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This study offers a thorough examination of the zero voltage switching (ZVS) operation range and deadband conditions for a bidirectional DC-DC converter with phase shift control, featuring dual H-bridge. The analysis considers the soft switching range of the DAB converter, accounting for the impact of the headband and the ZVS capacitor. By applying the differential equation of the circuit during deadband time, a sufficient constraint for the input and output bridges can be calculated. The findings indicate that as the output voltage increases, the minimum phase shift value required to achieve ZVS decreases, and expanding the phase shift value will expand the ZVS range and reduce switching losses. The study provides simulation results for various operating conditions, validating the theoretical analysis of the proposed system. In addition, the results furnish information about the circuit behavior during the deadband and waveforms. Finally, MATLAB/SIMULINK verifies the simulation results for different operating stages. [ABSTRACT FROM AUTHOR]

The fungal toxin aflatoxin B1 (AB1) and its reactive intermediate, aflatoxin B1-8, 9 epoxide, could cause liver cancer by inducing DNA adducts. AB1 exposure can induce changes in the expression of several cancer-related genes. In this study, the effect of AB1 exposure on breast cancer MCF7 and normal breast MCF10A cell lines at the phenotypic and epigenetic levels was investigated to evaluate its potential in increasing the risk of breast cancer development. We hypothesized that, even at low concentrations, AB1 can cause changes in the expression of important genes involved in four pathways, i.e., p53, cancer, cell cycle, and apoptosis. The transcriptomic levels of BRCA1, BRCA2, p53, HER1, HER2, cMyc, BCL2, MCL1, CCND1, WNT3A, MAPK1, MAPK3, DAPK1, Casp8, and Casp9 were determined in MCF7 and MCF10A cells. Our results illustrate that treating both cells with AB1 induced cytotoxicity and apoptosis with reduction in cell viability in a concentration-dependent manner. Additionally, AB1 reduced reactive oxygen species levels. Phenotypically, AB1 caused cell-cycle arrest at G1, hypertrophy, and increased cell migration rates. There were changes in the expression levels of several tumor-related genes, which are known to contribute to activating cancer pathways. The effects of AB1 on the phenotype and epigenetics of both MCF7 and MCF10A cells associated with cancer development observed in this study suggest that AB1 is a potential risk factor for developing breast cancer. [ABSTRACT FROM AUTHOR]

Enzymes have evolved to catalyze their precise reactions at the necessary rates, locations, and time to facilitate our development, to respond to a variety of insults and challenges, and to maintain a healthy, balanced state. Enzymes achieve this extraordinary feat through their unique kinetic parameters, myriad regulatory strategies, and their sensitivity to their surroundings, including substrate concentration and pH. The Cancer Genome Atlas (TCGA) highlights the extraordinary number of ways in which the finely tuned activities of enzymes can be disrupted, contributing to cancer development and progression often due to somatic and/or inherited genetic alterations. Rather than being limited to the domain of enzymologists, kinetic constants such as kcat, Km, and kcat/Km are highly informative parameters that can impact a cancer patient in tangible ways--these parameters can be used to sort tumor driver mutations from passenger mutations, to establish the pathways that cancer cells rely on to drive patients' tumors, to evaluate the selectivity and efficacy of anti-cancer drugs, to identify mechanisms of resistance to treatment, and more. In this review, we will discuss how changes in enzyme activity, primarily through somatic mutation, can lead to altered kinetic parameters, new activities, or changes in conformation and oligomerization. We will also address how changes in the tumor microenvironment can affect enzymatic activity, and briefly describe how enzymology, when combined with additional powerful tools, and can provide us with tremendous insight into the chemical and molecular mechanisms of cancer. [ABSTRACT FROM AUTHOR]

In this paper, the hyperbolic tangent function method is applied for constructing exact solutions for space-time conformal fractional Burgers' equation. Furthermore, the space-time conformal fractional Burgers' equation is tested for the Painlevé property, and consequently, new numerous exact solutions are generated via Bäcklund transform. [ABSTRACT FROM AUTHOR]

Background: We aimed to define the published impact, efficacy, cost‐effectiveness and precise role of the Isiris‐α device: the world's first sterile, single‐use grasper integrated flexible cystoscope (SUGIFC) for ureteral stent removal. Methods: After PROSPERO registration (CRD42021228755), the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) guidelines were utilized. The search terms "Grasper Integrated Flexible Cystoscope," and "Isiris," within the following databases: PubMed, Scopus, Cochrane Library, Web of Science and EMBASE were searched. Results: In this review, a cumulative total experience (10 publications) included 970 "SUGIFC" procedures (755 patients). However, only 366/970 procedures were actually used for "ureteral stent removal," with the remainder being surveillance cystoscopy only (603/970) or foreign body retrieval (1/970). Procedure‐related and device failures in planned "removal of ureteral stents," was reported in 8/366 (346 patients) and 1/366 (346 patients), respectively. The cost–benefit utilizing the SUGIFC device is advantageous compared to "in‐theatre" stent removals and favours less busy centres where maintenance, repair and replacement costs are more relevant. Other listed benefits include shorter stent indwelling times, shorter procedure duration, lower rates of bacteriuria and urinary tract infections, fewer emergency department visits and lower readmission rates. Technical limitations include the absence of an independent working channel, a narrower visual field and the lack of image universality since the monitor is device‐specific. Conclusion: The SUGIFC device needs to be outweighed against local costs and individual health systems. Its application in ambulatory ureteral stent removal may become significant due to the accessibility and convenience that it offers the attending urologist. [ABSTRACT FROM AUTHOR]

