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Background and objective: Few studies on endoscopic management of primary obstructive megaureter (POM) in adult patients have been reported. Our objective was to describe our technique and long-term outcomes for endoscopic management of adult POM. Methods: We included 76 adult POM patients undergoing endoscopic management between September 2015 and January 2024. Under endoscopic control, the stricture was dilated to 24–30 Fr while maintaining a balloon pressure of 25–35 atm for 3 min. An additional incision of the stenotic ring using either an electrode or holmium laser was performed in 39 patients. Data for patient characteristics, intraoperative variables, surgical complications, and follow-up results were analyzed. A descriptive statistical analysis was performed. Surgical success was defined as no tubes or stents in the body, stable or improved symptoms and renal function, and the absence of reflux or obstruction during the follow-up period. Key findings and limitations: All procedures were completed without conversion to open or laparoscopic surgery. The median operative time was 45 min (range 16–165) with median estimated blood loss of 2 ml (range 0–150). The median postoperative hospital stay was 3 d (range 1–15). No intraoperative complication occurred. At median postoperative follow-up of 42 mo (range 3–100) the overall success rate was 92.1%. Restenosis of the vesicoureteral junction (Clavien-Dindo grade III) occurred in five patients (6.6%), and high-grade vesicoureteral reflux occurred in one patient (1.3%), all of whom required secondary reconstruction surgery. Conclusions and clinical implications: The results indicate that our endoscopic management for adult POM is safe and effective, with favorable long-term outcomes. This approach could potentially serve as a first-line treatment option for adult POM. Patient summary: Primary obstructive megaureter (POM) occurs when the flow of urine is blocked because of a narrow segment in the tube between the kidney and bladder (ureter), which causes widening of the ureter further up. For our minimally invasive technique, a telescope is inserted through the urethra and bladder to reach the ureter for surgical treatment. Our results show that this is a safe procedure for POM in adults.

ABSTRACT Introduction: We aim to compare the safety and effectiveness of the KangDuo (KD)-Surgical Robot-01 (KD-SR-01) system and the da Vinci (DV) system for robot-assisted radical nephroureterectomy (RARNU). Materials and Methods: This multicenter prospective randomized controlled trial was conducted between March 2022 and September 2023. Group 1 included 29 patients undergoing KD-RARNU. Group 2 included 29 patients undergoing DV-RARNU. Patient demographic and clinical characteristics, perioperative data, and follow-up outcomes were collected prospectively and compared between the two groups. Results: There were no significant differences in patient baseline demographic and preoperative characteristics between the two groups. The success rates in both groups were 100% without conversion to open or laparoscopic surgery or positive surgical margins. No significant difference was observed in docking time [242 (120-951) s vs 253 (62-498) s, P = 0.780], console time [137 (55-290) min vs 105 (62-220) min, P = 0.114], operative time [207 (121-460) min vs 185 (96-305) min, P = 0.091], EBL [50 (10-600) mL vs 50 (10-700) mL, P = 0.507], National Aeronautics and Space Administration Task Load Index scores, and postoperative serum creatinine levels between the two groups. None of the patients showed evidence of distant metastasis, local recurrence, or equipment-related adverse events during the four-week follow-up. One (3.4%) patient in Group 2 experienced postoperative enterovaginal and enterovesical fistulas (Clavien-Dindo grade III). Conclusions: The KD-SR-01 system is safe and effective for RARNU compared to the DV Si or Xi system. Further randomized controlled studies with larger sample sizes and longer durations are required.

Traumatic ureteral injury is a rare and challenging condition of the urinary system. To summarize the clinical features of patients with traumatic ureteral injury and examine the literature on traumatic ureteral injuries from the past 20 years. The clinical data of 30 patients with traumatic ureteral injury in Peking University First Hospital, Beijing Jiangong Hospital, as well as Emergency General Hospital from August 2015 to August 2023 were retrospectively collected. The clinical characteristics, management strategies, and follow-up outcomes were analyzed, and a review of the literature on traumatic ureteral injury from the past 20 years was conducted. The traumatic types in the case series was composed of sharp injury, impact injury, and falling injury, with 9, 16, and 5 cases, respectively. Ureteral injury was diagnosed immediately in 12 cases, while 18 cases had a delayed diagnosis. Besides, the median time from ureteral injury to operations was 8.5 months (IQR: 4–13 months) in the patients who received upper urinary tract repair surgery, including ureteral stenting in one case, ureteroureterostomy in four cases, pyeloplasty in two cases, lingual mucosal graft ureteroplasty in one case, ileal ureter replacement in five cases, and nephrectomy in one cases. The mean follow-up time is 39.1 ± 24.8 months. Concerning renal function, postoperative creatinine was substantially lower than preoperative one (78.6 ± 13.7 µmol/L vs 88.8 ± 17.0 µmol/L, p = 0.0009), and postoperative urea was significantly lower than preoperative one (4.6 ± 1.6 µmol/L vs 5.9 ± 1. 3 mmol/L, p = 0.0016). Traumatic ureteral injury is challenging to recognize due to its deep anatomical location, making timely diagnosis crucial. It is important to choose an appropriate reconstruction method based on severity, location, length to restore urinary tract continuity as early as possible.

