Tubeless PCNL versus standard PCNL for the treatment of upper urinary tract stones: a propensity score matching analysis.

PURPOSE: In this study, the feasibility of tubeless percutaneous nephrolithotomy (PCNL) for the treatment of upper urinary tract stones was investigated. METHODS: From January 2021 to December 2022, the clinical data of 273 patients who received tubeless PCNL (Group A) were studied. The control group includes clinical data from 302 patients (from January 2019 to October 2022) who received standard PCNL (Group B). The baseline characteristics were consistent between the two groups after using the propensity score matching (PSM) method. Compare the preoperative clinical characteristics, postoperative complications, residual stones, catheterization time, and hospital stay between the two groups. RESULTS: 146 pairs of patients were successfully paired through PSM. There was no statistically significant difference in operative time, blood leukocyte counts, haemoglobin decrease, fever, urinary extravasation, sepsis, bleeding, blood transfusion rates, embolism, and residual stones after surgery between the two groups; Postoperative day 1 and discharge day, the VAS pain score in Group A was significantly lower than that in Group B. The catheterization time and hospitalization time of patients in Group A were significantly lower than those in Group B. CONCLUSION: According to the inclusion and exclusion criteria, selecting suitable patients for tubeless PCNL is safe and effective, while significantly alleviating pain and reducing catheterization time and hospital stay.

ACVAE: A novel self-adversarial variational auto-encoder combined with contrast learning for time series anomaly detection.

Deep generative models have advantages in modeling complex time series and are widely used in anomaly detection. Nevertheless, the existing deep generative approaches mainly concentrate on the investigation of models' reconstruction capability rather than customizing a model suitable for anomaly detection. Meanwhile, VAE-based models suffer from posterior collapse, which can lead to a series of undesirable consequences, such as high false positive rate etc. Based on these considerations, in this paper, we propose a novel self-adversarial variational auto-encoder combined with contrast learning, short for ACVAE, to address these challenges. ACVAE consist of three parts 〈T,E,G〉, wherein the transformation network T is employed to generate abnormal latent representations similar to those normal latent representations encoded by the encoder E, and the decoder G is used to distinguish the two representations. In the framework of this model, the normal reconstructions are considered as positive samples and abnormal reconstructions as negative samples, and the contrast learning is executed on the part E to measure the similarities between inputs and positive samples, dissimilarities between inputs and negative samples. Thus, an improved objective function is proposed by integrating two novel regularizers, one refers to adversarial mechanism and the other involves contrast learning, in which the encoder E and decoder G hold the capability to distinguish, and decoder G is constrained to mitigate the posterior collapse. We perform several experiments on five datasets, whose results show ACVAE outperforms state-of-the-art methods.

No bladder irrigation versus continuous bladder irrigation after HoLEP: a propensity score matching analysis.

PURPOSE: In this study, the feasibility of a no bladder irrigation strategy after transurethral holmium laser enucleation of the prostate (HoLEP) for the treatment of benign prostatic hyperplasia (BPH) was studied. METHODS: From August 2021 to December 2021, the clinical data of 62 patients who received no bladder irrigation after HoLEP (Group A) were studied. The control group contained the clinical data of 150 patients in the same therapy group (from January 2021 to July 2021) who received continuous bladder irrigation after HoLEP (Group B). The baseline was consistent after using the propensity score matching (PSM) method, and the differences between groups were compared. The pre- and postoperative complications, international prostate symptom score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR) of the two groups were compared, accompanied by a follow-up evaluation of surgical effects. RESULTS: 47 pairs of patients were successfully matched by PSM. There was no statistically significant difference in the intraoperative conditions and the incidence of early postoperative complications between the two groups (P > 0.05). Before and one month after the surgery, significant differences were also found in the IPSS, QOL, Qmax, and PVR of both groups (P < 0.05). Within one month after the surgery, no statistically significant difference was found in IPSS, QOL, Qmax, PVR, or the incidence of early postoperative complications between the two groups (P > 0.05). CONCLUSION: For appropriately selected patients according to the exclusion criteria, the no bladder irrigation strategy after HoLEP for BPH is safe and effective.

Highly Sensitive Readout Interface for Real-Time Differential Precision Measurements with Impedance Biosensors.

