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In case of minor migrants, absence of valid identification documents that clearly define age is a critical issue, because without these data the child cannot enjoy the rights provided by the Convention on the Rights of the Child. Differentiation between minors and adults is fundamental when age is disputed in human identification, asylum seeking, criminal liability, and child abuse fields. Few indications are available about qualitative/statistical agreement of different age estimation methods. Ages of 301 individuals were estimated through two dental methods in order to: determine quantitative and statistical agreements in legal age definition; identify practical recommendations. The study pointed out discrepancy between the two methods in 7/301 cases. From a statistical point of view, this finding corresponded to an almost perfect agreement. Thus, authors suggested that the two methods can be alternately used for legal age assessment, but operators should use both methods when the estimated age is 18.5 years., Competing Interests: The authors have not conflict of interest to disclose., (© 2021 The Author(s).)

Advances in roll-to-roll processing of graphene and carbon nanotubes have at last led to the continuous production of high-quality coatings and filaments, ushering in a wave of applications for flexible and wearable electronics, woven fabrics, and wires. These applications often require specific electrical properties, and hence precise control over material micro- and nanostructure. While such control can be achieved, in principle, by closed-loop processing methods, there are relatively few noncontact and nondestructive options for quantifying the electrical properties of materials on a moving web at the speed required in modern nanomanufacturing. Here, we demonstrate a noncontact microwave method for measuring the dielectric constant and conductivity (or geometry for samples of known dielectric properties) of materials in a millisecond. Such measurement times are compatible with current and future industrial needs, enabling real-time materials characterization and in-line control of processing variables without disrupting production.

Attempts at depositing uniform films of nanoparticles by drop-drying have been frustrated by the "coffee-stain" effect due to convective macroscopic flow into the contact line. Here, we show that uniform deposition of nanoparticles in aqueous suspensions can be attained easily by drying the droplet in an ethanol vapor atmosphere. This technique allows the particle-laden water droplets to spread on a variety of surfaces such as glass, silicon, mica, PDMS, and even Teflon. Visualization of droplet shape and internal flow shows initial droplet spreading and strong recirculating flow during spreading and shrinkage. The initial spreading is due to a diminishing contact angle from the absorption of ethanol from the vapor at the contact line. During the drying phase, the vapor is saturated in ethanol, leading to preferential evaporation of water at the contact line. This generates a surface tension gradient that drives a strong recirculating flow and homogenizes the nanoparticle concentration. We show that this method can be used for depositing catalyst nanoparticles for the growth of single-walled carbon nanotubes as well as to manufacture plasmonic films of well-spaced, unaggregated gold nanoparticles.

Background: There is conclusive evidence that human papillomavirus (HPV) infections of the cervix are a necessary cause of cervical cancer. In Italy there are consistent data of HPV prevalence in women aged 25 - 64 years, but there is limited data for younger women. The objective of this on-going 3-year prospective cohort study is to investigate the prevalence, acquisition, clearance and persistence of HPV infections in young Tuscan women and the risk factors correlated with such events., Methods: One thousand and sixty-six women aged between 18 and 24 years were enrolled and received an initial HPV test. They were asked to return to the clinic over the study period for further tests every 12 months, if their HPV HR result was negative, or every 6 months, if positive. Additionally, women with an HPV positive result were given a cytological examination and if the cytological diagnosis was ASC-US or more severe, only women with HPV HR, were referred for colposcopy., Results: We present here data for the enrollment phase of the study. At baseline, within the study sample, just under 30% of women were infected by HPV and 19.3% of women were infected with oncogenic types. A relationship was highlighted between HPV infection, number of sexual partners (in particularly in the last 3 years) and the lifetime number of partner's partners. Condom use showed a slight protective effect in univariate analysis but these data were not statistically significant in multivariate analysis. The association between HPV infection and demographic and behavioural variables were tested by crude odds ratio (OR). Multivariate logistic regression was applied to compute the adjusted odds ratios., Conclusions: The prevalence of oncogenic HPV types was high in young Tuscan women. The 3-year follow-up of this cohort may provide a better understanding of the processes of acquisition, clearance and persistence of infection and the correlated risk factors.

Background Genital skin conditions are rare and pose a diagnostic challenge due to their diverse pathology. Patient anxiety and referral decisions add complexity for primary caregivers. Demographics and overlapping symptoms complicate diagnosis, causing anxiety for both patients and clinicians. Social stigma and apprehension to seek healthcare might delay treatment. Accurate differentiation between benign and potentially serious conditions is crucial. Objective We aim to provide clinicians with a clear and concise framework to assist them in risk stratification, treatment decisions and referral pathways for common genital skin conditions. Discussion Differentiating normal variations is crucial to minimise unnecessary investigations and alleviate patient anxiety. Circumcision status, pigmentation and genetics influence disease presentation. We highlight benign conditions for reassurance. Inflammatory genital lesions might arise from various causes. Biopsies remain essential for accurately diagnosing uncertain cases. Sexually transmitted infections (STIs) should be promptly diagnosed and treated. Neoplastic conditions can evolve rapidly, requiring an urgent specialist referral. [ABSTRACT FROM AUTHOR]

Amelanotic melanoma (AM) is a subtype of hypomelanotic or completely amelanotic melanoma. AM is a rare subtype of melanoma that exhibits a higher recurrence rate and aggressiveness as well as worse surveillance than typical melanoma. AM shows a dysregulation of melanin production, cell cycle control, and apoptosis pathways. Knowing these pathways has an application in medicine due to targeted therapies based on the inhibiting elements of the abovementioned pathways. Therefore, we summarized and discussed AM biochemical and molecular induction pathways and personalized medicine approaches, clinical management, and future directions due to the fact that AM is relatively rare. AM is commonly misdiagnosed. Hence, the role of biomarkers is becoming significant. Nonetheless, there is a shortage of biomarkers specific to AM. BRAF, NRAS, and c-KIT genes are the main targets of therapy. However, the role of BRAF and KIT in AM varied among studies. BRAF inhibitors combined with MAK inhibitors demonstrate better results. Immune checkpoint inhibitors targeting CTLA-4 combined with a programmed death receptor 1 (PD-1) show better outcomes than separately. Fecal microbiota transplantation may overcome resistance to immune checkpoint therapy of AM. Immune-modulatory vaccines against indoleamine 2,3-dioxygenase (IDO) and PD ligand (PD-L1) combined with nivolumab may be efficient in melanoma treatment. [ABSTRACT FROM AUTHOR]

