Fabrication of PTFE + TiO2/Ag coatings on 316L/polydopamine with advanced mechanical, bio-corrosion, and antibacterial properties for stainless steel Catheters.

This study explores the corrosion resistance and antibacterial properties of a PTFE + TiO2/Ag coating applied to 316 L stainless steel. To enhance adhesion, a polydopamine interlayer was chemically deposited onto the steel surface. The PTFE + TiO2 coating was subsequently applied through immersion, followed by the deposition of silver nanoparticles using a chemical method. Optimization of the polydopamine interlayer involved varying temperature, time, stirring speed, and drying parameters. The optimal conditions for the polydopamine interlayer were determined to be 60 °C for 1 h, 300 rpm stirring, and 24-h drying in a freeze dryer. Analytical results demonstrated that both the PTFE + TiO2 and PTFE/PTFE + TiO2/Ag coatings exhibited exceptional corrosion resistance, with corrosion currents of 3.3 × 10-5 and 3.2 × 10-4 µA/cm2, respectively. Antibacterial assessments showcased the remarkable ability of the PTFE/PTFE + TiO2/Ag coating, containing 5% silver content, to effectively inhibit bacterial penetration within a 6.5 mm radius. Furthermore, this coating displayed a water contact angle of 143°, classifying it as a hydrophobic coating. The photocatalytic efficiency (Rs) was determined to be 3.18 × 10-3 A/W, a performance level comparable to that of a standard UV sensor. These findings underscore the substantial enhancements in corrosion resistance, antibacterial performance, and hydrophobic characteristics achieved with the PTFE + TiO2/Ag coating, particularly through the novel optimization of the polydopamine interlayer. This coating exhibits great promise for multifunctional protective applications in diverse fields, particularly demonstrating its suitability for implants and bio-coatings.

Investigating the effect of parasites (toxoplasma gondii RH strain, Leishmania major (MRHO/IR/75/ER), and hydatid cyst) antigens on Alzheimer's disease: An in vivo evaluation.

This study aimed to investigate the effects of parasite antigens on Alzheimer's symptoms in animal model. Alzheimer's model was induced in Wistar rats using Amyloid-beta peptide, and treated with parasite crude antigens from T. gondii RH strain, L. major (MRHO/IR/75/ER), and HC. Spectrophotometry and real-time PCR were used to evaluate the oxidative stress levels, antioxidant enzyme activity, and gene expression of NLRP3, IL-8, IL-1ß, and Caspase-1. Histological assays were performed to investigate structural changes in the hippocampus. Apoptosis was analyzed using an Annexin V Apoptosis by Flow cytometer. The levels of total oxidant, antioxidant, and SOD increased in the Alzheimer's group compared with the control group, but these factors were lower in the L. major group. The apoptosis in the treated groups was lower compared to the Alzheimer's group. IL-8 expression was significantly higher in all Alzheimer's groups, but decreased in the HC and L. major treated group compared to Alzheimer's. IL-1ß and Caspase-1 expression were similarly increased in all groups compared with the control group, but decreased in the antigen-treated groups compared with Alzheimer's. NLRP3 expression was increased in all groups compared with the control group, with lower expression in HC group, but significantly decreased in L. major group compared with Alzheimer's. In histological results, only L. major group could play a therapeutic role in pathological damage of the hippocampus. The results showed that parasite antigens, specifically L. major antigens, may have neuroprotective effects that reduce oxidative stress, apoptosis, and histopathological changes in response to AD in animal model.

Partial nephrectomy in multiple mixed epithelial and stromal tumors (MEST).

Mixed epithelial and stromal tumor (MEST) of the kidney is not a common diagnosis. This tumor usually mimics solid-cystic malignant renal tumors and most cases are treated surgically. Here, we presented a 35-year-old female with simultaneous two separate large solid-cystic masses with contrast enhancement in lower and upper pole of left kidney which were managed surgically via partial nephrectomy. Microscopic evaluation showed solid-cystic tumor with variably sized cysts lined by flattened to cuboidal epithelium that was compatible with MEST. Follow up evaluation revealed normal parenchymal renal tissue and proper function without any evidence of local recurrence.

Long-term follow-up of intravesical abobotulinumtoxinA (Dysport®) injections in women with idiopathic detrusor overactivity.

