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Eun Joo Choi,1 Dong-Hyun Kim,1 Woong Ki Han,1 Ho-Jin Lee,2 Imhong Kang,3 Francis Sahngun Nahm,1,4 Pyung-Bok Lee1,4 1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea; 2Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea; 3Department of Anesthesiology and Pain Medicine, Bundang Chuk Hospital, Seongnam, Korea; 4Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of KoreaCorrespondence: Pyung-Bok LeeDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam, 13620, KoreaTel +82-31- 787-7499Fax +82-31- 787-4063Email painfree@snubh.orgPurpose: Particulate steroids used in epidural steroid injections have been suspected as a cause of post-procedural embolic events. Some particulate steroids have been suspended only when the transforaminal approach is used for an epidural block of the spine. In contrast, non-particulate steroids are generally accepted for safety during epidural steroid injections. However, the safety of using a mixture of non-particulate steroids and local anesthetics is unknown. This study analyzed whether mixtures of commonly used non-particulate steroids and local anesthetics form crystals in solution.Methods: We mixed non-particulate steroids (betamethasone sodium phosphate, dexamethasone sodium phosphate, and dexamethasone palmitate) and local anesthetics (ropivacaine, levobupivacaine, bupivacaine, and lidocaine) at different ratios. We used fluorescence microscopy to observe whether crystals formed in mixed solutions; we also measured the pH of each steroid, local anesthetic, and the mixtures.Results: Ropivacaine or levobupivacaine and betamethasone sodium phosphate produced large crystals (> 50 μm). Ropivacaine or levobupivacaine and dexamethasone sodium phosphate produced small crystals (< 10 μm). Lidocaine and all non-particulate steroids produced no identifiable crystals; dexamethasone palmitate and all local anesthetics did not form significant particulates. Betamethasone sodium phosphate and dexamethasone sodium phosphate demonstrated basic pH, while all local anesthetics demonstrated acidic pH. Mixtures showed a wide pH range.Conclusion: Non-particulate steroids can form crystals upon combination with local anesthetics. Crystal formation may be caused by alkalinization of steroids. The mixing of ropivacaine or levobupivacaine and betamethasone sodium phosphate may require caution during an epidural steroid injection. Lidocaine or bupivacaine is recommended as a local anesthetic. Dexamethasone palmitate is a candidate for a mixture, but additional studies on its safety and effectiveness are needed.Keywords: epidural space, injections, lidocaine, local anesthetics, particle size, steroids

Francis Sahngun Nahm,1,2 Sang-Soep Nahm,3 Woong Ki Han,1 Ho Young Gil,4 Eunjoo Choi,1 Pyung Bok Lee1,2 1Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea; 2College of Medicine, Seoul National University, Seoul, South Korea; 3Laboratory of Veterinary Anatomy, College of Veterinary Medicine, Konkuk University, Seoul, South Korea; 4Department of Anesthesiology and Pain Medicine, Ajou University Hospital, Suwon, South Korea Purpose: Complex regional pain syndrome (CRPS) is a rare but refractory pain disorder. Recent advanced information retrieval studies using text-mining and network analysis have suggested nuclear factor kappa B (NFκB) as a possible central mediator of CRPS. The brain is also known to play important roles in CRPS. The aim of this study was to evaluate changes in cerebral NFκB in rats with CRPS. Materials and methods: The chronic post-ischemia perfusion (CPIP) model was used as the CRPS animal model. O-rings were applied to the left hind paws of the rats. The rats were categorized into three groups according to the results of behavioral tests: the CPIP-positive (A) group, the CPIP-negative (B) group, and the control (C) group. Three weeks after the CPIP procedure, the right cerebrums of the animals were harvested to measure NFkB levels using an ELISA. Results: Animals in group A had significantly decreased mechanical pain thresholds (P

Photodynamic therapy (PDT) holds promise as a cancer treatment modality due to its potential for enhanced therapy precision and safety. To enhance deep tissue penetration and minimize tissue adsorption and phototoxicity, developing photosensitizers activated by second near-infrared window (NIR-II) light shows significant potential. However, the efficacy of PDT is often impeded by tumor microenvironment hypoxia, primarily caused by irregular tumor vasculature. Fortunately, the stimulator of interferon genes (STING) pathway, known for immune activation, has been linked to vasculature normalization. In this study, we developed a nanoplatform (Fe-THBQ/SR) by loading a STING agonist (SR-717) into an iron-tetrahydroxy-1,4-benzoquinone (Fe-THBQ) metal-organic framework. Fe-THBQ was proven to be an effective NIR-II photosensitizer, generating numerous reactive oxygen species (ROS) under 1064 nm laser irradiation. These ROS downregulated heat shock protein expression, consequently promoting mild-photothermal therapy (mild-PTT), and facilitated ferroptosis by depleting glutathione (GSH)/glutathione peroxidase 4. Moreover, Fe-THBQ/SR released SR-717 upon GSH stimulation, synergizing with the ROS-mediated double-stranded DNA leakage to enhance STING activation. This process contributed to tumor vasculature normalization and hypoxia alleviation, thereby enhancing the PDT efficacy. Overall, we presented a versatile single-laser-triggered nanoplatform (Fe-THBQ/SR) for NIR-II PDT and NIR-II mild-PTT and simultaneously coupled it with the effective activation of STING to form a reinforcing cycle. These synergistic enhancements increased the immunogenicity of tumor cells, remodeled the immunosuppressive tumor microenvironment, increased T lymphocyte infiltration, and improved therapeutic outcomes.

The design of three-dimensional covalent organic frameworks (3D COFs) using linear and trigonal linkers remains challenging due to the difficulty in achieving a specific non-planar spatial arrangement with low-connectivity building units. Here, we report the novel 3D COFs with linear and trigonal linkers, termed TMB-COFs, exhibiting srs topology. The steric hindrance provides an additional force to alter the torsion angles of peripheral triangular units, guiding the linear unit to connect with the trigonal unit into 3D srs frameworks, rather than the more commonly observed two-dimensional (2D) hcb structures. Furthermore, we comprehensively examined the hydrogen peroxide photocatalytic production capacity of the TMB-COFs in comparison with analogous 2D COFs. The experimental results and DFT calculations demonstrate a significant enhancement in photocatalytic hydrogen peroxide production efficacy through framework regulation. This work emphasizes the steric configuration using low connectivity building units, offering a fresh perspective on the design and application of 3D COFs., (© 2024 Wiley-VCH GmbH.)

