Comparison Between Retrograde and Antegrade Ureteroscopic Laser Lithotripsy for the Management of Medium-Sized Proximal Ureteral Stones: A Randomized Prospective Study.

OBJECTIVES: This study aimed to present the outcomes of retrograde and antegrade ureteroscopic laser lithotripsy in the treatment of proximal ureteral stones ranging in size from 10 to 20 millimeters in diameter. PATIENTS AND METHODS: From March 2023 to December 2023, 70 patients were included in this prospective randomized double-arm interventional study. Patients were divided into two groups: Group 1 (35 patients) had semi-rigid retrograde ureteroscopic laser lithotripsy, and Group 2 (35 patients) had semi-rigid antegrade ureteroscopic laser lithotripsy. RESULTS: In terms of length of hospitalization, there was a statistically significant distinction between the groups that were evaluated (p = 0.001). Group (1) showed a statistically significant distinction in Hb and HCT levels before and after the procedure (p < 0.05), whereas Group (2) showed a similar difference in Hb, creatinine, and HCT levels before and after the operation (p < 0.05). The antegrade group had much more hemorrhage than the retrograde group. Reduced hemoglobin (p = 0.008) and hemoglobin saturation (p = 0.029) were most noticeable in the antegrade group. Regarding stone-free rates (SFRs), no statistically significant difference was noted between the groups (p = 0.643). CONCLUSION: Both retrograde and antegrade ureteroscopic laser lithotripsy are dependable and successful for the treatment of proximal ureteral stones. For medium-sized proximal ureteral stones (10-20 mm), retrograde ureteroscopic laser lithotripsy may be the first option due to its shorter hospital stays, decreased bleeding rates, blood transfusion needs, and temporary rise in serum creatinine.

Flaring Inflammation and ER Stress by an Organelle-Specific Fluorescent Cage.

The endoplasmic reticulum (ER) plays an important role in protein synthesis and its disruption can cause protein unfolding and misfolding. Accumulation of such proteins leads to ER stress, which ultimately promotes many diseases. Routine screening of ER activity in immune cells can flag serious conditions at early stages, but the current clinically used bio-probes have limitations. Herein, an ER-specific fluorophore based on a biocompatible benzothiadiazole-imine cage (BTD-cage) with excellent photophysical properties is developed. The cage outperforms commercially available ER stains in long-term live cell imaging with no fading or photobleaching over time. The cage is responsive to different levels of ER stress where its fluorescence increases accordingly. Incorporating the bio-probe into an immune disorder model, a 6-, 21-, and 48-fold increase in intensity is shown in THP-1, Raw 246.7, and Jurkat cells, respectively (within 15 min). These results strongly support that this system can be used for rapid visual and selective detection of ER stress. It is envisaged that tailoring molecular interactions and molecular recognition using supramolecular improved fluorophores can expand the library of biological probes for enhanced selectivity and targetability toward cellular organelles.

Exploring the potential of combined B-mode features and color Doppler ultrasound in the diagnosis of ureteric stone as an alternative to ionizing radiation exposure by computed tomography.

OBJECTIVE: To assess the diagnostic efficacy of integrating B-mode and color Doppler capabilities of ultrasound (US) to establish a robust standalone diagnostic tool for the diagnosis of ureteric stones as an alternative to non-contrast-enhanced computed tomography (NCCT). METHODS: A total of 140 consecutive patients diagnosed with ureteric stones using NCCT were enrolled. On the same day, US in both B-mode and Color Doppler was performed by an experienced radiologist who was blinded to the NCCT scan results. The diagnostic rate of US for stone detection was recorded. Additionally, baseline patient and stone characteristics were analyzed for their association with the accuracy of stone detection using US. RESULTS: US exhibited a high sensitivity of 91.43%, detecting 128 out of 140 stone foci. Notably, ureteric stones in the proximal and uretero-vesical junction (UVJ) segments were readily identifiable compared to those in the pelvic region (p = 0.0003). Additionally, hydronephrosis enhanced the US's ability to detect stones (p < 0.0001). Conversely, abdominal gases and obesity adversely affected US capabilities (p < 0.0001 and p = 0.009, respectively). Stone side, size, and density showed no statistically significant impact (p > 0.05). CONCLUSIONS: US with its color Doppler capabilities could serve as a reliable and safe alternative imaging modality in the diagnostic work up of patients with ureterolithiasis. Factors including stone location, Hydronephrosis, weight and abdominal gases significantly influenced its accuracy.