Background: Ureteral stent insertion and subsequent removal remains one of the most common procedures performed in endourology. We aimed to evaluate a novel, one‐step method, permitting simultaneous stent removal and guidewire passage using a self‐constructed suture snare via standard cystoscopy. This method should be used prior to ureteroscopy, in cases of minimal stent encrustation and peri‐ureteral mucosal oedema, where identification and subsequent cannulation of the ureteral orifice may be a challenge. Methods: A self‐constructed suture snare is constructed using an open‐ended ureteral catheter to facilitate this novel 'Switch' technique. Operative duration, cost feasibility and potential complications with this novel method were assessed in patients with an indwelling stent duration above 100 days. Results: Age inclusion in this study ranged from 21 to 35 years, with kidney, ureter and bladder scores below 6, in the five patients assessed. Previous ureteral stent indwelling time ranged from 106 to 315 days. Reasons for (pre‐stented) ureteroscopy were mostly stone related. The overall recorded procedure time for the Switch technique was successfully performed in less than 96 s (range 68–95 s) in all cases within this series. No procedure‐related complications were reported. Conclusion: Utilizing the suture snare, the novel Switch technique was successfully performed in all cases assessed. This method is both time and cost feasible and could be easily utilized in resource‐limited areas, regional centres or in cases where a stent grasper is not available, may have malfunctioned or cannot adequately approximate due to distal ureteral stent encrustation. [ABSTRACT FROM AUTHOR]

This report presents the latest data from ongoing excavations at Jebel Moya, Sudan. This year saw the opening of five new trenches and continued excavation of an archaeologically rich trench. We have recovered four individual burials, a mud brick wall and a number of animal and archaeobotanical remains. The excavations also yielded a longer pottery sequence, showing clearly that the site was in use by at least the sixth millennium BC. This season confirms the long and complex history of Jebel Moya and provides the material for future studies on population health and subsistence. This season also saw an increase in community engagement and a more detailed study of the various historical trajectories that make up the biography of Jebel Moya. [ABSTRACT FROM AUTHOR]

Background: Tizanidine, an α-2 adrenoceptor agonist, is widely prescribed for the management of spasticity in adults. Case reports on pediatric tizanidine overdose are limited. Here, we report a case of pediatric tizanidine toxicity that was reversed with naloxone. Case presentation: A 3-year-old male presented to the emergency department with lethargy, bradycardia, and bradypnea after accidental ingestion of multiple tizanidine tablets. Improvements in the level of consciousness and respiratory and heart rates were observed after two intravenous administrations of naloxone at a dose of 0.05 and 0.1 mg/kg, respectively. Conclusions: This case report provides further evidence regarding the use of naloxone as a viable antidote for centrally acting α-2 receptor agonists and presents additional epidemiologic data on childhood tizanidine poisoning. [ABSTRACT FROM AUTHOR]

Background: Urinary diversion procedures frequently result in bacterial colonisation. There is an increased incidence of developing urinary tract infections (UTIs) in this patient population. Current guidelines, however, recommend against treating this colonisation. This systematic review aimed to determine when and how to test, monitor, and treat bacteriuria in patients with urinary diversion. Methods: A systematic search strategy was conducted based on keywords "urinary diversion" and "bacteriuria", on MEDLINE, Embase, and Google Scholar. Articles were screened and included only if they reported on (i) testing methods for bacteriuria, (ii) surveillance of bacteriuria over time, or (iii) when and how to treat bacteriuria. Results were summarised and reported using a narrative synthesis. Results: Altogether, 26 studies were included in this review. Inconsistencies were noted in the definitions of bacteriuria, with most studies reporting bacteriuria as > 104 cfu/mL (8/17 studies). Bacteriuria prevalence varied greatly (range 9.1–100%). Monitoring bacteriuria over time may help detect a reduction in bacteriuria, as demonstrated in three studies (follow-up range 5–18 months; sample size 18–56). The link between preceding bacteriuria and subsequent UTIs has not been fully explored yet. Short-term antimicrobial therapy may be useful in the immediate post-operative setting; however, long-term prophylactic treatment is ineffective in preventing bacteriuria. Conclusions: We recommend consistent reporting of bacteriuria definitions, the benefits of monitoring bacteriuria over time, and use of short-term antimicrobial therapy; bacteriuria should not be treated with long-term therapy. [ABSTRACT FROM AUTHOR]

The archaeology and history of the Red Sea area of eastern Sudan during the Medieval period has been receiving increased attention in recent years. This paper reviews the observations of the recent archaeology and landscape surveys and integrates them with the ongoing work undertaken by The Suakin and the Red Sea Project for Archaeological Environmental and Cultural Studies directed by Ahmed Adam and undertaken by the Department of Archaeology, University of Khartoum. To date, important information has been uncovered by the expedition relating to the earliest Medieval occupation and the forms and impact of Islamic trade activity. The majority of the new data come from Suakin, 'Aydhâb (Aidab) and Badi', principal ports along the Sudanese Red Sea coast that played a major role in this trade. Previously, little was known about the area beyond these ports. The work done by the expedition so far lays the foundation for future field seasons to better understand long-term human settlements during the Medieval period of eastern Sudan by integrating archaeological surveys with excavations and oral histories. [ABSTRACT FROM AUTHOR]

This paper outlines the ways in which the project is addressing the colonial legacy of Henry Wellcome as well as presenting the data from the first three field seasons at Jebel Moya, south-central Sudan. These data have substantially revised our chronological and socio-economic understanding of the site. Our excavations, initiated in 2017 and continued in 2019 and 2022, show a longer, more continuous occupation of the site than has been previously recognised. The faunal and botanical remains have implications for the spread of early domesticates in the eastern Sahel and for climate changes, and raise issues of resilience. There is confirmed human burial activity from at least the third millennium BC onwards, while the pottery continues to yield information about the variety of decoration and, for the final Assemblage 3, data on its usage. Overall, the continued importance of the site for the eastern Sahel is re-emphasised. [ABSTRACT FROM AUTHOR]

Building upon Brass' previous research on Jebel Moya, which included a comprehensive reanalysis of the pottery from Wellcome's 1911–14 expeditions curated at the British Museum, new research activities by the University College London–University of Khartoum–NCAM Expedition to the Southern Gezira project have included locating and examining for the first time the Late Mesolithic sherds from Jebel Moya curated at the National Museum in Khartoum. Representative samples from the sites of Shaqadud Midden and Shaqadud S21 at the British Museum have also been re-examined. The aims of these activities were threefold: to test the reliability and cohesiveness of and patterning in the Shaqadud collection through the expanded application of attribute analysis, to determine if Caneva's observations of décor patterns on Jebel Moya's Late Mesolithic sherds could be replicated and to obtain better visibility into the nature of its pottery assemblage from this time, and to use the resulting data to test the viability of the central Sudan being a fulcrum of cultural interchanges during the late sixth and early fifth millennium BC. We conclude that there was a piecemeal establishment of networks along which there was diffusion of ideas and animals, and perhaps low numbers of people, into the central and south-central Sudan. [ABSTRACT FROM AUTHOR]

