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Aim: Patients with metabolic dysfunction‐associated steatotic liver disease (MASLD) are at increased risk of incident cardiovascular disease. However, the clinical characteristics and prognostic importance of MASLD in patients presenting with acute myocardial infarction (AMI) have yet to be examined. Methods: This study compared the characteristics and outcomes of patients with and without MASLD presenting with AMI at a tertiary centre in Singapore. MASLD was defined as hepatic steatosis, with at least one of five metabolic criteria. Hepatic steatosis was determined using the Hepatic Steatosis Index. Propensity score matching was performed to adjust for age and sex. The Kaplan‐Meier curve was constructed for long‐term all‐cause mortality. Cox regression analysis was used to investigate independent predictors of long‐term all‐cause mortality. Results: In this study of 4446 patients with AMI, 2223 patients with MASLD were matched with patients without MASLD using propensity scores. The mean follow‐up duration was 3.4 ± 2.4 years. The MASLD group had higher rates of obesity, diabetes and chronic kidney disease than their counterparts. Patients with MASLD had early excess all‐cause mortality (6.8% vs. 3.6%, p <.001) at 30 days, with unfavourable mortality rates sustained in the long‐term (18.3% vs. 14.5%, p =.001) compared with those without MASLD. After adjustment, MASLD remained independently associated with higher long‐term all‐cause mortality (hazard ratio 1.330, 95% confidence interval 1.106‐1.598, p =.002). Conclusion: MASLD embodies a higher burden of metabolic dysfunction and is an independent predictor of long‐term mortality in the AMI population. Its early identification may be beneficial for risk stratification and provide therapeutic targets for secondary preventive strategies in AMI. [ABSTRACT FROM AUTHOR]

This paper presents two studies in which a peer‐assisted learning condition was compared to an individual learning condition. The first study used the paired‐associates learning task and the second study used an incrementally more complex task—the remote associate test. Participants in the peer‐assisted learning condition worked in groups of four. They had to solve a given problem individually and give a first answer before being able to request to see their peers' solutions; then, a second answer was issued. After six sessions of peer‐assisted practice, a final individual test was administered. Peer interaction was found to benefit learning in both studies but the benefit transferred to the final test only in the second study. Fine‐grained behavioral analyses and computational modeling suggested that the benefits of peer interaction were (partially) offset by its costs, particularly increased cognitive load and error exposure. Overall, the superiority of peer‐assisted learning over individual learning was more pronounced in the more complex task and for the more difficult problems in that task. A peer‐assisted learning condition was compared to an individual learning condition. The benefits of peer interaction were (partially) offset by its costs, particularly increased cognitive load and error exposure. The superiority of peer‐assisted learning over individual learning was more pronounced in the more complex task and for the more difficult problems in that task. [ABSTRACT FROM AUTHOR]

Introduction: Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) affects extra‐respiratory systems, with small‐scale studies showing worsened male lower urinary tract symptoms (LUTS) after coronavirus disease 2019 (COVID‐19). This study explores the correlation between SARS‐CoV‐2 infection and male benign prostatic hyperplasia (BPH) complications using large‐scale real world data. Materials and methods: All male patients attending the public healthcare system in Hong Kong receiving alpha‐blocker monotherapy for LUTS from 2021 to 2022 were included in this study. Patients with and without positive polymerase chain reaction (PCR) test for SARS‐CoV‐2 are selected as the exposure group and control group, respectively. Baseline characteristics are retrieved, with propensity score matching performed to ensure balance of covariates between the two groups. BPH complications were then compared and subgroup analyses were performed. Results: After propensity score matching, 17,986 patients were included for analysis, among which half had PCR‐confirmed SARS‐CoV‐2 infection (n = 8993). When compared to controls, the SARS‐CoV‐2 group demonstrated statistically significant higher incidence of retention of urine (4.55% vs. 0.86%, p < 0.001), haematuria (1.36% vs. 0.41%, p < 0.001), clinical urinary tract infection (UTI) (4.31% vs. 1.49%, p < 0.001), culture‐proven bacteriuria (9.02% vs. 1.97%, p < 0.001) and addition of 5ARI (0.50% vs. 0.02%, p < 0.001). Subgroup analysis demonstrated similar differences across different age groups. There are no statistically significance differences in incidence of retention, haematuria, or addition of 5ARI across different COVID‐19 severities. Conclusions: SARS‐CoV‐2 infection is associated with increased incidence of urinary retention, haematuria, UTI and the addition of combination therapy in the short term, regardless of COVID‐19 severity. This is the largest study demonstrating the detrimental urological effects of SARS‐CoV‐2 infection. [ABSTRACT FROM AUTHOR]

Aim: To examine the prevalence and prognosis of hepatic steatosis and fibrosis in post‐acute myocardial infarction (AMI) patients. Methods: Patients presenting with AMI to a tertiary hospital were examined from 2014 to 2021. Hepatic steatosis and advanced hepatic fibrosis were determined using the Hepatic Steatosis Index and fibrosis‐4 index, respectively. The primary outcome was all‐cause mortality. Cox regression models identified determinants of mortality after adjustments and Kaplan–Meier curves were constructed for all‐cause mortality, stratified by hepatic steatosis and advanced fibrosis. Results: Of 5765 patients included, 24.8% had hepatic steatosis, of whom 41.7% were diagnosed with advanced fibrosis. The median follow‐up duration was 2.7 years. Patients with hepatic steatosis tended to be younger, female, with elevated body mass index and an increased metabolic burden of diabetes, hypertension and hyperlipidaemia. Patients with hepatic steatosis (24.6% vs. 20.9% mortality, P <.001) and advanced fibrosis (45.6% vs. 32.9% mortality, P <.001) had higher all‐cause mortality rates compared with their respective counterparts. Hepatic steatosis (adjusted hazard ratio 1.364, 95% CI 1.145‐1.625, P =.001) was associated with all‐cause mortality after adjustment for confounders. Survival curves showed excess mortality in patients with hepatic steatosis compared with those without (P =.002). Conclusions: Hepatic steatosis and advanced fibrosis have a substantial prevalence among patients with AMI. Both are associated with mortality, with an incrementally higher risk when advanced fibrosis ensues. Hepatic steatosis and fibrosis could help risk stratification of AMI patients beyond conventional risk factors. [ABSTRACT FROM AUTHOR]

