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There are close links between solar UV radiation, climate change, and plastic pollution. UV-driven weathering is a key process leading to the degradation of plastics in the environment but also the formation of potentially harmful plastic fragments such as micro- and nanoplastic particles. Estimates of the environmental persistence of plastic pollution, and the formation of fragments, will need to take in account plastic dispersal around the globe, as well as projected UV radiation levels and climate change factors.
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Energía Solar , Rayos Ultravioleta , Rayos Ultravioleta/efectos adversos , Cambio Climático , Contaminación Ambiental , Tiempo (Meteorología)RESUMEN
Acute myeloid leukemia (AML) with t(8;21) (q22;q22), which forms RUNX1::RUNX1T1 fusion gene, is classified as a favorable-risk group. However, the presence of mutations in KIT exon 17 results in an adverse prognosis in this group. Avapritinib, a novel tyrosine kinase inhibitor, was designed to target KIT mutation. We report a retrospective study of four pediatric patients with AML with t(8:21) and KIT exon 17 mutation who were treated with avapritinib, three of them failed to demethylate drugs and donor lymphocyte infusion targeting RUNX1::RUNX1T1-positivity after allogeneic hematopoietic stem cell transplantation (allo-HSCT). So far, all patients with RUNX1::RUNX1T1 positivity had turned negative after 1, 9, 7, 2 months of avapritinib treatment. The common adverse effect of avapritinib is neutropenia, which is well-tolerated. This case series indicates that avapritinib may be effective and safe for preemptive treatment of children with AML with t(8;21) and KIT mutation after allo-HSCT, providing a treatment option for preventing relapse after allo-HSCT.
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The products containing pyrimidine scaffolds exhibit various important physiological and biological activities. To date, the strategies to generate 4,5,6-trisubstituted pyrimidines were not reported. Here, a copper-catalyzed reaction of 2H-azirines with α-isocyanoacetates or α-isocyanoacetamides has been developed, rapidly preparing 4,5,6-trisubstituted pyrimidines. The mechanistic results reveal that this strategy underwent a formal 1, 3-dipolar [3 + 2] cycloaddition/ring-expanding/oxidative aromatization procedure to construct the desired pyrimidines.
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This Assessment Update by the Environmental Effects Assessment Panel (EEAP) of the United Nations Environment Programme (UNEP) considers the interactive effects of solar UV radiation, global warming, and other weathering factors on plastics. The Assessment illustrates the significance of solar UV radiation in decreasing the durability of plastic materials, degradation of plastic debris, formation of micro- and nanoplastic particles and accompanying leaching of potential toxic compounds. Micro- and nanoplastics have been found in all ecosystems, the atmosphere, and in humans. While the potential biological risks are not yet well-established, the widespread and increasing occurrence of plastic pollution is reason for continuing research and monitoring. Plastic debris persists after its intended life in soils, water bodies and the atmosphere as well as in living organisms. To counteract accumulation of plastics in the environment, the lifetime of novel plastics or plastic alternatives should better match the functional life of products, with eventual breakdown releasing harmless substances to the environment.
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Plásticos , Contaminantes Químicos del Agua , Humanos , Plásticos/toxicidad , Ecosistema , Rayos Ultravioleta , Cambio Climático , Contaminantes Químicos del Agua/análisisRESUMEN
An efficient and metal-free method for the synthesis of 3-aryl pyrido[1,2-a]indoles from aryne intermediates and 2-pyridinyl-substituted p-QMs was successfully developed under ambient conditions. The reaction offered a novel and practical protocol to access some diverse functional molecules in good to excellent yields. The proposed mechanism indicated that the reaction proceeded via a formal [3 + 2] cycloaddition step.
