Enzymatic Glucose Fiber Sensor for Glucose Concentration Measurement with a Heterodyne Interferometry.

In this study, we developed a glucose fiber sensor incorporating heterodyne interferometry to measure the phase difference produced by the chemical reaction between glucose and glucose oxidase (GOx). Both theoretical and experimental results showed that the amount of phase variation is inversely proportional to glucose concentration. The proposed method provided a linear measurement range of the glucose concentration from 10 mg/dL to 550 mg/dL. The experimental results indicated that the sensitivity is proportional to the length of the enzymatic glucose sensor, and the optimum resolution can be obtained at a sensor length of 3 cm. The optimum resolution of the proposed method is better than 0.6 mg/dL. Moreover, the proposed sensor demonstrates good repeatability and reliability. The average relative standard deviation (RSD) is better than 10% and satisfied the minimum requirement for point-of-care devices.

Effect of videourodynamic subtypes on treatment outcomes of female dysfunctional voiding.

INTRODUCTION AND HYPOTHESIS: Dysfunctional voiding (DV) is not uncommon in women and is typically challenging to treat. This study retrospectively investigated the long-term treatment outcomes of DV women with different videourodynamics (VUDS) characteristics. METHODS: Data of women with VUDS-proven DV (n = 302) were retrospectively analyzed. All patients at first received biofeedback pelvic floor muscle training and medications; urethral sphincter botulinum toxin A injection was administered after treatment failure. Long-term follow-up outcomes were graded by global response assessment (GRA) and objective responses of decrease of detrusor pressure (Pdet), increase in maximum flow rate (Qmax) and voiding efficiency (VE). The treatment outcomes were investigated among different VUDS subgroups. RESULTS: Of 302 women, 165 (54.6%) had mid-urethral DV, 117 (38.7%) had distal urethral DV, and 20 (6.6%) had both bladder neck dysfunction (BND) and mid-urethral DV. A total of 170 (56.3%) patients were available for follow-up VUDS after treatment. Pdet was decreased in all three subgroups, but increase in Qmax and VE was only noted in the BND plus DV subgroup. Overall, 120 (70.6%) patients showed improvement (GRA ≥ 1), including 14 with BND plus DV (93.3%), 50 with mid-urethral DV (60.8%) and 56 with distal urethral DV (77.8%) (p = 0.044). All three subgroups showed significant reduction in bladder outlet obstruction index after treatment, with BND plus DV subgroup showing the greatest reduction. CONCLUSIONS: Women with DV have different VUDS characteristics resulting from different pathophysiological mechanisms and treatment results. The VUDS characteristics may help predict treatment outcomes of female DV.

Highly Modulated In-Fiber Mach-Zehnder Interferometer Based on an Ultracompact Leaky-Guided Liquid Core.

We proposed a novel sensor based on an ultracompact leaky-guided liquid core fiber Mach-Zehnder interferometer (LLCFMZI) for high modulation of an interference spectrum. The sensor structure is based on a micro-sized hollow-core fiber (HCF) splicing a tilt end face single-mode fiber (SMF) to create a miniature oblique gap for the effective access of different liquids. The liquid core with a relatively lower refractive index (RI) than the cladding can achieve a leaky-mode optical waveguide (LMOW) mechanism, and its volume is only approximately 7.85 pL. In addition, the utilized micro-length HCF can reduce the energy loss of core in the LMOW to obtain an acceptable extinction ratio (>30 dB) with high temperature (T) sensitivity in the interference spectra. Experimental results show that the interference spectra can be highly modulated within the wide measurement range of 1250-1650 nm with a steadily linear response for thermal effect. The measured temperature sensitivities (T-sensitivities) of various liquids of DI water, ethanol, and Cargille-liquid (nD = 1.305) are 0.8869, 4.4754, and 4.8229 nm/°C, and the corresponding measured thermal optics coefficient (TOC) are -4.16 × 10-5, -2.11 × 10-4, and -3.6 × 10-4 °C-1, respectively. Measurement results demonstrate that the used liquids with a higher TOC can obtain better T-sensitivity modulation. The highest experimental sensitivity of the liquid-core filled with Cargille-liquid (nD = 1.40) is up to +13.87 nm/°C with a corresponding TOC of -4.07 × 10-4 °C-1. Furthermore, the experimental and theoretical values are in good agreement according to FSR the measuring scheme that investigates the effectiveness of the proposed LLCFMZI.

