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We present a design and first use of a kJ level laser facility for research of non-local thermodynamic equilibrium atomic physics using the buried layer target method. The target design included a metal layer buried inside a plastic tamper with thicknesses tailored to the expected laser intensities. The target was illuminated from each side by two laser beams with intensities of 0.5–5 × 1014 W/cm2. The advanced diagnostic suite included static and time-resolved imagers and spectrometers with various spectral resolutions. A 3D printed dual elliptically curved spectrometer is presented, and its results are compared to a traditional crystal spectrometer. Experimental results and radiation hydrodynamic simulations demonstrate that the target achieved the desired thermodynamic conditions of ne ≈ 1021–1022 cm−3 and Te ≈ 1–2 keV. [ABSTRACT FROM AUTHOR]

La presente investigación tuvo como objetivo relacionar el nivel de conocimiento y las prácticas de fotoprotección sobre los efectos de la radiación solar en la población del Distrito de Moquegua, 2015. Corresponde a una investigación de tipo No experimental, transeccional. La población de estudio para la presente investigación estuvo constituida por los habitantes del Distrito de Moquegua. La muestra es aleatoria, es representativa y comprendió a 202 personas para tener una seguridad del 95 %. Se aplicó la escala likert para determinar el nivel de conocimiento y prácticas de foto protección y los resultados indicaron que la población del Distrito de Moquegua está representada por un regular nivel de conocimiento y prácticas de fotoprotección, con un 57 % para el nivel de conocimiento y 53 % para el nivel de prácticas de fotoprotección. Para determinar la relación entre el nivel de conocimiento y las prácticas de fotoprotección se aplicó la prueba del Chi cuadrado dando como resultado 15,6402 superior al valor deseado 9,49 del Chi tabular. Concluyéndose que existe una relación estadística significativa entre ambas variables. El grado de correlación es positiva y bajo (0,227

Purpose: Uric acid stones (UAS) can be treated non-invasively by oral chemolysis. However, it is crucial to identify individuals who are most likely to benefit from this approach, specifically, patients with pure UAS. The aim of this study was to develop a nomogram that can differentiate between pure and mixed UAS., Methods: A retrospective analysis of demographic, clinical and stone composition data of patients with a predominant UAS composition (≥ 50%) treated between 2014 and 2022., Results: A total of 135 patients were included in the analysis, 37.8% had mixed UAS (50-90% UA) and 62.2% had pure UAS (≥ 95% UA). The mean stone density and the percentage of radiopaque stones in the pure UAS group were significantly lower than those in the mixed UAS group (450 Hounsfield Units [HU] vs. 600 HU, and 24% vs. 58%, respectively). A stepwise multivariate logistic regression revealed that lower stone density, bigger size, decreased stone opacity and older age are predictive variables for pure UAS. Accordingly, a nomogram was generated with a receiver operating characteristic (ROC) curve that showed an area under the curve (AUC) of 0.78. A patient with a total score of 156 has a probability of > 95% for pure UAS., Conclusion: Imaging and demographic data can be used to identify patients with pure UAS. The nomogram may be useful for counseling patients regarding oral chemolysis. Future validation of the nomogram with a different data set is required to assess its efficacy., (© 2024. The Author(s).)

Introduction: The workload for benign prostatic hyperplasia (BPH) surgery is expected to rise with an increase in life expectancy and a growing population. Surgical modalities for BPH have evolved, shifting toward minimally invasive transurethral procedures. This study aimed to investigate the trends in BPH surgical procedures across medical centers in Israel., Methods: Data from seven academic medical centers in Israel from 2010 to 2022 were analyzed. Procedures included open prostatectomy, transurethral prostatectomy (TURP), holmium laser enucleation of the prostate (HoLEP), and photovaporization of the prostate (PVP). Statistical analyses were employed, including t tests, ANOVA, and ARIMA models., Results: Over 12 years, 13,478 BPH procedures were performed. TURP was the most common (72%), followed by open surgery (12%), HoLEP (12%), and PVP (3%). Annual procedures increased by approximately 5% each year, with a cumulative surge of 63% cases by 2022. The average patient's age remained stable. TURP and HoLEP showed continual growth, while open surgery declined. HoLEP exhibited a shorter length of hospital stay compared to other modalities. Predictive models suggest open prostatectomy will cease within 2 years, while TURP and HoLEP will continue to rise., Conclusion: This study highlights a significant increase in BPH surgical procedures over time, with a notable preference for TURP and HoLEP. The findings emphasize the importance of size-independent techniques like HoLEP for optimal healthcare management in the future., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Objective: To compare the perioperative outcomes of supine and prone percutaneous nephrolithotomy (PCNL). Methods: A retrospective search of a tertiary medical center database yielded 517 patients who underwent supine ( n = 91) or prone ( n = 426) PCNL between September 2015 and July 2020. Data on demographics, baseline clinical parameters, and stone burden were included as predictors in a logistic regression model, generating a set of propensity scores. Seventy patients after supine PCNL were propensity score-matched 1:1 with patients after prone PCNL and compared for operative time, perioperative complications, system complexity, and stone-free rate. Results: We found that the operative time was significantly shorter in the supine PCNL group than in the prone PCNL group (85.5 ± 25.2 min vs. 96.4 ± 25.8 min, respectively; p = 0.012). The majority of both groups had low-grade (I-II) complexity systems (85.6% and 88.6%, respectively), with no significant difference among all grade groups ( p = 0.749). There were no significant differences between the supine and prone PCNL groups in terms of the overall perioperative complication rate (8.6% vs. 4.3%, respectively; p = 0.301) or stone-free rate (74.3 vs. 65.7%, respectively; p = 0.356), while the rate of blood transfusion was significantly higher in the supine group ( p = 0.023). Conclusions: In our study, we used propensity score matching to compare patients who underwent PCNL in the supine or prone position, adjusting for selection bias. Supine PCNL was associated with a shorter operative time but a higher blood transfusion rate, with no differences in the overall complication and stone-free rates.

