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In the treatment of metastatic lesions in advanced renal cell carcinoma (RCC), no clear consensus exists regarding whether immunotherapy should be combined with surgical resection or metastasectomy. Systemic therapies have significantly improved outcomes for advanced RCC patients and extended both progression-free and overall survival. However, complete disease eradication with drug therapy alone remains rare, and this limitation has renewed interest in metastasectomy for metastatic RCC. Although robust evidence is still lacking, many researchers have suggested that aggressive surgical approaches involving metastasectomy may improve survival in selected patients by controlling the cancer burden through the resection of primary and metastatic lesions. Novel immunotherapies have transformed solid tumor treatment, prompting a reevaluation of the role of metastasectomy. Recent studies have shown promise in combining systemic therapies with metastasectomy for metastatic RCC, emphasizing the need for further research and individualized, multidisciplinary approaches.

"Purpose: To evaluate how a family history of prostate cancer influences the progression of the disease in individuals with prostate cancer undergoing active surveillance. Materials and Methods: We conducted a thorough literature search in PubMed/MEDLINE, Embase, and Cochrane Library up to June 2023. This systematic review was registered in PROSPERO (CRD42023441853). The study evaluated the effects of family history of prostate cancer (intervention) on disease progression (outcome) in prostate cancer patients undergoing active surveillance (population) and compared them to those without a family history (comparators). For time to disease progression outcomes, the extracted data were synthesized using the inverse variance method on the log hazard ratios scale. Results: A total of eight studies were incorporated into this systematic review and meta-analysis. The combined hazard ratio for unadjusted disease progression was 1.06 (95% confidential interval [CI] 0.66–1.69; p=0.82). The combined hazard ratio for adjusted disease progression was 1.31 (95% CI 1.16–1.48; p

Abstract Background The role of cytoreductive nephrectomy (CN) in the treatment of metastatic renal cell carcinoma (mRCC) remains unclear in the immuno-oncology (IO) era. The results of two randomized trials, CARMENA and SURTIME, questioned the role and timing of CN. However, despite the latest advances in the systemic treatment of mRCC, previous trials have only used targeted therapy, and no studies have fully investigated the role of CN in immune checkpoint inhibitor (CPI) settings, and there is an urgent need for future studies to better define the role and timing of CN. Methods This study is an open-label, multi-center, parallel, prospective, randomized, interventional clinical study to evaluate the efficacy of CN in combination with CPIs in mRCC patients with International mRCC Database Consortium (IMDC) intermediate- and poor-risk. Synchronous mRCC patients with ≤ 3 IMDC risk features will be randomly allocated to three groups (1, upfront CN; 2, deferred CN; and 3, systemic therapy [ST] only). For ST, the nivolumab plus ipilimumab combination regimen, one of the standard regimens for intermediate- and poor-risk mRCC, is chosen. The primary endpoint is overall survival. The secondary endpoints are progression-free survival, objective response rate, number of participants with treatment-related adverse events, and number of participants with surgical morbidity. We will analyze the genetic mutation profiles of the tumor tissue, circulating tumor DNA, urine tumor DNA, and tumor-infiltrating lymphocytes. The gut and urine microbial communities will be analyzed. The study will begin in 2022 and will enroll 55 patients. Discussion This study is one of the few prospective randomized trials to evaluate the benefit of CN in the treatment of synchronous mRCC in the IO era. The SEVURO-CN trial will help identify the role and timing of CN, thereby rediscovering the value of CN. Trial registration ClinicalTrials.gov, NCT05753839. Registered on 3 March 2023.

Abstract The current thyroid ultrasound relies heavily on the experience and skills of the sonographer and the expertise of the radiologist, and the process is physically and cognitively exhausting. In this paper, we report a fully autonomous robotic ultrasound system, which is able to scan thyroid regions without human assistance and identify malignant nod- ules. In this system, human skeleton point recognition, reinforcement learning, and force feedback are used to deal with the difficulties in locating thyroid targets. The orientation of the ultrasound probe is adjusted dynamically via Bayesian optimization. Experimental results on human participants demonstrated that this system can perform high-quality ultrasound scans, close to manual scans obtained by clinicians. Additionally, it has the potential to detect thyroid nodules and provide data on nodule characteristics for American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) calculation.

The ventilation system is one of the essential safety systems in underground power spaces. Over the years, active ventilation has been widely employed for heat dissipation in underground power spaces. In operation, high-power equipment generates significant heat, necessitating sufficient heat dissipation for smooth and efficient functioning. The effectiveness of the ventilation system is influenced by airflow, making aerodynamics a crucial aspect of studying underground power spaces. This study establishes a comprehensive hybrid model (a combination of physical and data-driven models) representing underground power spaces. Ansys Fluent and MATLAB are used to simulate and calculate temperature fields for various structures. The physical model employs model order reduction to achieve efficient computation without compromising accuracy. For the data-driven model, a genetic neural network is developed for multifactor nonlinear optimisation to evaluate and analyse thermal behaviour within the space. The integrated hybrid model enables efficient and high-precision calculations for the underground power space’s ventilation system. The research outcomes provide a theoretical foundation for practical construction and design schemes of underground power spaces, contributing significantly to ensuring their safety and optimal functionality in real-world applications.

Purpose: To understand the clinical differences of cystitis glandularis (CG), a proliferative disorder of urinary bladder epithelium, based on the extent of cystoscopic findings in patients without a history of urinary tract malignancy. Materials and Methods: We conducted a review of patients diagnosed with CG in two tertiary hospitals from 2005 to 2021. Patients with previous or concurrent history of urinary tract malignancy were excluded. Medical records, including demographics, endoscopic and all available imaging studies, and managements, were reviewed. Patients were divided into two types according to extent of the lesion, and their clinical features were compared. Results: In total, 110 patients were enrolled in the final analysis, with 36 (32.7%) classified as extensive type and 74 (67.3%) as focal type. Patients with extensive type were predominantly males and relatively younger than those with focal type (p=0.025). Voiding problems were more strongly associated and hydronephrosis caused by CG was significantly more common in the extensive type (p=0.005 and p=0.003, respectively). Multiple transurethral resection procedures were more frequently performed in the extensive type (p=0.017). Subsequent urinary tract malignancy was observed in four patients, all of whom had focal-type CG. Conclusions: There were significant differences in clinical features between the extensive- and focal-types CG. The extensive type was more often associated with urologic complications. Meanwhile, in the focal type, subsequent urinary tract malignancy might develop during the follow-up period. Thus, thorough initial work-up and careful follow-up is necessary despite the benign nature of CG. Annual surveillance cystoscopy may be appropriate.