Landslides are common in tropical and subtropical regions with hilly terrains and heavy rainstorms, and can cause significant economic, ecological, and social impacts. Natural forest succession is usually slow on landslides due to poor soil structure and lack of woody plant seeds, and often comes with a higher risk of repeated landslides. Active forest restoration has been increasingly suggested as an effective alternative to restore exposed landslide scars. Here, we evaluated the effectiveness of using different seed coatings and surface soil treatments on seed germination and seedling establishment of pioneer and late‐successional tree species on landslide scars in Hong Kong. Our results show that biochar‐dominant seed coating boosted seed germination rate by an additional 9.33% (Standard error = 0.04), while clay‐dominant seed coating did not show significant effects. The effects on seedling survival were not significant in both seed coating and surface soil treatments. Our results also show that large seed and later successional species have significantly higher germination rates than pioneer species and are able to successfully establish on landslide sites. These results suggest that direct seeding using a biochar seed coat with large seeds or late‐successional species is a useful method to enhance tree seed germination—an essential first step to restore the forests after landslide disturbances, with potential to be extended to other humid tropical and subtropical forests. [ABSTRACT FROM AUTHOR]

Infectious virus diseases, particularly coronavirus disease 2019, have posed a severe threat to public health, whereas the developed therapeutic and prophylactic strategies are seriously challenged by viral evolution and mutation. Therefore, broad‐spectrum inhibitors of viruses are highly demanded. Herein, an unprecedented antiviral strategy is reported, targeting the viral glycan shields with hypervalent mannose‐binding nanoparticles. The nanoparticles exhibit a unique double‐punch mechanism, being capable of not only blocking the virus–receptor interaction but also inducing viral aggregation, thereby allowing for inhibiting the virus entry and facilitating the phagocytosis of viruses. The nanoparticles exhibit potent and broad‐spectrum antiviral efficacy to multiple pseudoviruses, including severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and its major variants (D614G, N501Y, N439K, Δ69‐70, Delta, and Omicron; lentiviruses expressing only the spike proteins), as well as other vital viruses (human immunodeficiency virus 1 and Lassa virus), with apparent EC50 values around the 10−9 m level. Significantly, the broad‐spectrum inhibition of authentic viruses of both wild‐type SARS‐CoV‐2 and Delta variants is confirmed. Therefore, this hypervalent glycan‐shield targeting strategy opens new access to broad‐spectrum viral inhibition. [ABSTRACT FROM AUTHOR]

Objective: Multiple trials have demonstrated the metabolic effects of sodium/glucose cotransporter 2 (SGLT2) inhibitors in patients regardless of diabetes status, and recent trials have been conducted on the combined sodium/glucose cotransporter 1 and sodium/glucose cotransporter 2 (SGLT1/SGLT2) inhibitors. Therefore, a meta-analysis was conducted to investigate the weight reduction effects and dose-response relationship of SGLT inhibitors and to assess the relative efficacy of SGLT1/SGLT2 inhibitors.Methods: Four electronic databases (PubMed, Embase, Cochrane, and Scopus) were searched on November 21, 2020, for articles published from January 1, 2000, up to November 21, 2020.Results: In total, 116 randomized-controlled trials were included, with a combined cohort of 98,497 patients. Overall, patients had a mean weight reduction of -1.79 kg (95% CI: -1.93 to -1.66, p < 0.001) compared with placebo. This effect was observed across diabetes status, duration of follow-up, various comorbidities, and all SGLT drug types. Mean BMI changes were -0.71 kg/m2 (95% CI: -0.94 to -0.47, p < 0.001) compared with placebo. Canagliflozin, empagliflozin, sotagliflozin, and licogliflozin showed a dose-response relationship for mean weight change. Compared with SGLT2 inhibitors, SGLT1/SGLT2 inhibitors had a significantly larger reduction in weight.Conclusions: SGLT inhibitors demonstrated weight reduction benefits in this meta-analysis. Further studies are needed to clarify their role in weight management. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) neutralizing antibodies are shown to be effective therapeutics for providing coronavirus disease 2019 (COVID‐19) protection. However, recurrent variants arise and facilitate significant escape from current antibody therapeutics. Bispecific antibodies (bsAbs) represent a unique platform to increase antibody breadth and to reduce neutralization escape. Herein, a novel immunoglobulin G–variable domains of heavy‐chain‐only antibody (IgG–VHH) format bsAb derived from a potent human antibody R15‐F7 and a humanized nanobody P14‐F8‐35 are rationally engineered. The resulting bsAb SYZJ001 efficiently neutralizes wild‐type SARS‐CoV‐2 as well as the alpha, beta, gamma, and delta variants, with superior efficacy to its parental antibodies. Cryo‐electron microscopy structural analysis reveals that R15‐F7 and P14‐F8‐35 bind to nonoverlapping epitopes within the RBD and sterically hindered ACE2 receptor binding. Most importantly, SYZJ001 shows potent prophylactic and therapeutic efficacy against SARS‐CoV‐2 in three established mouse models. Collectively, the current results demonstrate that the novel bsAb format is feasible and effective, suggesting great potential as an inspiring antiviral strategy. [ABSTRACT FROM AUTHOR]

SARS‐CoV‐2 has evolved into a panel of variants of concern (VOCs) and constituted a sustained threat to global health. The wildtype (WT) SARS‐CoV‐2 isolates fail to infect mice, while the Beta variant, one of the VOCs, has acquired the capability to infect standard laboratory mice, raising a spreading risk of SARS‐CoV‐2 from humans to mice. However, the infectivity and pathogenicity of other VOCs in mice remain not fully understood. In this study, we systematically investigated the infectivity and pathogenicity of three VOCs, Alpha, Beta, and Delta, in mice in comparison with two well‐understood SARS‐CoV‐2 mouse‐adapted strains, MASCp6 and MASCp36, sharing key mutations in the receptor‐binding domain (RBD) with Alpha or Beta, respectively. Our results showed that the Beta variant had the strongest infectivity and pathogenicity among the three VOCs, while the Delta variant only caused limited replication and mild pathogenic changes in the mouse lung, which is much weaker than what the Alpha variant did. Meanwhile, Alpha showed comparable infectivity in lungs in comparison with MASCp6, and Beta only showed slightly lower infectivity in lungs when compared with MASCp36. These results indicated that all three VOCs have acquired the capability to infect mice, highlighting the ongoing spillover risk of SARS‐CoV‐2 from humans to mice during the continued evolution of SARS‐CoV‐2, and that the key amino acid mutations in the RBD of mouse‐adapted strains may be referenced as an early‐warning indicator for predicting the spillover risk of newly emerging SARS‐CoV‐2 variants. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to show the status of radical prostatectomy (RP) for prostate cancer since the introduction of the Surgical Outcomes Monitoring and Improvement Programme (SOMIP) among hospitals from six clusters under the Hospital Authority. Patients and Methods: All RPs including robot‐assisted laparoscopic RP (RALRP), traditional laparoscopic RP (LRP) and open RP (ORP) performed between July 2009 and June 2017 were reviewed through electronic patient records under the SOMIP. The pre‐operative cancer characteristics, perioperative parameters, pathology, functional outcomes and early oncological outcomes were studied. Results: A total of 1998 men were included in the analysis including 1446 RALRP, 500 LRP and 52 ORP cases. The overall mean procedure time was 295, 258 and 239 minutes, respectively. About 80.4% of RP cases had blood loss of more than 100 ml with a mean blood loss of 671 ml and transfusion rate of 7.4%. The overall 30‐day morbidity rate was 13.2%, including anastomotic leakage rate of 3.9% and unplanned readmission rate of 2.5%. Only 1 (0.2%) procedure‐related mortality was reported in the LRP group. The mean pre‐operative serum prostate‐specific antigen level was 10.9 ng/mL and 93.6% achieved less than 0.1 ng/mL after the operation. RALRP had a significantly less estimated blood loss (581 ml vs. 759 ml; P <.0001), less transfusion rate (5% vs. 10.8%; P <.0001) and less morbidity rate (10.4% vs. 19.4%; P <.0001) than LRP. RALRP also had a shorter length of post‐operative stay (5.5 days vs. 8.3 days; P <.0001) and better early continence rate at 3 months (39.5% vs. 27.6%; P =.0001) as well as 6 months (58.4% vs. 51.1%; P =.007) than LRP. Positive surgical margins were noted to be lower in the RALRP group (27.2% vs. 38.4%). Conclusion: RALRP seems to be the standard approach for prostate cancer in Hong Kong. The procedure showed greater minimally invasive benefit, better early functional outcome and early oncological outcome of better surgical margin positive rate. [ABSTRACT FROM AUTHOR]