Owing to the intrinsic excellent mechanical, electrical, and thermal properties of carbon nanotubes (CNTs), carbon nanotube fibers (CNTFs) have been expected to become promising candidates for the next-generation of high-performance fibers. They have received considerable interest for cutting-edge applications, such as ultra-light electric wire, aerospace craft, military equipment, and space elevators. Wet-spinning is a broadly utilized commercial technique for high-performance fiber manufacturing. Thus, compared with array spinning from drawable CNTs vertical array and direct dry spinning from floating catalyst chemical vapor deposition (FCCVD), the wet-spinning technique is considered to be a promising strategy to realize the production of CNTFs on a large scale. In this tutorial review, we begin with a summative description of CNTFs wet-spinning process. Then, we discuss the high-concentration CNTs wet-spinning dope preparation strategies and corresponding non-covalent adsorption/charge transfer mechanisms. The filament solidification during the coagulation process is another critical procedure for determining the configurations and properties for derived CNTFs. Next, we discuss post-treatment, including continuous drafting and thermal annealing, to further optimize the CNTs orientation and compact configuration. Finally, we summarize the physical property-structure relationship to give insights for further performance promotion in order to satisfy the prerequisite for detailed application. Insights into propelling high-performance CNTFs production from lab-scale to industry-scale are proposed, in anticipation of this novel fiber having an impact on our lives in the near future. [ABSTRACT FROM AUTHOR]

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This study investigates the impact of spin-coating speed on the performance of carbon nanotube (CNT)-based optoelectronic synaptic devices, focusing on their long-term memory properties. CNT films fabricated at lower spin speeds exhibited a greater thickness and density compared to those at higher speeds. These denser films showed enhanced persistent photoconductivity, resulting in higher excitatory postsynaptic currents (EPSCs) and the prolonged retention of memory states after UV stimulation. Devices coated at a lower spin-coating speed of 2000 RPM maintained EPSCs above 70% for 3600 s, outperforming their higher-speed counterparts in long-term memory retention. Additionally, the study demonstrated that the learning efficiency improved with repeated UV stimulation, with fewer pulses needed to achieve the maximum EPSC in successive learning cycles. These findings highlight that optimizing spin-coating speeds can significantly enhance the performance of CNT-based synaptic devices, making them suitable for applications in neuromorphic computing and artificial neural networks requiring robust memory retention and efficient learning. [ABSTRACT FROM AUTHOR]

Today's wireless environments, soft robotics, and space applications demand delicate design of devices with tunable performances and simple fabrication processes. Here we show strain-based adjustability of RF/microwave performance by applying frequency-selective patterns of conductive Ti3C2Tx MXene coatings on low-cost acetate substrates under ambient conditions. The tailored performances were achieved by applying frequency-selective patterns of thin Ti3C2Tx MXene coatings with high electrical conductivity as a replacement to metal on low-cost flexible acetate substrates under ambient conditions. Under quasi-axial stress, the Kirigami design enables displacements of individual resonant cells, changing the overall electromagnetic performance of a surface (i.e., array) within a simulated wireless channel. Two flexible Kirigami-inspired prototypes were implemented and tested within the S, C, and X (2-4 GHz, 4-8 GHz, and 8-12 GHz) microwave frequency bands. The resonant surface, having ~1/4 of the size of a standard A4 paper, was able to steer a beam of scattered waves from each resonator by ~25°. Under a strain of 22%, the resonant frequency of the wired co-planar resonator was shifted by 400 MHz, while the reflection coefficient changed by 158%. Deforming the geometry impacted the spectral response of the components across three arbitrary frequencies in the 4-10 GHz frequency range. With this proof of concept, we anticipate implementing thin films of MXenes on technologically relevant substrates, achieving multi-functionality through cost-effective and straightforward manufacturing. Modern communication applications may demand devices with tunable performances and simple fabrications. Here, we show strain dependent, adjustable RF/microwave performance by applying patterns of conductive Ti3C2Tx MXene coatings on low-cost acetate substrates in a straightforward coating process. [ABSTRACT FROM AUTHOR]

The growing need for the multiband photodetection of a single scene has promoted the development of both multispectral coupling and broadband detection technologies. Photodetectors operating across the infrared (IR) to terahertz (THz) regions have many applications such as in optical communications, sensing imaging, material identification, and biomedical detection. In this review, we present a comprehensive overview of the latest advances in broadband photodetectors operating in the infrared to terahertz range, highlighting their classification, operating principles, and performance characteristics. We discuss the challenges faced in achieving broadband detection and summarize various strategies employed to extend the spectral response of photodetectors. Lastly, we conclude by outlining future research directions in the field of broadband photodetection, including the utilization of novel materials, artificial microstructure, and integration schemes to overcome current limitations. These innovative methodologies have the potential to achieve high-performance, ultra-broadband photodetectors. [ABSTRACT FROM AUTHOR]

Carbon nanotubes (CNTs) have been regarded as emerging materials in various applications. However, the range of biomedical applications is limited due to the aggregation and potential toxicity of powder-type CNTs. To overcome these issues, techniques to assemble them into various macroscopic structures, such as one-dimensional fibers, two-dimensional films, and three-dimensional aerogels, have been developed. Among them, carbon nanotube fiber (CNTF) is a one-dimensional aggregate of CNTs, which can be used to solve the potential toxicity problem of individual CNTs. Furthermore, since it has unique properties due to the one-dimensional nature of CNTs, CNTF has beneficial potential for biomedical applications. This review summarizes the biomedical applications using CNTF, such as the detection of biomolecules or signals for biosensors, strain sensors for wearable healthcare devices, and tissue engineering for regenerating human tissues. In addition, by considering the challenges and perspectives of CNTF for biomedical applications, the feasibility of CNTF in biomedical applications is discussed. [ABSTRACT FROM AUTHOR]