In recent years, the number of studio residential buildings has increased significantly in Korea, as well as in many other countries, due to changes in living patterns. In Korea especially, there have been many fire accidents in studio residential buildings, which have caused a huge number of casualties and property damages, because the buildings were not adequately equipped for firefighting. In this study, the egress safety of a typical studio residential building in Korea is analyzed. Fire simulations were performed with variables of the fire location and the capacity of the smoke exhaust system to estimate the available safe egress time (ASET); egress simulations were also performed with the variable of egress delay time, and the required safe egress time (RSET) was determined. Then, the egress safety was evaluated, and the criteria for egress safety evaluation were proposed based on the simulation results. A studio residential building with a floor plan different from the prototype was used to validate the proposed egress safety criteria. Finally, a simple evaluation model is presented to estimate the required safe egress time (RSET) without simulation and to examine the impact of bottlenecks.

In structures manufactured using 3D concrete printing, cracks can easily propagate along the interface between printed layers. Therefore, it was necessary to determine the interlayer bond strength. In this study, direct shear and tensile tests were performed to determine the interlayer bond stability of the 3DCP members. To confirm the appropriateness of the mix proportion used to fabricate the specimens, the open time available for printing was identified via a mixing test, and the extrudability and buildability were verified via a printing test. In addition, direct shear and tensile tests were performed using the specimen manufacturing method (i.e., mold casting and 3D printing) and printing time gap (PTG) between the laminated layers as key test variables. The interlayer bond strengths of the specimens, according to the variables obtained from the test results, were compared and analyzed based on the interfacial shear strength standards presented in the current structural codes. In the direct shear test, failure occurred at the interlayers of all the specimens, and the interlayer bond strength tended to decrease with increasing PTG. In addition, the interlayer bond strength of the direct shear specimens exceeded the interfacial shear strength suggested by current structural codes. In contrast, in the direct tensile test, interlayer surface failure occurred only in some specimens, and there was no distinct change in the interlayer bond strength owing to PTG.

The oncologic outcomes of cytoreductive prostatectomy (CRP) in oligometastatic prostate cancer (OmPCa) are still controversial. Therefore, we conducted a systematic review and meta-analysis on the oncologic outcome of CRP in OmPCa. OVID-Medline, OVID-Embase, and Cochrane Library databases were searched to identify eligible studies published before January 2023. A total of 11 studies (929 patients), 1 randomized controlled trial (RCT) and 10 non-RCT studies, were included in the final analysis. RCT and non-RCT were further analyzed separately. End points were progression-free-survival (PFS), time to castration-resistant prostate cancer (CRPCa), cancer-specific-survival (CSS) and overall-survival (OS). It was analyzed using hazard ratio (HR) and 95% confidence intervals (CIs). In PFS, in RCT, HR=0.43 (CIs=0.27–0.69) was shown statistically significant, but in non-RCTs, HR=0.50 (CIs=0.20–1.25), there was no statistical difference. And, in time to CRPCa was statistically significant in the CRP group in all analyses (RCT; HR=0.44; CIs=0.29–0.67) (non-RCTs; HR=0.64; CIs=0.47–0.88). Next, CSS was not statistically different between the two groups (HR=0.63; CIs=0.37–1.05). Finally, OS showed better results in the CRP group in all analyses (RCT; HR=0.44; CIs=0.26–0.76) (non-RCTs; HR=0.59; CIs=0.37–0.93). Patients who received CRP in OmPCa showed better oncologic outcomes compared to controls. Notably, time to CRPC and OS showed significantly improved compared with control. We recommend that experienced urologists who are capable of managing complications consider CRP as a strategy to achieve good oncological outcomes in OmPCa. However, since most of the included studies are non-RCT studies, caution should be exercised in interpreting the results.

IntroductionWe analyzed daily pre-treatment- (PRE) and real-time motion monitoring- (MM) MRI scans of patients receiving definitive prostate radiotherapy (RT) with 1.5 T MRI guidance to assess interfractional and intrafractional variability of the prostate and suggest optimal planning target volume (PTV) margin.Materials and methodsRigid registration between PRE-MRI and planning CT images based on the pelvic bone and prostate anatomy were performed. Interfractional setup margin (SM) and interobserver variability (IO) were assessed by comparing the centroid values of prostate contours delineated on PRE-MRIs. MM-MRIs were used for internal margin (IM) assessment, and PTV margin was calculated using the van Herk formula.ResultsWe delineated 400 prostate contours on PRE-MRI images. SM was 0.57 ± 0.42, 2.45 ± 1.98, and 2.28 ± 2.08 mm in the left-right (LR), anterior-posterior (AP), and superior-inferior (SI) directions, respectively, after bone localization and 0.76 ± 0.57, 1.89 ± 1.60, and 2.02 ± 1.79 mm in the LR, AP, and SI directions, respectively, after prostate localization. IO was 1.06 ± 0.58, 2.32 ± 1.08, and 3.30 ± 1.85 mm in the LR, AP, and SI directions, respectively, after bone localization and 1.11 ± 0.55, 2.13 ± 1.07, and 3.53 ± 1.65 mm in the LR, AP, and SI directions, respectively, after prostate localization. Average IM was 2.12 ± 0.86, 2.24 ± 1.07, and 2.84 ± 0.88 mm in the LR, AP, and SI directions, respectively. Calculated PTV margin was 2.21, 5.16, and 5.40 mm in the LR, AP, and SI directions, respectively.ConclusionsMovements in the SI direction were the largest source of variability in definitive prostate RT, and interobserver variability was a non-negligible source of margin. The optimal PTV margin should also consider the internal margin.

Purpose The aim of this study was to evaluate the 10-year oncological outcomes of bladder preservation with transurethral resection of bladder tumor (TURBT) and intravesical bacillus Calmette-Guérin (BCG) instillation in selected patients with superficial muscle-invasive bladder cancer (MIBC). Materials and Methods Patients diagnosed with superficial MIBC (stage T2a) by TURBT between 2001 and 2009 were included. Cystectomy-free survival, recurrence-free survival (RFS), progression-free survival (PFS), and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Cox regression analysis was used to identify predictors of each type of survival. Results Of 145 patients, 135 underwent bladder preservation and 10 underwent immediate radical cystectomy (RC). Among the latter, 9 patients showed downstaging. During a median follow-up of 132 months (interquartile range, 96–161 months), 13 patients underwent RC, with a 10-year cystectomy-free survival rate of 83.9%. Seventy patients (48.3%) had recurrence, and the 10-year RFS rate was 48.9%. Progression occurred in 12 patients (8.3%), with a 10-year PFS rate of 90.1%. Death occurred only in patients who exhibited progression; 5 patients (3.4%) died of bladder cancer, and the 10-year CSS rate was 96.5%. Tumors greater than 3 cm were associated with RC, and a high tumor grade predicted recurrence. RC was related to progression and cancer-specific mortality. Conclusions Although high-grade tumors require careful follow-up, bladder preservation with TURBT and intravesical BCG instillation can enable the successful management of selected patients with stage T2a MIBC less than 3 cm, without carcinoma in situ or tumor-associated hydronephrosis, in a nonmetastatic setting.

