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Quang Tuan Pham,1 Thua Nguyen Tran,2 Thanh Thuy Le-Thi,1 Anh Khoa Phan,3 Anh Vu Nguyen4 1Cardiology Department, Hue Central Hospital, Hue City, Vietnam; 2Department of General Internal Medicine and Geriatrics, Hue Central Hospital, Hue City, Vietnam; 3Emergency Department of Cardiovascular Intervention, Hue Central Hospital, Hue City, Vietnam; 4Cardiovascular Center, Hospital of University of Medicine and Pharmacy, Hue City, VietnamCorrespondence: Thua Nguyen Tran, Department of General Internal Medicine and Geriatrics, Hue Central Hospital, Hue City, Vietnam, Tel +84 903597695, Email tranthuanguyen23@gmail.comObjectives: To assess left ventricular diastolic function by using echocardiography in patients with dilated cardiomyopathy, and the relationship between left ventricular diastolic function and left ventricular dilatation, New York Heart Association (NYHA) heart failure index, left ventricular ejection fraction, and left ventricular fractional shortening.Methods: A descriptive cross-sectional study was conducted on patients with primary dilated cardiomyopathy hospitalized in Hue Central Hospital from April 2018 to August 2020.Results: The mean end-diastolic left ventricular volume was 133.57± 31.58 mL and the mean end-systolic left ventricular volume was 99.9± 26.03 mL. The mean left atrial volume was 61.63± 27.13 mL. The mean end-diastolic and end-systolic left ventricular diameters were 66.11± 7.3 mm and 57.7± 8.02 mm, respectively. The mean left ventricular ejection fraction was 24.68± 5.97%. The mean left ventricular fractional shortening was 12.91± 4.55%. The highest rate was grade II diastolic dysfunction (44.6%), followed by grade III diastolic dysfunction (35.8%) and grade I diastolic dysfunction at 19.6%. There was a moderate positive correlation between the left ventricular diastolic dysfunction and the NYHA class of heart failure with r=0.445, p< 0.001. All dilated cardiomyopathy patients in the study group had mainly grade II–III severe diastolic dysfunction.Conclusions: Routine evaluation of diastolic function in patients with heart failure can help in elucidation of pathogenesis and management of patients. This dysfunction was clearly demonstrated by the change in the parameters of the evaluation of left ventricular diastolic function on echocardiography according to the 2016 ASE/EACVI recommendations, a new recommendation introduced to approach the assessment of diastolic function in a more convenient and easier way.Keywords: dilated cardiomyopathy, left ventricular diastolic dysfunction

Constitutive activation of the Wnt/beta-catenin pathway has been implicated as the primary cause of colon cancer. However, the major transducers of Wnt signaling in the intestine, T-cell factor 1 (TCF-1) and TCF-4, have opposing functions. Knockout of TCF-4 suppresses growth and maintenance of crypt stem cells, whereas knockout of TCF-1 leads to adenomas. These phenotypes suggest that TCF-4 is Wnt-promoting, whereas TCF-1 acts like a tumor suppressor. Our study of TCF expression in human colon crypts reveals a mechanistic basis for this paradox. In normal colon cells, a dominant-negative isoform of TCF-1 (dnTCF-1) is expressed that is equally distributed between nuclear and cytoplasmic compartments. In colon cancer cells, TCF-1 is predominantly cytoplasmic. Localization is because of active nuclear export and is directed by an autocrine-acting Wnt ligand that requires Ca2+/calmodulin-dependent kinase II (CaMKII) activity for secretion and a downstream step in the export pathway. TCF-4 remains nuclear; its unopposed activity is accompanied by downregulation of dnTCF-1 and increased expression of full-length isoforms. Thus, the dnTCF-1 and TCF-4 balance is corrupted in cancer by two mechanisms, a Wnt/CaMKII kinase signal for nuclear export and decreased dnTCF-1 expression. We propose that dnTCF-1 provides homeostatic regulation of Wnt signaling and growth in normal colon, and the alterations in nuclear export and promoter usage contribute to aberrant Wnt activity in colon cancer.