Abstract Purpose To present the experience of ileal ureter with ileocystoplasty (IUC), and compare the outcomes of IUC in minimally invasive procedures to open procedures. Patients and methods From December 2017 to April 2023, twenty patients underwent IUC in open or minimally invasive (including laparoscopic and robotic) procedures. The baseline characteristics, perioperative data and follow-up outcomes were collected. Success was defined as relief of clinical symptoms, stable postoperative serum creatine and absence of radiographic obstruction. The perioperative and follow-up outcomes of open procedures and minimally invasive procedures were compared. Results The etiology included pelvic irradiation (14/20), urinary tuberculosis (3/20) and surgical injury (3/20). Bilateral ureter strictures were repaired in 15 cases. The surgeries conducted consisted of open procedures in 9 patients and minimally invasive procedures in 11 patients. Compared to open procedures, minimally invasive surgeries had less median estimated blood loss (EBL) (100 ml vs. 300 min, p = 0.010) and shorter postoperative hospitalization (27 d vs. 13 d, p = 0.004). Two patients in the open group experienced grade 3 complications (sigmoid fistula and acute cholecystitis in one patient, and pulmonary embolism in another patient). Over a median follow-up period of 20.1 months, the median bladder functional capacity was 300 ml, with a 100% success rate of IUC. Conclusion IUC is feasible in both open and minimally invasive procedures, with acceptable complications and a high success rate. Minimally invasive procedures can have less EBL and shorter postoperative hospitalization than open procedure. However, prospective studies with larger groups and longer follow-up are needed.

ABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. Results: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. Conclusions: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients’ quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success.

Abstract. Continuous cutaneous urinary diversion is challenging when the appendix is physically unavailable. The Yang–Monti channel is an alternative to the tunneled appendix for urinary diversion. We present a case involving a 49-year-old man who underwent total urethrectomy and cystostomy 10 months previously. No tumor recurrence was observed; however, the patient experienced severe catheter-related bladder irritation after the procedure. The patient was readmitted to the authors’ hospital and underwent laparoscopic continent cutaneous urinary diversion using extracorporeal construction of a modified Yang–Monti channel. The operation lasted 232 minutes, with an estimated blood loss of 10 mL. The patient was discharged from hospital 6 days after surgery and removal of the cystostomy tube. After this, clean intermittent catheterization was performed every 3 hours for 4 weeks. Five years after the procedure, the modified Yang–Monti channel was still used for clean intermittent catheterization without any stomal stenosis being observed. The patient was satisfied with his postoperative quality of life.

Magnetoresistance (MR) oscillations serve as a hallmark of intrinsic quantum behavior, traditionally observed only in conducting systems. Here we report the discovery of MR oscillations in an insulating system, the vertical junctions of CrPS_{4} which is a two-dimensional A-type antiferromagnetic semiconductor. Systematic investigations of MR peaks under varying conditions, including electrode materials, magnetic field direction, temperature, voltage bias, and layer number, elucidate a correlation between MR oscillations and spin-canted states in CrPS_{4}. Experimental data and analysis point out the important role of the in-gap electronic states in generating MR oscillations, and we propose that spin selected interlayer hopping of localized defect states may be responsible for it. Our findings not only illuminate the unusual electronic transport in CrPS_{4} but also underscore the potential of van der Waals magnets for exploring interesting phenomena.

Magnetic two-dimensional (2D) materials have garnered significant attention for their potential to revolutionize 2D spintronics due to their unique magnetic properties. However, their air-sensitivity and highly insulating nature of the magnetic semiconductors present substantial challenges for device fabrication with effective contacts. In this study, we introduce a polycarbonate (PC)-assisted transfer method that effectively forms van der Waals (vdW) contacts with 2D materials, streamlining the fabrication process without the need for additional lithography. This method is particularly advantageous for air-sensitive magnetic materials, as demonstrated in Fe3GeTe2. It also ensures excellent interface contact quality and preserves the intrinsic magnetic properties in magnetic semiconductors like CrSBr. Remarkably, this method achieves a contact resistance four orders of magnitude lower than that achieved with traditional thermally evaporated electrodes in thin-layer CrSBr devices and enables the observation of sharp magnetic transitions similar to those observed with graphene vdW contacts. Compatible with standard dry-transfer processes and scalable to large wafer sizes, our approach provides a straightforward and effective solution for developing complex magnetic heterojunction devices and expanding the applications of magnetic 2D materials.

