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Keyuri Adhikari,1,* Khalid M Kamal,1,* Ki Jin Jeun,1 David A Nolfi,2 Mohammed Najeeb Ashraf,3 Christopher Zacker4 1Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USA; 2Gumberg Library, Duquesne University, Pittsburgh, PA, USA; 3Medical Affairs, SciVoc Consulting Inc, Toronto, Ontario, Canada; 4Global Value & Access, Cerevel Therapeutics, Cambridge, MA, USA*These authors contributed equally to this workCorrespondence: Khalid M Kamal, Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Email kkamal@hsc.wvu.eduBackground: Schizophrenia is a complex, chronic mental health disorder that confers a substantial disease burden globally. Oral antipsychotic treatments (OATs) are the mainstay for treating early and advanced stages of schizophrenia. Our systematic review aimed to synthesize literature describing real-world effectiveness, economic, and humanistic outcomes of OATs (asenapine, brexpiprazole, cariprazine, iloperidone, lumateperone, lurasidone, olanzapine/samidorphan, paliperidone, and quetiapine) for successful management of the disease.Methods: PubMed, American Psychological Association PsycINFO (EBSCOhost), and Cumulative Index of Nursing and Allied Health Literature were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting real-world effectiveness, costs, humanistic, behavioral (eg, interpersonal relations, suicide ideation), medication adherence, and product-switching outcomes for selected OATs published in English from January 2010 to March 2022 were identified and evaluated qualitatively.Results: We included 48 studies with different designs providing extensive evidence on schizophrenia. All studies were conducted in countries outside of the United States. In most studies, antipsychotic medications were more effective than placebo, suggesting their value in the management of schizophrenia. Sixteen studies measured the economic outcomes of OATs. Eight studies assessed humanistic outcomes, while one reported behavioral outcomes in three second-generation antipsychotics. Medication adherence was described in two studies, while five studies evaluated product switching. Non-adherence was commonly reported for OATs. Medication non-adherence and treatment discontinuation were predominant factors contributing to the economic burden of schizophrenia.Conclusion: Our research showcased a significant knowledge gap across OATs spanning the humanistic and behavioral outcomes and medication adherence and switching, suggesting a need for robust evidence generation to help clinicians and payers make informed decisions regarding treatment opportunities and cost-effective strategies for patients with schizophrenia.Keywords: schizophrenia, behavioral outcomes, cost-effectiveness, humanistic outcomes, medication adherence, product switching

Mitigating methane (CH 4 ) emissions using methanotrophs (methane-oxidizing bacteria, MOB), is a simple, energy efficient and cheap technology. The abundance and distribution of MOB in the environmental samples is critical for efficient removal of emitted CH 4 from any source. This study evaluated the performance of farm soils without and with cheap, easily accessible bulking materials as sustainable hybrid biofilter media. Soil-only biofilters removed up to 865 ± 19 g CH 4 m -3 d -1 with well-drained organic carbon-rich soils compared with 264 ± 14 g CH 4 m -3 d -1 for poorly drained soil. The removal efficiency decreased with increasing flow rate (0.16→0.24 L min -1 ) and subsequent priming could not return soil biofilters to their previous removal rate.Hybrid biofilters using organic, carbon-rich soils and compost removed up to 2698 g CH 4 m -3 d -1 (flow rate 0.35 L min -1 ). Increasing CH 4 flow rates also reduced their efficiency, but the hybrid biofilters with compost quickly regained most of their efficiency and removed up to 2262 g CH 4 m -3 d -1 (flow rate 0.3 L min -1 ) after remixing of biofilter media. These results show that hybrid biofilters removed higher CH 4 than soil-only biofilters and were also more resilient. The MOB gene abundance results complement the CH 4 removal capacity of both soil-only and hybrid biofilter materials used. The more aerobic, carbon-rich soils had more abundant MOB than the poorly drained soil. The most porous hybrid biofilter with compost and more available nutrients to sustain bacterial growth and activity had the highest MOB abundance and removed the most CH 4 .

Extreme weather and climate events have become more frequent and directly affect the ecological structure and function of integrated grazing lands. While the Great Plains have experienced a long history of regular disturbances from drought and floods, grazing, and fires, the increased frequency and magnitude of these disturbances can reduce ecological resilience, largely depending on management practices. Alternative strategies designed to adaptively manage grazing land resources based on the ecology of the system should increase the resistance and resilience to disturbances when compared to prevailing practices. Determining the ecologic and economic value of alternative strategies will require long-term evaluations across large spatial scales. The Long-Term Agroecosystem Research network has been established to evaluate the differences between alternative and prevailing practices among 18 strategically located sites and across decadal time scales throughout the continental United States. A key integrated grazing land site within this network is the Texas Gulf located at the Riesel Watersheds in the Blackland Prairie of Central Texas. At this study site, the differences between alternative and prevailing grazing management strategies are now being evaluated. The alternative strategy was designed using a combination of knowledge of the site and species ecology with modern-day tools and technologies. Alternatively, the prevailing practice implements a conventional year-round continuous grazing system with heavy reliance on hay and supplemental protein during winter. Results will provide grazing land managers with economically viable adaptive management choices for increasing ecological resilience following extreme and frequent disturbance events., (© 2024 The Author(s). Journal of Environmental Quality published by Wiley Periodicals LLC on behalf of American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Texas Gulf is one of the 18 regional sites that is part of the USDA-ARS Long-Term Agroecosystem Research (LTAR) network and focuses on cropland and integrated grazing land research in Central Texas, addressing challenges posed by soil characteristics, climate variability, and urbanization. This paper provides brief site descriptions of the two Cropland Common Experiments being conducted in the Texas Gulf LTAR region, emphasizing conservation tillage practices and precision agriculture techniques. The plot-scale study is located in Temple, TX, at the USDA-ARS Grassland, Soil and Water Research Laboratory and examines conventional tillage, strip tillage, and no tillage practices. The field-scale study, located in Riesel, TX, at the USDA-ARS Riesel Watersheds, assesses the impact of no tillage, cover crops, fertility management, adaptive management, and precision conservation on crop yield, profitability, and environmental footprint. Key measurements include soil and plant analyses, greenhouse gas fluxes, runoff water quantity and quality, and field operations recorded with precision agriculture equipment. Despite challenges posed by urban encroachment, future research aims to incorporate new technologies, such as unmanned ground vehicles, to enhance sustainability and productivity of the agricultural landscape. These experiments provide valuable insights for stakeholders, contributing to the development of sustainable agricultural practices tailored to the unique challenges within the Texas Gulf LTAR region., (© 2024 The Author(s). Journal of Environmental Quality published by Wiley Periodicals LLC on behalf of American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America.)