Purpose: To determine whether inhibition of the F11 receptor/JAM-A (F11R) using F11R-specific antagonist peptide 4D results in inhibition of smooth muscle cell (SMC) proliferation and migration in vivo, known as neointimal hyperplasia (NIH), using a mouse focal carotid artery stenosis model (FCASM)., Materials and Methods: The mouse FCASM was chosen to test the hypothesis because the dominant cell type at the site of stenosis is SMC, similar to that in vascular access stenosis. Fourteen C57BL/6 mice underwent left carotid artery (LCA) partial ligation to induce stenosis, followed by daily injection of peptide 4D in 7 mice and saline in the remaining 7 mice, and these mice were observed for 21 days and then euthanized. Bilateral carotid arteries were excised for histologic analysis of the intima and media areas., Results: The mean intimal area was significantly larger in control mice compared with peptide 4D-treated mice (0.031 mm 2 [SD ± 0.024] vs 0.0082 mm 2 [SD ± 0.0103]; P = .011). The mean intima-to-intima + media area ratio was significantly larger in control mice compared with peptide 4D-treated mice (0.27 [SD ± 0.13] vs 0.089 [SD ± 0.081]; P = .0079). NIH was not observed in the right carotid arteries in both groups., Conclusions: Peptide 4D, an F11R antagonist, significantly inhibited NIH in C57BL/6 mice in a FCASM., (Copyright © 2023 SIR. Published by Elsevier Inc. All rights reserved.)

Objective: To compare long-term reoperation rate and functional outcomes between EEP (endoscopic enucleation of the prostate) and TURP (transurethral resection of the prostate)., Evidence Acquisition: A systematic literature review of Medline, Scopus, and Web of Science was conducted with primary outcome assessed being reoperation rate and secondary outcomes after a long term (> 3 years) being functional outcomes or related values (prostate volume, PSA level, etc.)., Evidence Synthesis: Five studies were found with long-term follow-up 4-7 years. EEP reoperation rate ranged from 0 to 1.27%, while from 1.7 to 17.6% for TURP. Meta-analysis showed significantly lower OR for EEP, 0.27 (95% CI 0.24-0.31), with notable homogeneity of the results, I 2  = 0%. Long-term Qmax and IPSS were significantly better for EEP. Q max pooled mean difference was 1.79 (95% CI 1.72-1.86) ml/s with a high concordance among the studies, I 2  = 0%. IPSS mean difference -1.24 (95% CI - 1.28 to - 1.2) points, I 2  = 57% but QoL did not differ, with mean difference being 0.01 (95% CI - 0.02 to 0.04), I 2  = 0%. IIEF-5 score was also significantly better for EEP, mean difference 1.08 (95% CI 1.03-1.13), but heterogeneity was high, I 2  = 70%. PSA level and prostate volume were only reported in one study and favored EEP slightly yet statistically significant., Conclusion: EEP had a significantly lower reoperation rate and better functional outcomes (Q max and IPSS) at long term compared with TURP. It may also be beneficial in terms of IIEF-5, PVR, and PSA level., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Spatial and temporal variations in the atmospheric bomb radiocarbon make it a very useful tracer and a dating tool. With the introduction of more atmospheric bomb radiocarbon records, the spatial and temporal changes in bomb radiocarbon are becoming clearer. Bomb radiocarbon record from a pine tree in the northern Israel region shows that the Δ 14 C level in the region is closer to the northern hemisphere zone (NH) 1 as compared to the northern hemisphere zone (NH) 2. A comparison of this pine's Δ 14 C record with a nearby olive tree's Δ 14 C values also highlights changes in the growing season of the olive wood from one year to the other. The observation suggests that olive wood 14 C ages can show offset compared to the IntCal curve, and thus they should be interpreted cautiously., (© 2023. The Author(s).)