Purpose: This study aims to develop and implement an economic evaluation using a micro-costing approach to provide a precise and transparent analysis of the direct costs of cystoscopic procedures in Korean hospitals. The study seeks to identify key cost components and evaluate whether current reimbursement rates accurately reflect these direct costs., Materials and Methods: Significant variations in cost items were identified across different studies. An economic evaluation was conducted using a micro-costing methodology for the cost analysis of cystoscopic procedures, developed through literature review, data collection from studies, and expert consultations., Results: Gangnam Severance Hospital (GSH) performed 2,188 cystoscopic procedures, including 1,847 cystoscopies and 341 JJ stent removals, with average costs of $100.8 and $110.6, respectively. At National Health Insurance Service Ilsan Hospital (NHIMC), 1,463 procedures were performed, including 1,167 cystoscopies and 296 JJ stent removals, with average costs of $119.2 and $125.3. Cystoscopy costs at GSH were driven by reprocessing ($45.8, 45.4%) and equipment ($33.1, 32.9%), while NHIMC's were $52.5 (44.0%) for equipment and $48.7 (40.8%) for reprocessing. Both hospitals incurred financial losses, with NHIS (National Health Insurance Service) covering only about 71.7% and 60.6% of costs for cystoscopy, and 71.0% and 62.7% for JJ stent removal., Conclusions: The significant discrepancy between HIRA (Health Insurance Review & Assessment Service)'s estimated costs and those identified here suggests that current fees for cystoscopic procedures may be underestimated and require reassessment. Given the results, reevaluating these rates is essential to ensure fair compensation for healthcare providers and to deliver optimal patient care., Competing Interests: The authors have nothing to disclose., (© The Korean Urological Association.)

Background: Spinal cord stimulators (SCSs) are used to reduce pain and improve quality of life in patients with complex regional pain syndrome (CRPS). However, many patients opt for device removal after SCS implantation due to diminished effect or complications. There is limited research on the actual duration of SCS use in CRPS patients, and no nationwide population-based studies exist. This study aimed to estimate the real-world duration of SCS use in CRPS patients and examine the influencing factors on the duration of SCS use by analyzing the National Healthcare Insurance Database., Methods: Adult patients (age ≥ 18) with CRPS who underwent permanent SCS implantation between 2014 and 2021 were included. The authors analyzed the median duration of SCS implantation and evaluated the impacts of age, sex, hospital type, and insurance type., Results: Of 408 potential patients, 373 patients were included. The median duration of SCS use was 4.4 (95% confidence interval [CI]: 4.0-4.8) years. Male patients retained SCSs longer than female patients (4.7 vs . 4.0 years, P = 0.014), and veterans' healthcare beneficiaries showed the longest duration of SCS use (median 6.9 [95% CI: 4.6-7.8] years). Age and hospital type did not affect the duration of SCS use ( P = 0.381 and P = 0.122, respectively)., Conclusions: The median SCS use duration in CRPS patients was 4.4 years. Considering the high cost and invasiveness of SCS, patients should be informed about the expected duration of SCS use, alongside potential risks and benefits.

Diatomic catalysts enhance photocatalytic CO 2 reduction through synergistic effects. However, precisely regulating the distance between two catalytic centers to achieve synergistic catalysis poses significant challenges. In this study, a series of one-dimensional (1D) covalent organic frameworks (COFs) are designed with adjustable micropores to facilitate efficient CO 2 photoreduction. CO 2 molecules are anchored between dual-cobalt centers within micropores, thus effectively reducing their activation energy and initiating the photocatalytic process. Additionally, the formation of *COOH intermediates is significantly influenced by the coordination microenvironment around dual-cobalt sites. Notably, COF-Co-N 4 exhibited remarkable CO 2 photoreduction activity with a CO evolution rate of 110.3 µmol·g -1 ·h -1 , which surpasses most of previously reported single-atom-site photocatalysts. Comprehensive characterization and density functional theory (DFT) calculations revealed that 1D COFs with dual-cobalt sites possess the ability to anchor CO 2 molecules, thereby enhancing the efficacy of synergistic catalysis. Simultaneously, COF-Co-N 4 with quadruple nitrogen coordination significantly reduced the energy barrier of crucial *COOH intermediate, facilitating efficient photocatalytic CO 2 reduction. This study meticulously modulated the coordination microenvironment surrounding dual-cobalt synergistic sites, providing new insight into the design of high-performance photocatalysts., (© 2024 Wiley‐VCH GmbH.)

Rational construction of high-performance ionic conductors is a critical challenge in the field of energy storage. In this study, a series of 1D anionic titanium-based covalent organic frameworks (COFs) containing abundant alkali metal ion migration sites, namely, COF-M-R (M = Li, Na, K; R = H, Me, Et), is constructed. The integration of negative TiO 6 2- sites on 1D anionic COFs allows alkali metal cations to migrate directly through the channels. Meanwhile, the π-π stacking of 1D chain-to-chain allows the distribution of ion-migration sites in 2D planes. In view of this, multidimensional ionic transport in COFs is realized to achieve high ionic conductivity. COF-M-Rs exhibit an increased ionic conductivity as the counterions change from Li + to Na + to K + . Notably, COF-Na-Et has an impressive ionic conductivity as high as 0.81 × 10 -3 S cm -1 . The different decorated groups (H, Me, and Et) on the skeleton influence the dissociation of the cation from the polyanion. This study offers deep insights into the design of COF-based solid-state electrolytes to achieve high ionic conductivity by increasing the ionic transport dimensions., (© 2024 Wiley‐VCH GmbH.)

Lipids perform a diverse and unique array of functions in insects. Lipases are key enzymes in lipid metabolism, and their metabolic products are crucial for development and reproduction of insects. Here, a total of 110 lipase genes were identified in the genome of Spodoptera frugiperda. Cluster analysis indicated that neutral lipases constitute the majority of lipases. Tissue expression profile analysis displayed that most lipase genes were highly expressed in the larval gut of S. frugiperda. Some lipases exhibited a diet-specific expression pattern, which implied their roles in host adaptation. Key domain analysis proved that none of the neutral lipases highly expressed in the gut has an integrated lid domain, while most lipases highly expressed in the fat body contained both the integrated lid domain and β9 loop, indicating the activity loss of neutral lipases in guts. The assay of triacylglycerol (TAG) hydrolytic activity confirmed that the gut had the lowest activity when compared to that of fat body and epidermis. Interestingly, the opposite TAG hydrolytic activity trends across mating were observed between adult males and females, implying that lipase played different roles in the reproduction of both sexes. In conclusion, neutral lipases lost TAG hydrolytic activity in S. frugiperda guts, but retained the activity in fat body. Neutral lipases would play vital roles in many physiological processes in insects, especially in insect reproduction, which provides palpable targets for novel insecticide development to control insect population growth., (© 2024 Institute of Zoology, Chinese Academy of Sciences.)

The excessive heat accumulation has been the greatest danger for chips to maintain the computing power. In this paper, a passive thermal management strategy for electronics cooling was developed based on the water vapor desorption process of the covalent organic frameworks (COFs). The precise regulation for the number of carbonyl group and the ratio of hydrophilicity and hydrophobicity within pore channels was achieved by water adsorption sites engineering. In particular, COF-THTA with abundant water adsorption sites exhibited highest water uptake and desorption energy, which facilitate efficient cooling of electronics. In proof-of-concept testing, COF-THTA coating (40×40 mm) provided a temperature drop of 7.5 °C in 25 minutes at a heating power of 937.5 W/m 2 , and remained stable after 10 intermittent heat cycles. Furthermore, the equivalent enthalpy of COF-THTA coating can reach up to 1136 J/g coating . In real application scenarios, COF-THTA coating improved the performance of two real computing devices by 26.73 % and 22.61 %, respectively. This strategy based on COFs provides a new thinking for passive thermal management, exhibiting great potential in efficient cooling of electronics., (© 2024 Wiley-VCH GmbH.)

