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CONTEXT: Surgical management of lower urinary tract symptoms (LUTS)/benign prostatic obstruction (BPO) aims at ablating prostate adenoma by resection, enucleation, or vaporisation. Apart from established ablation modes according to the European Association of Urology guidelines, various technologies have emerged as safe/effective alternatives but remain under investigation. OBJECTIVE: To explore short-term benefits/harms of emerging technologies for surgical management of LUTS/BPO. EVIDENCE ACQUISITION: A systematic literature search was conducted using MEDLINE, EMBASE, and CENTRAL via Ovid up to June 18, 2022. We included randomised controlled trials (RCTs) exploring aquablation, prostatic arterial embolisation (PAE), Rezum, prostatic urethral lift (PUL), and temporary implantable nitinol device (iTIND) versus sham/transurethral resection of the prostate (TURP). EVIDENCE SYNTHESIS: We included ten RCTs (1108 men). Aquablation versus TURP: insignificant change in International Prostate Symptoms Score (IPSS; mean difference [MD] 0.0, 95% confidence interval [CI] -2.44 to 2.44), quality of life (QoL; MD 0.30, 95% CI -0.81 to 0.21), maximum urinary flow rate (Qmax; MD -0.30, 95% CI -3.71 to 3.11), retreatment (risk ratio [RR] 0.18, 95% CI 0.02-1.66), and urinary incontinence (UI; RR 0.71, 95% CI 0.26-1.95). PAE versus monopolar TURP (M-TURP): insignificant change in IPSS (MD 3.33, 95% CI -28.39 to 35.05), QoL (MD 0.12, 95% CI -0.30 to 0.54), International Index of Erectile Function (IIEF-5; MD 3.07, 95% CI -1.78 to 7.92), and UI (RR 0.15, 95% CI 0.01-2.86), and significant change in Qmax (MD -9.52, 95% CI -14.04 to -5.0), favouring M-TURP. PAE versus bipolar TURP: insignificant change in IPSS (MD -2.80, 95% CI -6.61 to 1.01), QoL (MD -0.69, 95% CI -1.46 to 0.08), Qmax (MD -3.51, 95% CI -8.08 to 1.06), UI (RR 0.14, 95% CI 0.01-2.51), and retreatment (RR 1.91, 95% CI 0.19-19.63). PUL versus TURP: insignificant change in QoL (MD 0.40, 95% CI -0.29 to 1.09), UI (RR 0.13, 95% CI 0.02-1.05), and retreatment (RR 0.48, 95% CI 0.12-1.86), and significant change in IPSS (MD 3.40, 95% CI 0.22-6.58), and IIEF-5 (MD 3.00, 95% CI 0.41-5.59) and Qmax (MD -9.60, 95% CI -13.44 to -5.76), favouring PUL and TURP, respectively. Rezum and iTIND have not been evaluated in RCTs against TURP to date. CONCLUSIONS: Supporting evidence for clinical use of aquablation, PAE, PUL, Rezum, and iTIND is very limited. Benefits/harms should be investigated further in high-quality RCTs. PATIENT SUMMARY: This review summarises the evidence for the clinical use of aquablation, prostatic arterial embolisation (PAE), prostatic urethral lift (PUL), Rezum, and temporary implantable nitinol device (iTIND) to manage lower urinary tract symptoms secondary to benign prostatic obstruction. The supporting evidence for the clinical usage of aquablation, PAE, PUL, Rezum, and iTIND is very limited. Benefits and harms should be investigated further in high-quality randomised controlled trials.
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Arsenic is a carcinogen, and long-term exposure to it may result in the development of multi-organ disease. Understanding the underlying intricate molecular network of toxicity and carcinogenicity is crucial for identifying a small set of differentially expressed biomarker genes to predict the risk of the exposed population. In this paper, a multiple kernel learning (MKL) embedded multi-objective swarm intelligence technique has been proposed to identify the candidate biomarker genes from the transcriptomic profile of arsenicosis samples. To achieve the optimal classification accuracy along with the minimum number of genes, a multi-objective random spatial local best particle swarm optimization (MO-RSplbestPSO) has been utilized. The proposed MO-RSplbestPSO also guides the multiple kernel learning mechanism which provides data specific classification. The proposed computational framework has been applied to the developed whole genome DNA microarray prepared using blood samples collected from a specific arsenic exposed area of the Indian state of West Bengal. A set of twelve biomarker genes, with four novel genes, are successfully identified for the classification of exposure to arsenic and its subcategories, which can be used as future prognostic biomarkers for screening of arsenic exposed populations. Also, the biological significance of each gene is detailed to delineate the complex molecular networking and mode of toxicity.
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Arsénico , Inteligencia , Biomarcadores , AlgoritmosRESUMEN
Microgreen based functional juice blends containing fenugreek (Trigonella foenum-graecum), kinnow mandarin (Citrus reticulate) and aloe vera (Aloe brobadensis) in different ratios were blended with sorbitol and stevia. The different ratios of juice blends were analyzed for total soluble solids, sedimentation, viscosity and titrable acidity. They were also screened for total phenolic content, total carotenoid content and antioxidant properties such as DPPH, reducing power and metal chelating activity. The formulation with highest TPC, TCC and antioxidant property was selected to optimize a microgreen based functional juice. The optimized microgreen blend formulation had 20 ml 100-1 ml microgreen juice, 40 ml 100-1 ml kinnow juice, 8.5 ml 100-1 ml sorbitol, 1.78 g 100-1 ml stevia and 29.72 ml 100-1 ml aloe vera juice. It had high protein, minerals (sodium and potassium) and vitamin (vitamin C) content as well as good source beta-carotene, phenols and antioxidants. Antioxidant helps in reducing diabetic complications by reducing the oxidative stress and because of their protective action against reactive oxygen species.
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Antioxidantes , Frutas , Alimentos Funcionales , Antioxidantes/análisis , Antioxidantes/farmacología , Ácido Ascórbico/análisis , Bebidas/análisis , Frutas/química , Fenoles/análisisRESUMEN
We study quantum entanglement and its relation to transport in a non-equilibrium interacting double dot system connected to electronic baths. The dynamical properties in the non-interacting regime are studied using an exact numerical approach whereas the steady state properties are obtained following the well-known non-equilibrium Green's function (NEGF) approach. By means of mutual information and concurrence we explore the connection between the quantum correlations in the system and the current flowing through the dots. It is observed that entanglement between the dots is heavily influenced by the degeneracy or the lack thereof, of the dot levels. In the non-degenerate case, the concurrence falls sharply when the applied bias crosses a certain critical value. In contrast when the dot energy levels are degenerate, the concurrence reaches a very high asymptotic value of 1/2. When interactions are switched on, the degeneracy is lifted, and once again concurrence falls to zero beyond a critical value of the applied bias. Lastly it is observed that the concurrence can be made to reach almost the value of 1.0 if the chemical potential in both baths are made very large (while keeping the sign the same) provided the dot levels are kept degenerate within the non-interacting limit. A combination of NEGF method, brute-force numerics and asymptotics are employed to corroborate our findings.
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The process of aging is characterized by numerous changes in the body which has an overall negative effect on the health and lifestyle of elderly. Nutrition deserves special attention as an individual reaches old age. It plays a vital role in affecting the quality of life, including physical, mental and social health. The physiological decline in food intake is very common among older age and this result in nutritional deficiencies. These increased nutritional deficiencies are the major risk factors for certain chronic diseases and deteriorated age related health. Thus, the adoption of nutritional intervention can be a measure to tackle the current situation of nutritional deficiencies and promote a healthy lifestyle.