ABSTRACT Purpose: Ureteroplasty using buccal or lingual mucosa graft Is feasible for complex proximal ureteral stricture (1, 2). Ileal ureter replacement is considered as the last resort for ureteral reconstruction. Totally intracorporeal robot-assisted ileal ureter replacement can be performed safely and effectively (3). In China, the KangDuo Surgical Robot 2000 Plus (KD-SR-2000 Plus) has been developed featuring two surgeon consoles and five robotic arms. This study aims to share our experience with totally intracorporeal robot-assisted bilateral ileal ureter replacement using KD-SR-2000 Plus. Materials and Methods: A 59-year-old female patient underwent a complete intracorporeal robot-assisted bilateral ileal ureter replacement for the treatment of ureteral strictures using KD-SR-2000 Plus. The surgical procedure involved dissecting the proximal ends of the bilateral ureteral strictures, harvesting the ileal ureter, restoring intestinal continuity, and performing an anastomosis between the ileum and the ureteral end as well as the bladder. The data were prospectively collected and analyzed. Results: The surgery was successfully completed with single docking without open conversion. The length of the harvested ileal ureter was 25 cm. The docking time, operation time and console time were 3.4 min., 271 min and 231 min respectively. The estimated blood loss was 50 mL. The postoperative hospitalization was 6 days. No perioperative complications occurred. Conclusions: It is technically feasible to perform totally intracorporeal robot-assisted bilateral ileal ureter replacement for the treatment of ureteral strictures using KD-SR-2000 Plus. A longer follow-up and a larger sample size are required to evaluate its safety and effectiveness.

Abstract. Background:. The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system. Methods:. From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed. Results:. A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively. Conclusion:. The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.

Objective: To assess the feasibility of internal suspension technique in retroperitoneal robot-assisted laparoscopic partial nephrectomy (rRAPN) with a new robotic platform called KangDuo Surgical Robot-01 (KD-SR-01) system (Suzhou KangDuo Robot Co., Ltd., Suzhou, China) and discuss its surgical technique. Methods: A 44-year-old male patient was admitted with a 2.5 cm tumor on dorsolateral upper pole of the left kidney. The R.E.N.A.L. nephrometry score of this patient was 4x. This patient underwent rRAPN with KD-SR-01. The perinephric fat between the tumor and Gerota's fascia was preserved, which was used for internal suspension traction during tumor resection. Postoperative follow-up data were collected. Results: The surgery was successfully carried out with a duration of 127 min, in which the docking time was 6 min 25 s and console time was 60 min. The warm ischemia time was 19 min 53 s, and the estimated blood loss was 0 mL. The pathological histology showed a pathological tumor stage 1a clear cell renal cell carcinoma, with a negative surgical margin. The World Health Organization/International Society of Urological Pathology (WHO/ISUP) grade of this patient was Grade 2. No recurrence was observed during the 6-month follow-up. Conclusion: Internal suspension in rRAPN is feasible and effective with use of the new robotic system KD-SR-01.

Abstract Introduction Robotic ureteral reconstruction (RUR) has been widely used to treat ureteral diseases. To summarize the surgical techniques, complications, and outcomes following RUR, as well as to compare data on RUR with open and laparoscopic ureteral reconstruction. Methods Our systematic review was registered on the PROSPERO (CRD42022309364) database. The PubMed, Cochrane and Embase databases were searched for publications in English on 06-Feb-2022. Randomised-controlled trials (RCTs) or non-randomised cohort studies with sample size ≥ 10 cases were included. Results A total of 23 studies were included involving 996 patients and 1004 ureters from 13 non-comparative, and 10 retrospective comparative studies. No RCT study of RUR was reported. The success rate was reported ≥ 90% in 15 studies. Four studies reported 85–90% success rate. Meta-analyses for comparative studies showed that RUR had significantly lower estimated blood loss (EBL) (P = 0.006) and shorter length of stay (LOS) (P

Observational data on ocean subsurface temperature and salinity are patently insufficient because in situ observations are complex and costly, while satellite remote-sensed measurements are abundant but mainly focus on sea surface data. To make up for the ocean interior data shortage and entirely use the abundant satellite data, we developed a data-driven deep learning model named Convformer to reconstruct ocean subsurface temperature and salinity fields from satellite-observed sea surface data. Convformer is designed by deeply optimizing Vision Transformer and ConvLSTM, consisting of alternating residual connections between multiple temporal and spatial attention blocks. The input variables consist of sea surface temperature (SST), sea surface salinity (SSS), sea surface height (SSH), and sea surface wind (SSW). Our results demonstrate that Convformer exhibits superior performance in estimating the temperature-salinity structure of the tropical Pacific Ocean. The all-depth average root mean square error (RMSE) of the reconstructed subsurface temperature (ST)/subsurface salinity (SS) is 0.353 °C/0.0695 PSU, with correlation coefficients (R²) of 0.98663/0.99971. In the critical thermocline, although the root mean square errors of ST and SS reach 0.85 °C and 0.121 PSU, respectively, they remain smaller compared to other models. Furthermore, we assessed Convformer’s performance from various perspectives. Notably, we also delved into the potential of Convformer to extract physical and dynamic information from a model mechanism perspective. Our study offers a practical approach to reconstructing the subsurface temperature and salinity fields from satellite-observed sea surface data.