Abstract Regular safety inspections of existing reinforced concrete (RC) structures are required according to the regulations and criteria set by each country. In South Korea, the safety inspection regulations provided by the Korea Infrastructure Safety and Technology Corporation (KISTEC) are followed. These regulations were developed based on fuzzy theory to avoid subjective decisions, and provide standardized deterioration grades for member types, floors, and the entire structure. However, the safety inspection regulation by the KISTEC often provides unconservative evaluation results. In particular, as the importance factors of beam and slab members are set lower than those of other members, there are cases in which deteriorations occurring in beams and slabs are not properly reflected in the floor level evaluation. In this study, to overcome such limitations, case studies were carried out and modified importance factors for structural member types were proposed considering the failure probabilities of each member type based on the reliability theory. The importance modification factor was calculated based on the strength ratio of structural members so that the more dangerous the members are, the more impact they give on the evaluation. Overall, compared to the KISTEC method, the proposed method provided conservative but practical assessment results, and it was found that the proposed importance factors can be very useful to properly reflect the effects of damaged members on the deterioration status evaluation of the floors and the entire structure.

Abstract Bond–slip is an important characteristic that determines the stiffness, displacement, and load-bearing capacity of a reinforced concrete (RC) beam. It is essential for performing a precise numerical analysis of the beam. In most cases, bond–slip models can define the bond–slip curve only when there are experimental data. However, many bond test data have been obtained from pull-out tests, and the dominant view is that the bond–slip behavior observed in the pull-out test is quite different from that in an actual RC beam. Therefore, a mapping function that makes it possible to estimate the bond–slip behaviors of beam specimens using those of pull-out specimens was developed in this study. A total of 255 pull-out specimen data and 75 beam specimen data were collected from previous studies, and the importance and influence of each feature of the two groups were analyzed using random forest and K-means clustering. The mapping function was derived using genetic programming, and its accuracy was verified through a comparison with existing models. The proposed model exhibits a high degree of accuracy in estimating bond–slip and bond strength in beam specimens and can provide useful information for understanding the difference in bond–slip behaviors between the two groups.

Purpose:Purpose: We aimed to investigate the association between androgen deprivation therapy (ADT) and the risk of dementia ac-cording to subtypes of dementia in men with prostate cancer. Materials and Methods:Materials and Methods: We performed a nationwide population-based cohort study using the nationwide claims database in Korea. A total of 195,308 men with newly diagnosed prostate cancer were identified between January 2008 and December 2017, and 132,700 men were selected for analysis after applying inclusion and exclusion criteria. The patients were divided into ADT and non-ADT groups. To adjust for imbalances in relevant comorbidities between the groups, exact matching was performed. Study events included newly developed Alzheimer’s disease, vascular dementia, and overall dementia. Cox pro-portional hazard regression models were used. Results:Results: After exact matching, 44,854 men with prostate cancer were selected for the main analysis. In age-adjusted Cox regression analysis, the ADT group was significantly associated with increased risks for overall dementia (hazard ratio [HR], 1.070; 95% confidence interval [CI], 1.009–1.134; p=0.0232) and Alzheimer’s disease (HR, 1.086; 95% CI, 1.018–1.160; p=0.0127), compared to the non-ADT group. No difference in vascular dementia risk was observed between the two groups (HR, 0.990; 95% CI, 0.870–1.126; p=0.8792). Conclusions:Conclusions: The risk of overall dementia increased in men who received ADT. According to dementia subtypes, ADT was associated with an increased risk of Alzheimer’s disease, but not with vascular dementia.

Abstract Steel bridge deck pavement has always been a key and difficult point in the construction of long-span bridges. In practical engineering, common paving material is asphalt, and serious damage is caused on the pavement layer in the early stage. In this study, a high-performance high-content hybrid fibre polymer concrete was used as the paving material. A test was conducted on the small beam of the composite structure formed by the pavement layer and steel plate, and a positive/negative bending moment test was conducted to analyse the stiffness and bearing capacity of the composite structure. As revealed in the research results, the flexural and tensile stiffness of the structure and the bearing capacity of the composite structure showed superior performance, increased significantly with the pavement thickness, but increased slowly after the pavement thickness exceeded 80 mm and the increase in thickness contributed little to the bearing capacity. Under the simulated action of a positive/negative bending moment, the pavement layer still exhibited certain ductile failure features when the structure was bearing an ultimate load. This proves that high-content hybrid fibre polymer concrete exhibits suitable mechanical properties for steel bridge deck pavement.

Purpose: To investigate the efficacy, safety, and tolerability of oro-dispersible film (ODF) formulation of mirodenafil 50 mg and 100 mg for the treatment of patients with erectile dysfunction (ED) in Korea. Materials and Methods: A multicenter, randomized, double-blind, placebo-controlled, parallel-group study of 129 subjects was performed. Subjects were randomized to either placebo or mirodenafil ODF 50 mg or 100 mg to be taken in an “on demand” manner for 8 weeks. The primary efficacy variable was the International Index of Erectile Dysfunction (IIEF)-5 questionnaire. The secondary efficacy variables comprised Sexual Encounter Profile questions 2 and 3 (SEP2 and SEP3), the Global Assessment Question (GAQ), and the Life Satisfaction Checklist (LSC). Results: IIEF-5 was significantly increased in all groups after treatment. However, compared to the placebo group, only the mirodenafil ODF 100 mg group showed a significant difference. SEP2 and SEP3 were increased in both mirodenafil groups; however, the increase was not statistically significant for SEP2. In terms of GAQ and LSC, the mirodenafil ODF groups showed significant increases compared with the baseline. Most treatment-associated adverse events were mild and resolved spontaneously. Conclusions: Mirodenafil ODF is an effective and well-tolerated agent for the treatment of patients with ED in Korea.

Background and Objectives: Percutaneous nephrolithotomy (PCNL) is still the gold-standard treatment for large and/or complex renal stones. Endoscopic combined intrarenal surgery (ECIRS) was developed with the goal of minimizing the number of access tracts of PCNL while simultaneously improving the one-step stone-free rate (SFR). The aim of this study was to share the experience of the consecutive 200 cases of ECIRS in one institute and analyze surgical outcomes of mini-ECIRS and standard ECIRS. Materials and Methods: We performed ECIRS for 200 adult patients between July 2017 and January 2020. An ECIRS was performed with the patient under general anesthesia in the intermediate-supine position. Surgeries were finished using a tubeless technique with a simple ureteral stent insertion. Results: There were significant differences in the mean maximal stone length (MSL), the variation coefficient of stone density (VCSD), the linear calculus density (LCD), the Seoul National University Renal Stone Complexity (S-ReSC), and the modified S-ReSC scores in stone characteristics, and estimated blood loss (EBL) and operation time in peri-operative outcomes between conventional and mini-ECIRS. After propensity-score matching, there was only a difference in EBL between the two groups. In logistic regression models, MSL [odds ratio (OR) 0.953; 95% confidence interval (CI) 0.926–0.979; p < 0.001], LCD (OR 4.702; 95% CI 1.613–18.655; p = 0.013) were significant factors for the success rate after ECIRS. Conclusions: In patients who underwent a mini-ECIRS, the stones were relatively smaller and less complex, and the operation time was shorter. However, if the size of stones was similar, there was no difference in the success rate, but EBL was lower in mini-ECIRS than in standard surgery.