To determine risk factors for urinary retention (UR) after robot-assisted radical cystectomy (RALC) with orthotopic neobladder diversion. A total of 269 patients who underwent RALC with orthotopic neobladder diversion from 2008 to 2019 at seven tertiary hospitals were retrospectively analyzed. There were 68 patients who had UR (UR arm) and 201 patients who did not have UR (no-UR arm). UR was defined as voiding dysfunction without catheterization or more than 100 mL of residual urine after voiding. Preoperative demographics, perioperative factors, pathology outcomes, and postoperative complications of UR and no-UR arms were compared and predictors of UR were identified. Among demographic factors, only gender proportion showed a difference, with male proportion being significantly lower in the UR arm than in the no-UR arm (81% vs 92%, p = 0.010). For perioperative outcomes, anastomosis site stricture (27% vs 11%, p = 0.003) and length of hospital stays (23 days vs. 19 days, p = 0.001) were significantly higher in the UR arm than in the no-UR arm. In multiple logistic regression analysis, female (OR 3.32, 95% CI: 1.43-7.72) and body mass index (BMI) (OR 1.10, 95% CI 1.00-1.20) were UR predictors. UR after RALC with orthotopic neobladder diversion is significantly increased in females. Multiple logistic regression analysis identified female and BMI elevation as UR predictors., Competing Interests: Declarations Conflict of interest The authors declare no competing interests. Ethical approval We performed this retrospective, multi-institutional study after Institutional Review Board (IRB) approval of Seoul National University Bundang Hospital (Approval number: B-2309–853-303) and in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments., (© 2024. The Author(s).)

The low immunogenicity of tumors, along with the abnormal structural and biochemical barriers of tumor-associated vasculature, impedes the infiltration and function of effector T cells at the tumor site, severely inhibiting the efficacy of antitumor immunotherapy. In this study, a cobaloxime catalyst and STING agonist (MSA-2)-coloaded Wurster-type covalent organic framework (Co-TB COF-M) with internal electron transfer-enhanced catalytic capacity was developed as a COF-based immune activator. The covalently anchored cobaloxime adjusts the energy band structure of TB COF and provides it with good substrate adsorption sites, enabling it to act as an electron transmission bridge between the COF and substrate in proton reduction catalytic reactions. This property significantly enhances the sonodynamic catalytic performance. Under sono-irradiation, Co-TB COF-M can produce a substantial amount of reactive oxygen species (ROS) to induce Gasdermin D-mediated pro-inflammatory pyroptosis, thereby effectively enhancing the immunogenicity of tumors. Furthermore, MSA-2 is specifically released in response to ROS at the tumor site, minimizing the off-target side effects. More importantly, Co-TB COF-induced STING activation normalizes tumor vasculature and increases the expression of endothelial T cell adhesion molecules, which greatly enhance the infiltration and function of effector T cells. Thus, Co-TB COF-M as an immune activator could remold the tumor microenvironment, leading to increased infiltration and an improved function of T cells for immunotherapy.

Background/Objectives: Oligometastatic prostate cancer (OMPC) represents an early stage of metastatic disease characterized by a limited number of lesions. Recent advancements in imaging and treatment have revived interest in personalized therapies, including metastasis-directed radiotherapy (OMDRT) and primary prostate radiotherapy (PPR). This study evaluates the impact of OMDRT timing and the role of PPR on survival outcomes in OMPC patients; Methods: In this retrospective cohort study, 82 patients with OMPC who underwent OMDRT between 2010 and 2019 were analyzed. Patients were classified based on OMDRT timing (early vs. late) and disease type (synchronous vs. metachronous). Progression-free survival (PFS) and overall survival (OS) were the primary endpoints, assessed via Kaplan-Meier analysis and Cox proportional hazards models; Results: Among the patients, 36 (43.9%) had synchronous and 46 (56.1%) had metachronous OMD. With a median follow-up of 32 months, the 5-year PFS and OS rates were 77.5% and 88.5%, respectively. Early OMDRT significantly improved PFS (HR 0.461, 95% CI: 0.257-0.826, p = 0.009) and OS (HR 0.219, 95% CI: 0.080-0.603, p = 0.003). Subgroup analysis showed the most favorable outcomes for synchronous OMD patients receiving early OMDRT, with a median PFS of 22.2 months and a 5-year survival rate of 42.1%. The treatment of the primary prostate provided a survival benefit in the OS of synchronous OMD patients (5-year 83.1% vs. 50%, p = 0.025), and there was a further improvement in OS after PPR (5-year 87.7% vs. 50%, p = 0.015). Conclusions: Early OMDRT significantly enhances survival outcomes in OMPC, in both synchronous and metachronous cases. The integration of PPR can further improve results, emphasizing the importance of early intervention and personalized treatment strategies. To more definitively clarify our findings across various clinical situations, further studies with larger cohorts or prospective designs are necessary.

Despite the prevalent of hexagonal, tetragonal, and triangular pore structures in two-dimensional covalent organic frameworks (2D COFs), the pentagonal pores remain conspicuously absent. We herein present the Cairo pentagonal tessellated COFs, achieved through precisely chosen geometry and metrics of the linkers, resulting in unprecedented mcm topology. In each pentagonal structure, porphyrin units create four uniform sides around 15.5 Å with 90° angles, while tetrabiphenyl unit establish a bottom edge about 11.6 Å with 120° angles, aligning precisely with the criteria of Cairo Pentagon. According to the narrow bandgap and strong near-infrared (NIR) absorbance, as-synthesized COFs exhibit the efficient singlet oxygen ( 1 O 2 ) generation and photothermal conversion, resulting in NIR photothermal combined photodynamic therapy to guide cancer cell apoptosis. Mechanistic studies reveal that the good 1 O 2 production capability upregulates intracellular lipid peroxidation, leading to glutathione depletion, low expression of glutathione peroxidase 4, and induction of ferroptosis. The implementation of pentagonal Cairo tessellations in this work provides a promising strategy for diversifying COFs with new topologies, along with multimodal NIR phototherapy., (© 2024. The Author(s).)