Sodium hexametaphosphate (SHMP) is a common depressant used in rutile flotation, especially for silicate gangue minerals such as amphibole. However, the experiment found that in the benzyl hydroxamic acid (BHA) system, SHMP of small concentrations affected the flotation recovery of rutile. In this work, the influence mechanism of SHMP concentration on the flotation of rutile in the BHA system was studied by flotation test, adsorption capacity determination, ζ potential determination, infrared spectrum analysis, and X-ray photoelectron spectroscopy (XPS) analysis. The test results show that in the BHA system, SHMP chemically adsorbs on the rutile surface, hindering the effect of BHA on the rutile surface, and hydrolyzes in the pulp to form hydrophilic colloids. When the concentration of BHA is 40 mg/L and that of SHMP is 6 mg/L, the effect of SHMP is the most obvious. However, with the increase of SHMP concentration to 8-10 mg/L, its effect on the recovery of rutile became very weak. When the concentration of SHMP is lower than 6 mg/L, the SHMP anion-metaphosphate ion (SHMP - ) interacts with the hydrophilic colloidal particles on the surface of rutile, which affects the combination of BHA and the active sites on the surface of rutile, thus affecting the recovery of rutile. When the concentration of SHMP continues to increase, the SHMP - adsorbed on the rutile surface is removed from the rutile surface due to the charge repulsion and the competitive adsorption of BHA.

N-trans -cinnamoyltyramine (NTCT) has been identified from an allelopathic Vietnamese rice accession OM 5930. This study employed bioassays to analyze NTCT's effects on shoot and root growth of multiple test and weed species. NTCT demonstrated potent inhibitory effects on cress, lettuce, canola, palmer amaranth, timothy, barnyardgrass, red sprangletop, and weedy rice, with increasing concentrations leading to substantial reductions in growth in all species. Linear regression analysis of dose response curves revealed ED 50 values for NTCT, providing critical insights into the concentration required for 50% growth inhibition in each species. They revealed high sensitivity of the test species cress and lettuce, intermediate sensitivities of barnyardgrass, red sprangletop, timothy, and amaranth, and comparatively lower sensitivity of two weedy rice accessions. The findings underscore NTCT's efficacy in suppressing the growth of a wide range of weeds, including both grasses and broadleaf species. As such, NTCT may hold promise as a tool for sustainable weed management, particularly in addressing herbicide-resistant weeds in diverse ecological settings., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Plant‐Environment Interactions published by New Phytologist Foundation and John Wiley & Sons Ltd.)

Background/aim: Colorectal cancer (CRC) is the third most common malignancy and the second most common cause of cancer-related deaths worldwide. Adavosertib (AZD1775), a small molecule inhibitor of WEE1 kinase, abrogates G 2 /M cell cycle arrest and induces double-stranded DNA breaks. According to previous findings, adavosertib, in combination with other DNA-damaging agents, causes premature mitosis and cell death in p53-mutated cancer cells mainly via abrogation of the G 2 /M cell cycle checkpoint. This study aims to evaluate the inhibition of WEE1 kinase by adavosertib as monotherapy in the TP53-wildtype human CRC cell line HCT116., Materials and Methods: In this study, HCT116 cells were treated with different concentrations of adavosertib for 24 to 72 hours. Cell viability was assessed by Water-Soluble Tetrazolium 1 (WST-1) assay and crystal violet assays. Cell migration was evaluated by the wound healing assay. Cell cycle distribution and apoptosis were analyzed by flow cytometry., Results: The IC 50 value of adavosertib for the HCT116 cell line was 0.1310 μM. Adavosertib monotherapy (both 0.125 and 0.250 μM) significantly reduced cell viability, inhibited cell migration and abrogated intra-S phase cell cycle arrest. In addition, 0.250 μM of adavosertib significantly induced apoptosis in HCT116 cells., Conclusion: Adavosertib effectively inhibits the TP53-wildtype HCT116 cells via the abrogation of intra-S phase cell cycle arrest. Our findings suggest that adavosertib monotherapy may be a potential targeted therapy for CRC., (Copyright © 2024 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Rosai-Dorfman disease (RDD) with craniocervical junction involvement is a rare clinical entity. We present herein a case of a pediatric patient with craniocervical junction RDD which was surgically treated. A 10-year-old female with a history of B-cell acute lymphoblastic leukemia (B-ALL) in remission and RDD presented with frontal migraine headaches. She previously had a right posterior chest wall lesion which was biopsy-proven RDD. She was found on imaging to have a dural-based right craniocervical junction lesion. Given her history of B-ALL, after a multidisciplinary discussion, the decision was made to proceed with resection with possible initiation of cobimetinib or clofarabine. The patient underwent a suboccipital craniotomy, C1 laminectomy, and resection of the dural-based lesion. Gross total resection was achieved, and histopathology confirmed the diagnosis of RDD. She was discharged home on postoperative day 4. No recurrence was seen on follow-up imaging at 3 months. We conducted a systematic literature review examining all cases of pediatric intracranial RDD and all cases of craniocervical junction RDD. This represents, to the best of our knowledge, only the second case of pediatric craniocervical junction RDD. Although RDD is often self-limiting, medical treatment is often considered for intracranial disease, but tissue confirmation is necessary. Surgical resection provides histopathologic diagnosis and can sometimes serve as definitive treatment for a particular lesion., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Urologists face challenges in obtaining public research funding, leading to increasing reliance on the industry for research support. This study aimed to examine the extent and