The chemical vapour deposition (CVD) grown carbon nanotubes (CNTs) forest can be transformed into its yarn and sheet thus provides a novel way to harness the excellent properties of microscopic CNTs at a macroscopic scale. The long length CNTs yarn and sheet have been developed from a highly drawable and spinnable vertically aligned CNTs forest with millimetre scale array height based on the parametric investigations of a practically viable single-step CVD growth process. The CNTs growth analysis reveals 'root growth' type of growth mechanism. The growth temperature, gas residence time tuned with carrier gas flow rate and controlled supply of hydrogen gas are found to predominantly influence the properties of the CNTs forest like purity, defects levels, spinnability which ultimately controls the quality of the developed CNTs yarn and sheet. The CNTs forest grown from parametrically tuned CVD produced the CNTs with very low defect level of 0.26, inferred from Raman studies and high purity of 98%, accessed from TGA. The CNTs forest grown at growth temperature 840 °C with 300:25:300 sccm optimal ratios of gas flow rates for argon, hydrogen and acetylene are highly spinnable into its long length yarn and sheet which demonstrated excellent tensile strength of ~ 1.186 GPa and ~ 210 MPa, respectively, and electrical conductivity of 2.05 × 104 S/m and 2.57 × 104 S/m, respectively, revealing the strong influence of the purity and level of disorder on the quality of the CNTs yarn and sheet. The high degree of alignment of CNTs within its sheet was assessed from the polarized Raman studies. The obtained excellent physical properties of the grown CNTs forest, its yarn and sheet are comparable with the other reports suggesting its suitability for relevant applications. [ABSTRACT FROM AUTHOR]

Long-segment lichen sclerosus (LS) urethral stricture is a challenge for urologists. Limited data are available for surgeons to make a surgical decision between Kulkarni and Asopa urethroplasty. In this retrospective study, we investigated the outcomes of these two procedures in patients with LS urethral stricture. Between January 2015 and December 2020, 77 patients with LS urethral stricture underwent Kulkarni and Asopa procedures for urethroplasty in the Department of Urology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (Shanghai, China). Of the 77 patients, 42 (54.5%) underwent the Asopa procedure and 35 (45.5%) underwent the Kulkarni procedure. The overall complication rate was 34.2% in the Kulkarni group and 19.0% in the Asopa group, and no difference was observed (P = 0.105). Among the complications, no statistical difference was observed in the incidence of urethral stricture recurrence (P = 0.724) or glans dehiscence (P = 0.246) except for postoperative meatus stenosis (P = 0.020). However, the recurrence-free survival rate between the two procedures was significantly different (P = 0.016). Cox survival analysis showed that antiplatelet/anticoagulant therapy use (P = 0.020), diabetes (P = 0.003), current/former smoking (P = 0.019), coronary heart disease (P < 0.001), and stricture length (P = 0.028) may lead to a higher hazard ratio of complications. Even so, these two techniques can still provide acceptable results with their own advantages in the surgical treatment of LS urethral strictures. The surgical alternative should be considered comprehensively according to the patient characteristics and surgeon preferences. Moreover, our results showed that antiplatelet/anticoagulant therapy use, diabetes, coronary heart disease, current/former smoking, and stricture length may be contributing factors of complications. Therefore, patients with LS are advised to undergo early interventions for better therapeutic effects. [ABSTRACT FROM AUTHOR]

The Monti Pisani massif (Tuscany, central Italy) is an isolated mountain relief known for its rich geodiversity, including a remarkable palaeontological heritage from the Palaeozoic, Mesozoic and Cenozoic eras. The Palaeozoic record consists of exquisitely preserved plant remains and rarer invertebrates of Permo-Carboniferous age, which testify to extensive rainforests and large swamps that thrived in an alluvial system under a humid, (sub)tropical climate. In addition to invertebrate shells, invertebrate trace fossils and microbial structures, the Mesozoic record features a diverse Middle Triassic tetrapod ichnoassemblage consisting of tracks of lepidosauromorphs, archosaurs (among which are the earliest dinosauromorph fossils of Italy) and nonmammalian therapsids. These vertebrates lived in a subsiding costal setting that stretched across an expanding rift valley under a subarid climate. The Cenozoic record features abundant fossils of terrestrial vertebrates (including spectacular members of the mammalian megafauna) from karst deposits, testifying to the manifold inhabitants of the massif during the glacial and interglacial phases of the Late Pleistocene. Overall, this long-lasting fossil record remarkably demonstrates how much the Earth's environments have been changing through the Phanerozoic. The outstanding palaeontological heritage of the Monti Pisani area is in need of specific efforts of conservation and valorisation, especially with respect to the many palaeontological sites that punctuate the massif. [ABSTRACT FROM AUTHOR]

Perovskite solar cells (PSCs) have exhibited tremendous potential in photovoltaic fields owing to their appreciable performance and simple fabrication. Nevertheless, device performances are still required to be further improved before commercial applications. As one‐dimensional materials, carbon nanotubes (CNTs) have been utilized to regulate stability and efficiency of PSCs because of their excellent chemical stability, flexibility, as well as tunable optical and electrical characteristics. In this review, we comprehensively summarize various functions of CNTs in PSCs, such as transparent electrodes, hole/electron‐transport layers, counter electrodes, perovskite additives, and interlayers. Additionally, applications of CNTs toward the advancement of flexible and semitransparent PSCs are provided. Finally, we preview the challenges and research interests of using CNTs in high‐efficiency and stable perovskite devices. [ABSTRACT FROM AUTHOR]

This paper studies the dependence of the specific heat capacity (Cp) of activated carbon obtained by the activation of coke fines on temperature (T, K) and the dependence of electrical resistance (R, Om) on temperature (T, K). In the course of the work, it was found that in the temperature range of 298.15–448 K on the curve of dependence Cp − f(T) at 323 K there is a jump in heat capacity, associated with a phase transition of the second kind. Measurements of the temperature dependence of electrical resistance on temperature were also carried out, which showed that activated carbon in the temperature range of 293–343 K exhibits metallic conductivity, turning into a semiconductor in the temperature range of 343–463 K. The calculation of the band gap showed that the resulting activated carbon is a semiconductor with a moderately narrow band gap. The satisfactory agreement of the phase transition temperatures on the curves of the temperature dependences of the heat capacity on temperature (323 K) and on the curves of the dependences of electrical resistance and the relative permittivity on temperature (343 K) indicates the nature of this phase transition, i.e., at a temperature of 323 K, the change in heat capacity is associated with the transition from semiconductor conductivity to metallic. [ABSTRACT FROM AUTHOR]

Carbon nanotubes (CNTs) are proving to be versatile nanomaterials that exhibit superior and attractive electrical, optical, chemical, physical, and mechanical properties. Different kinds of CNTs exist, and their associated properties have been actively explored and widely exploited from fundamental studies to practical applications. Obtaining high‐quality CNTs in large volumes is desirable, especially for scalable electronic, photonic, chemical, and mechanical systems. At present, abundant but random CNTs are synthesized by various growth methods including arc discharge, chemical vapor deposition, and molecular beam epitaxy. An economical way to secure pristine CNTs is to disperse the raw soot of CNTs in solutions, from which purified CNTs are collected via sorting methods. Individual CNTs are generally hydrophobic, not readily soluble, requiring an agent, known as a surfactant to facilitate effective dispersions. Furthermore, the combination of surfactants, polymers, DNA, and other additives can enhance the purity of specific types of CNTs in confidence dispersions. With highly‐pure CNTs, designated functional devices are built to demonstrate improved performance. This review surveys and highlights the essential roles and significant impacts of surfactants in dispersing and sorting CNTs. [ABSTRACT FROM AUTHOR]

