Interstitial needles versus intracavitary applicators only for locally advanced cervical cancer: results from real-life dosimetric comparisons.

Background and purpose: Image-guided adapted brachytherapy (IGABT) is superior to other radiotherapy techniques in the treatment of locally advanced cervical cancer (LACC). We aimed to investigate the benefit of interstitial needles (IN) for a combined intracavitary/interstitial (IC/IS) approach using IGABT over the intracavitary approach (IC) alone in patients with LACC after concomitant external beam radiotherapy (EBRT) and chemotherapy. Materials and methods: We included consecutive patients with LACC who were treated with IC/IS IGABT after radiochemotherapy (RCT) in our retrospective, observational study. Dosimetric gain and sparing of organs at risk (OAR) were investigated by comparing the IC/IS IGABT plan with a simulated plan without needle use (IC IGABT plan) and the impact of other clinical factors on the benefit of IC/IS IGABT. Results: Ninety-nine patients were analyzed, with a mean EBRT dose of 45.5 ± 1.7 Gy; 97 patients received concurrent chemotherapy. A significant increase in median D90% High Risk Clinical target volume (HR-CTV) was found for IC/IS (82.8 Gy) vs IC (76.2 Gy) (p < 10-4). A significant decrease of the delivered dose for all OAR was found for IC/IS vs IC for median D2cc to the bladder (77.2 Gy), rectum (68 Gy), sigmoid (53.2 Gy), and small bowel (47 Gy) (all p < 10-4). Conclusion: HR-CTV coverage was higher with IC/IS IGABT than with IC IGABT, with lower doses to the OAR in patients managed for LACC after RCT. Interstitial brachytherapy in the management of LACC after radiotherapy provides better coverage of the target volumes, this could contribute to better local control and improved survival of patients.

Construction of a Hair Implantation Needle Using Injection Needles and Assessment of its Efficiency Compared with Other Planting Methods.

INTRODUCTION: Hair transplantation surgery requires the efficient completion of hair follicles and thus appropriate hair implantation needles. The objectives of this study were to evaluate the effectiveness and feasibility of self-made hair implantation needles using injection needles and evaluate the speed of different hair implantation methods. METHODS: Four patients were randomly assigned to four groups. A gem knife pre-punching planting method was used for the patient in Group A, while Group B received immediate implantation after punching with ordinary injection needles, Group C was treated with synchronized punching and planting using hair implanters, and Group D was treated with a self-made hair implantation needle. The speed of the different implantation methods for single and double hair follicles and the differences between the planting of single and double hair follicles were assessed. RESULTS: Group D was found to have the fastest hair planting speed for both single and double hair follicles, followed by Groups C and A, with the slowest speed observed in Group B. Groups A and B were associated with significantly lower speeds of double hair planting than single hair planting, There was no significant difference between Groups C and D. CONCLUSIONS: The self-made hair implantation needle is a novel and efficient tool for synchronized punching and planting. It has a faster planting speed and does not require assistance. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Prediction of prostate cancer aggressiveness using magnetic resonance imaging radiomics: a dual-center study.

PURPOSE: The Gleason score (GS) and positive needles are crucial aggressive indicators of prostate cancer (PCa). This study aimed to investigate the usefulness of magnetic resonance imaging (MRI) radiomics models in predicting GS and positive needles of systematic biopsy in PCa. MATERIAL AND METHODS: A total of 218 patients with pathologically proven PCa were retrospectively recruited from 2 centers. Small-field-of-view high-resolution T2-weighted imaging and post-contrast delayed sequences were selected to extract radiomics features. Then, analysis of variance and recursive feature elimination were applied to remove redundant features. Radiomics models for predicting GS and positive needles were constructed based on MRI and various classifiers, including support vector machine, linear discriminant analysis, logistic regression (LR), and LR using the least absolute shrinkage and selection operator. The models were evaluated with the area under the curve (AUC) of the receiver-operating characteristic. RESULTS: The 11 features were chosen as the primary feature subset for the GS prediction, whereas the 5 features were chosen for positive needle prediction. LR was chosen as classifier to construct the radiomics models. For GS prediction, the AUC of the radiomics models was 0.811, 0.814, and 0.717 in the training, internal validation, and external validation sets, respectively. For positive needle prediction, the AUC was 0.806, 0.811, and 0.791 in the training, internal validation, and external validation sets, respectively. CONCLUSIONS: MRI radiomics models are suitable for predicting GS and positive needles of systematic biopsy in PCa. The models can be used to identify aggressive PCa using a noninvasive, repeatable, and accurate diagnostic method.

