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To investigate the feasibility of single-port (SP) robotic pyeloplasty by comparing perioperative outcomes with those of multiport (MP) robotic pyeloplasty. We reviewed the data from patients who underwent robot-assisted pyeloplasty for ureteropelvic junction obstruction (UPJO) at a single tertiary institution between March 2016 and May 2022. Radiographic and symptomatic improvements were assessed 3 months postoperatively. Propensity score matching was performed for age, sex, body mass index, and hydronephrosis grade. Of the 15 S P-pyeloplasty and 28 MP-pyeloplasty cases, 14 from each group were matched using 1:1 matching. The SP group had shorter console and operative times without significant differences. Blood loss was lower in the SP group than in the MP group (p = 0.019). The length of hospital stay, opioid use on the operative day, and pain score at discharge did not differ between the two groups. The mean cost for surgery was higher in the SP group than in the MP group (p < 0.001). The mean cost of hospitalization was comparable between the two groups (p = 0.083). The cosmetic numerical rating scale scores were significantly higher in the SP group (p = 0.014). Symptoms improved in all patients, and the radiographic improvement rates were 92.9% in the SP group and 100% in the MP group. SP-pyeloplasty showed cosmetic benefits, lower blood loss, operative time, and console time compared with MP-pyeloplasty. In patients who underwent surgery for UPJO for the first time, SP surgery can show comparable outcomes when compared to MP surgery. [ABSTRACT FROM AUTHOR]

Background and Objectives: Transgender people are defined as individuals whose gender identity does not entirely match their sex assigned at birth. Gender surgery typically represents the conclusive and irreversible step in the therapeutic process, especially for the impact on the reproductive sphere. The increased awareness of gender dysphoria and the expanding array of medical and surgical options, including minimally invasive techniques, contribute to the gradual increase in the social impact of transgender surgery. There are several surgical techniques for "gender assignment", such as vaginal, laparotomic, laparoscopic, and robotic, and the novel approach of vaginal natural orifice transluminal endoscopic surgery to perform a hysterectomy and bilateral salpingo-oophorectomy (BSO). The purpose of this review is to assess the various surgical approaches (hysterectomy and salpingo-oophorectomy) for gender reassignment in order to determine the best option in clinical practice for the female-to-male population in terms of surgical outcomes such as operative time, surgical complication, hospital discharge, postoperative pain, and bleeding. Materials and Methods: This systematic review includes studies from 2007 to 2024. Special consideration was given to articles documenting the characteristics and management of female-to-male reassignment surgery. Finally, eight papers were included in this review. Results: The literature analysis considered surgical techniques ranging from traditional surgery to innovative methods like vaginal natural orifice transluminal endoscopic surgery and robotic-assisted laparoscopic hysterectomy. Vaginal natural orifice transluminal endoscopic surgery and the robotic approach offer potential benefits such as reduced postoperative pain and shorter hospital stays. While vaginal natural orifice transluminal endoscopic surgery may encounter challenges due to narrow access and smaller vaginal dimensions, robotic single-site hysterectomy may face instrument conflict. Conclusions: The conventional laparoscopic approach remains widely used, demonstrating safety and efficacy. Overall, this review underscores the evolving landscape of surgical techniques for gender affirmation and emphasizes the necessity for personalized approaches to meet the specific needs of transgender patients. [ABSTRACT FROM AUTHOR]

Arterial compliance (AC) plays a crucial role in vascular aging and cardiovascular disease. The ability to continuously estimate aortic AC or its surrogate, pulse pressure (PP), through wearable devices is highly desirable, given its strong association with daily activities. While the single-site photoplethysmography (PPG)-derived arterial stiffness indices show reasonable correlations with AC, they are susceptible to noise interference, limiting their practical use. To overcome this challenge, our study introduces a noise-resistant indicator of AC: Katz's fractal dimension (KFD) of PPG signals. We showed that KFD integrated the signal complexity arising from compliance changes across a cardiac cycle and vascular structural complexity, thereby decreasing its dependence on individual characteristic points. To assess its capability inmeasuring AC,we conducted a comprehensive evaluation using both in silico studies with 4374 virtual human data and real-world measurements. In the virtual human studies, KFD demonstrated a strong correlation with AC (r = 0.75), which only experienced a slight decrease to 0.66 at a signal-to-noise ratio of 15dB, surpassing the best PPG-morphology-derived AC measure (r = 0.41) under the same noise condition. In addition, we observed that KFD's sensitivity to AC varied based on the individual's hemodynamic status,whichmay further enhance the accuracy of AC estimations. These in silico findings were supported by real-world measurements encompassing diverse health conditions. In conclusion, our study suggests that PPGderived KFD has the potential to continuously and reliably monitor arterial compliance, enabling unobtrusive and wearable assessment of cardiovascular health. [ABSTRACT FROM AUTHOR]

Background and Objectives: Transgender people are defined as individuals whose gender identity does not entirely match their sex assigned at birth. Gender surgery typically represents the conclusive and irreversible step in the therapeutic process, especially for the impact on the reproductive sphere. The increased awareness of gender dysphoria and the expanding array of medical and surgical options, including minimally invasive techniques, contribute to the gradual increase in the social impact of transgender surgery. There are several surgical techniques for “gender assignment”, such as vaginal, laparotomic, laparoscopic, and robotic, and the novel approach of vaginal natural orifice transluminal endoscopic surgery to perform a hysterectomy and bilateral salpingo-oophorectomy (BSO). The purpose of this review is to assess the various surgical approaches (hysterectomy and salpingo-oophorectomy) for gender reassignment in order to determine the best option in clinical practice for the female-to-male population in terms of surgical outcomes such as operative time, surgical complication, hospital discharge, postoperative pain, and bleeding. Materials and Methods: This systematic review includes studies from 2007 to 2024. Special consideration was given to articles documenting the characteristics and management of female-to-male reassignment surgery. Finally, eight papers were included in this review. Results: The literature analysis considered surgical techniques ranging from traditional surgery to innovative methods like vaginal natural orifice transluminal endoscopic surgery and robotic-assisted laparoscopic hysterectomy. Vaginal natural orifice transluminal endoscopic surgery and the robotic approach offer potential benefits such as reduced postoperative pain and shorter hospital stays. While vaginal natural orifice transluminal endoscopic surgery may encounter challenges due to narrow access and smaller vaginal dimensions, robotic single-site hysterectomy may face instrument conflict. Conclusions: The conventional laparoscopic approach remains widely used, demonstrating safety and efficacy. Overall, this review underscores the evolving landscape of surgical techniques for gender affirmation and emphasizes the necessity for personalized approaches to meet the specific needs of transgender patients.