Design and Implementation of a Novel Measuring Scheme for Fiber Interferometer Based Sensors.

This paper presents a novel measuring scheme for fiber interferometer (FI) based sensors. With the advantages of being small sizes, having high sensitivity, a simple structure, good durability, being easy to integrate fiber optic communication and having immunity to electromagnetic interference (EMI), FI based sensing devices are suitable for monitoring remote system states or variations in physical parameters. However, the sensing mechanism for the interference spectrum shift of FI based sensors requires expensive equipment, such as a broadband light source (BLS) and an optical spectrum analyzer (OSA). This has strongly handicapped their wide application in practice. To solve this problem, we have, for the first time, proposed a smart measuring scheme, in which a commercial laser diode (LD) and a photodetector (PD) are used to detect the equivalent changes of optical power corresponding to the variation in measuring parameters, and a signal processing system is used to analyze the optical power changes and to determine the spectrum shifts. To demonstrate the proposed scheme, a sensing device on polymer microcavity fiber Fizeau interferometer (PMCFFI) is taken as an example for constructing a measuring system capable of long-distance monitoring of the temperature and relative humidity. In this paper, theoretical analysis and fundamental tests have been carried out. Typical results are presented to verify the feasibility and effectiveness of the proposed measuring scheme, smartly converting the interference spectrum shifts of an FI sensing device into the corresponding variations of voltage signals. With many attractive features, e.g., simplicity, low cost, and reliable remote-monitoring, the proposed scheme is very suitable for practical applications.

Comparative study of efficacy and safety between bladder body and trigonal intravesical onabotulinumtoxina injection in the treatment of interstitial cystitis refractory to conventional treatment-A prospective, randomized, clinical trial.

PURPOSE: Intravesical onabotulinumtoxinA (BoNT-A) injection can relieve symptoms of interstitial cystitis/bladder pain syndrome (IC/BPS). However, the therapeutic efficacy of different injection sites is not well known. This study compared therapeutic efficacy and safety between bladder body and trigonal BoNT-A injection. MATERIALS AND METHODS: Patients were randomly treated with 100U of BoNT-A in 10 mL saline injected into 20 bladder body sites or 10 trigonal sites. The primary endpoint was changes of Visual Analog Scale (VAS) for Pain at 8th week after injection. Secondary endpoint included changes of Global Response Assessment (GRA), urinary frequency episodes, O'Leary-Sant score (OSS), and urodynamic study. RESULTS: Thirty-nine patients (bladder body, N = 20; trigone, N = 19) completed the study visits. Patients in both group had significant improvement in VAS, OSS, and functional bladder capacity after treatment. There was no significant difference in changes of urinary frequency, voided volume, post-void residual volume, and bladder capacity from baseline to 8 weeks between groups. Thirteen (65.0%) patients in bladder body group and 10 (52.6%) patients in trigone group had decrease of VAS more than 2 points after treatment (P = 0.43). Excellent symptom improvement (GRA ≥ 2) was noted in 9 (45%) patients with bladder body injection and 10 (52.6%) patients with trigonal injection (P = 0.63). Nine (45.0%) patients in bladder body group and 10 (52.6%) in trigonal group experienced dysuria after treatment (P = 0.52). CONCLUSION: No significant difference in the improvement of IC symptoms and urodynamic parameters after intravesical BoNT-A injection in the bladder body or trigone. The rate of adverse events was similar between groups.

Histopathological characteristics of ketamine-associated uropathy and their clinical association.

AIM: To investigate the histopathological findings in ketamine-associated uropathy (KU) and their clinical association. METHODS: Thirty-eight KU patients had received history investigation and video urodynamic study. Twelve of them were clinically mild KU who were admitted for cystoscopic hydrodistention. The other 26 patients were severe KU who were admitted for enterocystoplasty with or without ureter reimplantation. Bladder and ureter specimens were harvested during operation, and a single pathologist reviewed all specimens under hematoxylin and eosin stain. The severity of histopathological findings was graded with a 4-point scale (0: none, 1: mild, 2: moderate, and 3: severe) RESULTS: Inflammatory cells infiltrations and nerve hyperplasia were found in the mucosa, muscle, and subserosal layers of KU bladders and ureter. In the mild KU bladder mucosa, the predominant component of the infiltrating inflammatory cells was lymphocytes. In contrast, neutrophils, eosinophils, lymphocytes, and plasma cells infiltration were noted in the mucosa of almost all severe KU bladders. Clinical severe KU was significantly correlated with severe to moderate lymphocytes, plasma cells, neutrophils, eosinophils infiltration, and nerve hyperplasia in bladder mucosa. KU patients with moderate or severe neutrophils or lymphocytes infiltration in bladder mucosa had significantly more severe bladder pain and smaller bladder capacity. CONCLUSION: The histological findings of KU showed whole-layer inflammation and nerve hyperplasia in bladder mucosa. The severity of inflammatory cell infiltration in the bladder mucosa is associated with clinical symptoms. A histopathological examination might be a useful tool to discriminate the KU severity in patients.