Pain perception in 4-6-year-old children following intraoral dental injection with 26 and 31-gauge needles: a randomized controlled trial.

Background: Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles. Methods: Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted. Results: When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001). Conclusion: Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.

Effect of early cannulation with metal needles on arteriovenous fistula patency in patients undergoing hemodialysis.

BACKGROUND: Autogenous arteriovenous fistula (AVF) is the preferred vascular access mode. However, the earliest possible time for AVF puncture and whether premature puncture affects the AVF patency rate remain unclear. METHODS: In this multicenter retrospective cohort study, adult uremic patients who underwent AVF surgery for the first time at Taizhou Hospital or Enze Hospital of Zhejiang Province between September 1, 2018 and August 31, 2021 were enrolled. All patients were followed up for 1 year after puncture, and the status of fistula establishment and puncture, subsequent patency, loss to follow-up, renal transplantation, conversion to peritoneal dialysis, abandonment of the fistula, and death, were recorded. RESULTS: A total of 465 patients with AVFs were included in this study, including 59 (12.7%) patients with fistulas that were cannulated within 30 days. In the early puncture group, the levels of serum creatinine and urea nitrogen were higher, while the levels of hemoglobin and albumin were lower, suggesting that these patients needed urgent dialysis. Furthermore, the rate of non-cuffed catheter use was higher, while the rate of cuffed catheter use was lower, and femoral vein puncture was preferred over internal jugular vein puncture. The mean duration of catheter indwelling was shorter in the early puncture group (19 vs 70 days, p < 0.001). The estimated AVF primary and cumulative functional patency at 12 months was 81.1% versus 82.3% and 98.3% versus 98.7% in the early puncture and control groups, respectively. Kaplan-Meier analysis revealed no significant difference in AVF primary and cumulative functional patency between the two groups. CONCLUSIONS: In patients with an established fistula in urgent need of hemodialysis, to avoid new catheterization, a puncture can be performed within 30 days in those with well-developed blood vessels after adequate ultrasound and clinical evaluation without affecting the patency of the fistula.

Awareness, Perception, and Practice Regarding Needle-Stick Injury and Its Prevention Among Healthcare Workers in a Tertiary Care Hospital in Southern India.