The coronavirus disease 2019 pandemic has drawn attention to telesurgery. Important advances in fifth-generation (5G) mobile telecommunication technology have facilitated the rapid evolution of telesurgery. Previously, only a single console was used in telesurgery; thus, there was the possibility of open or laparoscopic conversion. Furthermore, the 5G network has not been available for regional hospitals in China. From October 2021 to April 2022, dual-console telesurgeries with the KangDuo Surgical Robot-01 (KD-SR-01) system were performed using 5G and wired networks in an animal experiment and clinical study. A partial nephrectomy in a porcine model was performed successfully using a wired network. The console time, warm ischemia time, and control swap time were 69 min, 27 min, and 3 s, respectively. The mean latency time was 130 (range, 60–200) ms. A 32-yr-old male patient successfully underwent a remote pyeloplasty using a series connection of 5G wireless and wired networks. The console time and control swap time were 98 min and 3 s, respectively. The mean latency time was 271 (range, 206–307) ms. In the two studies, data pocket loss was

ABSTRACT Purpose Horseshoe kidney (HSK) is the most common renal fusion anomaly, occurring in 0.25% of the population (1). It presents technical obstacles to pyeloplasty for ureteropelvic junction obstruction (UPJO) despite robotic assistance (2, 3). KangDuo-Surgical-Robot-01 (KD-SR-01), an emerging robotic platform in China, has yielded satisfactory outcomes in pyeloplasty (4, 5). We first describe our modified technique of robotic bilateral pyeloplasty for UPJO in HSK using KD-SR-01 system in the Lithotomy Trendelenburg position. Materials and Methods A 36-year-old man with HSK and bilateral UPJO suffered right flank pain due to renal calculi (Figure-1). Repeated double-J stent insertion and ureteroscopy lithotripsy did not relieve his symptoms. A robot-assisted modified bilateral dismembered V-shaped flap pyeloplasty was performed using KD-SR-01 system in the Lithotomy Trendelenburg position. Results Total operative time was 298 minutes with 50 ml estimated blood loss. There was no conversion to laparoscopic or open surgery. A follow-up of 14 months showed relieving symptoms and stable renal function. Cine magnetic resonance urography and computed tomography urography revealed improved hydronephrosis and good drainage. No intraoperative or postoperative complications occurred. Conclusions It is technically feasible to perform a KD-SR-01-assisted modified bilateral dismembered V-shaped flap pyeloplasty in the Lithotomy Trendelenburg position for HSK. This procedure achieves managing UPJO on both sides without redocking the system and provides a wider operative field. In addition, it may be associated with better ergonomics, better cosmetic outcomes, and less possibility of postoperative bowel adhesion. However, further investigation is still warranted to confirm its safety, efficacy, and advantages over traditional procedures.

Abstract Background Complete intracorporal robotic ileal ureteric replacement is challenging. We aimed to present the surgical technique of robotic ileal ureter replacement with extracorporeal ileal segment preparation for long ureteral strictures. Methods From March 2019 to March 2021, 18 patients underwent robotic ileal ureter replacement with extracorporeal ileal segment preparation by one experienced surgeon. The demographic, perioperative, and follow-up data were recorded. Success was defined as the resolution of the presenting symptom, a stable estimated glomerular filtration rate and unobstructive drainage on imaging examination. Results All 18 surgeries were successfully completed without conversion. The median length of the intestinal tube used was 20 (12–30) cm. The median operative time was 248 (170–450) min, the median estimated blood loss was 50 (10–200) ml, and the median postoperative hospital stay was 7 (5–27) days. At a median follow-up of 16 (13–28) months, all patients were symptom-free. No or mild hydronephrosis was confirmed in 17 patients; 1 patient had moderate hydronephrosis without peristalsis of the ileal ureter. The renal function was stable in all patients. The overall success rate was 100%. Postoperative complications, including 4 cases of urinary infections (Grade I), 1 case of an incision hernia (Grade I), 4 cases of kidney stone formation (Grade I), 6 cases of metabolic acidosis (Grade I), 4 cases of incomplete ileus (Grade II), and 1 case of an incision infection (Grade IIIb). Conclusions Robot-assisted laparoscopic ileal ureter replacement with extracorporeal ileal segment preparation is safe, feasible, and effective for the treatment of long ureteral strictures, especially in high-volume tertiary referral centers with extensive robotic surgery experience capable of managing severe peri-operative complications.