This research endeavours to study the growth of ultralong carbon nanotubes (UL-CNTs) from methane using diverse catalysts, namely FeCl3, bi-metallic Fe-Cu, Fe-Ni, and Fe-Co chlorides. Aqueous catalyst solutions were evenly dispersed on silica substrates and grown at 950 °C in the presence of hydrogen via a horizontal chemical vapour deposition (CVD) furnace. The samples underwent characterisation by Raman spectroscopy, scanning electron microscopy (SEM), and optical microscopy to identify the quality of CNTs and enumerate individual UL-CNTs. Our findings revealed that FeCl3, as a mono-metallic catalyst, generated the longest UL-CNTs, which measured 1.32 cm, followed by Fe-Cu (0.85 cm), Fe-Co (0.7 cm), and Fe-Ni (0.6 cm), respectively. The G/D ratio (graphene to defects) from the Raman spectroscopy was the highest with the FeCl3 catalyst (3.09), followed by Fe-Cu (2.79), Fe-Co catalyst (2.13), and Fe-Ni (2.52). It indicates that the mono-iron-based catalyst also produces the highest purity CNTs. Moreover, this study scrutinises the vapour-liquid-solid (VLS) model for CNT growth and the impact of carbide formation as a precursor to CNT growth. Our research findings indicate that forming iron carbide (Fe3C) is a crucial transition phase for amorphous carbon transformation to CNTs. Notably, the iron catalyst generated the longest and densest CNTs relative to other iron-based bi-metallic catalysts, which is consistent with the temperature of carbide formation in the mono-metallic system. From correlations made using the phase diagram with carbon, we conclude that CNT growth is favoured because of increased carbon solubility within the mono-metallic catalyst compared to the bi-metallic catalysts. [ABSTRACT FROM AUTHOR]

Introducing carbon nanotubes (CNTs) capable of anchoring on nanofibers establishes new possibilities in many applications, such as lithium–sulfur batteries and laminated composites. Direct growth and attachment of CNTs eliminate dispersion challenges such as detachment or transfer of CNTs onto another medium and damage to CNTs, making them inadequate for practical applications. This study facilitated the direct growth of conductive CNTs on curved, high-temperature resistant polymeric polybenzimidazole (PBI) nanofiber surfaces via chemical vapor deposition (CVD). Control of CVD process parameters, including nucleation and growth times (10 or 15 min) and catalyst concentration (1 or 10 mM) at 600 °C resulted in the growth of radially oriented CNTs on PBI nanofiber surfaces and provided morphology-dominated behavior both on physical and electrical properties. Morphological analyses showed that optimizing catalyst concentration (10 mM) and CVD process parameters, including nucleation (15 min) and growth times (10 min and 15 min), yielded uniform CNT coverage and conformity. A systematic exploration of mesoscopic morphologies revealed a strong correlation between physical parameters such as CNT array lengths and electrical conductivity, up to 0.039 ± 0.004 S/cm. The proposed CNT growth method could offer in situ structural tunability to respond to application-related requirements from energy storage to the rate capability of lithium-based batteries. [ABSTRACT FROM AUTHOR]

Supercapacitors have been attracting a remarkable research interest due to their outstanding intrinsic properties, such as high electrical response, great durability, and a wide range of operating temperature and voltage. In this work, the synthesis and evaluation of the electrochemical performances of graphene oxide doped with Bismuth oxide (Bi2O3@GO) and reduced graphene oxide doped with Bismuth oxide (Bi2O3@rGO) without any binder material were carried out using a low concentration (1.0 M) of KOH electrolyte. The solvothermal method of nanomaterial synthesis was employed. The produced nanomaterial was studied using X-ray diffraction (XRD), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), and electrochemical characterizations. An improved performance was recorded by the electrode made of Bi2O3@rGO, which achieved 560 Fg−1 specific capacitance at 5 mVs−1 scan rate; 28 Whkg−1 and 17 kWkg−1 energy and power densities, respectively. The electrode also retained 99% of its capacitance after 3000 galvanostatic charge–discharge (GCD) cycles. [ABSTRACT FROM AUTHOR]

Background: Stricture urethra is generally limited to anterior urethra. At present, there are only a few studies which focus exclusively on the histopathology of stricture urethra disease. Aims and Objectives: The aims of this study were to assess the urethral stricture pathology specimens for determining the severity of chronic inflammation and characteristics of stricture, demographics, and patient-reported outcome measures in patients with inflammatory and non-inflammatory strictures. Materials and Methods: This was a prospective and observational study done on 60 male patients of anterior urethral stricture disease who underwent excision biopsy of stricture during urethroplasty. Pre-operative urinary symptoms assessment was done with a questionnaire provided to all patients and data maintained to assess patient-reported outcomes in inflammatory and non-inflammatory stricture urethra. Cohorts comprising strictures with no inflammation, mild, and moderate to severe inflammation were developed and stricture, the patient characteristics were compared. Results: In a total of 60 histopathological stricture specimens, there was no inflammation in 40%, mild and moderate inflammation was in 28% and 3.3%, respectively. Lichen sclerosis-related strictures had moderate to severe inflammation and most of the strictures were in bulbar urethra (51.6%). Patients with BXO changes showed more inflammation. In patients with inflammatory strictures, hesitancy, straining, and stream were statistically more compared to non-inflammatory strictures. Idiopathic is the most predominant etiology for stricture which showed no inflammation. Conclusion: Histopathological analysis of urethral stricture showed significant tissue heterogeneity in clinically similar strictures. Chronic inflammation was commonly found in stricture specimens indicating active antigen presentation for underlying pathology and patients with inflammatory strictures reported worse health outcomes. [ABSTRACT FROM AUTHOR]