A Dual-Polymer Fiber Fizeau Interferometer for Simultaneous Measurement of Relative Humidity and Temperature.

This paper presents a novel design method in which a dual-polymer fiber Fizeau interferometer (DPFFI) is proposed for simultaneously measuring relative humidity (RH) and temperature (T). Since the polymer is intrinsically highly sensitive to both RH and T, the polymer fiber Fizeau interferometer (PFFI) exhibits cross-sensitivity of RH and T. In general, it is difficult to demodulate the optical responses from both variations of RH and T using a single PFFI. If two PFFIs with different structures are combined, they will individually exhibit distinct sensitivity responses with respect to RH and T, respectively. The technical problem of analyzing multiple interferences of the optical spectra of the DPFFI and the individual sensitivity of RH and T to each PFFI is obtained using the fast Fourier transform (FFT). A mathematical method is applied to solve the simultaneous equations of the DPFFI, so that the two variables RH and T can be determined at the same time. Experimental results, indicating good sensitivity and accuracy, with small measurement errors (average errors of ~1.46 °C and ~1.48%, respectively), are shown, determining the feasibility, and verifying the effectiveness, of the proposed DPFFI sensor.

A Hot-Polymer Fiber Fabry-Perot Interferometer Anemometer for Sensing Airflow.

This work proposes the first hot-polymer fiber Fabry-Perot interferometer (HPFFPI) anemometer for sensing airflow. The proposed HPFFPI is based on a single-mode fiber (SMF) endface that is attached to a UV-cured polymer to form an ultracompact fiber Fabry-Perot microcavity. The proposed polymer microcavity was heated using a low-cost chip resistor with a controllable dc driving power to achieve a desired polymer's steady-state temperature (T) that exceeds the T of the surrounding environment. The polymer is highly sensitive to variations of T with high repeatability. When the hot polymer was cooled by the measured flowing air, the wavelength fringes of its optical spectra shifted. The HPFFPI anemometers have been experimentally evaluated for different cavity lengths and heating power values. Experimental results demonstrate that the proposed HPFFPI responses well in terms of airflow measurement. A high sensitivity of 1.139 nm/(m/s) and a good resolution of 0.0088 m/s over the 0~2.54 m/s range of airflow were achieved with a cavity length of 10 µm and a heating power of 0.402 W.

Urothelial Dysfunction, Suburothelial Inflammation and Altered Sensory Protein Expression in Men with Bladder Outlet Obstruction and Various Bladder Dysfunctions: Correlation with Urodynamics.

PURPOSE: We investigated urothelial integrity, suburothelial inflammation and the expression of sensory proteins in the bladder urothelium of male patients with bladder outlet obstruction and various bladder dysfunctions. MATERIALS AND METHODS: We prospectively enrolled 33 men with urodynamically proven bladder outlet obstruction as the study group. Bladder biopsies were obtained from all study patients and 10 control patients. The expression of E-cadherin, zonula occludens-1, tryptase, apoptosis, TRPV (transient receptor potential vanilloid) 1 and 4, ß3 adrenoreceptor, M2 and M3 muscarinic receptors, P2X3 receptor, and inducible/epithelial nitric oxide synthase were compared between study and control patients. RESULTS: Study patients had significantly lower expression of E-cadherin, and a higher number of suburothelial mast and apoptotic cells than controls. Additionally, higher expression of P2X3 and M2 muscarinic receptors, and lower expression of M3 muscarinic receptor were detected in study patients. The detrusor underactivity subgroup was characterized by significantly higher expression of ß3 adrenoreceptors and lower expression of inducible nitric oxide synthase than in controls. In study patients a significantly positive correlation was noted between voided volume and E-cadherin expression (r = 0.372), volume at first sensation of filling and ß3 adrenoreceptor expression (r = 0.386), and detrusor pressure and M2 muscarinic receptor expression (r = 0.496) in the bladder urothelium (each p <0.05). CONCLUSIONS: Urothelial dysfunction, suburothelial inflammation, cellular apoptosis and alterations in sensory proteins are prominent in bladder dysfunction secondary to bladder outlet obstruction. Impaired urothelial signaling and sensory transduction pathways appear to reflect the pathophysiology of bladder dysfunction and detrusor underactivity in patients with bladder outlet obstruction.