Background: Intestinal volvulus is a potentially life‐threatening condition that occurs when loops of bowel twist around its supporting mesentery and associated vasculature. Clinicians often rely on various radiological investigations for prompt diagnosis to avoid complications such as bowel infarction. This review assesses the clinical reliability of the ultrasonographic whirlpool sign (WS) in the diagnosis of intestinal volvulus. Methods: In adherence with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta‐analyses) statement, a systematic search of BMJ Best Practice, Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus and Web of Science databases was performed (August 2017), using relevant search terms. Selected studies were ranked for quality and relevance using the CASP (Critical Appraisal Skills Program) tool. Results: Sixteen articles (1640 participants) were assessed. The mean and median sample size was 102.5 (SD ± 192.23) and 28 (range 7–770), respectively. The WS was positive in 212 of 255 (83.1%) patients with intestinal volvulus. Meta‐analysis of the studies that provided sufficient data resulted in a pooled sensitivity and specificity of 87.42% (95% confidence interval (CI): 81.05–92.25) and 98.63% (95% CI: 97.88–99.18), respectively, with an estimated summary effect of 5.28 (95% CI: 4.47–6.08, P < 0.001). There was negligible inter‐study heterogeneity, which was suggested by an I2 statistic of 0% (95% CI: 0.00–76.34) and a τ2 parameter of 0 (95% CI: 0.00–5.35). Conclusion: Though the pooled sensitivity was less than ideal (87.42%), this review and meta‐analysis nevertheless supports the reliability of the ultrasonographic WS as an acceptable indicator of intestinal volvulus. [ABSTRACT FROM AUTHOR]

Purpose: A positive whirlpool sign (WS) is defined as the presence of a spiral-like pattern when the spermatic cord is assessed during ultrasonography (US), using standard, high-resolution ultrasonography (HRUS) and/or color Doppler sonography (CDS), in the presence of testicular torsion. The objective of this review was to assess the validity and accuracy of this sign by performing a comprehensive systematic literature review and meta-analysis.Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a comprehensive literature search was performed (August, 2017), using the following databases: BMJ Best Practice, Cochrane Library, Embase, PubMed, Scopus, and Web of Science. Selected studies were further assessed for relevance and quality using the Oxford 2010 Critical Appraisal Skills Program (CASP).Results: Of the studies assessed, a total of 723 participants were included, with a mean of 72.3 (SD 71.9) participants. Of the participants, 226 (31.3%) were diagnosed with testicular torsion (TT). Meta-analysis of the studies that provided sufficient data resulted in a pooled sensitivity and specificity of the WS of 0.73 (95% CI, 0.65-0.79) and 0.99 (95% CI, 0.92-0.99), respectively. Removal of all neonates increased the pooled sensitivity to 0.92 (95% CI, 0.70-0.98) while the pooled specificity remained almost unchanged at 0.99 (95% CI, 0.95-1.00). The estimated summary effect of all studies with sufficient data was 4.34 (95% CI, 1.01-7.67; n = 394; p = 0.001). A large degree of heterogeneity was suggested by an I2 statistic of 88.27% (95% CI, 68.60-98.68%). Removal of neonatal subjects increased the estimated summary effect to 5.32 (95% CI, 1.59-9.05; n = 375; p = 0.001).Conclusion: The WS, when correctly diagnosed, may be viewed as a very definitive sign for TT in the pediatric and adult populations. However, its role in neonates is limited. [ABSTRACT FROM AUTHOR]

Objectives: To validate the newly designed ultrasound-guided suprapubic catheter insertion trainer (US-SCIT) model against the real life experience by enrolling participants with prior confidence in the technique of US-guided suprapubic catheter (SPC) insertion.Methods: The US-SCIT was self-constructed from common disposables and equipment found in the emergency department. A validation questionnaire was completed by all participants after SPC insertion on the US-SCIT model.Results: Fifty participants enrolled in the study. Each participant had reported confidence in the SPC insertion technique, prior to participation in this study. There were 13 "super-users" (>65 previous successful real life SPC insertions) in the study. The total material cost per US-SCIT unit was 1.71 USD. The US-SCIT's value in understanding the principals of US-guided SPC insertion had a mean score of 8.86 (standard deviation [SD] 1.03), whereas its value in simulating contextual anatomy had a mean score of 8.26 (SD 1.48). The mean score of the model's ability to provide realistic sensory feedback was 8.12 (SD 1.78), whereas that of realism of initial urine outflow was 9.06 (SD 1.20). Simulation with the model compared well with real life SPC insertion, with a mean score of 8.30 (SD1.48).Conclusions: The US-SCIT model performed well in various spheres developed to assess its ability to simulate real life SPC insertion. We are confident that this low-cost, validated, US compatible SPC trainer, constructed from common material present in the ED, will be a valuable learning asset to trainees across the globe. [ABSTRACT FROM AUTHOR]

Purpose: The use of mobile phone applications (Apps) has modernised the conventional practice of medicine. The diagnostic ability of the current Apps in prostate specific antigen monitoring, and its diagnostic ability within prostate cancer (PCa) risk calculators have not yet been appraised. We aimed to review, rate and assess the everyday functionality, and utility of all the currently available PCa risk calculator Apps.Methods: A systematic search on iTunes, Google Play Store, Blackberry World and Windows Apps Store, was performed on 23/11/2017, using the search term ‘prostate cancer risk calculator’. After applying the exclusion criteria, each App was individually assessed and rated using pre-set criteria and grading was performed using the validated uMARS scale.Results: In total, 83 Apps were retrieved. After applying our exclusion criteria, only 9 Apps were relevant, with 2 duplicated, and the remaining 7 were suitable for critical review. Data sizes ranged from 414 kb to 10.1 Mb. The cost of the Apps ranged from South African rand (ZAR) 0.00 to ZAR 29.99. The overall mean category uMARS scores ranged from 2.8/5 to 4.5/5. Apps such as Rotterdam Prostate Cancer Risk Calculator, Coral—Prostate Cancer Nomogram Calculator and CPC Risk Calculator, performed the best.Conclusions: The current PCa risk calculator mobile Apps available may be beneficial in counselling the concerned at risk patient. These Apps have potential to assist both the patient and the urologist alike. The PCa risk calculator App ‘predictability’ may be further enhanced by the incorporation of newly validated risk factors and predictors for PCa. [ABSTRACT FROM AUTHOR]