Background: Management of urethral stricture related to lichen sclerosus (LS) is now gradually changing from surgical to nonsurgical due to availability of anti-inflammatory agents such as corticosteroids and calcineurin inhibitors. We determined the clinical impact of these agents in such patients on outpatient department basis in terms of improvement in symptoms on International Prostate Symptom Score (IPSS), external skin appearance, and maximum urinary flow rate (Qmax). Materials and Methods: Eighty patients of meatal stenosis and penile urethral stricture with histopathologically proven LS were divided into two groups, and clinical and predetermined parameters such as Qmax, IPSS, and changes in external appearance were compared between these groups after 3 months of topical and intraurethral application of clobetasol and tacrolimus with self-calibration. Results: A significant intragroup difference was noted in IPSS (P < 0.001) as well as Qmax (P < 0.001); postintervention intergroup difference in IPSS was not significant (P = 0.94) and however postintervention intergroup difference in Qmax was significant in favor of clobetasol (P = 0.007). A significantly increased number of additional procedures were done in the group receiving intraurethral tacrolimus (P = 0.0473) with significantly less number of skin complication in the group with topically applied clobetasol (P = 0.003). Conclusion: Though both clobetasol and tacrolimus, improved symptom score, Qmax and local external appearance yet topical and intra-urethral clobetasol application via urethral self calibration seems to be better option for lichen sclerosus related urethral stricture in terms cost and local complications. [ABSTRACT FROM AUTHOR]

Introduction and Objectives. Lichen sclerosus (LSc) is a chronic inflammatory process of the skin characterized by its unique histological features. It affects men and women of all ages, mainly in the anogenital area. The etiologies and exact pathophysiology are not well-known; however, LSc can be considered a precursor to male genital squamous cell carcinoma. We aim, through this case-control study, to potentially associate genital LSc with risk factors and certain patient characteristics in Lebanese adult males. Materials and Methods. A nested case-control study design was chosen. Subjects enrolled were adult male patients who had a circumcision between January 2010 and December 2020 at our university hospital, with a confirmed LSc diagnosis on pathology. Cases were matched with controls by age with a ratio of 1 : 1, all of whom were circumcised and had a negative pathology report. Data collection consisted of sociodemographic, behavioral, and past medical and familial history characteristics. Results. A total of 94 patients were enrolled. The mean age was 49.81 (±22.92) in the group of men with LSc. No significant differences in sociodemographic characteristics (age and BMI) were found between the two compared groups. Smoking cannot predict LSc as opposed to alcohol consumption, which we found to be a protective factor against the appearance of LSc (p = 0.027). Men with LSc had significantly higher rates of diabetes (p = 0.021) and hypertension (p = 0.004). No associations were found between LSc and the presenting chief complaints, family history of LSc, and past penile trauma. Conclusion. In this study, we were able to compare multiple variables between 47 circumcised patients diagnosed with LSc and a control group. We found that LSc patients showed higher rates of diabetes and hypertension. A potential protective effect of alcohol consumption is to be explored in future projects with bigger sample sizes and higher statistical powers. [ABSTRACT FROM AUTHOR]

Executing complex behaviors requires precise control of muscle activity. Our understanding of how the nervous system learns and controls motor skills relies on recording electromyographic (EMG) signals from multiple muscles that are engaged in the motor task. Despite recent advances in tools for monitoring and manipulating neural activity, methods for recording in situ spiking activity in muscle fibers have changed little in recent decades. Here, we introduce a novel experimental approach to recording high-resolution EMG signals using parylene-coated carbon nanotube fibers (CNTFs). These fibers are fabricated via a wet spinning process and twisted together to create a bipolar electrode. Single CNTFs are strong, extremely flexible, small in diameter (14-24 im), and have low interface impedance. We present two designs to build bipolar electrode arrays that, due to the small size of CNTF, lead to high spatial resolution EMG recordings. To test the EMG arrays, we recorded the activity of small (4 mm length) vocal muscles in songbirds in an acute setting. CNTF arrays were more flexible and yielded multiunit/bulk EMG recordings with higher SNR compared with stainless steel wire electrodes. Furthermore, we were able to record single-unit recordings not previously reported in these small muscles. CNTF electrodes are therefore well-suited for high-resolution EMG recording in acute settings, and we present both opportunities and challenges for their application in long-term chronic recordings. [ABSTRACT FROM AUTHOR]

In the last three decades, radiopharmaceuticals have proven their effectiveness for cancer diagnosis and therapy. In parallel, the advances in nanotechnology have fueled a plethora of applications in biology and medicine. A convergence of these disciplines has emerged more recently with the advent of nanotechnology-aided radiopharmaceuticals. Capitalizing on the unique physical and functional properties of nanoparticles, radiolabeled nanomaterials or nano-radiopharmaceuticals have the potential to enhance imaging and therapy of human diseases. This article provides an overview of various radionuclides used in diagnostic, therapeutic, and theranostic applications, radionuclide production through different techniques, conventional radionuclide delivery systems, and advancements in the delivery systems for nanomaterials. The review also provides insights into fundamental concepts necessary to improve currently available radionuclide agents and formulate new nano-radiopharmaceuticals. [ABSTRACT FROM AUTHOR]

Background: To optimize results reporting after penile cancer (PC) surgery, we proposed a Tetrafecta and assessed its ability to predict overall survival (OS) probabilities. Methods: A purpose-built multicenter, multi-national database was queried for stage I–IIIB PC, requiring inguinal lymphadenectomy (ILND), from 2015 onwards. Kaplan–Meier (KM) method assessed differences in OS between patients achieving Tetrafecta or not. Univariable and multivariable regression analyses identified its predictors. Results: A total of 154 patients were included in the analysis. The 45 patients (29%) that achieved the Tetrafecta were younger (59 vs. 62 years; p = 0.01) and presented with fewer comorbidities (ASA score ≥ 3: 0% vs. 24%; p < 0.001). Although indicated, ILND was omitted in 8 cases (5%), while in 16, a modified template was properly used. Although median LNs yield was 17 (IQR: 11–27), 35% of the patients had <7 nodes retrieved from the groin. At Kaplan–Maier analysis, the Tetrafecta cohort displayed significantly higher OS probabilities (Log Rank = 0.01). Uni- and multivariable logistic regression analyses identified age as the only independent predictor of Tetrafecta achievement (OR: 0.97; 95%CI: 0.94–0.99; p = 0.04). Conclusions: Our Tetrafecta is the first combined outcome to comprehensively report results after PC surgery. It is widely applicable, based on standardized and reproducible variables and it predicts all-cause mortality. [ABSTRACT FROM AUTHOR]