Long-term follow up and predictive factors for successful outcome of transurethral incision of the bladder neck in women with detrusor underactivity.

BACKGROUND/PURPOSE: Detrusor underactivity (DU) is a common urologic problem. Our previous study revealed the transurethral incision of the bladder neck (TUI-BN) improves short-term voiding efficiency (VE) in female patients with DU. This study focused on the long-term outcomes of TUI-BN and identified the predictive factors of satisfactory outcomes. METHODS: A total 50 women with DU for whom medical treatment failed underwent TUI-BN. The urodynamic parameters at baseline and follow-up visits were analyzed. Patients with VEs >50% were considered to have satisfactory outcomes. Baseline urodynamic parameters were analyzed as factors predictive of outcomes. RESULTS: After a mean follow up of 61.8 months, 26 of 50 patients had satisfactory outcomes. The mean VE, maximum flow rate, voided volume, detrusor pressure, and postvoid residual volume significantly improved after TUI-BN. A higher intravesical pressure [Pves, odds ratio (OR) = 1.023, p = 0.013] and smaller first sensation of bladder filling (OR = 0.990, p = 0.020) at baseline were predictive factors for satisfactory outcomes. The multivariate analysis revealed that only baseline Pves was a significant predictor of satisfactory outcomes (OR = 1.024, p = 0.038). The receiver operating characteristic curve analysis of baseline Pves showed that the area under the curve was 0.767 (95% confidence interval = 0.624-0.876). The optimal cutoff value of Pves for a satisfactory outcome was 45 cmH2O, which had a specificity of 78.26% and acceptable sensitivity of 73.08%. CONCLUSION: TUI-BN improved VE in women with DU over the long term. A higher Pves compared to a lower Pves was predictive of satisfactory surgical outcomes.

Dual hollow core fiber-based Fabry-Perot interferometer for measuring the thermo-optic coefficients of liquids.

A microcavity fiber Fabry-Perot interferometer (MFFPI) that is based on dual hollow core fibers (HCFs) is developed for measuring the thermo-optic coefficients (TOCs) of liquids. The proposed MFFPI was fabricated by fusion-splicing a tiny segment of the main-HCF with a diameter D of 30 µm and another section of feeding-HCF with a diameter of 5 µm. Then, the main-HCF was filled with liquid by capillary action through the feeding-HCF by immersing the MFFPI in the liquid. The TOCs of the Cargille liquid (n(D)=1.3), deionized (DI) water, and ethanol were accurately determined from the shift of the interference wavelength, which was due to the temperature variation. Our experimental results were also compared with other published studies to investigate the effectiveness of the proposed sensing scheme. The major advantage is that the miniature MFFPI can achieve the measurement of the TOCs of the liquids with picoliter volume, and the measured liquids also can be sealed off and stored inside the HCF to prevent contamination.

Asymmetrical dual tapered fiber Mach-Zehnder interferometer for fiber-optic directional tilt sensor.

This work proposes a novel, highly sensitive and directional fiber tilt sensor that is based on an asymmetrical dual tapered fiber Mach-Zehnder interferometer (ADTFMZI). The fiber-optic tilt sensor consists of two abrupt tapers with different tapered waists into which are incorporated a set of iron spheres to generate an asymmetrical strain in the ADTFMZI that is correlated with the tilt angle and the direction of inclination. Owing to the asymmetrical structure of the dual tapers, the proposed sensor can detect the non-horizontal/horizontal state of a structure and whether the test structure is tilted to clockwise or counterclockwise by measuring the spectral responses. Experimental results show that the spectral wavelengths are blue-shifted and red-shifted when the sensor tilts to clockwise (-θ) and counterclockwise ( + θ), respectively. Tilt angle sensitivities of about 335 pm/deg. and 125 pm/deg. are achieved in the -θ and + θ directions, respectively, when the proposed sensing scheme is utilized.