trends in industry-sponsored research payments to urologists from 2014 to 2022 in the United States., Methods: We identified all US urologists using the Centers for Medicare and Medicaid Services National Plan and Provider Enumeration System database and extracted their industry-sponsored research payments data from the Centers for Medicare and Medicaid Services Open Payments Database. We performed descriptive analyses of the payments data., Results: Among 13,902 US urologists, 1330 (9.6%) received at least one industry-sponsored research payment. Urologists received $605.1 million between 2014 and 2022. Of all research payments, 98.7% ($597.4 million) were associated research payments for research where urologists served as principal investigators. The top 10% of urologists in research payments received 79.3% ($480.0 million) of total research payments. Only 0.4% ($2.3 million) of research payments were for preclinical research, whereas registered clinical trials totaled $159.0 million (26.3% of all research payments). The annual value of research payments increased from $35.2 million in 2014 to $101.7 million in 2022. The average percentage change in total payments showed a significant annual increase of 13.9% (95% CI, 11.6%-16.3%; P < .001) in value. There was no significant trend in the number of urologists receiving research payments., Conclusions: Industry-sponsored research payments to urologists are substantial and have increased in both payment amount and number over time.

Objective: To assess the extent of racial reporting and enrollment in randomized controlled trials (RCTs) of minimally invasive surgical therapies (MIST) for the office-based treatment of benign prostatic hyperplasia (BPH)., Methods: A systematic review was conducted for RCTs assessing 6 office-based MISTs: transurethral microwave thermotherapy (TUMT), prostatic artery embolization, prostatic urethral lift, temporary implantable nitinol device, water vapor thermal therapy, and Optilume. MEDLINE, Embase, and the Cochrane CENTRAL databases were searched up to November 3, 2023. Publications were excluded if they (1) did not address one of the aforementioned office-based MISTs for the treatment of BPH; (2) were not RCTs; (3) were an abstract or conference proceeding; or (4) were not published in English. In addition to study characteristics, data about racial reporting were collected. Two independent reviewers completed screening at title, abstract, and full-text levels, with conflicts resolved by consensus with a third reviewer., Results: A total of 61 publications representing 37 unique RCTs (n = 4027 unique patients) were reviewed, with publication years spanning from 1993 to 2023. TUMT was the most frequently studied MIST. Most publications (79%) were based solely in Europe or North America. Over 50% of the publications were multicenter trials. None of the included publications reported on race/ethnicity of study participants., Conclusion: None of the 61 included publications of RCTs of office-based MISTs provided information on racial/ethnic composition of study participants. There is a staggering gap in the standardization of race/ethnicity reporting and enrollment within RCTs of MISTs. More granular data on race/ethnicity allow for better generalizability and equity., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: DDN is supported by a Canadian Institutes of Health Research (CIHR) Vanier Canada Graduate Scholarship, the CMCC/Atrium Hold’em for Life Oncology Fellowship, and the Ontario Ministry of Health Clinician-Investigator Program. DSE received grants or contracts from Boston Scientific, Medtronic, Procept, Zenflow, and Proverum, is a paid consultant to Boston Scientific, Astellas, Procept, Medtronic, and Olympus, and received honoraria from Boston Scientific, Medtronic, Olympus, and Procept outside of the submitted work. CJDW received grants or contracts from Knight Therapeutics, Bayer, and Tolmar Pharmaceuticals Canada outside the submitted work. All other authors report no conflicts., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Recent advances surrounding in vitro spermatogenesis (IVS) have shown potential in creating a new paradigm of regenerative medicine in the future of fertility treatments for males experiencing non-obstructive azoospermia (NOA). Male infertility is a common condition affecting approximately 15% of couples, with azoospermia being present in 15% of infertile males (Cocuzza et al., 2013; Esteves et al., 2011a). Treatment for patients with NOA has primarily been limited to surgical sperm retrieval combined with in vitro fertilization intracytoplasmic sperm injection (IVF-ICSI); however, sperm retrieval is successful in only half of these patients, and live birth rates typically range between 10 and 25% (Aljubran et al., 2022). Therefore, a significant need exists for regenerative therapies in this patient population. IVS has been considered as a model for further understanding the molecular and cellular processes of spermatogenesis and as a potential regenerative therapeutic approach. While 2D cell cultures using human testicular cells have been attempted in previous research, lack of proper spatial arrangement limits germ cell differentiation and maturation, posing challenges for clinical application. Recent research suggests that 3D technology may have advantages for IVS due to mimicry of the native cytoarchitecture of human testicular tissue along with cell-cell communication directly or indirectly. 3D organotypic cultures, scaffolds, organoids, microfluidics, testis-on-a-chip, and bioprinting techniques have all shown potential to contribute to the technology of regenerative treatment strategies, including in vitro fertilization (IVF). Although promising, further work is needed to develop technology for successful, replicable, and safe IVS for humans. The intersection between tissue engineering, molecular biology, and reproductive medicine in IVS development allows for multidisciplinary involvement, where challenges can be overcome to realize regenerative therapies as a viable option., (Copyright © 2024. Published by Elsevier Ltd.)