Approximate solutions of the spin and pseudospin symmetries under coshine Yukawa tensor interaction.

The approximate solutions of the Dirac equation for spin symmetry and pseudospin symmetry are studied with a coshine Yukawa potential model via the traditional supersymmetric approach (SUSY). To remove the degeneracies in both the spin and pseudospin symmetries, a coshine Yukawa tensor potential is proposed and applied to both the spin symmetry and the pseudospin symmetry. The proposed coshine tensor potential removes the energy degenerate doublets in both the spin symmetry and pseudospin symmetry for a very small value of the tensor strength (H = 0.05). This shows that the coshine Yukawa tensor is more effective than the real Yukawa tensor. The non-relativistic limit of the spin symmetry is obtained by using certain transformations. The results obtained showed that the coshine Yukawa potential and the real Yukawa potential has the same variation with the angular momentum number but the variation of the screening parameter with the energy for the two potential models differs. However, the energy eigenvalues of the coshine Yukawa potential model, are more bounded compared to the energies of the real Yukawa potential model.

The outcomes of flexible ureteroscopy for renal calculi of 2 cm or more with and without the use of ureteral access sheath: A retrospective study.

INTRODUCTION: The rate of success of retrograde intrarenal surgery (RIRS) for treating urinary tract stones is high, and the procedure is growing in popularity. The routine use of ureteral access sheath (UAS) remains somewhat controversial. The aim of this study was to assess the efficacy and safety of employing UAS during flexible ureteroscopy for treating renal stones ≥ 2 cm. METHODS: This retrospective study was accomplished from January 2021 to February 2023. From 495 consecutives flexible ureteroscopies, 112 patients had renal stones ≥ 2 cm (60 patients with the use of UAS and 52 patients without). The stone-free status was verified after 8 weeks of operation. RESULTS: The average diameter of the renal stones in non-UAS or UAS treated groups was 22.5 mm and 22.6, respectively. None of the groups differed significantly in terms of stone side, stone size, stone position, or Hounsfield unite but there was significant difference (p < 0.001) among two groups as regard pre-operative stenting (cases with UAS had 23.3% pre-operative stenting). CONCLUSIONS: It is not always necessary to use UAS in conjunction with flexible ureteroscopy and laser lithotripsy to treat renal calculi bigger than or equal two cm. Without the assistance of UAS, the surgery may be carried out successfully and safely.

Caging the Hofmeister Effect by a Biomimetic Supramolecular Receptor.

The effect of anions on the solubility and function of proteins was recognized in 1888 and is now termed the Hofmeister effect. Numerous synthetic receptors are known that overcome the associated anion recognition bias. However, we are unaware of a synthetic host being used to overcome Hofmeister effect perturbations to natural proteins. Here, we report a protonated small molecule cage complex that acts as an exo-receptor and displays non-Hofmeister solubility behavior, with only the chloride complex remaining soluble in aqueous media. This cage allows for the activity of lysozyme to be retained under conditions where anion-induced precipitation would otherwise cause it to be lost. To our knowledge, this is the first time a synthetic anion receptor is used to overcome the Hofmeister effect in a biological system.

Sleep-Disordered Breathing and Its Association with Nocturnal Enuresis at the Primary Schools in Saudi Arabia: A Cross-Sectional Study.