Background: Anaphylaxis is a significant health burden in most Western countries, but there are little published data on the incidence and pattern of anaphylaxis in Asia. We aim to determine the incidence rate and pattern of anaphylaxis over the past decade among the pediatric population in Hong Kong. Methods: Medical records of patients presenting with allergy‐related symptoms during the period 2010 to 2019 were examined. Pediatric patients aged below 18 years who fulfilled the diagnostic criteria for anaphylaxis laid out by the NIAID/FAAN were analyzed. Incidence rates were calculated using population statistics as the denominator. All information pertaining to the anaphylaxis events and patients' characteristics was retrieved using standardized data collection forms. Results: The overall 10‐year estimated incidence of anaphylaxis was 9.76 per 100,000 person‐years, with a rising trend of anaphylaxis incidence across time. Food‐induced anaphylaxis accounted for the majority of hospital presentations, of which peanut and shellfish were the top food triggers in our population. Majority of anaphylaxis episodes were of Grade 4 severity, and young age was a significant predictor of severe allergic reactions. Half of the anaphylaxis episodes were misdiagnosed and adrenaline was only utilized in 42.2% of cases, of which 9.4% were administered adrenaline prior to hospital arrival. Conclusions: An increasing trend of anaphylaxis incidence over the past decade is evident in Hong Kong children, with a discrepantly low accuracy in diagnosis and suboptimal management of anaphylaxis. There is a pressing need to heighten public and physicians' awareness of the distinctive features of anaphylaxis in the pediatric age‐group. [ABSTRACT FROM AUTHOR]

Background & Aims: How adiposity influences the effect of genetic variants on non‐alcoholic fatty liver disease (NAFLD) in the Asian population remains unclear. We aimed to study the association between genetic risk variants and susceptibility/severity of NAFLD in the lean, overweight and obese individuals. Methods: Nine hundred and four community subjects underwent proton‐magnetic resonance spectroscopy and transient elastography examination. Lean (<23 kg/m2), overweight (23‐24.9 kg/m2) and obesity (≥25 kg/m2) were defined according to the body mass index cut‐offs for Asians. NAFLD was defined as intrahepatic triglycerides ≥5%. PNPLA3, TM6SF2, MBOAT7 and 9 other gene polymorphisms were analysed by rhAMPTM SNP assays. Results: Five hundred and twenty‐nine (58.5%), 162 (17.9%) and 213 (23.6%) subjects were lean, overweight and obese, respectively. The prevalence of NAFLD was 12.4%, 41.4% and 59.1% in the three groups (P <.001). Amongst those with NAFLD, lean subjects (30.3%) were more likely to carry the PNPLA3 rs738409 GG genotype than overweight (17.9%) and obese subjects (17.4%) (P =.003). Compared with the CC genotype, the GG genotype was associated with the greatest increase in the risk of NAFLD in lean subjects (odds ratio [OR] 6.04), compared with overweight (OR 3.43, 95% CI [1.06, 11.14]) and obese subjects (OR 2.51, 95% CI [0.93, 6.78]). Additionally, the TM6SF2 rs58542926 TT genotype was associated with reduced serum triglycerides only in lean subjects. A gene‐BMI effect was not observed for the other gene polymorphisms. Conclusions: The PNPLA3 rs738409 gene polymorphism has a greater effect on liver fat in Asian lean individuals than in overweight or obese ones. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is a highly prevalent and underdiagnosed medical condition, which is associated with various cardiovascular and metabolic diseases. The current mainstay of therapy is continuous positive airway pressure (CPAP); however, CPAP is known to be poorly accepted and tolerated by patients. In randomized controlled trials evaluating CPAP in cardiovascular outcomes, the average usage was less than 3.5 hours, which is below the 4 hours per night recommended to achieve a clinical benefit. This low adherence may have resulted in poor effectiveness and failure to show cardiovascular risk reduction. The mandibular advancement device (MAD) is an intraoral device designed to advance the mandible during sleep. It functions primarily through alteration of the jaw and/or tongue position, which results in improved upper airway patency and reduced upper airway collapsibility. The MAD is an approved alternative therapy that has been consistently shown to be the preferred option by patients who are affected by OSA. Although the MAD is less efficacious than CPAP in abolishing apnea and hypopnea events in some patients, its greater usage results in comparable improvements in quality‐of‐life and cardiovascular measures, including blood pressure reduction. This review summarizes the impact of OSA on cardiovascular health, the limitations of CPAP, and the potential of OSA treatment using MADs in cardiovascular risk reduction. [ABSTRACT FROM AUTHOR]

