyl amine, and lysophospholipids were found discriminative regarding the prostate cancer diagnosis.
Gonadectomy in Patients with Disorder of Sexual Development
Authors: Chen Kuan-Ting , Tai Yi-Sheng , Chiang I-Ni , Chang Hong-Chiang , Huang Kuo-How
Published: December 2021

Objective:

The objective of this study is to investigate clinical characteristics and treatment outcomes of patients with disorder of sexual development (DSD) who underwent gonadectomy at a single tertiary center.

Materials and Methods:

We retrospectively enrolled patients with DSD who received gonadectomies in our hospital from 2000 to 2015. The clinical presentations, laboratory tests, image studies, operative findings, and pathology reports were collected by reviewing medical records.

Results:

A total of 18 patients with DSD were analyzed, including 17 46XY karyotype and one 45X/46XY karyotype. Among them, 17 patients were assigned female gender. The most common diagnoses were androgen insensitive syndrome (n = 5), 46XY gonad dysgenesis (n = 5), and 17α-hydroxylase deficiency (n = 3). Initial presentations included amenorrhea (n = 9), ambiguous genitalia (n = 5), and abnormal prenatal screening (n = 3). The peak age of gonadectomies was 5 at infantile (1–2 years) and 7 at adolescent period (11–15 years). A total of 19 gonadectomies were performed without complications; pure inguinal approach in 6, inguinal plus laparoscopy exploration in 13. There were no malignancies in all resected gonads; in addition, spermatogenesis was found in only one resected gonad.

Conclusions:

Female gender assignment was more frequently chosen in our series. The presentations and diagnoses in children with DSD were various; it is important to select individualized treatment strategy for these patients.
Early Diagnosis of CYP17A1 Compound Heterozygous Mutations in a 46, XY Child with Disorders of Sexual Development
Authors: Laochareonsuk Wison , Jaruratanasirikul Somchit , Maneechay Wanwisa , Sangkhathat Surasak
Published: December 2021

17-Hydroxylase/17,20-lyase deficiency is a rare congenital disorder accounting for 1% of congenital adrenal hyperplasia. This disease is recessively expressed as autosomal inheritance through mutations in the CYP17A1 gene, leading to defective levels of glucocorticoids and sex hormones. Individuals with loss-of-function mutations usually present with phenotypic female genitalia, primary amenorrhea, or hypertension in puberty caused by excessive production of mineralocorticoids. In this report, we describe a girl with CYP17A1 mutations diagnosed even though the pathognomonic symptoms had not developed. Herein, we report a case of a 3-year-old girl who prenatally diagnosed as a 46, XY female. After birth, the baby had normal female-type external genitalia without symptoms. She underwent a gonadectomy at the age of 3 years. To explore the pathogenesis of her condition, her genomic data were reviewed for genes involved in disorders of sexual differentiation (DSDs) using high-throughput sequence data from a whole-exome study. Pathogenic variants causing frameshift mutation involving codon 329 of CYP17A1 and a concomitant missense mutation involving codon 358 of the same gene were detected, mutations which are likely to result in loss of function of the enzyme. Each mutation was inherited from each of the parents, both holding carrier status. In addition, her younger sister (46, XX) acquired those identical variants without any abnormal phenotypical traits. Loss-of-function mutations of CYP17A1 which may cause secondary hypertension are not commonly identified in early life because of the wide spectrum of clinical manifestations and various pathophysiologies, which manifest in different sexes. Affected cases usually present later in life with hypertension or primary amenorrhea. High-throughput sequencing is suggested in DSD cases as it may give a precise diagnosis, enabling a proactive treatment plan and prevention of sequelae that potentially occur in puberty.
Augmentation Enterocystoplasty for Patients with Ketamine-induced Cystitis
Authors: Hung Chu-Hsuan , Hsieh Shu-Wei , Chen Shao-Kuan , Lin Chih-Ming
Published: December 2021

Purpose:

Ketamine abuse has been a worldwide issue recently. Ketamine-induced cystitis (KC) is an annoying urinary tract symptom secondary to long-term ketamine abuse. The aim of our study is to review clinical outcomes of bladder augmentation enterocystoplasty (AE) for the patients with KC.

Materials and Methods:

We performed bladder AE for eight patients with refractory symptoms of KC (severe bladder pain, micturition pain, urgency, frequency, and contracted bladder). All the patients received conservative treatment at clinics or referred from other hospital.