The correlation between nocturnal enuresis (NE) and sleep-disordered breathing (SDB) was reported. We aim to determine whether there is an association between NE and SDB in children and to assess the prevalence of SDB and NE in primary school children aged 6-12 years in Saudi Arabia. A cross-sectional observational study was conducted among the caregivers of children aged 6-12 years in all Saudi Arabia regions. The data were gathered through a self-administered online questionnaire. It included demographic information, weight and height, and associated comorbidities, in addition to the weekly frequencies of snoring symptoms and of enuresis, as well as of unrefreshing sleep using Likert-type response scales. Counts and percentages, the mean ± standard deviation, chi-square test, independent samples t-test, and regression analysis were used in the statistical analysis using R v 3.6.3. The questionnaire was completed by 686 respondents. Most respondents did not report any comorbidities in their children (77.1%). Asthma and adenotonsillar hypertrophy were reported in 16.2% and 15.6% of children, respectively. Unrefreshing sleep, mouth breathing at night, snoring, chronic nasal obstruction, and difficulty breathing while asleep were reported once or twice per week in 38%, 34%, 28%, 18%, and 18% of children, respectively. The prevalence of NE was 22.3%, with about 36.6% of children having NE two or more times per week. Significantly, NE was reported in 26.6% of children who slept before 10 PM compared to 19% of children who slept after 10 PM; in 28.6% of children who snored or loudly snored (57.1%) three times or more per week; and in 51.2% and 27.5% of children with difficulty breathing while asleep and who breathed through their mouth at night for one or two nights per week, respectively. A multivariable regression analysis showed that male gender (OR = 1.52, p = 0.010), obesity (OR = 1.24, p = 0.028), early sleeping time (OR = 1.40, p = 0.048), loud snoring for three or more nights per week (OR = 1.54, p = 0.001), difficulty breathing for one or two nights per week (OR = 1.85, p = 0.010), and mouth breathing at night for one or two nights per week (OR = 1.55, p = 0.049) were associated with higher odds of NE. Our study revealed that 22.3% of primary school children reported suffering from NE. SDB is a common problem among children with NE. The exact mechanism that links SDB to the increase in the risk of NE is unknown. Male gender, obesity, early sleeping time, loud snoring, difficulty breathing, and mouth breathing at night are potential independent risk factors of NE in school-age children.

HER2/neu expression status of post BCG recurrent non-muscle-invasive bladder urothelial carcinomas in relation to their primary ones.

BACKGROUND: Transurethral resection (TUR) followed by adjuvant therapy is still the treatment of choice of Non-Muscle-Invasive Bladder Urothelial Carcinoma (NMIBUC). However, recurrence is one of the most troublesome features of these lesions. Early second resection and adjuvant BCG therapy has been shown to improve the outcome. OBJECTIVE: To evaluate the prognostic value of C-erbB-2 (HER2/neu) expression status in Non-Muscle-Invasive Bladder Urothelial Carcinoma cases, before and after intravesical Bacillus Calmette Guerin (BCG immunotherapy). MATERIALS AND METHODS: HER2/neu expression was studied in 120 (Ta-T1) Non-Muscle-Invasive Urothelial Carcinoma cases. The expression was evaluated and compared to the expression after Bacillus Calmette Guerin (BCG) immunotherapy. RESULTS: HER2/neu expression in low and high grade of the Non- Muscle-Invasive Urothelial Carcinoma was (38%) and (83%) respectively. The difference of the expression rates by tumor grade was statistically significant. In recurring lesions post BCG therapy, C-erbB-2 expression was markedly decreased (31.6%) when compared to its expression before therapy (65%). CONCLUSIONS: The HER2/neu expression increased as the tumor grade rose. The reduction in expression following BCG treatment in Non-Invasive transitional cell carcinoma cases could reflect a reduction of the potential malignancy of the tumor.

Polycage membranes for precise molecular separation and catalysis.