Objective: Only a few numbers of studies have been published on the use of abobotulinumtoxinA (Dysport®) in idiopathic detrusor overactivity (IDO). This study reported the long-term follow-up of women with IDO who were treated with intravesical Dysport® injections. Methods: Two hundred and thirty-six patients with IDO who had failed first-line conservative and antimuscarinic therapy received 500-900 units of Dysport® between April 2014 and July 2015. All patients were followed up for 5 years after their initial injection and interviewed on the phone. Results: A total of 236 women with IDO aged from 18 years to 84 years (mean±standard deviation: 49.6±15.9 years) were included in our study. The median follow-up time for patients was 36.5 (range: 10-70) months, and the median recovery time after injection was 18.5 (range: 0-70) months. A total of 83 (35.2%) patients stated that they had subjective improvement of their symptoms whereas 84 (35.6%) patients did not report any improvement in symptoms. The initial International Consultation on Incontinence Questionnaire Overactive Bladder mean score was 6.9 (standard deviation 3.4). There was a positive association between the median recovery time and the components of the International Consultation on Incontinence Questionnaire Overactive Bladder questionnaire. Conclusion: In a sub-population of overactive bladder patients with IDO who have failed first-line therapy, a single intravesical Dysport® injection can resolve patient symptoms completely or reduce the symptoms to an acceptable level that can be controlled with antimuscarinics or re-injection on demands.

Amplifying pathological detection in EEG signaling pathways through cross-dataset transfer learning.

Pathology diagnosis based on EEG signals and decoding brain activity holds immense importance in understanding neurological disorders. With the advancement of artificial intelligence methods and machine learning techniques, the potential for accurate data-driven diagnoses and effective treatments has grown significantly. However, applying machine learning algorithms to real-world datasets presents diverse challenges at multiple levels. The scarcity of labeled data, especially in low regime scenarios with limited availability of real patient cohorts due to high costs of recruitment, underscores the vital deployment of scaling and transfer learning techniques. In this study, we explore a real-world pathology classification task to highlight the effectiveness of data and model scaling and cross-dataset knowledge transfer. As such, we observe varying performance improvements through data scaling, indicating the need for careful evaluation and labeling. Additionally, we identify the challenges of possible negative transfer and emphasize the significance of some key components to overcome distribution shifts and potential spurious correlations and achieve positive transfer. We see improvement in the performance of the target model on the target (NMT) datasets by using the knowledge from the source dataset (TUAB) when a low amount of labeled data was available. Our findings demonstrated that a small and generic model (e.g. ShallowNet) performs well on a single dataset, however, a larger model (e.g. TCN) performs better in transfer learning when leveraging a larger and more diverse dataset.

Quality of in-hospital care in traumatic spinal column and cord injuries (TSC/SCI) in I.R Iran.

PURPOSE: This study aimed to implement the Quality of Care (QoC) Assessment Tool from the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to map the current state of in-hospital QoC of individuals with Traumatic Spinal Column and Cord Injuries (TSCCI). METHODS: The QoC Assessment Tool, developed from a scoping review of the literature, was implemented in NSCIR-IR. We collected the required data from two primary sources. Questions regarding health system structures and care processes were completed by the registrar nurse reviewing the hospital records. Questions regarding patient outcomes were gathered through patient interviews. RESULTS: We registered 2812 patients with TSCCI over six years from eight referral hospitals in NSCIR-IR. The median length of stay in the general hospital and intensive care unit was four and five days, respectively. During hospitalization 4.2% of patients developed pressure ulcers, 83.5% of patients reported satisfactory pain control and none had symptomatic urinary tract infections. 100%, 80%, and 90% of SCI registration centers had 24/7 access to CT scans, MRI scans, and operating rooms, respectively. Only 18.8% of patients who needed surgery underwent a surgical operation in the first 24 h after admission. In-hospital mortality rate for patients with SCI was 19.3%. CONCLUSION: Our study showed that the current in-hospital care of our patients with TSCCI is acceptable in terms of pain control, structure and length of stay and poor regarding in-hospital mortality rate and timeliness. We must continue to work on lowering rates of pressure sores, as well as delays in decompression surgery and fatalities.

Development of PDMS/TiO2/Ag3PO4 antibacterial coating on 316L/PDMS implants: Evaluation of superhydrophobicity, bio-corrosion, mechanical behaviour, surface nanostructure and chemistry.