Despite the wide range of uses of rabbits (Oryctolagus cuniculus) as experimental models for pain, as well as their increasing popularity as pets, pain assessment in rabbits is understudied. This study is the first to address automated detection of acute postoperative pain in rabbits. Using a dataset of video footage of n = 28 rabbits before (no pain) and after surgery (pain), we present an AI model for pain recognition using both the facial area and the body posture and reaching accuracy of above 87%. We apply a combination of 1 sec interval sampling with the Grayscale Short-Term stacking (GrayST) to incorporate temporal information for video classification at frame level and a frame selection technique to better exploit the availability of video data., (© 2023. Springer Nature Limited.)

Objective: To evaluate the long-term stone-free rate (SFR) of retrograde intra-renal surgery (RIRS) in the treatment of lower pole renal calculi using only basket relocation and identify independent predictors of stone-free status., Methods: All consecutive patients undergoing RIRS lower pole renal calculi at a single high-volume tertiary center were analyzed retrospectively. Lower pole stones were relocated to the upper pole, where laser lithotripsy was performed. All patients were followed up in the clinic following the surgery and yearly thereafter. The stone-free status was assessed with a combination of an abdominal ultrasound and abdominal X-ray, or an abdominal non-contrast computed tomography if the stones were known to be radiolucent., Results: A total of 480 consecutive patients who underwent RIRS for treatment of lower pole renal calculi, between January 2012 and December 2018, were analyzed from a prospectively maintained database of 3000 ureteroscopies. With a median follow-up time of 18.6 months, the mean SFR was 94.8%. The procedures were unsuccessful in 26 (5.4%) patients due to unreachable stones. The median stone size of the unreachable stones was 12 mm (range 10-30 mm). Multivariable logistic regression analysis revealed two predictors of SFR for lower pole stones: a small cumulative stone burden (odds ratio [OR]: 0.903, 95% confidence interval [CI]: 0.867-0.941, p <0.0001) and preoperative ureteral stent insertion (OR: 0.515, 95% CI: 0.318-0.835, p =0.007)., Conclusion: The long-term SFR of RIRS for the treatment of lower pole stones with basket displacement with appropriate patient selection is high., Competing Interests: The authors declare no conflict of interest., (© 2022 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.)

Objective: To compare procedure burden, oncologic, surgical and renal-function outcomes between patients with low-grade upper urothelial cancer (UTUC) who were referred for either radical management (RM) or kidney-sparing endoscopic management (EM)., Patients and Methods: We retrospectively reviewed data of all patients treated for UTUC at our tertiary medical center between 2000 and 2018 and selected patients diagnosed with unilateral low-grade UTUC., Results: Twenty-four patients were treated with EM and 37 with RM. Surgical and oncologic risk factors were similar between the arms except for tumor size. Mean follow-up was 4.9 ± 3.4 years. The 5-year overall-survival rate was 85% with EM and 84% with RM (P = .707). Metastasis-free and cancer-specific survival were also similar (P = .994, P = .960). End-of-follow-up average glomerular filtration rates were 58.7 ± 21.5 and 49.2 ± 22.1 mL/min/1.73 m 2 , respectively (P = .12). Ninety-two percent of patients managed endoscopically had local recurrences, with an average of 3.2 recurrences per patient. Four (17%) patients underwent salvage radical nephroureterectomy. Procedure burden was higher with EM, having 6.5 ± 4.4 operations and 344 ± 272 minutes under anesthesia compared with 1.9 ± 0.4 operations (P <.0001) and 213 ± 84 minutes under anesthesia (P = .031) with RM. Cost-of-care analysis revealed higher costs for EM in both private and publicly funded medical insurance plans., Conclusion: Patients undergoing endoscopic management had an 83% chance of preserving their kidney and an 81% chance of 5-year metastasis-free survival at a cost of 6.5 ± 4.4 operations during a mean follow-up of 4.9 ± 3.4 years. Our findings support EM for low-grade UTUC as a valid option from oncological aspects but highlight the associated costs., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Purpose: Low-grade intermediate-risk nonmuscle-invasive bladder cancer (LG IR NMIBC) is a recurrent disease, thus requiring repeated transurethral resection of bladder tumor under general anesthesia. We evaluated the efficacy and safety of UGN-102, a mitomycin-containing reverse thermal gel, as a primary chemoablative therapeutic alternative to transurethral resection of bladder tumor for patients with LG IR NMIBC., Materials and Methods: This prospective, phase 2b, open-label, single-arm trial recruited patients with biopsy-proven LG IR NMIBC to receive 6 once-weekly instillations of UGN-102. The primary end point was complete response (CR) rate, defined as the proportion of patients with negative endoscopic examination, negative cytology and negative for-cause biopsy 3 months after treatment initiation. Patients with CR were followed quarterly up to 12 months to assess durability of treatment effect. Safety and adverse events were monitored throughout the trial., Results: A total of 63 patients (38 males and 25 females 33-96 years old) enrolled and received ≥1 instillation of UGN-102. Among the patients 41 (65%) achieved CR at 3 months, of whom 39 (95%), 30 (73%) and 25 (61%) remained disease-free at 6, 9 and 12 months after treatment initiation, respectively. A total of 13 patients had documented recurrences. The probability of durable response 9 months after CR (12 months after treatment initiation) was estimated to be 73% by Kaplan-Meier analysis. Common adverse events (incidence ≥10%) included dysuria, urinary frequency, hematuria, micturition urgency, urinary tract infection and fatigue., Conclusions: Nonsurgical primary chemoablation of LG IR NMIBC using UGN-102 resulted in significant treatment response with sustained durability. UGN-102 may provide an alternative to repetitive surgery for patients with LG IR NMIBC.