Background Needle stick injuries caused by various sharp and other items like hypodermic needles and intravenous cannulas are important occupational hazards for healthcare workers (HCW). Preventing injuries is the most effective way to protect workers and requires good awareness and perceptions associated with practice on a daily basis. Therefore, we did a descriptive cross-sectional study involving healthcare workers in a tertiary care hospital to find the level of awareness, perception, and practice associated with needle stick injury and its prevention. Methodology A descriptive cross-sectional study was conducted in a tertiary care hospital, in south India. 400 healthcare workers (doctors, nurses, technicians, and housekeeping staff) with more than one year of experience were randomly selected. An anonymous, self-reporting, semi-structured questionnaire was administered. Results are expressed in mean, standard deviation, frequency, and percentages. Results Out of 400 respondents, 89% had good awareness about proper disposal practices. However,44% of the participants had the misbelief that recapping needles was recommended to prevent needle stick injury (NSI), and 30.5% practiced it, with the doctors being the majority. The majority (79.8%) knew that HIV, Hepatitis B & C are blood-borne pathogens that HCWs are most commonly exposed to through needle-stick injury (NSI). However, only 49% knew that Hepatitis B has the highest risk of transmission following a needle prick. 75% were aware of the correct Hepatitis B vaccination doses. Most of the healthcare workers (89.5%) claimed to be aware of the procedure and guidelines to be followed after a needle stick injury and 96% felt that they would report NSI immediately. Awareness regarding Hepatitis C prevention was comparatively poor, with only 47% having knowledge regarding the non-availability of Hepatitis C Vaccination and& 46% about the non-availability of post-exposure prophylaxis for Hepatitis C. Among the healthcare workers, 61% were worried about having needle stick injuries but 56.5% felt that their own personal safety is secondary to patient care. Among the HCWs, 91.3% believed that needle stick injuries can be prevented. Most of the participants (93.5%) ensure that others around them take extra precautions while handling sharp/ needles. The majority, i.e. 88%, utilized a designated container for disposal of sharp items, while only 53% of respondents utilized a needle cutter or shredder. 85% of HCWs had attended specific training programs on the usage of safe devices/sharps in the preceding one-year period and 72.8% had completed the vaccination against Hepatitis B. Conclusion Awareness regarding needle stick injury and its prevention is patchy and not adequate across different sections of healthcare workers. Perceptions regarding needle stick injury and its prevention revealed an overall positive attitude. Practices related to needle stick injury and its prevention seem to be reasonably good except when related to recapping and waiting to dispose of until the completion of the session. Training sessions need to be tailored for specific participant groups and a 'one size fits all' philosophy cannot be followed.

A Survey of Needle Steering Approaches in Minimally Invasive Surgery.

In virtue of a curved insertion path inside tissues, needle steering techniques have revealed the potential with the assistance of medical robots and images. The superiority of this technique has been preliminarily verified with several maneuvers: target realignment, obstacle circumvention, and multi-target access. However, the momentum of needle steering approaches in the past decade leads to an open question-"How to choose an applicable needle steering approach for a specific clinical application?" This survey discusses this question in terms of design choices and clinical considerations, respectively. In view of design choices, this survey proposes a hierarchical taxonomy of current needle steering approaches. Needle steering approaches of different manipulations and designs are classified to systematically review the design choices and their influences on clinical treatments. In view of clinical consideration, this survey discusses the steerability and acceptability of the current needle steering approaches. On this basis, the pros and cons of the current needle steering approaches are weighed and their suitable applications are summarized. At last, this survey concluded with an outlook of the needle steering techniques, including the potential clinical applications and future developments in mechanical design.

Optimization of production conditions, isolation, purification, and characterization of tannase from filamentous fungi.

Tannase-producing filamentous fungi residing alongside tannin-rich ambient in the Northwest Himalayas were isolated at laboratory conditions and further identified by 18S ribosomal RNA gene sequencing. Five most potent tannase producing strains (EI ≥ 2.0), designated Aspergillus fumigatus AN1, Fusarium redolens AN2, Penicillium crustosum AN3, Penicillium restrictum AN4, and Penicillium commune AN5, were characterized. The strain Penicillium crustosum AN3 exhibited a maximum zone dia (25.66 mm ± 0.38). During solid-state fermentation, a maximal amount of tannase was attained with Penicillium crustosum AN3 using pine needles (substrate) by adopting response surface methodology for culture parameter optimization. Gel filtration chromatography yielded 46.48% of the partially purified enzyme with 3.94-fold of tannase purification. We found two subunits in enzyme-117.76 KDa and 88.51 KDa, respectively, in the SDS-PAGE. Furthermore, the characterization of partially purified tannase revealed a maximum enzyme activity of 8.36 U/mL at 30 °C using a substrate concentration (methyl gallate) of 10 mM. To broaden the knowledge of crude enzyme application, dye degradation studies were subjected to extracellular crude tannase from Penicillium crustosum AN3 where the maximum degradation achieved at a low enzyme concentration (5 ppm).