SUMMARY: The Internet of Everything (IoE), clearly a 21st century's technology, brilliantly plays with digital data obtained from analog sources, bringing together two different realities, the analog (physical/real), and the digital (cyber/virtual) worlds. Then, with the boundaries of IoE still analog in nature, the required functions at the interface involve sensing, measuring, filtering, converting, processing, and connecting, which imply that the analog layer governs the entire system in terms of accuracy and precision. Furthermore, such interface integrates several analog and mixed‐signal subsystems that comprise mainly signal transmission and reception, frequency generation, energy harvesting, data, and power conversion. This paper sets forth a state‐of‐the‐art design perspective of some of the most critical building blocks used in the analog/digital interface, covering wireless cellular transceivers, millimeter‐wave frequency generators, energy harvesting interfaces, plus, data and power converters, that exhibit high quality performance achieved through low‐power consumption, high energy‐efficiency, and high speed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the safety and feasibility of robot‐assisted single‐port radical prostatectomy using the da Vinci single‐port surgical system. Methods: This was a prospective phase 1 clinical study of prostate cancer patients undergoing robot‐assisted single‐port radical prostatectomy using the da Vinci single‐port surgical system. Primary outcome measures included the conversion rate and 30‐day complications after surgery. Secondary outcome measures included operative time, blood loss, hospital stay, duration of catheterization, final pathological outcomes and number of lymph nodes yielded at pelvic lymphadenectomy. Results: From February to August 2017, 20 patients were included in the present study. The mean age was 67.7 ± 6.0 years. The mean preoperative prostate‐specific antigen level was 15.3 ± 11.3 ng/mL, and the mean prostate size was 36.6 ± 15.5 mL. Preoperatively, 12 (60%) patients had a Gleason score of 6, four (20%) had a Gleason score of 7 and four (20%) had a Gleason score of 8–10. The mean operative time was 208.9 ± 35.2 min, and the mean blood loss was 296.3 ± 220.7 mL. None of the patients required conversion. The mean hospital stay was 5.0 ± 1.7 days. Among the patients, six (15%) had T2a disease, one (5%) had T2b disease, seven (35%) had T2c disease and nine (45%) had T3a disease on final pathology. A mean number of 8.3 ± 7.1 lymph nodes were yielded at pelvic lymphadenectomy. There were no intraoperative complications. The observed postoperative complications were Clavien grade I–II, and all resolved with conservative management. Conclusion: Robot‐assisted single‐port radical prostatectomy using the da Vinci surgical system is safe and technically feasible. [ABSTRACT FROM AUTHOR]

In this study, mechanical vibration is used for hydrogen generation and decomposition of dye molecules, with the help of BiFeO3 (BFO) square nanosheets. A high hydrogen production rate of ≈124.1 μmol g−1 is achieved under mechanical vibration (100 W) for 1 h at the resonant frequency of the BFO nanosheets. The decomposition ratio of Rhodamine B dye reaches up to ≈94.1 % after mechanical vibration of the BFO catalyst for 50 min. The vibration‐induced catalysis of the BFO square nanosheets may be attributed to the piezocatalytic properties of BFO and the high specific surface area of the nanosheets. The uncompensated piezoelectric charges on the surfaces of BFO nanosheets induced by mechanical vibration result in a built‐in electric field across the nanosheets. Unlike a photocatalyst for water splitting, which requires a proper band edge position for hydrogen evolution, such a requirement is not needed in piezocatalytic water splitting, where the band tilting under the induced piezoelectric field will make the conduction band of BFO more negative than the H2/H2O redox potential (0 V) for hydrogen generation. [ABSTRACT FROM AUTHOR]

Abstract: Background: Watch‐PAT 200, a novel portable sleep device worn on the wrist, has been validated against polysomnography. Although sleep disordered breathing (SDB) screening is recommended in patients with cardiovascular disease, no study has reported a comparison of results from Watch‐PAT 200 and level III portable devices. Methods: Patients (n = 140) admitted with a first ST‐segment elevation myocardial infarction (STEMI) participated in a hospital‐based sleep study using the Watch‐PAT 200 and a level III portable device (Embletta Gold) simultaneously within five days of admission. SDB was defined as an apnea‐hypopnea index (AHI) of >15 events/h. Results: The left ventricular ejection fraction was normal (≥50%), impaired (30%‐49%) and poor (<30%) in 66 (47.1%), 71 (50.7%), and three (2.2%) patients, respectively. Among 116 patients with a successful paired sleep study, the prevalence of SDB was 53.5% (Watch‐PAT 200) and 51.7% (Embletta Gold). The agreement of AHI measured by the two devices was moderately good, with an intra‐class correlation value of 0.72 (95% confidence interval, 0.62‐0.80; P < .01). Agreement between the two devices in diagnosing at least mild (AHI ≥5), moderate‐to‐severe (AHI ≥15) and severe (AHI ≥30) SDB was 78% (kappa 0.47; P < .01), 77% (kappa 0.55; P < .01) and 80% (kappa 0.49; P < .01), respectively. At a 15‐month follow‐up, SDB status based on the two devices was associated with the occurrence of adverse cardiovascular events in 48.3% and 44.8%, respectively (P = .56). Conclusion: We found a high prevalence of SDB in patients presenting with a first STEMI. Agreement between two portable sleep devices was moderately good. [ABSTRACT FROM AUTHOR]

Abstract: Lead‐free tin sulfide (SnS), with an analogous structure to SnSe, has attracted increasing attention because of its theoretically predicted high thermoelectric performance. In practice, however, polycrystalline SnS performs rather poorly as a result of its low power factor. In this work, bulk sodium (Na)‐doped SnS single crystals are synthesized using a modified Bridgman method and a detailed transport evaluation is conducted. The highest zT value of ≈1.1 is reached at 870 K in a 2 at% Na‐doped SnS single crystal along the b‐axis direction, in which high power factors (2.0 mW m−1 K−2 at room temperature) are realized. These high power factors are attributed to the high mobility associated with the single crystalline nature of the samples as well as to the enhanced carrier concentration achieved through Na doping. An effective single parabolic band model coupled with first‐principles calculations is used to provide theoretical insight into the electronic transport properties. This work demonstrates that SnS‐based single crystals composed of earth‐abundant, low‐cost, and nontoxic chemical elements can exhibit high thermoelectric performance and thus hold potential for application in the area of waste heat recovery. [ABSTRACT FROM AUTHOR]

