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Summary: Bridgeless ac‐dc converters are the optimal choice for many applications, as they offer many advantages such as low distorted supply current, high power factor, and improved efficiency. This paper presents a new topology for a single‐phase bridgeless ac‐dc converter. The proposed hybrid topology is based on integrating the inverting and non‐inverting buck‐boost dc‐dc converters that are connected to the ac supply through an LC filter. To insure sinusoidal supply current, the proposed hybrid bridgeless ac‐dc converter is operated in discontinuous current mode. The proposed converter has many merits, such as a reduced number of components, enhanced efficiency, and soft start‐up capability. The operation modes and design of the proposed converter are presented. In addition, a design method is proposed for the input LC filter to minimize the voltage stress across switches. Moreover, a small signal model for the proposed converter is developed. The proposed converter topology is simulated to evaluate the dynamic behavior and verify the accuracy of the presented small signal model. Furthermore, an 850 W prototype is developed to validate the features of the proposed converter experimentally. Tight voltage regulation, sinusoidal supply current, and near‐to‐unity power factor operation are observed from the results, regardless of supply or load disturbances. [ABSTRACT FROM AUTHOR]

Background Laparoscopic surgery has become the gold standard approach for almost all abdominal surgeries with subsequent increase of its related complications mainly trocar-site hernia. Patients and methods This is a prospective interventional study aims to evaluate the efficacy and safety of Nasr fascial closure, time needed to close the trocar site and occurrence of bleeding or other postoperative complications. We included patients who underwent laparoscopic surgery in General Surgery Department, Aswan University Hospital. Results One hundred seventy patients were included in our study. Most of participants were females representing 94.1% of patients. The mean age of participants was 40.9 ±9.7 years and the median (interquartile range) total time for the complete closure of the port site was 63.0 s (76.8 s). After the follow-up period of 12-15 months, no patient developed trocar-site hernia. Conclusion Nasr device provides a safe, fast and effective technique for closure of laparoscopic port sites. [ABSTRACT FROM AUTHOR]

Background Laparoscopic surgery is now the accepted method of choice for practically all abdominal procedures. A number of trocar site closure techniques have been developed, but many of them are unaffordable and/or difficult to employ. Patients and methods The objective of this prospective interventional study is to assess the duration required to close the trocar site, the incidence of hemorrhage or other postoperative problems, and the safety and effectiveness of a novel fascial closure technique (the Madany closure). Patients who were eligible for laparoscopic cholecystectomy at the Aswan University Hospital's General Surgery Department were included. Results One hundred and thirty patients were included in our study. Most of the participants were females, representing 93.08% of patients. The mean age of participants was 40.07±10.02 years, and the median (interquartile range) total time for the complete closure of the port site was 83.5 s (44.75 s). After the follow-up period of 6 months, no patient developed a trocar-site hernia. Conclusion The Madany closure technique provides a safe, fast, and effective technique for the closure of laparoscopic port sites. [ABSTRACT FROM AUTHOR]

Introduction and Objective: To compare the safety and efficacy of Holmium Laser Xpeeda Vaporization and GreenLight XPS Vaporization of the prostate in patients with prostate size ≤80 g. Methods: Ninety-two men with benign prostatic hyperplasia (BPH) and prostate size ≤80 g scheduled for laser prostatectomy were included in this prospective randomized trial. Outcome measures were collected and compared, including International Prostate Symptom Score (IPSS), quality of life (QoL), flow rate, postvoid residual urine volume (PVR), International Index of Erectile Dysfunction (IIEF)-15, prostate-specific antigen (PSA), transrectal ultrasound prostate volume, and catheterization time. Perioperative complications were also recorded. Patients were offered a trial of void (TOV) 3 hours after their procedures. All patients were followed-up at 1, 3, 6, and 12 months. Results: There were no significant differences in preoperative baseline data between the two surgical groups. Operative parameters and postoperative outcomes were comparable. Effective same-day TOV was noted in 73.1% and 72.7% of the Xpeeda and GreenLight XPS patients, respectively (p = 0.98). All patients were discharged home within 24 hours of their surgeries. The laser energy and postoperative complications were significantly lower in the Xpeeda group (p = 0.002 and p = 0.026, respectively). At 3 months, the PSA levels significantly dropped in both groups (p = 0.002 and p < 0.001). There were no significant differences in functional and sexual outcomes between the two groups at 12 months. Conclusions: Holmium Laser Xpeeda Vaporization and GreenLight XPS Vaporization are safe and effective in the treatment of BPH. Same-day discharge with early TOV is a feasible option. Clinical Trials.gov Identifier: NCT04386941. [ABSTRACT FROM AUTHOR]

This paper focuses on digital archiving and the establishment of open Access digital repositories in three selected Nigerian Universities. Despite the abundance of vital information kept in the traditional archives of Nigerian universities, many researchers cannot easily access it due to the seeming absence of proper digitization and online visibility. It is also observed that the practice of archiving and the management of information in the repositories in Nigerian universities is limited to the central library, which makes access to information in the satellite archives across the departments and in the administrative units very difficult. This paper therefore, intends to; determine the nature, existence and the roles of digital repositories in the three selected Nigerian universities and to identify the types of information sources and resources available in their digital repositories, among others. Qualitative research methodology was adopted. Data was purposefully obtained from the websites of the three Selected Nigerian universities. The findings of this study indicate that the Digital Repositories existed in the three selected universities studied with different names, and were found to contain volumes of scholarly information sources and resources, which were organized in a systematic and chronological order, but it is not well structured to specifically link resources in the departments, faculties and other units of the universities with the central repositories. It was also found that Digital Repositories were not always accessible, possibly due to inadequate ICT infrastructure and necessary staff skills for their effective maintenance. It was concluded that the repositories existed for over a decade and were providing information services to its users. It was recommended that, the management of the universities studied should imbibe strong maintenance culture to effectively manage the Digital Repositories for sufficient access to scholarly information sources and resources and should consider the installations and deployment of necessary ICT infrastructure, as well as the right software configurations including the provision of regular staff training for proper digitisation and digitalisation of work processes and procedures in the repositories for efficient results and the promotion of Digital Data Literacy in Africa. [ABSTRACT FROM AUTHOR]

Background: Febrile seizures (FS) frequently manifest in children below 5 years of age. Although the exact etiology is still unknown, genetic predisposition, changes in neurotransmitter levels, and serum electrolyte imbalance are some of the known risk factors. This study examined the possible association between serum magnesium levels in children with FS compared to febrile children without seizures. Methods: A retrospective case-control study was conducted from February 2019 to January 2021, recruiting 230 age and gender-matched cases and controls (115 each). Extracted data were analyzed using SPSS using an independent student's t-test, Chi-square test, and Pearson's correlation analysis. Results: The mean serum magnesium levels were 0.93 ± 0.129 vs 0.97 ± 0.0961; p < 0.001, between cases and controls respectively. Similarly, hypomagnesemia (<0.85 mmol/L) was detected in 26.1% and 8.7% of the cases and controls, respectively; p < 0.001. A significant negative correlation was found between serum magnesium levels and the occurrence of febrile seizures; r = [-0.169], p < 0.05. Conclusion: Serum magnesium was significantly low in febrile children with seizures compared to those without, and hypomagnesemia was associated with the occurrence of febrile seizures. These results portray hypomagnesemia as a possible risk factor for febrile seizure, and so should be validated in future large cohort studies so that guidelines are set for proper management of these children. [ABSTRACT FROM AUTHOR]

Materials and Methods: We carried out a retrospective analysis of patients who underwent top-down HoLEP for the management of recurrent BPH at our institution. Patients who had previously undergone TURP were assigned to group I, while those with no history of prostate surgery were allocated to group II. Preoperative clinical characteristics, enucleation time, resected tissue weight, morcellation time, energy used, and intraoperative and postoperative complications were recorded and statistically analyzed. Patients were followed up postoperatively at 1, 3, 6, and 12 months. The evaluation included the International Prostate Symptom Score (IPSS), quality of life assessment (QoL), maximum urinary flow rate (Qmax), postvoid residual urine test (PVR), and continence status.Results: Two hundred and sixty-nine patients were included in this study. Group I consisted of 68 patients with recurrent BPH, while group II included 201 patients. There were no statistically significant differences in preoperative characteristics between both groups. The median enucleation time for group I (67.5 min (25-200)) was not significantly longer than that for group II (60 min (19-165) (p=0.25)). Operative outcomes, including morcellation time, resected weight, catheter duration, and hospital stay, were comparable between both groups. At 1, 3, 6, and 12 months, all urinary functional outcomes showed significant improvement, and there were no significant differences between the two groups. At 3 months' follow-up, two patients in group I and three patients in group II experienced stress urinary incontinence (SUI). At the last follow-up visit, one patient from group I presented with persistent SUI.Conclusions: For managing recurrent and nonrecurrent cases of BPH, top-down HoLEP is safe with comparable urinary functional outcomes. Patients with a history of previous prostate surgery can be counselled that their prior transurethral procedure does not reduce the benefits of HoLEP. [ABSTRACT FROM AUTHOR]