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BACKGROUND: Pain is a dynamic experience that varies over time, but it remains unknown whether trajectories of pain are associated with subsequent cognitive decline. The purpose of this study was to identify distinct trajectories of pain presence and activity-limiting pain and investigate their longitudinal associations with the rate of subsequent cognitive decline in older adults. METHODS: A total of 5685 participants from the English Longitudinal Study of Ageing (ELSA) and 7619 participants from the Health and Retirement Study (HRS) were included. Pain presence trajectories were identified over eight years in the ELSA and 10 years in the HRS, while trajectories of activity-limiting pain were identified over 10 years in the HRS. We utilised linear mixed-effects models to investigate the long-term relationship between pain trajectories and the rate of cognitive decline across various domains, including memory, orientation, executive function and global cognition. RESULTS: Three pain presence trajectories were identified. Moderate-increasing and high-stable groups exhibited steeper declines in global cognition than the low-stable group. Furthermore, individuals in the moderate-increasing group experienced a more rapid decline in executive function, while the high-stable group showed a faster decline in orientation function. Two trajectories of activity-limiting pain were identified, with the moderate-increasing group experiencing a faster decline in orientation function and global cognition. CONCLUSIONS: The trajectories of both pain presence and activity-limiting pain are linked to the rate of subsequent cognitive decline among older people. Interventions for specific pain trajectories might help to delay the decline rate of cognition in specific domains.
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Disfunción Cognitiva , Dolor , Humanos , Anciano , Masculino , Femenino , Estudios Longitudinales , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/psicología , Disfunción Cognitiva/diagnóstico , Dolor/psicología , Dolor/diagnóstico , Dolor/epidemiología , Cognición , Anciano de 80 o más Años , Persona de Mediana Edad , Factores de Tiempo , Envejecimiento/psicología , Función Ejecutiva , Factores de Riesgo , Inglaterra/epidemiología , Factores de EdadRESUMEN
BACKGROUND: The risk factors for hemorrhagic cystitis (HC) in children undergoing hematopoietic stem cell transplantation (HSCT) are unclear. Therefore, we conducted this systematic review and meta-analysis to investigate the risk factors for HC in children undergoing HSCT. METHODS: We performed this meta-analysis by retrieving studies from PubMed, EMBASE, and the Cochrane Library up to October 10, 2023, and analyzing those that met the inclusion criteria. I2 statistics were used to evaluate heterogeneity. RESULTS: Twelve studies, including 2,764 patients, were analyzed. Male sex (odds ratio [OR] = 1.52; 95% confidence interval [CI], 1.16-2.00; p = 0.003, I2 = 0%), allogeneic donor (OR = 5.28; 95% CI, 2.60-10.74; p < 0.00001, I2 = 0%), human leukocyte antigen (HLA) mismatched donor (OR = 1.86; 95% CI, 1.00-3.44; p = 0.05, I2 = 31%), unrelated donor (OR = 1.58; 95% CI, 1.10-2.28; p = 0.01, I2 = 1%), myeloablative conditioning (MAC) (OR = 3.17; 95% CI, 1.26-7.97; p = 0.01, I2 = 0%), busulfan (OR = 2.18; 95% CI, 1.33-3.58; p = 0.002, I2 = 0%) or anti-thymoglobulin (OR = 1.65; 95% CI, 1.07-2.54; p = 0.02, I2 = 16%) use, and cytomegalovirus (CMV) reactivation (OR = 2.64; 95% CI, 1.44-4.82; p = 0.002, I2 = 0%) were risk factors for HC in children undergoing HSCT. CONCLUSIONS: Male sex, allogeneic donor, HLA-mismatched, unrelated donor, MAC, use of busulfan or anti-thymoglobulin, and CMV reactivation are risk factors for HC in children undergoing HSCT.