Root canal disinfection is of utmost importance in the success of the treatment, thus, a novel method for achieving root canal disinfection by electromagnetic waves, creating a synergistic reaction via electric and thermal energy, was created. To study electromagnetic stimulation (EMS) for the disinfection of root canal in vitro, single rooted teeth were instrumented with a 45.05 Wave One Gold reciprocating file. Specimens were sterilized and inoculated with Enterococcus faecalis ATCC 29,212, which grew for 15 days to form an established biofilm. Samples were treated with 6% sodium hypochlorite (NaOCl), 1.5% NaOCl 1.5% NaOCl with EMS, 0.9% saline with EMS or 0.9% saline. After treatments, the colony forming units (CFU) was determined. Data was analyzed by Wilcoxon Rank Sums Test (α = 0.05). One sample per group was scored and split for confocal laser scanning microscopy imaging. There was a significant effect with the use of NaOCl with or without EMS versus 0.9% saline with or without EMS (p = 0.012 and 0.003, respectively). CFUs were lower when using 0.9% saline with EMS versus 0.9% saline alone (p = 0.002). Confocal imaging confirmed CFU findings. EMS with saline has an antibiofilm effect against E. faecalis and can potentially be applied for endodontic disinfection.

The volcanic eruption of Santorini in the Bronze Age left detectable debris across the Mediterranean, serving as an anchor in time for the region, synchronizing chronologies of different sites. However, dating the eruption has been elusive for decades, as radiocarbon indicates a date about a century earlier than archaeological chronologies. The identification of annual rings by CT in a charred olive branch, buried alive beneath the tephra on Santorini, was key in radiocarbon dating the eruption. Here, we detect a verified annual growth in a modern olive branch for the first time, using stable isotope analysis and high-resolution radiocarbon dating, identifying down to the growing season in some years. The verified growth is largely visible by CT, both in the branch's fresh and charred forms. Although these results support the validity of the Santorini branch date, we observed some chronological anomalies in modern olive and simulated possible date range scenarios of the volcanic eruption of Santorini, given these observed phenomena. The results offer a way to reconcile this long-standing debate towards a mid-sixteenth century BCE date.

Objectives: To evaluate prospectively whether a tubeless (JJ stent-only) percutaneous nephrolithotomy (PCNL) might reduce the risk of hydrothorax, compared to an approach where a nephrostomy tube is left., Materials and Methods: We conducted a two-arm open-label prospective randomized study (NCT02036398) comparing tubeless supra-costal PCNL (with a JJ stent only) to standard PCNL (with nephrostomy tube and JJ stent) using intention-to-treat (ITT) and per-protocol (PP) analyses. All patients underwent a standard single-stage prone supra-costal procedure with single-tract access. Complication data were collected according to the Clavien-Dindo grading system. The primary endpoint was the rate of hydrothorax, and secondary endpoints included stone-free rate (SFR) and complication rate. Multivariable logistic regression analysis identified factors associated with hydrothorax formation., Results: Out of 101 patients approached, 75 were finally analysed. No differences were observed between the two arms with regard to baseline demographic and stone characteristics. The mean largest stone size ranged between 23 and 24.2 mm. No significant difference was seen in the mean operating time and length of hospital stay. The incidence of hydrothorax was significantly higher in the nephrostomy group in comparison to the tubeless group (37.8% vs 15.8%, P = 0.031, and 38.4% vs 13.8%, P = 0.016, in the ITT and PP analyses, respectively). The SFR and complication rate were similar in both groups using the ITT and PP analyses. Multivariable logistic regression analysis showed that nephrostomy tube placement was the only covariate associated in a statistically significant manner to hydrothorax (odds ratio 3.628, 95% confidence interval 1.073-12.265; P = 0.038)., Conclusion: The rate of hydrothorax in supra-costal PCNL is associated with the type of postoperative drainage left. When possible, a tubeless approach should be applied as it may confer a lower risk of hydrothorax., (© 2019 The Authors BJU International © 2019 BJU International Published by John Wiley & Sons Ltd.)