The photo-thermoelectric (PTE) effect in electronic materials effectively combines photo-absorption-induced local heating and associated thermoelectric conversion for uncooled and broadband photo-detection. In particular, this work comprehensively summarizes the operating mechanism of carbon nanotube (CNT)-film-based PTE sensors and ubiquitous non-destructive inspections realized by exploiting the material properties of CNT films. Formation of heterogeneous material junctions across the CNT-film-based PTE sensors, namely photo-detection interfaces, triggers the Seebeck effect with photo-absorption-induced local heating. Typical photo-detection interfaces include a channel–electrode boundary and a junction between P-type CNTs and N-type CNTs (PN junctions). While the original CNT film channel exhibits positive Seebeck coefficient values, the material selections of the counterpart freely govern the intensity and polarity of the PTE response signals. Based on these operating mechanisms, CNT film PTE sensors demonstrate a variety of physical and chemical non-destructive inspections. The device aggregates broad multi-spectral optical information regarding the targets and reconstructs their inner composite or layered structures. Arbitrary deformations of the device are attributed to the macroscopic flexibility of the CNT films to further monitor targets from omni-directional viewing angles without blind spots. Detection of blackbody radiation from targets using the device also visualizes their behaviors and associated changes. [ABSTRACT FROM AUTHOR]

Owing to their high thermal and optical performances, carbon nanotube (CNT) films are used in various photo-thermo-electric (PTE) applications, such as terahertz (THz) sensing and energy harvesting. To improve the performance of PTE devices, a device structure should be designed based on a deep understanding of the thermal and optical responses of the CNT film. However, the optical properties of CNT films in the THz frequency region remain unclear because of the difficulties associated with device processing and measurements. Herein, we report our findings on the thermal and optical characteristics of CNT films. The shape of the CNT film that maximizes the product of the thermal and optical factors (optimal structure of the PTE sensor) depends on the frequency of the irradiating electromagnetic wave. The optimal film thickness and width values for THz irradiation range from 300--600 nm and 50--70 µm, respectively. Subsequently, we fabricated a serially connected, multi-element PTE sensor with an optimal device structure and enhanced the detection sensitivity by approximately 13 times compared with a single-element PTE sensor. In addition, we demonstrated the first THz spectroscopy application using a PTE sensor. The findings of this study, thermal/optical factor enhancement, and micro-sized CNT film processing technology can be used to improve the performance of all CNT-based photothermal devices, including PTE sensors and thermoelectric generators. [ABSTRACT FROM AUTHOR]

Background: One-stage buccal mucosa graft urethroplasty (BMGU) is advised for non-obstructing, simple penile strictures due to lichen sclerosus (LS), while a multistage approach is preferred for most complex cases. Our study aims to evaluate long-term treatment outcomes and patient-reported outcomes (PROs) in patients undergoing multistage BMGU for LS-associated penile strictures. Methods: This is a retrospective analysis of prospectively collected data on multistage penile BMGU from 2001. All patients underwent a 2-stage (2St) or 3-stage (3St) BMGU with the final closure of the urethral plate. PROs were collected from a pre-defined questionnaire. Results: Twenty patients were successfully treated, while five experienced recurrence. If a first-stage Johanson was only performed, a 3St-BMGU was more likely, and higher treatment success was observed. A time course between the first and last stages shorter than 12 m was an independent predictor of treatment failure. Patients reported high overall satisfaction and urinary flow improvement. Sexual life was not significantly affected, while aesthetic appearance was the most affected dimension. Conclusions: Staged approaches have satisfactory treatment success rates, likely depending on the duration from the first to the last stage. PROs do not differ based on the number of stages performed, and overall satisfaction with the procedure is high. [ABSTRACT FROM AUTHOR]

Background: Early inflammatory lesions of lichen sclerosus are histopathologically difficult to diagnose until the hallmark of the disease i.e., papillary sclerosis becomes visible in histological sections. Pre-sclerotic and late or resolved phases of the disease have not been extensively studied. Methods: We retrospectively reviewed all cases diagnosed as genital lichen sclerosus over a ten-year period from 2006 to 2016, correlating the clinical findings with the histological features. Results: A total of 133 cases of genital lichen sclerosus (90 males and 43 females) were identified. Both genders demonstrated a similar histological spectrum. Fifty eight (44%) cases were identified as having pre-sclerotic lichen sclerosus, 64 (48%) as having progressive disease and 11 (8%) cases were classified as fully resolved with atrophy. Asymptomatic vitiligoid lesions were identified in 19 (14%) cases of which 12 were male. Low-grade squamous cell carcinoma was seen within the areas affected by long-standing lichen sclerosus, in four patients (3%, 2 male). Limitations: We studied only haematoxylin and eosin stained sections. The presence of basement membrane thickening could have been better illustrated with the periodic acid–Schiff stain. Conclusion: The pathogenesis of lichen sclerosus probably involves an immune reaction to the basement membrane at the epidermal interface and around the adnexa. The initial band of inflammation shifts gradually downwards from the epidermal interface into the dermis destroying the vascular channels and appendages, resulting in excessive deposition of altered extracellular matrix. Basilar infiltration of lymphocytes along with a grossly vacuolated or thickened basement membrane is proposed as the characteristic diagnostic feature of the pre-sclerotic stage. Greater awareness of the clinicopathological spectrum of lichen sclerosus should enable early diagnosis and treatment, thereby preventing structural damage and possible malignant transformation in chronic cases. [ABSTRACT FROM AUTHOR]

Carbon nanotubes (CNTs) with superior mechanical properties are expected to play a role in the next generation of critical engineering mechanical materials. Crucial advances have been made in CNTs, as it has been reported that the tensile strength of defect-free CNTs and carbon nanotube bundles can approach the theoretical limit. However, the tensile strength of macro carbon nanotube fibers (CNTFs) is far lower than the theoretical level. Although some reviews have summarized the development of such fiber materials, few of them have focused on the controllable preparation and performance optimization of high-strength CNTFs at different scales. Therefore, in this review, we will analyze the characteristics and latest challenges of multiscale CNTFs in preparation and strength optimization. First, the structure and preparation of CNTs are introduced. Then, the preparation methods and tensile strength characteristics of CNTFs at different scales are discussed. Based on the analysis of tensile fracture, we summarize some typical strategies for optimizing tensile performance around defect and tube–tube interaction control. Finally, we introduce some emerging applications for CNTFs in mechanics. This review aims to provide insights and prospects for the controllable preparation of CNTFs with ultra-high tensile strength for emerging cutting-edge applications. [ABSTRACT FROM AUTHOR]