Background: The role of cytoreductive nephrectomy (CN) in the treatment of metastatic renal cell carcinoma (mRCC) remains unclear in the immuno-oncology (IO) era. The results of two randomized trials, CARMENA and SURTIME, questioned the role and timing of CN. However, despite the latest advances in the systemic treatment of mRCC, previous trials have only used targeted therapy, and no studies have fully investigated the role of CN in immune checkpoint inhibitor (CPI) settings, and there is an urgent need for future studies to better define the role and timing of CN., Methods: This study is an open-label, multi-center, parallel, prospective, randomized, interventional clinical study to evaluate the efficacy of CN in combination with CPIs in mRCC patients with International mRCC Database Consortium (IMDC) intermediate- and poor-risk. Synchronous mRCC patients with ≤ 3 IMDC risk features will be randomly allocated to three groups (1, upfront CN; 2, deferred CN; and 3, systemic therapy [ST] only). For ST, the nivolumab plus ipilimumab combination regimen, one of the standard regimens for intermediate- and poor-risk mRCC, is chosen. The primary endpoint is overall survival. The secondary endpoints are progression-free survival, objective response rate, number of participants with treatment-related adverse events, and number of participants with surgical morbidity. We will analyze the genetic mutation profiles of the tumor tissue, circulating tumor DNA, urine tumor DNA, and tumor-infiltrating lymphocytes. The gut and urine microbial communities will be analyzed. The study will begin in 2022 and will enroll 55 patients., Discussion: This study is one of the few prospective randomized trials to evaluate the benefit of CN in the treatment of synchronous mRCC in the IO era. The SEVURO-CN trial will help identify the role and timing of CN, thereby rediscovering the value of CN., Trial Registration: ClinicalTrials.gov, NCT05753839. Registered on 3 March 2023., (© 2024. The Author(s).)

Constructing artificial photocatalysts with panchromatic solar energy utilization remains an appealing challenge. Herein, two complementary photosensitizers, [Ru(bpy) 3 ] 2+ (bpy = 2,2'-bipyridine) and porphyrin dyes, have been cosensitized in metal covalent organic frameworks (MCOFs), resulting in the MCOFs with strong light absorption covering the full visible spectrum. Under panchromatic light irradiation, the cosensitized MCOFs exhibited remarkable photocatalytic H 2 evolution with an optimum rate of up to 33.02 mmol g -1 h -1 . Even when exposed to deep-red light (λ = 700 ± 10 nm), a commendable H 2 production (0.79 mmol g -1 h -1 ) was still obtained. Theoretical calculation demonstrated that the [Ru(bpy) 3 ] 2+ and porphyrin modules in our MCOFs have a synergistic effect to trigger an interesting dual-channel photosensitization pathway for efficient light-harvesting and energy conversion. This work highlights the potential of combining multiple PSs in MCOFs for panchromatic photocatalysis.

To investigate the influence of preoperative smoking history on the survival outcomes and complications in a cohort from a large multicenter database. Many patients who undergo radical cystectomy (RC) have a history of smoking; however, the direct association between preoperative smoking history and survival outcomes and complications in patients with muscle-invasive bladder cancer (MIBC) who undergo robot-assisted radical cystectomy (RARC) remains unexplored. We conducted a retrospective analysis using data from 749 patients in the Korean Robot-Assisted Radical Cystectomy Study Group (KORARC) database, with an average follow-up duration of 30.8 months. The cohort was divided into two groups: smokers (n = 351) and non-smokers (n = 398). Propensity score matching was employed to address differences in sample size and baseline demographics between the two groups (n = 274, each). Comparative analyses included assessments of oncological outcomes and complications. After matching, smoking did not significantly affect the overall complication rate (p = 0.121). Preoperative smoking did not significantly increase the occurrence of complications based on complication type (p = 0.322), nor did it increase the readmission rate (p = 0.076). There were no perioperative death in either group. Furthermore, preoperative smoking history showed no significant impact on overall survival (OS) [hazard ratio (HR) = 0.87, interquartile range (IQR): 0.54-1.42; p = 0.589] and recurrence-free survival (RFS) (HR = 1.12, IQR: 0.83-1.53; p = 0.458) following RARC for MIBC. The extent of preoperative smoking (≤ 10, 10-30, and ≥ 30 pack-years) had no significant influence on OS and RFS in any of the categories (all p > 0.05). Preoperative smoking history did not significantly affect OS, RFS, or complications in patients with MIBC undergoing RARC., (© 2024. The Author(s).)

Objective: To evaluate the association between long-term exposure to ambient ozone (O 3 ) and sperm quality. Methods: From January 1, 2014, to December 31, 2019, healthy sperm donors were recruited through the Human Sperm Bank of Shandong University Affiliated Reproductive Hospital. A total of 37 977 sperm donation data from 2 971 healthy volunteers were analyzed. The average annual O 3 concentration (0.01°× 0.01°) was matched according to household address. A multivariate mixed-effect model was used to analyze the exposure-response relationship between the average O 3 exposure concentration and sperm quality in the previous year, with each donor as a random intercept. All results were presented as % changes with 95% confidence intervals ( CIs ) for all sperm parameters associated with 10 μg/m 3 increases in O 3 . The effects of individual characteristics on the association between O 3 and sperm quality were evaluated by stratified analysis. Results: The average O 3 concentration in the year before semen collection was (107.09±7.50) μg/m 3 . Each 10 μg/m 3 increase in O 3 was associated with declined sperm concentration (-3.12%, 95% CI :-4.55%, -1.67%), total sperm count (-5.21%, 95% CI :-7.28%, -3.09%), total sperm motility (-1.49%, 95% CI :-2.37%, -0.61%), progressive motility (-2.53%, 95% CI :-3.78%, -1.26%), total motile sperm count (-5.82%, 95% CI :-8.17%, -3.41%), and progressively motile sperm count (-6.22%, 95% CI :-8.73%, -3.64%). Men aged 30 and above, obese, and with lower education levels might be more susceptible to the influence of O 3 on sperm quality, but the difference was not statistically significant ( P> 0.05). Conclusion: Long-term exposure to O 3 in Shandong Province is associated with a decrease in sperm quality.

Designing artificial photocatalysts for CO 2 reduction is challenging, mainly due to the intrinsic difficulty of making multiple functional units cooperate efficiently. Herein, three-dimensional metal covalent organic frameworks (3D MCOFs) were employed as an innovative platform to integrate a strong Ru(ii) light-harvesting unit, an active Re(i) catalytic center, and an efficient charge separation configuration for photocatalysis. The photosensitive moiety was precisely stabilized into the covalent skeleton by using a rational-designed Ru(ii) complex as one of the building units, while the Re(i) center was linked via a shared bridging ligand with an Ru(ii) center, opening an effective pathway for their electronic interaction. Remarkably, the as-synthesized MCOF exhibited impressive CO 2 photoreduction activity with a CO generation rate as high as 1840 μmol g -1 h -1 and 97.7% selectivity. The femtosecond transient absorption spectroscopy combined with theoretical calculations uncovered the fast charge-transfer dynamics occurring between the photoactive and catalytic centers, providing a comprehensive understanding of the photocatalytic mechanism. This work offers in-depth insight into the design of MCOF-based photocatalysts for solar energy utilization., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

In this study, we aimed to assess the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on semen parameters. The study comprised 110 sperm volunteers who self-reported SARS-CoV-2 infection from the Human Sperm Bank of the Center for Reproductive Medicine, Shandong University (Jinan, China). The volunteers had normal sperm concentration before infection. Each volunteer provided semen samples before and after infection. We selected 90 days after infection as the cutoff point. Semen parameters within 90 days after infection of 109 volunteers (group A) were compared with semen parameters before infection. Moreover, semen parameters on or after 90 days after infection of 36 volunteers (group B) were compared with semen parameters before infection. Furthermore, based on whether the volunteers had completed the three-dose SARS-CoV-2 vaccination booster, volunteers in group A and B were further divided into two subgroups separately. Semen parameters were compared before and after infection in each subgroup. Our results showed that in this cohort population, the semen quality in volunteers with normal sperm concentrations before infection decreased after SARS-CoV-2 infection within 90 days, while the semen quality returned to preinfection levels after 90 days. The completion of a three-dose SARS-CoV-2 vaccination booster may exert a protective effect on semen quality after infection., (Copyright © 2023 Copyright: © The Author(s)(2023).)