Normal-phase (NP) liquid chromatography is one of the most effective methods for separating isomers with sensitive structural features, including xanthophyll isomers. In this work, reverse-phase (RP) and NP liquid chromatography (LC), with silica gel and diol phase, respectively, were evaluated for the separation of xanthophyll isomers. The results showed that RP LC with monomeric C18 phase not only poorly separate all xanthophyll isomers in egg yolk but also requires additional sample preparation to eliminate triacylglycerols in egg yolk. The diol phase of NP-LC provided the highest efficiency for separating lutein, zeaxanthin, and their cis-isomers with isocratic separation using mobile phases consisting of n-hexane and polar modifiers (such as acetone, methyl tert-butyl ether, or ethyl acetate). To determine the xanthophyll content, peak areas from LC and total absorbance from spectrophotometry measurements were used. The approach was applied to analyze the xanthophylls of nine commercial egg samples. The results revealed that five out of nine analyzed samples contained a high level of canthaxanthin, which contributes to color enhancement but not to prevent age-related macular degeneration. Together, it shows that NP LC with diol phase combined with spectrophotometry is a powerful tool to monitor xanthophylls in eggs., (© 2024 Wiley‐VCH GmbH.)

Objective: To assess the effect of gestational age-based dosing of unfractionated heparin (UFH) compared with standard dosing of UFH for thromboprophylaxis on an elevated serum activated partial thromboplastin time (aPTT) during prolonged antepartum hospitalizations., Methods: This was a randomized trial of pregnant persons who were admitted in the antepartum period for at least 72 hours. Participants were randomly allocated to the standard dose of UFH (5,000 units subcutaneously every 12 hours) or the gestational age-based dose of UFH (first trimester [less than 14 weeks]: 5,000 units subcutaneously every 12 hours; second trimester [14-27 6/7 weeks]: 7,500 units subcutaneously every 12 hours; third trimester (28 weeks or more): 10,000 units subcutaneously every 12 hours). The primary outcome was the proportion of antepartum patients who had an elevated serum aPTT value above the normal range (more than 36.2 seconds) 6 hours after an UFH dose. Secondary outcomes included the development of venous thromboembolism (VTE) and reported side effects of heparin administration., Results: Between December 15, 2020, and April 1, 2022, 97 patients with antepartum hospitalizations were screened and 46 were randomized: 22 allocated to standard dosing and 24 allocated to gestational age-based dosing of UFH. A significantly greater proportion of antepartum patients who received gestational age-based dosing had an abnormal elevation in aPTT compared with those who received standard dosing (33.3% vs 4.8%, P =.02). Gestational age-based dosing resulted in higher maximum [interquartile range] aPTT (30.4 [27.4, 37.5] vs 26.6 [23.0, 29.6], P =.01) and anti-Xa levels (0.09 [0.09, 0.11] vs 0.09 [0.09, 0.09], P =.04). There was no significant difference in VTE between groups ( P =.47)., Conclusion: Gestational age-based dosing of UFH for thromboprophylaxis of antepartum hospitalizations was associated with significantly increased rates of elevated coagulation parameters compared with standard fixed dosing. This study suggests a need for close monitoring if higher doses of UFH during pregnancy are used later in gestation. The efficacy of gestational age-based dosing compared with standard dosing for UFH to prevent thromboembolic events remains an area for future investigation., Clinical Trial Registration: ClinicalTrials.gov , NCT04635839., Competing Interests: Financial Disclosure Cristianna Vallera's institution received funding from the Society for Obstetric Anesthesia & Perinatology. The other authors did not report any potential conflicts of interest., (Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Background and Objective: Adherence to guideline recommendations can improve the quality of care for patients with prostate cancer (PCa). Our aim was to assess adherence to guidelines for locoregional PCa by international region., Methods: The study cohort comprised patients diagnosed with locoregional PCa in the 10-country Movember TrueNTH Global Registry (n = 62 688; 2013-2022). We assessed adherence to four quality metrics: (1) active surveillance for low-risk PCa; (2) definitive treatment within 12 mo of diagnosis for unfavorable-risk PCa; (3) no staging imaging for favorable-risk PCa; and (4) staging imaging for unfavorable-risk PCa. For χ 2 analyses, we combined the three most recent years