[Display omitted] • Ru(III) sites in solid micellar catalyst can be reversible switched to Ru0 clusters. • Ru(III) single-sites selectively catalyze the hydrogenation of functional groups. • Ru0 nanoclusters in contrast are very active for hydrogenating aromatic rings. Traditionally, catalytic active sites are robust; they do not change after a reaction. We show here that the Ru(III) active sites in a solid micellar Ru(III)@MCM catalyst can be controllably switched to Ru0 nanoclusters and vice versa by a mild treatment. The Ru(III) single-sites selectively catalyze the hydrogenation of functional groups such as carbonyl, and double and triple bonds in aromatic compounds via heterolytic H 2 activation. The Ru0 nanoclusters in contrast are very active for hydrogenating aromatic rings. Ru0 nanoclusters are reversibly formed from the Ru(III) sites via hydrolysis and reduction as shown by XAS, HRTEM, CO adsorption, and DFT calculations. The reported strategy offers reversible switching between oxidized and metallic states of Ru to perform different chemical transformations, achieving on-demand active sites. [ABSTRACT FROM AUTHOR]

Objective: The temporal complexity of photoplethysmography (PPG) provides valuable information about blood pressure (BP). In this study, we aim to interpret the stochastic PPG patterns with a model-based simulation, which may help optimize the BP estimation algorithms. Methods: The classic four-element Windkessel model is adapted in this study to incorporate BP-dependent compliance profiles. Simulations are performed to generate PPG responses to pulse and continuous stimuli at various timescales, aiming to mimic sudden or gradual hemodynamic changes observed in real-life scenarios. To quantify the temporal complexity of PPG, we utilize the Higuchi fractal dimension (HFD) and autocorrelation function (ACF). These measures provide insights into the intricate temporal patterns exhibited by PPG. To validate the simulation results, continuous recordings of BP, PPG, and stroke volume from 40 healthy subjects were used. Results: Pulse simulations showed that central vascular compliance variation during a cardiac cycle, peripheral resistance, and cardiac output (CO) collectively contributed to the time delay, amplitude overshoot, and phase shift of PPG responses. Continuous simulations showed that the PPG complexity could be generated by random stimuli, which were subsequently influenced by the autocorrelation patterns of the stimuli. Importantly, the relationship between complexity and hemodynamics as predicted by our model aligned well with the experimental analysis. HFD and ACF had significant contributions to BP, displaying stability even in the presence of high CO fluctuations. In contrast, morphological features exhibited reduced contribution in unstable hemodynamic conditions. Conclusion: Temporal complexity patterns are essential to single-site PPG-based BP estimation. Understanding the physiological implications of these patterns can aid in the development of algorithms with clear interpretability and optimal structures. [ABSTRACT FROM AUTHOR]

Background: The mainstay of treatment for early-stage cervical cancer is surgery; we present a 5-year experience of robotic single-site radical hysterectomy (RSRH) focused on surgical and oncologic outcomes. Methods: This retrospective study included 44 cases of RSRH performed in patients with early-stage cervical cancer. Results: The median follow-up period for the 44 patients was 34 months. The mean total operation time was 156.07 ± 31.77 min, while mean console time was 95.81 ± 24.95 min. Two cases had complications, which required surgical management, while four cases (9.1%) exhibited recurrence. The disease-free survival rate at 5 years was 90.9%. The sub-division analysis showed that Stage Ia2 and stage Ib1 patient sub-group showed better DFS than that of the stage Ib2 patient sub-group. The learning curve analysis showed that the CUSUM-T initially peaks at the sixth case then gradually decreases before rising and peaking at the 24th case. After 24th case, the CUSUM-T gradually decreases and reaches zero. Conclusion: The surgical outcomes of RSRH for early-stage cervical cancer treatment were safe and acceptable. However, RSRH could be considered carefully only in well-selected patient groups. Large-scale prospective studies are necessary in the future to validate the results. [ABSTRACT FROM AUTHOR]

With the recognition of the significant advantages of minimizing surgical trauma, laparoscopic single site surgery with robotic system has attracted more and more attention from surgeons because of its higher accuracy, stable vision and excellent ergonomics. Since gynecological surgery involves the female pelvic cavity, transumbilical or transvaginal natural cavity robotic laparoscopic single site surgery presents many advantages and possibilities. However, R-LESS in gynecological surgery is at the early stage of development and the specific advantages are still controversial. Here, we provided an overview of the application advancement of robotic single-site laparoscopic surgery in gynecology, and described indications and technique, highlighting the potential development direction and possibilities in the future.

Due to the propagation effect, the arrival time of the ground wave peak is delayed when sferics propagate at long distances. In this work, we propose a new method combined with a numerical algorithm to correct the effect of the ground wave peak time delay and calculate the ionosphere height using the difference between the arrival time of the ground wave and the skywave. The results showed that, with each increase of the propagation distance by 100 km, the delay in arrival time of the ground wave peak increased by an average of 0.9 μs. For the first and second reflectance heights, the maximum heights observed at night were 86 km and 89 km, and the minimum heights during the day were 66 km and 69 km, respectively. Using the difference in arrival time between the ground wave and skywave and the ionosphere equivalent reflection height, a single site was used to estimate the distance of lightning occurring within 900 km. This method had an average relative error of 14.6%, an average absolute error of 128.8 km, and a median distance error of 52.6 km. Finally, the percentage of data with an estimated deviation within 10% increased from 52% to 65%.