Background: Robotic kidney transplantation (RKT) is a novel and welcomed innovation yielding good surgical outcomes. However, data on the feasibility and safety of performing RKT by surgeons with a lack of prior minimally invasive surgery (MIS) experience are limited. The authors aimed to evaluate the surgical and functional results of RKT and present the learning curves (LC) of RKT by a single surgeon with no prior experience in MIS., Materials and Methods: This was a retrospective study of all RKT performed between November 2019 and April 2023 at Severance Hospital in Seoul, South Korea. The authors analyzed surgical and functional outcomes, as well as complication rates of RKT in comparison to open kidney transplantation (OKT). The authors evaluated LCs using the cumulative summation method to describe the number of cases associated with the competency of a single surgeon., Results: A total of 50 patients who underwent RKT and 104 patients who underwent OKT were included in this study. In RKT group, the median surgical console time was 193 min (interquartile range, 172-222) and the median vascular anastomoses time was 38 min (35-44). Total operation time was 323 min (290-371) and rewarming time was 62.5 min (56.0-70.0) in RKT group compared to 210 min (190-239) and 25 min (21-30), respectively, in OKT group. Despite extended surgical durations with a robotic technique, both groups had comparable intraoperative and postoperative outcomes, as well as renal function. Estimated blood loss and post-transplant hospital stays were significantly lower in RKT group than in OKT group. LC analysis of RKT by the single surgeon revealed that surgical competence was achieved after 15 cases., Conclusion: Even if surgeons do not have prior experience with MIS, they can rapidly overcome the LC and safely perform RKT with adequate preparation and acquisition of basic robotic surgical techniques., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)

Insect odorant binding proteins (OBPs) were initially regarded as carriers of the odorants involved in chemosensation. However, it had been observed that a growing number of OBP genes exhibited broad expression patterns beyond chemosensory tissues. Here, an OBP gene (OBP31) was found to be highly expressed in the larval ventral nerve cord, adult brain and male reproductive organ of Spodoptera frugiperda. An OBP31 knockout strain (OBP31 -/- ) was generated by CRISPR/Cas9 mutagenesis. For OBP31 -/- , the larvae needed longer time to pupate, but there was no difference in the pupal weight between OBP31 -/- and wild type (WT). OBP31 -/- larvae showed stronger phototaxis than the WT larvae, indicating the importance of OBP31 in light perception. For mating rhythm of adults, OBP31 -/- moths displayed an earlier second mating peak. In the cross-pairing of OBP31 -/- and WT moths, the mating duration was longer, and hatchability was lower in OBP31 -/- group and OBP31 +/- ♂ group than that in the WT group. These results suggested that OBP31 played a vital role in larval light perception and male reproductive process and could provide valuable insights into understanding the biological functions of OBPs that were not specific in chemosensory tissues., (© 2023 Royal Entomological Society.)

Insects coordinate a variety of mechanisms to overcome the feeding challenges, including gene transcriptional plasticity and stable symbioses in the gut. Here, Spodoptera frugiperda larvae were reared on corn and rice plants for successive generations to obtain two specific strains. The rice strain displayed a longer developmental period, lower female fecundity, and intrinsic growth rate at G1 and G5 but not at G10. KEGG analysis of the G1, G5, and G11 gut transcriptome indicated that detoxification enzymes might play vital roles in host adaptation. RNAi-mediated knockdown of CYP12A2 and UGT41B8 , which were highly expressed in the gut of the rice strain, significantly reduced the larval adaptability to rice. Besides, the dsCYP12A2 -treated larvae displayed an increased sensitivity to luteolin, a flavonoid phytochemical. The KEGG function prediction of gut microbiota indicated that the high enrichment level of metabolism in the rice strain would play essential roles in rice adaptation.

Non-platinum noble metals are highly desirable for the development of highly active, stable oxygen reduction reaction (ORR) electrocatalysts for fuel cells and metal-air batteries. However, how to improve the utilization of non-platinum noble metals is an urgent issue. Herein, a highly efficient catalyst for ORR was prepared through homogeneous loading of Pd precursors by a domain-limited method in a three-dimensional covalent organic framework (COF) followed by pyrolysis. The morphology of the Pd nanoparticles (Pd NPs) was well maintained after carbonization, which was attributed to the rigid structure of the 3D COF. Thanks to the uniform distribution of Pd NPs in the carbon, the catalyst exhibited a remarkable half-wave potential of 0.906 V and a Tafel slope of 70 mV dec -1 in 0.1 M KOH, surpassing the commercial Pt/C catalyst (0.863 V and 75 mV dec -1 ). Furthermore, a maximum power density of 144.0 mW cm -2 was achieved at 252 mA cm -2 , which was significantly higher than the control battery (105.1 mW cm -2 ). This work not only provides a simple strategy for in-situ preparation of highly dispersible metal catalysts in COFs, but also offers new insights into the ORR electrocatalysis., (© 2023 Wiley-VCH GmbH.)

Humidity is one of the most important indicators affecting human health. Here, a pair of covalent organic frameworks (COFs) of positional isomers (p-COF and o-COF) for indoor humidity regulation is reported. Although p-COF and o-COF have the same sql topology and pore size, they exhibit different water adsorption behaviors due to the subtle differences in water adsorption sites. Particularly, o-COF exhibits a steep adsorption isotherm in the range of 45-65% RH with a hysteresis loop, which is perfectly suitable for indoor humidity regulation. In the laboratory experiment, when the humidity of the external environment is 20-75% RH, o-COF can control the humidity of the room in the range of 45-60% RH. o-COF has shown great potential as a dual humidification/dehumidification adsorbent for indoor humidity regulation., (© 2023 Wiley-VCH GmbH.)