Diffraction gratings serve as a suitable optical element for spectral analysis, as light is spatially separated by its constituting wavelengths. Unlike conventional bar gratings that produce many high-diffraction orders, sinusoidal gratings enable suppression of the high orders, leaving only the first order. This makes the sinusoidal grating a promising candidate for spectral analysis for a wide range of wavelengths. Here, we provide a comparative analysis both theoretically and experimentally of two different two-dimensional binary amplitude sinusoidal gratings for high-order suppression. The grating efficiency and the corresponding spectral resolutions are calculated. The two nanofabricated gratings provide accurate experimental spectrum with high correlation between measurements.

Purpose: To reduce the high recurrence rate of nephrolithiasis, patients are routinely prescribed secondary chemoprevention therapy with alkali citrate (Alkasolve ® ; Sam-On Ltd) for uric acid stones and hypocitraturia or hydrochlorthiazide (Disothiazide ® ; Dexcel Ltd) for hypercalciuria. However, data on adherence to these regimens are limited. The aim of this study was to assess rates of long-term adherence to alkali citrate and hydrochlorothiazide and reasons for nonadherence. Materials and Methods: Patients on follow-up for kidney stone disease at a dedicated tertiary stone clinic, from 2010 to 2016, were asked to complete a telephone survey on adherence to secondary prevention medications and reasons for nonadherence. Compliance was also verified by actual drug distribution as reported through a computerized monitoring system. Results: The cohort included 356 patients with mean age of 58 years, 199 (64% men, 36% women) treated with alkali citrate and 143 (68% men, 32% women) treated with hydrochlorothiazide. Adherence rates were 42% in the alkali citrate group and 52% in the hydrochlorothiazide group ( p  = 0.05). The main reason for noncompliance in the alkali citrate group (22%) was the number of pills needed to be taken daily. Adverse drug effects were the most common reason for noncompliance in the hydrochlorothiazide group (24%) and in 10% of the alkali citrate group ( p  < 0.0005). Adherence was poorer in younger patients who did not regularly take other medications than in older patients with other chronic diseases and polypharmacy. Conclusions: About half the patients with clear metabolic abnormalities who were prescribed secondary chemoprevention with hydrochlorothiazide and alkali citrate failed to adhere to the prescribed regimen. Reasons for noncompliance differed between both drugs. The findings of this study may help clinicians to identify patients at risk for nonadherence and suggests potential means to improve compliance rates.

A new system which combines two independent diagnostic devices on the same line of sight is used to measure the X-ray spectrum in the 50-1000 eV regime. The first device is an array of six channels of time-resolved X-ray diodes (XRD's), arranged to cover the spectral band with low spectral resolution (λ/Δλ ∼ 3). The second device is a time-integrated sinusoidal transmission grating spectrometer (STGS) with a wide spectral range coverage and moderate spectral resolution (λ/Δλ ∼ 30). The spectral band of each XRD can be tuned by selecting a cathode, an x-ray mirror, and a filter. The novel sinusoidal shape of the STGS allows acquisition of a pure first-order spectrum without contribution of high dispersion orders, resulting in a higher accuracy spectrum measurement. The system described here has recently been used [Y. Ehrlich et al., Rev. Sci. Instrum. 88, 043507 (2017)] to demonstrate an improved unfolding algorithm of an XRD-acquired spectrum, achieved by experimental information gathered from the STGS measurement.

Charred olive wood is abundant in the archaeological record, especially around the Mediterranean. As the outermost ring closest to the bark is assumed to represent the latest time that the tree was alive, the radiocarbon date obtained from the outermost rings of an olive branch buried during the Santorini volcanic eruption is regarded as crucial evidence for the date of this cataclysmic event. The date of this eruption has far reaching consequences in the archaeology of the Aegean, Egypt and the Levant, and the understanding of their interconnections. We analyzed the radiocarbon concentrations in cross-sections from a modern olive tree trunk as well as from a living branch, and obtained near-annual resolution dates using the radiocarbon "bomb peak". In both cases we show that radiocarbon dates of the last formed wood along the circumference are not chronologically homogenous, and can differ by up to a few decades. Thus the outermost wood layer does not necessarily represent the date of the last year of growth. These findings challenge the interpretation of the results obtained from dating the olive branch from the Santorini volcanic eruption, as it could predate the eruption by a few decades. In addition, our results are also significant for any future studies based on archaeologically preserved olive wood.