Bioinspired composite packed in blunt needles, integrated microextraction and determination of oxycodone and naloxone in saliva by substrate spray mass spectrometry.

BACKGROUND: Opioids are effective painkillers used for medical purposes. Their prolonged ingestion can provoke some side effects (including overdose or constipation) that are minimized by using opioid antagonists (e.g., naloxone). The rapid determination of opioids and their antagonists in biosamples is essential for an effective medical treatment. The direct combination of sample preparation and mass spectrometry (MS) fits well in this scenario. It can speed up the analysis achieving a good selectivity, which relies on the sample preparation and MS, and sensitivity levels. RESULTS: This article presents a novel substrate-spray mass spectrometry interface based on a polydopamine-cotton (PDA-Cel) composite hosted inside the inner diameter of a 14-gauge blunt needle to determine oxycodone and naloxone in saliva samples. The needle is used as a microextraction device and a substrate for mass spectrometric analysis. The lack of sharpness of the 14-gauge (14G) blunt needles challenges the formation of the electrospray (ESI), and a commercial 10 µL pipette tip is proposed as a simple solution to this shortcoming. Under the optimum parameters, the proposed method was validated, obtaining limits of detection lower than 0.6 µg L-1, linear range up to 200 µg L-1, and linearity better than 0.9915. Relative standard deviation (RSD) and relative recoveries (RR) were studied at three different concentration levels (2, 40, and 200 µg L-1). RSD values were better than 20.7 %, and RR ranged from 90 to 114 %. Finally, a positive sample from a patient under medical treatment was analyzed. SIGNIFICANCE AND NOVELTY: 14G blunt needles have been demonstrated as effective extraction devices due to their low price (<0.15 € per extraction unit), their better safety (avoiding finger pricking), and their higher hosting capacity (up to 8 mg of sorbent). The conductivity of stainless steel permits their use as electrospray emitters, making their direct combination to MS easier. The large variety of fibrous sorbents makes this approach versatile enough to be adapted to other analytical problems.

Exploring the uncommon: Unusual instance of retained fractured needles in a patient of intravenous drugs abuse.

Retained needle fragments commonly serve as sources of recurrent infections with a potential to embolize to the heart and lungs and can lead to life-threatening consequences. Here, we report a case of a 46-year-old male with a history of intravenous drug user and chronic forearm wounds, presenting with sepsis. Several retained needles are identified on CT scan, several days postadmission. This case highlights the importance of timely assessment of infectious sources in patients with history of intravenous drug abuse.

A two-in-one thiosemicarbazide and whole pine needle-based adsorbent for rapid and efficient adsorption of methylene blue dye and mercuric ions.

Herein, we report the synthesis of an oxidized pine needle-thiosemicarbazone Schiff base (OPN-TSC) from whole pine needles (WPN) as a dual-purpose adsorbent to remove a cationic dye, methylene blue (MB), and Hg2+ ions in separate processes. The adsorbent was synthesized by periodate oxidation of WPN followed by a reaction with thiosemicarbazide. The syntheses of OPN and OPN-TSC were confirmed by FTIR, XRD, FESEM, EDS, BET, and surface charge analysis. The emergence of new peaks at 1729 cm-1 (-CHO stretching) and 1639 cm-1 (-COO- stretching) in the FTIR spectrum of OPN confirmed the oxidation of WPN to OPN. FTIR spectrum of OPN-TSC has a peak at 1604 cm-1 (C = N stretching), confirming the functionalization of OPN to OPN-TSC. XRD studies revealed an increase in the crystallinity of OPN and a decrease in the crystallinity of OPN-TSC because of the attachment of thiosemicarbazide to OPN. The values of %removal for MB and Hg2+ ions by OPN-TSC were found to be 87.36% and 98.2% with maximum adsorption capacity of 279.3 mg/g and 196 mg/g for MB and Hg2+ ions, respectively. The adsorption of MB followed pseudo-second-order kinetics with correlation coefficient (R2 of 0.99383) and Freundlich isotherm (R2 = 0.97239), whereas Hg2+ ion removal demonstrated the Elovich (R2 = 0.97076) and Langmuir isotherm (R2 = 0.95110). OPN-TSC is regenerable with significant recyclability up to 10 cycles for both the adsorbates. The studies established OPN-TSC as a low-cost, sustainable, biodegradable, environmentally benign, and promising adsorbent for the removal of hazardous cationic dyes and toxic metal ions from wastewater and industrial effluents, especially the textile effluents.