Field deployment is critical to developing numerous sensitive impedance transducers. Precise, cost-effective, and real-time readout units are being sought to interface these sensitive impedance transducers for various clinical or environmental applications. This paper presents a general readout method with a detailed design procedure for interfacing impedance transducers that generate small fractional changes in the impedance characteristics after detection. The emphasis of the design is obtaining a target response resolution considering the accuracy in real-time. An entire readout unit with amplification/filtering and real-time data acquisition and processing using a single microcontroller is proposed. Most important design parameters, such as the signal-to-noise ratio (SNR), common-mode-to-differential conversion, digitization configuration/speed, and the data processing method are discussed here. The studied process can be used as a general guideline to design custom readout units to interface with various developed transducers in the laboratory and verify the performance for field deployment and commercialization. A single frequency readout unit with a target 8-bit resolution to interface differentially placed transducers (e.g., bridge configuration) is designed and implemented. A single MCU is programmed for real-time data acquisition and sine fitting. The 8-bit resolution is achieved even at low SNR levels of roughly 7 dB by setting the component values and fitting algorithm parameters with the given methods.

AC and DC Differential Bridge Structure Suitable for Electrochemical Interfacial Capacitance Biosensing Applications.

This paper presents a capacitive differential bridge structure with both AC and DC excitation and balancing capability for low cost electrode-solution interfacial capacitance biosensing applications. The proposed series RC balancing structure offers higher sensitivity, lower susceptibility to common-mode interferences, and drift control. To evaluate the bridge performance in practice, possible effects of initial bridge imbalance due to component mismatches are investigated considering the required resolution of the balancing networks, sensitivity, and linearity. This evaluation is also a guideline to designing the balancing networks, balancing algorithm and the proceeding readout interface circuitry. The proposed series RC bridge structure is implemented along with a custom single frequency real-time amplification/filtering readout board with real-time data acquisition and sine fitting. The main specifications for the implemented structure are 8-bit detection resolution if the total expected fractional capacitance change at the interface is roughly 1%. The characterization and measurement results show the effectiveness of the proposed structure in achieving the design target. The implemented structure successfully achieves distinct detection levels for tiny total capacitance change at the electrode-solution interface, utilizing Microcystin-(Leucine-Arginine) toxin dilutions as a proof of concept.

Feature Selection Based on Neighborhood Self-Information.

The concept of dependency in a neighborhood rough set model is an important evaluation function for the feature selection. This function considers only the classification information contained in the lower approximation of the decision while ignoring the upper approximation. In this paper, we construct a class of uncertainty measures: decision self-information for the feature selection. These measures take into account the uncertainty information in the lower and the upper approximations. The relationships between these measures and their properties are discussed in detail. It is proven that the fourth measure, called relative neighborhood self-information, is better for feature selection than the other measures, because not only does it consider both the lower and the upper approximations but also the change of its magnitude is largest with the variation of feature subsets. This helps to facilitate the selection of optimal feature subsets. Finally, a greedy algorithm for feature selection has been designed and a series of numerical experiments was carried out to verify the effectiveness of the proposed algorithm. The experimental results show that the proposed algorithm often chooses fewer features and improves the classification accuracy in most cases.

Malignant ureteral obstruction: experience and comparative analysis of metallic versus ordinary polymer ureteral stents.

BACKGROUND: To study the outcome and experience of using metallic stents in treating patients with malignant ureteral obstruction (MUO). METHODS: Seventy-six patients with MUO were assigned to the metallic stent group (MSG) or the ordinary polymer stent group (OPSG) according to the different materials. The success rate of the operation, duration of operation, patency rate serum creatinine values ,postoperative complications and QOL scores were compared between the two groups. RESULTS: In the OPSG and MSG, the success rates of the operation were 95.5% and 96.9%, respectively, and the durations of the operation were 20.6 ± 2.2 min and 50.9 ± 10.3 min (P < 0.01), respectively. There was no significant difference between the groups in serum creatinine values at 3 days after the operation (P > 0.05); however, the creatinine values at 3 days after the operation decreased significantly compared with those before the operation (P < 0.01). In the OPSG, there was no significant difference in creatinine values between 3 days and 6 months after operation, while the creatinine values 1 year after operation were increased significantly compared to those at 3 days after the operation (P < 0.05). In the MSG, there was no significant difference among creatinine values at different intervals (P > 0.05). The total rate of post-procedural complication was lower in the MSG than that in the OPSG(P < 0.05). There was no significant difference in the QOL score between the two groups before the operation (P > 0.05); however, the QOL scores at 6 months and 1 year after the operation were higher in the MSG than that in the OPSG(P < 0.05). In the MSG, there was no significant difference in the QOL score between preoperation and 6 months after surgery. Similarly, there was also no difference in the QOL score between 6 months after surgery and 1 year after surgery(P > 0.05). On the contrary, the differences of QOL score in the OPSG group were much significant between disparate time intervals (P < 0.05). CONCLUSIONS: For patients with MUO who require long-term retention of the stent, metallic stents with longer indwelling time are superior to ordinary polymeric stents.