The water oxidation reaction plays an important role in clean energy conversion, utilization, and storage, but mimicking the oxygen-evolving complex of photosystem II for designing active and stable water oxidation catalysts (WOCs) is still an appealing challenge. Here, we innovatively engineered a molecular ruthenium WOC as a metal complex building unit to construct a series of three-dimensional metal covalent organic frameworks (3D MCOFs) for realizing efficient oxidation catalysis. The resultant MCOFs possessed rare 3D interlocking structures with inclined interpenetration of two-dimensional covalent rhombic nets, and the Ru sites were periodically arranged in the crystalline porous frameworks. Impressively, these MCOFs showed excellent performance towards water oxidation (the O 2 evolution rate is as high as 2830 nmol g -1 s -1 ) via the water nucleophilic attack pathway. Besides, the MCOFs were also reactive for oxidizing organic substrates. This work highlights the potential of MCOFs as a designable platform in integrating molecular catalysts for various applications., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Odorant-binding proteins (OBPs) play key roles in the perception of semiochemicals in insects. Several OBPs in insect olfactory systems have been functionally characterized, and they provide excellent targets for pest control. The functions of some OBPs that are highly expressed in the nonsensory organs of insects remain unclear. Here, the physiological function of an OBP (OBP27) that was highly expressed in the nonsensory organs of Spodoptera frugiperda was studied. OBP27 was nested within the Plus-C cluster according to phylogenetic analysis. The transcription of OBP27 steadily increased throughout the development of S. frugiperda, and transcripts of this gene were abundant in the fat body and male reproductive organs. An OBP27 knockout strain with an early frameshift mutation was obtained using the clustered regularly interspaced palindromic repeats (CRISPR) / CRISPR-associated protein 9 (Cas9) system. The development time of OBP27 -/- larvae was significantly longer than that of other larvae. Both male and female OBP27 -/- pupae weighed significantly less than wild-type (WT) pupae. In crosses of OBP27 -/- males or females, the mating rate was lower and the mating duration was longer for OBP27 -/- male-WT female pairs than for WT-WT pairs. By contrast, the mating rate, hatching rate, and number of eggs of OBP27 -/- female-WT male pairs and WT-WT pairs were similar. These findings indicate that OBP27 plays an important role in the larval development and mating process in male adults. Generally, our findings provide new insights into the physiological roles of nonsensory OBPs., (© 2023 Institute of Zoology, Chinese Academy of Sciences.)

Various techniques have been formulated to reduce pain and ensure early recovery after surgery, as these are major concerns among surgeons, anesthesiologists, and patients. Erector spinae plane block (ESPB), the injection of local anesthetic into the fascial plane, is a simple and novel analgesia technique widely used due to its minimal risk of complications. ESPB has been tried in various surgeries; however, no study has reported its use in colorectal surgery. This study investigated whether ESPB could promote early recovery following laparoscopic colorectal surgery (LCS) by reducing opioid consumption and pain intensity. After randomization into the ESPB or control groups, an ultrasound-guided ESPB was performed at the thoracic 10 th -11th level with 40 mL of 0.25% bupivacaine or normal saline. The ESPB group used less fentanyl during the initial 24 h after surgery (P = 0.004) and experienced less pain (P < 0.05 at all-time points) than the control group. The time to the first ambulation and the length of hospital stay were shorter in the ESPB group than in the control group (P = 0.015 and P = 0.008, respectively). In conclusion, ESPB could promote early recovery by reducing opioid consumption and pain intensity in patients receiving LCS., (© 2023. The Author(s).)

The CRISPR/Cas9 system has been successfully applied in dozens of diverse species; although the screening of successful CRISPR/Cas9 editing events remains particularly laborious, especially for those that occur at relatively low frequency. Recently, a co-CRISPR strategy was proved to enrich the desired CRISPR events. Here, the co-CRISPR strategy was developed in the Fall armyworm, Spodoptera frugiperda, with kynurenine 3-monooxygenase gene (kmo) as a marker. The kmo mosaics induced by single-guide RNAs (sgRNAs)/Cas9 displayed the darker green color phenotype in larvae, compared with wild type (brown), and mosaic-eye adults were significantly acquired from the mosaic larvae group. In the kmo knockout strain, no significant difference was observed in larval development and adult reproduction. Acetylcholinesterase 2 (ace2) and Wnt1 were selected as target genes to construct the co-CRISPR strategy using kmo marker. By co-injection of kmo and ace2 sgRNAs, the mutant efficiency of ace2 was significantly increased in the kmo mosaic (larvae or adults) groups. Similarly, more malformed pupae with Wnt1 mutations were observed in the darker green larvae group. Taken together, these results demonstrated that kmo was a suitable visible marker gene for the application and extension of co-CRISPR strategy in Fall armyworm. Using darker green color in larvae or mosaic-eye in adults from kmo knockout as a marker, the mutant efficiency of a target gene could be enriched in a Fall armyworm group consisting of marked individuals. The co-CRISPR strategy is helpful for gene function studies by the knockout technique with no or lethal phenotypes., (© 2022 Institute of Zoology, Chinese Academy of Sciences.)

A highly stretchable and tissue-adhesive multifunctional sensor based on structurally engineered islets embedded in ultra-soft hydrogel is reported for monitoring of bladder activity in overactive bladder (OAB) induced rat and anesthetized pig. The use of hydrogel yielded a much lower sensor modulus (1 kPa) compared to that of the bladder (300 kPa), while the strong adhesiveness of the hydrogel (adhesive strength: 260.86 N/m) allowed firm attachment onto the bladder. The change in resistance of printed liquid metal particle thin-film lines under strain were used to detect bladder inflation and deflation; due to the high stretchability and reliability of the lines, surface strains of 200% could be measured repeatedly. Au electrodes coated with Platinum black were used to detect electromyography (EMG). These electrodes were placed on structurally engineered rigid islets so that no interfacial fracture occurs under high strains associated with bladder expansion. On the OAB induced rat, stronger signals (change in resistance and EMG root-mean-square) were detected near intra-bladder pressure maxima, thus showing correlation to bladder activity. Moreover, using robot-assisted laparoscopic surgery, the sensor was placed onto the bladder of an anesthetized pig. Under voiding and filling, bladder strain and EMG were once again monitored. These results confirm that our proposed sensor is a highly feasible, clinically relevant implantable device for continuous monitoring OAB for diagnosis and treatment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: Ureteral strictures are a common complication after kidney transplantation. Open reconstruction is preferred for long-segment ureteral strictures that cannot be resolved endoscopically; however, it is known to have the potential to fail. We report 2 successful cases of robotic reconstruction surgery of a transplant ureter using the native ureter with the aid of intraoperative Indocyanine green (ICG)., Materials and Methods: Patients were placed in semi-lateral position. Using Da Vinci Xi, the transplant ureter was dissected, and the stricture site was identified. End-to-side anastomosis of the native ureter to the transplant ureter was performed. ICG was utilized to identify the course of the transplant ureter and confirm the vascularity of the native ureter., Results: Case 1: A 55-year-old female underwent renal transplantation at another hospital. She had recurrent febrile urinary tract infections (UTIs) and a ureteral stricture requiring percutaneous nephrostomy (PCN). The PCN and ureteral stent were removed successfully after surgery. The patient had only 1 febrile UTI episode after surgery. Case 2: A 56-year-old female underwent renal transplantation at another hospital. She had acute pyelonephritis 1-month post-transplantation, and a long-segment ureteral stricture was identified. She developed a UTI with anastomosis site leakage in the early postoperative period, which resolved with conservative treatment. The PCN and ureteral stent were removed 6 weeks after surgery., Conclusions: Robotic surgery for managing long-segment ureteral stricture after kidney transplantation is safe and feasible. The use of ICG during surgery to identify the ureter course and its viability can improve the success., Competing Interests: The authors have nothing to disclose., (© The Korean Urological Association.)