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Cistitis Hemorrágica , Trasplante de Células Madre Hematopoyéticas , Hemorragia , Niño , Femenino , Humanos , Masculino , Cistitis Hemorrágica/etiología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Hemorragia/etiología , Factores de Riesgo , Factores Sexuales , Acondicionamiento Pretrasplante/efectos adversosRESUMEN
BACKGROUND: Envelope stress responses (ESRs) are critical for adaptive resistance of Gram-negative bacteria to envelope-targeting antimicrobial agents. However, ESRs are poorly defined in a large number of well-known plant and human pathogens. Dickeya oryzae can withstand a high level of self-produced envelope-targeting antimicrobial agents zeamines through a zeamine-stimulated RND efflux pump DesABC. Here, we unraveled the mechanism of D. oryzae response to zeamines and determined the distribution and function of this novel ESR in a variety of important plant and human pathogens. RESULTS: In this study, we documented that a two-component system regulator DzrR of D. oryzae EC1 mediates ESR in the presence of envelope-targeting antimicrobial agents. DzrR was found modulating bacterial response and resistance to zeamines through inducing the expression of RND efflux pump DesABC, which is likely independent on DzrR phosphorylation. In addition, DzrR could also mediate bacterial responses to structurally divergent envelope-targeting antimicrobial agents, including chlorhexidine and chlorpromazine. Significantly, the DzrR-mediated response was independent on the five canonical ESRs. We further presented evidence that the DzrR-mediated response is conserved in the bacterial species of Dickeya, Ralstonia, and Burkholderia, showing that a distantly located DzrR homolog is the previously undetermined regulator of RND-8 efflux pump for chlorhexidine resistance in B. cenocepacia. CONCLUSIONS: Taken together, the findings from this study depict a new widely distributed Gram-negative ESR mechanism and present a valid target and useful clues to combat antimicrobial resistance.
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Antiinfecciosos , Clorhexidina , Humanos , Bacterias Gramnegativas/metabolismo , Antibacterianos/farmacología , Proteínas Bacterianas/metabolismoRESUMEN
Situated in the north of the Qinghai-Tibet Plateau, the Qaidam Basin experiences limited precipitation and significant evaporation. Despite these conditions, it stands out as one of the most densely distributed lakes in China. The formation of these lakes is controversial: whether the lake water primarily originates from local precipitation or external water sources. To address this issue, this paper explores the recharge sources of lakes in the Qaidam Basin and the circulation patterns of groundwater from a remote sensing perspective. Based on deep learning networks, we optimized the soft object regions of the Object-Contextual Representations Network (OCRNet) and proposed the Remote·Sensing Adaptive-Improved OCRNet (RSA-IOCRNet). Compared with seven other networks, RSA-IOCRNet obtained better experimental results and was used to construct an area sequence of 16 major lakes in the Qaidam Basin. Combined with multi-source data, the comprehensive analysis indicates no significant correlation between climatic factors and lake changes, while an obvious correlation between lakes and groundwater changes in the eastern Qaidam, consisting with the results of the field survey. Deep-circulating groundwater recharges numerous Qaidam lakes through upwelling from fault zones, such as Gasikule Lake and Xiaochaidan Lake. Groundwater in the Qaidam Basin is more depleted in hydrogen-oxygen isotope characteristics than surface water in the basin, but similar to some river water in the endorheic Tibetan Plateau. This indicates that Tibetan seepage water, estimated at approximately 540 billion m3/a, is transported through the Qaidam Basin via deep circulation. Moreover, it rises to recharge the groundwater and lakes within this basin through fracture zones, extending to various arid and semi-arid regions such as Taitema Lake. This work provides a new perspective on the impact of deep groundwater on lakes and water circulation in these areas.
