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ObjectiveTo report changing practice in the management of intra-diverticular bladder tumours. MethodsWe undertook a review of all intra-diverticular bladder tumours in our prospectively maintained institutional database. ResultsA total of 28 patients (male = 27, female = 1) with a median age of 71 years (IQR 61 to 76) were diagnosed with intra-diverticular bladder tumours (IDBT) between March 2013 and February 2021. Fourteen had visible and 3 had non-visible haematuria, while 11 patients had lower urinary tract symptoms. Median axial diameter of the diverticula was 46 mm (IQR 35 to 69), and median neck diameter was 9 mm (IQR 7 to 11). All patients had CT-urography and 5 patients also had an MRI. Surgical treatment consisted of diverticulectomy (n = 11), diverticulectomy and ipsilateral ureteric reimplantation (n = 11), radical cystectomy and ileal conduit (n = 4), or radical cystectomy and orthotopic bladder (n = 2). Eleven patients had open procedures, and 17 had robotic assisted surgery.Final pathological stages were T0 (n = 2), Ta (n = 5), T1 (n = 7), T3a (n = 8) and T3b (n = 6). Twenty-four patients had urothelial carcinoma (including one nested variant and 4 with squamous differentiation) and 2 had small cell carcinoma. Three patients had neoadjuvant systemic chemotherapy, 2 had intravesical bacillus Calmette-Guerin (BCG) with mitomycin, and one had BCG monotherapy preoperatively. Five patients had adjuvant systemic chemotherapy while 7 had adjuvant intravesical therapies. Mean follow-up period was 37.8 months (±25.3). Mean recurrence-free survival was 61.5% (CI 45.7 to 77.4) and mean overall survival 71.6 % (CI 57.4 to 85.8). Ten patients (37%) died of cancer. ConclusionManagement of intra-diverticular bladder tumours is evolving. Bladder-sparing approaches are gaining popularity. Robot-assisted diverticulectomy is preferable as it reduces the morbidity resulting from treatment

The role of Real-Time PCR assays for surveillance and rapid screening for pathogens is garnering more and more attention because of its versatility and ease of adoption. The goal of this study was to design, test, and evaluate Real-Time TaqMan PCR assays for the detection of botulinum neurotoxin (bont/A-G) genes from currently recognized BoNT subtypes. Assays were computationally designed and then laboratory tested for sensitivity and specificity using DNA preparations containing bont genes from 82 target toxin subtypes, including nine bivalent toxin types; 31 strains representing other clostridial species; and an extensive panel that consisted of DNA from a diverse set of prokaryotic (bacterial) and eukaryotic (fungal, protozoan, plant, and animal) species. In addition to laboratory testing, the assays were computationally evaluated using in silico analysis for their ability to detect bont gene sequences from recently identified toxin subtypes. Seventeen specific assays (two for each of the bont/C, bont/D, bont/E, and bont/G subtypes and three for each of the bont/A, bont/B, and bont/F subtypes) were designed and evaluated for their ability to detect bont genes encoding multiple subtypes from all seven serotypes. These assays could provide an additional tool for the detection of botulinum neurotoxins in clinical, environmental and food samples that can complement other existing methods used in clinical diagnostics, regulatory, public health, and research laboratories.