This study aimed to investigate the impact of dietary tributyrin (TB) in the low fish meal (high-Clostridium autoethanogenum protein, CAP) diet on the growth, antioxidation, lipid metabolism and intestinal microbiota of largemouth bass (Micropterus salmoides). For eight weeks, largemouth bass (15.05 ± 0.58 g) were fed on eight isonitrogenous and isolipid diets with graded levels of dietary TB (0 g/kg, 0.2 g/kg, 0.4 g/kg, 0.8 g/kg, 1.6 g/kg, 3.2 g/kg, 4.0 g/kg and 8.0 g/kg). The findings showed that the weight gain rate (WGR) and specific growth rate (SGR) were increased by 1.6 g/kg of dietary TB. The protein efficiency and deposition ratios were linearly affected by dietary TB. The broken-line model based on the WGR revealed that 1.617 g/kg of dietary TB was sufficient for optimal growth. The digestive enzyme activities and villus length of the intestine were increased by dietary TB (1.6 g/kg). Total antioxidant capacity (T-AOC), superoxide dismutase (SOD) and catalase (CAT) activities were significantly improved, and the malondialdehyde (MDA) and protein carbonyl (PC) contents were significantly decreased after dietary TB. The expressions of nuclear factor erythroid 2-related factor 2 (nrf2) and kelch like ech associated protein 1 (keap1) in the liver and intestine were significantly increased and decreased by 1.6 g/kg of dietary TB, respectively. The mRNA levels of copper-zinc superoxide dismutase (cuznsod), cat, heme oxygenase-1 (ho-1) and glutathione peroxidase (gpx) were significantly upregulated. Dietary TB could significantly affect the total protein (TP) and albumin (ALB) content in the serum. The aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities were the lowest at 1.6 g/kg of TB group. Besides, the hepatocyte vacuolation and nuclear translocation were alleviated after supplementation of 0.2‰− 3.0‰ of dietary TB. The total cholesterol (T-CHO), high density lipoprotein cholesterol (HDLC) and low density lipoprotein cholesterol (LDLC) were significantly increased by dietary TB. The triglycerides (TG) content was decreased by dietary TB. The mRNA levels of sterol regulatory element-binding protein 1-c (srebp1-c), acetyl-coa carboxylase alpha (accα), fatty acid synthase (fasn) and accβ in the liver were significantly downregulated, and peroxisome proliferator-activated receptor alpha (pparα) and carnitine palmitoyltransferase 1 (cpt-1) were upregulated by 1.6 g/kg of dietary TB. Dietary TB had effects on the intestine microbes of largemouth bass. The Cetobacterium was present in the highest percentage and increased from 41% (0 g/kg TB) to 59% (1.6 g/kg TB). The Mycoplasmataceae was the second most predominant genus and decreased from 90% in the 0 g/kg of TB group to 10% in the 1.6 g/kg of TB group. In summary, the dietary TB could be supplemented in the CAP-based diet for better growth and antioxidation, lipid metabolism and intestinal microbiota of largemouth bass.

Estimating the intensity of tropical cyclones (TCs) is beneficial for preventing and reducing the impact of natural disasters. Most existing methods for estimating TC intensity utilize single-satellite or single-band remote sensing images, but they lack the ability to quantify the uncertainty of the estimation results. However, TC, as a typical chaotic system, often requires confidence intervals for intensity estimates in real-world emergency decision-making scenarios. Additionally, the use of multi-source image inputs contributes to the uncertainty of the model. Consequently, this study introduces a neural network (MTCIE) that utilizes multi-source satellite images to provide probabilistic estimates of TC intensity. The model utilizes infrared and microwave images from multiple satellites as inputs. It uses a dual-branch self-attention encoder to extract TC image features and provides uncertainty estimates for TC intensity. Furthermore, a dataset for estimating the intensity of multi-source TC remote sensing images (MTCID) is constructed through the registration of latitude, longitude, and time, along with data augmentation. The proposed method achieves a MAE of 7.42 kt in deterministic estimation, comparable to mainstream networks like TCIENet. In uncertain estimation, it outperforms methods like MC Dropout in the PICP metric, providing reliable probability estimates. This supports TC disaster emergency decision making, enhancing risk mitigation in real-world applications.

Abstract Introduction To describe our initial experience with ileal ureteral replacement (IUR) for the management of ureteral avulsion (UA) during ureteroscopic lithotripsy. Methods Between September 2010 and April 2021, ten patients received ileal ureteral replacement for ureteral avulsion during ureteroscopic lithotripsy. Anterograde urography and computed tomography urography (CTU) were applied to evaluate the lesion. Follow-up was performed with magnetic resonance urography and renal ultrasound as well as clinical assessment of symptoms. We retrospectively analysed the clinical data of ten patients treated with ileal ureteral replacement for the treatment of ureteral avulsion. Results Four patients underwent open ileal ureteral replacement, two underwent laparoscopic ileal ureteral replacement, and four underwent robotic-assisted ileal ureteral replacement. The mean operative time (OT) was 310 min (range 191–530). The mean estimated blood loss (EBL) was 193 mL (range 10–1000). The mean length of the ileal graft was 21 cm (range 12–25). The median postoperative hospital time was 13 days (range 7–19). All surgeries were effectively completed, and no case required open conversion in laparoscopic and robotic-assisted surgeries. There was no obvious hydronephrosis according to contrast-enhanced computed tomography 3-dimensional reconstruction images without serious complications or progressive hydronephrosis during a median follow-up duration of 51 months (range 5–131), and the success rate was 100%. Conclusions Our initial results and experience showed that ileal ureteral replacement for the management of ureteral avulsion during ureteroscopic lithotripsy is safe and feasible.