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Monitoreo del Ambiente , Agua Subterránea , Lagos , Tecnología de Sensores Remotos , Agua Subterránea/análisis , Agua Subterránea/química , Monitoreo del Ambiente/métodos , China , TibetRESUMEN
Inland shallow lakes are recognized as an important source of greenhouse gases (GHGs), and their contribution is expected to increase due to global eutrophication. The generation and release of GHGs involved multiple variables, leading to many uncertain potential factors. This study examined the emission characteristics of GHGs at the water-air interface in 12 shallow lakes categorized into four eutrophic levels in the Yangtze River basin. The average emission rates of CH4, CO2 and N2O were 1.55, 3.43, 18.13 and 30.47 mg m-2 h-1, 4.12, 14.64, 25.11 and 69.84 mg m-2 h-1, and 0.2, 0.25, 0.43 and 0.79 mg m-2 day-1 in the oligotrophic, mesotrophic, eutrophic and hypereutrophic lakes, respectively. There were significant correlations between eutrophic levels and the emission rates of CH4 and CO2 (p < 0.05). Redundancy analysis and Mantel test were conducted to further examine the key factors influencing carbon emissions from eutrophic water. It was found that the presence of algae and nutrients in the overlying water played a crucial role in the release of GHGs, indicating the importance of ecosystem productivity in the carbon budget of the lake. In order to assess the bioavailability of organic matter, a new indicator called R(P/H) was proposed. This indicator represents the ratio of protein and humus-like components, which were obtained through EEMs-PARAFAC modeling. The relationship between R(P/H) and CH4 was found to be exponential (R2 = 0.90). Additionally, R(P/H) showed a linear relationship with CO2 and N2O (R2 = 0.68, R2 = 0.75). Therefore, it is crucial to consider R(P/H) as an important factor in accurately estimating global GHG emission fluxes in the future, especially with advancements in the database.
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Gases de Efecto Invernadero , Gases de Efecto Invernadero/análisis , Lagos/análisis , Ecosistema , Dióxido de Carbono/análisis , Metano/análisis , Agua/análisis , Carbono/análisis , ChinaRESUMEN
Birnessite is ubiquitous in the natural environment where heavy metals are retained and easily transformed. The surface properties and structure of birnessite change with the changes in external environmental conditions, which also affects the fate of heavy metals. Clarifying the effect and mechanism of the birnessite phase transition process on heavy metals is the key to taking effective measures to prevent and control heavy metal pollution. Therefore, the four transformation pathways of birnessite are summarized first in this review. Second, the relationship between transformation pathways and environmental conditions is proposed. These relevant environmental conditions include abiotic (e.g., co-existing ions, pH, oxygen pressure, temperature, electric field, light, aging, pressure) and biotic factors (e.g., microorganisms, biomolecules). The phase transformation is achieved by the key intermediate of Mn(III) through interlayer-condensation, folding, neutralization-disproportionation, and dissolution-recrystallization mechanisms. The AOS (average oxidation state) of Mn and interlayer spacing are closely correlated with the phase transformation of birnessite. Last but not least, the mechanisms of heavy metals immobilization in the transformation process of birnessite are summed up. They involve isomorphous substitution, redox, complexation, hydration/dehydration, etc. The transformation of birnessite and its implication on heavy metals will be helpful for understanding and predicting the behavior of heavy metals and the crucial phase of manganese oxides/hydroxides in natural and engineered environments.
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Manganeso , Metales Pesados , Manganeso/química , Adsorción , Metales Pesados/química , Óxidos/química , Compuestos de Manganeso/química , Oxidación-ReducciónRESUMEN
It is vital to create flexible batteries as power sources to suit the needs of flexible electronic devices because they are widely employed in wearable and portable electronics. The direct methanol fuel cell (DMFC) is a desirable alternative portable energy source since it is a clean, safe, and high energy density cell. The traditional DMFC in mechanical assembly and its unbending property, however, prevent it from being employed in flexible electrical devices. In this study, the flexible membrane electrode assembly (MEA) with superior electrical conductivity and nanoscale TiC-modified carbon cloth (TiC/CC) is used as supporting layer. Additionally, solid methanol fuels used in the manufacturing of flexible all-solid-state DMFC have the advantages of being tiny, light, and having high energy density. Furthermore, the DMFC's placement and bending angle have little effect on its performance, suggesting that DMFC is appropriate for flexible portable energy. The flexible all-solid-state DMFC's power density can reach 14.06 mW cm-2 , and after 50 bends at 60°, its voltage loss can be disregarded. The flexible all-solid DMFC has an energy density that is 777.78 Wh Kg-1 higher than flexible lithium-ion batteries, which is advantageous for the commercialization of flexible electronic products.