Nanocomposite coatings based on polydimethylsiloxane were developed by adding silver phosphate and titania nanoparticles with a PDMS pre-layer for 316L stainless steel. FTIR spectra and XRD patterns confirmed the synthesis of TiO2 and Ag3PO4 nanoparticles and nanocomposite coating. FESM and AFM images show that with the increase of Ag3PO4 nanoparticles, the roughness of coatings increased (Ra and Rq for adding 7 wt% of Ag3PO4 coating was 29 and 293 nm). The wettability results demonstrated that the presence of 7 wt% Ag3PO4 nanoparticles in the coating has the highest water contact angle (152 °). Nano-scratch results proved that creating a pre-layer of PDMS can increase the scratch resistance of PDMS + TiO2+Ag3PO4 nanocomposite coating (displacement and scratch coefficient were 408 nm and 0.07µΝ-1/2 with the pre-layer). Corrosion current density of 316lSS with PDMS + TiO2+Ag3PO4 coating was 0.00045 µA/cm2, while for 316LSS with pure PDMS coating was 0.00114 µA/cm2 at 37 °C in PBS solution. The Nyquist curves showed the diameter of the semicircle for the nanocomposite coating was larger than pure PDMS coating, which indicates the higher corrosion resistance of the nanocomposite coating (5.98 × 107 Ω). By increasing Ag3PO4 nanoparticles from 1 to 7 wt%, the number of E. coli bacteria in contact with the nanocomposite decreased significantly from 580000 to 31000 CFU/cm2. In the disk diffusion test, the largest inhibition zone was related to the nanocomposite coating with the addition of 7 wt% Ag3PO4 (23 mm). Therefore, the PDMS + TiO2+Ag3PO4 nanocomposite coating has improved properties such as superhydrophobicity, advanced mechanical behavior, bio-corrosion resistance, and antibacterial activity.

Trust in higher guidance and suicidality in Afghan students under the Taliban regime

Background/Objective: After years of war, political instability and natural catastrophes high rates of PTSD and depression have been found in the Afghan population. On this background, it was investigated whether religious beliefs (trust in higher guidance; TIHG) moderated the association between PTSD symptoms and/or depression and suicidal ideation. Method: A total of 279 Afghan university students (61.6% women; aged 18 to 30 years) took part in this cross-sectional study between July and November 2022. Self-report measures of PTSD, depression, suicidal ideation, trust in higher guidance were used. Results: Severe PTSD symptoms were reported by 58.4%, clinically relevant depression symptoms were reported by 55.2% and current suicidal ideation was reported by 44.4% of the sample. TIHG moderated the impact of PTSD symptoms, on suicidal ideation. TIHG and depression were unrelated. Conclusion: PTSD symptoms, depression and suicidal ideation show an alarmingly high prevalence in this specific sample of Afghan students. TIHG seems to be a resilience factor of special importance. (AU)

Comparison of different urinary diversions after radical cystectomy in Iran: Assessment of health-related quality of life and financial burden in a Middle Eastern country.

OBJECTIVES: To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran. PATIENTS AND METHODS: In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly. RESULTS AND LIMITATIONS: In total 187 patients were identified-orthotopic neobladder (ONB) (N = 75), ileal conduit (IC) (N = 57), and cutaneous ureterostomy (CU) (N = 55)-and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning (p = 0.003, 0.011, 0.045) as well as better body image (p < 0.001), lower short- and long-term financial burden (p = 0.034 and <0.001, respectively), marginally lower complication rate (p = 0.049), and better 5-year overall survival (p < 0.001), in comparison with other UDs. Patients who underwent CU had the lowest HRQOL and worst survival. Limitations were retrospective design and possibility of selection bias. CONCLUSIONS: In this first study that assesses a Middle Eastern collective; ONB seems to be the UD of choice with regard to HRQOL and economic burden when there is no contraindication.

Post-discharge follow-up of patients with spine trauma in the National Spinal Cord Injury Registry of Iran during the COVID-19 pandemic: Challenges and lessons learned.

PURPOSE: The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients. METHODS: An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into three groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage. RESULTS: Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% to 100%, 22%-100% and 29%-100% for groups 1 - 3. CONCLUSIONS: To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.

Intravesical Injection of Abobotulinumtoxin-A in Patients with Bladder Pain Syndrome/Interstitial Cystitis.