The evolution of the chemical and pharmaceutical industry requires effective and less energy-intensive separation technologies. Engineering smart materials at a large scale with tunable properties for molecular separation is a challenging step to materialize this goal. Herein, we report thin film composite membranes prepared by the interfacial polymerization of porous organic cages (POCs) (RCC3 and tren cages). Ultrathin crosslinked polycage selective layers (thickness as low as 9.5 nm) are obtained with high permeance and strict molecular sieving for nanofiltration. A dual function is achieved by combining molecular separation and catalysis. This is demonstrated by impregnating the cages with highly catalytically active Pd nanoclusters ( ~ 0.7 nm). While the membrane promotes a precise molecular separation, its catalytic activity enables surface self-cleaning, by reacting with any potentially adsorbed dye and recovering the original performance. This strategy opens opportunities for the development of other smart membranes combining different functions and well-tailored abilities.

Urethral advancement and glanuloplasty versus tubularized incised plate urethroplasty for distal hypospadias repair: a prospective randomized study.

BACKGROUND: About one in 200 to one in 300 male births has hypospadias. The prevalence of this congenital anomaly varies worldwide. The meatus is located distally in approximately 70% of cases. Several surgical techniques were described for distal hypospadias repair; despite this, there is no ideal approach. This study compares urethral advancement &glanuloplasty, and TIP techniques in terms of feasibility, duration of operation, and complications. Patients and. METHODS: This prospective randomized comparative study was conducted at Al-Azhar University Hospitals from April 2022 to October 2022. Fifty-seven cases with different types of hypospadias were assessed for eligibility. Among them, seven cases were excluded due to the presence of severe chordee (n = 3), proximal variant (n = 2), and recurrent cases of hypospadias (n = 2). Fifty cases were randomly divided into two groups using a 1:1 ratio (computer-generated randomization). Twenty-five cases were subjected to urethral advancement and glanuloplasty, and the rest were subjected to tubularized incised plate (TIP) urethroplasty. RESULTS: The mean age of all studied cases was 4.2 years. Approximately 52% had coronal or sub-coronal meatus, whereas 48% had glandular meatus. Both groups were matched according to age and meatus location (p > 0.05). No statistically significant difference was observed between the two groups regarding duration of operation, postoperative pain, and postoperative hospital stay. In addition, both groups did not differ significantly in late complications (meatal stenosis, meatal retraction, fistula, and glans dehiscence). CONCLUSIONS: Both urethral advancement &glanuloplasty, and TIP urethroplasty have comparable short-term outcomes. Urethral advancement and glanuloplasty is preferred in certain conditions, especially in circumcised children or those with a narrow urethral plate. TRIAL REGISTRATION: The study protocol was approved by the Pan African Clinical Trials Registry (number for the registry is: PACTR202211757905870) on (29/11/2022). All procedures were performed per the Helsinki Declaration.

Randomized comparison of effect of standard antibiotic prophylaxis versus enhanced prophylactic measures on rate of urinary tract infection after flexible ureteroscopy.

PURPOSE: To compare the rate of post-flexible ureteroscopy urinary tract infection (UTI) in patients subjected to the standard antibiotic prophylaxis alone versus enhanced prophylactic measures. METHODS: A prospective randomized controlled study included 256 patients subjected to flexible ureteroscopy (FURS) for ureteral or renal stones from March 2018 to July 2022. Treatment groups included the standard antibiotic prophylaxis group (group 1, n=128) and the enhanced prophylaxis group (group 2, n=128). Patients in group 1 were injected with intravenous fluoroquinolone one hour preoperatively, and oral antibiotics were used for 24 h postoperatively. Patients in group 2 had urine culture ten days before the procedure; antibiotic-culture based was given for positive asymptomatic cases, while the procedure was deferred for active UTI. RESULTS: The study groups were comparable regarding patient demographics, stone characteristics, operative time, and intraoperative complications. The overall hospitalization time was 1.68 ± 0.81 days. Postoperative, and overall complications were significantly higher in group 1 (15.6% vs. 6.3%, p = 0.04 and 26.6% vs. 17.2%, p = 0.047), respectively. Twenty patients (15.6 %) in the standard prophylaxis group were diagnosed with UTI in comparison to 8 patients (6.3 %) in the enhanced prophylaxis group (p = 0.047). CONCLUSIONS: Urinary tract infection after FURS could be reduced significantly by utilizing the suggested enhanced prophylactic approach.