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Reversed nonlinear dynamics is predicted to be capable of enhancing the quantum sensing in unprecedented ways. Here, we report the experimental demonstration of a loss-tolerant (external loss) and quantum-enhanced interferometer. Two cascaded optical parametric amplifiers are used to judiciously construct an interferometry with two orthogonal squeezing operation. As a consequence, a weak displacement introduced by a test cavity can be amplified for measurement, and the measured signal-to-noise ratio is better than that of both conventional photon shot-noise limited and squeezed-light assisted interferometers. We further confirm its superior loss-tolerant performance by varying the external losses and comparing with both conventional photon shot-noise limited and squeezed-light assisted configurations, illustrating the potential application in gravitational wave detection.
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Bladder outlet obstruction (BOO) is a common disease that always make the bladder develops from inflammation to fibrosis. This study was to investigate the effect of exosomes from human urine-derived stem cells (hUSCs) on bladder fibrosis after BOO and the underlying mechanism. The BOO mouse model was established by inserting a transurethral catheter, ligation of periurethral wire, and removal of the catheter. Mouse primary bladder smooth muscle cells (BSMCs) were isolated and treated with TGFß1 to mimic the bladder fibrosis model in vitro. Exosomes from hUSCs (hUSC-Exos) were injected into the bladder of BOO mice and added into the culture of TGFß1-induced BSMCs. The associated factors in mouse bladder tissues and BSMCs were detected. It was confirmed that the treatment of hUSC-Exos alleviated mouse bladder fibrosis and down-regulated fibrotic markers (a-SMA and collagen III) in bladder tissues and TGFß1-induced BSMCs. Overexpression of NRF1 in hUSC-Exos further improved the effects of hUSC-Exos on bladder fibrosis both in vivo and in vitro. TGFßR1 was a target of NRF1 and miR-301b-3p, and miR-301b-3p was a target of NRF1. It was next characterized that hUSC-Exos carried NRF1 to up-regulate miR-301B-3p, thereby reducing TGFßR1level. Our results illustrated that hUSC-Exos carried NRF1 to alleviate bladder fibrosis through regulating miR-301b-3p/TGFßR1 pathway.
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Exosomas , MicroARNs , Obstrucción del Cuello de la Vejiga Urinaria , Humanos , Ratones , Animales , Vejiga Urinaria/metabolismo , Exosomas/genética , Exosomas/metabolismo , Obstrucción del Cuello de la Vejiga Urinaria/genética , Obstrucción del Cuello de la Vejiga Urinaria/metabolismo , Obstrucción del Cuello de la Vejiga Urinaria/patología , Células Madre/metabolismo , MicroARNs/genética , MicroARNs/metabolismo , FibrosisRESUMEN
BACKGROUND AND AIMS: Abiotic and biotic factors simultaneously affect tree growth and thus shape community structure and dynamics. In particular, trees of different size classes show different growth responses to soil nutrients and neighbourhood crowding, but our understanding of how species' joint responses to these factors vary between size classes remains limited in multi-storied temperate forests. Here, we investigated size class differences in tree growth response to soil gradients and neighbourhood crowding in an old-growth temperate forest. METHODS: We combined growth data over 15 years from 38 902 individuals of 42 tree species with trait data in a 25-ha temperate forest plot in northeast China. We built hierarchical Bayesian models of tree growth to examine the effects of soil gradients and neighbourhood crowding between size classes and canopy types. KEY RESULTS: We found that soil and neighbours mainly acted separately in shaping tree growth in small and large trees. Soil total nitrogen and phosphorus increased tree growth in small trees, in particular of understorey species, but not in large trees. Neighbours reduced tree growth in both tree size classes, with stronger effects on large than small trees, and on canopy than understorey species. Furthermore, small trees with higher specific leaf area grew faster in fertile soils, and small trees with less seed mass grew faster in crowded environments. Large trees with higher specific leaf area, specific root length and less seed mass grew faster in crowded environments, while these traits had limited influence on tree growth response to soil gradients. CONCLUSIONS: Our study highlights the importance of size class in modulating the response of tree growth to soil and neighbours, and the differential role of species canopy types and functional traits in capturing these effects in large vs. small trees.
