Translational research will fail without surgical leadership: SCOTRRCC a successful surgeon-led Nationwide translational research infrastructure in renal cancer.

BACKGROUND: High quality human biosamples with associated high quality clinical data are essential for successful translational research. Despite this, the traditional approach is for the surgeon to act as a technician in the tissue collection act. Biomarker research presents multiple challenges and the field is littered with failures. Tissue quality, poor clinical information, small sample numbers and lack of validation cohorts are just a few reasons for failure. It is clear that the surgeon involved in tissue acquisition must be fully engaged in the process of biosampling for a specific condition, as this will negate many of the issues for translational research failure due to an inadequate bioresource. APPROACH: In this Matter for Debate paper, the Scottish Collaboration On Translational Research into Renal Cell Cancer (SCOTRRCC) is discussed as an example of a urological surgery lead bioresource which has resulted in a National collection of renal cancer tissue and blood (from over 900 patients to date), negating all of the traditional issues with biobanks because of close enagagement and acknowledgement of urologists and uropathologists from seven centres around Scotland. SCOTRRCC has leveraged renal cancer research in Scotland resulting in several high impact publications and providing a springboard for future research in this disease in Scotland and beyond. CONCLUSIONS: The SCOTRRCC model presented here can be transferred to other surgical disciplines for success in translational research.

Synthesis of high-entropy germanides and investigation of their formation process.

High-entropy alloys and compounds have emerged as an attractive research area in part because of their distinctive solid-solution structure and multi-element compositions that provide near-limitless tailorability. A diverse array of reports describing high-entropy compounds, including carbides, nitrides, sulfides, oxides, fluorides, silicides, and borides, has resulted. Strikingly, exploration of high-entropy germanides (HEGs) has remained relatively limited. In this study, we present a detailed investigation into the synthesis of HEGs, specifically AuAgCuPdPtGe and FeCoNiCrVGe, via a rapid thermal annealing. The structural, compositional, and morphological characteristics of the synthesized HEGs were assessed using laboratory X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM). Complementing these post-synthesis analyses, we interrogated the formation and growth mechanisms using in situ heating XRD and TEM and determined that HEG formation involved initial decomposition of germanane (GeNSs) during the annealing, followed by gradual grain growth via atom diffusion at temperatures below 600 °C, and finally a rapid grain growth process at elevated temperatures.

Not all silicon quantum dots are equal: photostability of silicon quantum dots with and without a thick amorphous shell.

Luminescent colloidal silicon quantum dots (SiQDs) are sustainable alternatives to metal-based QDs for various optical applications. While the materials are reliant on their photoluminescence efficiency, the relationship between the structure and photostability of SiQDs is yet to be well studied. An amorphous silicon (a-Si) shell was recently discovered in SiQDs prepared by thermally-processed silicon oxides. As a-Si is known as a source of defects upon UV irradiation, the disordered shell could potentially have an adverse effect on the optical properties of nanoparticles. Herein, the photostability of ∼5 nm diameter SiQDs with an amorphous shell was compared with that of over-etched SiQDs of equivalent dimensions that bore an a-Si shell of negligible thickness. An UV-induced degradation study was conducted by subjecting toluene solutions of SiQDs to 365 nm light-emitting diodes (LEDs) under an inert atmosphere for predetermined times up to 72 hours. The structure, composition, and optical responses of the exposed SiQDs were evaluated.

Facile synthesis of high-entropy alloy nanoparticles on germanane, Ge nanoparticles and wafers.

The unique solid-solution structure and multi-element compositions of high-entropy alloy nanoparticles (HEA NPs) have garnered substantial attention. Various methods have been developed to prepare a diverse array of HEA NPs using different substrates for support and stabilization. In this study, we present a facile surface-mediated reduction method to prepare HEA NPs (AuAgCuPdPt) decorated germanane (HEA NPs@GeNSs), and employ X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM) to characterize their structure, composition, and morphology. Subsequently, we demonstrate that the HEA NPs can be liberated from the surfaces of GeNSs as freestanding systems via straightforward exposure to UV light. We also explore germanium nanoparticles (GeNPs) as an alternative substrate for HEA NP formation/production, given their similarity to germanane and their Ge-H surface. Finally, we extend our investigation to bulk Ge wafers and demonstrate successful deposition of HEA NPs.

Understanding silicon monoxide gas evolution from mixed silicon and silica powders.

Silicon on silica materials are ubiquitous in 21st century technology. From nanoparticles to integrated circuits, these systems are integral for modern semiconductor fabrication. While the Si-SiO2 interface is often (incorrectly) presumed to be stable, the direct reduction of silica by silicon is possible at high temperatures, resulting in the evolution of silicon monoxide (SiO) gas. Under appropriate conditions, this somewhat unexpected reaction can complicate solid state nanomaterial syntheses by etching away the desired products. This report describes an investigation into the SiO evolution reaction by interrogation of powdered Si-SiO2 mixtures before and after thermal treatment. The impacts of processing temperature, time, and sample composition are examined and discussed. Of particular importance, this investigation reveals the underappreciated role of silica crystallinity (cristobalite) in this solid-state reaction under comparatively low temperature conditions (ca. 1200 °C). With an improved understanding of SiO evolution, we hope to inspire new creative pathways for Si-SiO2 interface manipulation.

"Turning the dials": controlling synthesis, structure, composition, and surface chemistry to tailor silicon nanoparticle properties.