of data entered by region for each outcome, with adjustment for multiple tests (p = 0.05 ÷ 4 = 0.0125). We also conducted multivariable logistic regression and temporal analyses., Key Findings and Limitations: Active surveillance rates for low-risk PCa ranged from 85% in Australia/New Zealand (vs USA: adjusted odds ratio [aOR] 1.042, 95% confidence interval [CI] 0.740-1.520) to 14% in Central Europe (aOR 0.028, 95% CI 0.022-0.036). For patients with unfavorable-risk disease, the highest uptake rate for treatment within 12 mo of diagnosis was in Central Europe (98%; aOR 2.885, 95% CI 1.260-6.603), compared to 70% in Italy (aOR 0.031, 95%CI 0.014-0.072). The proportion of patients with favorable-risk disease who did not undergo imaging ranged from 94% in the USA to 30% in Italy (aOR 0.004, 95% CI 0.002-0.008), while the rate of imaging for unfavorable-risk PCa ranged from 8% in Hong Kong (aOR 65.222, 95% CI 43.676-97.398) to 39% in the USA (all χ 2 p < 0.0125). Regional temporal trends also varied., Conclusions and Clinical Implications: In this international study comparing adherence to quality care metrics for the quality of care for locoregional PCa, we identified regional variance, possibly because of regional differences in cultural attitudes and health care structures. These benchmarks highlight opportunities for interventions to improve adherence to evidence-based guidelines., Patient Summary: Our study shows that adherence to recommended management goals for patients with prostate cancer varies greatly by global region., (Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Recombinant adeno-associated viruses (AAVs) allow rapid and efficient gene delivery to the nervous system, are widely used in neuroscience research, and are the basis of FDA-approved neuron-targeting gene therapies. Here we find that an innate immune response to the AAV genome reduces dendritic length and complexity and disrupts synaptic transmission in mouse somatosensory cortex. Dendritic loss is apparent 3 weeks after injection of experimentally relevant viral titers, is not restricted to a particular capsid serotype, transgene, promoter, or production facility, and cannot be explained by responses to surgery or transgene expression. AAV-associated dendritic loss is accompanied by a decrease in the frequency and amplitude of miniature excitatory postsynaptic currents and an increase in the proportion of GluA2-lacking, calcium-permeable AMPA receptors. The AAV genome is rich in unmethylated CpG DNA, which is recognized by the innate immunoreceptor Toll-like receptor 9 (TLR9), and acutely blocking TLR9 preserves dendritic complexity and AMPA receptor subunit composition in AAV-injected mice. These results reveal unexpected impacts of an immune response to the AAV genome on neuronal structure and function and identify approaches to improve the safety and efficacy of AAV-mediated gene delivery in the nervous system., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Study Objective: To determine the median perioperative blood loss (PBL) during minimally invasive surgical (MIS) myomectomy., Design: Prospective pilot study., Setting: Large academic teaching hospital., Patients: Thirty-one patients underwent laparoscopic or robotic myomectomy and completed a postoperative complete blood count (CBC) from November 2020 to August 2022. Patients had to have at least one fibroid greater than or equal to 3 cm on preoperative imaging., Interventions: A CBC was collected preoperatively within 7 days of surgery. Estimated blood loss (EBL) was determined by the surgeon intraoperatively. A repeat CBC was drawn between postoperative days 2 through 4. PBL was calculated using the equation PBL = (patient weight in kg × 65 cc/kg) × (preoperative hematocrit - postoperative hematocrit)/preoperative hematocrit., Measurements and Main Results: Median PBL (536.3 cc [270.0, 909.3]) was greater than median EBL (200.0 cc [75.0, 500.0]). PBL ranged from a net gain of 191.5 cc to net loss of 2362.5 cc. Median size of the largest fibroid on preoperative imaging was 8.8 cm (6.6, 11.5), and median weight of fibroids removed was 321 g (115, 519). About half of patients (51.6%) had one fibroid removed, and 48.4% had 2 or more fibroids removed. Five patients were converted to laparotomy, 4 from robotic approaches. Two patients required a blood transfusion., Conclusion: Calculated PBL was greater than intraoperative EBL. This suggests there is continued blood loss post myometrial bed closure. Blood loss should be evaluated both during and after myomectomy, as intraoperative EBL underestimates total PBL., (Copyright © 2024 AAGL. Published by Elsevier Inc. All rights reserved.)