Purpose: To analyze malignancy of computed tomography (CT) and magnetic resonance imaging (MRI) results in the same renal mass., Materials and Methods: We retrospectively reviewed 1,216 patients who underwent partial nephrectomy from January 2017 to December 2021 in our institute. Patients who had both CT and MRI reports prior to surgery were included. We compared the diagnostic accuracy between the CT and the MRI. The patients were divided into two groups according to the consistency of reports: the 'Consistent group' and the 'Inconsistent group'. The Inconsistent group was further divided into two subgroups. Group 1 is the case that showed benign findings on CT but malignancy on MRI. Group 2 is the cases of malignancy on CT but benign on MRI., Results: 410 patients were identified. Benign lesion was identified in 68 cases (16.6%). The sensitivity, specificity and diagnostic accuracy of MRI was 91.2%, 36.8%, and 82.2% respectively, whereas that of CT was 84.8%, 41.2%, and 77.6% respectively. Consistent group were 335 cases (81.7%) and inconsistent group were 75 cases (18.3%). The mean mass size was significantly smaller in the inconsistent group compared to the consistent group (consistent group vs. inconsistent group: 2.31±0.84 cm vs.1.84±0.75 cm, p<0.001). Also, the Group 1 had higher odds of malignancy compared to Group 2 in the renal mass size 2-4 cm (odds ratio, 5.62 [1.02-30.90])., Conclusions: Smaller mass size affects the discrepancy of CT and MRI reports. In addition, MRI showed better diagnostic performance in mismatch cases in the small renal masses., Competing Interests: The authors have nothing to disclose., (© The Korean Urological Association.)

Atmospheric moisture is a sustainable clean water source that can solve the shortage of fresh water in arid areas. Herein a 2D covalent organic framework (COF-ok) was reported as a promising porous sorbent for solar-driven atmospheric water harvesting. COF-ok with ortho-ketoenamine linkage was extremely stable in harsh environment, including in boiling water, strong acids and bases. Because of the balanced hydrophilic and hydrophobic sites in channels, COF-ok showed a high water uptake of 0.33 g g -1 at a low relative humidity of 34 % featuring a characteristic S-shaped water sorption isotherm with low regeneration temperature (∼45 °C) and excellent cyclic stability. A laboratory-scale water harvesting system could collect water of 161 g kg -1 under sunlight., (© 2022 Wiley-VCH GmbH.)

Three metal covalent organic frameworks (MCOFs), namely RuCOF-ETTA, RuCOF-TPB and RuCOF-ETTBA, were synthesized by incorporating the photosensitive Ru II tris(2,2'-bipyridine) unit into the skeleton. Interestingly, each RuCOF contains three isostructural covalent organic frameworks that interlock together with the Ru II centers serving as point of registry. The covalently linked network coupling with uniformly distributed Ru II units allowed the RuCOFs to exhibit superior chemical stability, strong light-harvesting ability, and high photocatalytic activity toward hydrogen evolution (20 308 μmol g -1  h -1 ). This work illustrates the potential of developing versatile MCOFs-based photocatalysts from functionalized metal complex building unit and further enriches the MCOFs family., (© 2022 Wiley-VCH GmbH.)

Purpose: To compare surgical outcomes between robot-assisted laparoendoscopic single-site (R-LESS) surgery using the da Vinci Si or Xi system and the da Vinci SP system for partial nephrectomy. Materials and Methods: From 2008 to 2020, 66 partial nephrectomies were performed using a single-site robotic approach: 44 used the da Vinci Xi or Si system (R-LESS group) and 22 used the da Vinci SP system (SP group). After 1:1 propensity score matching, surgical outcomes were compared between groups. Results: Median patient age was 51.5 years. Median tumor size was 2.1 cm and was not significantly different between groups. Median operation time was longer in the R-LESS group (R-LESS vs SP: 180 vs 155 minutes, p  = 0.034), but median warm ischemic time was comparable between groups. Estimated blood loss was higher in the R-LESS group (R-LESS vs SP: 215 vs 20 mL, p  < 0.001). Median operation time was significantly shorter in the SP group in patients with moderate- to high-complexity tumors (R-LESS vs SP: 200 vs 172 minutes, p  = 0.035). Rates of trifecta achievement were similar between groups (63.6% in both groups, p  = 1.00). Conclusions: R-LESS and da Vinci SP methods are both feasible approaches for single-site incision robotic partial nephrectomy. The da Vinci SP platform allows "true" single-site surgery without additional ports and provides a wider working space. It was associated with better performance than R-LESS partial nephrectomy. In complex tumors, operation time was shorter with SP partial nephrectomy than with R-LESS partial nephrectomy, suggesting that the SP method is especially advantageous for managing complex renal tumors.

Objective: Nonsurgical spinal decompression therapy (NSDT) is a conservative treatment for the lumbosacral herniated intervertebral disc (L-HIVD). This study aimed to evaluate the clinical effectiveness of the NSDT and change in disc volume through magnetic resonance imaging (MRI) in subacute L-HIVD., Methods: Sixty patients with subacute L-HIVD were randomized into either the decompression group (group D, n  = 30) or the nondecompression group (group N, n  = 30). In group D, NSDT was performed ten times in eight weeks. In group N, pseudodecompression therapy (no force) was performed with the same protocol. Lower back and lower leg pain intensities and functional improvements were measured by the visual analog scale and the Korean Oswestry Disability Index (K-ODI). The change in the lumbosacral disc herniation index (HI) was evaluated through a follow-up MRI three months after the therapy., Results: The lower leg pain intensity in group D was lower than that in group N at two months ( p =0.028). Additionally, there were significantly lower K-ODI scores in group D at two and three months ( p =0.023, 0.019) than in group N. The change in HI after the therapy was -27.6 ± 27.5 (%) in group D and -7.1 ± 24.9 (%) in group N, with a significant difference ( p =0.017). Approximately 26.9% of patients in group D and no patients in group N showed over 50% reduction in HI ( p =0.031)., Conclusion: NSDT may be a suitable treatment option for conservative treatment of subacute L-HIVD., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2022 Eunjoo Choi et al.)

Objectives: To evaluate postoperative complications following robot-assisted radical cystectomy in patients diagnosed with bladder cancer and reveal if there are predictors for postoperative complications., Methods: Prospectively collected medical records of 730 robot-assisted radical cystectomy patients between 2007/04 and 2019/05 in 13 tertiary referral centers were reviewed. Perioperative outcomes were compared between two groups by postoperative complications (complication vs non-complication). We assessed recurrence-free survival, cancer-specific survival, and overall survival between groups. Regression analyses were implemented to identify factors associated with postoperative complications., Results: Any total and high-grade complication (Clavien-Dindo grade ≥3) rates were 57.8% and 21.1%, respectively. Patients in complication group had significantly higher proportion of diabetes mellitus (P = 0.048), chronic kidney disease (P = 0.011), dyslipidemia (P < 0.001), longer operation time (P = 0.001), more estimated blood loss (P = 0.001), and larger intraoperative fluid volume (P < 0.001). There was a significant difference in cancer-specific survival (log-rank P = 0.038, median cancer-specific survival: both groups not reached). Dyslipidemia (odds ratio 2.59, P = 0.002) and intraoperative fluid volume (odds ratio 1.0002, P = 0.040) were significantly associated with high-grade postoperative complications. Diabetes mellitus (odds ratio 1.97, P = 0.028), chronic kidney disease (odds ratio 1.89, P = 0.046), dyslipidemia (odds ratio 5.94, P = 0.007), and intraoperative fluid volume (odds ratio 1.0002, P = 0.009) were significantly associated with any postoperative complications., Conclusions: Patients with diabetes mellitus, chronic kidney disease, dyslipidemia, or a relatively large intraoperatively infused fluid volume are more likely to develop postoperative complications. Patients with postoperative complications might have a possibility of lower cancer-specific survival rate., (© 2022 The Japanese Urological Association.)