OBJECTIVE: This study aimed to evaluate retrospectively the outcomes of Abobotulinumtoxin-A (Dysport®) intravesical injection in refractory interstitial cystitis/ bladder pain syndrome patients to first- and second-line treatment. MATERIALS AND METHODS: From March 2016 to 2021, 44 adult patients with bladder pain syndrome who were refractory to first- and second-line treatment were enrolled in our study. The Bladder Pain/Interstitial Cystitis Symptom Score questionnaire was filled out for every patient before and 1-3 months after intervention in addition to urodynamic evaluation. Patient satisfaction was evaluated using a scoring system that was defined as high or >80% improvement (highly satisfied), intermediate 40%-79% (intermediate satisfaction), and poor 0%-39% improvement. RESULTS: The mean age of our study population was 57 years, including 41 females and 3 males. The mean follow-up time was 9 months. According to the results of urodynamics, 68% of cases had low capacity, and detrusor overactivity, while 18% had only low capacity. In terms of the endpoint outcome, half of the patients (52%) had intermediate satisfaction, whereas 41% reported a good response. Only 3 cases had no response or felt (7%) any improvement after the intervention (poor response). The paired t-test analysis revealed that the mean Bladder Pain/Interstitial Cystitis Symptom Score was reduced after injection (P = .001). CONCLUSION: Our results showed the efficacy and safety of intravesical injections with Abobotulinumtoxin-A (Dysport®) in patients with interstitial cystitis/bladder pain syndrome. Further randomized controlled trials are recommended to investigate its superiority over placebo considering the need for anesthesia, the occurrence of local complications, risks of urinary retention, and a large post-void residual (PVR) volume.

Host oxidative stress in piroplasmosis: A review in domestic animals.

Piroplasmida is an order of economically important blood parasites, including Babesia, Theileria, and Cytauxzoon, transmitted to mammals by ticks. Oxidative stress is a state in which the balance between oxidants and antioxidants is disturbed so that antioxidants cannot compensate for the harmful effects of oxidants. Due to the high concentration of oxygen and hemoglobin in red blood cells (RBCs), these are among the first cells exposed to oxidative damage. When RBCs are exposed to oxidative stress, their hemoglobin is oxidized, and lipid peroxidation leads to membrane instability, deformation, hemolysis, and anemia. Oxidative stress has a fundamental role in the pathogenesis of these parasites. In the present review article, we collected studies on the oxidative stress caused by Piroplasmida in domestic animals. What is obtained from the total review of studies conducted on piroplasmosis revealed that in these infections, the host faces oxidative stress, and the resultant oxidative injury plays a fundamental role in their pathogenicity. Further studies are needed to be carried out on the more precise role of oxidative stress, the use of more sensitive diagnostic biomarkers, and the possible therapeutic role of antioxidant agents in piroplasmosis.

Nutritional vitamin D supplementation in chronic hemodialysis: An uncontrolled open-label trial.

The present study was evaluated by the incidence of vitamin D deficiency and management of hemodialysis (HD) patients with low doses of vitamin D over 6 months. This uncontrolled open-label trial was fulfilled in descriptive and then analytical phases from 2008 to 2010 recruiting chronic HD patients in our province. For this purpose, 169 patients undergoing regular HD were randomly selected and their vitamin D level was measured. Then, 54 patients with vitamin D levels less than 30 ng/mL entered the second phase. This group received 50,000 IU vitamin D3 monthly for 6 months. The mean vitamin D level in 169 patients was 21.73 ± 20.27 ng/mL. As well, 62.7% had vitamin D levels less than 30 ng/mL. Following the six-month intervention, mean vitamin D levels elevated significantly from 17.03 ± 7.4 to 42.8 ± 16.9 ng/mL (P < .0001). In this study, the incidence rate of vitamin D deficiency was 62.7%, lower than that in previous research in patients undergoing chronic HD. Vitamin D3 administration at lower doses than healthy people could significantly increase vitamin D level.

Validation and psychometric properties of the Persian version of the MISSCARE survey.

AIM: To conduct, translate, and psychometric evaluation of the MISSCARE-Persian Survey. DESIGN: A cross-sectional study was conducted in Iran in February-June 2021. METHODS: The translation of the MISSCARE Survey was accomplished according to World Health Organization (WHO) guidelines. Construct validity was performed by (N = 300) exploratory factor analysis and confirmation. To assess the reliability, internal consistency was assessed using Cronbach's alpha coefficient, and relative stability was assessed using the interclass correlation coefficient (ICC). The study adhered to COSMIN guidelines. RESULTS: The exploratory factor analysis, which resulted in the identification of three factors in the second part of the tool, explained 79.6% of the total variance. Confirmatory factor analysis indicated the model's good fit of information. The reliability of the first and second parts of the tool was 0.912 and 0.901, respectively. Additionally, the ICC was found to be 0.687 for the first and 0.706 for the second part of the tool.