Several approaches have been developed to estimate age, an important aspect of forensics and orthodontics, using different measures and radiological examinations. Here, through meta-analysis, we determined the validity of age estimation methods and reproducibility of bone/dental maturity indices used for age estimation. The PubMed and Google Scholar databases were searched to December 31, 2021 for human cross-sectional studies meeting pre-defined PICOS criteria that simultaneously assessed the reproducibility and validity. Meta-estimates of validity (mean error: estimated age-chronological age) and intra- and inter-observer reproducibility (Cohen's kappa, intraclass correlation coefficient) and their predictive intervals (PI) were calculated using mixed-effect models when heterogeneity was high (I2 > 50%). The literature search identified 433 studies, and 23 met the inclusion criteria. The mean error meta-estimate (mixed effects model) was 0.08 years (95% CI − 0.12; 0.29) in males and 0.09 (95% CI − 0.12; 0.30) in females. The PI of each method spanned zero; of nine reported estimation methods, Cameriere's had the smallest (− 0.82; 0.47) and Haavikko's the largest (− 7.24; 4.57) PI. The reproducibility meta-estimate (fixed effects model) was 0.98 (95% CI 0.97; 1.00) for intra- and 0.99 (95% CI 0.98; 1.00) for inter-observer agreement. All methods were valid but with different levels of precision. The intra- and inter-observer reproducibility was high and homogeneous across studies. [ABSTRACT FROM AUTHOR]

Objectives Dental age determination relies on the presence of wisdom teeth, which can be assigned to specific age ranges according to their stage of development. The purpose of this study is to highlight the applicability of the Demirjian staging of layman compared to expert, as well as the inclusion of all four wisdom teeth in the overall assessment, in order to emphasize and critically highlight a precise age estimation in clinical practice, especially in the case of agenesis or the presence of less than all four wisdom teeth. Material and Methods: In this study, dental age determination is performed and compared by a trained layperson and an expert using 385 orthopantomograms. The radiographs of known chronological age from male patients in the age range of 11–22 years were acquired from the University Medical Center Mainz. All four wisdom teeth were radiologically viewed if present. Demirjian staging with stages A–H was applied, and regression analysis was performed. Results: The relationship between mineralization of wisdom teeth (18, 28, 38 and 48) and age was linear for all teeth (p < 0.01), except for tooth 18 (p = 0.02). Comparing the prediction of the four teeth individually revealed that the lower teeth gave better predictions than the upper ones (R2 ≥ 0.50 vs. R2 < 0.50). Conclusions: For clinical use, the mandibular wisdom teeth should be preferred when performing dental age estimation using the Demirjian staging method. As a result of the present analysis, two ways of determining dental age by wisdom teeth can be suggested. One is to take only tooth 38, with the formula: age = 3.3 + 0.73 × mineralization of tooth_38. The second recommendation would be to take tooth_48. If both are unavailable, the formula would be age = −0.5 + 0.94 × mineralization tooth_28. Utilizing tooth 18 would not lead to more precise results. [ABSTRACT FROM AUTHOR]

Vertically aligned carbon nanotubes (VACNT) are manufactured nanomaterials with excellent properties and great potential for numerous applications. Recently, research has intensified toward achieving VACNT synthesis on different planar and non-planar substrates of various natures, mainly dependent on the user-defined application. Indeed, VACNT growth has to be adjusted and optimized according to the substrate nature and shape to reach the requirements for the application envisaged. To date, different substrates have been decorated with VACNT, involving the use of diffusion barrier layers (DBLs) that are often insulating, such as SiO2 or Al2O3. These commonly used DBLs limit the conducting and other vital physico-chemical properties of the final nanomaterial composite. One interesting route to improve the contact resistance of VACNT on a substrate surface and the deficient composite properties is the development of semi-/conducting interlayers. The present review summarizes different methods and techniques for the deposition of suitable conducting interfaces and controlled growth of VACNT on diverse flat and 3-D fibrous substrates. Apart from exhibiting a catalytic efficiency, the DBL can generate a conducting and adhesive interface involving performance enhancements in VACNT composites. The abilities of different conducting interlayers are compared for VACNT growth and subsequent composite properties. A conducting interface is also emphasized for the synthesis of VACNT on carbonaceous substrates in order to produce cost-effective and high-performance nano-engineered carbon composites. [ABSTRACT FROM AUTHOR]

Hydrophilic surface-enhanced Raman spectroscopy (SERS) substrates were prepared by a combination of TiO2-coatings of aluminium plates through a direct titanium tetraisopropoxide (TTIP) coating and drop coated by synthesised gold nanoparticles (AuNPs). Differences between the wettability of the untreated substrates, the slowly dried Ti(OH)4 substrates and calcinated as well as plasma treated TiO2 substrates were analysed by water contact angle (WCA) measurements. The hydrophilic behaviour of the developed substrates helped to improve the distribution of the AuNPs, which reflects in overall higher lateral SERS enhancement. Surface enhancement of the substrates was tested with target molecule rhodamine 6G (R6G) and a fibre-coupled 638 nm Raman spectrometer. Additionally, the morphology of the substrates was characterised using scanning electron microscopy (SEM) and Raman microscopy. The studies showed a reduced influence of the coffee ring effect on the particle distribution, resulting in a more broadly distributed edge region, which increased the spatial reproducibility of the measured SERS signal in the surface-enhanced Raman mapping measurements on mm scale. [ABSTRACT FROM AUTHOR]

A comprehensive characterization of various carbon nanotube (CNT) yarns provides insight for producing high-performance CNT yarns as well as a useful guide to select the proper yarn for a specific application. Herein we systematically investigate the correlations between the physical properties of six CNT yarns produced by three spinning methods, and their structures and the properties of the constituent CNTs. The electrical conductivity increases in all yarns regardless of the spinning method as the effective length of the constituent CNTs and the density of the yarns increase. On the other hand, the tensile strength shows a much stronger dependence on the packing density of the yarns than the CNT effective length, indicating the relative importance of the interfacial interaction. The contribution of each physical parameter to the yarn properties are quantitatively analyzed by partial least square regression. [ABSTRACT FROM AUTHOR]