Comparative study between ureter first approach and conventional open Anderson-Hynes pyeloplasty in paediatric patients: A prospective randomised study.

BACKGROUND: Uretero-pelvic junction obstruction is the most common form of congenital anomaly of the kidney and urinary tract with an incidence of about 1/1.000-1.500 of births and the aetiology and pathogenesis of this anomaly are still unclear until now. METHODS: This is a prospective randomized comparative study conducted from March 2022 to December 2022. Thirty children with uretero-pelvic junction obstruction were included and randomly divided into two groups according to a 1:1 ratio (computer-generated randomization, single blind). Fifteen cases (12 males and 3 female) were subjected to ureter first approach pyeloplasty, and another fifteen (9 males and 6 female) were subjected to conventional Anderson Hynes pyeloplasty. RESULTS: The mean age of all patients was 6.7 ± 5.4 years in ureter first approach group and 5.1 ± 4.3 years in conventional Anderson-Hynes pyeloplasty group. There were no significant differences between the two groups regarding age, gender, presentation, side, preoperative renogram and post-operative renogram. Also, there were no significant differences between the two groups regarding operative time (in first group 110.3 ± 12.4 and in the second group 111.2 ± 12.0 with p < 0.836), pre and post-operative complication rate. Two cases of urinary tract infections in the first group, one of them having fever, and four cases in the second group, two of them having fever (p < 0.651); four cases of loin pain in the first group and one case in the second group (p < 0.330); one case in the first group having pro- longed leakage of urine for 7 days in post-operative period (p < 0.309). However GFR and t 1/2 improved significantly after operation in both groups (p < 0.001). CONCLUSIONS: Ureter first approach is a simple and effective procedure in children with good short term outcomes and could be done safely especially for beginners and less expert surgeons. Finally, it can overcome the problem of long ureteric stricture that may be found intraoperatively because you can shift easily to a flap procedure and complete a tension free anastomosis.

Correlation between serum copeptin and urinary aquaporin-2 levels in children with primary monosymptomatic nocturnal enuresis.

OBJECTIVES: To determine the utility of serum copeptin and urinary aquaporin-2 (AQP2) levels in diagnosing primary monosymptomatic nocturnal enuresis (PMNE) in children. METHODS: This study comprised 58 children (30 males and 28 females), aged 9.7 (±2.9) years with PMNE enuresis. Another 29 children (16 males and 13 females) aged 10.2 (±3.3) without nocturnal enuresis (NE) were recruited as a control group. History taking, clinical examination, and assessment of serum copeptin (blood) and AQP-2 levels (urine) were performed in all participants. RESULTS: Serum levels of copeptin, potassium and urinary AQP-2, and urine creatinine levels were lower in the PMNE group compared to the control group (p < 0.001 for all). No significant differences in body mass index, urine specific gravity, serum sodium, serum creatinine, or estimated glomerular filtration rate were observed between groups. This study evaluated both serum copeptin and AQP-2 levels in healthy and enuretic children. CONCLUSIONS: In this study, serum levels of copeptin (blood) and AQP2 (urine) were significantly lower in enuretic patients compared to healthy controls. Further, the measurement of urinary AQP-2 levels is more practical than serum copeptin levels due to lower invasiveness.

Management of the parotid for high-risk cutaneous squamous cell carcinoma: A review from the salivary section of the American Head and Neck Society.

BACKGROUND: Metastases to the parotid nodal basin in patients with high-risk cutaneous squamous cell carcinoma (HRcSCC) impact disease specific survival (DSS) and overall survival (OS). METHODS: A writing group convened by the Salivary Section of the American Head and Neck Society (AHNS) developed contemporary, evidence-based recommendations regarding management of the parotid nodal basin in HRcSCC based on available literature, expert consultation, and collective experience. The statements and recommendations were then submitted and approved by the AHNS Salivary Committee. RESULTS: These recommendations were developed given the wide variation of practitioners who treat HRcSCC in order to streamline management of the parotid nodal basin including indications for imaging, surgery, radiation, and systemic treatment options as well. CONCLUSIONS: This clinical update represents contemporary optimal management of the parotid nodal basin in HRcSCC and is endorsed by the Salivary Section of the AHNS.