The male-limited inheritance of Y chromosomes favors alleles that increase male fitness, often at the expense of female fitness. Determining the mechanisms underlying these sexually antagonistic effects is challenging because it can require studying Y-linked alleles while they still segregate as polymorphisms. We used a Y chromosome polymorphism in the house fly, Musca domestica , to address this challenge. Two male determining Y chromosomes (Y M and III M ) segregate as stable polymorphisms in natural populations, and they differentially affect multiple traits, including male courtship performance. We identified differentially expressed genes encoding odorant binding proteins (in the Obp56h family) as candidate agents for the courtship differences. Through network analysis and allele-specific expression measurements, we identified multiple genes on the house fly III M chromosome that could serve as trans regulators of Obp56h gene expression. One of those genes is homologous to Drosophila melanogaster CG2120 , which encodes a transcription factor that binds near Obp56h . Upregulation of CG2120 in D. melanogaster nervous tissues reduces copulation latency, consistent with this transcription factor acting as a negative regulator of Obp56h expression. The transcription factor gene, which we name speed date , demonstrates a molecular mechanism by which a Y-linked gene can evolve male-beneficial effects., Competing Interests: PD, AM, OH, AO, VS, TT, RM No competing interests declared, KA Kiran Adhikari is affiliated with Oxford Biomedica Solutions LLC. The author has no financial interests to declare, (© 2024, Delclos, Adhikari et al.)

Background and Aims: Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well-being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal., Methods: A cross-sectional study was conducted among 412 undergraduate healthcare students using a self-administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs., Results: Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1-2 servings/day) was reported by 79.9% students. Short sleep duration (5-6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs ( p  < 0.01)., Conclusion: Multiple HRBs were highly prevalent among the students. A considerable proportion demonstrated a clustering of risky lifestyle factors, which were linked to poor mental health. Interventions should address academic burden, promote positive health behaviors, and target mental well-being in this vulnerable group., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Background and Objective: Generative artificial intelligence models are among the most promising and widely used tools used in health care. This review investigates GPT-4 answers to decision-making questions regarding the diagnosis and treatment of urolithiasis across several clinical settings and their correspondence to the current European Association of Urology (EAU) guidelines., Methods: In March 2024, the GPT-4 model was asked 11 questions, containing a brief description of a patient with urolithiasis. All questions were grouped according to urolithiasis care step: diagnosis, urgent care, scheduled intervention, and metaphylaxis. When responses were received, compliance with the current EAU guidelines was assessed by experienced urologists., Key Findings and Limitations: Although all responses were provided with information that corresponded to EAU guidelines, six of the 11 answers were associated with missed guideline-provided parts, and incorrect data were given in eight of the 11 answers. GPT-4 is relatively safe in the initial diagnostic flow of patients suspected of having stones within the urinary tract and during treatment planning; however, its understanding of all the nuances of metaphylaxis leaves much to be desired and is far from the dogma given in the EAU guidelines. Moreover, GPT-4 knowledge of strategy and algorithm is not always aligned with the EAU guidelines., Conclusions and Clinical Implications: Despite the fact that from the perspective of patients with urolithiasis, GPT-4 is capable of answering their questions well, the specificity of questions from urologists is labor intensive for its current version, and necessitates the ability to interpret it correctly and further attempts to improve it. While some aspects of diagnostics are more accurate, these struggle with surgical planning and algorithms in line with the EAU guidelines., Patient Summary: The generative artificial intelligence (AI) model GPT-4 is capable of answering urology-related questions, but lacks detailed responses. Although some aspects of the diagnostics are accurate, knowledge of surgical planning is not in line with the European Association of Urology guidelines. Future improvements should focus on efforts to enhance the accuracy, reliability, and clinical relevance of AI tools in urology., (© 2024 The Author(s).)

There is a high prevalence of antisocial personality disorder (ASPD) in individuals affected by substance use disorders (SUD). However, there is limited information on the specific patterns of association of ASPD with SUD severity and specific SUD diagnostic criteria. We investigated the association of alcohol, cannabis, cocaine, opioid, and tobacco use disorders (AUD, CanUD, CocUD, OUD, and TUD, respectively) in 1660 individuals with ASPD and 6640 controls matched by sex (24% female), age, and racial/ethnic background in a sample ascertained for addiction-related traits. Generalized linear regressions were used to test ASPD with respect to the five DSM-5 SUD diagnoses, their severity (i.e., mild, moderate, severe), and their diagnostic criteria. We found that ASPD is associated with the diagnosis and severity of AUD (Odds Ratio, ORs = 1.89 and 1.25), CanUD (ORs = 2.13 and 1.32), and TUD (ORs = 1.50 and 1.21) (ps < 0.003). Of the specific diagnostic criteria, the "hazardous use" criterion showed the strongest association with ASPD across the five SUDs investigated (from OR TUD  = 1.88 to OR CanUD  = 1.37). However, when criteria of different SUDs were included in the same model, ASPD was independently associated only with TUD "hazardous use" and CocUD "attempts to quit". Attempting to quit cocaine was inversely related to the presence of ASPD and remained significant (OR = 0.57, 95% confidence interval = 0.36-0.89) after controlling for interactive effects with sex. The current work provides novel insights into ASPD-SUD comorbidity, supporting the existence of different SUD patterns among individuals affected by ASPD., (© 2024. The Author(s).)