Feature Selection Based on Neighborhood Discrimination Index.

Feature selection is viewed as an important preprocessing step for pattern recognition, machine learning, and data mining. Neighborhood is one of the most important concepts in classification learning and can be used to distinguish samples with different decisions. In this paper, a neighborhood discrimination index is proposed to characterize the distinguishing information of a neighborhood relation. It reflects the distinguishing ability of a feature subset. The proposed discrimination index is computed by considering the cardinality of a neighborhood relation rather than neighborhood similarity classes. Variants of the discrimination index, including joint discrimination index, conditional discrimination index, and mutual discrimination index, are introduced to compute the change of distinguishing information caused by the combination of multiple feature subsets. They have the similar properties as Shannon entropy and its variants. A parameter, named neighborhood radius, is introduced in these discrimination measures to address the analysis of real-valued data. Based on the proposed discrimination measures, the significance measure of a candidate feature is defined and a greedy forward algorithm for feature selection is designed. Data sets selected from public data sources are used to compare the proposed algorithm with existing algorithms. The experimental results confirm that the discrimination index-based algorithm yields superior performance compared to other classical algorithms.

Roles of autophagy-related genes Beclin-1 and LC3 in the development and progression of prostate cancer and benign prostatic hyperplasia.

Prostate cancer (PCa) is common in Western populations and the second leading cause of cancer-related mortality among males in North America, with an increasing morbidity in China and other Asian countries. The aim of this study was to evaluate the protein expression of autophagy-related genes Beclin-1 and LC3 in patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) and elucidate their association with p53 and Bcl-2. The total protein of 34 PCa and 50 BPH samples was extracted and the expression of Beclin-1 and LC3 was analyzed by western blotting assay. Subsequently, a total of 96 paraffin-embedded BPH tissue samples was subdivided into 2 groups, one group in which patients had received 5α-reductase inhibitor, due to its effect of androgen ablation, and the control group, in which patients had not received the 5α-reductase inhibitor. The samples were randomly collected and examined using immunohistochemical (IHC) analysis. The western blot analysis demonstrated that Beclin-l and LC3 expression was higher in BPH tissues compared to PCa tissues (P<0.001). There was no statistically significant difference between PCas of different Gleason scores (P>0.05). The result of IHC revealed that Beclin-l and LC3 expression in the group of patients who had received the 5α-reductase inhibitor was significantly higher compared to that in the control group; however, the expression of Bcl-2 and p53 was lower (P<0.05). Beclin-1 expression exhibited a negative correlation with Bcl-2 (r=-0.402, P<0.001), whereas LC3 expression exhibited a positive correlation with Beclin-1 (r=0.345, P=0.001) and a negative correlation with Bcl-2 (r=-0.216, P=0.035). It was suggested that autophagy-related genes Beclin-l and LC3 may be involved in the development and progression of PCa. In addition, the expression of these genes was higher in patients with BPH who had received a 5α-reductase inhibitor, due to androgen reduction. As a result, the induced autophagy may reduce the risk of PCa.

[Study on the natural foci of Marmota himalayana plague in Sichuan province].

OBJECTIVE: To explore the existence of natural foci on Marmota himalayana plague in Sichuan province and to provide basis for prevention and control of the disease. METHODS: Both epidemiological investigation and laboratory tests were used to provide the host animal and fleas of the vectors with Yersinia pestis carriers. RESULTS: 30 species of animals were found to belong to 10 orders. Ochotona curzoniae and M. himalayana were the most common ones while 7 species of the fleas belonged to 7 genera and 3 families. M. himalayana was the main reservoirs while Callopsylla dolabris and Oropsylla silantiewi served as vectors. The 13 Y. pestis were identified from 43 Marmota samples. 8 samples were identified under IHA, with the highest titer of herding-dogs serum as 1:10,240. 19 samples were F1 antigen positive using RIHA and the highest titer of M. himalayana serum was 1:409,600. The major foci was 4545 km2, distributed at Dege county in Sichuan province. CONCLUSION: We have confirmed the existence of natural foci on M. himalayana plague in Sichuan province.