Stereotactic radiosurgery for IDH wild type glioblastoma: an international, multicenter study.

OBJECTIVE: Isocitrate dehydrogenase (IDH) mutation status is recommended used for diagnosis and prognostication of glioblastoma patients. We studied efficacy and safety of stereotactic radiosurgery (SRS) for patients with recurrent IDH-wt glioblastoma. METHODS: Consecutive patients treated with SRS for IDH-wt glioblastoma were pooled for this retrospective observational international multi-institutional study from institutions participating in the International Radiosurgery Research Foundation. RESULTS: Sixty patients (median age 61 years) underwent SRS (median dose 15 Gy and median treatment volume: 7.01 cm3) for IDH-wt glioblastoma. All patients had histories of surgery and chemotherapy with temozolomide, and 98% underwent fractionated radiation therapy. MGMT status was available for 42 patients, of which half of patients had MGMT mutant glioblastomas. During median post-SRS imaging follow-up of 6 months, 52% of patients experienced tumor progression. Median post-SRS progression free survival was 4 months. SRS prescription dose of > 14 Gy predicted longer progression free survival [HR 0.357 95% (0.164-0.777) p = 0.009]. Fifty-percent of patients died during post-SRS clinical follow-up that ranged from 1 to 33 months. SRS treatment volume of > 5 cc emerged as an independent predictor of shorter post-SRS overall survival [HR 2.802 95% CI (1.219-6.444) p = 0.02]. Adverse radiation events (ARE) suggestive of radiation necrosis were diagnosed in 6/55 (10%) patients and were managed conservatively in the majority of patients. CONCLUSIONS: SRS prescription dose of > 14 Gy is associated with longer progression free survival while tumor volume of > 5 cc is associated with shorter overall survival after SRS for IDH-wt glioblastomas. AREs are rare and are typically managed conservatively.

Stereotactic radiosurgery for glioblastoma considering tumor genetic profiles: an international multicenter study.

OBJECTIVE: Molecular profiles, such as isocitrate dehydrogenase (IDH) mutation and O6-methylguanine-DNA methyltransferase (MGMT) methylation status, have important prognostic roles for glioblastoma patients. The authors studied the efficacy and safety of stereotactic radiosurgery (SRS) for glioblastoma patients with consideration of molecular tumor profiles. METHODS: For this retrospective observational multiinstitutional study, the authors pooled consecutive patients who were treated using SRS for glioblastoma at eight institutions participating in the International Radiosurgery Research Foundation. They evaluated predictors of overall and progression-free survival with consideration of IDH mutation and MGMT methylation status. RESULTS: Ninety-six patients (median age 56 years) underwent SRS (median dose 15 Gy and median treatment volume 5.53 cm3) at 147 tumor sites (range 1 to 7). The majority of patients underwent prior fractionated radiation therapy (92%) and temozolomide chemotherapy (98%). Most patients were treated at recurrence (85%), and boost SRS was used for 12% of patients. The majority of patients harbored IDH wild-type (82%) and MGMT-methylated (62%) tumors. Molecular data were unavailable for 33 patients. Median survival durations after SRS were similar between patients harboring IDH wild-type tumors and those with IDH mutant tumors (9.0 months vs 11 months, respectively), as well as between those with MGMT-methylated tumors and those with MGMT-unmethylated tumors (9.8 vs. 9.0 months, respectively). Prescription dose > 15 Gy (OR 0.367, 95% CI 0.190-0.709, p = 0.003) and treatment volume > 5 cm3 (OR 1.036, 95% CI 1.007-1.065, p = 0.014) predicted overall survival after controlling for age and IDH status. Treatment volume > 5 cm3 (OR 2.215, 95% CI 1.159-4.234, p = 0.02) and absence of gross-total resection (OR 0.403, 95% CI 0.208-0.781, p = 0.007) were associated with inferior local control of SRS-treated lesions in multivariate models. Nine patients experienced adverse radiation events after SRS, and 7 patients developed radiation necrosis at 59 to 395 days after SRS. CONCLUSIONS: Post-SRS survival was similar as a function of IDH mutation and MGMT promoter methylation status, suggesting that molecular profiles of glioblastoma should be considered when selecting candidates for SRS. SRS prescription dose > 15 Gy and treatment volume ≤ 5 cm3 were associated with longer survival, independent of age and IDH status. Prior gross-total resection and smaller treatment volume were associated with superior local control.