Context: The precarious work arrangements experienced by many long-term care workers have led to the creation of a “shared” workforce across residential, home, and community aging care sectors. This shared workforce was identified as a contributor to the spread of COVID-19 early in the pandemic. Objective: This analysis sought to review policy measures targeting the long-term care workforce across seven high income jurisdictions during the first year of the COVID-19 pandemic. The focus was on financial supports introduced to recognize long-term care workers for the increased risks they faced, including both (1) health risks posed by direct care provision during the pandemic and (2) economic risks associated with restrictions to multi-site work. Method: Environmental scan of publicly available policy documents and government news releases published between March 1, 2020 and March 31, 2021, across seven high income jurisdictions. Findings: While there was limited use of financial measures in the United States to compensate long-term care workers for the increased health risks they faced, these measures were widely used across Canada, as well as in Wales, Scotland, and Australia. Moreover, there was a corresponding use of financial measures to protect workers from income loss in parts of Canada, Australia and the UK. Limitations: Our analysis did not include additional policy measures such as sick pay or recruitment incentives. We also relied primarily on publicly available policy documentation. In some cases, documents had been archived or revised, making it difficult to ascertain and clarify original information and amendments. Implications: While these financial measures are temporary, they brought to light long-standing issues related to the supply of and support for workers providing care to older adults in long-term care homes.

Context: The precarious work arrangements experienced by many long-term care workers have led to the creation of a "shared" workforce across residential, home, and community aging care sectors. This shared workforce was identified as a contributor to the spread of COVID-19 early in the pandemic. Objective: This analysis sought to review policy measures targeting the long-term care workforce across seven high income jurisdictions during the first year of the COVID-19 pandemic. The focus was on financial supports introduced to recognize long-term care workers for the increased risks they faced, including both (1) health risks posed by direct care provision during the pandemic and (2) economic risks associated with restrictions to multi-site work. Method: Environmental scan of publicly available policy documents and government news releases published between March 1, 2020 and March 31, 2021, across seven high income jurisdictions. Findings: While there was limited use of financial measures in the United States to compensate long-term care workers for the increased health risks they faced, these measures were widely used across Canada, as well as in Wales, Scotland, and Australia. Moreover, there was a corresponding use of financial measures to protect workers from income loss in parts of Canada, Australia and the UK. Limitations: Our analysis did not include additional policy measures such as sick pay or recruitment incentives. We also relied primarily on publicly available policy documentation. In some cases, documents had been archived or revised, making it difficult to ascertain and clarify original information and amendments. Implications: While these financial measures are temporary, they brought to light long-standing issues related to the supply of and support for workers providing care to older adults in long-term care homes. [ABSTRACT FROM AUTHOR]

Single-atom cobalt centers on various oxide surfaces (TiO2, MgO, SBA-15, AlPO, and Y-Zeolite) were prepared and evaluated as water oxidation catalysts by photochemical water oxidation experiments. Superior catalytic rates were observed for cobalt sites on basic supporting oxides (TiO2 and MgO) relative to those on acidic oxides (Y-Zeolite, AlPO, and SiO2). Per-atom turnover frequencies of ca. 0.04 s-1 were achieved, giving initial rates 100 times greater than that of a surface atom of a Co3O4 nanoparticle. Contrary to expectations based on theoretical work, no apparent correlation was observed between the catalytic rates and the oxygen atom affinities of the supporting oxides. (Graph Presented).

Objective: To summarize the scientific published literature on new robotic platforms with potential use in gynecology and review their evolution from inception until the present day. The goal was to describe the current characteristics and possible prospects of these platforms. Mechanism: A non-systematic search of PubMed, Cochrane Library Central, EMBASE, MEDLINE, and Scopus databases was conducted to identify scientific literature on new robotic platforms and review their evolution from inception until January 2022. Only English-language publications were included in this analysis. The following keywords were used: “new robotic platforms”, “robot”, “Revo-I”, “Versius®”, “Senhance®”, “Single-Site”, “Single-Port”, “Multi-Port”, “EDGE SP1000”, “Flex®”, and “Hominis®”. Abstract reviews were conducted to determine the relevance of the review aims. Full-text analysis of all relevant English-language original articles was subsequently performed by one author (R.F.) and summarized after discussion with an independent third party (L.S., M.P.). No formal quality assessment of the included studies was conducted. Findings in brief: The Da Vinci robotic system is the leading platform in the robotic surgery market. Other new platforms have published peer-reviewed articles in the field of gynecology. Senhance® and Da Vinci SP® have the most substantial proof of their capacity to perform multi-incision and single-incision robotic surgery, respectively. Hominis® has the potential to play a major role in ultra-minimally invasive and scarless approaches. Conclusions: The significant advantages of Intuitive’s robots justify their worldwide dissemination. However, their drawbacks have motivated other companies to develop innovative solutions. Our research shows that the majority of these new platforms are still at the beginning of their technical and scientific validation but seem very promising.