Optimal insertion site for ultrasound-guided radial artery catheterization utilizing the dynamic needle tip positioning technique: A prospective randomized controlled study.

BACKGROUND: The dynamic needle tip positioning technique represents an advanced version of the short-axis out-of-plane ultrasound-guided approach employed for radial artery catheterization. The study aimed to explore the most effective insertion site capable of expeditiously and accurately executing the procedure in a clinical setting. METHODS: A prospective randomized controlled study encompassed 246 elective surgery patients necessitating invasive arterial monitoring. Participants were randomly assigned to three distinct groups: Site 1 (targeting the radial styloid process), Site 2 (midway between Sites 1 and 3), and Site 3 (distal one-third of the forearm). The dynamic needle tip positioning technique was implemented across all groups. Crucial parameters, such as first-attempt success rate, time to success, overall success rate, total catheterization time, number of attempts, and complications, were meticulously documented and compared. RESULTS: The Site 2 cohort presented a significantly heightened first-attempt success rate compared to Site 1 (97.5% vs 80%, p = 0.003) and Site 3 (97.5% vs 81.25%, p = 0.006). Moreover, Site 2 displayed a reduced time to success in contrast to Site 1 (31.5 vs 38, p = 0.003) and Site 3 (31.5 vs 40, p = 0.006). Total catheterization time was significantly shorter in Site 2 compared to Site 1 (32 vs 42.5, p < 0.001) and Site 3 (32 vs 43.5, p < 0.001). Site 2 necessitated fewer attempts than Site 1 (p = 0.02) and Site 3 (p = 0.03). Male gender and puncture at Site 2 were associated with expedited time to success. Adverse events manifested more frequently in the Site 3 group compared to the Site 1 group (15% vs 3.75%, p = 0.03) and the Site 2 group (15% vs 2.5%, p = 0.01). CONCLUSIONS: The optimal insertion site for ultrasound-guided radial artery catheterization utilizing the dynamic needle tip positioning technique in adult patients is situated midway between the radial styloid process and the distal one-third of the forearm.

Utilizing Cymbopogon Proximus Grass Extract for Green Synthesis of Zinc Oxide Nanorod Needles in Dye Degradation Studies.

This study successfully synthesized zinc oxide nanorod needles (ZnO-NRNs) using an environmentally friendly method employing Cymbopogon Proximus extract. The resulting ZnO-NRNs exhibited exceptional physicochemical and structural properties, confirmed through various characterization techniques, including UV-Vis spectrophotometry, dynamic light scattering (DLS), transmission electron microscopy (TEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDX). The analysis revealed a hexagonal wurtzite structure with high crystallinity, a 3.6 eV band gap, and a notably blue-shifted absorption band. ZnO-NRNs showed impressive photocatalytic activity, degrading Rhodamine B dye by 97% under UV and visible sunlight, highlighting their photostability and reusability. This green synthesis process offers cost effectiveness and environmental sustainability for practical applications.

Ultrasound-assisted extraction of polyphenols from pine needles (Pinus elliottii): Comprehensive insights from RSM optimization, antioxidant activity, UHPLC-Q-Exactive Orbitrap MS/MS analysis and kinetic model.