Adaptive laboratory evolution (ALE) can be used to make bacteria less susceptible to oxidative stress. An alternative to large batch scale ALE cultures is to use microfluidic platforms, which are often more economical and more efficient. Microfluidic ALE platforms have shown promise, but many have suffered from subpar cell passaging mechanisms and poor spatial definition. A new approach is presented using a microfluidic Evolution on a Chip (EVoc) design which progressively drives microbial cells from areas of lower H 2 O 2 concentration to areas of higher concentration. Prolonged exposure, up to 72 h, revealed the survival of adaptive strains of Lacticaseibacillus rhamnosus GG, a beneficial probiotic often included in food products. After performing ALE on this microfluidic platform, the bacteria persisted under high H 2 O 2 concentrations in repeated trials. After two progressive exposures, the ability of L. rhamnosus to grow in the presence of H 2 O 2 increased from 1 mm H 2 O 2 after a lag time of 31 h to 1 mm after 21 h, 2 mm after 28 h, and 3 mm after 42 h. The adaptive strains have different morphology, and gene expression compared to wild type, and genome sequencing revealed a potentially meaningful single nucleotide mutation in the protein omega-amidase., (© 2024 Wiley‐VCH GmbH.)

This cross-sectional study investigated the antimicrobial resistance (AMR) patterns of gram-negative pathogens isolated from 4,789 hospitalized patients with lower respiratory tract infections (LRTIs). Of the collected specimens, 1,325 (27.7%) tested positive for gram-negative bacteria. Acinetobacter baumannii (38.6%), Pseudomonas aeruginosa (33.5%), Klebsiella pneumoniae (18.7%), Escherichia coli (5.6%), and Klebsiella aerogenes (3.5%) were the most prevalent isolates. AMR analysis revealed high resistance rates (79.9%-100%) of A. baumannii isolates to multiple classes of antibiotics except amikacin, trimethoprim/sulfamethoxazole, and colistin. P. aeruginosa displayed low resistance to colistin (< 10%) but high resistance to other antibiotics. K. pneumoniae displayed high resistance rates of 90.0%-100.0% to most penicillins, whereas resistance rates were notably lower for colistin (7.1%) and amikacin (16.7%). K. aerogenes exhibited high resistance to various antibiotics and sensitivity to amikacin (95.1%), ampicillin (100.0%), and colistin (100.0%). E. coli isolates exhibited resistance to ampicillin (96.9%) and maximum sensitivity to several antibiotics. Our study identified significant AMR trends and highlighted the prevalence of multidrug-resistant strains (93.6% for K. aerogenes and 69.1%-92.4% for other isolates). These findings emphasize the urgent need for appropriate antibiotic management practices to combat AMR in gram-negative pathogens associated with LRTIs.

Hypothesis: The adsorption of heavy metal ions such as Pb(II) onto negatively charged minerals such as silica is expected to alter the structure and the interactions at the silica/aqueous interfaces. Besides the solution pH, the inner-sphere sorption of Pb(II) is expected to regulate the surface charge/potential, hypothesized to control the actions of monovalent anions in the aqueous environment. These complex pictures can be probed directly using surface-sensitive sum-frequency generation (SFG) spectroscopy., Experiments: The pH-dependent water structure within the double layer at silica/aqueous interfaces under the influence of different ions was examined using SFG. The recorded SFG spectra were deconvoluted into the Stern layer (SL) and diffuse layer (DL) using the maximum entropy method in conjunction with the electrical double-layer theory., Findings: Standalone monovalent sodium salts do not exhibit ion-specific effects on the silica/aqueous interfaces. However, the mixture of Pb(II) species and each of these salts display profound ion-specific effects on the structure of silica/aqueous interfaces, indicating the role of Pb(II) as an enabler of the ion-specificity of the investigated monovalent anions. The interesting effect arises from a complex interplay between the physical processes (i.e., electrostatic interactions, screening effects, etc.) and chemical processes such as the hydrolysis of Pb(II) ions, ion complexation, protonation and deprotonation of the surface silanol group., 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 © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Purpose: Functional problems such as incontinence and sexual dysfunction after radical prostatectomy (RP) are important outcomes to evaluate surgical quality in prostate cancer (PC) care. Differences in survival after RP between countries are known, but differences in functional outcomes after RP between providers from different countries are not well described., Methods: Data from a multinational database of patients with PC (nonmetastatic, treated by RP) who answered the EPIC-26 questionnaire at baseline (before RP, T0) and 1 year after RP (T1) were used, linking survey data to clinical information. Casemix-adjusted incontinence and sexual function scores (T1) were calculated for each country and provider on the basis of regression models and then compared using minimally important differences (MIDs)., Results: A total of 21,922 patients treated by 151 providers from 10 countries were included. For the EPIC-26 incontinence domain, the median adjusted T1 score of countries was 76, with one country performing more than one MID (for incontinence: 6) worse than the median. Eighteen percent of the variance ( R 2 ) of incontinence scores was explained by the country of the providers. The median adjusted T1 score of sexual function was 33 with no country performing perceivably worse than the median (more than one MID worse), and 34% ( R 2 ) of the variance of the providers' scores could be explained by country., Conclusion: To our knowledge, this is the first comparison of functional outcomes 1 year after surgical treatment of patients with PC between different countries. Country is a relevant predictor for providers' incontinence and sexual function scores. Although the results are limited because of small samples from some countries, they should be used to enhance cross-country initiatives on quality improvement in PC care.