Purpose: To objectively evaluate surgically induced astigmatism (SIA) after phacotrabeculectomy using keratometry and topography and to compare the magnitude of SIA and the refractive outcomes of single-site and twin-site phacotrabeculectomies. Methods: Forty prospective subjects were enrolled in the study and were randomized into single-site and twin-site cohorts. SIA was objectively assessed using keratometry and Orbscan before and at three months after surgery. For both cohorts, the changes in SIA were assessed using power vector analysis compared at the third month after surgery. Results: Each cohort consisted of 20 eyes. The preoperative parameters and postoperative IOP were comparable and similar, respectively, in both the cohorts (P = 0.1). Majority of the patients in both the cohorts had preoperative against-the-rule (ATR) astigmatism. The median change in SIA at the three-month postoperative visit was similar in both the cohorts, with a small increase in ATR astigmatism. Although the SIA change measured by keratometry in the J0 component was similar in both the groups (P = 0.54), that of J45 was significantly different (P = 0.01). However, the median change in SIA was similar in both the groups for both the J0 (P = 0.52) and J45 components (P = 0.94) when measured by Orbscan. The SIA in both the groups measured with keratometry (P = 0.62) and topography (P = 0.52) were clinically and statistically similar. In both the groups, the refraction was similar at 1 month and 3 months. Conclusion: The SIA as measured with keratometry and topography was similar in the single-site and twin-site phacotrabeculectomy cohorts at the end of 3-months. The postoperative refraction was stabilized in 1-month in both the groups.

Arterial compliance (AC) plays a crucial role in vascular aging and cardiovascular disease. The ability to continuously estimate aortic AC or its surrogate, pulse pressure (PP), through wearable devices is highly desirable, given its strong association with daily activities. While the single-site photoplethysmography (PPG)-derived arterial stiffness indices show reasonable correlations with AC, they are susceptible to noise interference, limiting their practical use. To overcome this challenge, our study introduces a noise-resistant indicator of AC: Katz's fractal dimension (KFD) of PPG signals. We showed that KFD integrated the signal complexity arising from compliance changes across a cardiac cycle and vascular structural complexity, thereby decreasing its dependence on individual characteristic points. To assess its capability in measuring AC, we conducted a comprehensive evaluation using both in silico studies with 4374 virtual human data and real-world measurements. In the virtual human studies, KFD demonstrated a strong correlation with AC ( r = 0.75), which only experienced a slight decrease to 0.66 at a signal-to-noise ratio of 15dB, surpassing the best PPG-morphology-derived AC measure ( r = 0.41) under the same noise condition. In addition, we observed that KFD's sensitivity to AC varied based on the individual's hemodynamic status, which may further enhance the accuracy of AC estimations. These in silico findings were supported by real-world measurements encompassing diverse health conditions. In conclusion, our study suggests that PPG-derived KFD has the potential to continuously and reliably monitor arterial compliance, enabling unobtrusive and wearable assessment of cardiovascular health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xing, Hong, Alastruey, Long, Liu and Dong.)

Abstract Background The aim of this study was to analyze the experience of two surgeons who have different laparoscopic skills and case volume, with single-site robotic cholecystectomy (SSRC) and evaluate their learning curves. Methods All SSRCs performed between March 2013 and April 2015 were retrospectively reviewed. The patients were divided among two surgeons based on the surgeon’s level of laparoscopic skills and case volume. Surgeon 1 had experience in advanced laparoscopy while surgeon 2 had basic laparoscopic skills. Patients’ demographic data, intraoperative and short-term postoperative results were assessed. Results The analysis included 102 patients for surgeon 1 and 15 patients for surgeon 2. There were no major or minor complications in either cohort. Operative time was significantly longer for surgeon 2, conversion to laparoscopy rate was 4% for surgeon 1 compared to 20% for surgeon 2, P = 0.044, which is statistically significant. Conclusions SSRC is an easy and safe procedure that can be quickly learned and performed in a reproducible manner by surgeons with experienced laparoscopic skills and greater case volume.

• Ni-based catalysts have been prepared on titanosilicates by a simple route. • The prepared catalysts show outstanding propylene epoxidation performance. • DFT calculations and HRTEM have helped understand the catalysts behavior. • Formation of Ni-O-Ti interfaces is crucial to obtain efficient catalysts. • The catalysts are extremely cost-effective compared to Au-based systems. An efficient gas-phase production of propylene oxide (PO) with noble metal-free catalysts could modify the industrial output of this valuable compound. We present a novel catalyst based on well-dispersed Ni nanoparticles loaded on a Ti-SiO 2 support for the propylene epoxidation reaction using H 2 /O 2 mixtures. XPS, High Resolution Transmission Electron Microscopy (HRTEM), and UV–Vis corroborate both the small size of Ni particles and the excellent dispersion and incorporation of Ti as tetrahedral single site species into the silica framework. The catalytic results under steady-state conditions at low temperature (200 °C) show high PO selectivity (around 85%) with a substantial propylene conversion (over 6%) and excellent H 2 efficiency (~37%) using only 0.5 wt% of Ni on Ti-SiO 2 (Ti/Si = 0.01 M ratio). In this work, we have also carried out a preliminary DFT study to gain understanding of the characteristics that make this nickel catalyst active and selective for the propene epoxidation reaction. [ABSTRACT FROM AUTHOR]

Purpose: To objectively evaluate surgically induced astigmatism (SIA) after phacotrabeculectomy using keratometry and topography and to compare the magnitude of SIA and the refractive outcomes of single-site and twin-site phacotrabeculectomies.Methods: Forty prospective subjects were enrolled in the study and were randomized into single-site and twin-site cohorts. SIA was objectively assessed using keratometry and Orbscan before and at three months after surgery. For both cohorts, the changes in SIA were assessed using power vector analysis compared at the third month after surgery.Results: Each cohort consisted of 20 eyes. The preoperative parameters and postoperative IOP were comparable and similar, respectively, in both the cohorts (P = 0.1). Majority of the patients in both the cohorts had preoperative against-the-rule (ATR) astigmatism. The median change in SIA at the three-month postoperative visit was similar in both the cohorts, with a small increase in ATR astigmatism. Although the SIA change measured by keratometry in the J0 component was similar in both the groups (P = 0.54), that of J45 was significantly different (P = 0.01). However, the median change in SIA was similar in both the groups for both the J0 (P = 0.52) and J45 components (P = 0.94) when measured by Orbscan. The SIA in both the groups measured with keratometry (P = 0.62) and topography (P = 0.52) were clinically and statistically similar. In both the groups, the refraction was similar at 1 month and 3 months.Conclusion: The SIA as measured with keratometry and topography was similar in the single-site and twin-site phacotrabeculectomy cohorts at the end of 3-months. The postoperative refraction was stabilized in 1-month in both the groups. [ABSTRACT FROM AUTHOR]

