bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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.
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.
Conhecimento especializado de professoras de Educação Infantil no âmbito da classificação em matemática em um contexto de formação continuada
Authors: Doiche Savoy Erica , Rodrigues de Almeida Alessandra , Ribeiro Miguel 
Published: December 2021

Este artigo forma parte de uma pesquisa que se associa ao objetivo de aceder e compreender o conhecimento especializado revelado por professoras de Educação Infantil sobre classificação de figuras geométricas. Esse conhecimento especializado é considerado na perspectiva do Mathematics Teachers’ Specialized Knowledge – MTSK. As informações foram coletadas em um contexto de formação continuada com oito professoras da Educação Infantil (crianças de dois a seis anos de idade) onde foi implementada uma Tarefa para a Formação. O tópico classificação, foi escolhido devido ao seu papel potencial para o desenvolvimento do entendimento matemático relacional; da percepção espacial e como forma de pensar matematicamente a resolução de problemas. Os resultados apontam que as professoras revelam um conhecimento relacionado ao Knowledge of Topics (KoT), já que conhecem que para classificar é necessário identificar características das figuras e estabelecer critérios. Porém, verificou-se a falta de familiaridade com algumas figuras geométricas não standard, suas propriedades e a relação da classificação com o desenvolvimento do pensamento matemático e abstrato, o que salienta a necessidade de considerar este tópico de forma intencional na formação de professores da Educaçao Infantil para que se busque desenvolver as especificidades do conhecimento de modo que as crianças possam entender matemática.
EVALUASI KELAYAKAN USAHA AGRIBISNIS JAGUNG DITINJAU DARI ASPEK KEUANGAN
Authors: John Darwis  , Sadewo Yosua Damas 
Published: December 2021

Penelitian ini bertujuan untuk mengetahui pendapatan usaha agribisnis jagung, untuk mengetahui kelayakan bisnis pada usaha agribisnis jagung ditinjau dari aspek keuangan. Penelitian ini merupakan jenis penelitian kuantitatif deskriptif, adapun alat yang digunakan dalam mengumpulkan datadata yang ada yaitu melalui laporan keuangan, dokumentasi, obeservasi dan studi literatur. Dengan menggunakan analisis data hasil evaluasi, guna menjawab permasalahan yang ada. Adapun analisis yang digunakan yaitu menggunakan rumus penerimaan TR= P X Q , pendapatan II = TR – TC, revenue cost ratio R/C = TR TC , benefit cost ratio B/C =PDTC , BEP = Biaya tetap total : (1 - biaya variabel total : nilai penjualan), Payback period =investasi awal arus kas X 1 tahun sehingga dengan analisis yang ada mendapatkan hasil penelitian dimana pendapatan yang didapat selama proses produksi yaitu pendapatan pada bulan April 2020 Rp. – 435.000, pendapatan pada bulan Agustus 2020 Rp.- 90.600, pendapatan bulan November 2020 Rp. -95.000, dan pendapatan bulan Februari 2021 Rp. 677.200. hasil yang didapat dalam melakukan evaluasi kelayakan terdapat dua kriteria yang pertama hasil penelitian revenue cost ratio dimana pada bulan April 2020 hasil yang didapat R/C -0,53 < 1, bulan Agustus 2020 R/C -0,90 < 1, bulan November 2020 R/C 0,89 < 1 dan bulan Februari 2021 R/C 1,33 > 1 , dan yang kedua hasil penelitian benefit cost ratio dimana pada bulan April 2020 hasil B/C – 0,48 < 1, bulan Agustus 2020 B/C -0,09 < 1, bulan November 2020 B/C-0,10 < 1 dan bulan Februari B/C 0,32 < 1. BEP yang di hasilkan dalam usaha agribisnis jagung pada bulan April 2020 BEP Rp 11.250.000, bulan Agustus 2020 BEP Rp. 1.046.511, bulan November 2020 BEP Rp. 1.070.428 dan bulan Februari 2020 1.097.560 dan Payback Period yang dihasilkan dalam jangka waktu 3,04 Tahun.