Administration of daily 5 mg tadalafil improves endothelial function in patients with benign prostatic hyperplasia

Introduction: Tadalafil is a promising phosphodiesterase (PDE) 5 inhibitor prescribed for erectile dysfunction (ED). Daily low dose (5?mg) of tadalafil has also been used for the treatment of male lower urinary tract symptoms (LUTS) associated with benign prostate hyperplasia (BPH). PDE5 inhibitors induce relaxation of smooth muscle cells in the urethra, prostate, bladder neck, and blood vessels. The aim of this study was to investigate the efficacy of tadalafil on vessels endothelial function, in patients with male LUTS symptoms associated with BPH.

Methods: The Institutional Review Board (IRB) approved this clinical study and informed consents had been obtained from 81 BPH patients.

The following male LUTS parameters: international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), voiding volume, max and mean voiding flow on voiding flowmetry examination and post-voiding residual urine (RU) were compared at 0, 1, 3, 6, and 12 months after a daily dose of 5?mg tadalafil.

In addition, erectile function was evaluated by the sexual health inventory for men (SHIM) score and vessels endothelial function and peripheral neuropathy were assessed by the brachial-ankle pulse wave velocity (baPWV), ankle brachial index (ABI), and vibration perception threshold (VPT) at 0, 3, 6, and 12 months after treatment.

Results: The mean age of 81 patients was 66.4?±?11.4 years old. Their prostate size was 30.2?±?22.1?ml.

Male LUTS parameters including IPSS, OABSS, and RU showed significant improvement from 1 to 12 months after tadalafil administration. Max and mean voiding flow was significantly increased at 6 months after tadalafil treatment.

The SHIM score showed significant improvement after 3 months. Whilst, the results of baPWV also showed significant improvement from 3 to 12 months. ABI was also significantly improved at 6 months. However, there was no change in the VPT at any time point.

Conclusions: Tadalafil is effective for both male LUTS and ED. It is also shown that tadalafil improves baPWV, which we can conclude that higher vessels elasticity has been obtained. This major finding of this study shows that tadalafil has the potency to improve vessels endothelial dysfunction in patients with BPH.     

Communicating Geographical Risks in Crisis Management: The Need for Research

In any crisis, there is a great deal of uncertainty, often geographical uncertainty or, more precisely, spatiotemporal uncertainty. Examples include the spread of contamination from an industrial accident, drifting volcanic ash, and the path of a hurricane. Estimating spatiotemporal probabilities is usually a difficult task, but that is not our primary concern. Rather, we ask how analysts can communicate spatiotemporal uncertainty to those handling the crisis. We comment on the somewhat limited literature on the representation of spatial uncertainty on maps. We note that many cognitive issues arise and that the potential for confusion is high. We note that in the early stages of handling a crisis, the uncertainties involved may be deep, i.e., difficult or impossible to quantify in the time available. In such circumstance, we suggest the idea of presenting multiple scenarios.     

Perceived Inflation Persistence

This article constructs and estimates a measure called perceived inflation persistence that can be used to determine if professional forecasters’ inflation forecasts indicate there has been a change in inflation persistence. This measure is built via the implied autocorrelation function that follows from the estimates obtained using a forecaster-specific state-space model. Findings indicate that U.S. perceived inflation persistence has changed since the mid-1990s with more consensus among forecasters at lower levels of persistence. When compared to the autocorrelation function for actual inflation, forecasters typically react less to shocks to inflation than the actual inflation data would suggest.     

Meningococcal serogroup B outbreak response University of Wisconsin-Madison

A meningococcal serogroup B (MenB) outbreak at a large public university prompted an emergency response to immunize undergraduates. Objective: To report on a successful meningococcal serogroup B (MenB) vaccine clinic response at a large public university. Methods: We assembled the team leaders to write this case report. Results: Activation of the emergency plan and points of dispensing required cooperation of many units on campus under the leadership of university health officials with support from Centers for Disease Control and Prevention, state division of public health and the city-county health department. Significant efforts to provide consistent messages to students and parents regarding the outbreak and the availability of the MenB vaccines were made. Volunteers were recruited to staff the clinics alongside university healthcare providers. Over 22,000 doses of vaccine were administered. Conclusion: We report our experience and lessons learned which may be helpful to universities in preventing and responding to disease outbreaks.     

An improved cluster two-stage randomized response model

In this paper, Abdelfatah and Mazloum's (2015) two-stage randomized response model is extended to unequal probability sampling and stratified unequal probability sampling, both with and without replacement. The extended models result in more efficient estimators than Lee et al.'s (2014) estimators of the proportion of the population having a sensitive attribute.     

Treatment Choice With Trial Data: Statistical Decision Theory Should Supplant Hypothesis Testing

Abstract

A central objective of empirical research on treatment response is to inform treatment choice. Unfortunately, researchers commonly use concepts of statistical inference whose foundations are distant from the problem of treatment choice. It has been particularly common to use hypothesis tests to compare treatments. Wald’s development of statistical decision theory provides a coherent frequentist framework for use of sample data on treatment response to make treatment decisions. A body of recent research applies statistical decision theory to characterize uniformly satisfactory treatment choices, in the sense of maximum loss relative to optimal decisions (also known as maximum regret). This article describes the basic ideas and findings, which provide an appealing practical alternative to use of hypothesis tests. For simplicity, the article focuses on medical treatment with evidence from classical randomized clinical trials. The ideas apply generally, encompassing use of observational data and treatment choice in nonmedical contexts.     

Exact distributions of two non-central generalized Wilks's statistics

We derive the exact expressions of the probability density function (pdf) and the cumulative distribution function (cdf) of Wilks's likelihood ratio criterion Λ and Wilks-Lawley's statistic U in the non-central linear and the non-central planar cases. Those expressions are given in rapidly converging infinite series and can be used for numerical computation. For applications, we compute the exact power of these statistics in a multivariate analysis of variance exercise, and show by simulation the precision of our analytic formulae.     

A general central limit theorem and a subsampling variance estimator for α‐mixing point processes

We establish a central limit theorem for multivariate summary statistics of nonstationary α‐mixing spatial point processes and a subsampling estimator of the covariance matrix of such statistics. The central limit theorem is crucial for establishing asymptotic properties of estimators in statistics for spatial point processes. The covariance matrix subsampling estimator is flexible and model free. It is needed, for example, to construct confidence intervals and ellipsoids based on asymptotic normality of estimators. We also provide a simulation study investigating an application of our results to estimating functions.     

基于犹豫直觉模糊语言集均值-标准差偏好距离的多属性决策研究

在犹豫直觉模糊语言集和语言尺度函数的基础上定义了均值-标准差偏好的Hamming距离，并提出了基于犹豫直觉模糊语言集距离TOPSIS和TODIM的多属性决策方法，进一步利用这两种方法对实例问题建筑商的招标方案进行排序，并讨论了偏好参数对排序结果的灵敏度分析。为验证上述方法的有效性，与已有方法对同一实例的排序结果进行了比较分析。