Personality is influenced by both genetic and environmental factors and is associated with other psychiatric traits such as anxiety and depression. The 'big five' personality traits, which include neuroticism, extraversion, agreeableness, conscientiousness and openness, are a widely accepted and influential framework for understanding and describing human personality. Of the big five personality traits, neuroticism has most often been the focus of genetic studies and is linked to various mental illnesses, including depression, anxiety and schizophrenia. Our knowledge of the genetic architecture of the other four personality traits is more limited. Here, utilizing the Million Veteran Program cohort, we conducted a genome-wide association study in individuals of European and African ancestry. Adding other published data, we performed genome-wide association study meta-analysis for each of the five personality traits with sample sizes ranging from 237,390 to 682,688. We identified 208, 14, 3, 2 and 7 independent genome-wide significant loci associated with neuroticism, extraversion, agreeableness, conscientiousness and openness, respectively. These findings represent 62 novel loci for neuroticism, as well as the first genome-wide significant loci discovered for agreeableness. Gene-based association testing revealed 254 genes showing significant association with at least one of the five personality traits. Transcriptome-wide and proteome-wide analysis identified altered expression of genes and proteins such as CRHR1, SLC12A5, MAPT and STX4. Pathway enrichment and drug perturbation analyses identified complex biology underlying human personality traits. We also studied the inter-relationship of personality traits with 1,437 other traits in a phenome-wide genetic correlation analysis, identifying new associations. Mendelian randomization showed positive bidirectional effects between neuroticism and depression and anxiety, while a negative bidirectional effect was observed for agreeableness and these psychiatric traits. This study improves our comprehensive understanding of the genetic architecture underlying personality traits and their relationship to other complex human traits., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Background: The cysteine-aspartic acid protease caspase-3 is recognized as the main executioner of apoptosis in cells responding to specific extrinsic and intrinsic stimuli. Caspase-3 represents an interesting biomarker to evaluate treatment response, as many cancer therapies exert their effect by inducing tumour cell death. Previously developed caspase-3 PET tracers were unable to reach routine clinical use due to low tumour uptake or lack of target selectivity, which are two important requirements for effective treatment response evaluation in cancer patients. Therefore, the goal of this study was to develop and preclinically evaluate novel caspase-3-selective activity-based probes (ABPs) for apoptosis imaging., Results: A library of caspase-3-selective ABPs was developed for tumour apoptosis detection. In a first attempt, the inhibitor Ac-DW3-KE (Ac-3Pal-Asp-βhLeu-Phe-Asp-KE) was 18 F-labelled on the N-terminus to generate a radiotracer that was incapable of adequately detecting an increase in apoptosis in vivo. The inability to effectively detect active caspase-3 in vivo was likely attributable to slow binding, as demonstrated with in vitro inhibition kinetics. Hence, a second generation of caspase-3 selective ABPs was developed based on the Ac-ATS010-KE (Ac-3Pal-Asp-Phe(F 5 )-Phe-Asp-KE) with greatly improved binding kinetics over Ac-DW3-KE. Our probes based on Ac-ATS010-KE were made by modifying the N-terminus with 6 different linkers. All the linker modifications had limited effect on the binding kinetics, target selectivity, and pharmacokinetic profile in healthy mice. In an in vitro apoptosis model, the least hydrophilic tracer [ 18 F]MICA-316 showed an increased uptake in apoptotic cells in comparison to the control group. Finally, [ 18 F]MICA-316 was tested in an in vivo colorectal cancer model, where it showed a limited tumour uptake and was unable to discriminate treated tumours from the untreated group, despite demonstrating that the radiotracer was able to bind caspase-3 in complex mixtures in vitro. In contrast, the phosphatidylethanolamine (PE)-binding radiotracer [ 99m Tc]Tc-duramycin was able to recognize the increased cell death in the disease model, making it the best performing treatment response assessment tracer developed thus far., Conclusions: In conclusion, a novel library of caspase-3-binding PET tracers retaining similar binding kinetics as the original inhibitor was developed. The most promising tracer, [ 18 F]MICA-316, showed an increase uptake in an in vitro apoptosis model and was able to selectively bind caspase-3 in apoptotic tumour cells. In order to distinguish therapy-responsive from non-responsive tumours, the next generation of caspase-3-selective ABPs will be developed with higher tumour accumulation and in vivo stability., (© 2024. The Author(s).)