To examine the ability of a new specimen handling technique to improve histopathological yield of ureteroscopic biopsies, performed in patients with suspected upper tract urothelial carcinoma (UTUC). In a bi-center retrospective study we compared the results of the new tissue handling technique (group 1) with the standard technique (group 2). In the new technique, to achieve maximal tissue preservation, the specimen is mounted on filter paper prior to embedding in paraffin. Multivariate analysis was performed to determine which factors are associated with optimal histological results. We further compared the biopsies with the final specimen in a subgroup of patients who underwent nephroureterectomy (NU). Of 55 ureteroscopic biopsies, 1 biopsy from group 1 (new technique) and 3 biopsies from group 2 (standard technique) were inadequate for pathological examination. 51 UTUC specimens were analyzed. Tumor grade and stage were determined in 85% and 63% of the patients in group 1 and in 83% and 25% of group 2 (p=0.85 and p=0.007). Orientation was preserved in 82% of group 1 and 42% of group 2 (p=0.003). On multivariate analysis biopsy technique and biopsy diameter were found to predict stage determination (p=0.01 and p=0.007) and tissue orientation (p=0.005 and p=0.04). Among patients who underwent NU, stage concordance between the biopsy and final pathology was observed in 56% and 27% of the patients in group 1 and 2, respectively. The new processing technique for small UTUC forceps biopsies decreases the rate of biopsies with insufficient material and improves biopsy interpretation.

Objective: To present a reliable technique for fluoroscopic controlled, large-bore, ureteral stent placement and exchange in transplant kidneys with persistent ureterovesical strictures., Materials and Methods: We reviewed the medical charts of all patients who underwent kidney transplant with persistent ureterovesical strictures who underwent ureteral stent placement or exchange at our institution between 2005 and 2015 using the new technique. Clinical characteristics and treatment outcomes of the study cohort were analyzed., Results: Ureteral stent insertion or stent exchange, using this technique, was performed in 32 renal transplant units. Median operating time was 24 minutes (interquartile range, 21-36.75 minutes). The overall success rate of the technique at first attempt was 96.9%. In 1 patient, drainage of the transplanted kidney with a nephrostomy tube was indicated after procedure failure. No other local or systemic complications were encountered, and no stent encrustation was noted in this cohort of patients. Renal function remained stable in all patients during a median follow-up of 59 months (interquartile range, 28-61 months)., Conclusion: Herein, we present in detail a step-by-step technique for the insertion and exchange of large-bore ureteral stents in transplanted kidneys. The technique was shown to be safe, effective, and highly successful., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The age of living massive olive trees is often assumed to be between hundreds and even thousands of years. These estimations are usually based on the girth of the trunk and an extrapolation based on a theoretical annual growth rate. It is difficult to objectively verify these claims, as a monumental tree may not be cut down for analysis of its cross-section. In addition, the inner and oldest part of the trunk in olive trees usually rots, precluding the possibility of carting out radiocarbon analysis of material from the first years of life of the tree. In this work we present a cross-section of an olive tree, previously estimated to be hundreds of years old, which was cut down post-mortem in 2013. The cross-section was radiocarbon dated at numerous points following the natural growth pattern, which was made possible to observe by viewing the entire cross-section. Annual growth rate values were calculated and compared between different radii. The cross-section also revealed a nearly independent segment of growth, which would clearly offset any estimations based solely on girth calculations. Multiple piths were identified, indicating the beginning of branching within the trunk. Different radii were found to have comparable growth rates, resulting in similar estimates dating the piths to the 19th century. The estimated age of the piths represent a terminus ante quem for the age of the tree, as these are piths of separate branches. However, the tree is likely not many years older than the dated piths, and certainly not centuries older. The oldest radiocarbon-datable material in this cross-section was less than 200 years old, which is in agreement with most other radiocarbon dates of internal wood from living olive trees, rarely older than 300 years.

Purpose: The purpose of the study was to evaluate the radiation dose of the Kodak 9000 cone-beam computed tomography (CBCT) device for different anatomical areas using a pediatric phantom., Methods: Absorbed doses resulting from maxillary and mandibular region three by five cm CBCT volumes of an anthropomorphic 10-year-old child phantom were acquired using optical stimulated dosimetry. Equivalent doses were calculated for radiosensitive tissues in the head and neck area, and effective dose for maxillary and mandibular examinations were calculated following the 2007 recommendations of the International Commission on Radiological Protection (ICRP)., Results: Of the mandibular scans, the salivary glands had the highest equivalent dose (1,598 microsieverts [μSv]), followed by oral mucosa (1,263 μSv), extrathoracic airway (pharynx, larynx, and trachea; 859 μSv), and thyroid gland (578 μSv). For the maxilla, the salivary glands had the highest equivalent dose (1,847 μSv), followed closely by oral mucosa (1,673 μSv), followed by the extrathoracic airway (pharynx, larynx, and trachea; 1,011 μSv) and lens of the eye (202 μSv)., Conclusion: Compared to previous research of the Kodak 9000, completed with the adult phantom, a child receives one to three times more radiation for mandibular scans and two to 10 times more radiation for maxillary scans.