Viral pathogens can rapidly evolve, adapt to novel hosts, and evade human immunity. The early detection of emerging viral pathogens through biosurveillance coupled with rapid and accurate diagnostics are required to mitigate global pandemics. However, RNA viruses can mutate rapidly, hampering biosurveillance and diagnostic efforts. Here, we present a novel computational approach called FEVER (Fast Evaluation of Viral Emerging Risks) to design assays that simultaneously accomplish: 1) broad-coverage biosurveillance of an entire group of viruses, 2) accurate diagnosis of an outbreak strain, and 3) mutation typing to detect variants of public health importance. We demonstrate the application of FEVER to generate assays to simultaneously 1) detect sarbecoviruses for biosurveillance; 2) diagnose infections specifically caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); and 3) perform rapid mutation typing of the D614G SARS-CoV-2 spike variant associated with increased pathogen transmissibility. These FEVER assays had a high in silico recall (predicted positive) up to 99.7% of 525,708 SARS-CoV-2 sequences analyzed and displayed sensitivities and specificities as high as 92.4% and 100% respectively when validated in 100 clinical samples. The D614G SARS-CoV-2 spike mutation PCR test was able to identify the single nucleotide identity at position 23,403 in the viral genome of 96.6% SARS-CoV-2 positive samples without the need for sequencing. This study demonstrates the utility of FEVER to design assays for biosurveillance, diagnostics, and mutation typing to rapidly detect, track, and mitigate future outbreaks and pandemics caused by emerging viruses.

Various novel hypercrosslinked porous polymers with phosphonium salt incorporated into their networks were developed. These porous materials have high BET surface areas (up to 1168 m2 g−1) and can be used to selectively capture CO2 and efficiently convert CO2 into cyclic carbonates. [ABSTRACT FROM AUTHOR]

IMPORTANCE:Microbial biomass is one of the most common microbial parameters used in land carbon (C) cycle models, however, it is notoriously difficult to measure accurately. To understand the consequences of mismeasurement, as well as the broader importance of microbial biomass abundance as a direct driver of ecological phenomena, greater quantitative understanding of the role of microbial biomass abundance in environmental processes is needed. Using microcosms, we manipulated the initial biomass of numerous microbial communities across a 100-fold range and measured effects on CO2 production during plant litter decomposition. We found that the effects of initial biomass abundance on CO2 production was largely attenuated within a week, while the effects of community type remained significant over the course of the experiment. Overall, our results suggest that initial microbial biomass abundance in litter decomposition within an ecosystem is a weak driver of long-term C cycling dynamics.

A range of masses can manifest in the region encompassing the femoral triangle and the inguinal canal in women. These groin masses can be classified as being neoplasms, infectious or inflammatory processes, vascular conditions, as well as congenital abnormalities. Such inguinal masses can cause aching and pain sensations in the groin region, which can worsen after prolonged activity. A comprehensive history and physical examination are sufficient in making a diagnosis of the type of inguinal mass. Imaging modalities such as computed tomography, ultrasonography, or magnetic resonance imaging demonstrate a better understanding of local anatomical characteristics of the inguinal area, allowing for a diagnosis and the characterization of the groin pathologic conditions. Most inguinal masses are often repaired or need surgical intervention through open or laparoscopic technique. A combination of the clinical history, anatomical classification, and unique imaging features can aid clinicians in an accurate diagnosis of the inguinal or inguinofemoral mass in the female groin region. Keywords: Groin, Inguinal mass, Inguinofemoral mass, Inguinal canal, Round ligament varicosities, Inguinal hernia, Femoral hernia, Femoral triangle, Laparoscopic surgery

Ureterosciatic hernia, defined as a suprapiriform or infrapiriform herniation of the pelvic ureter, is the sliding of the ureters into the pelvic fossa, fovea, or greater or lesser sciatic foramen. This type of hernia is the rarest form of pelvic sciatic hernias. It may cause a wide range of cryptic clinical symptoms of pain, obstructive uropathy, sepsis, or renal failure. This condition has been described in terms of involvement in inguinal, femoral, sciatic, obturator, and thoracic regions. A high index of clinical suspicion is essential for diagnosis because the hernia develops in the pelvic cavity and becomes overlayed by the large gluteal muscle. Since ureterosciatic hernias have not been adequately reviewed in the literature due to the limited number of case reports, we aim to aid the clinician's knowledge by discussing the relevant anatomy, classification, clinical symptoms, optional radiology, optional diagnostic instrumentation, and management. Treatment options include non-surgical and surgical intervention. Vena caval filters may be preoperatively indicated due to the proximity of the pelvic venous vasculature in the surgical field. Treatment must also be mandated for intraoperative and postoperative vascular, neurological, and other anticipated complications of complex ureterosciatic hernia repair. Keywords: Ureter, Sciatic hernia, Ureteral obstruction, Sepsis, Hydronephrosis, Renal failure