Insights into the Genetic Evolution of Duck Hepatitis A Virus in Egypt.

Duck hepatitis virus (DHV) is one of the commercially important diseases of ducklings worldwide. It is an acute and highly infectious disease of ducklings caused by three different serotypes (1-3) of duck hepatitis A virus (DHAV), and serotype 1 is the most common in poultry. To date, little is known about the prevalence and genetic characterisation of DHAV-1 in Egypt. In the current study, isolation and complete genomic analyses of DHAVs circulating in commercial duck farms in different Egyptian governorates were conducted. A total of eighteen samples were collected from six Egyptian governorates of 3-11 days old ducklings (Pekin and Mullard) with a history of nervous signs and high mortality rates. Five out of eighteen (5/18) samples were screened positive for the DHAV-1 based on the VP1 gene. These samples were individually used for virus isolation in embryonated duck embryos (EDE), followed by complete genome sequencing. Phylogenomic analyses showed that DHAV serotype I; genotype I were diversified into four different groups (1-4). Most of the recent circulating Egyptian DHAV strains are clustered within group 4, while isolates characterised within this study were clustered within group 1. Recombination analyses revealed that the emergence of a new recombinant virus-DHAV-1 strain Egypt-10/2019-through recombination. Likewise, the selective pressure analyses showed the existence, inside or near areas of the viral attachment or related functions, of positive scores highlighting the importance of natural selection and viral evolution mechanism at different protein domains. The findings of this study provide updated information on the epidemiological and genetic features of DHAV-1 strains and underscore the importance of DHAV surveillance as well as re-evaluation for currently used vaccines.

Dose homogeneity analysis of adjuvant radiation treatment in surgically resected brain metastases: Comparison of IORT, SRS, and IMRT indices.

PURPOSE: Although surgery remains a treatment option for symptomatic brain metastases, the need for adjuvant radiation after surgery is widely accepted as standard. Despite a multitude of randomized trials aimed at identifying the ideal radiation treatment plan for surgically resected metastases, the development of new delivery regiments necessitates a periodic re-evaluation of dosimetric performance/outcome. Here, we compare the homogeneity index (HI) across three platforms: single-session stereotactic radiosurgery (SRS), multisession stereotactic radiotherapy, and intraoperative radiotherapy (IORT). METHODS AND MATERIALS: Patients treated with IORT after surgical resection of brain metastases were identified and dosimetric parameters collected from the dose-volume histograms based on the development of conformal plans for adjuvant radiation using Gamma Knife-SRS (GK-SRS), linear accelerator based intensity-modulated radiation therapy, and IORT. HIs were calculated using four established methods and compared across platforms within the patient cohort. Statistical analyses were performed using analysis of variance. RESULTS: The mean maximal doses for the GK-SRS and IMRT plans were 30 Gy and 29 Gy with margin prescription doses of 16 Gy and 24 Gy, respectively. The IORT dose was 30 Gy to the applicator surface. HIs varied based on calculation methods, but maintained consistency when comparing across platforms with IORT having the lower mean HI value (0.56; 95% confidence interval (CI) 0.55-0.60) in single-fraction treatment, compared with GK-SRS (0.77; 95% CI 0.76-0.80). The mean multisession IMRT HI was lower than both single-fraction treatment modalities at 0.41 (95% CI 0.40-0.42). CONCLUSIONS: When using the HI as the primary dosimetric parameter for adjuvant radiation plans after surgical resection of brain metastases IORT offers improved dose homogeneity compared with GK-SRS in single-fraction treatment, whereas fractionated LINAC-based IMRT was superior with respect to the HI in comparison among all three methods.