This paper presents the development of a numerical model for predicting and studying the effects of tool nose geometries and its interactions with cutting parameters during orthogonal cutting of AISI 1045 steel. The process performance characteristics studied were cutting temperature, effective stress, cutting forces and tool wear. The cutting simulations were done using the commercial DEFORM-2D R V 11.3 software, based on the finite element method (FEM). The cutting tool used had a round nose with various nose radii (0.01–0.9 mm), while the machining parameters tested were the feed rate (0.1–0.3 mm/rev), the cutting speed (100–500 m/min) and the rake angle (–5° to +10°). The interactions between the tool nose radius and the cutting parameters (speed, feed) were found to affect mostly the cutting stress and, slightly, the tool wear rate. These interactions did not much influence the cutting temperature, that was found to be high when the tool nose radius and/or the cutting speed were high. The maximum temperature was found to occur at the middle of the tool-chip contact length and at the interaction of nose radius and flank face of the tool. Except for some fluctuations, there was no significant difference in tool wear rate between small and large nose radius scales. [ABSTRACT FROM AUTHOR]

AbstractThis study provides an updated quantitative analysis and prospective paleoenvironment reconstruction of the Tut oilfield, Shushan Basin, North Egypt to evaluate the hydrocarbon reservoirs in space and times for further development plans and modeling in the Tethyan region. Two sporomorph interval zones (Classopollis brasiliensis and Afropollis jardinus), and one total foraminiferal Range Zone (Thomasinella punica) are proposed. Three palynofacies assemblages are differentiated using cluster analysis of the different palynofacies parameters. The paleoenvironmental conditions during the Cenomanian were reconstructed. Palynofacies assemblage I of the Baharyia Formation suggests a marginally dysoxic-oxic basin environment with a common occurrence of ostracods and terrestrial organic matter, while palynofacies assemblage II reflects the high abundance of dinoflagellate cysts, suggesting a suboxic-anoxic middle neritic environment. Palynofacies assemblage III of the upper part of the Abu Roash G Member represents a relatively deep water inner-middle neritic environment. Three 3rd order significant sequences separated by two hiatus surfaces (Ce3 and Ce4) are described and correlated with the global eustatic sea-level. The hydrocarbon evaluation results show that the samples from the Abu Roash G Member contain oil-prone material of kerogen type II, while the samples of the Baharyia Formation are characterized by kerogen type III (gas-prone). Spore coloration analysis reveals that the samples from the studied units are too immature to produce gas or oil and are ineffective as sources of hydrocarbons. [ABSTRACT FROM AUTHOR]

Background: Motor neuron disease is a heterogeneous group of progressive neurodegenerative disorders, most common of which is amyotrophic lateral sclerosis (ALS). There are many clinical and radiological criteria to diagnose amyotrophic lateral sclerosis and to differentiate it from other motor neuron disease and neurodegenerative disorders. Neuro-sonography is one of the easily applied tools to diagnose and differentiate ALS. ALS diagnosis is delayed up to 3 years according to some authors due to the wide differential diagnosis, with cervical degeneration being a common misdiagnosis. The objective of this study was to evaluate the role of neuro-sonography in diagnosis and differentiation of amyotrophic lateral sclerosis from other causes of progressive mixed upper and lower motor neuron lesion. Results: A total neuro-sonography score at a cut-off point (≤ 127) predicted patients with ALS, with good (85%) accuracy, sensitivity = 73% and specificity = 83% (p < 0.01) and Lt median arm score at a cut-off point (≤ 6) predicted patients with ALS, with good (88%) accuracy, sensitivity = 86% and specificity = 86% (p < 0.01) and the median nerve at the arm level was the most sensitive and specific nerve to predict patients with ALS. Conclusion: Neuro-sonography of peripheral nerves is a recent, noninvasive, accessible technique that can be used in early diagnosis of ALS. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: The GreenLight™ MoXy® laser fiber has been used since 2010 for benign prostatic hyperplasia procedures. We tested a novel principle to increase the saline irrigation flow rates beyond the current standard of gravity drip (∼22 cc/minutes) within the fiber-attached cooling system to potentially prevent excessive tissue adherence and to eliminate the likelihood of degradation due to abnormal overheating. The objective was to assess differences between the ordinary and active pumping methods with ≥2 times flow rate after conditioning of the laser fiber. Materials and Methods: A controllable full, tissue-contact system was utilized for conditioning in a porcine model, applying 180 W of vaporization mode of GreenLight XPS console for 30 continuous minutes. Four groups were evaluated using different saline flow rates; the nominal flow rate (control group, 22 mL/minute), digital pump set (35 mL and 50 mL/minute), and a manual pressure cuff with hand pump set using a 3-L saline bag with pressure of 300 mmHg (35–80 mL/minute). At the end of the conditioning process, a mechanical pull force test was executed on the fiber metal cap to evaluate the bonding strength. A failed event was defined as the natural detachment of the metal cap during the conditioning process or a cap pull force smaller than 22.24 N resulting in detachment. Additional physical parameters, including fiber tip temperature information and laser beam power transmission efficiency, were analyzed. Results: Detachment of the cap occurred less frequently when using the 300 mmHg pressure cuff saline bag compared to the nominal flow rate (6.67% vs 50%, respectively). The average operating fiber tip temperatures were lower in the higher flow rate groups compared to nominal, measured at 315°C and 305°C. compared to 442°C. Moreover, a significantly lower FiberLife Event count and an ∼5% increase of the average final laser transmission efficiency were observed in the higher flow rate groups. Conclusions: Our study demonstrates superior results when using active pumping or high-pressure systems to increase saline flow rates in terms of laser fiber durability without any additional cost. More specifically, use of a manual pressure cuff with starting pressure at 300 mmHg, a system that is readily available in most operating rooms, increases MoXy fiber durability. Further studies are required to assess if this technique will improve user experience, clinical outcomes, and procedure costs. [ABSTRACT FROM AUTHOR]

Background: Prostate size estimation is a valuable clinical measure widely utilized in urology. This study evaluated the accuracy of preoperative transabdominal ultrasound (TAUS) compared to radical prostatectomy specimens and transrectal ultrasound (TRUS) in estimating prostate volume and identifying presence of median lobe, across different size groups, using the standard ellipsoid formula. The effect of median lobe on accuracy was also assessed. Materials and Methods: Ninety-eight men undergoing robot-assisted radical prostatectomy were enrolled in this study. Preoperative evaluation of prostate volume was done using measurements obtained from TAUS using the Clarius C3 handheld wireless point-of-care ultrasound (POCUS) and from TRUS Clarius EC7. Participants were grouped based on prostate size (<30, 30–60, and >60 g). Mean absolute percentage of error was used to evaluate accuracy. Mean percentage of error determined if there was an overestimation or underestimation. Correlation between each TAUS size group, true prostate weight and TRUS was assessed. Results: Irrespective of body mass index, TAUS accurately identified median lobe in all men. No statistically significant difference was found between specimen weight and TAUS prostate size for the >60 g group. Among this same group, a strong correlation was noted between specimen weight and TAUS prostate size (r = 0.911, p < 0.001). There was also a strong correlation between TAUS and TRUS measurements for this group (r = 0.950, p < 0.001). Presence of median lobe did not have an impact on measurement accuracy. Conclusions: Bedside handheld wireless POCUS provides rapid, inexpensive, noninvasive, and clinically accurate TAUS prostate assessments for larger prostates. Such features as identifying median lobes and measuring prostate volumes are valuable tools, whereas patient counseling on lower urinary tract symptoms, elevated prostate-specific antigen, and benign prostate hyperplasia are surgical options. [ABSTRACT FROM AUTHOR]