Two-dimensional (2D) materials, characterized by their atomically thin nature and exceptional properties, hold significant promise for future nano-electronic applications. The precise control of carrier density in these 2D materials is essential for enhancing performance and enabling complex device functionalities. In this study, we present an electron-beam (e-beam) doping approach to achieve controllable carrier doping effects in graphene and MoS2 field-effect transistors (FETs) by leveraging charge-trapping oxide dielectrics. By adding an atomic layer deposition (ALD)-grown Al2O3 dielectric layer on top of the SiO2/Si substrate, we demonstrate that controllable and reversible carrier doping effects can be effectively induced in graphene and MoS2 FETs through e-beam doping. This new device configuration establishes an oxide interface that enhances charge-trapping capabilities, enabling the effective induction of electron and hole doping beyond the SiO2 breakdown limit using high-energy e-beam irradiation. Importantly, these high doping effects exhibit non-volatility and robust stability in both vacuum and air environments for graphene FET devices. This methodology enhances carrier modulation capabilities in 2D materials and holds great potential for advancing the development of scalable 2D nano-devices.

In underground coal mines, the stability of the retracement channel in the surrounding rock is crucial for the safe and efficient retracement of the equipment and to guarantee the continuity of the retracement work. To reveal the deformation and damage mechanism of the surrounding rock of an auxiliary retracement channel (ARC) and the determination method for the reasonable spacing of two retracement channels during the end of the mining period, the deviatoric stress field in front of the working face and the change in the shape characteristics of the plastic zone in the ARC are investigated in this paper. The formation of ultimate stress equilibrium, high deviatoric stress, decreasing deviatoric stress, and low deviatoric stress environments in front of the working face during the end of mining occur successively, and the different deviatoric stress environments are the main reasons for the different shape characteristics of the plastic zone in the surrounding rock. The changes in the shape characteristics of the plastic zone correspond to the changes in the shape characteristics in the zone with deviatoric stress and exhibit the following order: full plastic deformation zone, butterfly-shaped zone, elliptical zone, and circular plastic zone. A reasonable spacing determination method for the two retracement channels is proposed: the ARC is arranged in the decreasing deviatoric stress environment, where the surrounding rock plastic zone shape is elliptical, and the ARC is relatively stable. Based on this research result, the spacing of the double retracement channels at the Lijiahao 22-116 working face was determined to be 25 m, which achieved a positive application effect and allowed the safe and efficient retracement of the working face equipment.

Abstract Background To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. Methods To present the experience with the surgical management of ureteral endometriosis (UE) in our single center. A retrospective analysis of 40 patients with UE who presented with intraoperative surgical findings of endometriosis involving the ureter and pathology-proven UE was performed. Results Forty patients (median age, 42.5 years) with histological evidence of UE were included. Six (15%) patients had a history of endometriosis. Twenty-one (52%) patients had urological symptoms, and 19 (48%) patients were asymptomatic. All patients had hydronephrosis. The mean glomerular filtration rate (GFR) of the ipsilateral kidney was significantly worse than that of the contralateral kidney (23.4 vs 54.9 ml/min; P

Abstract Purpose This study aims to identify predictive local recurrence risk factors and site-specific local recurrence pattern of upper tract urothelial carcinoma (UTUC) with different primary tumor locations. Methods Three hundred and eighty-nine UTUC patients with radical nephroureterectomy were included in this study. Univariate and multivariate Cox proportional hazards regressions were performed to measure the risk of local recurrence. We also mapped the position of local recurrence sites stratified by primary tumor locations. Results A total of 73 patients (18.7%) developed local recurrence within a median follow-up of 41 months (range, 3-80 months). For patients with local recurrence, the median interval of local recurrence was 9 months. Ureter tumor, multifocality, T stage, G grade, lymph node metastasis (LNM), lymph node dissection (LND), and lymph vascular invasion (LVI) were all significantly associated with increased local recurrence by univariable analyses (P < 0.05). Only multifocality, T3–4, G3, and LNM remained independent predictors of increased local recurrence by multivariable analyses. Adjuvant radiotherapy could reduce the local recurrence (HR = 0.177; 95% CI 0.064-0.493, P = 0.001). Patients with local recurrence had poorer cancer-specific survival (4-year cancer-specific survival rate 36 ± 7.5% vs 88.4 ± 2.2%, P = 0.000). We evaluated local recurrence pattern stratified by tumor locations. Para-aortic lymph node region was the most common recurrence area for all the patients. Left-sided UTUC had more than 70% recurrent lymph nodes in the left para-aortic region (LPA). For right-sided UTUC patients, recurrent para-aortic lymph nodes distributed in the LPA (33.3%), aortocaval (AC) (41.5%), and right paracaval (RPC) (25.2%) regions. Recurrence in the internal and external iliac regions was only found in the distal ureter group (P < 0.05). Renal pelvic fossa recurrence was only found in renal pelvic tumor (22.2%, P = 0.007). The ureter tumor bed recurrence rate was higher for ureter patients (P = 0.001). Conclusions Multifocality, T3–4, G3, and LNM are predictors of higher local recurrence rate of UTUC. Adjuvant radiotherapy can reduce local recurrence rate. Local recurrence patterns are different according to primary tumor locations.