With the aim of minimising the patient’s postoperative pain, expediting recovery and improving cosmesis, the idea of performing a laparoscopic procedure through a single abdominal incision was introduced. In the present report, we describe five different access routes to the prostate that may be at the surgeon’s disposal with the potential of decreasing patient’s perioperative morbidity. Robotic radical prostatectomy has been refined and became a standard of care in surgery for localised prostate cancer. The advent of single-port robotic surgery has prompted the re-discovery of different access routes to the prostate and ideally all of them are feasible. The potential for avoiding the abdominal cavity will decrease the surgical morbidity and minimise the surgical dissection. In the near future, each of the described approaches could be chosen on the basis of the patient’s preoperative comorbidities, body habitus, anatomy, and disease characteristics and location. [ABSTRACT FROM AUTHOR]

In this mini-review, the state-of-the-art of transition metal catalyzed selective dimerization of ethylene to butenes is presented. Catalytic activities, operating conditions, as well as the C 4 and 1-butene/ cis - and trans -2-butene selectivities, are discussed. The scope of the review is 2000-present. [ABSTRACT FROM AUTHOR]

Background: Single-incision laparoscopic surgery has gained widespread attention because of its potential benefits such as less skin incision and faster recovery. Up to now, only one meta-analysis (performed in 2013; including 9 studies, a total of 585 cases) compared single-incision laparoscopic right colectomy (SILRC) with conventional laparoscopic right colectomy (CLRC). An updated meta-analysis was undertaken to explore more convinced comparative findings between SILRC and CLRC.Materials and Methods: The search for studies that compared SILRC with CLRC was done on PubMed, Embase, Web of Science, and the Cochrane Library. A total of 17 studies (including 1778 cases) were identified, the data of appointed outcomes were extracted and analyzed.Results: Patient demographics (age, gender, body mass index and previous abdominal operation) did not differ significantly. No significant differences were found between SILRC and CLRC in operative time, conversion, reoperation, perioperative complications, postoperative mortality, and 30-days readmission. Pathological outcomes, including lymph nodes harvested, proximal resection margin, and distal resection margin, were similar. SILRC showed less estimated blood loss (weighted mean difference [WMD]: -15.67 ml; 95% confidence interval [CI], -24.36 to -6.98; p = 0.0004), less skin incisions (WMD: -1.56 cm; 95%CI, -2.63 to -0.49; p = 0.004) and shorter hospital stay (WMD: -0.73d; 95%CI, -1.04 to -0.41; p < 0.00001), without publication bias.Conclusion: SILRC may provide a safe and feasible alternative to CLRC with similar short-term outcomes and aesthetic advantage of less skin incision. Well-designed randomized controlled trials, involving large cases and carrying long-term outcomes, are needed. [ABSTRACT FROM AUTHOR]

A metal coordination supramolecule constructed by 1,2,3-triazopyridine derivatives (PYTA) coordinated Pt(II) or Pd(II) can be worked as a cocatalyst to boost photocatalytic hydrogen evolution. [Display omitted] • 1,2,3-triazopyridine derivatives(PYTA) coordinated Pt(II) or Pd(II) supramolecular is constructed. • PYTA-Pd(II) and PYTA-Pt(II) are used as co-catalysts for photocatalytic H 2 evolution. • PYTA-Pd(II) and PYTA-Pt(II) enhance the charge transfer and H 2 evolution. • TOF of Pd(II) or Pt(II) is prominently higher than that of common Pd and Pt metal. In artificial photocatalysis, sluggish kinetics of surface redox reactions and high charge recombination have been the barriers to photocatalytic conversion efficiency. Herein, metallosupramolecular complexes PYTA-Pd(II) and PYTA-Pt(II) were constructed by 1,2,3-triazopyridine derivatives (PYTA) coordinated Pt(II) and Pd(II). Originating from their planar conjugate structure and metal active center, PYTA-Pd(II) and PYTA-Pt(II) worked as molecular co-catalysts that can not only reduce the energy barrier of hydrogen evolution but also promote charge transfer. When g-C 3 N 4 (CN) is loaded with PYTA-Pd(II) or PYTA-Pt(II), its photocatalytic H 2 evolution reaction activity increased by 264 and 303 times, respectively. Moreover, the turnover frequency (TOF) of the Pd(II) in the CN/PYTA-Pd(II) is 25.94-fold than that of the Pd metal in the CN/Pd photocatalyst. And the TOF of Pt(II) in the CN/PYTA-Pt(II) photocatalyst is 9.37-fold than that of the Pt metal in the CN/Pt photocatalyst. These metallosupramolecular co-catalysts represent a new and highly effective approach to boost photocatalytic H 2 evolution and have provided fertile new ground for creating high-efficiency photosynthesis systems, increasing the utilization efficiency of noble-metal. [ABSTRACT FROM AUTHOR]

Objective: Robot-assisted rectal surgery is gaining popularity, and robotic single-site surgery is also being explored clinically. We report our initial experience with robotic transanal total mesorectal excision (R-taTME) and radical proctectomy using the robotic single-site plus one-port (R-SSPO) technique for low rectal surgery. Methods: Between July 2015 and March 2016, 15 consecutive patients with ultra-low rectal lesions underwent R-taTME followed by radical proctectomy using the R-SSPO technique by a single surgeon. The clinical and pathological results were retrospectively analyzed. Results: The median operative time was 473 (range, 335-569) min, and the estimated blood loss was 33 (range, 30-50) mL. The median number of lymph nodes harvested was 12 (range, 8-18). The median distal resection margin was 1.4 (range, 0.4-3.5) cm, and all patients had clear circumferential resection margins. We encountered a left ureteric transection intraoperatively in one patient, and another patient required reoperation for postoperative adhesive intestinal obstruction. There was no 30-day mortality. Conclusion: R-taTME followed by radical proctectomy using the R-SSPO technique for patients with low rectal lesions is technically feasible and safe without compromising oncologic outcomes. However, there were considerable limitations and a steep learning curve using current robotic technology. [ABSTRACT FROM AUTHOR]