Increased apoptosis and suburothelial inflammation in patients with ketamine-related cystitis: a comparison with non-ulcerative interstitial cystitis and controls.

OBJECTIVE: To investigate the suburothelial inflammation and urothelial dysfunction that occurs with ketamine-related cystitis (KC) and interstitial cystitis/bladder pain syndrome (IC/BPS). PATIENTS AND METHODS: Bladder tissues from 16 patients with KC, 17 patients with IC/BPS and 10 control subjects were analysed. Immunofluorescence staining of the junction protein E-cadherin was carried out, and tryptase levels and a TUNEL assay were used to assess mast-cell activation and urothelial apoptosis, respectively. The fluorescence intensity of E-cadherin was measured using the ImageJ method. The percentages of activated mast cells and apoptotic cells were calculated as positive cells per unit area (4 µm(2) ). RESULTS: The mean (sd) ages of the patients in the KC, IC/BPS and control groups were 25.0 (3.8), 41.3 (13.7) and 50.5 (9.6) years, respectively (P < 0.05). The mean (sd) distributions of E-cadherin in KC (10.1 [11.2]) and IC/BPS (25.1 [16.3]) tissues were significantly lower than in the control tissues (42.4 [16.7]; both P < 0.05). The mean (sd) number of activated mast cells, measured by tryptase signals in the KC (6.5 [3.7]) and IC/BPS (4.6 [3.0]) tissues, were significantly higher than in the control tissues (1.3 [1.12]; both P < 0.05). TUNEL staining showed a significantly higher mean (sd) number of apoptotic cells in KC (4.4 [2.5]) and IC/BPS (2.4 [1.7]) tissues than in control tissues (0.1 [0.3]; both P < 0.05). Tissues from the KC bladders had significantly lower expression of E-cadherin (P = 0.024) and significantly higher numbers of apoptotic cells (P = 0.02) compared with the IC/BPS bladder tissues. Greater numbers of apoptotic cells and lower expression levels of E-cadherin significantly correlated with maximum bladder capacity in the overall patient samples (P < 0.05). CONCLUSIONS: KC and IC/BPS tissues both showed defective junction protein, increased suburothelial inflammation and increased urothelial cell apoptosis. Decreased expression of E-cadherin and increased apoptosis were more severe in KC than in IC/BPS bladder tissues and these findings were associated with the clinical symptoms of KC and IC/BPS.

Treating overactive bladder symptoms after transurethral prostatic surgery for benign prostatic hyperplasia - Which medication to choose?

Objectives: Overactive bladder (OAB) symptoms are often encountered in patients after transurethral resection of the prostate (TUR-P) or transurethral incision of the prostate (TUI-P) for benign prostatic obstruction (BPO). Either antimuscarinics or ß-3 agonist has been found effective in relieving OAB symptoms. However, urologists usually do not prescribe such medication immediately after TUR-P or TUI-P to avoid an increase in postvoid residual and risk of urinary tract infection. If OAB medication can be used and adverse events (AEs) can be reduced to minimum, patients' quality of life after bladder outlet obstruction surgery could be improved. This study compared the safety and efficacy between solifenacin and mirabegron in men undergoing TUR-P or TUI-P. Materials and Methods: This prospective, randomized trial compared the safety and efficacy of OAB medication on the reduction in Urgency Severity Score (USS), OAB Symptoms Score (OABSS), International Prostate Symptom Score, and urgency urinary incontinence episodes in men with BPO undergoing surgical intervention. All patients could void smoothly after catheter removal and were randomly received daily solifenacin 5 mg, mirabegron 50 mg, or no interventions for 4 weeks. At 2 and 4 weeks postoperatively, participants' OAB symptoms and AEs were evaluated. Results: A total of 57 men were enrolled in this study with a mean age of 70.8 ± 6.1 years. At 2 weeks postoperatively, USS (1.56 ± 1.72 vs. 2.39 ± 1.72 vs. 2.26 ± 1.73, P < 0.011) and OABSS (5.33 ± 3.65 vs. 7.67 ± 4.19 vs. 8.58 ± 4.31, P < 0.000) were significantly reduced in patients taking solifenacin, mirabegron, or control, respectively. Two patients in the solifenacin group developed urinary retention. However, the changes of variables at 4 weeks postoperatively were insignificant among the three groups. Conclusion: Solifenacin and mirabegron are two different drug classes both equally effective in treating immediate OAB symptoms after TUR-P or TUI-P. However, OAB symptoms could be relieved at 4 weeks without any medication. Considering AEs, ß-3 agonist has a more favorable safety profile than antimuscarinics.