Detection methods that do not require nucleic acid amplification are advantageous for viral diagnostics due to their rapid results. These platforms could provide information for both accurate diagnoses and pandemic surveillance. Influenza virus is prone to pandemic-inducing genetic mutations, so there is a need to apply these detection platforms to influenza diagnostics. Here, we analyzed the Fast Evaluation of Viral Emerging Risks (FEVER) pipeline on ultrasensitive detection platforms, including a waveguide-based optical biosensor and a flow cytometry bead-based assay. The pipeline was also evaluated in silico for sequence coverage in comparison to the U.S. Centers for Disease Control and Prevention’s (CDC) influenza A and B diagnostic assays. The influenza FEVER probe design had a higher tolerance for mismatched bases than the CDC’s probes, and the FEVER probes altogether had a higher detection rate for influenza isolate sequences from GenBank. When formatted for use as molecular beacons, the FEVER probes detected influenza RNA as low as 50 nM on the waveguide-based optical biosensor and 1 nM on the flow cytometer. In addition to molecular beacons, which have an inherently high background signal we also developed an exonuclease selection method that could detect 500 pM of RNA. The combination of high-coverage probes developed using the FEVER pipeline coupled with ultrasensitive optical biosensors is a promising approach for future influenza diagnostic and biosurveillance applications.

Lumbar hernias develop through the weakening of the posterolateral abdominal wall associated with the Petit's triangle or the Grynfeltt-Lesshaft triangle. Clinicians are generally unfamiliar with the presentation of lumbar hernias, which frequently leads to misdiagnosis and delay of treatment. Prompt failure to diagnose and surgically correct lumbar hernias have resulted in increased morbidity. This review addresses the anatomical and clinical concepts associated with the bilateral costoiliac spaces, which may be implicated in the increased prevalence of left-sided hernias. Knowledge of the contents and boundaries of this enclosure can aid the physician in diagnosis. We explore the intraperitoneal and retroperitoneal diseases that present at the lumbocostal space, including lumbar hernias, which can be classified as congenital, acquired, traumatic, or iatrogenic in origin. In an evaluation, imaging is crucial for assessing musculofascial layer disruptions and hernia contents. Open and laparoscopic surgery, as well retromuscular lumbar hernia repair, are options to explore in surgical intervention, particularly if there are challenges in preliminary pain management. Keywords: Lumbar hernia, Costoiliac spaces, Petit's triangle, Grvnfeltt-lesshaft triangle, Lumbocostovertebral syndrome

The urachus is a tubular structure that extends cranially from the anterior dome of the bladder to the umbilicus. Urachal anomalies (UA) formation results from incomplete involution of this embryonic structure, leading to various pathologies. Congenital UA can be divided into five groups: patent urachus, umbilical-urachal sinus, vesicourachal diverticulum, urachal cyst, and alternating sinus. Typically, a patent urachus is detected around birth, while the other congenital UA tend to be asymptomatic. Due to the relatively rare incidence and presenting symptoms mirroring intraabdominal or pelvic diseases, UA is not typically considered in differential diagnosis. When viewed in the differential, diagnosis of congenital UA and acquired urachal remnant diseases is elusive because of the heterogeneous clinical presentation and no uniform diagnosis protocol. Herein, we provide a comprehensive review of urachal embryology, anatomy, clinical manifestations, and the current trends in diagnostic evaluation and management of UA, with an emphasis on pediatrics. Keywords: Urachus, Urachal remnant, Umbilical discharge, Umbilical mass, Vitelline duct, Hematuria