Objective: The temporal complexity of photoplethysmography (PPG) provides valuable information about blood pressure (BP). In this study, we aim to interpret the stochastic PPG patterns with a model-based simulation, which may help optimize the BP estimation algorithms. Methods: The classic four-element Windkessel model is adapted in this study to incorporate BP-dependent compliance profiles. Simulations are performed to generate PPG responses to pulse and continuous stimuli at various timescales, aiming to mimic sudden or gradual hemodynamic changes observed in real-life scenarios. To quantify the temporal complexity of PPG, we utilize the Higuchi fractal dimension (HFD) and autocorrelation function (ACF). These measures provide insights into the intricate temporal patterns exhibited by PPG. To validate the simulation results, continuous recordings of BP, PPG, and stroke volume from 40 healthy subjects were used. Results: Pulse simulations showed that central vascular compliance variation during a cardiac cycle, peripheral resistance, and cardiac output (CO) collectively contributed to the time delay, amplitude overshoot, and phase shift of PPG responses. Continuous simulations showed that the PPG complexity could be generated by random stimuli, which were subsequently influenced by the autocorrelation patterns of the stimuli. Importantly, the relationship between complexity and hemodynamics as predicted by our model aligned well with the experimental analysis. HFD and ACF had significant contributions to BP, displaying stability even in the presence of high CO fluctuations. In contrast, morphological features exhibited reduced contribution in unstable hemodynamic conditions. Conclusion: Temporal complexity patterns are essential to single-site PPG-based BP estimation. Understanding the physiological implications of these patterns can aid in the development of algorithms with clear interpretability and optimal structures., Competing Interests: CJ is employed by Jinan Guoke Medical Technology Development Co., Ltd. W-FD is employed by Suzhou GK Medtech Science and Technology Development (Group) Co., Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Xing, Huang, Hao, Jiang and Dong.)

Objectives: To perform a survey of the current state of laparoendoscopic single-site surgery (LESS) and its implementation in the treatment of malignant disease of the urinary tract. Although it is a recent development in the field of laparoscopic surgery with still unproven long-term results, LESS may prove to be more commonly performed in the coming years while managing urologic cancer patients. Materials and Methods: A PubMed search was conducted using the key words laparoendoscopic single-site surgery, LESS, urologic cancer. Relevant articles were reviewed for data on the management of urologic malignancy with LESS. Results: The first articles describing LESS for urologic cancers were published in 2007. Since then, published experience with this technique has increased. LESS has been implemented as an alternative to conventional laparoscopic surgery and open surgery for the treatment of major urologic cancers. The proposed advantages of LESS are the aesthetic benefit of a single incision and a quicker and less painful recovery. Disadvantages are the lack of instrument triangulation, instrument clashing and the steeper learning curve. As this is a fairly recent technical innovation, long-term functional and oncological results for LESS have not yet been published. Conclusions: LESS is a novel technical advance over conventional laparoscopic surgery, and it can be successfully used in the treatment of patients with urologic cancers. Published data support the feasibility and safety of LESS interventions for major urologic cancers, and newer data may assist in finding LESS′s ultimate position among therapeutic options for patients with urologic malignancies.

Background: Laparoendoscopic single-site surgery (LESS) has recently been applied successfully in the performance of a host of surgical procedures. Preliminary consensus from the experts is that this mode of surgery is technically challenging and requires expertise. The transition from trainee to practicing surgeon, especially in complex procedures with challenging learning curves, takes time and mentor-guided nurturing. However, the trainee needs to use platforms of training to gain the skills that are deemed necessary for undertaking the live human case. Objective: This article aims to demonstrate a step-by-step means of how to acquire the necessary instrumentation and build a training model for practicing steeplechase exercises in LESS for urological surgeons and trainees. The tool built as a result of this could set the platform for performance of basic and advanced skills uptake using conventional, bent and articulated instruments. A preliminary construct validity of the platform was conducted. Materials and Methods: A box model was fitted with an R-Port™ and camera. Articulated and conventional instruments were used to demonstrate basic exercises (e.g. glove pattern cutting, loop stacking and suturing) and advanced exercises (e.g. pyeloplasty). The validation included medical students (M), final year laparoscopic fellows (F) and experienced consultant laparoscopic surgeons (C) with at least 50 LESS cases experience in total, were tested on eight basic skill tasks (S) including manipulation of the flexible cystoscope (S1), hand eye coordination (S2), cutting with flexible scissors (S3), grasping with flexible needle holders (S4), two-handed maneuvers (S5), object translocation (S6), cross hand suturing with flexible instruments (S7) and conduction of an ex-vivo pyeloplasty. Results: The successful application of the box model was demonstrated by trainee based exercises. The cost of the kit with circulated materials was less than £150 (Pounds Sterling). The noncamera handling skills (S2-S8) of the ex-vivo training model for LESS can distinguish between laparoscopically naοve fellows and experienced consultants in LESS. S4-S8 showed the highest level of construct validity, by accurately differentiating among the M, F and C groups. Conclusion: LESS requires a significant amount of skill and has an inherent steep learning curve. The ex-vivo model described provides a cost-effective means that a trainee or training unit can build for optimising preliminary skill acquisition in LESS for urological trainees. It has construct validity in several tasks. Such platform models should be tested further with an emphasis on rapid sequence uptake of optimal skills, prior to undertaking the live human case.