Widely tunable and ultrasensitive leaky-guided multimode fiber interferometer based on refractive-index-matched coupling.

This investigation presents a simple, widely tunable, and ultrasensitive sensor that is based on a leaky-guided multimode fiber interferometer (MMFI) operated under refractive-index-matched coupling. By use of a material with an appropriate dispersion profile around the MMFI as a cladding yields strong index-matched coupling, which performs ultrasensitive sensing in variations of the surroundings. Index matching at a single wavelength yields a coupling wavelength dip with a narrow bandwidth and a high extinction ratio of over 25 dB. The wavelength dip can also be effectively tuned, greatly shifting with a variation in temperature (T) or refractive index (RI), when the index-matched condition is satisfied. This work demonstrates that the proposed sensor responds sensitively to T with an extremely high tuning efficiency of 50 nm/°C and an excellent sensitivity to RI of 113,500 nm per RI unit.

Real-World Data Regarding Satisfaction to Botulinum Toxin A Injection into the Urethral Sphincter and Further Bladder Management for Voiding Dysfunction among Patients with Spinal Cord Injury and Voiding Dysfunction.

PURPOSE: This study aimed to investigate improvement in voiding condition after the initial botulinum toxin A (BoNT-A) injection into the urethral sphincter among patients with chronic spinal cord injury (SCI) and voiding dysfunction. Moreover, subsequent surgical procedures and bladder management were evaluated. MATERIALS AND METHODS: From 2011 to 2020, 118 patients with SCI and dysuria who wanted to void spontaneously received their first BoNT-A injection at a dose of 100 U into the urethral sphincter. Improvement in voiding and bladder conditions after BoNT-A treatment were assessed. Next, patients were encouraged to continually receive BoNT-A injections into the urethral sphincter, convert to other bladder managements, or undergo surgery. After undergoing bladder management and surgical procedures, the patients were requested to report improvement in voiding condition and overall satisfaction to bladder conditions. Then, data were compared. RESULTS: In total, 94 male and 24 female participants were included in this analysis. Among them, 51 presented with cervical, 43 with thoracic, and 24 with lumbosacral SCI. After BoNT-A injections into the urethral sphincter, 71 (60.2%) patients, including 18 (15.3%) with excellent, and 53 (44.9%) with moderate improvement, had significant improvement in voiding condition. Patients with cervical SCI (66.6%), detrusor overactivity and detrusor sphincter dyssynergia (72.0%), partial hand function (80.0%), and incomplete SCI (68.4%) had a better improvement rate than the other subgroups. Only 42 (35.6%) patients continually received treatment with BoNT-A injections into the urethral sphincter. Meanwhile, more than 60% of patients who converted their treatment to augmentation enterocystoplasty (n = 5), bladder outlet surgery (n = 25), BoNT-A injections into the detrusor muscle (n = 20), and medical treatment (n = 55) had moderate and marked improvement in voiding dysfunction and overall satisfaction. DISCUSSION: Although BoNT-A injections into the urethral sphincter could improve voiding condition, only patients with SCI who presented with voiding dysfunction were commonly satisfied. Those whose treatments were converted to other bladder managements, which can promote urinary continence, or to surgical procedures, which can facilitate spontaneous voiding, had favorable treatment outcomes.

A Dual-Cavity Fiber Fabry-Pérot Interferometer for Simultaneous Measurement of Thermo-Optic and Thermal Expansion Coefficients of a Polymer.

This paper presents a novel method based on a dual-cavity fiber Fabry-Pérot interferometer (DCFFPI) for simultaneously measuring the thermo-optic coefficient (TOC) and thermal expansion coefficient (TEC) of a polymer. The polymer is, by nature, highly responsive to temperature (T) in that its size (length, L) and refractive index (RI, n) are highly dependent on the thermal effect. When the optical length of the polymer cavity changes with T, it is difficult to distinguish whether there is a change in L or n, or both. The variation rates of L and n with a change in T were the TOC and TEC, respectively. Therefore, there was a cross-sensitivity between TOC and TEC in the polymer-based interferometer. The proposed DCFFPI, which cascades a polymer and an air cavity, can solve the above problem. The expansion of the polymer cavity is equal to the compression of the air cavity with the increase in T. By analyzing the individual optical spectra of the polymer and air cavities, the parameters of TOC and TEC can be determined at the same time. The simultaneous measurement of TOC and TEC with small measured deviations of 6 × 10-6 (°C-1) and 3.67 × 10-5 (°C-1) for the polymer NOA61 and 7 × 10-6 (°C-1) and 1.46 × 10-4 (°C-1) for the NOA65 can be achieved. Experimental results regarding the measured accuracy for the class of adhesive-based polymer are presented to demonstrate the feasibility and verify the usefulness of the proposed DCFFPI.