Background: We evaluated the risk of developing primary open-angle glaucoma (POAG) according to androgen deprivation therapy (ADT) status in patients with prostate cancer. Materials and methods: From the nationwide claims database in South Korea, 218,203 men with prostate cancer were identified between 2008 and 2017. After applying the inclusion and exclusion criteria, a total of 170,701 patients (42,877 in the ADT and non-ADT groups and 127,824 in the non-ADT group) were included in the analysis. To adjust for comorbidities between cohorts, exact matching was performed. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of POAG associated with ADT after controlling for potential confounding factors. Results: In the matched cohort, the ADT group had a lower proportion of newly developed POAG than the non-ADT group (2.10% vs. 2.88%, respectively; P

Abstract We evaluated the risk of osteoporosis and fractures associated with androgen deprivation therapy (ADT) use and duration in men with prostate cancer. From the nationwide claims database in South Korea, a total of 218,203 men with prostate cancer were identified between 2008 and 2017. After applying the inclusion and exclusion criteria, a total of 144,670 patients were included in the analysis. To adjust for comorbidities between cohorts, 1:1 propensity score matching was used. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of events associated with ADT, after controlling for potential confounding factors. In the matched cohort, there were differences in the incidence of newly developed osteoporosis (8.79% in the ADT group vs. 7.08% in the non-ADT group, p

Superhydrophobicity, a unique natural phenomenon observed in organisms such as lotus leaves and desert beetles, has inspired extensive research on biomimetic materials. Two main superhydrophobic effects have been identified: the “lotus leaf effect” and the “rose petal effect”, both showing water contact angles larger than 150°, but with differing contact angle hysteresis values. In recent years, numerous strategies have been developed to fabricate superhydrophobic materials, among which 3D printing has garnered significant attention due to its rapid, low-cost, and precise construction of complex materials in a facile way. In this minireview, we provide a comprehensive overview of biomimetic superhydrophobic materials fabricated through 3D printing, focusing on wetting regimes, fabrication techniques, including printing of diverse micro/nanostructures, post-modification, and bulk material printing, and applications ranging from liquid manipulation and oil/water separation to drag reduction. Additionally, we discuss the challenges and future research directions in this burgeoning field.

Background and Objectives: Ureteral stent insertion passively dilates the ureter. Therefore, it is sometimes used preoperatively before flexible ureterorenoscopy to make the ureter more accessible and facilitate urolithiasis passage, especially when ureteroscopic access has failed or when the ureter is expected to be tight. However, it may cause stent-related discomfort and complications. This study aimed to assess the effect of ureteral stenting prior to retrograde intrarenal surgery (RIRS). Materials and Methods: Data from patients who underwent unilateral RIRS for renal stone with the use of a ureteral access sheath from January 2016 to May 2019 were retrospectively analyzed. Patient characteristics, including age, sex, BMI, presence of hydronephrosis, and treated side, were recorded. Stone characteristics in terms of maximal stone length, modified Seoul National University Renal Stone Complexity score, and stone composition were evaluated. Surgical outcomes, including operative time, complication rate, and stone-free rate, were compared between two groups divided by whether preoperative stenting was performed. Results: Of the 260 patients enrolled in this study, 106 patients had no preoperative stenting (stentless group), and 154 patients had stenting (stenting group). Patient characteristics except for the presence of hydronephrosis and stone composition were not statistically different between the two groups. In surgical outcomes, the stone-free rate was not statistically different between the two groups (p = 0.901); however, the operation time for the stenting group was longer than that of the stentless group (44.8 ± 24.2 vs. 36.1 ± 17.6 min; p = 0.001). There were no differences in the complication rate between the two groups (p = 0.523). Conclusions: Among surgical outcomes for RIRS with a ureteral access sheath, preoperative ureteral stenting does not provide a significant advantage over non-stenting with respect to the stone-free rate and complication rate.

Recent advances in cell therapy have shown the potential to treat kidney diseases. As the treatment effects of the cell therapies are mainly attributed to secretomes released from the transplanted cells, the delivery of secretomes or conditioned medium (CM) has emerged as a promising treatment option for kidney disease. We previously demonstrated that the controlled delivery of human placental stem cells (hPSC)-derived CM using platelet-rich plasma (PRP) ameliorated renal damages and restored kidney function in an acute kidney injury (AKI) model in rats. The proteomics study of the hPSC-CM revealed that hPSC secrets several proteins that contribute to kidney tissue repair. Based on our results, this study proposed that the proteins expressed in the hPSC-CM and effective for kidney repair could be used as a recombinant protein cocktail to treat kidney diseases as an alternative to CM. In this study, we analyzed the secretome profile of hPSC-CM and identified five proteins (follistatin, uPAR, ANGPLT4, HGF, VEGF) that promote kidney repair. We investigated the feasibility of delivering the recombinant protein cocktail to improve structural and functional recovery after AKI. The pro-proliferative and anti-apoptotic effects of the protein cocktail on renal cells are demonstrated in vitro and in vivo. The intrarenal delivery of these proteins with PRP ameliorates the renal tubular damage and improved renal function in the AKI-induced rats, yielding similar therapeutic effects compared to the CM delivery. These results indicate that our strategy may provide a therapeutic solution to many challenges associated with kidney repair resulting from the lack of suitable off-the-shelf regenerative medicine products.

Purpose Overactive bladder (OAB) symptoms might be affected by weather, but only a few clinical studies have investigated this issue. We investigated seasonal variations in OAB-drug prescription rate (DPR) in men using nationwide claims data in Korea. Methods A total of 2,824,140 men aged over 18 years were included from the Health Insurance Review and Assessment service – National Patient Sample data between 2012 and 2016. Depending on the monthly average temperature, the seasons were divided into 3 groups, namely, hot (June, July, August, and September), intermediate (April, May, October, and November), and cold (January, February, March, and December) seasons. OAB-DPR was estimated using the claims data, and differences in its rate were examined among the 3 seasonal groups. Results The overall OAB-DPR was 1.97% (55,574 of 2,824,140). The OAB-DPR were 0.38%, 0.63%, 0.92%, 1.74%, 4.18%, 7.55%, and 9.69% in the age groups of under 30, 30s, 40s, 50s, 60s, 70s, and over 80 years, respectively; thus, the prescription rate increased with age (P

Abstract The current design codes discuss the effective compressive strengths of columns, which reflect a decrease in load transfer performance that can occur when columns and slabs have different concrete compressive strengths. The effective compressive strength of a column increases as it is confined by the slab, and the design codes mandate three different effective compressive strengths for interior columns (confinement on four sides), exterior columns (confinement on three sides), and corner columns (confinement on two sides). For both corner and exterior columns, the confinement effect of the slab is significantly smaller than that for the interior column, and there is a more marked decrease in load transfer performance. However, there is still a lack of theoretical studies investigating the effective compressive strengths of the corner and exterior columns. Therefore, based on the analysis model established in previous research, this study has proposed an equation for calculating the effective compressive strengths of the corner, exterior and isolated columns without any confinement effects of the slab. In addition, axial loading tests of isolated columns were conducted and the proposed equation was verified.