Extracting polyphenolic bioactive compounds from Pinus elliottii needles, a forestry residue, promises economic and environmental benefits, however, relevant experimental data are lacking. Herein, a comprehensive investigation of the polyphenolic composition of pine needles (PNs) was carried out. Ultrasound-Assisted Extraction (UAE) was applied to extract the polyphenolic compounds of pine needles. The optimal conditions of extracts were determined by Response Surface Methodology (RSM). The maximum total phenolic content (TPC) of 40.37 mg GAE/g PNs was achieved with solid-liquid ratio of 1:20, 60 % ethanol, and 350 W for 25 min at 45 °C. Polyphenolic extracts showed antioxidant activity in scavenging free radicals and reducing power (DPPH, IC50 41.05 µg/mL; FRAP 1.09 mM Fe2+/g PNs; ABTS, IC50 214.07 µg/mL). Furthermore, the second-order kinetic model was also constructed to describe the mechanism of the UAE process, with the extraction activation energy estimated at 12.26 kJ/mol. In addition, 37 compounds in PNs were first identified by UHPLC-Q-Exactive Orbitrap MS/MS, including flavonoids and phenolic acids. The results suggest that Ultrasound-Assisted is an effective method for the extraction of natural polyphenolic compounds from pine needles and this study could serve as a foundation for utilizing phenolics derived from PNs in the food and pharmaceutical industries.

Management of the intraoperative loss of microsurgical needles: A literature review and clinical survey.

Data on the incidence, management, and consequences of retained microsurgical needles in plastic and reconstructive surgery remains sparse. Research suggests that a mobile C-arm x-ray has a low detection rate for needles of size 8-0 or smaller. By means of a literature review, and survey, we aimed to investigate the current practice employed in the event of the intraoperative loss of a microsurgical needle. A literature review was conducted investigating the incidence, current management strategies, and consequences of retained microsurgical needles. This informed the questions included in a survey investigating management strategies employed in the intra-operative loss of a microsurgical needle. Results from the literature review show an overall low detection rate of microsurgical needles on imaging. Of the forty responders who completed the survey, 80% did not use a mobile C-arm x-ray to locate a missing microsurgical needle. Of the 20% that had done so, x-ray had been unsuccessful in locating the needle in all cases. Portable x-ray has a definite role to play in locating needles of size 7-0 or larger. This study suggests that suture needles of size 8-0 or smaller cannot be reliably detected on x-ray. Regarding management of this event, one should consider the risk of harm to the patient if retained, against the risk of searching for the needle. Based on the results of this work as well as existing published data, we advise against obtaining intra-operative x-rays in the event of a lost needle size 8-0 and above. Appropriate documentation should be completed.

Prevalence and stability of blood-injection-injury phobia in childhood-A prospective community study in Norway.

AIM: An individual with a blood-injection-injury (BII) phobia often avoids exposure to triggers, such as blood tests and clinic appointments, leading to potentially serious health complications. This population-based study examined the prevalence, stability and course of BII phobia in children and adolescents. METHODS: The data came from the Trondheim Early Secure Study, conducted from 2007 to 2018. All children born in Trondheim, Norway, in 2003 and 2004 were invited to attend. Clinical interviews were conducted by trained personnel to assess BII phobia in 1042 children (51% female) every 2 years from 4 to 14 years of age. Latent growth curves and logistic regression analyses were used in the data analysis. RESULTS: Just under 20% of the cohort experienced a BII phobia at least once, with no significant sex differences. The prevalence of BII phobias increased from 3% at 4 years of age and peaked at about 8% at 10 years of age, before levelling off. The two-year stability increased as 12-14 years of age approached. CONCLUSION: The prevalence of BII was affected by age, but not sex. Early BII phobias often recede with time, but children may need treatment if they persist from 8 years of age.

High-Efficient Microdroplet Harvesting and Detaching Inspired from Sarracenia Lid Trichome.