Background: The introduction provides an in-depth understanding of the acetabulum's anatomical structure and its significance in hip joint biomechanics. It highlights the variability in acetabular morphology among normal individuals, emphasizing the importance of establishing normal ranges for accurate diagnosis of acetabular deformities. The section also underscores the role of geographical, racial, and anatomical factors in influencing acetabular parameters, crucial for orthopedic interventions and surgical outcomes like total hip arthroplasty. Furthermore, it discusses the limitations of traditional imaging methods and the necessity of advanced techniques like computed tomography (CT) scans for precise evaluation and preoperative planning in hip surgeries., Materials and Methods: The study adopted a cross-sectional design at a tertiary care center, enrolling 94 participants using purposive sampling for CT evaluation of acetabular morphology. Morphometric parameters including center edge angle of Wiberg, acetabular angle of Sharp, acetabular version, acetabular depth, and joint space width were measured using CT scans, while BMI categorization and statistical analyses were conducted to explore gender-based and side-based differences and correlations with BMI and age., Results: The study included 94 patients with ages ranging from 20 to 82 years (mean age: 49±15 years), predominantly in the 41-50 years age group. Female participants slightly outnumbered males. The mean BMI was 23.5±3.2 kg/m 2 , with variations across different age and BMI categories. Most morphometric parameters showed no significant differences between sexes or sides but did correlate with age and BMI, notably the center edge angle positively correlating with BMI in males., Conclusions: The study found correlations between morphometric parameters of the acetabulum and both age and BMI. Specifically, the center edge angle demonstrated a positive correlation with BMI in males and a weak positive correlation with age. Acetabular angle showed a negative correlation with BMI, highlighting potential implications for understanding hip joint health and conditions related to BMI changes., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: This study aimed to assess the erectogenic properties of isoliquiritigenin taking sildenafil (SDF) as the standard., Methods: The binding affinity of isoliquiritigenin (ISL) with the erectile marker proteins (endothelial nitric oxide synthase [eNOS] and enzyme phosphodiesterase type 5 [PDE5]) was investigated using Autodock Vina, which was validated using molecular dynamics simulation. Furthermore, the effect of ISL on the eNOS and PDE5 messenger ribonucleic acid (mRNA) expression and the sexual behavior of mice was investigated, along with the assessment of the pharmacokinetics of ISL., Key Findings: The results revealed that the binding affinity of ISL-eNOS/PDE5 and SDF-eNOS/PDE5 was in the range of -7.5 to -8.6 kcal/mol. The ISL-eNOS/PDE5 complexes remained stable throughout the 100 ns simulation period. Root mean square deviation, Rg, SASA, hydrogen, and hydrophobic interactions were similar between ISL-eNOS/PDE5 and SDF-eNOS/PDE5. Analysis of mRNA expressions in paroxetine (PRX)-induced ED mice showed that the co-administration of PRX with ISL reduced PDE5 and increased eNOS mRNA expression, similar to the co-administered group (PRX+SDF). The sexual behavior study revealed that the results of PRX+ISL were better than those of the PRX+SDF group. Pharmacokinetic evaluation further demonstrated that ISL possesses drug-like properties., Conclusions: The results showed that ISL is equally potent as SDF in terms of binding affinity, specific pharmacological properties, and modulating sexual behavior., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Maternal depression and anxiety occurring beyond the 1-year postpartum period can lead to significant suffering for both mother and child. This study aimed to systematically review and synthesize studies reporting the prevalence and incidence of maternal depression and anxiety beyond 1 year post-childbirth., Methods: A systematic literature review of the PsycINFO, Medline, and Embase databases identified studies reporting on the prevalence and/or incidence of depression and/or anxiety among mothers between 1 and 12 years post-childbirth. The quality of the included studies was assessed. Findings were synthesized qualitatively., Results: Twenty-one studies were identified that met the inclusion and exclusion criteria. All studies reported the prevalence of depression, with 31 estimates ranging from 6.6% at 3 to 11 years post-childbirth to 41.4% at 3 to 4 years post-childbirth. Five of these studies also reported the prevalence of depression in subgroups (e.g., ethnic origin, income, marital status). Four studies reported the prevalence of anxiety, with nine estimates ranging from 3.7% at 5 years post-childbirth to 37.0% at 3 to 4 years post-childbirth. Only one study reported incidence. The quality of the included studies was variable, with most studies scoring above 7/9., Conclusion: Maternal anxiety and depression remain prevalent beyond the first year postpartum, particularly in marginalized subgroups. Current observational studies lack consistency and produce highly variable prevalence rates, calling for more standardized measures of depression and anxiety. Clinical practice and research should consider the prevalence of maternal anxiety and depression beyond this period., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: To report outcomes of multicenter series of penile cancer patients undergoing robot-assisted video endoscopic inguinal lymph node dissection (RA-VEIL). Materials and Methods: In this retrospective analysis from 3 tertiary care centers in India, consecutive intermediate-/high-risk carcinoma penis (CaP) patients with nonpalpable inguinal lymphadenopathy and/or nonbulky (<3 cm) mobile inguinal lymphadenopathy undergoing RA-VEIL were included. Patients with matted/bulky (>3 cm) and fixed lymphadenopathy were excluded. Demographic, clinical, and intraoperative data were recorded. Perioperative complications were graded by the Clavien-Dindo classification (CDC). The International Society of Lymphology (ISL) {0-III} grading was used for the assessment of lymphedema. Incidence and pattern of recurrences were assessed on follow-up. Results: From January 1, 2011, to September 30, 2023, 115 patients (230 groins) underwent bilateral RA-VEIL for CaP. The median age of the cohort was 60 (50-69) years. Clinically palpable (either unilateral or bilateral) inguinal lymphadenopathy was seen in 54 patients (47%). The "per groin" median operative time was 120 (100-140) minutes with median lymph node yield of 12 (9-16). No complications were recorded in 87.8% groins operated, with major complications (CDC 3) seen in 2.6% groins. At a median follow-up of 13.5 months, 13 patients had documented recurrences and there were 10 cancer-related deaths. No port-site recurrences were observed. No/minimal lymphedema (ISL 0/I) was seen in 94% legs. Conclusion: RA-VEIL demonstrates safety and oncologic efficacy in penile cancer patients presenting with clinically nonpalpable and/or nonbulky inguinal lymphadenopathy, with favorable functional outcomes.

Background: Social capital can be used as a conceptual framework to include social context as a predictor of human papillomavirus (HPV) vaccination and cervical cancer screening behaviours. However, the effectiveness of interventions that use social capital as a mechanism to improve uptake of immunization and screening remains elusive., Objective: To synthesize empirical evidence on the impact of social capital interventions on HPV immunization and cervical cancer screening and describe key characteristics of such interventions., Methods: Using a rapid review methodology, a search of literature published between 2012 and 2022 was conducted in four databases. Two researchers assessed the studies according to inclusion criteria in a three-step screening process. Studies were assessed for quality and data concerning social capital and equity components and intervention impact were extracted and analyzed using narrative synthesis., Results: Seven studies met the inclusion criteria. Studies found improved knowledge, beliefs and intentions regarding HPV immunization and cervical cancer screening. None of the studies improved uptake of immunization; however, three studies found post-intervention improvements in uptake of cervical cancer screening. All studies either tailored their interventions to meet the needs of specific groups or described results for specific disadvantaged groups., Conclusion: Limited evidence suggests that interventions that consider and reflect local context through social capital may be more likely to increase the uptake of HPV immunization and cervical cancer screening. However, further research must be done to bridge the gap in translating improvements in knowledge and intention into HPV immunization and cervical cancer screening behaviours., Competing Interests: Competing interests None.