Background: Deciding whether to continue or discontinue aspirin prior to interventional procedures is a major concern for pain physicians. Many guidelines have been published on the discontinuation of aspirin before invasive procedures; however, the recommendations are inconsistent and do not consider individual platelet function. Furthermore, many studies have shown a high prevalence of aspirin resistance  in patients taking this medication., Objectives: To determine the necessity of discontinuing aspirin prior to interventional pain procedures in relation to individual platelet function., Study Design: Multicenter, cross-sectional study., Setting: University-affiliated hospitals., Methods: We examined platelet function among patients scheduled for an interventional pain procedure by measuring their closure time using collagen/epinephrine cartridges in a commercial platelet-function analyzer. The patients were categorized into either an aspirin-taking or nonaspirin-taking group (Group A or Group N, respectively). The proportion of patients who showed normal/abnormal platelet function was calculated and compared between the groups., Results: A total of 1,111 patients were included in this study. In Group A, 56.4% (102/181) showed normal platelet function, whereas 43.6% (79/181) showed abnormal platelet function. In Group N, 85.8% (798/930) and 14.2% (132/930) showed normal and abnormal platelet function, respectively., Limitation: The proportion of laboratory, not clinical aspirin resistance was evaluated. Factors affecting platelet function were not investigated exhaustively., Conclusion: The high prevalence of normal platelet function in patients taking aspirin suggests no necessity of discontinuation before procedures in such patients. Abnormal platelet function can occur even in patients who are not taking aspirin. Therefore, platelet function should be measured and considered on a case-by-case basis prior to interventional procedures, and discontinuation of aspirin should be decided based on these factors.

Despite the fact that high-valent nickel-based oxides exhibit promising catalytic activity for the urea oxidation reaction (UOR), the fundamental questions concerning the origin of the high performance and the structure-activity correlations remain to be elucidated. Here, we unveil the underlying enhanced mechanism of UOR by employing a series of prepared cation-vacancy controllable LiNiO 2 (LNO) model catalysts. Impressively, the optimized layered LNO-2 exhibits an extremely low overpotential at 10 mA cm -2 along with excellent stability after the 160 h test. Operando characterisations combined with the theoretical analysis reveal the activated lattice oxygen in layered LiNiO 2 with moderate cation vacancies triggers charge disproportion of the Ni site to form Ni 4+ species, facilitating deprotonation in a lattice oxygen involved catalytic process., (© 2022 Wiley-VCH GmbH.)

Renal cell carcinoma (RCC) frequently recurs or metastasizes after surgical resection. Everolimus, an mTOR inhibitor, is used as a second-line treatment, but the response of RCC to everolimus is insufficient. Metformin is an antidiabetic drug; recent reports have indicated its anti-cancer effects in various cancers, and it is known to have synergistic effects with other drugs. We investigated the possibility of coadministering everolimus and metformin as an effective treatment for RCC. RCC cells treated with a combination of the two drugs showed significantly inhibited cell viability, cell migration, and invasion, and increased apoptosis compared to those treated with each drug alone. An anti-cancer synergistic effect was also confirmed in the xenograft model. Transcriptome analysis for identifying the underlying mechanism of the combined treatment showed the downregulation of mitochondrial fusion genes and upregulation of mitochondrial fission genes by the combination treatment. Changes in mitochondrial dynamics following the combination treatment were observed using LysoTracker, LysoSensor, and JC-1 staining. In conclusion, the combination of everolimus and metformin inhibited RCC growth by disrupting mitochondrial dynamics. Therefore, we suggest that a treatment combining metformin and everolimus disrupts mitochondrial dynamics in RCC, and may be a novel strategy for RCC treatment.

Clear cell renal cell carcinoma (ccRCC) alters metabolic signals frequently, leading to mitochondrial dysfunction, such as increase of glycolysis and accumulation of lipid. Sirtuin3 (SIRT3) is a key factor for the regulation of both mitochondrial integrity and function. SIRT3 is downregulated and contributes in both cancer development and progression in ccRCC. The aim of this study is to investigate SIRT3-regulated mitochondrial biogenesis in ccRCC. SIRT3 overexpression alone reduced glucose uptake rate and enhanced membrane potential in mitochondria. ccRCC with overexpressed SIRT3 further improved the lethal effects when combined with anticancer drugs (Resveratrol, Everolimus and Temsirolimus). Cell viability was markedly decreased in a dose-dependent manner when treated with resveratrol or mTOR inhibitors in SIRT3 overexpressing ccRCC. In conclusion, SIRT3 improved mitochondrial functions in ccRCC through metabolic reprogramming. Mitochondrial reprogramming by SIRT3 regulation improves the sensitivity to anticancer drugs. The combination of SIRT3 and resveratrol functioned synergistically lethal effect in ccRCC., Competing Interests: The authors have declared that no competing interests exist.

Introduction: The time criteria used in many studies of postherpetic neuralgia (PHN) are arbitrary and do not have supporting evidence. Therefore, this study sought to determine the definite time criterion for PHN by analyzing the skin temperature to estimate the time point when zoster-induced skin inflammatory reaction ends., Methods: Infrared thermography was used to measure the difference in skin temperature between the affected and unaffected areas (ΔTemp) in the craniocervical and thoracic regions of patients with herpes zoster (HZ). Because the ΔTemp changes from a positive value to zero when the skin is no longer inflamed, a ΔTemp ≤ 0 was defined as the end of skin inflammation, and this time point was considered the starting point for PHN. This cutoff time point was estimated using receiver operating characteristic (ROC) curve analysis., Results: A total of 503 patients were included in this study. The ROC curve analysis showed that the time point when the ΔTemp was ≤ 0 occurred at 12 weeks after HZ onset (95% confidence interval 11-15 weeks, area under the ROC curve 0.901). Using this time point as the time criterion of PHN, the sensitivity, specificity, and classification accuracy were 0.807, 0.905, and 0.871, respectively., Conclusions: The transition of skin temperature from warm to cold occurs 12 weeks after HZ onset, which implies the end of local inflammation. Therefore, PHN associated with pathophysiologic change may be defined as 12 weeks after the skin rash. This finding provides a theoretical basis for the timing definition of PHN., (© 2022. The Author(s).)