Silicon nanoparticles (SiNPs) can be challenging to prepare with defined size, crystallinity, composition, and surface chemistry. As is the case for any nanomaterial, controlling these parameters is essential if SiNPs are to realize their full potential in areas such as alternative energy generation and storage, sensors, and medical imaging. Numerous teams have explored and established innovative synthesis methods, as well as surface functionalization protocols to control these factors. Furthermore, substantial effort has been expended to understand how the abovementioned parameters influence material properties. In the present review we provide a commentary highlighting the benefits and limitations of available methods for preparing silicon nanoparticles as well as demonstrations of tailoring optical and electronic properties through definition of structure (i.e., crystalline vs. amorphous), composition and surface chemistry. Finally, we highlight potential opportunities for future SiNP studies.

Management of a persistent ileo-ureteric anastomotic leak with bilateral ureteric occlusion using angioplasty balloon catheters.

The ileal conduit continues to be the most common form of urinary diversion performed worldwide. As a result of improved surgical technique the perioperative mortality and morbidity for patients undergoing ileal conduit urinary diversion has reduced remarkably. However, one early complication that may occur is that of urinary leak at the ileo-ureteric anastomosis. Urinary anastomotic leaks may be associated with significant morbidity and mortality. Although a small initial leakage postoperatively is common, the problem arises in cases of continued urinary leakage from the ileo-ureteric anastomosis. We report the management of a persistent ileo-ureteric anastomotic leak using angioplasty balloons catheters to occlude both ureters.

Dual kidney transplantation with organs from extended criteria cadaveric donors.

PURPOSE: The critical shortage of kidneys available for transplantation has led to alternate strategies to expand the pool. Transplantation of the 2 kidneys into a single recipient using organs suboptimal for single kidney transplantation was suggested. We assessed results in 24 grafts allocated for dual kidney transplantation vs those in a control group of 44 designated for single kidney transplantation. Each group underwent pretransplant biopsy and recipients were age matched. MATERIALS AND METHODS: Dual kidney transplantation was done in 24 of 1,091 transplants (2.1%) from 2001 to 2008. In patients with dual kidney transplant vs single kidney transplant mean recipient age was 60.6 vs 60.8 years, mean HLA-A, B and DR mismatches were 3.3 vs 2.9, and average patient waiting time was 15.6 vs 13.9 months. All grafts were perfused with University of Wisconsin solution with a mean cold ischemia time of 17.9 hours. On donor dual kidney biopsy in the dual kidney transplant vs single kidney transplant group the average fibrosis rate was 30% (range 25% to 45%) vs 25% (range 3% to 40%) and the glomerulosclerosis rate was 17.9% (range 3.2% to 40.7%) vs 7.1% (range 0% to 50%). RESULTS: Good postoperative renal function was noted in 14 dual kidney transplantation cases. Acute tubular necrosis requiring dialysis developed in 5 patients as well as acute rejection in 1. Two dual kidney recipients (8%) died in the postoperative period with no single kidney deaths. One patient underwent bilateral transplantectomy. Mean anesthesia time was longer in the dual group (371 vs 212 minutes). Patient and graft survival was equivalent to that in the control group at 36 months. CONCLUSIONS: Careful selection of marginal kidneys based on clinical and histological criteria allows the use of organs that would not ordinarily be sufficient for transplantation with acceptable outcomes. This is a valid strategy to address the organ shortage.

Can we avoid surgery in elderly patients with renal masses by using the Charlson comorbidity index?

OBJECTIVE To determine the safety of surveillance for localized contrast-enhancing renal masses in elderly patients whose comorbidities precluded invasive management; to provide an insight into the natural history of small enhancing renal masses; and to aid the clinician in identifying those patients who are most suitable for a non-interventional approach. PATIENTS AND METHODS We conducted a retrospective chart review of 26 consecutive patients (16 men and 10 women), who were followed for > or =1 year, with localized solid enhancing renal masses between 1998 and 2006. These patients were unfit or unwilling to undergo radical or partial nephrectomy. None had their tumours surgically removed. Study variables included age, presentation, tumour size, growth rate, Charlson comorbidity index (CMI) and available pathological data. RESULTS The mean (range) patient age was 78.14 (63-89) year, with a mean follow-up of 28.1 (12-72) months. The mean tumour size was 4.25 (2.5-8.7) cm at diagnosis. The tumour growth rate was 0.44 cm/year; among smaller masses (T1a) it was 0.15 cm/year, vs 0.64 cm/year in the larger masses (T1b and T2). The mean CMI was 2.96. There were 11 deaths overall; 10 patients died from unrelated illnesses. One death was directly attributable to metastatic renal cancer; this patient had an initial tumour diameter of 5.4 cm and a CMI of 6. All patients who died had a CMI of > or =3. CONCLUSIONS Elderly patients with small renal tumours (T1a) and comorbidity scores of > or =3 were more likely to die as a result of their comorbidities rather than the renal tumour. Surveillance of small renal masses appears to be a safe alternative in elderly patients who are poor surgical candidates, where the overall growth rate appears to be slow.

Novel interventional radiologic technique for removal of urethral foreign body.

Numerous accounts of foreign objects inserted into the urethra have been documented. A minimally invasive approach should be used for removal when possible. We describe a novel interventional radiologic approach that was used for removal of a hairpin located in the bulbar urethra.