Background The Anderson- Hynes pyeloplasty ( AHP) is a surgical technique used in the management of pelvi-ureteric junction obstruction. This operation has been performed for over six decades and has etched its name in the annals of urology. But are we all really referring to the same procedure? Methods A systematic review of the Ovid MEDLINE( R) and Ovid OLDMEDLINE( R) database from 1946 to 20 June 2014 was performed for the terms ' Anderson and Hynes' and ' Anderson- Hynes', with later restriction to the title of journal article. Each respective author's descriptive images (figures/photographic) of technique performed was compared with the original procedure. Non-English figure legends were translated using online translational tools. Results In total, 242 articles were retrieved. Streamlining this search to articles with the above search terms restricted to article title revealed 58 (34 English/24 non-English) articles. Only 29/58 papers had referenced the original procedure. Operative images were present in 17/58 of the articles claiming to have performed the AHP. Within these papers, only 7/17 articles depicted both the L-shaped cut and pelvic flap. Diverse variations were observed in the remainder 10/17 articles. This was a worldwide phenomenon, observed more commonly in recent decades and when minimally invasive techniques were used. Conclusion The AHP is often not performed as was originally described. Over the decades, surgeons have unknowingly attributed variations to this procedure. Based on this review, a novel 'geometric classification' system has been proposed to better define the dismembered pyeloplasty. [ABSTRACT FROM AUTHOR]

Herein, we describe a case of a 14-year-old boy with straddle injury to the base of the penis, sustained during an indoor rock climbing accident, who presented with severe urethraggia. Urethral injury was confirmed with retrograde urethrography. The patient became hemodynamically unstable from persistent blood loss, and corporal arterial injury was diagnosed on computed tomography angiography. The urethraggia was successfully controlled with angioembolization. The unique aspects of this case were the challenges in establishing the diagnosis on the background of the abnormal presentation of vascular injury of blood loss as opposed to painless priapism. [ABSTRACT FROM AUTHOR]

Introduction. Acute urinary retention is a rare occurrence in women necessitating further investigation. Potential underlying causes may be broadly classified into obstructive, neurological, pharmacological, and psychogenic categories. Case. A 36-year-old nulliparous female presented to the Emergency Department with a two-day history of acute urinary retention. Point-of-care ultrasonography and CT scan imaging confirmed the presence of a large uterine mass causing compression of the bladder. The acute retention was relieved with urethral catheterization. A Uterine leiomyoma was confirmed on histology after hysterectomy. Discussion. Once the acute urinary retention has been relieved by insertion of a urethral catheter, the underlying cause of the obstruction must be determined. Although uterine leiomyoma is a fairly common finding in the general population, it is an extremely rare cause of acute urinary retention in women with just a handful of reported cases in the literature. [ABSTRACT FROM AUTHOR]

Congenital anterior urethral diverticulum is a rare cause of urethral obstruction in boys. We report on the antenatal diagnosis of this rare phenomenon, making this the sixth prenatally diagnosed case in the English literature (to the best of our knowledge). Our initial prenatal assessment, postnatal endoscopic management, along with the eventual clinical course is outlined. The embryologic theories, differential diagnosis, literature review, imaging, and treatment modalities of this entity are discussed. [ABSTRACT FROM AUTHOR]

A 3-year-old female child presented with a history of recurrent urinary tract infections. On general examination, polydactyly and a pelvic mass were present. An imperforate hymen was also documented on vaginal inspection. Further inquiry revealed a positive history of parental consanguinity. A magnetic resonance imaging study defined a hydrometrocolpos responsible for an obstructive cause of the recurrent urinary tract infections. In view of the above, a diagnosis of McKusick-Kaufman syndrome was made. Formal surgical repair of the imperforate hymen with hydrometrocolpos drainage resulted in complete symptom resolution. McKusick-Kaufman syndrome, its presentation, symptoms, differential diagnosis, and underlying genetics were further expanded. [ABSTRACT FROM AUTHOR]

Background The Erythrocyte Binding Antigen (EBA) 175 has been considered as one of the most important Plasmodium falciparum (P. falciparum) merozoite ligands that mediate invasion of the erythrocytes through their sialated receptor: Glycophorin A (GPA). The effect of the EBA 175 dimorphic alleles (F and C) on the severity of the disease is not yet fully understood. Therefore this study was designed to assess the distribution of the divergent dimorphic alleles of P. falciparum EBA-175 (F and C) in three different geographical areas in Sudan and the possible association of this dimorphism with the severity of the disease. Methods A sum of 339 field isolates of P. falciparum obtained from patients in three different geographical areas in Sudan were screened for the dimorphic alleles (F, C) of the EBA-175 using nested PCR. Results The percentage of F, C, and mixed F/C alleles were; 41%, 51%, and 8% respectively. F and C alleles showed significantly different distributions in the various geographic areas (p = 0.00). There was no significant association between malaria clinical manifestation and P. falciparum EBA-175 F and C alleles frequencies Conclusions This study showed a significant differential distribution of F and C alleles in different geographical malaria endemic areas. No significant association was observed between F and C alleles and different malaria phenotypes. [ABSTRACT FROM AUTHOR]

Study Type - Diagnostic (exploratory cohort) Level of Evidence 2b What's known on the subject? and What does the study add? The PCA3 assay has shown significant potential amongst the initial studies carried out in Western countries. This assay performed in line with previous studies. We have shown this marker to perform independent of prostatic volume and have identified potential indications for its use in our setting. However, we have not observed the PCA3 assay to outperform the PSA level across the risk spectrum. OBJECTIVES [ABSTRACT FROM AUTHOR]