Therapeutic outcome of active management in male patients with detrusor underactivity based on clinical diagnosis and videourodynamic classification.

Detrusor underactivity (DU) could be resulted from many different etiologies. Patients with DU might have reduced bladder sensation, low detrusor contractility, and large post-void residual volume. This study analyzed therapeutic outcome of active management for male DU patients, based on clinical and urodynamic characteristics. Male DU patients aged > 18 years old were retrospectively reviewed from the videourodynamic study (VUDS) records in recent 10 years. The patients' demographics, VUDS results, treatment modalities, and treatment outcome were analyzed. The treatment outcomes were compared among patients with different DU subgroups, clinical diagnosis and treatment modalities. Patients with voiding efficiency of > 66.7% were considered having a successful treatment outcome. For comparison, 30 men with normal VUDS finding served as the control arm. Most of the DU patients had reduced bladder sensation. The reduced bladder sensation is closely associated with low detrusor contractility. After active treatment, a successful outcome was achieved in 68.4% of patients after bladder outlet surgery, 59.1% after urethral botulinum toxin A injection, and 57.6% after medical treatment, but only 18.2% after conservative treatment. A successful treatment outcome was achieved in patients with an intact detrusor contractility, either low (69.2%) or normal voiding pressure (81.8%), and in patients with a normal or increased bladder sensation (78.1%). However, patients with detrusor acontractile (41.3%) or absent bladder sensation (17.9%) had less favorable treatment outcome after any kind of urological management. This study revealed that active management can effectively improve voiding efficiency in patients with DU. The normal bladder sensation, presence of adequate detrusor contractility, and bladder outlet narrowing during VUDS provide effective treatment strategy for DU patients. Among all management, BOO surgery provides the best treatment outcome.

Wavelength multiplexing multiple-image encryption using cascaded phase-only masks in the Fresnel transform domain.

We propose a method of wavelength multiplexing based on a modified Gerchberg-Saxton algorithm (MGSA) and a cascaded phase modulation scheme in the Fresnel transform domain to reduce the cross talk in the multiple-image-encryption framework. First, each plain image is encoded to a complex function by using the MGSA. Next, the phase components of the created complex functions are multiplexed with different wavelength parameters, and then they are modulated before being combined together as a phase-only function, which is recorded in the first phase-only mask (POM). Finally, the second POM is generated by applying the MGSA again on the amplitude derived from the summation of the total created complex functions. Simulation results show that the cross talk between multiplexed images has been significantly reduced compared with an existing similar method. Therefore, the multiplexing capacity in encrypting multiple gray-scale images can be increased accordingly.

[Project to enhance accuracy of nursing assessments performed by medical and surgical ICU nursing staffs].

BACKGROUND: Some nurses do not have the skills necessary to evaluate general ICU patient condition and the meaning of laboratory data adequately. This can influence nursing care quality and patient safety. Between October 16th and 29th, 2009, this project employed a checklist to evaluate nursing assessment accuracy in medical and surgical ICUs. The unexpectedly low accuracy rate of two-thirds (63.4 percent) was caused by factors including poor nursing assessment cognizance, lack of experience performing nursing assessments, nursing assessment skills taught only to experienced nursing staff, and a lack of nursing assessment guidelines. PURPOSE: This project was designed to improve nursing assessment cognizance and accuracy among nursing staff. RESOLUTION: The authors: 1. Established formal nursing assessment guidelines; 2. made a CD-ROM to introduce nursing assessment basics; and 3. employed lectures and simulation exercises to teach nursing assessment skills. RESULTS: Nursing assessment accuracy improved significantly to 85.8 percent and actual nursing assessment cognizance scores ranged between 68.7 and 83.1. CONCLUSIONS: This project effectively improved nursing assessment accuracy and may be considered and referenced by relevant medical organizations.