Single-port, single-incision laparoscopy is part of the natural development of minimally invasive surgery. Refinement and modification of laparoscopic instrumentation has resulted in a substantial increase in the use of laparoendoscopic single-site surgery (LESS) in urology over the past 2 years. Since the initial report of single-port nephrectomy in 2007, the majority of laparoscopic procedures in urology have been described with a single-site approach. This includes surgery on the adrenal, ureter, bladder, prostate, and testis, for both benign and malignant conditions. In this review, we describe the current clinical applications and results of LESS in Urological Surgery. To date this evidence comes from small case series in centres of excellence, with good results. Further well-designed prospective trials are awaited to validate these findings.

This work demonstrated a facile methodology to construct single Nb site catalysts with merely 0.63 wt% Nb by employing α-hydroxy carboxylic acid-functionalized cotton fiber as green and sustainable supporting material. The as-synthesized catalysts have been characterized thoroughly and exhibited a superior catalytic activity for selective oxidation of aniline into azoxybenzene with nearly 100% utilization efficiency of H 2 O 2 under mild and green conditions. Notably, it demonstrated the highest TOF (4806 h−1) among the currently reported heterogeneous catalysts. Moreover, the catalyst has steadily been operated under continuous-flow conditions, which afforded significant benefits compared to batch processes as reported in these transformations. The activity test and catalyst characterization indicated that the atomically dispersed Nb-peroxo coordination centers were actually catalytic sites. Especially, the α-hydroxy carboxylic acid groups on cotton fiber played an important role in coordinating/stabilizing single Nb site. Moreover, 1H MAS NMR spectra verified that there exists an acid-base interaction between arylamines and free α-hydroxy carboxylic acid groups covalently grafted on cotton fiber, which was favorable for adsorption and activation of the substrates. Mechanism studies indicated that the azoxy derivatives were produced through condensation step between N-phenylhydroxylamine and nitrosobenzene rather than direct oxidation of azobenzene. The work provides an economical and environmentally friendly approach to construct single–site catalysts for the oxidation catalysis. [Display omitted] • Cotton fiber-supported single Nb site catalysts have been constructed by a facile approach. • The catalysts show superior performance for the continuous oxidation of arylamines to azoxybenzene. • The atomically dispersed Nb-peroxo coordination centers are catalytic sites. • There is an interaction of arylamines with free carboxylic acid groups on surface. • The interaction endows the oxidation reaction with outstanding catalytic performance. [ABSTRACT FROM AUTHOR]

Objective: To discuss the feasibility of single-site robotic surgery for benign gynecologic tumors and early stage gynecologic cancers. Methods: In this single institution, prospective analysis, we analyzed six patients who had undergone single-site robotic surgery between December 2013 and August 2014. Surgery was performed using the da Vinci Si Surgical System. Patient characteristics and surgical outcomes were analyzed. Results: Single-site robotic surgery was performed successfully in all six cases. The median patient age was 48 years, and the median body mass index was 25.5 kg/m² (range, 22 to 33 kg/m²). The median total operative time was 211 minutes, and the median duration of intracorporeal vaginal cuff suturing was 32 minutes (range, 22 to 47 minutes). The median duration of pelvic lymph node dissection was 31 minutes on one side and 27 minutes on the other side. Patients' postoperative courses were uneventful. The median postoperative hospital stay was 4 days. No postoperative complications occurred. Conclusion: When used to treat benign gynecologic tumors and early stage gynecologic cancers, the single-site da Vinci robotic surgery is feasible, safe, and produces favorable surgical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: Herein, we firstly present the robotic single-site cholecystectomy (RSSC) as performed in Asia and evaluate whether it could overcome the limitations of conventional laparoscopic single-site cholecystectomy. Materials and Methods: From October 2013 to November 2013, RSSC for benign gallbladder (GB) disease was firstly performed consecutively in five patients. We evaluated these early experiences of RSSC and compared factors including clinicopathologic factors and operative outcomes with our initial cases of single-fulcrum laparoscopic cholecystectomy (SFLC). Results: Four female patients and one male patient underwent RSSC. Neither open conversion nor bile duct injury or bile spillage was noted during surgery. In comparisons with SFLC, patient-related factors in terms of age, sex, Body Mass Index, diagnosis, and American Society of Anesthesiologist score showed no significant differences between two groups. There were no significant differences in the operative outcomes regarding intraoperative blood loss, bile spillage during operation, postoperative pain scale values, postoperative complications, and hospital stay between the two groups (p<0.05). Actual dissection time (p=0.003) and total operation time (p=0.001) were significantly longer in RSSC than in SFLC. There were no drain insertion or open conversion cases in either group. Conclusion: RSSC provides a comfortable environment and improved ergonomics to laparoscopic single-site cholecystectomy; however, this technique needs to be modified to allow for more effective intracorporeal movement. As experience and technical innovations continue, RSSC will soon be alternative procedure for well-selected benign GB disease. [ABSTRACT FROM AUTHOR]

Silica supported iridium and rhodium nanoparticles were prepared via surface organometallic chemistry (SOMC). Following the synthesis and characterization of organometallic molecular precursors [(COD)MOSiOR]2 (M = Ir or Rh; R = Me or Si(OtBu)3), their controlled grafting on partially dehydroxylated silica yields isolated dinuclear surface species, as determined by ¹H and 13C solid state NMR as well as infrared transmission spectroscopies and elemental analysis. The decomposition under hydrogen of the well-defined surface species affords a narrow size distribution and a homogeneous spatial repartition of small M(0) particles despite a high metal density (1.2 ± 0.3 nm and 1.4 ± 0.3 nm for Ir and Rh, respectively). A combination of transmission electronic microscopy and gas chemisorption provides the H2 and CO adsorption stoichiometries on the metal surface, which are highly dependent on the precursor and the preparation route, indicating the necessity to control each step and the danger to determine particle size solely from chemisorption studies for small iridium and rhodium supported particles. [ABSTRACT FROM AUTHOR]