Objective: We assessed the availability and readiness of health facilities to provide cervical cancer screening services in Nepal., Design: Cross-sectional study., Setting: We used secondary data from a nationally representative 2021 Nepal Health Facility Survey, specifically focusing on the facilities offering cervical cancer screening services., Outcome Measures: We defined the readiness of health facilities to provide cervical cancer screening services using the standard WHO service availability and readiness assessment manual., Results: The overall readiness score was 59.1% (95% CI 55.4% to 62.8%), with more equipment and diagnostic tests available than staff and guidelines. Public hospitals (67.4%, 95% CI 63.0% to 71.7%) had the highest readiness levels. Compared with urban areas, health facilities in rural areas had lower readiness. The Sudurpashchim, Bagmati and Gandaki provinces had higher readiness levels (69.1%, 95% CI 57.7% to 80.5%; 60.1%, 95% CI 53.4% to 66.8%; and 62.5%, 95% CI 56.5% to 68.5%, respectively). Around 17% of facilities had trained providers and specific guidelines to follow while providing cervical cancer screening services. The basic healthcare centres (BHCCs) had lower readiness than private hospitals. Facility types, province and staff management meetings had heterogeneous associations with three conditional quantile scores., Conclusion: The availability of cervical cancer screening services is limited in Nepal, necessitating urgent action to expand coverage. Our findings suggest that efforts should focus on improving the readiness of existing facilities by providing training to healthcare workers and increasing access to guidelines. BHCCs and healthcare facilities in rural areas and Karnali province should be given priority to enhance their readiness., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: To summarise the uses, outcomes and implementation of interactive voice response (IVR) as a tobacco cessation intervention., Data Sources: A systematic review was conducted. Searches were performed on 3 May 2023. The strategies used keywords such as "tobacco cessation", "smoking reduction" and "interactive voice recording". Ovid MEDLINE ALL, Embase, APA PsycINFO, CINAHL, Cochrane Library and Web of Science were searched. Grey literature searches were also conducted., Study Selection: Titles and abstracts were assessed by two independent reviewers. Studies were included if IVR was an intervention for tobacco cessation for adults; any outcomes were reported and study design was comparative. Any abstract included by either reviewer proceeded to full-text review. Full texts were reviewed by two independent reviewers., Data Extraction: Data were independently extracted by two reviewers using a standardised form. The Risk of Bias Tool for Randomised Trials and the Risk of Bias in Non-Randomised Studies of Interventions tools were used to assess study quality., Data Synthesis: Of 308 identified abstracts, 20 moderate-quality to low-quality studies were included. IVR was used standalone or adjunctly as a treatment, follow-up or risk-assessment tool across populations including general smokers, hospitalised patients, quitline users, perinatal women, patients with cancer and veteran smokers. Effective studies found that IVR was delivered more frequently with shorter follow-up times. Significant gaps in the literature include a lack of population diversity, limited implementation settings and delivery schedules, and limited patient and provider perspectives., Conclusions: While the evidence is weak, IVR appears to be a promising intervention for tobacco cessation. However, pilot programmes and research addressing literature gaps are necessary., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiologic agent of coronavirus disease 2019 (COVID-19), has posed significant challenges to global health. While much attention has been directed towards understanding the primary mechanisms of SARS-CoV-2 infection, emerging evidence suggests co-infections or superinfections with other viruses may contribute to increased morbidity and mortality, particularly in severe cases of COVID-19. Among viruses that have been reported in patients with SARS-CoV-2, seropositivity for Human cytomegalovirus (HCMV) is associated with increased COVID-19 risk and hospitalization. HCMV is a ubiquitous beta-herpesvirus with a seroprevalence of 60-90 % worldwide and one of the leading causes of mortality in immunocompromised individuals. The primary sites of latency for HCMV include CD14 + monocytes and CD34 + hematopoietic cells. In this study, we sought to investigate SARS-CoV-2 infection of CD14 + monocytes latently infected with HCMV. We demonstrate that CD14 + cells are susceptible and permissive to SARS-CoV-2 infection and detect subgenomic transcripts indicative of replication. To further investigate the molecular changes triggered by SARS-CoV-2 infection in HCMV-latent CD14 + monocytes, we conducted RNA sequencing coupled with bioinformatic differential gene analysis. The results revealed significant differences in cytokine-cytokine receptor interactions and inflammatory pathways in cells superinfected with replication-competent SARS-CoV-2 compared to the heat-inactivated and mock controls. Notably, there was a significant upregulation in transcripts associated with pro-inflammatory response factors and a decrease in anti-inflammatory factors. Taken together, these findings provide a basis for the heightened inflammatory response, offering potential avenues for targeted therapeutic interventions among HCMV-infected severe cases of COVID-19. SUMMARY: COVID-19 patients infected with secondary viruses have been associated with a higher prevalence of severe symptoms. Individuals seropositive for human cytomegalovirus (HCMV) infection are at an increased risk for severe COVID-19 disease and hospitalization. HCMV reactivation has been reported in severe COVID-19 cases with respiratory failure and could be the result of co-infection with SARS-CoV-2 and HCMV. In a cell culture model of superinfection, HCMV has previously been shown to increase infection of SARS-CoV-2 of epithelial cells by upregulating the human angiotensin-converting enzyme-2 (ACE2) receptor. In this study, we utilize CD14 + monocytes, a major cell type that harbors latent HCMV, to investigate co-infection of SARS-CoV-2 and HCMV. This study is a first step toward understanding the mechanism that may facilitate increased COVID-19 disease severity in patients infected with SARS-CoV-2 and HCMV., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest with the contents of this article., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Genitourinary fistulas are a well-recognized complication of various gynecological, obstetrical, and endourological interventions. The incidence of uretero-uterine fistula is very rare compared to other genitourinary fistulas. Few cases are reported in literature regarding the uretero- uterine fistula following manual vacuum aspiration of retained product of placenta. We report a case of 28 year multi-parous women who had presented with complain of involuntary passage of urine following manual vacuum aspiration for retained product of conception. Common tests for suspicion of uretero-uterine fistula include cystoscopy, triple swab test, and CT urography. Our patient was diagnosed in CT urography and was managed by exploratory laparotomy with end-to-end anastomosis of the right ureter, DJ stenting, and repair of a uterine perforation. Due to relatively rare incidence of this condition, there has not been a specific guideline for management. A multimodality and multidisciplinary approach have been proposed for the management of uretero-uterine fistulas., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Background: To compare various lower pole pelvicalyceal anatomical factors of stone bearing kidney with contralateral normal kidneys and determine whether these factors predispose to stone formation in one kidney., Methods: A descriptive study was done with Computed Tomography of 54 patients with solitary lower pole calculus in one kidney and normal contralateral kidney were included. Various lower pole pelvicalyceal anatomical factors like infundibulopelvic angle, infundibular width, infundibular length and calyceopelvic height of both stone bearing and contralateral kidneys were measured and compared for any differences Results: The mean infundibular width was 5.4±1.9mm on stone bearing kidneys and 5.2±2.05mm on contralateral normal kidneys. The mean infundibular length was 18.9±4.4mm on stone bearing kidneys and 18.8±3.9mm on contralateral normal kidneys. The mean infundibulopelvic angle was 47.9±10.8° on stone bearing kidneys and 47.6±11.2° on contralateral kidneys. The mean calyceopelvic height was 15.7±4.6mm on stone bearing kidneys and 15.5±3.9mm (range 7.5to 23.1mm) on contralateral kidneys. There were no statistically significant differences between stone bearing and contralateral normal kidneys in respect to these pelvicalyceal anatomical factors., Conclusions: In this study, we found no significant difference in lower pole pelvicalyceal anatomical factors between stone bearing kidneys and contralateral normal kidneys and therefore these factors do not seem to have significant role in stone formation in one kidney compared with the other.