Introduction: We investigated the direct and residual antibacterial effects of intracanal antimicrobials against bacterial biofilms obtained from infected mature and immature teeth with necrotic pulps., Methods: Sterile dentin slabs (n = 100) were inoculated with bacterial biofilms obtained from root canals of an immature or a mature tooth with pulpal necrosis and incubated anaerobically for 3 weeks (n = 50 per biofilm). Dentin infected with each type of biofilm received 1 week of treatment with 1 or 5 mg/mL double antibiotic paste (DAP) in methylcellulose hydrogels, calcium hydroxide, or placebo paste or received no treatment (n = 10). The pastes were removed, and biofilm disruption assays were performed. Additional dentin slabs (n = 100) were pretreated with the same treatments (n = 20). The pastes were rinsed off, and the samples were immersed in phosphate-buffered saline for 1 week. Thereafter, samples from the treatment groups were infected with bacterial biofilm from both clinical sources mentioned earlier (n = 10 per biofilm) and incubated anaerobically for 3 weeks before conducting biofilm disruption assays. Uninfected dentin slabs were used for both antibacterial experiments as negative control groups (n = 20)., Results: All antimicrobials showed significant direct antibacterial effects regardless of the biofilm source. Dentin pretreated with 5 mg/mL DAP provided significantly higher residual antibacterial effects in comparison with all other groups regardless of the source of biofilm. Dentin pretreated with calcium hydroxide did not show any residual antibacterial effects., Conclusions: Tested antimicrobials showed significant direct antibacterial effects. Only 5 mg/mL DAP exhibited significant residual antibacterial effects against bacterial biofilms from an infected root canal of an immature tooth., (Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Objective: We investigated the residual antibiofilm effects of different concentrations of double antibiotic paste (DAP) applied on radicular dentin for 1 or 4 weeks., Design: Dentin samples were prepared (n=120), sterilized and pretreated for 1 or 4 weeks with the clinically used concentration of DAP (500mg/mL), low concentrations of DAP (1, 5 or 50mg/mL) loaded into a methylcellulose system, calcium hydroxide (Ca(OH) 2 ), or placebo paste. After the assigned treatment time, treatment pastes were rinsed off and the samples were kept independently in phosphate buffered saline for 3 weeks. Pretreated dentin samples were then inoculated with Enterococcus faecalis and bacterial biofilms were allowed to grow for an additional 3 weeks. Biofilms were then retrieved from dentin using biofilm disruption assays, diluted, spiral plated, and quantified. Fisher's Exact and Wilcoxon rank sum tests were used for statistical comparisons (α=0.05)., Results: Dentin pretreatment for 4 weeks with 5, 50 or 500mg/mL of DAP demonstrated significantly higher residual antibiofilm effects and complete eradication of E. faecalis biofilms in comparison to a 1 week pretreatment with similar concentrations. However, dentin pretreated with 1mg/mL of DAP or Ca(OH) 2 did not provide a substantial residual antibiofilm effect regardless of the application time., Conclusions: Dentin pretreatment with 5mg/mL of DAP or higher for 4 weeks induced significantly higher residual antibiofilm effects in comparison to a 1 week pretreatment with the same concentrations., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

We investigated the direct and indirect (residual) antibacterial effects of various concentrations of triple antibiotic paste (TAP) loaded into a methylcellulose system. Enterococcus faecalis (E. faecalis) was grown on sterilized dentin blocks (n = 60) and treated with clinically used TAP (1,000 mg/mL), low concentrations of methylcellulose-based TAP (100, 10, and 1 mg/mL), placebo paste, or 1.5% NaOCl (n = 10). The pastes were then removed, and biofilm disruption assays were performed. Additional dentin blocks (n = 120) were pretreated with the same experimental groups (n = 20). The pastes were rinsed off, and the samples were immersed independently in phosphate-buffered saline for 2 and 4 weeks (n = 10). E.faecalis was then grown on the dentin blocks, and biofilm disruption assays were performed. Fisher's Exact and Wilcoxon rank sum tests were used for statistical analyses. With regard to direct antibacterial effects, all treatment groups demonstrated complete eradication of biofilms in comparison to placebo paste, while 10 mg/mL of TAP or higher provided substantial residual antibacterial effects. However, dentin treated with 1 mg/mL of TAP or 1.5% NaOCl did not provide substantial residual antibacterial effects. Dentin pretreated with 10 mg/mL of TAP or higher exhibited extended residual antibacterial effects and can thus be used during endodontic regeneration.(J Oral Sci 58, 575-582, 2016).