Purpose: Most Canadian hospitals face significant reductions in operating room access during the summer. We sought to assess the impact of longer wait times on the oncological outcomes of localized prostate cancer patients following robotic-assisted radical prostatectomy (RARP). Methods: We conducted a retrospective review of a prospectively maintained RARP database in two high-volume academic centers, between 2010 and 2019. Assessed outcomes included the difference between post-biopsy UCSF-CAPRA and post-surgical CAPRA-S scores, Gleason score upgrade and biochemical recurrence rates (BCR). Multivariable regression analyses (MVA) were used to evaluate the effect of wait times. Results: A total of 1057 men were included for analysis. Consistent over a 10 year period, summer months had the lowest surgical volumes despite above average booking volumes. The lowest surgical volume occurred during the month of July (7.1 cases on average), which was 35% less than the cohort average. The longest average wait times occurred for patients booked in June (93 ± 69 days, p < 0.001). On MVA, patients booked in June had significantly more chance of having an increase in CAPRA score [HR (95% CI) 1.64 (1.02–2.63); p = 0.04] and in CAPRA risk group [HR (95% CI) 1.82 (1.04–3.19); p = 0.03]. Cohort analysis showed fair correlation between CAPRA-score difference and wait time (Pearson correlation: r = − 0.062; p = 0.044). Conclusion: Our cohort results demonstrate that conventional RARP wait times are significantly and consistently prolonged during summer months over the past 10 years, with worse post-RARP oncological outcomes in terms of CAPRA scores. Other compensatory mechanisms to sustain consistent yearly operative output should be considered. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study is to evaluate the impact of having a nadir and persistently detectable ultrasensitive prostate-specific antigen (uPSA) between 0.01 and 0.1 ng/ml post-robot-assisted radical prostatectomy (RARP), on future biochemical recurrence (BCR). Methods: We conducted a retrospective analysis of a prospectively maintained cohort of 1359 men who underwent RARP, between 2006 and 2019. Patients were followed with uPSA at 1, 3, 6, 9, 12, 18, 24, 30, 36 months and annually thereafter. We included patients with PSA nadir values between 0.01 and 0.1 ng/ml within 6 months of surgery and with at least 2 follow-up measurements within the same range. We divided patients based on their BCR status and analyzed uPSA changes. Multivariable Cox-regression models (CRMs) were used to analyze variables predicting BCR-free survival (BCR-FS). Results: We identified 167 (12.3%) patients for analyses, with a mean follow-up time of 60.2 ± 31.4 months. In our cohort, 5-year BCR-FS rate was 86%. Overall, 32 (19.1%) patients had BCR, with a mean time to BCR of 43.7 ± 24.3 months. BCR-free patients had stable mean uPSA values ≤ 0.033 ng/ml, while patients who developed BCR showed a slowly rising trend over time, with a significant difference between groups starting at 9 months (p < 0.02). In multivariable CRMs, a rising uPSA starting at 9 months was an independent predictor of BCR (HR: 2.7; 95% CI 1.6–3.82; p = 0.013). Conclusion: In the present cohort, our results demonstrated that a considerable number of men have detectable uPSA values ranging between 0.01 and 0.1 ng/ml post-RARP. They can still be followed regularly to avoid patients' anxiety and salvage radiotherapy. Close follow-up is still required. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Most robot-assisted surgery (RAS) systems in Canada are donor-funded, with constraints on implementation and access due to significant costs, among other factors. Herein, we evaluated the impact of the growing multispecialty use of RAS on urologic RAS access and outcomes in the past decade. METHODS: We conducted a retrospective review of all RAS performed by different surgical specialties in two high-volume academic hospitals between 2010 and 2019 (prior to the COVID pandemic). The assessed outcomes included the effect of increased robot access over the years on annual robotic-assisted radical prostatectomy (RARP) volumes, surgical waiting times (SWT), and pathologically positive surgical margins (PSM). Data were collected and analyzed from the robotic system and hospital databases. RESULTS: In total, six specialties (urology, gynecology, general, cardiac, thoracic, and otorhinolaryngologic surgery) were included over the study period. RAS access by specialty doubled since 2010 (from three to six). The number of active robotic surgeons tripled from seven surgeons in 2010 to 20 surgeons in 2019. Moreover, there was a significant drop in average case volume, from a peak of 40 cases in 2014 to 25 cases in 2019 (p=0.02). RARP annual case volume followed a similar pattern, reaching a maximum of 166 cases in 2014, then declining to 137 cases in 2019. The mean SWT was substantially increased from 52 days in 2014 to 73 days in 2019; however, PSM rates were not affected by the reduction in surgical volumes (p<0.05). CONCLUSIONS: Over the last decade, RAS access by specialty has increased at two Canadian academic centers due to growing multispecialty use. As there was a fixed, single-robotic system at each of the hospital centers, there was a substantial reduction in the number of RAS performed per surgeon over time, as well as a gradual increase in the SWT. The current low number of available robots and unsustainable funding resources may hinder universal patient access to RAS. [ABSTRACT FROM AUTHOR]

Aims: The role of liver steatosis and increased liver enzymes (ALT) in increasing incident type 2 diabetes mellitus (T2DM) is debated, because of their differential effects on different ethnicities and populations. The aim of this study was to evaluate the role of elevated ALT in the development of T2DM in non-diabetic obese subjects receiving routine medical treatment. Methods: A total of 1005 subjects [296 men and 709 women, aged 45.7 ± 13.12 years, body mass index (BMI) 39.5 ± 4.86 kg/m2] were followed for a mean period of 14.3 ± 4.44 years. Subjects were evaluated for several metabolic variables, including the triglyceride-glucose index and the presence of metabolic syndrome (IDF 2005 definition), and were subdivided into ALT quartiles. Results: T2DM developed in 136 subjects, and the difference was significant between the first and the fourth ALT quartile (p = 0.048). Both at univariate analysis and at stepwise regression, ALT quartiles were associated with incident T2DM. Traditional risk factors for T2DM coexisted, with a somehow greater predictive value, such as triglyceride-glucose index, age, arterial hypertension, LDL-cholesterol, and metabolic syndrome. Conclusions: These data suggest an association between elevated ALT levels and the risk of incident T2DM in obesity. [ABSTRACT FROM AUTHOR]

Aims: Long-term comparisons between bariatric surgical techniques have been performed for gastric bypass (RYGB), sleeve gastrectomy (LSG), and biliopancreatic diversion (BPD) vs gastric banding (LAGB), but short-term studies (6 months-4 years) have only compared biliointestinal bypass (BIBP) and LAGB. The participating institutions regularly perform both BIBP and LAGB with a common protocol, and the aim of this retrospective study was to compare long-term effects of the two procedures on body weight, on clinical and metabolic variables, and on resolution of obesity and of diabetes.Methods: All procedures performed between 01/01/1998 and 31/12/2005 were considered; 73 out of 91 patients undergoing BIBP, and 154 out of 249 patients undergoing LAGB were evaluable up to 9 years.Results: BIBP was significantly more effective than LAGB in terms of weight loss and of resolution of obesity (BMI < 30 kg/m2), in terms of decrease of systolic blood pressure and of serum cholesterol, and similar in terms of resolution of diabetes. In addition, the effect of BIBP was stable, while the effect of LAGB decreased with time.Conclusions: Both BIBP and LAGB exert long-term effects on body weight, on blood pressure, and on resolution of diabetes mellitus; the effect of BIBP is significantly greater than the effect of LAGB in terms of weight loss, resolution of obesity, of control of systolic blood pressure and of serum cholesterol, but not in terms of resolution of diabetes. [ABSTRACT FROM AUTHOR]

Objectives: To characterize testosterone profile changes over time in a cohort of prostate cancer (PCa) patients managed with active surveillance (AS) and to assess its correlation with the initial disease characteristics and further progression.Methods: We conducted retrospective chart review of PCa patients managed with AS. Patients were followed with PSA, total, free and bioavailable testosterone measurements, physical examination, and by repeat biopsies or periodic magnetic resonance imaging. Disease progression was identified by follow-up biopsy changes or by imaging. A Cox proportional hazard regression models were used to assess the association between testosterone profile at baseline and the risk of progression.Results: For the 122 patients included in analyses, the mean age at diagnosis was 65.8 years; the mean follow-up time was 7.8 years. At baseline, 108 (88.5%) patients had a Gleason score of ≤ 6. In all, 45 (36.8%) patients had disease progression, with a mean time to progression of 4.6 years. During follow-up, PSA levels showed a rising trend, while testosterone profile levels showed a trend of decrease over time. There was no significant correlation between PSA and testosterone profile (total, free, and bioavailable) level changes over time (ρ = − 0.14, − 0.11 and − 0.16, P = 0.16, 0.34, and 0.20, respectively). In addition, multivariable analysis showed that serum-free testosterone was an independent predictor of disease progression (HR 0.93, 95% CI 0.88-0.99, P = 0.029).Conclusion: Our study results showed that testosterone profile measurements tended to decrease over time in PCa patients managed with AS. Free testosterone was a significant independent variable of disease progression. [ABSTRACT FROM AUTHOR]

