Partial least squares path modeling (PLS-PM) has become very popular in recent years, for measuring concepts that depend on different aspects and that are based on different types of relationships. PLS-PM represents a useful tool to explore relationships and to analyze the influence of the different aspects on the complex phenomenon analyzed. In particular, the use of higher-order constructs has allowed researchers to extend the application of PLS-PM to more advanced and complex models. In this work, our attention is focused on higher-order constructs that include reflective or formative relationships. Even if the dispute between formative models and reflective models is not exactly recent, it is still alive in current literature, for the most part within the context of structural equation models. This paper focuses attention on theoretical and mathematical differences between formative and reflective measurement models within the context of the PLS-PM approach. A simulation study is proposed in order to show how these approaches fit well in different modeling situations. The approaches have been compared using empirical application in a sustainability context. The findings from the simulation and the empirical application can help researchers to estimate and to use the higher-order PLS-PM approach in reflective and formative type models.

Aim: To evaluate whether a dose of 50 mg preserved the architecture of the corpora cavernosa biopsy in man. Methods: 21 patients (54–70 years old) who underwent radical prostatectomy for prostate cancer were treated with sildenafil citrate (50 mg, 3 times a week for 2 months) soon after surgery. They underwent cavernous biopsy before surgery and after 2 months of sildenafil treatment. Biopsy tissues were fixed in formalin, stained with Masson’s trichrome method, and evaluated with the Eureka Interface system with a per-area analysis, and elastic fibers were counted on 10–12 fields (×400) of five serial sections. Results: Two months after surgery the percent of connective tissue in cavernosa samples in all patients did not differ from that before surgery, being between 30 and 40% in the per-area analysis. Similarly, the elastic fiber count did not differ significantly before and after surgery. Conclusions: Sildenafil prevented the progression of fibrosis in prostatectomized patients. Its efficacy seems to result from an antiproliferative effect exerted on fibroblasts.

Nephrolithiasis has a multifactorial origin, and several disorders may coexist in the same patient. We made a basic and a specific laboratory evaluation. The complete metabolic evaluation consisted of a serum chemistry panel: blood sugar level, complete hemogram, serum electrolytes, GOT, GPT, calcium, phosphate, uric acid, and creatinine levels and RIA dosage of PTH, vitamin D₃, cAMP, FT4, FT3 and TSH. The complete analyses of random urinalysis and culture are: (1) dip-stick test: pH, leukocytes/bacteria and Brand’s test, and (2) 24-hour urine collection: calcium, magnesium, oxalate, phosphate, citrate, urea, urate, sodium, creatinine, choride, potassium. It is possible with these tests to identify secondary causes of nephrolithiasis and uncover coexisting problems that may have an impact on patient management. The future for diagnosis, prevention and therapy will be the identification of genetic alterations and related specific dosage.

Surgical liposuction can be considered an effective treatment for gynecomastia, in particular in the very early stages because the breast becomes irreversibly fibrous as the disease progresses. This surgical technique is simple and effective and is therefore to be considered favorable, especially because of the very short hospitalization and the absence of complications.

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The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.

AbstractChronic pain is the central problem in a variety of urological diseases. Pain is an unpleasant sensory and emotional experience associated with either actual or potential tissue damage, or described in terms of such damage. The aim of this research was to update knowledge about the ultrastructural, clinical, psychological and therapeutic aspects of chronic pain in urological diseases, in particular in chronic pelvic syndrome. In this paper we have revisited the most significant and discussed articles published in the last twenty five years, with particular references on the 2008 European Guidelines, searching key words (chronic pelvic pain syndrome, chronic pelvic pain, chronic prostatitis, interstitial cystitis, prostatodynia, urological disease) and data with a high level of evidence. The articles that we have analyzed show that pain is characterized by an initial tissue injury that can lead to sensitization, which is a decrease in the intensity of the stimulus needed to elicit a response by the nerve, involving the peripheral and central nervous systems. The chronic pain state is characterized by loss of inhibitory interneurons, establishment of aberrant excitatory synaptic connections and long-term potentiation of response due to changes in sensitivity of nerve synapses. Stress and hormones might also play a role in central sensitization. Pain also has a cognitive and emotional component. It is very difficult to treat, given the complex nature of the response and the interaction of physiological aspects

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