Time-integrated x-ray emission spectra of laser-irradiated Au disks were recorded using transmission grating spectrometry, at laser intensities of 10(13) to 10(14) W/cm(2). Radiation-hydrodynamics and atomic physics calculations were used to simulate the emitted spectra. Three major plasma regions can be recognized: the heat wave, the corona, and an intermediate region connecting them. An analysis of the spectral contribution of these three plasma regions to the integrated recorded spectrum is presented. The importance of accurate atomic modeling of the intermediate plasma region, between the corona and the heat wave, is highlighted. The influence of several aspects of the atomic modeling is demonstrated, in particular multiply-excited atomic configurations and departure from local thermal equilibrium.

Aim: This study explored the effects of dentine treated with two concentrations of double antibiotic paste (DAP) and ethylenediaminetetraacetic acid (EDTA) on the attachment and proliferation of dental pulp stem cells (DPSCs)., Materials and Methods: Radicular dentine samples were prepared with identical dimensions and randomized into six groups (n = 4). Four groups were treated with double antibiotic paste (DAP) at concentrations of 500 mg ml(-1) or 1 mg ml(-1) with or without EDTA. The other two groups were treated with EDTA only or received no treatment. DPSCs were seeded on each dentine sample (10 000 cells per sample). Lactate dehydrogenase activity assays were used to calculate the attached DPSCs after 1 day of incubation. Water soluble tetrazolium assays were performed to investigate DPSCs proliferation on the treated dentine samples after three additional days of incubation. Two-way anova followed by Tukey-Kramer tests was used for statistical analyses (α = 0.05)., Results: Dentine treated with 1 or 500 mg ml(-1) of DAP followed by EDTA caused significant increases in DPSCs attachment compared to the dentine treated with the DAP alone. The 500 mg ml(-1) of DAP with or without EDTA caused significant reductions in DPSCs proliferation. However, the treatment of dentine with 1 mg ml(-1) of DAP did not have significant negative effects on DPSCs proliferation regardless of the use of EDTA., Conclusion: The use of 1 mg ml(-1) of DAP followed by 10 min of irrigation with EDTA in endodontic regeneration procedure may have no negative effects on the attachment and proliferation of DPSCs., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Germ cell tumors (GCT) are relatively uncommon, accounting for only 1% of male malignancies in the United States. It has become an important oncological disease for several reasons. It is the most common malignancy in young men 15-35 years old. GCTs are among a unique numbers of neoplasms where biochemical markers play a critical role. Finally, it is a model of curable cancer. In this review we discuss cancer epidemiology, genetics, and therapeutic principles. Recent advances in the management of stage I GCT and controversies in the management of post chemotherapy residual mass are presented.

Background and Objective: Bacterial invasion into pulps of primary teeth can lead to infection and premature tooth loss in children. This pilot study aimed to explore whether the microbiota of carious exposures of dental pulps resembles that of carious dentin or that of infected root canals., Design: Children with severe early childhood caries were studied. Children were consented and extent of caries, plaque, and gingivitis measured. Bacteria were sampled from carious lesion biofilms and vital carious exposures of pulps, and processed by anaerobic culture. Isolates were characterized from partial sequences of the 16S rRNA gene and identified by comparison with taxa in the Human Oral Microbiome Database (http://www.HOMD.org). The microbiotas of carious lesions and dental pulps were compared using univariate and multivariate approaches., Results: The microbiota of cariously exposed pulps was similar in composition to that of carious lesion biofilms except that fewer species/taxa were identified from pulps. The major taxa identified belonged to the phyla Firmicutes (mainly streptococci) and Actinobacteria (mainly Actinomyces species). Actinomyces and Selenomonas species were associated with carious lesions whereas Veillonella species, particularly Veillonella dispar was associated with pulps. Other bacteria detected in pulps included Streptococcus mutans, Parascardovia denticolens, Bifidobacterium longum, and several Lactobacillus and Actinomyces species. By principal, component analysis pulp microbiotas grouped together, whereas those in caries biofilms were widely dispersed., Conclusions: We conclude that the microbiota of cariously exposed vital primary pulps is composed of a subset of species associated with carious lesions. Vital primary pulps had a dominant Firmicutes and Actinobacteria microbiota which contrasts with reports of endodontic infections which can harbor a gram-negative microbiota. The microbiota of exposed primary pulps may provide insight into bacterial species at the forefront of caries invasion in dentinal lesions that can invade into the pulp and the nature of species that need suppressing for successful pulp therapy.