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Background Renal cell carcinoma (RCC), one of the most fatal urologic tumors, accounts for approximately 3% of all adult cancers and exhibits a high metastatic index at diagnosis and a high rate of relapse. Radical or partial nephrectomy is a curative option for nonmetastatic RCCs. Targeted therapy has been shown to improve the survival of patients with metastatic RCCs. However, the underlying cellular and molecular events associated with RCC pathogenesis are not well known. Methods To investigate the clinical role of the transcription factor activator protein (AP)-2α in RCC, methylated CpG island recovery assays and microarray analysis were employed. COBRA and RT‒qPCR assays were performed to assess AP-2α expression in RCC. Results A negative correlation was noted between AP-2α mRNA expression levels and methylation status. Multivariate analyses showed that AP-2α mRNA was a major risk factor not only for overall and disease-free survival in RCC but also for disease-free survival in clear cell RCC. Conclusions Our results indicated that AP-2α expression was deregulated in RCC and associated with overall patient survival and disease-free survival. Such findings suggest that AP-2α might play an important role in the pathogenesis of RCC.

The DAVINCI SP system is an advanced robotic surgery platform allowing an endoscope and three articulated instruments to enter the body through a single incision while maintaining workspace triangulation. This open-label, single-arm clinical trial (ClinicalTrials.gov Identifier: NCT05403190 18/05/2022) evaluates the feasibility of using the DAVINVI SP system for extraperitoneal-approach robot-assisted radical prostatectomy (RaRP) in Taiwan. Two surgical techniques, the conventional anterior approach and the Hood technique, were used for RaRP. The primary endpoint was the success rate of RaRP with the DAVINCI SP system without conversion to multiport RaRP or open surgery. Secondary endpoints included perioperative variables, oncological outcomes, and functional outcomes. The study achieved a 100% success rate for the primary endpoint. Patients who underwent RaRP with the DAVINCI SP system had lower postoperative pain scores and shorter hospital stays. Additionally, 93.33% did not require a drain tube post-surgery, 80% achieved undetectable PSA levels at six months, and 96.67% regained continence within three months. The oncologic and continence outcomes are comparable between patients receiving conventional anterior approach or Hood technique. In conclusion, the DAVINCI SP system allows an effective extraperitoneal-approach RaRP, offering reduced pain, shorter hospital stays, and low drain tube placement rates. Trial registration : ClinicalTrials.gov (Identifier: NCT05403190 18/05/2022).

Purpose This study aimed to develop a novel model that combines both clinical and image-based parameters to predict early recovery of urinary incontinence after robotic-assisted radical prostatectomy (RARP) more easily and precisely. Materials and methods We retrospectively enrolled data from patients who underwent RARP performed by a single surgeon. Clinical parameters were collected through medical chart review. All patients received cystography one week after RARP to evaluate the anastomosis healing condition. All cystography images were analyzed by a single radiologist who was blinded to the clinical status of the patients. Multivariate analysis was performed to select significant predictors for early post-prostatectomy incontinence (PPI) recovery, defined as being pad-free within four weeks after surgery. Results A total of 293 patients were enrolled in this study. Among them, 26.7% experienced immediate dryness after surgery, while 47.6% achieved being pad-free within one month. The overall continence rate was over 90% six months after surgery. In univariate analysis, factors associated with early PPI recovery were BMI, T stage, NVB preservation, surgical margin status, downward bladder neck, and bladder neck angle on cystography. BMI, NVB preservation, and downward bladder neck remained significant in multivariate analysis (p-values = 0.041, 0.027, and 0.023, respectively). A nomogram model was established based on these three predictors. Conclusion This is the first model to combine preoperative clinical factors, peri-surgical factors, and postoperative image-based factors to predict PPI recovery after RARP. This model can assist clinicians in taking optimal actions for PPI and also reduce patient anxiety.

Exchange bias, a shift in the hysteresis loop of a ferromagnet arising from interfacial exchange coupling between adjacent ferromagnetic and antiferromagnetic layers, is an integral part of spintronic devices. Here, we show that spin–orbit torque generated from spin current, a promising approach to switch the ferromagnetic magnetization of next-generation magnetic random access memory, can also be used to manipulate the exchange bias. Applying current pulses to a Pt/Co/IrMn trilayer causes concurrent switching of ferromagnetic magnetization and exchange bias, but with different underlying mechanisms. This implies that the ferromagnetic magnetization and exchange bias can be manipulated independently. Our work demonstrates that spin–orbit torque in ferromagnet/antiferromagnet heterostructures facilitates independent manipulations of distinct magnetic properties, motivating innovative designs for future spintronics devices.Spin–orbit torque is used to control the magnetic exchange bias in a Pt/Co/IrMn trilayer.