ObjectiveWhole-exon sequencing (WES) is a commercially available tool for hereditary disease testing. However, little is known about hereditary upper-tract urothelial carcinoma (UTUC) in the Chinese population. This study aims to investigate the prevalence of Lynch syndrome (LS) in UTUC patients with high-risk features and identify the germline mutations of genetic predisposition gene mutations in those patients.MethodsIn total, 354 consecutive UTUC patients undergoing surgery were universally recruited, of whom 108 patients under 60 years old or with a personal/family history of cancer underwent universal immunohistochemistry staining to detect the expression of mismatch repair (MMR) proteins (MLH1, MSH2, MSH6 and PMS2). Patients with deficient or weak MMR protein staining or meeting the Amsterdam II criterion were defined as suspected LS patients, who further experienced microsatellite instability (MSI) (BAT25, BAT26, BAT40, D2S123, D5S346, D17S250) detection and performed WES analysis to explore germline pathogenic/likely pathogenic (P/LP) alterations.ResultsOf 108 patients, 90 (83.3%) cases were included due to younger than 60 years, and 18 cases due to personal/family history. IHC staining identified 21 patients with deficient MMR protein staining and 15 cases with weak MMR protein staining. Three cases met the Amsterdam II criterion but with proficient MMR protein staining. Finally, WES analysis was performed in 38 suspected LS patients and P/LP germline mutations were identified in 22 individuals. Genetic testing confirmed 5 LS cases, including 3 cases with novel mutations. MSI-harboring tumor was discovered in 4 LS cases, one of whom had weak MMR protein staining. Germline P/LP variants in DNA damage repair genes were found in 11 cases. In addition, we found that 11 patients had high- or moderate- penetrance P/LP mutations other than MMR genes. The common P/LP variants in high- or moderate-penetrance genes were 4 in ATM, 3 in MSH6 and KIT, and 2 in APC, NF1 and DICER.ConclusionsWe identified approximately 11% of UTUC cases as suspected LS and at least 1.4% patients with confirmed LS-associated UTUC. In addition, broader germline genetic testing could be considered to screen for cancer severity in hereditary UTUC patients.

The ionosphere serves as a critical medium for radio signal propagation in outer space. A good morphology of the global TEC distribution is very useful for both ionospheric studies and their relative applications. In this work, a deep learning framework was constructed for better spatial estimation in ionospheric TEC. Both the DCGAN and WGAN-GP were considered, and their performances were evaluated with spatial completion for a regional TEC. The performances were evaluated using the correlation coefficient, RMSE, and MAE. Moreover, the IAAC rapid products were used to make comparisons. The results show that both the DCGAN and WGAN-GP outperformed the IAAC CORG rapid products. The spatial TEC estimation clearly goes well with the solar activity trend. The RMSE differences had a maximum of 0.5035 TECu between the results of 2009 and 2014 for the DCGAN and a maximum of 0.9096 TECu between the results of 2009 and 2014 for the WGAN-GP. Similarly, the MAE differences had a maximum of 0.2606 TECu between the results of 2009 and 2014 for DCGAN and a maximum of 0.3683 TECu between the results of 2009 and 2014 for WGAN-GP. The performances of the CORG, DCGAN, and WGAN-GP were also verified for two selected strong geomagnetic storms in 2014 and 2017. The maximum RMSEs were 1.8354 TECu and 2.2437 TECu for the DCGAN and WGAN-GP in the geomagnetic storm on 18 February 2014, respectively, and the maximum RMSEs were 1.3282 TECu and 1.4814 TECu in the geomagnetic storm on 7 September 2017. The GAN-based framework can extract the detailed features of spatial TEC daily morphologies and the responses during geomagnetic storms.