Aim The use of surgical robots for radical cystectomies is increasing. In the present study, we evaluated the surgical outcomes after the transition from open radical cystectomy (ORC) to robot-assisted radical cystectomy (RARC) in a medium-volume hospital. Patients and Methods The present study was a retrospective review of radical cystectomies undertake at a university hospital. Ninety radical cystectomies were identified between 2006 and 2014, and divided into three cohorts of 30 cases. The surgical approach changed gradually from ORC to RARC. Patients' demographic data, length of hospital stay and surgical outcomes were reviewed and compared across the three periods. Results In cohorts 1, 2 and 3, radical cystectomies were robot assisted in 13.3, 33.3 and 83.3 per cent of cases, respectively. The overall length of stay (LOS) was similar in all cohorts. The median LOS after cystectomy with ileal conduit diversion reduced significantly from 19 to 12 days ( P < 0.0005). The rate of positive surgical margins was 20, 3.3 and 3.3 per cent in cohorts 1, 2 and 3, respectively, which was statistically significant ( P = 0.046). There was no difference in the rate of severe complications (Clavien grades 3-5) at 30 and 90 days. Conclusion RARC can be safely applied in medium-volume hospitals. Further investigation is needed to evaluate the advantages of RARC over ORC and laparoscopic approaches. [ABSTRACT FROM AUTHOR]

Aims Transesophageal echocardiographic ( TEE) findings of left atrial appendage ( LAA) thrombus, spontaneous echo contrast ( SEC), and LAA dysfunction are established risk factors of cardioembolic stroke. The semi-invasive nature of TEE limits its utility as a routine risk stratification tool. We aim to correlate TEE and transthoracic echocardiography ( TTE) pulsed Doppler measurements of LAA flow velocities and use TTE measurements to predict TEE findings. Methods and Results We prospectively measured pulsed Doppler LAA flow velocities in 103 consecutive patients on TEE and TTE. There was a strong correlation between TEE and TTE LAA emptying velocity ( LAA E) ( r = .88, P < .001) and a moderate correlation between LAA filling velocities ( r = .50, P < .001). TTE LAA E predicted the presence of thrombus or SEC independent of atrial fibrillation (AF). To predict the presence of thrombus or SEC, the optimal TTE LAA E cutoff was ≤30 cm/s in all patients (75% sensitive, 90% specific) and ≤31 cm/s in AF patients (80% sensitive, 79% specific). To predict LAA dysfunction ( TEE E ≤ 20 cm/s), the optimal TTE LAA E cutoff was ≤27 cm/s (100% sensitive, 89% specific in all patients and 100% sensitive, 74% specific in AF patients). Conclusions TTE assessment of LAA function is feasible and correlates well with the more invasive TEE method. It predicts the presence of thrombus, SEC, and LAA dysfunction on TEE. TTE LAA assessment has incremental value in thromboembolic risk stratification and should be utilized more frequently. [ABSTRACT FROM AUTHOR]

OBJECTIVE Evaluations of upper gastrointestinal toxicity from ketamine abuse are uncommon. This study investigated the clinical pattern of upper gastrointestinal symptoms in patients inhaling ketamine. METHODS In a cross-sectional study of 611 consecutive patients who were seeking treatment for ketamine uropathy in a tertiary hospital setting between August 2008 and June 2016, their clinical pattern of upper gastrointestinal symptoms was evaluated and compared with a control population of 804 non-users. RESULTS A total of 168 (27.5%) patients abusing ketamine (mean age 26.3 years, 58.9% female) reported the presence of upper gastrointestinal symptoms. These symptoms were significantly more prevalent in patients inhaling ketamine than in those who were not (27.5% vs 5.2%, P < 0.001). Their mean duration of ketamine abuse before symptom presentation was 5.0 ± 3.1 years. The presenting symptoms included epigastric pain ( n = 155, 25.4%), recurrent vomiting ( n = 48, 7.9%), anemia ( n = 36, 5.9%) and gastrointestinal bleeding ( n = 20, 3.3%). Uropathy symptoms were preceded by upper gastrointestinal symptoms for 4.4 ± 3.0 years in 141 (83.9%) patients. Logistic regression showed that elder age (odds ratio [OR] 1.06, P = 0.04), active abuser status (OR 1.60, P = 0.04) and longer duration of ketamine abuse (OR 1.00, P = 0.04) were independent factors associated with upper gastrointestinal toxicity. CONCLUSIONS Although epigastric symptoms are unusual in the young population, upper gastrointestinal toxicity was highly prevalent in those inhaling ketamine. Enquiries about ketamine abuse are recommended when assessing young patients with epigastric symptoms. [ABSTRACT FROM AUTHOR]

The research work extends the scaled boundary finite element method to non-deterministic framework defined on random domain wherein random behaviour is exhibited in the presence of the random-field uncertainties. The aim is to blend the scaled boundary finite element method into the Galerkin spectral stochastic methods, which leads to a proficient procedure for handling the stress singularity problems and crack analysis. The Young's modulus of structures is considered to have random-field uncertainty resulting in the stochastic behaviour of responses. Mathematical expressions and the solution procedure are derived to evaluate the statistical characteristics of responses (displacement, strain, and stress) and stress intensity factors of cracked structures. The feasibility and effectiveness of the presented method are demonstrated by particularly chosen numerical examples. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Environmental education and awareness training can help to develop and encourage a transition to a greener corporate culture. A series of environmental education and awareness training programmes of The Hongkong and Shanghai Banking Corporation Limited (HSBC) (Hong Kong) was used as a case study to assess how learning transfers through nature-based environmental education and awareness training and to investigate the possible outcomes of providing nature-based training to employees. Evaluation of the training outcomes, in terms of changes in employees' environmental knowledge, attitudes and behaviour, was surveyed by using retrospective post- and then-test questionnaires. Results showed that employees who joined these programmes gained knowledge and changed their values and behaviour towards the environment significantly. The study also indicated the establishment of trust in and satisfaction with the organization among employees through the training, which in turn promoted employees' organizational commitment towards corporate sustainability. Copyright © 2015 John Wiley & Sons, Ltd and ERP Environment [ABSTRACT FROM AUTHOR]

The cover image is based on the Research Article I Vegetation regeneration on natural terrain landslides in Hong Kong: Direct seeding of native species as a restoration tool i by Ying Ki Law et al., https://doi.org/10.1002/ldr.4492. [Extracted from the article]

Rapidly evolving fields of biomedical, energy, and (opto)electronic devices bring forward the need for deformable conductors with constantly rising benchmarks for mechanical properties and electronic conductivity. The search for conductors with improved strength and strain have inspired the multiple studies of nanocomposites and amorphous metals. However, finding conductors that defy the boundaries of classical materials and exhibit simultaneously high strength, toughness, and fast charge transport while enabling their scalable production, remains a difficult materials engineering challenge. Here, composites made from aramid nanofibers (ANFs) and gold nanoparticles (Au NPs) that offer a new toolset for engineering high strength flexible conductors are described. ANFs are derived from Kevlar macrofibers and retain their strong mechanical properties and temperature resilience. Au NPs are infiltrated into a porous, free-standing aramid matrix, becoming aligned on ANFs, which reduces the charge percolation threshold and facilitates charge transport. Further thermal annealing at 300 °C results in the Au-ANF composites with an electrical conductivity of 1.25 × 104 S cm−1 combined with a tensile strength of 96 MPa, a Young's modulus of 5.29 GPa, and a toughness of 1.3 MJ m−3. These parameters exceed those of most of the composite materials, and are comparable to those of amorphous metals but have no volume limitations. The plasmonic optical frequencies characteristic for constituent NPs are present in the composites with ANFs enabling plasmon-based optoelectronic applications. [ABSTRACT FROM AUTHOR]