Urothelial carcinomas of the upper urinary tract (UTUC) are rare tumors with a high malignancy degree. Radical nephroureterectomy (RNU) with bladder cuff excision remains one of the standard treatments in clinically localized or locally advanced UTUCs. However, the role of cytoreductive RNU in treating clinically lymph node-positive (N+) UTUCs remains unclear. A nationwide retrospective study was conducted by the Taiwan UTUC Collaboration Group from July 1988 to June 2022. Patients with clinical N + UTUC before initiation of cancer therapy were included in this study. Initial clinically node-positive disease was noted in 288 (5.4%) of the 5,301 patients. Of the patients, 239 (83%) patients underwent RNU. UTUC-related mortality was markedly higher among patients not receiving RNU than among those who underwent surgery (69.4% vs. 36%). After adjusting for the effects of stepwise enrolled parameters, multivariate analysis showed that undergoing RNU (or not) and smoking (or not) were the only independent predictors of overall survival (OS). After adjusting for the effects of significant stepwise enrolled variables, multivariate analysis showed that RNU and smoking (or not) were the only independent predictors of cancer-specific survival (CSS). Our findings showed that RNU is associated with better OS and CSS in Taiwanese patients with N + UTUC. Common patient characteristics and most cancer characteristics were not related to the outcome. Our results provide new evidence on the efficacy of RNU for patients with N + UTUC, which could alter and guide the direction of future treatment guidelines.

MRI-guided targeted biopsy (MRGB) was recommended as part of biopsy paradigm of prostate cancers by current guidelines. This study aimed to analyze the diagnostic efficacy of MRGB and systemic biopsy (SB), and to compare diagnostic capabilities within subgroups of MRGB: MRI-cognitive biopsy (MRCB) and MRI-fusion biopsy (MRFB). We retrospectively enrolled patients who underwent MRGB for suspicious malignant lesion(s) identified on MRI in a single tertiary center, sample size was 74 patients. An mpMRI was performed prior to biopsy and reviewed by an experienced radiologist specialized in prostate cancer. Per-person results of MRGB and each concomitant SB were analyzed as independent biopsies for its positive biopsy rate and positive core percentage. Per-lesion results of MRFB and MRCB were compared for the detection rate. Variables of interest were analyzed with t-test, chi-squared test, and logistic regression analysis. Statistical analyses were performed with IBM Statistical Product and Service Solutions (SPSS), Version 23 (IBM, Armonk, New York). Total of 74 patients fulfilled the inclusion criteria and were enrolled. MRFB had higher PCa detection rate comparing to both MRCB and SB (56.1%, 30.3%, and 33.9% respectively, p value = 0.036); clinically significant prostate cancer (csPCa) detection rate was also significantly higher in MRFB group (43.9%, 24.2%, and 16.9% in each group respectively, p value = 0.011). In per-lesion analysis, MRCB and MRFB had no significant difference in PCa and csPCa detection rate (41.0% vs. 26.2% and 29.5% vs. 16.7% respectively, p value = 0.090 and 0.103). In the lesion ≦ 1.3 cm group, MRFB could achieve higher PCa detection rate, comparing to MRCB (36.4% vs. 14.3%, p value = 0.047); there were also higher positive rates for PCa and csPCa per biopsied cores (22.1% vs. 6.8% and 15.6% vs. 2.7%, p value = 0.029 and 0.028, respectively). Further logistic regression of multi-variate analysis in subgroup of lesion ≦ 1.3 cm revealed that PIRADS score and biopsy method were significant predictors of positive biopsy result for PCa (p value = 0.045 and 0.026, respectively) and for csPCa (p value = 0.043 and 0.025, respectively). In patients receiving trans-perineal prostate biopsy, MRFB had higher cancer detection rate than MRCB and SB. In per lesion comparison, MRFB and MRCB had similar diagnostic accuracy. However, in lesions with diameter less than 1.3 cm, MRFB can provided better diagnose value for PCa and csPCa than MRCB.

Patients with end stage renal disease (ESRD) are at high risk of developing upper tract urothelial carcinoma (UTUC). Due to high recurrence rate of UTUC in contralateral kidney and ureter, and high risk of complications related to surgery and anesthesia, whether it’s necessary to remove both kineys and ureters at one time remains in debate. We utilized Taiwanese UTUC Registry Database to valuate the difference of oncological outcomes and perioperative complications between patients with ESRD with unilateral and bilateral UTUC receiving surgical resection. Patients with ESRD and UTUC were divided into three groups, unilateral UTUC, previous history of unilateral UTUC with metachronous contralateral UTUC, and concurrent bilatetral UTUC. Oncological outcomes, perioperative complications, and length of hospital stays were investiaged. We found that there is no diffence of oncological outcomes including overall survival, cancer specific survival, disease free survival and bladder recurrence free survival between these three groups. Complication rate and length of hospital stay are similar. Adverse oncological features such as advanced tumor stage, lymph node involvement, lymphovascular invasion, and positive surgical margin would negatively affect oncological outcomes.