Background and Objectives: To clinically validate the computed tomography (CT)-based three-dimension (3D) model for treatment planning and intraoperative navigation of ureteropelvic junction obstruction (UPJO) complicated with renal calculi. Materials and Methods: We retrospectively collected the data of 26 patients with UPJO and renal calculi who were surgically treated in our institution from January 2019 to December 2021. Before surgery, 3D models based on preoperative CT scans were constructed in all patients. Additionally, the patients were divided into three groups according to the results of 3D models, distinguished by different treatment of renal calculi, that is, left untreated (1), pyelolithotomy (2), and endoscopic lithotomy (3). The quantitative analysis of renal calculi parameters, and perioperative and follow-up data were compared. Results: The mean number of involved renal calyces (p = 0.041), and the mean maximum cross-sectional area (p = 0.036) of renal stones were statistically different among the three groups. There were no significant differences among the three groups in the mean operative time, mean estimated blood loss, mean pararenal draining time, and mean hospital stay. The intraoperative stone clearance rates were 100% (11/11) and 77.8% (7/9) in group 2 and group 3, respectively. The trends of increased estimated glomerular filtration rate and decreased creatinine on the average levels after surgery were observed, although these changes were not statistically significant. At a mean follow-up of 19.4 ± 6.4 months, the overall surgical success rate of the UPJO was 96.2% (25/26), and the overall success rate of renal calculi removal was 80.8% (21/26). Renal stones in 66.7% (4/6) of patients in group 1 spontaneously passed out. Conclusions: Preoperative 3D CT models have exact clinical value in the surgical planning and intraoperative navigation of UPJO patients complicated with renal calculi.

An increasing body of research has revealed that social behavior shapes the animal gut microbiome community and leads to the similarity among the same social group. However, some additional factors (e.g., diet and habitat within each social group) may also contribute to this similarity within the social group and dissimilarity between social groups. Here, we investigated the potential correlation between social behavior and the gut microbiome community in 179 musk deer from four breeding regions in the Maerkang Captive Center, Sichuan. The dominant gut microbiome phyla in the musk deer in this study were Firmicutes, Bacteroidetes, and Proteobacteria. We found significant effects on the alpha and beta diversity of the gut microbiome due to the breeding regions. The similarity within breeding regions was higher than that between the breeding regions. Due to their solitary lifestyle, captive musk deer are raised in single cages with no direct social contact most of the time. Deer in all of the breeding regions have the same diet and similar living conditions. However, during each mating season from November to January, in each region, one adult male and about six adult females will be put together into a large cage. Social behavior happens during cohabitation, including mating behavior, grooming within the same sex or between different sexes, and other social contact. Therefore, we speculated that high similarity within the breeding region might be associated with the social behavior during the mating season. This was a simple and straightforward example of the relationship between animal social behavior and the gut microbiome.

The Lesser Sand-Plover (Charadrius mongolus atrifrons) is a small shorebird in Charadriiformes. Here we assembled the complete mitochondrial genome of C. m. atrifrons (Aves: Charadriiformes) which is 16,919 bp in length and consisting of 13 protein-coding (PCGs), 2 ribosomal RNA, 22 transfer RNA and 1 control region. The overall A + T content of was 55.5%. The Maximum Likelihood (ML) tree based on the 12 concatenated mitochondrial protein-coding genes (except ND6 gene) placed C. m. atrifrons in a clade with C. alexandrines but separate from C. vociferus.

Abstract Background Ileal ureter replacement is an alternative treatment for various length ureter defects. We present our experience and outcome of ileal ureter replacement in China. Methods We retrospectively collected data of patients who underwent ileal ureter replacement between January 2010 and January 2015. We reviewed the medical history, indications for surgery, operative data, perioperative data, and outcomes. Besides, follow-up data included symptom, urine routine test, serum creatinine, serum electrolyte status, and radiographic test. Results There were 23 patients who underwent ileal ureter replacement by the same surgeon. Twenty patients were performed unilateral ileal ureter replacement, two patients underwent a combination of ileal ureter replacement and Boari flap-psoas hitch, and one received bilateral ileal ureter replacement. Among these patients, the main cause leading to surgical treatment was iatrogenic injuries (n = 15), especially urinary surgery procedure (n = 11). The median follow-up time was 45 months. There were 6 early complications and 6 late complications after operation. Only one patient suffered from small bowel-related complication and was cured by conservative treatment. Only the patient who underwent bilateral ileal ureter replacement had metabolic acidosis. And 22 patients (95.7%) had a good renal function. Conclusions Ileal ureter replacement is an efficacious and safe procedure for the therapy of long ureteral defects. With appropriate technical considerations, the complication rate may decrease.

Although penile amputation is a rare injury, it may occur caused by self-mutilation with psychiatric disturbances and sexual need, or due to accidents, iatrogenic injuries or revenge and marriage breakdown. A case of successful penile glans replantation by macroscopic repair using vein blood-letting therapy is presented. This case report shows the surgical procedure and postoperative care which may be critical for successful replantation. Keywords: Penile, Amputation, Replantation, Blood-letting