Exogenous and endogenous environmental factors can have simultaneous additive as well as interacting effects on life-history traits. Ignoring such interactions can lead to a biased understanding of variability in demographic rates and consequently population dynamics. These interactions have been the focus of decades-long debates on the mechanisms underlying small mammal population fluctuations. They have often been studied indirectly through seasonal effects, but studies considering them directly and more mechanistically are rare. We investigated the joint effects of exogenous (temperature, food availability) and endogenous (population density) factors on the demographic rates of a group-living diurnal rodent, the African striped mouse Rhabdomys pumilio using nine-year mark-recapture data from a population in the Succulent Karoo, South Africa. In general, higher temperatures and lower food availability were associated with higher survival, whereas high population densities were either beneficial or detrimental to survival depending on interacting food availability. High reproductive rates were related to lower temperatures, higher food availability and lower population density, and interactions among environmental factors mediated the strength of these relationships. Our study highlights the complex ways in which different environmental factors can interact to shape demographic rates and emphasizes the importance of explicitly including interactions among exogenous and endogenous factors into studies of population dynamics. [ABSTRACT FROM AUTHOR]

An individual0s survival and fitness depend on its ability to effectively allocate its time between competing behaviors. Sex, social tactic, season and food availability are important factors influencing activity budgets. However, few field studies have tested their influences. The African striped mouse (Rhabdomys pumilio) lives in highly seasonal habitats in southern Africa, and individuals can adopt different social tactics. We investigated seasonal changes in activity budgets of different tactics and predicted that individuals will reduce their activity in the non-breeding season to save energy when food availability is low and that young non-breeding adults ('philopatrics') invest mainly in activities related to gaining body mass to increase survival probability. We predicted old adults ('breeders'), which bred during the previous breeding season, to invest mainly in maintenance of their social status. We conducted 90 focal observations during the non-breeding season and 73 during the breeding season. Activity budgets of striped mice were season and tactic specific, with philopatrics, but not breeders, reducing activity when food availability was low, possibly to decrease energy expenditure. Philopatrics of both sexes foraged and basked more in the breeding season than during the non-breeding season. Male philopatrics gained body mass and female philopatrics maintained their body mass in both seasons. Sex-specific differences occurred during the breeding season, when female breeders foraged more than male breeders, while male breeders chased other individuals more than female breeders. These findings indicate that individuals adopting different social tactics display distinct behaviors to fulfill tactic-specific energetic needs. [ABSTRACT FROM AUTHOR]

A 4.3 m-long peat sequence from the shore of Lake Tiriara, Mangaia, Cook Islands, was analyzed using an ITRAX core scanner equipped with a magnetic susceptibility meter. Variations in the elemental profiles, providing insights into long- and short-term environmental changes over the last 3500 years, are supported by grain size data and diatom assemblages. The scattering ratio (Mo Inc/Mo Coh) was evaluated and found to represent a good proxy for organic matter in peat. X-Ray Fluorescence (XRF) data were processed by principal component analysis that confirmed the distinction of biogenic and detrital phases, organic matter and elements of marine origin. The record preserved in the peat sequence includes a peatland infilling stage followed by alternating drier and wetter periods. A notable steady increase in clay associated with high counts of detrital elements from 2000-1700 cal yr BP is attributed to increased erosion, which is most probably linked with human colonization and/or more intense chemical weathering linked with a wetter climate. Freshwater gastropods ( Melanoides sp.), which were possibly introduced by humans, or are native, occupied the wetland during a period of lower water level about 1000-1100 cal yr BP. Short-term changes in the elemental profiles are often linked with slight coarsening of the inorganic fraction that is, however, only revealed after grain size analysis. Peaks in marine indicators (Br, Cl, S, and/or Ca) associated with marine-dominated diatom assemblages most probably represent marine incursions through the underground tunnel in the makatea, a fossilized, uplifted coral limestone rim. While none of the marine event units present characteristics typical of cyclone or tsunami deposits, the concurrent or absent peak of detrital elements (Fe, Si, Rb, Ti, K) attributed to increased erosion of the volcanic cone associated with a cyclone is used to distinguish both types of events, as also suggested by principal component analysis. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to investigate the effect of an autologous fibrin sealant ( Vivostat) on the prevention of lymphatic leakage after radical cystectomy. Patients and Methods Patients who underwent laparoscopic radical cystectomy ( LRC) or robot-assisted radical cystectomy ( RARC) for the treatment of bladder cancer were enrolled. Autologous fibrin sealant was applied after the completion of bilateral pelvic lymph node dissection. The data were compared with those from matched RARC patients in a historical cohort. Results Ten consecutive RARC or LRC were performed using an autologous fibrin sealant. A statistically nonsignificant reduction in drain output (1165.5 m L, range = 225-3150 m L) was observed compared with 10 matched historical RARC patients who did not receive the autologous fibrin sealant (1927.2 m L, range = 240-4010 m L). No difference in the number of days of in-situ drainage or the length of hospital stay was found. Two patients in the control group developed asymptomatic lymphocele. One patient in the group treated with the autologous fibrin sealant developed deep vein thrombosis after RARC. Conclusion The use of an autologous fibrin sealant did not reduce lymphatic leakage after radical cystectomy. [ABSTRACT FROM AUTHOR]

Background and objective Limited data exist on the prevalence variation in sleep-disordered breathing (SDB) across different Asian ethnicities. This population study aimed to estimate the prevalence of SDB in Singapore, a multiethnic nation, and to quantify the prevalence variation among Chinese, Malays and Indians. Methods The Singapore Health Study 2012 was a cross-sectional population study conducted on adults aged 21-79 years. Among 2329 participants who completed baseline examination, a sample of 242 subjects completed home-based sleep testing with an Embletta device (type 3 monitor). Moderate-to-severe SDB, defined as an apnoea-hypopnoea index (AHI) of ≥15 events/h, was used to estimate prevalence. Results The weighted estimates of the population prevalence of moderate-to-severe SDB and sleep apnoea syndrome were 30.5% and 18.1%, respectively. Of subjects with AHI ≥15, 91.0% were previously undiagnosed. Moderate-to-severe SDB prevalence varied across the Chinese (32.1%), Malays (33.8%) and Indians (16.5%). The mean body mass index (BMI) was lowest in Chinese (23.3 kg/m2) and highest among Malays (26.0 kg/m2) and Indians (25.4 kg/m2). Compared with Chinese, Indians had lower odds of moderate-to-severe SDB after adjustment for age, sex and BMI (odds ratio 0.82, 95% CI: 0.70-0.96, P = 0.02). Conclusion Sleep-disordered breathing is prevalent but mostly undiagnosed among Asians in Singapore. There was a lower prevalence of SDB among Indians compared with Chinese that remained after adjustment for age, sex and BMI. Strategies are needed to optimize diagnosis and recognize ethnic differences in SDB prevalence. [ABSTRACT FROM AUTHOR]