A scheme is presented to estimate the magnetic hyperfine field due to orbital and spin current densities of 3d transition metal free ion and in a crystal field. Orbital and spin contributions to magnetic hyperfine fields of most of the 3d transition metal free ions are presented. The application of the formulae offered is tested on the ground state of the free ion Fe 2 + and when this ion is in the compound FeF 2 . The estimated orbital and spin contributions to magnetic hyperfine fields of Fe 2 + free ion are in good agreement with previously measured and estimated in the literature. The values of estimated orbital and spin contributions to magnetic hyperfine fields of Fe 2 + in FeF 2 compound depend on the effective 〈 r eff - 3 〉 values of the 〈 r - 3 〉 . The 〈 r eff - 3 〉 = 3.0 a.u. produces values of orbital and spin contribution to magnetic hyperfine fields that are also in good agreement with the measured and estimated ones in the literature. [ABSTRACT FROM AUTHOR]

A sequence biostratigraphic analysis has been done for the Upper Cretaceous-Lower Paleogene sedimentary outcrops at Wadi Raha, Sudr El-Hetan and Wadi El-Giddi areas in west-central Sinai. The sequences are subdivided into four carbonate rock units; from base to top: the Wata, Themed, Sudr and Waseiyit formations. The biostratigraphic analysis of the studied samples led to the identification of two main planktonic foraminiferal zones, three benthic foraminiferal zones with the ammonite zone. Eleven microfacies associations are recorded in the rock units. Nine constitutes a limestone facies with one constitutes a dolostone facies and one a claystone facies. The stratigraphic data, and the facies study support the identification of three major breaks (sequence boundaries) and four depositional sequences. The depositional sequences are subdivided into four supercycles and seven cycles of 3rd order. The oldest break (∼90-88.5Ma.) exists at the top of the Wata Formation coincides with the intra Turonian drop in the global sea level with the initiation of the Syrian Arc inversion phase. The second major break (85 - ∼75Ma.) coincides with the major inversion phase and the evolution of the doubly plunging anticlines. The third major break (∼68 through ∼53Ma.) represents the last phase of the Syrian Arc inversion and complete the missing of Paleocene sequences. [ABSTRACT FROM AUTHOR]

Irreducible tensor operators formulism has been employed to derive basis set charge densities from the expressions of t 2 g and e g eigenstates. The resulting basis set has been utilized to generate and visualized charge densities of pure and hybrid charge densities of single d electron and many-electron systems of transition-metal compounds. The role-plays by spin–orbit coupling contribution in mixing the densities have been demonstrated. The ground states of pentagonal bipyramidal, square planar, and trigonal bipyramidal complexes are due to spin–orbit coupling. The resulting charge densities are in full agreement with previous works in the literature. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: The aim of this study was to assess if there is a difference in survival after radical cystectomy (RC) when examined in relation to prior non-muscle invasive bladder cancer (NMIBC) disease vs. invasive cancer de novo at time of diagnosis. Methods: We conducted a retrospective study of all patients who underwent RC within Quebec health insurance medical services database during the years (2000-2009). Overall survival (OS) outcome was assessed with Kaplan-Meier curves and hazard ratios (HRs) adjusted for age and gender. Results: A total of 2,671 subjects met the eligibility criteria. Among them, 19.8% had presumed prior NMIBC that further progressed to invasive disease. Median survival after RC for patients with presumed prior NMIBC was 4.3 years as compared to patients with presumed invasive disease de novo 3.7 years (p = 0.007, Wilcoxon test). Patients with presumed NMIBC at the time of diagnosis had a 16% decrease in the risk of mortality after RC, when compared to patients with presumed invasive BC de novo (HR 0.84, 95% CI 0.73-0.96 (p = 0.0166)). Conclusion: Our results suggest a slightly better prognosis, regarding OS after RC for patients with presumed NMIBC who progressed to invasive disease, when compared to patients with presumed invasive disease de novo at the time of diagnosis. [ABSTRACT FROM AUTHOR]

Background and aim: Aim of this retrospective study was to compare long-term mortality and incidence of new diseases [diabetes and cardiovascular (CV) disease] in morbidly obese diabetic and nondiabetic patients, undergoing gastric banding (LAGB) in comparison to medical treatment. Patients and methods: Medical records of obese patients [body mass index (BMI) > 35 kg/m2 undergoing LAGB (n = 385; 52 with diabetes) or medical treatment (controls, n = 681; 127 with diabetes), during the period 1995-2001 (visit 1)] were collected. Patients were matched for age, sex, BMI, and blood pressure. Identification codes of patients were entered in the Italian National Health System Lumbardy database, that contains life status, causes of death, as well as exemptions, drug prescriptions, and hospital admissions (proxies of diseases) from visit 1 to September 2012. Survival was compared across LAGB patients and matched controls using Kaplan-Meier plots adjusted Cox regression analyses. Results: Observation period was 13.9 ± 1.87 (mean ± SD). Mortality rate was 2.6, 6.6, and 10.1 % in controls at 5, 10, and 15 years, respectively; mortality rate was 0.8, 2.5, and 3.1 % in LAGB patients at 5, 10, and 15 years, respectively. Compared to controls, surgery was associated with reduced mortality [HR 0.35, 95 % CI 0.19-0.65, p < 0.001 at univariate analysis, HR 0.41, 95 % CI 0.21-0.76, p < 0.005 at adjusted analysis], similar in diabetic [HR 0.34, 95 % CI 0.13-0.87, p = 0.025] and nondiabetic [HR 0.42, 95 % CI 0.19-0.97, p = 0.041] patients. Surgery was also associated with lower incidence of diabetes (15 vs 48 cases, p = 0.035) and CV diseases (52 vs 124 cases, p = 0.048), and of hospital admissions (88 vs 197, p = 0.04). Conclusion: Up to 17 years, gastric banding is associated with reduced mortality in diabetic and nondiabetic patients, and with reduced incidence of diabetes and cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Introduction and objectives: Previous studies reported improved outcomes for bladder cancer patients who had radical cystectomy (RC) performed by surgeons and hospitals with high annual RC volumes. The objective of this study was to determine the effect of high hospital and surgeon volume on overall survival after RC for bladder cancer in Quebec. Methods: We conducted a retrospective cohort study using data of patients who underwent RC for bladder cancer from 2000 to 2009. The cohort was obtained with the linkage of two health databases: the RAMQ database (data on medical services) and the ISQ database (vital status data). Hospital and surgeon volumes were defined as the average annual number of RC performed at an institution or by surgeon, respectively, during the study period. We considered high hospital and surgeon volume those found in the third and fourth quartiles of the distribution of hospital and surgeon volumes. The effect of high hospital and surgeon volume on survival was assessed by multivariate Cox proportional hazards models. Results: We analyzed a total of 2,778 patients who met inclusion criteria (75 % males). High hospital volume and surgeons were found to be significantly associated with improved overall survival (HR = 0.87, 95 % CI: 0.78-0.97 and HR = 0.81, 95 % CI: 0.71-0.91, respectively). The combined effect of high-volume hospital and high-volume surgeon decreased by 20 % the risk of long-term mortality (HR = 0.80, 95 % CI: 0.70-0.91). Conclusions: Compared to low-volume providers, having RC for bladder cancer performed in high-volume hospitals or by high-volume surgeon was associated with improved overall survival. [ABSTRACT FROM AUTHOR]

Introduction: Radical cystectomy (RC) is a very complex urologie procedure. Despite improvements in practice, technique and process of care, it is still associated with significant complications, including death, with reported postoperative mortality rates ranging from 0.8% to 8%. We examine the quality of surgical care indicators and document the mortality rates at 30, 60 and 90 days after RC across Quebec. Methods: Within the Régie de l'assurance maladie du Québec (RAMQ) administrative database (this database provides prospectively collected universal data on all medical services) and the Institut de la statistique du Québec (ISQ) database (this provides vital status data), we used procedure codes to identify patients who underwent RC for bladder cancer in Quebec over 10 years (between 2000 and 2009), as well as RC outcomes and dates of death. Data obtained were retrospectively analyzed in relation to multiple parameters, including patient characteristics and health-care providers' volumes. The outcomes analyzed included post-operative complications and mortality rates at 30, 60 and 90 days. Results: A total of 2778 RC were performed in 48 hospitals by 122 urologists across Quebec. Among them, 851 (30.6%) patients had at least one postoperative complication and 350 (12.6%) patients had more than one complication. The overall mortality rates at 30, 60 and 90 days were 2.8%, 5.3% and 7.5%, respectively, with significantly elevated 90-day mortality rates in some centres. In the multivariate analysis, increased age was associated with increased risk of post-RC complications and mortality. For example, patients over 75 had more chance of having at least one postoperative complication (odds ratio [OR] 1.66, 95% confidence interval [Cl]: 1.31-2.11 ) and mortality at 90 days (OR3.28, 95% Cl: 2.05-5.26). Provider volume effect on outcomes was statistically significant, with large hospitals having decreased risk of 30-day mortality (OR 0.29, 95% Cl: 0.12-0.70), 60-day mortality (OR 0.41, 95% Cl: 0.26-0.82) and 90-day mortality (OR 0.52, 95% Cl: 0.29-0.93) when compared to smaller hospitals. Surgeon volume showed weak, but not statistically significant, evidence of reduced odds of mortality for the high-volume surgeon. Limitations to our study include reliance on administrative data, which lack some relevant clinical information (such as patient functional status and tumour pathological characteristics) to perform risk adjustment analysis. Conclusion: Our study demonstrates that postoperative outcomes after RC in Quebec varies based on several parameters. In addition, 30-day postoperative mortality after RC in Quebec appears acceptable. However, 90-day postoperative mortality rates remain significantly elevated in some centres, particularly in the elderly. This requires further research. [ABSTRACT FROM AUTHOR]