Acid spills cause large-scale environmental damage and casualties. To respond to such incidents, a sensor capable of detecting acid leaks is required. Cellulose is a useful substrate material for the fast detection of acid leaks because it has high hydrophilicity and porosity. On the other hand, methods of manufacturing cellulose-based sensors are still complicated or time-consuming. Thus, in this study, a simple and rapid synthesis method for a cellulose-based pH sensor was proposed. The functionalization of α-cellulose was achieved via chloroacetyl chloride, and Congo red was covalently immobilized to the functionalized cellulose for detecting strong acids. The manufacturing process was composed of two steps as above and finished within 8 h. The developed sensor exhibited absorbance changes in the pH range of 0.2 to 3.0, and response time was shorter than 1 s. A prototype system using this sensor was manufactured and tested, and it detected acid leaks easily and quickly.

PurposeIn the context of the COVID-19 outbreak, the European Association of Urology (EAU) guidelines Rapid Reaction Group provided recommendations to manage muscle invasive bladder cancer (MIBC) based on priority levels: neoadjuvant chemotherapy (NAC) should be avoided for patients with T2-3N0M0 MIBC. This meta-analysis aims to evaluate the efficacy of NAC compared with radical cystectomy (RC) alone in improving the overall survival (OS) of patients with T2-4aN0M0 MIBC.Materials and methodsA systematic review was performed according to the PRISMA guidelines. The PubMed/Medline, EMBASE, and Cochrane Library databases were searched. The primary outcome was OS of patients with T2-4aN0M0 MIBC, and the secondary outcome was OS of patients with only T2N0M0 MIBC.ResultsEight studies were included in this meta-analysis. Overall, the quality of all studies was relatively high, and little publication bias was demonstrated. The OS was significantly better in the NAC with RC group than in RC alone (HR, 0.79; 95% CI, 0.68-0.92; p = 0.002). A subgroup analysis was performed on only patients with T2N0M0 MIBC, and five studies were included. There was no difference in the OS between the NAC with RC and the RC alone groups (HR, 0.83; 95% CI, 0.69-1.01 p = 0.06).ConclusionsAs recommended by the EAU guidelines Rapid Reaction Group, patients with T2N0M0 MIBC should strongly consider omitting NAC until the end of the COVID-19 pandemic. Whether to omit NAC in T3-4aN0M0 MIBC needs further discussion, and studies targeting only T2-3N0M0 MIBC are expected to proceed further.

IntroductionA single dose of preventive antibiotics is known to be sufficient to reduce the rate of infection-related complications in percutaneous nephrolithotomy (PCNL). However, some studies reported that the extended dose showed lower complications for high-risk groups. Therefore, we performed a systematic review and meta-analysis comparing single- and extended-dose antibiotic prophylaxis for PCNL.Materials and methodsRelevant studies that compared single- and extended-dose antibiotic prophylactic therapies were identified. Articles were selected from PubMed, EMBASE, KoreaMed, and Google Scholar up to September 2021. Fever and systemic inflammatory response syndrome (SIRS) were compared by meta-analysis. A subgroup analysis was performed according to the degree of risk to the patient.ResultsA total of 10 articles were included in this study. There were no significant differences between single dose and extended dose in the rate of fever [p = 0.93, OR = 0.96, 95% confidence interval (CI) 0.44-2.13, I2 = 64%]. Extended dose showed lower rate of SIRS compared to single dose (p = 0.0005, OR = 1.81, 95% CI 1.30-2.53, I2 = 53%); in the subgroup analysis, extended dose also showed lower rates of SIRS compared to single dose in high-risk patients (p ConclusionsThe results of our meta-analysis showed that single-dose antibiotic prophylaxis can be effective for PCNL, but extended-dose antibiotics can be required in high-risk patients to reduce post-PCNL infection-related complications.

The construction of steel deck pavements is still considered difficult worldwide, and interfacial bonding is a major factor influencing this construction. With the recent developments in the field of pavement materials, high-performance cement-based concrete is used to construct steel bridge deck pavements. However, ensuring adequate interface-bonding strength remains particularly complex and difficult. In this study, with the aim of striking the right balance between rigidity and flexibility, an interface-bonding material was formed using modified epoxy resin, cement, and rubber powder. Polymer lattice porous concrete was used as the paving material, and the interface-bonding effect was studied experimentally by employing three methods using the material: pull-off, dual-interface shear, and flexural tensile tests. The results showed that (1) the interface pull-off strength was higher than 4 MPa, that is, higher than twice that of epoxy asphalt pavements used currently on steel bridge decks, and the failure surface was located on the pavement material rather than on the bonding interface; (2) the interface flexural strength and tensile strength were significantly higher than those of epoxy asphalt at room temperature and those of the ordinary epoxy resin; (3) the dual-interface shear strength was nearly four times higher than that of epoxy asphalt. Therefore, the modified epoxy resin composite interface-bonding material suggested in this study is an excellent bonding material that can serve as a reference for interface-bonding of steel bridge deck pavements.

PurposeDuring the coronavirus disease 2019 (COVID-19) pandemic, the European Association of Urology (EAU) recommended that courses of intravesical bacillus Calmette-Guérin (BCG) therapy lasting more than 1 year could be safely terminated for patients with high-risk non-muscle-invasive bladder cancer (NMIBC). Thus, we conducted a systematic review and network meta-analysis according to EAU's COVID-19 recommendations.Materials and methodsA systematic review was performed following the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. We conducted a network meta-analysis of recurrence rate in patients with NMIBC receiving induction therapy (M0) and those receiving maintenance therapy lasting 1 year (M1) and more than 1 year (M2).ResultsNineteen studies of 3,957 patients were included for the network meta-analysis. In a node-split forest plot using Bayesian Markov Chain Monte Carlo (MCMC) modeling, there were no differences between the M1 and M2 groups in recurrence rate [odds ratio (OR) 0.95 (0.73-1.2)]. However, recurrence rate in the M0 group was higher than that in the M1 [OR 1.9 (1.5-2.5)] and M2 [OR 2.0 (1.7-2.4)] groups. P-score tests using frequentist inference to rank the treatments in the network demonstrated that the therapy used in the M2 group (P-score 0.8701) was superior to that used in the M1 (P-score 0.6299) and M0 groups (P-score 0). In rank-probability tests using MCMC modeling, the M2 group showed the highest rank, followed by the M1 and M0 groups.ConclusionIn the network meta-analysis, there were no differences between those receiving BCG maintenance therapies in terms of recurrence rate. In the rank tests, therapy lasting more than 1-year appears to be most effective. During the COVID-19 pandemic, 1-year maintenance therapy can be used, but after the COVID-19 pandemic, therapy lasting more than 1-year could be beneficial.