We report the facile synthesis and structural characterization of efficient bimetallic nickel catalysts that bear diamine-bis(benzotriazole phenolate) derivatives for the copolymerization of CO2 and epoxides. Thermally robust di-nickel 2 is an effective catalyst for the alternating copolymerization of cyclohexene oxide (CHO) with CO2 to give turnover numbers of up to >4000 and turnover frequencies of up to >400 h−1. Ni catalyst 2 leads to not only controlled CO2/CHO coupling, but it has also been applied to catalyze the copolymerization of 4-vinyl-1,2-cyclohexene oxide (VCHO) and CO2 to obtain the corresponding polycarbonate with the vinyl functionality on the side chains. This is the first example of a dinuclear Ni complex that is efficient for both CO2/VCHO copolymerization and the formation of a high-molecular-weight copolymer with a large amount of carbonate linkages. [ABSTRACT FROM AUTHOR]

Objectives The aim of the present study was to establish the safety and efficacy profile of transurethral resection in saline ( TURis) bipolar vaporization of the prostate relative to monopolar transurethral resection of prostate ( TURP) and to test the hospital stay efficiency after TURis vaporization. Materials and Methods in this multicenter, double-blinded, prospective, randomized controlled trial, men aged 50-75 years old were randomized into two arms: TURis bipolar vaporization and monopolar TURP. Intraoperative details, perioperative parameters, and postoperative functional outcomes were assessed after intervention. Follow-up with symptom score assessment, prostate volume measurement, and uroflowmetry were performed at 3 and 6 months. Results Eighty-four patients (mean age, 65.0 ± 5.6 years) were randomized into each study arm. TURis bipolar vaporization had a longer operative time than monopolar TURP (51.6 ± 24.5 vs 38.5 ± 20.3 min, P < 0.001). Postoperatively, the TURis group had a shorter catheter time (33.6 ± 23.7 vs 40.8 ± 29.4 h, P = 0.013) and a shorter length of hospital stay (43.14 ± 18.79 vs 52.33 ± 30.58 h, P = 0.013). The postoperative dysuria score was higher in the TURis vaporization arm. There was no statistically significant difference between the two arms in terms of hemoglobin change and postoperative complication. No significant difference was observed in quality of life score at 3 and 6 months. Conclusions TURis bipolar vaporization of the prostate is a safe and comparable alternative to monopolar TURP. It leads to a reduction in both catheter time and length of hospital stay. [ABSTRACT FROM AUTHOR]

Supramolecular chemistry utilizes coordination bonds to assemble molecular building blocks into a variety of sophisticated constructs. However, traditional coordination assemblies are based on organic compounds that have limited ability to transport charge. Herein, we describe coordination assembly of anisotropic FeS2 pyrite nanoparticles (NPs) that can facilitate charge transport. Zn2+ ions form supramolecular complexes with carboxylate end-groups on NP surface, leading to multiparticle sheets with liquid-crystal-like organization. Conductivity and Hall carrier mobility of the p-type layered semiconductor films with Zn2+ coordination bridging exceed those known for coordination compounds, some by several orders of magnitude. The nanoscale porosity of the assembled sheets combined with fast hole transport leads to high electrocatalytic activity of the NP films. The coordination assembly of NPs embraces the versatility of several types of building blocks and opens a new design space for self-organized materials combining nanoscale and supramolecular structural motifs. [ABSTRACT FROM AUTHOR]

Background/Aims Interleukin-28 B ( IL28B) and patatin-like phospholipase domain containing 3 ( PNPLA3) gene polymorphisms are associated with hepatitis C virus ( HCV) clearance and fatty liver, respectively. We aimed to test if their polymorphisms are associated with virologic responses in Chinese chronic hepatitis C ( CHC) patients. Methods This was a retrospective-prospective cohort study. Consecutive patients infected by genotype 1 and 6 HCV received antiviral therapy were included. Host IL- 28B rs12979860/rs8099917 and PNPLA3 rs738409 genotype were tested. The primary outcome was sustained virologic response (sustained virologic response [ SVR]: undetectable HCV RNA 24 weeks post-treatment). Results From 305 patients had positive antibody to HCV, 52 and 31 patients infected by genotype 1 and 6 HCV, respectively were recruited. Mean age was 58 ± 11 years; 70% were male. Mean baseline HCV RNA was 6.8 ± 2.7 log IU/ml. The SVR for patients infected by genotype 1 and 6 HCV was 67.3% and 90.3%, respectively. The proportions of IL28B genotypes were 78%, 21%, and 1% for TT/ TG/ GG at rs8099917, and 81%, 18%, and 1% for CC/ TC/ TT at rs12979860, respectively. The proportions of PNPLA3 rs738409 genotypes were 16%, 36%, and 48% for GG/ GC/ CC. IL28B genotype was significantly associated with SVR in patients infected by genotype 1 but not genotype 6 HCV, with 80% versus 38% of patients infected by genotype 1 achieved SVR carried TT versus TG/ GG at rs8099917, respectively ( P = 0.003). PNPLA3 genotype was not associated with SVR. Conclusions IL28B gene with rs8099917 T allele as an independent predictor of SVR in Chinese CHC patients infected by genotype 1 but not genotype 6 HCV. [ABSTRACT FROM AUTHOR]

Paragangliomas of the urinary bladder ( PUB) are uncommon and represent less than 1 per cent of all bladder tumours. They can manifest with classic symptoms and signs similar to those of adrenal pheochromocytoma, but the clinical presentation could be nonspecific. Preoperative diagnosis of this uncommon condition is difficult but important, owing to the potential for catecholamine crisis during surgery. In the present study, we review our experience of four cases of PUB and review the literature on this condition. [ABSTRACT FROM AUTHOR]