Introduction: According to the Royal College objectives of training in urology, urologie surgical procedures are divided as category A, B and C. We wanted to determine the level of proficiency required and achieved by urology training faculty for Royal College accreditation. Methods: We conducted a survey that was sent electronically to all Canadian urology training faculty. Questions focused on demographics (i.e., years of practice, geographic location, subspecialty, access to robotic surgery), operating room contact with residents, opinion on the level of proficiency required from a list of 54 surgical procedures, and whether their most recent graduates attained category A proficiency in these procedures. Results: The response rate was 43.7% (95/217). Among respondents, 92.6% were full timers, 21.1% practiced urology for less than 5 years and 3.2% for more than 30 years. Responses from Quebec and Ontario formed 69.4% (34.7% each). Of the respondents, 37.9% were uro-oncologists and 75.7% reported having access to robotic surgery. Sixty percent of faculty members operate with R5 residents between 2 to 5 days per month. When respondents were asked which categories should be listed as category A, only 8 procedures received 100% agreement. Also, results varied significantly when analyzed by sub-specialty. For example, almost 50% or more of uro-oncologists believed that radical cystectomy, anterior pelvic exenteration and extended pelvic lymphadenectomy should not be category A. The following procedures had significant disagreement suggesting the need for re-classification: glanular hypospadias repair, boari flap, entero-vesical and vesicovaginal fistulae repair. Overall, more than 80% of faculty reported that their recent graduating residents had achieved category A proficiency, in a subset of procedures. However, more than 50% of all faculty either disagreed or were ambivalent that all of their graduating residents were Category A proficient in several procedures. Conclusions: There is sufficient disagreement among Canadian urology faculty to suggest another revision of the current Royal College list of category A procedures. [ABSTRACT FROM AUTHOR]

Ninety random grain samples were collected and analyzed for mycotoxins, and the effect of gamma irradiation on the production of mycotoxins in grains was studied. Aspergillus, Penicillium, Mucor, Rhizopus, Fusarium, Alternaria, Scopulariopsis and Cladosporium were the most common fungal genera isolated from grains. Aspergillus flavus, Aspergillus niger, Aspergillus candidus, Aspergillus ochraceus, Penicillium citrinum, Penicillium expansum, Penicillium citreonigrum, Penicillium purpurogenum, Penicillium griseofulvum and Penicillium verrucosum were the most common Aspergillus and Penicillium species in grains. Out of 120 Aspergillus and Penicillium isolates, 80 were mycotoxin producers. Analysis of grains revealed the occurrence of aflatoxin B1 ochratoxin A, cycolopiazonic acid and citrinin. Of the 90 samples, 67 were positive for one or more mycotoxin. Irradiation of grains at dose of 2.0 and 4.0 kGy decreased significantly the total fungal counts compared with unirradiated controls. After 100 days of storage at room temperature, the unirradiated grains were contaminated with high concentrations of mycotoxins as compared with irradiated 4.0-kGy samples. Mycotoxin production in grains decreased with increasing irradiation doses and was not detected at 6.0 kGy over 100 days of storage. [ABSTRACT FROM AUTHOR]

• New pyrazole (3) and pyridazin-4(H)-one (4) derivatives were synthesized. • Their structures were determined by FTIR, NMR spectra and microanalysis. • Its molecular and supramolecule structure aspects were presented. • 3 and 4 are more safe than 5-fluorouracil against normal skin fibroblasts (HSF). • Both compounds are more active than 5-fluorouracil against MDA-MB231 and HCT cell lines. In this study, 2-(1-benzoyl-5‑hydroxy-3-phenyl-4,5-dihydro-1 H -pyrazol-5-yl)-1-phenylethan-1-one (3) and 3-benzyl-6-phenylpyridazin-4(1 H)-one (4) were synthesized, characterized and their anti-cancer activities were evaluated. The structures of both compounds were confirmed from their FTIR, 1H, 13C, 1H1H– COSY, 1H13C– HMQC NMR spectra and microanalysis. The structure of 4 is further confirmed using X-ray single crystal diffraction. The structure is not perfectly planar showing different degrees of twisting between the aromatic ring systems. Hirshfeld calculations revealed the importance of the O...H (7.8%), N...H (4.9%) and C...O (1.8%) short contacts in the supramolecular structure of 4. The two newly synthesized derivatives were first screened for cytotoxic activities on normal skin fibroblasts (HSF) for evaluating their safety profiles. More investigations were conducted by evaluating their anticancer activities against two human tumors (MDA-MB 231 and HCT). Both compounds were found more active than the reference 5-fluorouracil against MDA-MB231 showing IC 50 values of 8.02 µM and 6.205 µM for 3 and 4 , respectively, however, 68.155 µM and 71.8 µM on treating of HCT cells. Finally, both compounds were subjected for molecular docking studies into the binding site of the Aldehyde Dehydrogenase 1A (ALDH1A) enzyme based on findings of the earlier in vitro biological evaluation to get a better understanding of potential intermolecular interactions and look into the possibility of a binding pattern that may be responsible for the compounds inhibitory activities. [Display omitted] [ABSTRACT FROM AUTHOR]

Prolonged screen time (ST) has adverse effects on autistic characteristics and language development. However, the mechanisms underlying the effects of prolonged ST on the neurodevelopment of children with autism spectrum disorder (ASD) remain unclear. Neuroimaging technology may help to further explain the role of prolonged ST in individuals with ASD. This study included 164 cases, all cases were divided into low-dose ST exposure (LDE group 108 cases) and high-dose ST exposure (HDE group 56 cases) based on the average ST of all subjects. Spatial independent component analysis (ICA) was used to identify resting state networks (RSNs) and investigate intra- and inter-network alterations in ASD children with prolonged ST. We found that the total Childhood Autism Rating Scale (CARS) scores in the HDE group were significantly higher than those in the LDE group (36.2 ± 3.1 vs. 34.6 ± 3.9, p = 0.008). In addition, the developmental quotient (DQ) of hearing and language in the HDE group were significantly lower than those in the LDE group (31.5 ± 13.1 vs. 42.5 ± 18.5, p < 0.001). A total of 13 independent components (ICs) were identified. Between-group comparison revealed that the HDE group exhibited decreased functional connectivity (FC) in the left precuneus (PCUN) of the default mode network (DMN), the right middle temporal gyrus (MTG) of the executive control network (ECN), and the right median cingulate and paracingulate gyri (MCG) of the attention network (ATN), compared with the LDE group. Additionally, there was an increase in FC in the right orbital part of the middle frontal gyrus (ORBmid) of the salience network (SAN), compared with the LDE group. The inter-network analysis revealed increased FC between the visual network (VN) and basal ganglia (BG) and decreased FC between the sensorimotor network (SMN) and DMN, SMN and ATN, SMN and auditory network (AUN), and DMN and SAN in the HDE group, compared with the LDE group. There was a significant negative correlation between altered FC values in MTG and total CARS scores in subjects (r = − 0.18, p = 0.018). Conclusion: ASD children with prolonged ST often exhibit lower DQ of language development and more severe autistic characteristics. The alteration of intra- and inter-network FC may be a key neuroimaging feature of the effect of prolonged ST on neurodevelopment in ASD children. Clinical trial registration: ChiCTR2100051141. What is Known: • Prolonged ST has adverse effects on autistic characteristics and language development. • Neuroimaging technology may help to further explain the role of prolonged ST in ASD. What is New: • This is the first study to explore the impact of ST on intra- and inter-network FC in children with ASD. • ASD children with prolonged ST have atypical changes in intra- and inter-brain network FC. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to evaluate risk factors for 3-years mortality after hospital discharge in all inpatients admitted to a general hospital in Milano, Italy. A total of 2580 consecutive patients admitted to Ospedale San Paolo, July 1 to December 31, 2012, for several classes of diseases (internal medicine, cancer, infectious diseases, trauma and surgery, pneumonia, and heart diseases) were studied. Age, total disease, type of admission, length of admission, age-adjusted Charlson index, prognostic nutritional index (PNI), and full blood count were evaluated. Univariate Cox models were used to evaluate the association between variables and death. Of the 2580 consecutive patients (age 66.8 ± 19.36 years, mean ± SD), 920 died within 3 years after discharge. At univariate analysis, all investigated variables, except sex and lymphocytes, were associated with patient death. Stepwise regression analyses revealed that the age-adjusted Charlson index or age plus total diseases, type of admission, number of admissions, and PNI were significant risk factors in the whole sample and in some classes of disease. Results were superimposable when considering death from date of admission instead of date of discharge, meaning that in-hospital death was not relevant to the total death count (115 out of 902). Seriousness of baseline conditions represents the major risk factor for mortality in most classes of disease, and possibly influences other predictors, such as type of admission and length of stay. This suggests that the current model of hospital admission might be improved, for instance, through comprehensive care at home, instead of hospital admission, or before admission. [ABSTRACT FROM AUTHOR]