This paper shows an investigation of pulverized coal in new inclined jet burners for improving particle‐burning efficiency through parameter adjustment. The research focuses on the interaction between two oblique jet methane (CH 4 )/air premixed flame burners and a coal particle jet feeder on an impinging burner. Various parameters such as CH 4 /air ratios, gas fuel flow rates, deflection angles, and coal dust feed speeds are systematically examined. The findings of the study reveal the establishment of distinct flow field structures, characterized by collision and recirculation zones, upon the interaction of jets. Momentum transfer in the upstream airflow creates a preheating zone, fostering fuel–air mixing. Within these recirculation zones, coal particles undergo pyrolysis facilitated by temperature gradients, resulting in increased volatile output that promotes downstream combustion. Additionally, coal particles traversing recirculation zones with higher vorticity and elevated temperature regions tend to undergo early fragmentation and combustion of volatile components upon exiting these zones. This study underscores the intricate interplay of parameters in optimizing coal combustion efficiency and highlights avenues for further research and practical application. Observations indicate enhanced burner performance with increased CH 4 /air ratios and central flow speeds. The study identifies a correlation between the deflection angle and particle reduction rate, which increases from 63.5% to 64.7% with an increase in the deflection angle. The reduction rate ranges from 59.7% to 67.8% with a transition from fuel‐rich to fuel‐lean conditions. As velocity increases from 0.6 to 1.2 m/s, the particle reduction rate escalates from 57.5% to 74.5%.

Two geometric shape turbulence promoters (circular and square of same areas) of different array patterns using three-dimensional (3D) printing technology were designed for direct contact membrane distillation (DCMD) modules in the present study. The DCMD device was performed at middle temperature operation (about 45 °C to 60 °C) of hot inlet saline water associated with a constant temperature of inlet cold stream. Attempts to reduce the disadvantageous temperature polarization effect were made inserting the 3D turbulence promoters to promote both the mass and heat transfer characteristics in improving pure water productivity. The additive manufacturing 3D turbulence promoters acting as eddy promoters could not only strengthen the membrane stability by preventing vibration but also enhance the permeate flux with lessening temperature polarization effect. Therefore, the 3D turbulence promoters were individually inserted into the flow channel of the DCMD device to create vortices in the flow stream and increase turbulent intensity. The modeling equations for predicting the permeate flux in DCMD modules by inserting the manufacturing 3D turbulence promoter were investigated theoretically and experimentally. The effects of the operating conditions under various geometric shapes and array patterns of turbulence promoters on the permeate flux with hot inlet saline temperatures and flow rates as parameters were studied. The distributions of the fluid velocities were examined using computational fluid dynamics (CFD). Experimental study has demonstrated a great potential to significantly accomplish permeate flux enhancement in such new design of the DCMD system. The permeate flux enhancement for the DCMD module by inserting 3D turbulence promoters in the flow channel could provide a maximum relative increment of up to 61.7% as compared to that in the empty channel device. The temperature polarization coefficient (τtemp) was found in this study for various geometric shapes and flow patterns. A larger τtemp value (the less thermal resistance) was achieved in the countercurrent-flow operation than that in the concurrent-flow operation. An optimal design of the module with inserting turbulence promoters was also delineated when considering both permeate flux enhancement and energy utilization effectiveness.

In recent years, to attract global manufacturers, media reporters, and consumer attention, a popular term in search engines has been virtual reality (VR). In addition to video, entertainment, education, and medical, VR can be used in electronic commerce (E-commerce). Currently, most E-commerce platforms present products using 2D images, text-based interface or animation. However, consumers want to know more about the products while online shopping and compare the product’s material, color, and other elements. Therefore, combining VR with E-commerce can improve the user’s shopping experience. This study will focus on the characteristics of VR and E-commerce. This feature can be used to interactively study UI and UX between users and designers to generate design criteria. Experimental design is carried out through the modified SEM-CPU method. Then, we use the think-aloud protocols, Questionnaire for User Interaction Satisfaction, and User Experience Questionnaire to understand the user’s thoughts on UI and UX. Moreover, this study uses focus group to interview experts to obtain expert opinions on VR E-commerce. Induction and integration of data is carried out to produce design criteria by experimental results. Finally, the Delphi method is utilized to validate and evaluate the practicability of the design criterion. Through the “UI and UX design criteria of VR” generated by this study, many important design elements can be proposed and assessed in VR E-commerce. In closing, this study provides design and development suggestions for VR developers to improve the positive influence of UX.