The purpose of this review is to analyze the trend in optical features and flexibility changes of flexible ureteroscopes over the past decades, and determine the correlation of individual parameters with release period as well as with dimensional parameters. Flexible ureteroscopes mentioned in the literature or those commercially available were searched. To minimize the search bias, the instruments were grouped by release date time-periods of < 2000 year, 2000-2009, 2010-2019, and 2020 onwards. The final review included only those instrument models for which data on minimum and maximum depth of field, field of view, direction of view, and deflection degree had been determined. The correlation among features investigated as well as with release period was also determined. 61 models of flexible ureteroscopes (27 fibreoptic and 34 digital scopes) were included. Among the different features investigated among fiberoptic endoscopes, minimum depth of field positively and negatively correlated with channel size and field of view, respectively, whereas maximum depth of view and field of view positively correlated with overall shaft and deflection degree, respectively. Up and down deflection strongly correlated with each other and both were negatively proportional to the distal tip size. For the digital endoscopes, minimum depth of field negatively and positively correlated with distal tip size and working length, respectively. Maximum depth of field positively correlated with field of view, whereas the latter was negatively proportional to the overall shaft. As for the fiberoptic counterparts, up and down deflection strongly correlated with each other. Field of view, up and down deflection of fiberoptic flexible ureteroscopes, were significantly increased among fiberoptic and digital endoscopes over decades. As flexible ureteroscopy technology has evolved, there has been a trend towards increasing field of view with up and down deflection. Given the importance of scope ergonomics, one aspect of this popularity is the improvement of optical characteristics and deflection degree, which significantly correlates with the release period., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Epiretinal membrane (ERM) is a common retinal condition characterized by the presence of fibrocellular tissue on the retinal surface, often with visual distortion and loss of visual acuity. We studied European American (EUR), African American (AFR), and Latino (admixed American, AMR) ERM participants in the Million Veteran Program (MVP) for genome-wide association analysis-a total of 38,232 case individuals and 557,988 control individuals. We completed a genome-wide association study (GWAS) in each population separately, and then results were meta-analyzed. Genome-wide significant (GWS) associations were observed in all three populations studied: 31 risk loci in EUR subjects, 3 in AFR, and 2 in AMR, with 48 in trans-ancestry meta-analysis. Many results replicated in the FinnGen sample. Several GWS variants associate to alterations in gene expression in the macula. ERM showed significant genetic correlation to multiple traits. Pathway enrichment analyses implicated collagen and collagen-adjacent mechanisms, among others. This well-powered ERM GWAS identified novel genetic associations that point to biological mechanisms for ERM., Competing Interests: Declaration of interests J.G. is named as an inventor on PCT patent application #15/878,640 entitled “Genotype-guided dosing of opioid agonists,” filed January 24, 2018, and issued on January 26, 2021, as US Patent No. 10900082. J.G. is paid for editorial work for the journal Complex Psychiatry (Karger). D.E. is an ad hoc consultant for Alcon, Dutch Ophthalmic, GelMEDIX, and Genentech; reports research funding from Neurotech and Unity Biotechnology; is a member of the Advisory Board and Stockholder for InGel Therapeutics, Pykus Therapeutics, and RetMap; reports being Advisor, Patents, Royalties, and Stockholder in Aldeyra Therapeutics; and is a member of the Data Safety Monitoring Board for Asclepix. M.B.S. has in the past 3 years received consulting income from Acadia Pharmaceuticals, Aptinyx, atai Life Sciences, BigHealth, Bionomics, BioXcel Therapeutics, Boehringer Ingelheim, Clexio, Eisai, EmpowerPharm, Engrail Therapeutics, Janssen, Jazz Pharmaceuticals, NeuroTrauma Sciences, PureTech Health, Sumitomo Pharma, and Roche/Genentech. M.B.S. has stock options in Oxeia Biopharmaceuticals and EpiVario. He has been paid for his editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry). He is on the scientific advisory board for the Brain and Behavior Research Foundation and the Anxiety and Depression Association of America., (Published by Elsevier Inc.)