Utilizing advanced seismic techniques for delineating hydrocarbon accumulations in HST (High Stand System Tract) turbidite channel of Kafr El-Sheikh (KS) formation (Pliocene Age) located in the western part of South Batra field (SBF), Nile Delta – Egypt is investigated. 3D seismic data and four well logs helped in studying the properties of the channel. Three wells encountered the central part of the channel and showed thicker reservoir thickness than the fourth well, which encountered the levee. The channel is characterized by high porosity (25–30%) and relatively low water saturation (27–50%). The structural map showed that the channel is dipping towards the NE–SW. AVO analysis, scaled Poisson’s ratio, post-stack seismic inversion, and seismic attributes confirmed the presence of Class III gas sand. Variance attribute helped in imaging the channel and faults. Maps generated from spectral decomposition showed that the dominant frequency is around 15 hertz. Results of integrating different techniques were consistent and successfully helped in determining the geometry of the channel, discriminating between different lithologies and fluids, in addition to delineating the sweet spots and recommended locations for drilling. [ABSTRACT FROM AUTHOR]

The authors comment on a study published in a previous issue which reports on mortality in patients with and without diabetes undergoing gastric bypass or medical treatment. Topics covered include the benefit of gastric bypass versus medical treatment to patients with diabetes, long-term mortality with bariatric surgery in comparison with nonsurgical treatment, and the effectiveness of bariatric surgery in preventing mortality in patients with and without diabetes.

INTRODUCTION: The objective of our study was to evaluate the efficacy and durability of GreenLight laser prostatectomy for the management of acute urinary retention (AUR) and chronic urinary retention (CUR) and to determine outcomes compared to patients without preoperative urinary retention (UR). METHODS: We conducted a retrospective study of prospectively collected data from individuals who underwent GreenLight laser prostatectomy at our institution from May 2018 to July 2022. Patient demographics and outcome measures were recorded, including indications for the procedure, median urinary volume drained, or median postvoid residual urine volume (PVR) before catheterization or GreenLight laser prostatectomy. CUR was defined as PVR >300 mL in males able to void and initial catheter drainage >1000 mL in males unable to void in the absence of pain. All patients had postoperative followup visits at one, three, six, and 12 months. Our evaluation included the International Prostate Symptom Score (IPSS), quality-of-life (QoL) assessment, maximum urinary flow rate (Qmax), PVR, and catheter-free status. RESULTS: One hundred sixty-eight males who underwent GreenLight laser prostatectomy were included in our study. The UR group consisted of 88 patients (50 AUR and 38 CUR), and the lower urinary tract symptoms (LUTS) group was comprised of 80 individuals. There were no statistically significant differences between the AUR and CUR subgroups regarding demographics. The UR group had a significantly higher age and a significantly higher postoperative catheterization time compared to the LUTS cohort. The CUR subgroup had a significantly higher PVR at one, three, and six months compared to the AUR subgroup, although other outcome measures were similar between the two cohorts. During three- and six-month followup visits, the UR group had a significantly higher PVR than the LUTS cohort. At 12 months postoperative, the LUTS group had a higher catheter-free rate than the UR group (p=0.001). The successful first trial of void (TOV) rate for the UR and LUTS groups were 83% and 80%, respectively. At 12-month followup, the catheter-free rate for the UR and LUTS cohorts was 87.5% and 100%, respectively. CONCLUSIONS: GreenLight laser prostatectomy is an effective and durable treatment for UR, with a high catheter-free rate and comparable outcomes when performed to manage LUTS. [ABSTRACT FROM AUTHOR]

INTRODUCTION: We evaluated the impact of age on perioperative morbidity and clinical outcomes in patients undergoing GreenLight laser prostatectomy for benign prostatic hyperplasia (BPH). METHODS: We conducted a retrospective study of prospectively collected data from individuals who underwent GreenLight laser prostatectomy from May 2018 to July 2022. Patient demographics and outcome measures were recorded, including indications for the procedure and American Society of Anesthesiology (ASA) scores. All patients had postoperative followup visits at one, three, six, and 12 months. Our evaluation included the International Prostate Symptom Score (IPSS), quality of life (QoL) assessment, maximum urinary flow rate (Qmax), postvoid residual volume (PVR), and catheter-free status. RESULTS: One-hundred-sixty-eight males who underwent GreenLight laser prostatectomy were included. The non-octogenarian group consisted of 111 patients and the octogenarian group comprised 57 individuals. Based on ASA scores, most octogenarians were deemed high-risk (ASA III: 91.2%), while over half of non-octogenarians were lower-risk (ASA II: 53.2%) (p<0.001). Intraoperative parameters, including operative time, vaporization time, lasing time, and energy did not differ significantly between groups. There was no difference in the proportion of intraoperative complications between non-octogenarians and octogenarians (0.9% vs. 3.5%). Postoperative complications were not statistically significant between the two groups (p=0.608). There was also no observed difference in the proportion of patients requiring readmission (p=0.226) or retreatment (p=1.0). CONCLUSIONS: GreenLight laser prostatectomy is a safe and effective treatment for BPH regardless of age. It provides similar surgical and functional outcomes as younger men while maintaining the QoL of octogenarians. [ABSTRACT FROM AUTHOR]

Purpose: Testosterone replacement therapy (TRT) remains controversial in men with treated prostate cancer. We assessed its safety and functional impacts in patients after definitive surgical treatment with robotic-assisted radical prostatectomy (RARP). Methods: We performed a retrospective analysis of 1303 patients who underwent RARP during the years 2006–2019. We identified men with symptoms of andropause and low serum testosterone who received TRT post-RARP; then we divided the cohort into two groups accordingly for comparison. Biochemical recurrence (BCR) was the primary endpoint. Secondary endpoints included functional outcomes. Predictors of BCR, including the effect of TRT on BCR, were evaluated using univariable and multivariable logistic regression. Results: Among the forty-seven men who received TRT, the mean age was 60.83 years with a median follow-up of 48 months. Three (6.4%) and 157 (12.56%) patients experienced BCR in TRT and non-TRT groups, respectively. Baseline characteristics were similar between both groups except for higher mean BMI in the TRT group (p = 0.03). In the multivariate analysis (MVA), higher pre-RARP prostate-specific antigen (PSA) (p = 0.043), higher International Society of Urological Pathology score (p < 0.001), seminal vesical invasion (p = 0.018) and positive surgical margin (p < 0.001) were predictors of BCR. However, TRT was not (p = 0.389). In addition, there was a significant change in the Sexual Health Inventory for Men (p = 0.022), and serum testosterone level (p < 0.001) before and 6 months after initiation of TRT. Conclusion: Our findings suggest that TRT, in well-selected, closely followed, symptomatic men post-RARP is an oncologically safe and functionally effective treatment in prostate cancer patients post-RARP. [ABSTRACT FROM AUTHOR]