Fog harvesting plays a pivotal role in harnessing atmospheric water resources and holds significant promise for alleviating global water scarcity. Nonetheless, enhancing harvesting efficiency remains a persistent challenge, especially concerning the rapid detachment of droplets from surfaces. In this study, we discovered that the trichomes of Sarracenia not only efficiently harvest and transport liquid but also quickly drain harvested liquid. We have elucidated the augmentation mechanism behind effective fog harvesting and drainage within the lid of Sarracenia. The trichomes facing the counterflow can enhance fog harvesting efficiency by 80% through air-flow-assisted spreading of liquid film. The wedge corner generated by the interface between hydrophilic and hydrophobic surfaces, coupled with the reduction of cross-sectional angles, diminishes the adhesive force of liquid droplets, fosters droplet spheroidization, and substantially facilitates droplet detachment. In addition, the quantitative detachment of droplets can be achieved by adjusting the cross-sectional angle and wetting gradient. This integrated structure combining efficient condensation and detachment has diverse applications in cooling towers and seawater desalination.

Device malfunctions with use of EUS-guided fine-needle biopsy devices: Analysis of the MAUDE database.

Background: The safety of endoscopic ultrasound-guided tissue acquisition through fine-needle biopsy devices is well-established in clinical trials. The real-world experience of using these devices is not known. The authors analyzed the postmarketing surveillance data from the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database to answer this question. Methods: The Food and Drug Administration MAUDE database from January 2012 to June 2022 was accessed to evaluate for device malfunctions and patient-related adverse consequences of these malfunctions. Results: There were 344 device-related issues. Most issues were due to detachment or breakage of the device (n = 185 [53.7%]). Seventy-six of the breakages (40.8%) occurred during the procedure, whereas 89 cases (47.8%) occurred while removing the needle from the endoscope. The most common site of tissue biopsy at the time of needle breakage was the pancreas (44 [23.8%]).The common patient-related adverse events were retained foreign body (n = 50 [14.5%]) followed by bleeding (16, 4.6%). Six patients (3.4%) required a second intervention for removal of the retained foreign bodies including surgery in 2 cases. The device breakage damaged the endoscope in 3 cases (1.7%), and there was 1 case of needlestick injury to the nurse. Conclusion: The fine-needle biopsy devices can be associated with needle breakage and bending; these adverse events were not previously reported. Needle breakages can result in a retained foreign body that may require additional procedures including surgery. These real-world findings from the MAUDE database may inform clinical decisions and help improve clinical outcomes.

A sewing needle as a urethral foreign body: A case report and literature review.

Foreign bodies in the urethra can occur by self-insertion, and patients often hide the symptoms due to embarrassment. Foreign bodies act as a focus for infection and abscess formation and result in perforation or fistula when not detected on time. Foreign bodies can display symptoms such as frequent urination, dysuria, hematuria, urethrorrhagia, and obstruction. This case discusses a self-inserted urethral sewing needle that was removed cystoscopically from an adolescent.

Strategy of Coniferous Needle Biorefinery into Value-Added Products to Implement Circular Bioeconomy Concepts in Forestry Side Stream Utilization.

Sustainable development goals require a reduction in the existing heavy reliance on fossil resources. Forestry can be considered a key resource for the bioeconomy, providing timber, energy, chemicals (including fine chemicals), and various other products. Besides the main product, timber, forestry generates significant amounts of different biomass side streams. Considering the unique and highly complex chemical composition of coniferous needle/greenery biomass, biorefinery strategies can be considered as prospective possibilities to address top segments of the bio-based value pyramid, addressing coniferous biomass side streams as a source of diverse chemical substances with applications as the replacement of fossil material-based chemicals, building blocks, food, and feed and applications as fine chemicals. This study reviews biorefinery methods for coniferous tree forestry biomass side streams, exploring the production of value-added products. Additionally, it discusses the potential for developing further biorefinery strategies to obtain products with enhanced value.