Background and Objectives: Non-contrast computed tomography (NCCT) is widely used to evaluate urolithiasis. The NCCT attenuation, measured in Hounsfield units (HU), has been evaluated to predict stone characteristics. We propose a novel parameter, linear calculus density (LCD), and analyze variables from NCCT imaging to predict calcium oxalate (CaOx) stones, which are common and challenging to fragment. Materials and Methods: We retrospectively reviewed the medical records of patients with urolithiasis between 2014 and 2017. Among those, 790 patients were included. Based on the NCCT pre-treatment, the maximal stone length (MSL), mean stone density (MSD), and stone heterogeneity index (SHI) were obtained. In addition, the variation coefficient of stone density (VCSD = SHI/MSD × 100) and linear calculus density (LCD = VCSD/MSL) were calculated. In accordance with the stone analysis, the patients were divided into two groups (CaOx and non-CaOx groups). The logistic regression model and receiver operating characteristic (ROC) curve were used for predictive modeling. Results: In the CaOx group, the SHI, VCSD, and LCD were more significant than in the non-CaOx group (all p < 0.001). SHI (OR 1.002, 95% CI 1.001–1.004, p < 0.001), VCSD (OR 1.028, 95% CI 1.016–1.041, p < 0.001), and LCD (OR 1.352, 95% CI 1.270–1.444, p < 0.001) were significant independent factors for CaOx stones in the logistic regression models. The areas under the ROC curve for predicting CaOx stones were 0.586 for SHI, 0.66 for VCSD, and 0.739 for LCD, with a cut-point of 2.25. Conclusions: LCD can be a useful new parameter to provide additional information to help discriminate CaOx stones before treatment.

Background and Objectives: This systematic review and meta-analysis of randomized controlled trials was performed to compare the therapeutic effects and safety profiles of silodosin and tamsulosin for medical expulsive therapy (MET) of ureteral stones. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library, and Web of Science to identify articles published before July 2022 that described randomized controlled trials comparing silodosin and tamsulosin for MET of ureteral stones. Endpoints were stone expulsion rate, stone expulsion time, and total complication rate. Results: In total, 14 studies were included in our analysis. The size of ureteral stones was p < 0.01, odds ratio (OR) = 2.42, 95% confidence interval (CI) = 1.91 to 3.06, I2 = 0%) and significantly shorter stone expulsion time (p < 0.01, mean difference = −3.04, 95% CI = −4.46 to −1.63, I2 = 89%). The total complication rate did not significantly differ between silodosin and tamsulosin (p = 0.33, OR = 1.15, 95% CI = 0.87 to 1.52, I2 = 7%). Conclusions: Compared with tamsulosin, silodosin resulted in significantly better expulsion of ureteral stones

Prostate cancer is a common form of cancer in men, and androgen-deprivation therapy (ADT) is often used as a first-line treatment. However, some patients develop resistance to ADT, and their disease is called castration-resistant prostate cancer (CRPC). Identifying potential therapeutic targets for this aggressive subtype of prostate cancer is crucial. In this study, we show that statins can selectively inhibit the growth of these CRPC tumors that have lost their androgen receptor (AR) and have overexpressed the RNA-binding protein QKI. We found that the repression of microRNA-200 by QKI overexpression promotes the rise of AR-low mesenchymal-like CRPC cells. Using in silico drug/gene perturbation combined screening, we discovered that QKI-overexpressing cancer cells are selectively vulnerable to CDC42-PAK7 inhibition by statins. We also confirmed that PAK7 overexpression is present in prostate cancer that coexists with hyperlipidemia. Our results demonstrate a previously unseen mechanism of action for statins in these QKI-expressing AR-lost CRPCs. This may explain the clinical benefits of the drug and support the development of a biology-driven drug-repurposing clinical trial. This is an important finding that could help improve treatment options for patients with this aggressive form of prostate cancer.

Background and Objectives: During the coronavirus disease 2019 (COVID-19) outbreak, the European Association of Urology (EAU) Guidelines Office Rapid Reaction Group (GORRG) recommended that patients with clinical stage I (CSI) seminoma be offered active surveillance (AS). This meta-analysis aimed to evaluate the efficacy of AS versus adjuvant treatment with chemotherapy or radiotherapy for improving the overall survival (OS) of CSI seminoma patients. Materials and Methods: A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed/Medline, EMBASE, and Cochrane Library databases were searched. The primary outcome was 5-year OS, and the secondary outcome was the 5-year relapse-free survival (RFS). The outcomes were analyzed as odds ratios (ORs) and 95% confidence intervals (CIs). Results: A total of 14 studies were included. Overall, the quality scores were relatively high, and little publication bias was noted. In terms of the 5-year OS, 7 studies were analyzed; there was no significant difference between AS and adjuvant treatment (OR, 0.99; 95% CI, 0.41–2.39; p = 0.97). In terms of 5-year RFS, 12 studies were analyzed. Adjuvant treatment reduced the risk of 5-year recurrence by 85% compared with AS (OR, 0.15; 95% CI, 0.08–0.26; p < 0.001). Conclusions: In terms of the OS in CSI seminoma patients, no intergroup difference was noted, so it is reasonable to offer AS, as recommended by the EAU GORRG until the end of the COVID-19 pandemic. However, since there is a large intergroup difference in the recurrence rate, further research on the long-term (>5 years) outcomes is warranted.

Background and Objectives: Disposable flexible ureteroscopes have been widely used because of their cost-effectiveness and higher sterility potential compared with reusable flexible ureteroscopes. This study aimed to compare the surgical outcomes and complication rates in patients who undergo reusable or disposable flexible ureteroscopic stone surgeries (fURS) for urinary stone disease. Materials and Methods: A systematic review and meta-analysis were conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. This systematic review was registered with PROSPERO (CRD42022331291). Clinical trials comparing reusable and disposable fURS for stone disease were found from PubMed, EMBASE, Cochrane Library, and the Web of Science up to March 2022. Participants were patients with upper urinary tract stones; the interventions were reusable or disposable fURS. Outcomes, including stone-free rate, operation time, length of hospital stay, and complication rate, were compared for analysis. Results: Overall, 111 studies were identified, but after removing duplicate studies, 75 studies remained. Thirty-two of these studies were excluded. Of the 43 screened studies, 11 met the eligibility criteria. There was no difference in the stone-free rate (SFR) between disposable and reusable fURS (p = 0.14; OR = 1.36; 95% CI, 0.9 to 2.04). For operation time, no difference was identified between reusable and disposable fURS groups (p = 0.12; MD = −5.31; 95% CI, −12.08 to 1.46). For hospital stay, there was also no difference between the two groups (p = 0.61; MD = −0.03; 95% CI, −0.17 to 0.10). There was no significant difference in complication rate between the two groups (p = 0.85; OR = 0.95; 95% CI, 0.56 to 1.61). Conclusions: There were no differences in the SFR, operation time, length of hospital stay, and complication rate between reusable and disposable fURS. Disposable fURS may be a comparable alternative to reusable fURS.