Background and Aims The prognostic role of noninvasive assessments of liver fibrosis has been evolving. Our aim was to investigate the prognostic value of liver stiffness measurement ( LSM) with transient elastography and serum-based Hui index to predict hepatic events and deaths in chronic hepatitis B ( CHB) patients. Methods The main prospective cohort included 1555 consecutive CHB patients referred for transient elastography examination; a subgroup of 980 patients underwent follow-up assessments at least 3 years later formed the serial cohort. Cox proportional hazard model was performed to determine the relationship of LSM, Hui index and other clinical variables with hepatic events and deaths. Results During a mean follow-up of 69 ± 9 months, 119 patients (7.6%) developed hepatic events or deaths. Hepatic event-free survival was significantly decreased with increasing stages of LSM and Hui index. The 5-year cumulative probability of hepatic event-free survival of patients of Stage 1-7 of LSM were 99.3%, 98.8%, 95.7%, 90.9%, 89.6%, 74.6%, and 50.0%, respectively; that of Stage 1 to 3 of Hui index were 98.2%, 93.1%, and 77.5%, respectively. Independent predictors of hepatic event-free survival were age, baseline LSM, and follow-up Hui index. Serum ALT and body mass index affected the accuracy of prediction by LSM. Patients remained early stages of LSM or Hui index at follow-up visit had better survival compared to those remained at late stages. Conclusion Baseline and change in noninvasive parameters of liver fibrosis, LSM and Hui index, are accurate to predict hepatic event-free survival in CHB patients. [ABSTRACT FROM AUTHOR]

Objective To describe a service delivery model and report the baseline characteristics of patients investigated by a non-invasive approach for ketamine-associated uropathy. Patients and Methods This was a cross-sectional study in a prospective cohort of patients who attended their first visit and underwent non-invasive investigations at a dedicated centre to treat ketamine-associated uropathy in Hong Kong from December 2011 to July 2013. Data on demographics, illicit ketamine use, symptoms scores and voiding function parameters at baseline were prospectively collected. Differences between active abusers and ex-abusers, and risk factors for the most symptomatic group were investigated by univariate and multivariate analysis. Results In all, 318 patients completed the non-invasive assessment at their first visit and were eligible for inclusion. In all, 174 were female and the mean ( sd) age of the entire cohort was 24.4 (3.1) years. Patients had used ketamine for a mean ( sd) period of 81 (36) months. The mean ( sd) ketamine use per week was 18.5 (15.8) g. In all, 214 patients were active abusers while 104 were ex-abusers but had persistent lower urinary tract symptoms. The mean ( sd) voided volume, bladder capacity, and bladder emptying efficiency were 111.5 (110) mL, 152.5 (126) mL and 73.3 (26.9)%, respectively. The ex-abusers had a lower symptom score (19.3 vs 24.1; P < 0.001), a larger voided volume (126 vs 85 mL; P < 0.001), and a larger bladder capacity (204.8 vs 126.7 mL; P < 0.001) compared with active abusers. Multivariate analysis found female gender was associated with a higher symptom score (odds ratio [ OR] 2.39; 95% confidence interval [ CI] 1.35-4.23; P = 0.003) and a smaller voided volume ( OR 1.9; 95% CI 1.1-3.3; P = 0.02). Ketamine taken (g/week) was another risk factor for a higher symptom score ( OR 1.03; 95% CI 1.01-1.05; P = 0.002). Status of ex-abuser was the only protective factor associated with fewer symptoms, larger voided volume and bladder capacity. Conclusions An effective service model for recruiting patients with ketamine-associated uropathy is possible. With such a service model as a platform, further prospective studies are warranted to investigate the appropriate choice of treatment for this new clinical entity. [ABSTRACT FROM AUTHOR]

Objectives To investigate the role of low-intensity extracorporeal shockwave therapy in the treatment of erectile dysfunction. Methods This was a double-blinded, single-center, prospective, randomized, placebo-controlled trial. After a 2-week phosphodiesterase type 5 inhibitor washout period, patients were assessed with Sexual Health Inventory for Men, International Index of Erectile Function- ED domain scores and Erection Hardness Score. Randomization into either the low-intensity extracorporeal shockwave therapy group or the sham group took place. After the 9-week treatment period, patients were followed up 4 weeks later. Follow-up assessment was in the form of International Index of Erectile Function- ED domain score and Erection Hardness Score. Results A total of 70 patients were recruited into the study, 58 patients completed the study. A total of 28 patients were randomized into the sham therapy arm, and 30 patients were randomized into the low-intensity extracorporeal shockwave therapy arm. There was no significant difference between these two groups in baseline International Index of Erectile Function- ED domain score and Erection Hardness Score. The mean International Index of Erectile Function- ED domain score of the low-intensity extracorporeal shockwave therapy arm and sham arm in week 13 were 17.8 ± 4.8 and 15.8 ± 6.1, respectively ( P = 0.156). The mean Erection Hardness Scores in week 13 were 2.7 ± 0.5 and 2.4 ± 0.9, respectively ( P = 0.163). When patients were stratified into different baseline Sexual Health Inventory for Men subgroups, the pre-intervention and post-intervention difference in low-intensity extracorporeal shockwave therapy was found to be significant in the subgroup with severe erectile dysfunction (low-intensity extracorporeal shockwave therapy International Index of Erectile Function- ED domain improvement: 10.1 ± 4.1 vs sham therapy International Index of Erectile Function- ED domain improvement: 3.2 ± 3.3; P = 0.003). Conclusion The present trial shows the tolerability and clinical efficacy of low-intensity extracorporeal shockwave therapy in a subgroup of patients with erectile dysfunction. [ABSTRACT FROM AUTHOR]

Ketamine has become a popular recreational drug among Asians in recent years. Ketamine uropathy is well known to affect the lower urinary tract leading to urgency, frequency, incontinence and pelvic pain. Concomitant upper urinary tract involvement with ureteric stricture is less common. We hereby present a case of a patient with ketamine-related bladder contracture initially treated with augmentation cystoplasty, who subsequently developed left lower ureteric stricture requiring psoas hitch and ureteral re-implantation. We further discussed the fundamental principles in managing ketamine uropathy. [ABSTRACT FROM AUTHOR]

Lead magnesium niobate titanate is an important ferroelectric material. In this study, the terahertz ( THz) transmission properties of a 0.73 Pb( Mg1/3 Nb2/3) O3-0.27 PbTiO3 single crystal were investigated using a time-domain spectroscopy method. Complex refractive index and dielectric dispersion functions were determined from the amplitude and phase information derived from time-domain responses. Based on calculations, it was concluded that the room-temperature dielectric constant of the single crystal equal to ~30 at 1 THz. This result could be a useful reference for development of ferroelectric-material-based THz components and devices. [ABSTRACT FROM AUTHOR]