Objectives: Despite recent advances, the prognosis for primary malignant brain tumors (PMBTs) remains poor. Some commonly prescribed medications may exhibit anti-tumor properties in various cancers, and neurodegenerative diseases may activate pathways that counteract gliomagenesis. Our study is focused on determining if there is a correlation between the use of metformin, beta-blockers, angiotensin converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs), or the presence of Parkinson's disease (PD), and the survival rates following a diagnosis of a PMBT., Methods: This analysis of the 100% Texas Medicare Database identified patients aged 66+ years diagnosed with a supratentorial PMBT from 2014-2017. Cox proportional hazards regression was employed to analyze survival following diagnosis and associations of survival with surgical intervention, radiation, PD diagnosis, and prescription of metformin, beta-blockers, ACEIs, or ARBs., Results: There were 1,943 patients who met study criteria, and the median age was 74 years. When medication utilization was stratified by none, pre-diagnosis only, post-diagnosis only, or both pre- and post-diagnosis (continuous), continuous utilization of metformin, beta-blockers, ACEIs, or ARBs was associated with prolonged survival compared to no utilization (hazard ratio [HR]:0.45, 95% CI:0.33-0.62; HR:0.71. 95% CI:0.59-0.86; HR:0.59, 95% CI:0.48-0.72; and HR:0.45, 95% CI:0.35-0.58 respectively). PD was also associated with longer survival (HR:0.59-0.63 across the four models)., Discussion: Our study suggests that metformin, beta-blockers, ACEIs, ARBs, and comorbid PD are associated with a survival benefit among geriatric Medicare patients with supratentorial PMBTs.

Background: Colony stimulating factor 1 receptor (CSF1R) signaling is crucial for the maintenance and function of various myeloid subsets. CSF1R antagonism was previously shown to mitigate clinical severity in experimental autoimmune encephalomyelitis (EAE). The associated mechanisms are still not well delineated., Methods: To assess the effect of CSF1R signaling, we employed the CSF1R antagonist PLX5622 formulated in chow (PLX5622 diet, PD) and its control chow (control diet, CD). We examined the effect of PD in steady state and EAE by analyzing cells isolated from peripheral immune organs and from the CNS via flow cytometry. We determined CNS infiltration sites and assessed the extent of demyelination using immunohistochemistry of cerebella and spinal cords. Transcripts of genes associated with neuroinflammation were also analyzed in these tissues., Results: In addition to microglial depletion, PD treatment reduced dendritic cells and macrophages in peripheral immune organs, both during steady state and during EAE. Furthermore, CSF1R antagonism modulated numbers and relative frequencies of T effector cells both in the periphery and in the CNS during the early stages of the disease. Classical neurological symptoms were milder in PD compared to CD mice. Interestingly, a subset of PD mice developed atypical EAE symptoms. Unlike previous studies, we observed that the CNS of PD mice was infiltrated by increased numbers of peripheral immune cells compared to that of CD mice. Immunohistochemical analysis showed that CNS infiltrates in PD mice were mainly localized in the cerebellum while in CD mice infiltrates were primarily localized in the spinal cords during the onset of neurological deficits. Accordingly, during the same timepoint, cerebella of PD but not of CD mice had extensive demyelinating lesions, while spinal cords of CD but not of PD mice were heavily demyelinated., Conclusions: Our findings suggest that CSF1R activity modulates the cellular composition of immune cells both in the periphery and within the CNS, and affects lesion localization during the early EAE stages., (© 2024. The Author(s).)