Purpose To assess the effectiveness of alpha-1 adrenergic receptor blockers (α1-blockers) in the treatment of female lower urinary tract symptoms (LUTS). Methods A literature search was conducted using the PubMed/MEDLINE, Embase, and Cochrane Library databases. Fourteen studies with 1,319 patients were ultimately included. The study comprised 2 analyses: a comparison of urinary symptom scores, maximal flow rate (Qmax), and postvoid residual (PVR) urine volume before and after α1-blocker administration in 8 prospective, open-label studies and 5 randomized clinical trials (RCTs); and an evaluation of the same variables in α1-blocker and placebo groups in 4 RCTs. Results The first meta-analysis showed that, following treatment, patients exhibited statistically significant symptom relief (mean difference [MD], -5.85; 95% confidence interval [CI], -7.71 to -3.99; P

Purpose: We purposed to assess the effects of adjuvant chemotherapy (ACH) on survival outcomes in patients with locally advanced muscle-invasive bladder cancer (MIBC) who are treated with radical cystectomy (RC). Materials and Methods: Literature search was conducted in PubMed, Embase, and Cochrane library databases for all articles that were published until February 2018. Systematic review and meta-analysis were performed by pooling the randomized controlled trials (RCTs) that compared patients with locally advanced MIBC who received ACH after RC to those who underwent cystectomy alone. Endpoints were progression free survival (PFS) and overall survival (OS). Results: Four RCTs with a total of 490 patients were selected for the analysis. These four trials included patients with locally advanced MIBC. Pooled HRs for PFS and OS across the studies were 0.48 (95% confidence interval [CI], 0.39–0.60; p

Abstract The prestressed hollow-core slab (PHCS) is a precast concrete member that can maximize productivity and structural performance efficiency of concrete cross-section. For the PHCS members produced by extrusion method, however, it is difficult to provide the shear reinforcement due to its unique production method to form the hollow-cores in concrete section. The recently revised ACI318 Building Code Requirements stipulate that web-shear capacity of thick hollow-core member over 315 mm depth without the minimum shear reinforcement should be reduced in half, which may result in an excessively conservative shear design for the PHCS member compared to conventional prestressed concrete members with thin webs. In this study, shear tests on PHCS members, which have typical thicknesses widely used in precast construction industry, were conducted, and a large number of shear test data were additionally collected from previous studies to evaluate the current shear design criteria for PHCS in detail.

Summary: Background: Little is known about the preoperative predictive factors that could identify subsets of favorable patients who can be possibly cured with robot-assisted radical prostatectomy (RARP) alone in locally advanced prostate cancer (LAPCa). Our study was designed to identify clinical predictors of pathologic organ-confined disease (pOCD) in RARP setting. Methods: Between 2007 and 2013, clinicopathological and oncological data from 273 consecutive men undergoing robot-assisted RP with extended PLND for clinically LAPCa were reviewed in a single-institution, retrospectively. After exclusion of patients who received neoadjuvant hormone treatment before surgery, 186 subjects satisfied the final inclusion criteria. Results: Fourty-three patients (23.1% of total cohort) with preoperative clinically LAPCa patients were down-staged to pOCD following RARP. Preoperative prostate-specific antigen (PSA) level, preoperative PSAD, positive core percent, maximal tumor volume in any core, and biopsy Gleason score were significantly associated with down-staging into pOCD following RARP. Multivariate logistic regression analysis revealed that lower preoperative PSA (≤10 ng/mL) and maximal tumor volume in any core (≤70%) were independent predictors of pOCD following RARP. Conclusions: Approximately 23% of preoperative clinically LAPCa patients were down-staged to pOCD following RARP. Preoperative PSA and maximal tumor volume in any biopsy core might be useful clinical predictors of pOCD in clinically LAPCa patients in RARP setting. Keywords: Robotics, Prostatic neoplasms, Prostatectomy, Treatment outcome

This study aimed to evaluate the egress safety in nursing hospitals based on the capacity of the smoke exhaust system. To this end, the available safe egress time was calculated by analyzing changes in visibility, carbon monoxide, carbon dioxide, oxygen contents, and temperature depending on the fire duration. In addition, an egress simulation was performed using the number of workers (egress guides) and egress delay time as variables, and the required safe egress time was estimated. Based on the results, the egress safety of a prototype nursing hospital was evaluated. In this study, egress safety criteria to evaluate egress safety in a typical nursing hospital were presented, which are expressed in terms of normalized egress guides, the capacity ratio of the smoke exhaust system, and egress delay time. The proposed criteria can be used to evaluate the egress safety of typical nursing hospitals and to prepare complementary measures.

The degradation process of bearing performance in the whole life cycle is a complex and nonlinear process. However, the traditional neural network-based approaches usually consider the degradation process of bearing performance as linear, which does not accord with the actual situation of bearing degradation. To overcome this shortcoming, a rolling bearing’s remaining useful life prediction method based on a Squeeze-and-Excitation-Convolutional long short-term memory (SE-ConvLSTM) neural network was proposed based on the construction of a new health index in the process of bearing life evolution. The proposed method considered the change rule of the health indicator during the whole life cycle evolution of bearings, then constructed the health indicator by using the SE-ConvLSTM neural network, effectively improving the model prediction accuracy and training efficiency. Firstly, the original data are filtered and denoised by Ensemble Empirical Mode Decomposition. Combined with Principal Component Analysis (PCA) dimensionality reduction and the Local Outlier Factor (LOF) algorithm, the bearing’s life evolution interval is divided. Then, the health indicator is constructed based on the proposed SE-ConvLSTM model, and the remaining useful life of rolling bearings is predicted by a particle filter and double exponential model. The proposed method is compared with other related methods with the PHM2012 dataset, and the results show that the proposed method has higher accuracy in remaining useful life predictions. Compared with the traditional method, the health index construction based on the division of the lifespan evolution interval has higher practical significance.