Background: Recurrent Testicular Torsion (RTT) is a rarely reported event after previous testicular torsion (TT) repair. Both conditions have similar signs and symptoms. Various techniques have been attempted to reduce the incidence of retorsion. This review assesses the presentation, diagnosis, risk factors, management and outcomes associated with RTT. Methods: After PROSPERO Registration (CRD42021258997), a systematic search of PubMed, Google Scholar, Embase, Scopus, Web of Science, Cochrane Database of Systematic Reviews, Global Index Medicus and Cumulative Index to Nursing and Allied Health Literature (CIANHL) was performed using specific search terms. Study metadata including patient demographics, orchidopexy techniques, RTT rates and RTT timing were extracted. Results: Twenty‐six articles, comprising 12 case series and 14 case reports, with a total of 46 patients were included. Overall, the median (IQR) age of the pooled cohort was 18 (15–26) years, the median (IQR) time to presentation was 6 (3–36) hours from the onset of testicular pain. The most common presenting features were testicular pain (100%), testicular swelling (60.9%) and a high riding testicle (34.8%). The left testicle was most commonly affected (63.0%), RTT was on the ipsilateral side in relation to the primary episode of TT in 52.2% of cases, the median (IQR) interval between torsion and retorsion events was 4 (1.3–10.0) years, non‐absorbable sutures were the most common suture material used during orchidopexy after RTT (88.9%). Conclusion: RTT is a rare presentation to the Emergency Department. Even with a prior history of TT, RTT should be considered in patients presenting with classic symptoms. [ABSTRACT FROM AUTHOR]

Abstract: A geobotanical study of the travertine system of Saint-Guilhem-le-Désert (southern France) was carried out in order to reconstruct the local Holocene environment in a region where the postglacial vegetation history is poorly documented. The travertinisation process has started at ca. 8500 cal. BP, in a landscape dominated by Pinus sylvestris type (probably Pinus nigra sub sp. salzmannii). Around 7000 cal. BP, the travertine system recorded torrential events not evidenced at the regional scale, showing the particularity of the Verdus hydrological regime. More recently, ca. 5100 cal. BP, a lake or a marsh was filled within the Verdus plain, as attested to by sand and silt particles accumulated in the sequence. The present-day vegetation dominated by Quercus ilex, on south facing slopes, was most likely established between the Bronze Age and the Gallo-Roman period correlatively to the decline of Pinus nigra and deciduous Quercus, most probably under human influence. [Copyright &y& Elsevier]

• The fractional isothermal gas spheres have been solved using series expansion. • Comparison between the accelerated solution and the numerical one is in good agreement. • Fractional Physical parameters of the isothermal spheres are calculated. • Applications to the neutron stars are performed. The isothermal gas sphere is well known as a powerful tool to model many problems in astrophysics, physics, chemistry, and engineering. This singular differential equation has not an exact solution and solved only by numerical and approximate methods. In the present paper and within the framework of the Newtonian hydrostatic equilibrium, we have developed general analytical formulations for the fractional isothermal gas sphere. To obtain analytical expressions for mass, radius, and density, besides the fractional isothermal gas sphere, we used the conformable fractional calculus. Using the series expansion method, we obtained a general recurrences relation, which allows us to determine the series coefficients. The comparison of the series solution with the numerical ones for the fractional parameter α = 1 is good for dimensionless parameter up to x ≃ 3.2, beyond this value, the series diverges. We applied a combination of Euler-Abel and Pade techniques to accelerate the series, therefore accelerated series converge to the numerical desired value. We analyzed some physical parameters of a typical model of the neutron stars such as the mass-radius relation, density, and pressure ratio for different models. We found that the current models of the conformable neutron stars had smaller volumes and masses than both stars in the context of modified Rienmann-Liouville derivatives as well as the integer one. [ABSTRACT FROM AUTHOR]

The thoracic cavity is the rarest location of all the renal ectopic sites. We report a rare case of an acquired thoracic kidney associated with a previous congenital diaphragmatic hernia in a child with nephrotic syndrome. Although only 13 cases of the thoracic kidney in the pediatric age group have been described in worldwide reports during the past 25 years, we present the first to be associated with a recurrent diaphragmatic hernia. The classification, differential diagnosis, and management options of this rare form of ectopia are discussed. [Copyright &y& Elsevier]

Objectives: To identify and review the most up‐to‐date guidelines pertaining to bladder trauma in a unifying document as an updated primer in the management of all aspects relating to bladder injury. Methods: In accordance with the PRISMA statement, the most recent guidelines pertaining to bladder injury were identified and subsequently critically appraised. An electronic search of PubMed and Scopus databases was carried out in September 2023. Results: A total of six guidelines were included: European Association of Urology (EAU) guidelines on urological trauma (2023), EAU guidelines on paediatric urology (2022), Urotrauma: American Urological Association (AUA) (2020), Kidney and Uro‐trauma: World Society of Emergency Surgery and the American Association for the Surgery of Trauma (WSES‐AAST) guidelines (2019), Management of blunt force bladder injuries: A practice management guideline from the Eastern Association for the Surgery of Trauma (EAST) (2019), and EAU guidelines on iatrogenic trauma (2012). Recommendations were summarised with the associated supporting level of evidence and strength of recommendation where available. Conclusion: Several widely recognised professional organisations have published guidelines relating to the diagnosis, investigation, classification, management, and follow‐up related to bladder injury. There is consensus amongst all major guidelines in terms of diagnosis and management but there is some discrepancy and lack of recommendation with regards to the follow‐up of bladder injuries, iatrogenic bladder injury, paediatric bladder trauma, and spontaneous bladder rupture. The role of increasing minimally invasive techniques seem to be gaining traction in the select haemodynamically stable patient. Further research is required to better delineate this treatment option. [ABSTRACT FROM AUTHOR]