Background and aim: Several studies have shown that bariatric surgery reduces long term mortality compared to medical weight loss therapy. In a previous study we have demonstrated that gastric banding (LAGB) is associated with reduced mortality in patients with and without diabetes, and with reduced incidence of obesity co-morbidities (cardiovascular disease, diabetes, and cancer) at a 17 year follow-up. The aim of this study was to verify at a longer time interval (23 years) mortality and incidence of co-morbidities in patients undergoing LAGB or medical weight loss therapy. Patients and methods: As reported in the previous shorter-time study, medical records of obese patients [body mass index (BMI) > 35 kg/m2 undergoing LAGB (n = 385; 52 with diabetes) or medical treatment (controls, n = 681; 127 with diabetes), during the period 1995–2001 (visit 1)] were collected. Patients were matched for age, sex, BMI, and blood pressure. Identification codes of patients were entered in the Italian National Health System Lumbardy database, that contains life status, causes of death, as well as exemptions, prescriptions, and hospital admissions (proxies of diseases) from visit 1 to June 2018. Survival was compared across LAGB patients and matched controls using Kaplan–Meier plots adjusted Cox regression analyses. Results: Final observation period was 19.5 ± 1.87 years (13.4–23.5). Compared to controls, LAGB was associated with reduced mortality [HR = 0.52, 95% CI 0.33–0.80, p = 0.003], significant in patients with diabetes [HR = 0.46, 95% CI 0.22–0.94, p = 0.034], borderline significant in patients without diabetes [HR = 0.61, 95% CI = 0.35–1.05, p = 0.076]. LAGB was associated with lower incidence of diabetes (15 vs 75 cases, p = 0.001), of CV diseases (61 vs 226 cases, p = 0.009), of cancer (10 vs 35, p = 0.01), and of renal diseases (0 vs 35, p = 0.001), and of hospital admissions (92 vs 377, p = 0.001). Conclusion: The preventive effect of LAGB on mortality is maintained up to 23 years, even with a decreased efficacy compared with the shorter-time study, while the preventive effect of LAGB on co-morbidities and on hospital admissions increases with time. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to compare postoperative functional outcomes following robotic-assisted radical prostatectomy (RARP) in elderly men with localized prostate cancer. Methods: A retrospective review of a prospectively maintained database of men who underwent RARP between January 2007 and November 2018 was performed. Patients over 65 years of age were selected (N = 302) and then stratified by age group: 66–69 years old (N = 214) and ≥ 70 years old (N = 88). Full continence was defined as strict 0-pad per day usage. Preoperative potency included those with a Sexual Health Inventory for Men score ≥ 17. Preoperative and postoperative functional outcomes were assessed. Kaplan–Meier analysis was used to estimate time to recovery of continence in both groups. Results: Both groups had comparable preoperative parameters. Continence rates at 1, 3, 6, 9, 12, 18 and 24 months in the 66–69-year-old group were 6%, 34%, 61%, 70%, 74%, 80% and 87%, respectively. Comparatively in the ≥ 70-year-old group, continence rates were significantly lower at all time points (3%, 22%, 50%, 56%, 66%, 69% and 75%, respectively). Men in the 66–69-year-old group were significantly more likely to be continent after RARP when compared to patients 70 years of age and above [(Hazards ratio (HR) 0.73; 95%confidence interval 0.54–0.97, (p = 0.035)]. Conclusion: Our results suggest that RARP is feasible in elderly patients. Nevertheless, elderly patients in the ≥ 70-year-old group had significantly inferior postoperative continence rates compared to patients aged 66–69 years. Such information is valuable when counselling men during preoperative RARP planning to ensure that they have realistic postoperative expectations. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: Management of bladder cancer imposes a great economic challenge on the health care system; with the greatest share of this burden attributed to radical cystectomy (RC) and prolonged postoperative follow-up. Our aim was to characterize health care services utilization and evaluate associated cost predictors during the last 6 months of life in patients who had RC.Methods: We conducted a retrospective study within a cohort of 2,988 patients who had RC from 2000 to 2009. Data were obtained from the Quebec health insurance medical services database. We included patients who deceased during the study period, and survived at least 6 months after the first 90 postoperative days. Services billing codes were used to retrieve hospital, outpatient and imaging services. Linear regression models were used to assess predictors of costs.Results: From the 1,355 patients who deceased during the study period, we analyzed data of 799 subjects. Men formed 77.3% and 52.8% of patients were between 60 and 75 years of age at the time of RC. In their last 6 months of life, 17.2% of patients had surgery for major urinary tract complications, 25% had chemotherapy whereas 27.6% had radiotherapy. Also, 3.5% of patients had hemodialysis. Imaging was performed in 94.6% of patients. Urologist (specialist) visits ranked first where 72.3% of patients had 3,481 visits (average = 6 visits/pt) followed by medical subspecialist where 69% of patients had 10,010 visits (average = 18 visits/pt). For supportive care, 97% of patients had 25,560 family physician visits (average = 31 visits/pt) whereas only 16% of them had highly specialized care. Services utilization kept increasing with time especially during the last 2 months before death. Post-RC complications were significant predictor associated with increased costs at all assessed services (P<0.0001).Conclusion: Our study results suggest that health care services utilization varies in the assessed period. Urologists involvement in the process of care tends to decrease over time, in favor of other medical specialties, however, some health care services, such as highly specialized supportive care, may be underutilized. [ABSTRACT FROM AUTHOR]

There is little research on the role of urethrectomy during cystectomy in patients with micropapillary bladder cancer (MPBC). We present two cases of MPBC cystectomy and suggest that urethrectomy be performed concurrently as a preventive measure. The first case involved a woman who had a mixed solid and papillary bladder tumour. An anterior pelvic exenteration was performed as well as a total urethrectomy. The T4a micropapillary variant tumour was confirmed by pathology. The second case involved a man with T1 MPBC who was treated with a BCG induction course. A recurrent muscle-invasive MPBC was discovered during follow-up. During the radical cystoprostatectomy, the urethra was spared. T2 MPBC was discovered through pathology. He had a urethrectomy 6 months later due to urethral bleeding, and the pathology revealed micropapillary cancer of the urethra. [ABSTRACT FROM AUTHOR]

Introduction and Objective: The study's primary objective was to compare the laser efficiency and clinical outcomes of two widely used systems, the holmium MOSES laser and the thulium fiber laser (TFL), in managing kidney stones. The secondary outcomes were to evaluate the impact of stone composition on laser efficacy. Methods: We conducted a retrospective review of patients who underwent flexible ureteroscopy (f-URS) for solitary renal calculi between December 2020 and August 2022 at our institution and had a 3-month postoperative CT scan. Patient demographics and stone parameters were recorded, including stone site, size, volume, and density. Intraoperative data were collected and analyzed, including total operative time, ureteroscopy time, lasing time, technique, total energy delivered, and stone composition. All patients underwent a CT scan at 3 months follow-up. We recorded the presence of residual stones and the percentage of stone volume reduction. Ablation efficiency was calculated by dividing the energy utilized (J) by the stone volume (mm3). The ablation speed was calculated by dividing the stone volume (mm3) by the lasing time (seconds). Patients with a stone size <4 mm were deemed stone-free. Results: The MOSES and TFL groups comprised 62 and 49 patients, respectively. There were no significant differences between groups for baseline patient demographics or stone characteristics. The two modalities had comparable total energy, laser time, efficacy, and ablation speeds. No differences were detected in stone-free rates or complications between both groups. When dealing with calcium phosphate stones, we observed that the lasing time was significantly shorter with MOSES than TFL (7.95 vs 10.85 minutes, respectively [p = 0.01]). Conclusions: MOSES and TFL laser systems had comparable efficacy for lithotripsy of renal calculi during f-URS; however, calcium phosphate stones had a longer lasing time with TFL. REB Number: 100210. [ABSTRACT FROM AUTHOR]

Aim of the work: This study was designed to highlight internal fixation by intramedullary K-wires for displaced distal forearm fractures among children and analyze the results of this technique. We hypothesize that physis-sparing intramedullary fixation prevents displacement with a lower complication rate. Methods: This prospective case series involving 47 patients was conducted between February 2018 and December 2019. All patients with open physis presented with recent displaced distal forearm fractures were included, and all of them were treated with an intramedullary k-wire fixation for both bones with the assessment of the union rate, union time, suspected complication, radiographic evaluation, and functional outcome. Results: The study population consisted of 31 boys (66%) and 16 girls (34%). The mean age of the patients was 10.68 ± 2.728 years (range, 7–15 years). All fractures were united in a median of 6 weeks (range, 4–8 weeks), The functional outcome after 12 months was normal in 42 patients (89.4%), whereas, in five patients (10.6%), the functional parameters were minimally reduced. The median preoperative angulation improved from 36° (range, 24°–52°) preoperatively to 4° (range, 0°–10°) on immediate postoperative radiographs. After 12 months, the median angulation was 2° (range, 0°–7°) (p < 0.001). The angulation of the distal radius immediately after surgery and at the final follow-up was statistically correlated with the functional outcome (p < 0.001 and 0.002, respectively). Conclusion: This technique provides a good result with less susceptibility to re-displacement and low complication rates. Level of evidence: Level IV. [ABSTRACT FROM AUTHOR]