Local immunotherapy of glioblastoma: A comprehensive review of the concept.

Despite advancements in standard treatments, the prognosis of Glioblastoma (GBM) remains poor, prompting research for novel therapies. Immunotherapy is a promising treatment option for GBM, and many immunotherapeutic agents are currently under investigation. Chimeric antigen receptor (CAR) T cells are rapidly evolving in immunotherapy of GBM with many clinical trials showing efficacy of CAR T cells exerting anti-tumor activity following recognition of tumor-associated antigens (TAAs). Exhaustion in CAR T cells can reduce their capacity for long-term persistence and anti-tumor action. Local immunotherapy, which targets the tumor microenvironment and creates a more hospitable immunological environment for CAR T cells, has the potential to reduce CAR T cell exhaustion and increase immunity. Tertiary lymphoid structures (TLS) are ectopic lymphoid-like formations that can develop within the tumor microenvironment or in other non-lymphoid tissues. As a comprehensive local immunotherapy tool, the incorporation of TLS into an implanted biodegradable scaffold has amazing immunotherapeutic potential. The immune response to GBM can be improved even further by strategically inserting a stimulator of interferon genes (STING) agonist into the scaffold. Additionally, the scaffold's addition of glioma stem cells (GSC), which immunotherapeutic approaches may use to target, enhances the removal of cancer cells from their source. Furthermore, it has been demonstrated that GSCs have an impact on TLS formation, which helps to create a favorable tumor microenvironment. Herein, we overview local delivery of a highly specific tandem AND-gate CAR T cell along with above mentioned components. A multifaceted approach that successfully engages the immune system to mount an efficient targeted immune response against GBM is provided by the integration of CAR T cells, TLS, STING agonists, and GSCs within an implantable biodegradable scaffold. This approach offers a promising therapeutic approach for patients with GBM.

Trust in higher guidance and suicidality in Afghan students under the Taliban regime{fr}(Confianza en la orientación superior y suicidalidad en estudiantes afganos bajo el régimen Talibán).

Background/Objective: After years of war, political instability and natural catastrophes high rates of PTSD and depression have been found in the Afghan population. On this background, it was investigated whether religious beliefs (trust in higher guidance; TIHG) moderated the association between PTSD symptoms and/or depression and suicidal ideation. Method: A total of 279 Afghan university students (61.6% women; aged 18 to 30 years) took part in this cross-sectional study between July and November 2022. Self-report measures of PTSD, depression, suicidal ideation, trust in higher guidance were used. Results: Severe PTSD symptoms were reported by 58.4%, clinically relevant depression symptoms were reported by 55.2% and current suicidal ideation was reported by 44.4% of the sample. TIHG moderated the impact of PTSD symptoms, on suicidal ideation. TIHG and depression were unrelated. Conclusion: PTSD symptoms, depression and suicidal ideation show an alarmingly high prevalence in this specific sample of Afghan students. TIHG seems to be a resilience factor of special importance.

Reaction Mechanisms of Chlorine Dioxide with Phenolic Compounds─Influence of Different Substituents on Stoichiometric Ratios and Intrinsic Formation of Free Available Chlorine.

Chlorine dioxide (ClO2) is an oxidant applied in water treatment processes that is very effective for disinfection and abatement of inorganic and organic pollutants. Thereby phenol is the most important reaction partner of ClO2 in reactions of natural organic matter (NOM) and in pollutant degradation. It was previously reported that with specific reaction partners (e.g., phenol), free available chlorine (FAC) could form as another byproduct next to chlorite (ClO2-). This study investigates the impact of different functional groups attached to the aromatic ring of phenol on the formation of inorganic byproducts (i.e., FAC, ClO2-, chloride, and chlorate) and the overall reaction mechanism. The majority of the investigated compounds reacted with a 2:1 stoichiometry and formed 50% ClO2- and 50% FAC, regardless of the position and kind of the groups attached to the aromatic ring. The only functional groups strongly influencing the FAC formation in the ClO2 reaction with phenols were hydroxyl- and amino-substituents in ortho- and para-positions, causing 100% ClO2- and 0% FAC formation. Additionally, this class of compounds showed a pH-dependent stoichiometric ratio due to pH-dependent autoxidation. Overall, FAC is an important secondary oxidant in ClO2 based treatment processes. Synergetic effects in pollutant control and disinfection might be observable; however, the formation of halogenated byproducts needs to be considered as well.