The site of Jebel Moya, situated in the center of the southern Gezira Plain in southcentral Sudan, has an occupational sequence spanning at least five millennia until around 2000 years ago. Renewed excavation is shedding new light on its occupational chronology and socioeconomic history, including activities such as burial, savanna herding, and domesticated sorghum cultivation practices dating to at least the mid-third millennium BC. In the present study, predominantly final phase pottery sherds from the first millennium BC to the start of the first millennium AD (Assemblage 3) have been analyzed via a combination of thin section petrography and instrumental geochemistry to determine their raw materials and place of manufacture and reconstruct their manufacturing technology. Organic residue analysis was also conducted to identify the products processed within vessels found at the site. The results suggest the existence of a well-developed local ceramic craft tradition that persisted for over one thousand years. Pots from Assemblage 3 were used to process, store, and consume animal and plant products, thus reinforcing emerging evidence for early agro-pastoral activities. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to assess the relationship between coffee intake, obstructive sleep apnea risk (OSA), and glycemic control among patients with diabetes mellitus. Results: There were 110 patients with diabetes and 96 healthy control subjects (matched for age and sex) attending a diabetes center زinTabuk, Saudi Arabia during the period from June 2018–October 2019. Stop-Bang questionnaire was used to assess OSA risk, and Epworth Sleepiness Scale to investigate daytime sleepiness. OSA risk and daytime sleepiness were higher among patients with diabetes compared to controls (4.34 ± 1.61 vs. 2.86 ± 1.24, and 8.31 ± 4.40 vs. 6.39 ± 3.70 respectively, P < 0.5), while coffee consumption was not (4.64 ± 3.95 vs. 3.45 ± 3.06, P > 0.05). Women with diabetes were younger with short duration since the diagnosis of diabetes and consumed less coffee compared to men, P < 0.5. A negative correlation was found between coffee consumption and the duration of diabetes, while no correlation was found between coffee intake, the glycated hemoglobin, OSA risk, sex, and daytime sleepiness. Daytime sleepiness and OSA risk were commoners among patients with diabetes, they were not correlated with coffee consumption which was negatively correlated with the duration since diabetes diagnosis. Further larger multi-center studies investigating coffee intake among patients newly diagnosed with diabetes are recommended. [ABSTRACT FROM AUTHOR]

Recent research on hand detection and gesture recognition has attracted increasing interest due to its broad range of potential applications, such as human-computer interaction, sign language recognition, hand action analysis, driver hand behavior monitoring, and virtual reality. In recent years, several approaches have been proposed with the aim of developing a robust algorithm which functions in complex and cluttered environments. Although several researchers have addressed this challenging problem, a robust system is still elusive. Therefore, we propose a deep learning-based architecture to jointly detect and classify hand gestures. In the proposed architecture, the whole image is passed through a one-stage dense object detector to extract hand regions, which, in turn, pass through a lightweight convolutional neural network (CNN) for hand gesture recognition. To evaluate our approach, we conducted extensive experiments on four publicly available datasets for hand detection, including the Oxford, 5-signers, EgoHands, and Indian classical dance (ICD) datasets, along with two hand gesture datasets with different gesture vocabularies for hand gesture recognition, namely, the LaRED and TinyHands datasets. Here, experimental results demonstrate that the proposed architecture is efficient and robust. In addition, it outperforms other approaches in both the hand detection and gesture classification tasks. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 3‐month‐old male infant with a history of antenatal hydronephrosis. Topics discussed include the endoscopic incision revealing arterial bleeding originating from the ureterocele, the patient undergoing a relook procedure to prevent all bleeding, and Doppler flow revealing an underlying left iliac arteriovenous malformation.

Objectives To perform a systematic review of all cases of spontaneous rupture of the urinary bladder (SRUB) and to describe the demographic data, associated comorbidities, clinical presentation, diagnosis, relevant laboratory findings, associated factors, management, morbidity and mortality associated with the presentation of SRUB. Methods The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). A search was carried out across the following electronic databases: PubMed, Web of Science, Scopus, Google Scholar and the Cochrane Database of Systematic Reviews. Full texts of selected studies were analysed, and data extracted. The review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results A total of 278 articles comprising 240 case reports and 38 case series, with a total of 351 patients were included. The median (interquartile range [IQR]) age of all included patients was 47.5 (33-65) years. The median (IQR) time to presentation was 48 (24-96) h, with the major presenting symptom being abdominal pain (76%). In patients in whom the diagnosis was made prior to any intervention, the condition was misdiagnosed in 64% of cases. The diagnosis was confirmed during explorative open surgery in 42% of cases. Pelvic radiation (13%) and alcohol intoxication (11%) were the most common associated factors. Intraperitoneal rupture (89%) was much more common, with the dome of the bladder being most frequently involved (55%). The overall mortality was 15%. Conclusion This review identified a number of key factors that appear to be associated with an increased incidence of SRUB. It also emphasized the high rate of misdiagnosis and challenge in confirming the diagnosis. Overall, it highlighted the importance of the need for increased awareness and maintaining a high index of suspicion for this condition. [ABSTRACT FROM AUTHOR]

Background: The Erythrocyte Binding Antigen (EBA) 175 has been considered as one of the most important Plasmodium falciparum (P. falciparum) merozoite ligands that mediate invasion of the erythrocytes through their sialated receptor: Glycophorin A (GPA). The effect of the EBA 175 dimorphic alleles (F and C) on the severity of the disease is not yet fully understood. Therefore this study was designed to assess the distribution of the divergent dimorphic alleles of P. falciparum EBA-175 (F and C) in three different geographical areas in Sudan and the possible association of this dimorphism with the severity of the disease.Methods: A sum of 339 field isolates of P. falciparum obtained from patients in three different geographical areas in Sudan were screened for the dimorphic alleles (F, C) of the EBA-175 using nested PCR.Results: The percentage of F, C, and mixed F/C alleles were; 41%, 51%, and 8% respectively. F and C alleles showed significantly different distributions in the various geographic areas (p = 0.00). There was no significant association between malaria clinical manifestation and P. falciparum EBA-175 F and C alleles frequencies.Conclusions: This study showed a significant differential distribution of F and C alleles in different geographical malaria endemic areas. No significant association was observed between F and C alleles and different malaria phenotypes. [ABSTRACT FROM AUTHOR]