Carbon nanotube (CNT)/copper composites offer promise as lightweight temperaturestable electrical conductors for future electrical and electronic devices substituting copper. However, clarifying how constituent nanotube structures influence CNT/Cu electrical performances has remained a major research challenge. Here, we investigate the correlation between the CNT/Cu electrical performances and nanotube structure by preparing and characterizing composites containing nanotubes of different structural attributes. We prepared three types of composites--single-wall (SW)-CNT/Cu wires, SW-CNT/Cu pillars, and multi-wall (MW)-CNT/Cu wires. The composites were fabricated from the corresponding CNT templates by two-step Cu electrodeposition, which retains template nanotube attributes through the fabrication process. The nanotube characteristics (diameter, G/D, alignment, etc.) in each template as well as the internal structure and electrical performances of the corresponding composites were characterized. SW-CNT/Cu wires and pillars outperformed MW-CNT/Cu wires, showing ≈ 3x higher room-temperature four-probe conductivities (as high as 30-40% Cu-conductivity). SW-CNT/Cu also showed up to 4x lower temperature coefficients of resistances i.e., more temperature-stable conductivities thanMW-CNT/Cu. Our results suggest that few-walled small-diameter nanotubes can contribute to superior temperature-stable CNT/Cu conductivities. Better CNT crystallinity (high G/D), fewer nanotube ends/junctions, and nanotube alignment may be additionally beneficial. We believe that these results contribute to strategies for improving CNT/Cu performances to enable the real-world application of these materials as Cu substitutes. [ABSTRACT FROM AUTHOR]

Fibre lithium-ion batteries are attractive as flexible power solutions because they can be woven into textiles, offering a convenient way to power future wearable electronics1–4. However, they are difficult to produce in lengths of more than a few centimetres, and longer fibres were thought to have higher internal resistances3,5 that compromised electrochemical performance6,7. Here we show that the internal resistance of such fibres has a hyperbolic cotangent function relationship with fibre length, where it first decreases before levelling off as length increases. Systematic studies confirm that this unexpected result is true for different fibre batteries. We are able to produce metres of high-performing fibre lithium-ion batteries through an optimized scalable industrial process. Our mass-produced fibre batteries have an energy density of 85.69 watt hour per kilogram (typical values8 are less than 1 watt hour per kilogram), based on the total weight of a lithium cobalt oxide/graphite full battery, including packaging. Its capacity retention reaches 90.5% after 500 charge–discharge cycles and 93% at 1C rate (compared with 0.1C rate capacity), which is comparable to commercial batteries such as pouch cells. Over 80 per cent capacity can be maintained after bending the fibre for 100,000 cycles. We show that fibre lithium-ion batteries woven into safe and washable textiles by industrial rapier loom can wirelessly charge a cell phone or power a health management jacket integrated with fibre sensors and a textile display.Rechargeable lithium-ion batteries produced in the form of metre-long fibres can be woven into sturdy, washable textiles on an industrial loom and used to power other fabric-based electronic components. [ABSTRACT FROM AUTHOR]

We investigate electronic and electro-physical properties of mono- and bilayer armchair single-walled carbon nanotube (SWCNT) films located on substrates of different types, including substrates in the form of crystalline silicon dioxide (SiO2) films with P42/mnm and P3121 space symmetry groups. The SWCNT films interact with substrate only by van der Waals forces. The densities of electronic states (DOS) and the electron transmission functions are calculated for SWCNT films with various substrates. The electrical conductivity of SWCNT films is calculated based on the electron transmission function. It is found that the substrate plays an important role in the formation of DOS of the SWCNT films, and the surface topology determines the degree and nature of the mutual influence of the nanotube and the substrate. It is shown that the substrate affects the electronic properties of monolayer films, changing the electrical resistance value from 2% to 17%. However, the substrate has practically no effect on the electrical conductivity and resistance of the bilayer film in both directions of current transfer. In this case, the values of the resistances of the bilayer film in both directions of current transfer approach the value of ~6.4 kW, which is the lowest for individual SWCNT. [ABSTRACT FROM AUTHOR]

This work describes a generalized multitone multiharmonic scattering parameters ($\mathbf {M^{2}S}$ -parameters) measurement approach suitable for multiport nonlinear network characterization in the wave-variable domain. Based on the incommensurate (or offset) frequency concept, the $\mathbf {M^{2}S}$ -parameters are directly measurable quantities independent of the incident wave phases and display a mild nonlinear dependence on the incident wave amplitudes. They feature a well-defined relationship with the frequency-domain nonlinear transfer functions derived from the Volterra theory, representing a generalization to the multiinput multiharmonic case of the widely used single-input single-frequency describing function approach. The proposed framework allows to capture the nonlinear steady-state behavior from a reduced set of measurements and can be effectively exploited for performance prediction in application-like scenarios. The approach is here applied to RF transistor and power amplifier load-pull measurements, as well as to the case of broadband modulation, showing that the performance assessment of the device can be obtained in a straightforward way from the $\mathbf {M^{2}S}$ -parameters description. [ABSTRACT FROM AUTHOR]

Since the last decade, carbon nanomaterials have had a notable impact on different fields such as bioimaging, drug delivery, artificial tissue engineering, and biosensors. This is due to their good compatibility toward a wide range of chemical to biological molecules, low toxicity, and tunable properties. Especially for biosensor technology, the characteristic features of each dimensionality of carbon-based materials may influence the performance and viability of their use. Surface area, porous network, hybridization, functionalization, synthesis route, the combination of dimensionalities, purity levels, and the mechanisms underlying carbon nanomaterial interactions influence their applications in bioanalytical chemistry. Efforts are being made to fully understand how nanomaterials can influence biological interactions, to develop commercially viable biosensors, and to gain knowledge on the biomolecular processes associated with carbon. Here, we present a comprehensive review highlighting the characteristic features of the dimensionality of carbon-based materials in biosensing., (© 2023. Springer-Verlag GmbH Germany, part of Springer Nature.)

Recurrent male anterior urethral stricture disease is a complex surgical challenge that should be managed by reconstructive urologists with experience in stricture management. Diagnosis of recurrence requires both anatomic narrowing and patient symptoms identified on validated questionnaires, with limited role for intervention in asymptomatic treatment "failures". Endoscopic management has a very specific role in recurrence, and the choice of technique for urethroplasty depends on pre-operative urethrography and cystoscopy. Surgical success depends on addressing patient concerns, complete stricture excision, tissue quality optimization, and the use of multi-stage repair when indicated. Augmentation with genital skin flaps and/or grafts is often required, with buccal mucosa as the ideal graft source if local tissue is compromised. Salvage options including urinary diversion and perineal urethrostomy must also be considered in debilitated patients with severe disease or repeated treatment failures. Unique patient populations including patients with hypospadias and lichen sclerosis are among the highest risk for repeated recurrence and require special care in surgical technique, graft selection, and post-operative management. [ABSTRACT FROM AUTHOR]