Differences in the Urinary Microbiome of Patients with Overactive Bladder Syndrome with and without Detrusor Overactivity on Urodynamic Measurements.

INTRODUCTION: It has been hypothesized that the urinary microbiome might play an important role in OAB. Studies have been conducted on the association between OAB symptoms and the microbiome, although a possible causality still has to be determined. MATERIAL AND METHODS: In this study, 12 female patients, ≥18 years of age, with 'OAB DO+' and 9 female patients with 'OAB DO-' were included. Patients were excluded if they met one of the following exclusion criteria: bladder tumors and previous bladder operations; sacral neuromodulation; injection of Botox in the bladder; and TOT or TVT operations. Urine samples were collected and stored with patient informed consent and with the approval of the Hospital Ethical Review Board (Arnhem-Nijmegen). All OAB patients underwent urodynamics before collecting urine samples, and the diagnosis of detrusor overactivity was confirmed by two individual urologists. In addition, samples from 12 healthy controls who did not undergo urodynamic evaluation were analyzed. The 16S rRNA V1-V2 region amplification and gel electrophoresis were used to determine the microbiota. RESULTS: 12 of the OAB patients had DO shown on their urodynamic studies; the remaining 9 patients had a normoactive detrusor on their urodynamic measurements. Overall, there were no substantial differences among the demographic characteristics of the subjects. The samples were classified as the following: 180 phyla, 180 classes, 179 orders, 178 families, 175 genera, and 138 species. The least commonly observed phyla were Proteobacteria, with an average presence of 10%, followed by Bacteroidetes with 15%, Actinobacteria with 16%, and Firmicutes with 41%. Most of the sequences could be classified according to the genus level for each sample. DISCUSSION: Significant differences were observed in the urinary microbiome of patients with overactive bladder syndrome who have detrusor overactivity on urodynamics compared to OAB patients without detrusor overactivity and matched controls. OAB patients with detrusor overactivity have a significantly less diverse microbiome and show a higher proportion of Lactobacillus, particularly Lactobacillus iners. The results imply that the urinary microbiome could be involved in the pathogenesis of a specific phenotype of OAB. The urinary microbiome could be a new starting point to study the causes and treatments of OAB.

Metasurface-based realization of photonic time crystals.

Photonic time crystals are artificial materials whose electromagnetic properties are uniform in space but periodically vary in time. The synthesis of these materials and experimental observation of their physics remain very challenging because of the stringent requirement for uniform modulation of material properties in volumetric samples. In this work, we extend the concept of photonic time crystals to two-dimensional artificial structures-metasurfaces. We demonstrate that time-varying metasurfaces not only preserve key physical properties of volumetric photonic time crystals despite their simpler topology but also host common momentum bandgaps shared by both surface and free-space electromagnetic waves. On the basis of a microwave metasurface design, we experimentally confirmed the exponential wave amplification inside a momentum bandgap and the possibility to probe bandgap physics by external (free-space) excitations. The proposed metasurface serves as a straightforward material platform for realizing emerging photonic space-time crystals and as a realistic system for the amplification of surface-wave signals in future wireless communications.

The Effect of a Healthcare Services Hotline on Quality of Life and Hospital Readmissions for Patients with Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) is a common debilitating disease marked by frequent exacerbations and hospitalizations, economic burden, and reduced quality of life. This study aimed to determine the effect of a healthcare hotline on quality of life and hospital readmissions within 30 days of discharge for patients with COPD. Sixty patients with COPD who needed home healthcare services were recruited for this quasi-experimental study. A direct hotline was provided to patients and their caregivers in the intervention group to answer their questions about the disease. Data were collected using a demographics checklist, and St. George Respiratory Questionnaire. The number of hospitalizations and mean length of hospital stay in the intervention group within 30 days was significantly lower than the control group (p < 0.05). As for quality of life, only the mean score of symptoms was significantly different between the intervention and control groups (p < 0.05). The results showed the positive effect of a healthcare hotline on reducing readmission rates within 30 days of discharge and its low effect on quality of life of COPD patients.