Objectives: To perform a survey of the current state of laparoendoscopic single-site surgery (LESS) and its implementation in the treatment of malignant disease of the urinary tract. Although it is a recent development in the field of laparoscopic surgery with still unproven long-term results, LESS may prove to be more commonly performed in the coming years while managing urologic cancer patients. Materials and Methods: A PubMed search was conducted using the key words laparoendoscopic single-site surgery, LESS, urologic cancer. Relevant articles were reviewed for data on the management of urologic malignancy with LESS. Results: The first articles describing LESS for urologic cancers were published in 2007. Since then, published experience with this technique has increased. LESS has been implemented as an alternative to conventional laparoscopic surgery and open surgery for the treatment of major urologic cancers. The proposed advantages of LESS are the aesthetic benefit of a single incision and a quicker and less painful recovery. Disadvantages are the lack of instrument triangulation, instrument clashing and the steeper learning curve. As this is a fairly recent technical innovation, long-term functional and oncological results for LESS have not yet been published. Conclusions: LESS is a novel technical advance over conventional laparoscopic surgery, and it can be successfully used in the treatment of patients with urologic cancers. Published data support the feasibility and safety of LESS interventions for major urologic cancers, and newer data may assist in finding LESS's ultimate position among therapeutic options for patients with urologic malignancies. [ABSTRACT FROM AUTHOR]

Abstract: Background: As laparoscopy becomes a standard approach in many urological procedures, researchers strive to make minimally invasive surgery less invasive. Our objective was to apply recent innovations in equipment and surgical approaches to develop the technique and perform laparo-endoscopic single site radical prostatectomy (LESS-RP). Methods: The technique for LESS-RP was derived by combining existing techniques of standard laparoscopic RP and developing techniques of urological LESS. This incorporated newly available low-profile trocars, flexible instruments and a flexible-tip laparoscope. The procedure was performed through a single 3-cm transverse infra-umbilical incision. LESS-RP was completed successfully via a single operative site without auxiliary needles or trocars. Perioperative variables and postoperative outcomes were recorded and measured. Results: The operative time was 424min and the hospital stay was 10days because of a vesicourethral leak and ileus. The anastomotic leak resolved and the urethral catheter was removed at 4weeks after surgery. The final pathology showed negative margins and Gleason 3+4 pT2c prostatic adenocarcinoma. Conclusions: LESS-RP is feasible by replicating laparoscopic RP techniques and incorporating the LESS technique with the advent of flexible-tip laparoscopes and flexible instruments. After a learning curve has been overcome, this should be further tested prospectively to compare oncological and functional outcomes with laparoscopic and robotic-assisted RP. [Copyright &y& Elsevier]

This study estimates the change in aggregate consumer surplus associated with increased freshwater supply into two South African estuaries, namely, the Klein and the Kwelera. The estimation entailed the application of a contingent behaviour, single-site Clawson-Knetsch travel cost model. The value estimates derived reflect the benefit of improved freshwater supplies into the estuaries in question over the status quo. In a survey, a questionnaire was administered face-to-face to 240 households at the Klein Estuary and 231 households at the Kwelera Estuary during the period between December 2005 and April 2006. It was deduced that in 2006 the marginal recreational value of freshwater inflow into the Klein Estuary was 5.7 cents/m³ (ZAR0.057/m³) and into the Kwelera Estuary 1.1 cents/m³ (ZAR0.01 1/m³). [ABSTRACT FROM AUTHOR]

Aims: Right ventricular (RV) pacing may cause dyssynchronous left ventricular (LV) contraction and systolic dysfunction. Left ventricular-based pacing may prevent such deterioration. The aim of this study was to evaluate ventricular synchrony and function with permanent LV pacing (LVP) vs. RV pacing (RVP) in paediatric patients with normal cardiac anatomy. [ABSTRACT FROM PUBLISHER]

Abstract: The reactions of the bis(η5-cyclopentadienyl)methylzirconium cation (1) with four imines have been studied in the gas phase by Fourier transform ion cyclotron resonance mass spectrometry. Reactivity of the bis(η5-cyclopentadienyl)methylzirconium cation is governed by the availability of a labile hydrogen in the corresponding imine. The products observed differ from those that might be expected in analogy with earlier work on ketones, aldehydes and alkenes (e.g., zirconocene η3-enolate and η3-allyl complexes): azomethyne/benzylidene species are found instead of enamines; however, the general reaction mechanism resembles that proposed for ketones and alkenes. An elimination reaction leading to final products was shown to be preceded by a fast migratory insertion/deinsertion equilibrium for alkyl-substituted imines. Such an equilibrium is not possible for aryl-substituted imines due to lack of lability of the aryl groups and thus only methane elimination was observed for these imines. [Copyright &y& Elsevier]

Single-site polymerization catalysts enable exquisite control over alkene polymerization reactions to produce new materials with unique properties. Knowledge of catalyst speciation and fundamental kinetics are essential for full mechanistic understanding of zirconocene-catalyzed alkene polymerization. Currently the effect of activators on fundamental polymerization steps is not understood. Progress in understanding activator effects requires determination of fundamental kinetics for zirconocene catalysts with noncoordinating anions such as [B(C6F5)4]-. Kinetic NMR studies at low temperature demonstrate a very fast propagation rate for 1-hexene polymerization catalyzed by [(SBI)Zr(CH2SiMe3)][B(C6F5)4] [where SBI is rac-Me2Si(indenyl)2] with complete consumption of 1-hexene before the first NMR spectrum. Surprisingly, the first NMR spectrum reveals, aside from uninitiated catalyst, Zr-allyls as the sole catalyst-containing species. These Zr-allyls, which exist in two diastereomeric forms, have been characterized by physical and chemical methods. The mechanism of Zr-allyl formation was probed with a trapping experiment, leading us to favor a mechanism in which Zr-polymeryl undergoes β-H transfer to metal without dissociation of coordinated alkene followed by or-bond metathesis to form H2 and Zr-allyl. Zr-allyl species undergo slow reactions with alkene but react rapidly with H2 to form hydrogenation products. [ABSTRACT FROM AUTHOR]