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Bosques , Suelo , Teorema de Bayes , China , FenotipoRESUMEN
Plastic film mulching and urea nitrogen fertilization are widely used in agricultural ecosystems, but both their long-term use may leave a negative legacy on crop growth, due to deleterious effects of plastic and microplastic accumulation and acidification in soil, respectively. Here, we stopped covering soil with a plastic film in an experimental site that was previously covered for 33 years and compared soil properties and subsequent maize growth and yield between plots that were previously and never covered with the plastic film. Soil moisture was about 5-16% higher at the previously mulched plot than at the never-mulched plot, but NO3- content was lower for the former when with fertilization. Maize growth and yield were generally similar between previously and never-mulched plots. Maize had an earlier dough stage (6-10 days) in previously mulched compared to never-mulched plots. Although plastic film mulching did add substantial amounts of film residues and microplastic accumulation into soils, it did not leave a net negative legacy (given the positive effects of the mulching practice in the first place) for soil quality and subsequent maize growth and yield, at least as an initial effect in our experiment. Long-term urea fertilization resulted in a pH decrease of about 1 unit, which bring a temporary maize P deficiency occurring in early stages of growth. Our data add long-term information on this important form of plastic pollution in agricultural systems.
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Plásticos , Suelo , Suelo/química , Zea mays , Nitrógeno/análisis , Microplásticos , Ecosistema , Agua , Agricultura , Urea , Fertilización , ChinaRESUMEN
The occurrence of glucocorticoids (GCs) in agricultural soils has raised concerns due to their high polarity, widespread biological effects in vertebrates, and their potential to disrupt vital processes such as glucose metabolism and immune function. This study investigated the sorption and transport dynamics of three GCs, namely cortisone (COR), prednisolone (PNL), and triamcinolone acetonide (TCA) in five soil-water systems (S1-S5 systems). The sorption data of the GCs were fitted to a linear sorption model (R2 = 0.95-0.99), with organic carbon (OC) normalized sorption coefficients ranging from 2.26 ± 0.02 to 3.36 ± 0.02. The sorption magnitudes (Kd) of the GCs exhibited a nearly linear correlation with their corresponding octanol-water partition coefficients (logKow) in the S1-S3 systems. However, some deviations from linearity were observed in the S4 and S5 systems. Furthermore, a strong correlation was observed between the Kd values of the GCs and the OC% of the soils. These data indicated that specific and hydrophobic partitioning interactions governed the sorption of GCs onto soils. The transport data of the GCs were fitted to a two-site nonequilibrium model using the CXTFIT program (R2 = 0.82-0.98). The retardation factor (R) for each GC exhibited a positive correlation with the OC% and clay contents of soils. Additionally, the relationships between the logR values and logKow values of the GCs deviated slightly from linear correlation in most columns. These results indicated that specific interactions in the columns were more pronounced compared to the batch systems. An initial field-scale simulation demonstrated that frequent precipitation can facilitate the dilution and vertical transport of the GCs through soil profiles. The transport potential of the GCs was affected by the properties and soils and GCs. Overall, these findings provide valuable insights into the transport potential and associated environmental risks of GCs in soil-water systems.
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Cortisona , Contaminantes del Suelo , Suelo/química , Triamcinolona Acetonida , Prednisolona , Contaminantes del Suelo/análisis , Glucocorticoides , Carbono/química , Agua/química , AdsorciónRESUMEN
In non-ferrous metal smelting, the problem of gaseous arsenic in high-sulfur flue gas is difficult to solve. Now we have developed oxygen-enriched amorphous iron manganese oxide (AFMBO) based on the unique superiority of iron-manganese oxide for arsenic capture to realize the effective control of gaseous arsenic in the non-ferrous smelting flue gas. The experimental results show that the arsenic adsorption capacity of AFMBO is up to 102.7 mg/g, which has surpassed most of the current adsorbents. In particular, AFMBO can effectively capture gaseous arsenic even at 12% v/v SO2 concentrations (88.45 mg/g). Moreover, the spent AFMBO possesses pronounced magnetic characteristics that make it easier to separate from dust, which is conducive to reducing the secondary environmental risk of arsenic. In terms of mechanism study, various characterization methods are used to explain the important role of lattice oxygen and adsorbed oxygen in the capture process of gaseous arsenic. Moreover, the reason for the efficient arsenic removal performance of AFMBO is also reasonably explained at the microscopic level. This study provides ideas and implications for gaseous arsenic pollution control research.