Intrinsically Porous Molecular Materials (IPMs) for Natural Gas and Benzene Derivatives Separations.

ConspectusSeparating and purifying chemicals without heat would go a long way toward reducing the overall energy consumption and the harmful environmental footprint of the process. Molecular separation processes are critical for the production of raw materials, commodity chemicals, and specialty fuels. Over 50% of the energy used in the production of these materials is spent on separation and purification processes, which primarily includes vacuum and cryogenic distillations. Chemical manufacturers are now investigating modest thermal approaches, such as membranes and adsorbent materials, as they are more cognizant than ever of the need to save energy and prevent pollution. Porous materials, such as zeolites, metal-organic frameworks (MOFs), and covalent organic frameworks (COFs), have dominated the field of industrial separations as their high surface areas and robust pores make them ideal candidates for molecular separations of gases and hydrocarbons. Separation processes involving porous materials can save 70%-90% of energy costs compared to that of thermally driven distillations. However, most porous materials have low thermal, chemical, and moisture stability, in addition to limited solution processability, which tremendously constrain their broad industrial translation. Intrinsically porous molecular materials (IPMs) are a subclass of porous molecular materials that are comprised of molecular host macrocycles or cages that absorb guests in or around their intrinsic cavity. IPMs range from discrete porous molecules to assemblies with amorphous or highly crystalline structures that are held together by weak supramolecular interactions. Compared to the coordination or dynamic covalent bond-constructed porous frameworks, IPMs possess high thermal, chemical, and moisture stability and maintain their porosity under critical conditions. Moreover, the intrinsic porosity endows IPMs with excellent host-guest properties in solid, liquid (organic or aqueous), and gas states, which can be further utilized to construct diverse separation strategies, such as solid-gas adsorption, solid-liquid absorption, and liquid-liquid extraction. The diversity of host-guest interactions in the engineered IPMs affords a plethora of possibilities for the development of the ideal "molecular sieves". Herein, we present a different take on the applicability of intrinsically porous materials such as cyclodextrin (CD), cucurbiturils (CB), pillararene (P), trianglamines (T), and porous organic cages (POCs) that showed an impressive performance in gas purification and benzene derivatives separation. IPMs can be easily scaled up and are quite stable and solution processable that consequently facilitates a favorable technological transformation from the traditional energy-intensive separations. We will account for the main advances in molecular host-guest chemistry to design "on-demand" separation processes and also outline future challenges and opportunities for this promising technology.

Molecularly-porous ultrathin membranes for highly selective organic solvent nanofiltration.

Engineering membranes for molecular separation in organic solvents is still a big challenge. When the selectivity increases, the permeability tends to drastically decrease, increasing the energy demands for the separation process. Ideally, organic solvent nanofiltration membranes should be thin to enhance the permeant transport, have a well-tailored nanoporosity and high stability in harsh solvents. Here, we introduce a trianglamine macrocycle as a molecular building block for cross-linked membranes, prepared by facile interfacial polymerization, for high-performance selective separations. The membranes were prepared via a two-in-one strategy, enabled by the amine macrocycle, by simultaneously reducing the thickness of the thin-film layers (<10 nm) and introducing permanent intrinsic porosity within the membrane (6.3 Å). This translates into a superior separation performance for nanofiltration operation, both in polar and apolar solvents. The hyper-cross-linked network significantly improved the stability in various organic solvents, while the amine host macrocycle provided specific size and charge molecular recognition for selective guest molecules separation. By employing easily customized molecular hosts in ultrathin membranes, we can significantly tailor the selectivity on-demand without compromising the overall permeability of the system.