The fruits, leaves, and bark of the guava (Psidium guajava) tree have traditionally been used to treat a myriad of ailments, especially in the tropical and subtropical regions. The various parts of the plant have been shown to exhibit medicinal properties, such as antimicrobial, antioxidant, anti-inflammatory, and antidiabetic activities. Recent studies have shown that the bioactive phytochemicals of several parts of the P. guajava plant exhibit anticancer activity. This review aims to present a concise summary of the in vitro and in vivo studies investigating the anticancer activity of the plant against various human cancer cell lines and animal models, including the identified phytochemicals that contributes to their activity via the different mechanisms. In vitro growth and cell viability studies, such as the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the sulforhodamine B (SRB) assay, and the trypan blue exclusion test, were conducted using P. guajava extracts and their biomolecules to assess their effects on human cancer cell lines. Numerous studies have showcased that the P. guajava plant and its bioactive molecules, especially those extracted from its leaves, selectively suppress the growth of human cancer cells without cytotoxicity against the normal cells. This review presents the potential of the extracts of P. guajava and the bioactive molecules derived from it, to be utilized as a feasible alternative or adjuvant treatment for human cancers. The availability of the plant also contributes towards its viability as a cancer treatment in developing countries. [ABSTRACT FROM AUTHOR]

Background: A norovirus maintains its viability, infectivity and virulence by its ability to replicate. However, the biological mechanisms of the process remain to be explored. In this work, the NanoLuc™ Luciferase gene was used to develop a reporter-tagged replicon system to study norovirus replication. Methods: The NanoLuc™ Luciferase reporter protein was engineered to be expressed as a fusion protein for MNV-1 minor capsid protein, VP2. The foot-and-mouth disease virus 2A (FMDV2A) sequence was inserted between the 3'end of the reporter gene and the VP2 start sequence to allow co-translational 'cleavage' of fusion proteins during intracellular transcript expression. Amplification of the fusion gene was performed using a series of standard and overlapping polymerase chain reactions. The resulting amplicon was then cloned into three readily available backbones of MNV-1 cDNA clones. Results: Restriction enzyme analysis indicated that the NanoLucTM Luciferase gene was successfully inserted into the parental MNV-1 cDNA clone. The insertion was further confirmed by using DNA sequencing. Conclusion: NanoLuc™ Luciferase-tagged MNV-1 cDNA clones were successfully engineered. Such clones can be exploited to develop robust experimental assays for in vitro assessments of viral RNA replication. [ABSTRACT FROM AUTHOR]

Urothelial bladder tumours in childhood are extremely rare, with most cases being low grade, superficial disease of the papillary subtype with favourable outcomes. Urothelial (clear cell variant) carcinoma of bladder (UCCVCB) is an exceptional histological finding in both the adult and paediatric population. Herein we describe the first case of UCCVCB diagnosed in childhood. With this case being only the fourth report of confirmed muscle invasion in childhood, we discuss the entity of UCCVCB, and furthermore review all previously reported confirmed cases of childhood muscle invasive urothelial bladder cancer, in general. [ABSTRACT FROM AUTHOR]

Objectives: It is not known why only some hepatitis C virus (HCV) infected patients develop glomerulonephritis (GN). Therefore, we investigated the role of soluble complement regulators in the development of HCV associated GN. Methods: Patients with HCV associated GN who were admitted to our nephrology unit between July 2016 and July 2018 were recruited to the study (group 1). Two other age and sex matched groups were studied as control groups: patients with HCV without GN (group 2) and healthy HCV negative volunteers (group 3). There were 26 participants in each of the three groups at the end of the recruitment period. An assay of serum fluid-phase complement regulators was performed using enzyme linked immunosorbent assay technique. Three complement single nucleotide polymorphisms (SNPs) were analyzed using real time polymerase chain reaction (Taqman; thermo fisher scientific): rs2230199 and rs1047286 for complement 3 (C3) and rs800292 for complement factor H (CFH). Results: Serum levels of complement 4 binding protein (C4BP) were significantly lower in group 1 (median 70 ng/ml) than in groups 2 (median 88.8 ng/ml) and 3 (median 82.8 ng/ml) with p value of 0.007. The minor allele (allele A) of rs800292 for CFH was significantly higher in group 2 and group 3 (G 54% and A 46%) than in group 1 (G 73% and A 27%), p = 0.04. Conclusions: Low C4BP levels are associated with GN in HCV infected patients. In addition, rs800292 SNP in CFH protects against GN in patients with HCV. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Prostate cancer gene 3 urine assay for prostate cancer in Japanese men undergoing prostate biopsy," by A. Ochiai and colleagues in the 2011 issue.

Background: Although oral opioid agonist therapies (OATs), buprenorphine and methadone, are effective first-line treatments, OAT remains largely underutilized due to low retention rates and wide variation across programs. This rapid review therefore sought to summarize the retention rates reported by randomized controlled trials (RCTs) and controlled observational study designs that compared methadone to buprenorphine (or buprenorphine-naloxone). Methods: We searched four electronic databases (EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, up to April 2018) for RCTs and controlled observational studies that compared oral fixed-dose methadone to buprenorphine versus methadone (or buprenorphine-naloxone). Data were extracted separately for two different definitions of retention in treatment: (1) length of time retained in the study and (2) presence on the final day of a study. Separate random effects meta-analyses were performed for RCTs and controlled observational studies. Data from controlled observational studies where retention was measured as the length of time retained in the study were not amenable to meta-analysis. Results: Among 7603 studies reviewed, 10 RCTs and 3 observational studies met inclusion criteria (n = 5065) and compared fixed-dose oral buprenorphine with methadone. Across studies, the average retention rate was highly variable (RCTs: buprenorphine 20.0–82.5% and methadone 30.7–83.8%; observational studies: buprenorphine 20.2–78.3% and methadone 48.3–74.8%). For time period retained in the study, we observed no significant difference in treatment retention for buprenorphine versus methadone in RCTs (standardized mean difference [SMD] = − 0.07; 95% CI − 0.35–0.21, p = 0.63; quality of evidence: low). For presence on the final study day, we observed no significant difference between buprenorphine and methadone treatment retention in RCTs (risk ratio [RR] = 0.89; 95% CI 0.73–1.08, p = 0.24; quality of evidence: low) and controlled observational studies (RR = 0.75; 95% CI 0.36–1.58, p = 0.45). Conclusion: Meta-analysis of existing RCTs suggests retention in oral fixed-dose opioid agonist therapy with methadone appears to be generally equal to buprenorphine (or buprenorphine-naloxone), with wide variation across studies. Similarly, a meta-analysis of three controlled observational studies indicated no difference in treatment retention although there was significant heterogeneity among the included studies. The length of follow-up did not appear to affect the retention rate. Systematic review registration: PROSPERO CRD42018104452. [ABSTRACT FROM AUTHOR]