Background: Trans-cyclooctenes (TCOs) are highly strained alkenes with remarkable reactivity towards tetrazines (Tzs) in inverse electron-demand Diels-Alder reactions. Since their discovery as bioorthogonal reaction partners, novel TCO derivatives have been developed to improve their reactivity, stability, and hydrophilicity, thus expanding their utility in diverse applications., Main Body: TCOs have garnered significant interest for their applications in biomedical settings. In chemical biology, TCOs serve as tools for bioconjugation, enabling the precise labeling and manipulation of biomolecules. Moreover, their role in nuclear medicine is substantial, with TCOs employed in the radiolabeling of peptides and other biomolecules. This has led to their utilization in pretargeted nuclear imaging and therapy, where they function as both bioorthogonal tags and radiotracers, facilitating targeted disease diagnosis and treatment. Beyond these applications, TCOs have been used in targeted cancer therapy through a "click-to-release" approach, in which they act as key components to selectively deliver therapeutic agents to cancer cells, thereby enhancing treatment efficacy while minimizing off-target effects. However, the search for a suitable TCO scaffold with an appropriate balance between stability and reactivity remains a challenge., Conclusions: This review paper provides a comprehensive overview of the current state of knowledge regarding the synthesis of TCOs, and its challenges, and their development throughout the years. We describe their wide ranging applications as radiolabeled prosthetic groups for radiolabeling, as bioorthogonal tags for pretargeted imaging and therapy, and targeted drug delivery, with the aim of showcasing the versatility and potential of TCOs as valuable tools in advancing biomedical research and applications., (© 2024. The Author(s).)

Potency and urinary continence are adversely affected post-prostatectomy. The primary objective is oncological safety by ensuring negative surgical margins (NSM) and best functional recovery through nerve preservation in appropriate patients. NeuroSAFE technique of intra-operative frozen-section (IFS) analysis was devised for comprehensive assessment of surgical margins adjacent to the neurovascular tissue surface of the prostate. We analyzed our initial experience with this technique. Five NS-RARPs were performed utilizing the NeuroSAFE technique between October 2021 and February 2022. Patient demographics, disease stage, operative console time, post-operative complications, final histopathology, biochemical recurrence (BCR), erectile function, and urinary continence were recorded. The mean age of patients was 59.2 ± 1.3 years. All had clinically organ-confined disease with ISUP grade ≤ 3. The mean operative time of NS-RARP with NeuroSAFE was 240 ± 21 min and average NeuroSAFE time was 45 ± 3.8 min. All patients had NSM on IFS. No patient had Clavien-Dindo grade > 1 complications. Margins were negative on final histopathology. No patient had BCR at 6 and 12 weeks. Three patients were able to have sexual intercourse and only one patient required single precaution pad at 12 weeks. NeuroSAFE is feasible and can ensure intra-operative oncological safety of the NS procedure. Moreover, it gives the opportunity to convert positive surgical margin to prognostically favorable NSM by secondary resection. Our initial experience which is the first in India is encouraging with favorable functional outcomes. Large prospective studies and longer follow-up are required specially to evaluate the oncological benefit., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Indian Association of Surgical Oncology 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background and Objective: Colorectal cancer (CRC) screening is effective at reducing the incidence and mortality of CRC. To address suboptimal CRC screening rates, a faecal immunochemical test (FIT) multicomponent intervention was piloted in four urban multidisciplinary primary care clinics in Alberta from September 2021 to April 2022. The interventions included in-clinic distribution of FIT kits, along with FIT-related patient education and follow-up. This study explored barriers and facilitators to implementing the intervention in four primary clinics using the Consolidated Framework for Implementation Research (CFIR)., Methods: In-depth qualitative semistructured key informant interviews, guided by the CFIR, were conducted with 14 participants to understand barriers and facilitators of the FIT intervention implementation. Key informants were physicians, quality improvement facilitators and clinical staff. Interviews were analysed following an inductive-deductive approach. Implementation barriers and facilitators were organised and interpreted using the CFIR to facilitate the identification of strategies to mitigate barriers and leverage facilitators for implementation at the clinic level., Results: Key implementation facilitators reported by participants were patient perceived needs being met; the clinics' readiness to implement FIT, including staff's motivation, skills, knowledge, and resources to implement; intervention characteristics-evidence-based, adaptable and compatible with existing workflows; regular staff communications; and use of the electronic medical record (EMR) system. Key barriers to implementation were patient's limited awareness of FIT screening for CRC and discomfort with stool sample collection; the impacts of COVID-19 (patients missed appointment, staff coordination and communication were limited due to remote work); and limited clinic capacity (knowledge and skills using EMR system, staff turnover and shortage)., Conclusion: Findings from the study facilitate the refinement and adaption of future FIT intervention implementation. Future research will explore implementation barriers and facilitators in rural settings and from patients' perspectives to enhance the spread and scale of the intervention., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Blueberries ( Vaccinium section Cyanococcus ) have a wealth of bioactive compounds, including anthocyanins and other antioxidants, that offer significant health benefits. Preserving these compounds and maintaining the sensory and nutritional qualities of blueberry products such as juice during cold market storage is critical to meet consumer expectations for nutritious, safe, and minimally processed food. In this study, we compared the effects of two preservation processing techniques, high-temperature short-time (HTST) and continuous flow high-pressure homogenization (CFHPH), on blueberry juice quality during storage at 4 °C. Our findings revealed that inlet temperature ( T in ) of CFHPH processing at 4 °C favored anthocyanin retention, whereas T in at 22 °C favored ascorbic acid retention. After 45 days of storage, CFHPH (300 MPa, 1.5 L/min, 4 °C) juice retained up to 54% more anthocyanins compared to control at 0 day. In contrast, HTST treatment (95 °C, 15 s) initially increased anthocyanin concentrations but led to their subsequent degradation over time, while also significantly degrading ascorbic acid. Furthermore, CFHPH (300 MPa, 4 °C) juice had significantly lower polyphenol oxidase activity (>80% less than control), contributing to the overall quality of the juice. This innovative processing technique has the potential to improve commercial blueberry juice, and help meet the rising demand for healthy and appealing food choices.