Aim: Owing to the limited ability of current imaging modalities, several clinical T1 renal cell carcinomas (cT1 RCCa) can be pathologically upstaged to T3a (pT3a) after surgery. There have been some controversies regarding the oncological safety of partial nephrectomy (PNx) compared with radical nephrectomy (RNx) in these patients. We compared oncological outcomes of PNx and RNx in patients with upstaged pT3a RCCa. Methods: A systematic review was performed following the PRISMA guideline. PubMed, MEDLINE, Embase were searched. Oncological outcomes [recurrence-free survival (RFS), overall survival (OS) and cancer-specific survival (CSS)] between PNx and RNx were compared. The GRADE approach was used to rate the certainty of evidence. Results: A total of 7406 patients in 12 articles related to upstaged pT3a RCCa were included. In adjusted analysis, no difference was observed in RFS [hazard ratios (HR) 0.87; 95% confidence intervals (CI), 0.57–0.95; p = 0.88] and CSS (HR, 0.78; 95% CI, 0.59–1.04; p = 0.09) for PNx and RNx. Meanwhile, PNx was significantly associated with favorable OS compared with RNx (HR, 0.74; 95% CI, 0.57–0.95; p = 0.02). Conclusions: Our meta-analysis shows that patients treated with PNx have better or at least similar oncological outcomes compared with RNx in patients with upstaged pT3a RCCa from cT1. In particular, patients who had undergone PNx show a significantly improved OS. If PNx is available, we recommend performing PNx for all cT1 RCCa, even in patients with upstaging potential. However, due to the low level of evidence, large-scale randomized trials are required.

The Dugdale model is one of the most famous achievements in fracture mechanics due to its accurate predication of the size of the plastic zone at the crack tip in comparison with the experimental results. However, the Dugdale model is generally used for the analysis of infinite-width cracked plates, and it has not been successfully extended analytically for the analysis of finite-width cracked plates, which are more commonly seen in engineering structures. In this paper, the Dugdale model of finite-width cracked plates was analytically analyzed based on the crack line analysis method. Solving the plastic zone of the Dugdale model of a finite-width plate with a mode-I center crack was broken down into two problems of finite-width plates, and the analytical solutions of stress intensity factors of the two problems were obtained, respectively. Based on the superposition principle of stress intensity factors, the size of the plastic zone of the Dugdale model of a finite-width plate with a mode-I center crack was obtained. The results are in perfect consistency with the experimental values obtained by Dugdale himself, and the difference between the theoretical curve and the experimental values obtained by Dugdale was eliminated for the first time.

Nursing hospitals have a high probability of casualties during a fire disaster because they have many patients with impaired mobility. In this study, fire and egress simulations were conducted to evaluate the egress safety of a typical nursing hospital. The available safe egress time (ASET) of the prototype nursing hospital was calculated using Fire Dynamics Simulator, and the required safe egress time (RSET) was estimated by Pathfinder, reflecting characteristics of the occupants. The egress safety of the nursing hospital was then evaluated by comparing the ASET and RSET, considering the number of egress guides and delay time. According to the simulation results, the RSET increased as the egress delay time increased and the number of egress guides decreased. In addition, it is estimated that at least 20 workers (egress guides) should be on duty in the prototype nursing hospital, even during shiftwork and night duty. Based on the simulation results, egress safety criteria have been proposed in terms of normalized numbers of egress guides and egress delay time. The proposed criteria can be very easily applied to evaluate the egress safety of a typical nursing hospital in operation.

Abstract In this study, prestressed hybrid wide flange (PHWF) composite girders were proposed, and full-scale flexural tests were conducted to evaluate their structural performances. This new proposed girder system was developed and designed to effectively resist external loads considering the actual construction sequences. Two specimens with and without shear connectors were fabricated and tested to examine the effect of the shear connectors for achieving the fully-composite behaviors between a cast-in-place (CIP) concrete and the prefabricated prestressed steel–concrete composite girder. The test results showed that sufficient flexural strengths and deformation capacities can be obtained in both types of PHWF composite girders with and without shear connectors. To reflect the actual construction stages of the proposed PHWF composite girder, nonlinear flexural analyses were proposed considering the prestress effect and segmental effect before and after composite with the CIP concrete, respectively. The observed and analysis results of strain behaviors of the PHWF girder specimens were also compared and discussed in detail.

Abstract Background Prostate-specific antigen (PSA) screening more frequently detects early stage prostate cancer (PC). However, adverse pathologic features (APFs) after radical prostatectomy (RP) in low-risk PC occur. Previous related studies had utilized outdated staging criteria or small sample cohorts. In this study, we analyzed predictors of APFs after RP in low-risk PC using classification under the current criteria. Materials and methods We retrospectively reviewed medical records of 546 low-risk PC patients who had undergone RP. Low-risk PC was defined as PC with clinical T1–T2a, Gleason score ≤ 6, and PSA levels 4.5 ng/mL and number of positive cores > 2 in low-risk PC were significantly associated with APFs, and suggested as cut-off values for predicting APFs. Conclusions PSA > 4.5 ng/mL and number of positive cores > 2 in low-risk PC were associated with presence of APFs and patients with such records should be considered carefully to provide active surveillance.

Abstract In current design codes, crack control design criterion for prestressed concrete (PSC) members is stricter than conventional reinforced concrete (RC) members. In particular, it is stipulated that the net tensile stress of prestressing strands should be controlled under 250 MPa in the serviceability design of PSC members belonging to the Class C category section that is expected to be cracked due to flexure under service load conditions as defined in ACI318 code. Thus, the cracked section analysis is essentially required to estimate the tensile stress of the prestressing strands under the service loads, which requires very complex iterative calculations, thereby causing many difficulties in the applications of the Class C PSC members in practice. Thus, this study proposed a simple method to estimate the net tensile stress of the prestressing strands (Δf ps ) under the service load conditions, and also provided a summary table to be used for checking whether the net tensile stress (Δf ps ) exceeds the stress limit (250 or 350 MPa) with respect to the magnitude of effective prestress (f se ).

Purpose: This study aims to assess the predictive factors and treatment outcomes of Steinstrasse formation following shock wave lithotripsy (SWL) for ureter stone. Materials and Methods: The medical records of 1,418 ureter stone patients who underwent one-session SWL from November 2005 to May 2013 at our medical institute were retrospectively reviewed. Finally, 551 patients met inclusion criteria. Maximal length and location of stone, stone attenuation (Hounsfield units), and skin-to-stone distance (SSD) were determined on pretreatment non-contrast computed tomography. Results: Of 551 patients, 12 patients (2.2% of total cohort) developed Steinstrasse after one-session SWL. The Steinstrasse incidence was significantly associated with stone size, stone attenuation value, and SSD. Prophylactic ureter stenting was not a statistically significant predictor of Steinstrasse formation. After propensity-score matching, Steinstrasse group showed a significant shorter SSD compare to non-Steinstrasse group. Multivariate logistic regression and Bayesian analysis revealed that stone size, stone attenuation and SSD were significant predictor of Steinstrasse formation following SWL for ureter stone. The Steinstrasse resolved spontaneously in six patients and remaining six patients were treated by additional SWL. None of patients with Steinstrasse required ureteral stenting, percutaneous drainage, or consequent surgical intervention. Conclusions: Steinstrasse formation following SWL for ureter stone was rare event but nonnegligible. Large stone size, high stone attenuation and short SSD were significant predictors of Steinstrasse formation following SWL for ureter stone. Majority of patients with Steinstrasse formation could be treated conservatively in this clinical scenario.