Role of stem cell factor and mast cells in the progression of chronic glomerulonephritides. Background. Mast cells (MCs) have been implicated in the pathogenesis of atherosclerosis and tissue fibrosis. However, the role of MC in the development of renal fibrosis has not been fully elucidated. Stem cell factor (SCF; the ligand for MC c-kit receptor) is thought to attract and activate MCs. Methods. The intensity of MC infiltration and SCF expression in renal biopsies from 56 patients with different forms of primary and secondary glomerulonephritis and five controls were investigated by immunohistochemistry, using a monoclonal anti-human MC tryptase antibody and a polyclonal antihuman SCF antibody. Results. A large number of MCs were detected in the renal interstitium of the diseased kidneys. Immunostainable SCF was detected in tubular as well as interstitial cells. MC infiltration was significantly higher in glomerulonephritis (16.9 ± 10.2 cells/field) compared with controls (2.8 ± 2.1 cells/field, P = 0.03). Similarly, immunostainable SCF was 0.6 ± 0.3% for controls and 3.3 ± 2.1% in the glomerulonephritis group (P = 0.02). MC infiltration was highly correlated with SCF expression in diseased kidneys (r = 0.93, P = 0.0001). Double immunostain showed them to colocalize in some interstitial cells. Analysis of MC proliferation [proliferating cell nuclear antigen (PCNA) positivity] and apoptosis (in situ end labeling of DNA) showed these cells to be terminally differentiated. Both MCs and SCF were correlated with interstitial fibrosis (R = 0.71 for MC and R = 0.62 for SCF, P = 0.0001) and interstitial α-smooth muscle actin (R = 0.69 for MC and R = 0.60 for SCF P = 0.0001). Using regression analysis, the number of MC infiltration was found to be a very powerful determinant of interstitial fibrosis in the glomerulonephritis group (R2 = 91.4%). Conclusion. MCs as an infiltrating hematopoietic cell and its growth factor (SCF) seem to be up-regulated in glomerulonephritis, and may play a role in the development of renal fibrosis. [ABSTRACT FROM AUTHOR]

Traumatic penile amputation and re-implantation or refashioning is scarcely reported in the literature. We present our case, the first report of successful glans refashioning in an 11-year-old boy, using the Bracka (refashioning) technique after complete glans penis amputation from a dog bite injury, with unsuccessful re-implantation due to the nature of the injury, during the dog bite. We elaborate on the process, technique, as well as the satisfactory postoperative results of the abovementioned procedure. [ABSTRACT FROM AUTHOR]

Background: Testicular torsion (TT) is a urological emergency that affects one in 4000 males younger than 25 years. Delays in the management of TT may result in testicular ischaemia, testicular necrosis, orchidectomy and infertility. This review assesses the validity of near‐infrared spectroscopy (NIRS) as a diagnostic tool in the assessment and diagnosis of TT. Methods: A systematic search of Cochrane Database of Systematic Reviews, EMBASE, Google Scholar, PubMed, Scopus and Web of Science databases was performed in January 2019 using specific search terms. Selected studies were ranked and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and the Quality Assessment of Diagnostic Accuracy Studies‐2 tool. Results: A total of nine studies that included 253 subjects (88 animals and 165 humans) with a mean sample size of 28.1 (standard deviation 40.8) subjects were included. The mean difference in testicular tissue oxygen saturation between torsed and non‐torsed testes (Δ%StO2) were 45%, 42% (±5%), 26% and 5–18% in four animal studies and 2.0%, 3.0%, 6.7%, 6.8% and 23.0% in five human studies. The tissue oxygen saturation difference between contralateral healthy testes (controls) ranged from 1% to 10% in the five studies that alluded to this. Conclusion: The current body of evidence does not support the use of NIRS in the work‐up of TT. Well‐designed clinical trials with large patient samples are required to determine whether NIRS may have some future role as a diagnostic modality in TT. [ABSTRACT FROM AUTHOR]

Objectives: The R102G variant in complement 3 (C3) results in two allotypic variants: C3 fast (C3F) and C3 slow (C3S). C3F presents at increased frequency in patients with chronic kidney disease (CKD), our aim is to explore its role in CKD progression and mortality. Methods: Delta (Δ) eGFR for 2038 patients in the Salford Kidney Study (SKS) was calculated by linear regression; those with ≤-3ml/min/1.73m2/yr were defined as rapid progressors (RP) and those with ΔeGFR between -0.5 and +1ml/min/1.73m2/yr, labelled stable CKD patients (SP).A group of 454 volunteers was used as a control group. In addition, all biopsy-proven glomerulonephritis (GN) patients were studied regardless of their ΔeGFR. R102G was analysed by real-time PCR, and genotypic and allelic frequencies were compared between RP and SP along with the healthy control group. Results: There were 255 SP and 259 RP in the final cohort. Median ΔeGFR was 0.07 vs. -4.7 ml/min/1.73m2/yr in SP vs. RP. C3F allele frequency was found to be significantly higher in our CKD cohort (25.7%) compared with the healthy control group (20.6%); p = 0.008.However, there was no significant difference in C3F allele frequency between the RP and SP groups. In a subgroup analysis of 37 patients with IgA nephropathy in the CKD cohort (21 RP and 16 SP), there was a significantly higher frequency of C3F in RP 40.5% vs. 9.4% in SP; p = 0.003. In the GN group, Cox regression showed an association between C3F and progression only in those with IgA nephropathy (n = 114);HR = 1.9 (95% CI 1.1–3.1; p = 0.018) for individuals heterozygous for the C3F variant, increased further for individuals homozygous for the variant, HR = 2.8 (95% CI 1.2–6.2; p = 0.014). Conclusion: The C3 variant R102G is associated with progression of CKD in patients with IgA nephropathy. [ABSTRACT FROM AUTHOR]