Results:

Between 2007 and 2015, eight patients (seven males and one female), aged 26–48 years (mean 32.7 years), underwent AE as indicated. The duration of ketamine abuse ranged from 2 to 15 years (mean 6.8 years). Contracted bladder was noted in all patients, hydronephrosis in two and hydroureter in one under intravenous pyelography. Postoperative hospitalization ranged from 12 to 47 days (mean 22.4 days). Significant increases in estimated glomerular filtration rate (86.43 ± 21.47 vs. 103.14 ± 29.32 ml/min/1.73 m2,P < 0.05), functional bladder capacity (47.75 ± 10.07 vs. 273.13 ± 54.96 ml,P < 0.0001), and pain visual analog score (6.0 ± 1.2 vs. 1.75 ± 0.89,P < 0.0001) were noted after AE. Surgical complications included adhesion ileus, progressive impaired renal function, and enterovesical fistula. All the patients were satisfied with the outcomes of the surgery, based on their responses to the self-report questionnaires. All patients reported marked improvement in micturition pain and urinary frequency, which greatly elevated life quality. Most patients were followed up at the outpatient department within 1 year or were lost to follow-up after surgery.

Conclusion:

This case series demonstrated that for surgical management of refractory bladder pain and low bladder capacity resulting from KC, AE might be effective. However, cessation of ketamine use is the most important to prevent recurrence of the above symptoms.
Does Stone Analysis Have Better Predictive Value Than Urine Culture and Stone Culture for Predicting Systemic Inflammatory Response Syndrome Post Retrograde Intra Renal Surgery? A Single Center Pilot Study
Authors: Parikh Kandarp P. , Jain Ravi J. , Parikh Aditya K.
Published: December 2021

Purpose:

Infective complications such as fever, systemic inflammatory response syndrome (SIRS), septicemia, and shock are common and preventable complications after retrograde intrarenal surgery (RIRS). Patients with positive urine and stone cultures have a greater risk of SIRS. Infection stones (carbonate apatite) are bacteria-harboring stones that predispose to sepsis. A pilot study is conducted to establish the role of stone analysis in predicting SIRS after RIRS compared to urine and stone cultures.

Materials and Methods:

Sixty patients who underwent RIRS from January 2018 to June 2018 were prospectively evaluated with respect to preoperative urine culture, stone burden and location, operative time, postoperative clinical course, residual stone size, stone culture, stone analysis, and occurrence of septicemia-related events.

Results:

5 out of 60 patients who underwent RIRS developed SIRS (8%). Sensitivity levels of predicting SIRS were different, where urine culture (20%), stone culture (20%), and carbonate apatite on the stone analysis (60%). Positive urine culture and stone culture had no significant relation to the prediction of SIRS (P = 1). Carbonate apatite was present in 12 samples (20%) in varying proportions. The presence of apatite >50% of the total sample was in 5/60 samples (8%), which are referred to as infection stones. Three out of these 5 patients with infection stones developed SIRS (60%). Thus, the presence of carbonate apatite in the stone analysis had a statistically significant relation to SIRS (P < 0.01).

Conclusion:

The presence of carbonate apatite >50% on stone analysis has higher sensitivity than urine and stone culture in predicting SIRS after RIRS.
Retroperitoneal Fibrosis
Authors: Liu Chia-Hsiang , Wei Tzu-Chun , Lin Alex T. L. , Chang Yen-Hwa , Wu Howard H. H. , Kuo Junne-Yih , Chung Hsiao-Jen , Huang Eric Yi-Hsiu , Lin Chi-Cheh , Huang William J. S.
Published: December 2021

Objective:

Literature documented for the diagnosis and treatment of retroperitoneal fibrosis (RF) is still relatively limited and diverse, which makes it more challenging, especially in the Taiwanese population. This article was aimed to describe the clinical manifestations, laboratory results, diagnostic tool, and treatments in patients with RF from a single tertiary institute.

Patients and Methods:

The International Classification of Diseases, Ninth Revision code 594.3 was used to identify patients evaluated for RF between January 2005 and August 2015, at Taipei Veterans General Hospital. Medical records were reviewed, and clinical information was collected. RF was diagnosed on the basis of image findings, as well as clinical, pathological, and laboratory data. Different treatments were compared for their efficacy on the protection of renal function.

Results:

A total of 30 patients were included in the study. Twenty-three (76.7%) were male. The mean age at diagnosis was 65.9 ± 16.37. Mean body mass index was 31.5 ± 3.47. Biopsies were done in 13 patients (43.3%). Half of the patients had serum IgG4 test, and the mean value was 249.3 ± 205.1 mg/dL. Bilateral hydronephrosis was noted in 19 (63.3%) patients and was associated with poorer renal function than unilateral hydronephrosis at baseline. Most (93.3%) of the patients had improved renal function. However, statistically significant improvement was noted in patients with bilateral hydronephrosis instead of unilateral one. Compared with endoscopic ureteral stenting, surgical correction tended to have more renal functional protection, with significant serum creatinine (P = 0.006) and estimated glomerular flow rate (P = 0.035) change.