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Arsénico , Manganeso , Gases , Óxidos , Hierro , OxígenoRESUMEN
OBJECTIVES: In patients with detrusor overactivity with impaired contractility (DOIC), it is difficult to relieve abnormal lower urinary tract symptoms during both storage and voiding using sacral neuromodulation (SNM) with constant frequency stimulation (CFS). We sought to evaluate the efficacy and safety of SNM using variable frequency stimulation (VFS) in patients with DOIC by comparing it with outcomes of SNM with CFS. MATERIALS AND METHODS: Between September 2020 and May 2021, we prospectively enrolled 20 patients with DOIC, confirmed on urodynamic examination, and administered SNM with VFS. The patients were followed up and required to maintain voiding diaries and record scale scores of overactive bladder symptoms, psychology and quality of life, uroflowmetry, ultrasonic postvoid residual urine, and adverse events at baseline and during the CFS and VFS phases. RESULTS: The average testing phase was 26.3 ± 4.1 days. Compared with baseline values, overactive bladder symptom, psychologic health questionnaire, and quality of life scores, in addition to voiding frequency, urgency incontinence frequency, daily catheterization volume of voiding diary, and ultrasonic postvoid residual (PVR) decreased significantly during both the CFS and VFS phases (p < 0.05). The average voided volume, functional bladder capacity, and maximum urine flow rate significantly increased during the CFS and VFS phases (p < 0.05). In the VFS phase, voiding frequency, urgency incontinence frequency, daily catheterization volume of voiding diary, and ultrasonic PVR further decreased (p < 0.05), whereas functional bladder capacity, maximum urine flow rate, quality of life score, overactive bladder symptom score, and psychologic health questionnaire score further improved compared with results obtained in the CFS phase (p < 0.05). In the VFS phase, the success rate of further improvement of symptoms was 85.0%, and no new complications were noted. CONCLUSIONS: SNM that converts CFS into VFS may be an effective treatment option for patients with DOIC, exhibiting no increase in adverse events.
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Terapia por Estimulación Eléctrica , Vejiga Urinaria Hiperactiva , Humanos , Vejiga Urinaria Hiperactiva/terapia , Estudios Prospectivos , Calidad de Vida , Micción , Resultado del Tratamiento , Terapia por Estimulación Eléctrica/efectos adversos , Terapia por Estimulación Eléctrica/métodos , UrodinámicaRESUMEN
Yield and demand randomness are common in the industry, and loss aversion has been regarded as an inherent behavior for decision-makers. We combine these two factors and investigate a retailer's ordering decisions under both yield and demand randomness with loss aversion. Before the selling season, the demand is unknown and the loss-averse retailer places an order from an unreliable supplier with an uncertain yield rate. After the demand and supply from the unreliable supplier are known, the retailer can carry out emergency replenishment from a spot market during the selling season. We characterize the retailer's optimal ordering decisions in three scenarios: (1) the retailer is risk-neutral; (2) the retailer is loss-averse and has a zero reference profit; (3) the retailer is loss-averse and has a nonzero fixed reference profit (FRP). We compare the retailer's order quantities in the three scenarios and find that the order quantity of the loss-averse retailer with a zero reference profit is always lower than that of the risk-neutral retailer. However, the order quantity of the loss-averse retailer with a nonzero fixed reference profit is higher than that of the risk-neutral retailer when the salvage value is sufficiently large. Interestingly, we find that the loss-averse retailer's optimal order quantity decreases with the reference profit and increases with the loss-averse degree and the maximum fulfillment rate from the unreliable supplier under some conditions. We investigate these conditions under a uniform demand distribution. We further study the ordering quantity of the retailer with a prospect-dependent reference point (PRP) and compare the results under FRP and PRP.