Aim: To describe the development of the AWARE App, a novel web application for the rapid assessment of cardiovascular risk in Type 2 Diabetes Mellitus (T2DM) patients. We also tested the feasibility of using this App in clinical practice. Methods: Based on 2019 European Society of Cardiology/European Association for the Study of Diabetes criteria for cardiovascular risk stratification in T2DM, the AWARE App classifies patients into very high (VHCVR), high (HCVR) and moderate (MCVR) cardiovascular risk categories. In this retrospective clinical study, we employed the App to assess the cardiovascular risk of T2DM patients, while also collecting data about current glycaemic control and pharmacological treatment. Results: 2243 T2DM consecutive patients were evaluated. 72.2% of the patients were VHCVR, 8.9% were HCVR, 0.8% were MCVR while 18.2% did not fit into any of the risk categories and were classified as "moderate-to-high" (MHCVR). Compared with the other groups, patients with VHCVD were more frequently ≥ 65 years old (68.9%), with a longer disease duration (≥ 10 years [56.8%]), a history of cardiovascular disease (41.4%), organ damage (35.5%) and a higher numbers of cardiovascular risk factors. Patients with MHCVD generally had disease duration < 10 years (96%), younger age (50–60 years [55%]), no history of cardiovascular disease, no organ damage, and 1–2 cardiovascular risk factors (89%). Novel drugs such as Glucagon Like Peptyde 1 Receptor Agonists or Sodium-Glucose Linked Transporter 2 inhibitors were prescribed only to 26.3% of the patients with VHCVR and to 24.7% of those with HCVR. Glycaemic control was unsatisfactory in this patients population (HbA1c 7.5 ± 3.4% [58.7 ± 13.4 mmol/mol]). Conclusions: The AWARE App proved to be a practical tool for cardiovascular risk stratification of T2DM patients in real-world clinical practice. [ABSTRACT FROM AUTHOR]

Abstract A theory of polarized neutron magnetic form factors based on atomic current densities is presented and applied to Ce 3+ ion in CeP. The eigenvectors due to crystal field and induced by the applied magnetic fields are derived and utilized to estimate these form factors. The derived form factors of Γ 8 eigenstates are closer to experimental ones than those of Γ 7. This finding is in accord with previously published results. The magnetic form factors derived from the pure crystal field Γ 8 , the induced Γ 8 (1) and Γ 8 (3) eigenstates of phase I are almost given the same form factors. Similarly, this is also the case of the form factors of phase III. The similarity of the derived form factors in each phase is attributed to the domination of the crystal field splitting over external and internal applied magnetic fields. Due to other sources of magnetic scattering in phase I some deviations of the estimated form factors from the experimental ones persist. The derived form factors of Γ 8 eigenstates of phase III are in good agreement with experimental results. Highlights • A theory of polarized neutron magnetic form factors based on atomic current densities is presented and applied to Ce2+ ion in CeP. • The eigenvectors due to crystal field and an induced by the applied magnetic fields are derived. • The magnetic form factors derived from the pure crystal field and induced eigenstate are in good agreement with the experimental ones. [ABSTRACT FROM AUTHOR]

Abstract The Late Cretaceous-Early Eocene sedimentary sequences in the Central Eastern Desert of Egypt were studied in three shallow boreholes (Wassief, Um El-Huaitat, and Mohamed Rabah). This study focuses on an integrated investigation of biostratigraphy, lithostratigraphy and some geochemical parameters, to provide important clues to the relative sea-level changes and to interpret the prevailed depositional conditions. Micropaleontological study on planktonic foraminifera allows to identify eight zones, ranging in age from Late Cretaceous to Early Eocene. Three hiatal surfaces have been recognized as evidenced by missing formaniniferal zones: The first spans the Late Maastrichtian-Danian regional unconformity. The second one is recorded in the Late Paleocene. The third one is located at the Late Paleocene-Early Eocene (Thanetian-Ypresian) boundary. The environments of the study foraminiferal parameters range from the non-marine to outer neritic-upper bathyal. Petrographically, thirteen Microfacies Types (MFT) have been recorded. Three MFTs constitute the siliciclastic facies; MFT-1; silty to sandy mudstone, MFT-2; organic-rich silty mudstone, and MFT-3; fine-grained sandstone/glauconite intercalations. Two MFTs represent a phosphorite facies which are MFT-4; phosclast packstone to phosclast grainstone and MFT-5; phosooid packstone to phosooid grainstone. Eight MFTs characterize the carbonate facies; MFT-6; non-fossiliferous lime-mudstone, MFT-7; phosphatic foraminiferal pack/grainstone, MFT-8; bioclastic foraminiferal packstone, MFT-9; bioclastic foraminiferal wackestone, MFT-10; glauconitic phosphatic foraminiferal Wack-Packstone, MFT-11; non-fossiliferous dolomitic mudstone, MFT-12; dolomitic glauconitic lime-mudstone, and MFT-13; dolomitic bioclastic wackestone. The depositional environments of the study microfacies range from the terrestrial to open marine outer neritic-upper bathyal. Geochemical parameters have been used to improve the litho- and biostratigraphic framework: the major oxides, TOC wt.% and the Chondrite-normalized REE. Based on the vertical distribution of CaO/P 2 O 5 , TiO 2 /CaO and cerium (Ce)-anomaly, changes in paleo-bottom water redox conditions were reconstructed and correlated with relative sea level changes. Prior to the major transgression during deposition of the Duwi Formation under reducing marine conditions, the prevailing oxic to sub-oxic bottom water terrestrial conditions during deposition of the Quseir Formation. Highlights • Integrated investigation along Cretaceous-Paleogene in Safaga area is achieved. • Eight planktonic zones are identified. • Thirteen microfacies types have been recorded. • Geochemical parameters improved the litho- and biostratigraphic framework. • The depositional environments range from terrestrial to upper bathyal. [ABSTRACT FROM AUTHOR]

To synthesize existing evidence to evaluate the outcomes of different urinary catheter removal timing (early vs late) after urethroplasty. We performed a comprehensive search of PubMed, Embase, the Cochrane Library, and Web of Science from inception to August 7, 2022. Articles were initially screened by title, abstract, and subsequently by a full paper review before being included in the final analysis. All comparative studies that assessed the association between urethral catheterization duration and frequency of extravasation and recurrence rate in patients who underwent urethroplasty were included in the analysis. Exclusion criteria were case reports, case series, letters to editors, and non-English studies. The risk of bias was assessed using the Newcastle-Ottawa Scale. Of the 439 relevant records in the literature databases, 5 studies involving 634 patients were included. In all 5 studies, the extravasation rate was not significantly different between the early and late catheter removal groups. Among the 3 studies that reported recurrence rates, the recurrence rate was low, with no statistically significant difference between the early and late catheter removal groups. Wound and urinary tract infections were among the most common complications, with a higher rate in patients with late catheter removal. Early catheter removal following urethroplasty does not increase the rate of extravasation or recurrence during long-term follow-up. The existing evidence can serve as the foundation for additional research with a larger sample size. [ABSTRACT FROM AUTHOR]

Activated carbon fiber (ACF) was used to enhance the UV/Electro-Fenton (UV/EF) system to remove nitrobenzene (NB). Comparative removal of NB by ACF adsorption, electrolysis, and UV photolysis was investigated, which indicated ACF can significantly enhance the UV/EF (ACF) system to remove NB. By using ACF cathode, 98% of NB removal was achieved after 20 min, which was much higher than Ti cathode by 60%. The UV/EF (ACF) system was proved to have the feasibility of mineralization of nitrobenzene by the 90% of TOC removal after 5 h. ACF reuse experiments were carried, and the results showed ACF cathode could be reused for successive 4 runs with just 5% declination of NB removal. The impacts of several key influence factors (current intensity, electrolyte, and O 2 flux) were explored. Three different kinds of ACF (ACF 0 : original ACF; ACF N : treated by ammonia; ACF H : treated by nitric acid), methanol, tert-butyl (TBA) alcohol, phenol, and catalase were involved in the system to study the mechanism of the UV/EF (ACF) system. The results showed the combination of ACF and the UV/EF system could significantly improve the H 2 O 2 production and NB removal. Finally, the comparison of the electrical energy per order (EE/O) values between the UV/EF (ACF) and UV/EF (Ti) system showed that ACF can significantly improve the current efficiency of the UV/EF system. [ABSTRACT FROM AUTHOR]