Background: Enhanced recovery after surgery (ERAS) protocols have been associated with hypotensive episodes after autologous breast reconstruction. Gabapentin (Gaba), a nonopioid analgesic used in ERAS, has been shown to attenuate postoperative hemodynamic responses. This study assesses ERAS's impact, with and without Gaba, on postoperative hypotension after microvascular breast reconstruction., Methods: Three cohorts were studied: traditional pathway, ERAS + Gaba, and ERAS no-Gaba. We evaluated length of stay, inpatient narcotic use [morphine milligram equivalents (MME)], mean systolic blood pressure, hypotension incidence, and complications. The traditional cohort was retrospectively reviewed, whereas the ERAS groups were enrolled prospectively after the initiation of the protocol in April 2019 (inclusive of Gaba until October 2022)., Results: In total, 441 patients were analyzed. The three cohorts, in the order mentioned above, were similar in age and bilateral reconstruction rates (57% versus 61% versus 60%). The ERAS cohorts, both with and without Gaba, had shorter stays ( P < 0.01). Inpatient MME was significantly less in the ERAS + Gaba cohort than the traditional or ERAS no-Gaba cohorts (medians: 112 versus 178 versus 158 MME, P < 0.01). ERAS + Gaba significantly increased postoperative hypotensive events on postoperative day (POD) 1 and 2, with notable reduction after Gaba removal ( P < 0.05). Across PODs 0-2, mean systolic blood pressure was highest in the traditional cohort, followed by ERAS no-Gaba, then the ERAS + Gaba cohort ( P < 0.05). Complication rates were similar across all cohorts., Conclusions: Postmicrovascular breast reconstruction, ERAS + Gaba reduced overall inpatient narcotic usage, but increased hypotension incidence. Gaba removal from the ERAS protocol reduced postoperative hypotension incidence while maintaining similar stay lengths and complication rates., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Landfills are the primary endpoint for the disposal of PFAS-laden waste, which subsequently releases PFAS to the surrounding environments through landfill leachate. Ozone foam fractionation emerges as a promising technology for PFAS removal to address the issue. This study aims to (i) assess the effectiveness of the ozone foam fractionation system to remove PFAS from landfill leachate, and (ii) quantify equilibrium PFAS adsorption onto the gas-water interface of ozone bubbles, followed by a comparison with air foam fractionation. The results show that ozone foam fractionation is effective for PFAS removal from landfill leachate, with more than 90 % long-chain PFAS removed. The identified operating conditions provide valuable insights for industrial applications, guiding the optimization of ozone flow rates (1 L/min), dosing (43 mg/L) and minimizing foamate production (4 % wettability). The equilibrium modelling reveals that the surface excess of air bubbles exceeds that of ozone bubbles by 20-40 % at a corresponding PFAS concentration. However, the overall removal of PFAS from landfill leachate by ozone foam fractionation remains substantial. Notably, ozone foam fractionation generates foamate volumes 2 - 4 times less, resulting in significant cost savings for the final disposal of waste products and reduced site storage requirements., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Justin Baulch and Simon Dong report a relationship with Evocra Pty Ltd that includes: employment., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Introduction: Benign prostatic hyperplasia (BPH) is one of the most common diseases affecting men and can present with bothersome lower urinary tract symptoms (LUTS). Historically, transurethral resection of the prostate (TURP) has been considered the gold standard in the treatment of LUTS due to BPH. However, TURP and other traditional options for the surgical management of LUTS secondary to BPH are associated with high rates of sexual dysfunction. In the past decade, several novel technologies, including Aquablation therapy, convective water vapor therapy (Rezum), and transperineal prostate laser ablation (TPLA), have demonstrated promising evidence to be safe and effective while preserving sexual function., Methods: In this review, we discuss three ablative minimally invasive surgeries: Aquablation, Rezum, and TPLA. We review their techniques, safety, as well as perioperative and functional outcomes. We go into further detail regarding sexual function after these ablative minimally invasive surgical therapies., Results: Aquablation is a surgeon-guided, robot-executed, heat-free ablative waterjet procedure with sustained functional outcomes at 5 years while having no effect on sexual activity. Rezum is an innovative office-based, minimally invasive surgical option for BPH that delivers convective water vapor energy into prostate adenoma to ablate obstructing tissue. Rezum leads to significant improvements in Qmax, IPSS while preserving sexual function. TPLA is another office-based technology which uses a diode laser source to produce thermoablation. It leads to improvement in Qmax, IPSS, and QoL while preserving ejaculatory function., Conclusions: Overall, ablative minimally invasive surgical therapies have demonstrated excellent safety and efficacy profiles while preserving sexual function. These modalities should be discussed with patients to ensure informed and shared decision-making. Ablative minimally invasive surgical therapies may be particularly interesting to patients who value the preservation of their sexual function., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)