Conclusion:

RF in Taipei Veterans General Hospital was diagnosed through image, with the assistance of serum IgG4 and biopsy. There was a posttreatment improvement of renal function, especially in those with bilateral hydronephrosis. Surgical correction tended to be more beneficial than endoscopic procedure.
The Impact of Pseudoephedrine and Antihistamine on Lower Urinary Tract Symptoms in Male Patients with Rhinitis
Authors: Lee Chen-Che , Tam Yuan-Yun , Chang Ying-Hsu , Hsieh Ming-Li , Shao I-Hung
Published: December 2021

Purpose:

The effects of medications for treating nasal congestion on voiding function remain unclear. In this study, we aimed to elucidate the effects of the common decongestants, pseudoephedrine, and antihistamine, on voiding dysfunction in men without clinical lower urinary tract symptoms.

Materials and Methods:

We prospectively enrolled 200 consecutive male patients who visited the otolaryngology department for rhinitis from August 2015 to August 2016. These patients were then randomized to the pseudoephedrine or antihistamine groups. The International Prostate Symptom Score (IPSS) and postvoiding residual urine (PVR) were assessed before and 1 week after treatment and the results were analyzed. Patients were further stratified by age (≥50 years old vs. <50 years old) and IPSS (>7 vs. ≤7) in each group and comparison analyses were conducted.

Results:

There were no significant differences between the baseline characteristics of the pseudoephedrine and antihistamine groups. The IPSS total, IPSS voiding, and IPSS storage (IPSS-T, IPSS-V, and IPSS-S, respectively) tended to increase in the pseudoephedrine group but did not reach statistical significance. Similar results regarding IPSS-T and IPSS-V were seen in the antihistamine group. The IPSS-T increased significantly in patients ≥50 years old treated with pseudoephedrine, which was not observed in the antihistamine group. The IPSS-V was significantly higher in patients <50 years old treated with antihistamine. The PVR did not significantly change after treatment with both drugs. However, in patients with baseline IPSS-T >7 treated with pseudoephedrine, the PVR tended to increase.

Conclusion:

Pseudoephedrine and antihistamine have minimal effects on lower urinary tract function in the general male population. However, pseudoephedrine worsened IPSS-T in elderly men, whereas antihistamines worsened IPSS-V in younger men. In self-unaware voiding dysfunction male with IPSS-T > 7, pseudoephedrine may cause more PVR. Thus, in elderly men with rhinitis, antihistamines may be more suitable, while pseudoephedrine would be preferable in younger men.
Risk Factors of Morbidity and Mortality after Flexible Ureteroscopic Lithotripsy
Authors: Chuang Te-Yen , Kao Ming-Hong , Chen Po-Cheng , Wang Chung-Cheng
Published: December 2021

The use of the flexible ureteroscope for treating renal and ureteral calculi has rapidly increased in the last decade. Although the use of the flexible ureteroscope by experienced surgeons has excellent outcomes and safety profiles, several studies have reported many surgical complications with its use. We conducted a narrative review of the published literature sourced from PubMed. We used a combination of three keywords: “ureteroscope,” “morbidity,” and “urolithiasis,” with or without the additional keywords of “infection,” “mortality,” “hematoma,” and “ureteral injury.” Infection, bleeding, and ureteral injury are the main complications. We analyzed the possible causes of morbidity and death after the use of a flexible ureteroscope. Finally, we propose recommendations to prevent these complications.
Comparison of Stone-free Rate, Operation Procedure, and Complication Rate According to guy's Stone Score in Supine Percutaneous Nephrolithotomy
Authors: Ferdian Vicky , Manurung Yulfitro
Published: December 2021

Background and Aim:

Percutaneous nephrolithotomy (PCNL) was considered a safe and efficient method for removing kidney stones, with a low incidence of complications. This study aims to compare the success rate of PCNL based on guy's stone score (GSS) operating procedure and its complications.

Methods:

Data were collected from patients with kidney stones who underwent PCNL. A stone-free rate (SFR) was considered if the patient was either had no stone or had any stone that is <4 mm and asymptomatic residual fragment. Complications were assessed using the modified Clavien score, and SFR was assessed by abdominal radiography.

Results:

A total of 198 patients were included in this study. There was a significant difference in SFR between simple (GSS I and II) and complex stone (GSS III and IV) groups (P = 0.000). The operation procedure was longer in the complex group compared to the simple groups for both total operating time and stone fragmentation time (P = 0.000). X-ray time was not significantly different (P = 0.061). Almost all patients were classified as Clavien I, as there was no significant difference between the two groups for complication (P = 0.277) or blood loss (P = 0.176).

Conclusion:

The success rate of PCNL based on the GSS at Gunung Jati Regional Hospital is quite good. There was a difference in the SFR between the groups, and the operating procedure time was longer in the complex stone group. There was no difference between the simple stone and complex stone groups in PCNL complications, which indicated a good surgical practice.