Despite the availability of successful vaccines, measles outbreaks have occurred frequently in recent years, presumably due to the lack of proper vaccination implementation. Moreover, measles cases in adult groups, albeit small in number, indicate that the previously neglected adult group may need to be brought into vaccine coverage to achieve WHO's goal of measles eradication from the globe. In this study, we develop a novel transmission dynamics model to describe measles cases in adults and children to evaluate the role of adult infection in persistent measles cases and vaccination programs for eradication. Analysis of our model, validated by measles cases from outbreaks in Nepal, provides the vaccination reproduction number (conditions for measles eradication or persistence) and the role of contact network size. Our results highlight that while children are primary targets for measles outbreaks, a small number of infections in adults may act as a reservoir for measles, causing obstacles to eradication. Furthermore, our model analysis shows that while impactful controls can be achieved by children-focused vaccines, a combined adult-child vaccination program may help assert eradication of the disease., (© 2024 The Authors.)

The entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into human embryonic kidney (HEK293T) cells has been shown to be a cholesterol-rich, lipid raft-dependent process. In this study, we investigated if the presence of a cholesterol uptake receptor Niemann-pick type c1-like1 (NPC1L1) impacts SARS-CoV-2 cell entry. Initially, we utilized reporter-based pseudovirus cell entry assays and a spike (S) glycoprotein-mediated cell-to-cell fusion assay. Using Chinese hamster ovary (CHO-K1) cells, which lack endogenous receptors for SARS-CoV-2 entry, our data showed that the co-expression of NPC1L1 together with the ACE2 receptor synergistically increased SARS-CoV-2 pseudovirus entry even more than the cells expressing ACE-2 receptor alone. Similar results were also found with the HEK293T cells endogenously expressing the ACE2 receptor. Co-cultures of effector cells expressing S glycoprotein together with target cells co-expressing ACE-2 receptor with NPC1L1 significantly promoted quantitative cell-to-cell fusion, including syncytia formation. Finally, we substantiated that an elevated expression of NPC1L1 enhanced entry, whereas the depletion of NPC1L1 resulted in a diminished SARS-CoV-2 entry in HEK293T-ACE2 cells using authentic SARS-CoV-2 virus in contrast to their respective control cells. Collectively, these findings underscore the pivotal role of NPC1L1 in facilitating the cellular entry of SARS-CoV-2. Importance: Niemann-Pick type C1-like1 (NPC1L1) is an endosomal membrane protein that regulates intracellular cholesterol trafficking. This protein has been demonstrated to play a crucial role in the life cycle of several clinically important viruses. Although SARS-CoV-2 exploits cholesterol-rich lipid rafts as part of its viral entry process, the role of NPC1L1 in SARS-CoV-2 entry remains unclear. Our research represents the first-ever demonstration of NPC1L1's involvement in facilitating SARS-CoV-2 entry. The observed role of NPC1L1 in human kidney cells is not only highly intriguing but also quite relevant. This relevance stems from the fact that NPC1L1 exhibits high expression levels in several organs, including the kidneys, and the fact that kidney damages are reported during severe cases of SARS-CoV-2. These findings may help us understand the new functions and mechanisms of NPC1L1 and could contribute to the identification of new antiviral targets.

Assessment and proper management of sites contaminated with heavy metals require precise information on the spatial distribution of these metals. This study aimed to predict and map the distribution of Cd, Cu, Ni, Pb, and Zn across the conterminous USA using point observations, environmental variables, and Histogram-based Gradient Boosting (HGB) modeling. Over 9180 surficial soil observations from the Soil Geochemistry Spatial Database (SGSD) (n = 1150), the Geochemical and Mineralogical Survey of Soils (GMSS) (n = 4857), and the Holmgren Dataset (HD) (n = 3400), and 28 covariates (100 m × 100 m grid) representing climate, topography, vegetation, soils, and anthropic activity were compiled. Model performance was evaluated on 20 % of the data not used in calibration using the coefficient of determination (R 2 ), concordance correlation coefficient (ρ c ), and root mean square error (RMSE) indices. Uncertainty of predictions was calculated as the difference between the estimated 95 and 5 % quantiles provided by HGB. The model explained up to 50 % of the variance in the data with RMSE ranging between 0.16 (mg kg -1 ) for Cu and 23.4 (mg kg -1 ) for Zn, respectively. Likewise, ρ c ranged between 0.55 (Cu) and 0.68 (Zn), respectively, and Zn had the highest R 2 (0.50) among all predictions. We observed high Pb concentrations near urban areas. Peak concentrations of all studied metals were found in the Lower Mississippi River Valley. Cu, Ni, and Zn concentrations were higher on the West Coast; Cd concentrations were higher in the central USA. Clay, pH, potential evapotranspiration, temperature, and precipitation were among the model's top five important covariates for spatial predictions of heavy metals. The combined use of point observations and environmental covariates coupled with machine learning provided a reliable prediction of heavy metals distribution in the soils of the conterminous USA. The updated maps could support environmental assessments, monitoring, and decision-making with this methodology applicable to other soil databases, worldwide., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Published by Elsevier B.V.)

Robot-assisted surgery is developing as an acme of minimally invasive surgery, given its utmost dominance over laparoscopic surgery. The objective was to review the status of robotic surgery in urological practice with its advantages and disadvantages in current scenario. We conducted a literature search using MEDLINE and identified 72 articles which were relevant to urology. Single-port and various multiport robotic platforms like Da Vinci, Versius, Hugo RAS, Revo-I, Senhance, Mantra, Avatera, Hinotori, and MicroSurge are described with pros and cons. With a surge in different medical surgical robots purging into the market and a race to become the next standard of care in robotic surgery, it is only a matter of time when robotic surgery becomes financially comparable to laparoscopic surgeries., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)