Green light laser enucleation of the prostate with early apical release is safe and effective: single center experience and revision of the literature.

BACKGROUND: Green Light laser enucleation of the prostate (GreenLEP) is an endoscopic treatment to treat bladder outlet obstruction in men with large prostate (>100 cc). Herein, we describe our GreenLEP series and describe its safety and efficacy. METHODS: Between February 2014 and April 2019, 120 patients from a single center underwent en-bloc GreenLEP with early apical release. All procedures were performed with the AMS XPS laser generator (set: 120 W for vaporization and 20 W for coagulation). Morcellation was carried out with the Wolf Piranha morcellator. Data concerning the pre-, intra- and postoperative outcomes were prospectively collected. The follow-up data at 6, 12 months and at the last control were collected. RESULTS: The median age was 66.0 (IQR: 61.0-71.0) years; 37.5% of the patients were under antiplatelet/anticoagulant therapy, 15.0% had indwelling catheter history. The median prostate volume and the baseline PSA value were 98.5 mL (IQR 83.0-130.0) and 4.2 ng/mL (IQR: 3.2-6.8), respectively. The median operative and lasing time were 65.0 (IQR: 51.0-83.5) and 6.0 (IQR: 6.0-10.0) minutes, respectively. In the postoperative period 1 patient was transfused. The median follow-up was 18.0 (IQR: 12.0-39.5) months. All patients had significant improvement in terms of improvement of uroflowmetry (median from 9 mL/sec [IQR 7.8, 11.0] to 20.0 [IQR 18.0, 22.0], P<0.001) and symptoms control (IPSS median score from 26.0 mL/sec [IQR 22.0, 28.0] to 7.0 [IQR 6.0, 8.0], P<0.001]) over time. After 12 months 1 patient complained of stress incontinence (1 pad/day) and 1 of "de novo" wet urgency. CONCLUSIONS: En-bloc GreenLEP with early apical release is a safe and effective procedure even for large volume prostates. It allows us to limit the use of laser energy and shorten the operating times with stable and satisfactory long-term outcomes.

OPERA tau neutrino charged current interactions.

The OPERA experiment was designed to discover the vτ appearance in a vµ beam, due to neutrino oscillations. The detector, located in the underground Gran Sasso Laboratory, consisted of a nuclear photographic emulsion/lead target with a mass of about 1.25 kt, complemented by electronic detectors. It was exposed from 2008 to 2012 to the CNGS beam: an almost pure vµ beam with a baseline of 730 km, collecting a total of 1.8·1020 protons on target. The OPERA Collaboration eventually assessed the discovery of vµâ†’vτ oscillations with a statistical significance of 6.1 σ by observing ten vτ CC interaction candidates. These events have been published on the Open Data Portal at CERN. This paper provides a detailed description of the vτ data sample to make it usable by the whole community.

Prevalence and Correlates of Nonprescription Hormone Use Among Trans Women in São Paulo, Brazil.

Purpose: The purpose of this study was to determine the prevalence and correlates of nonprescription hormone use among Brazilian trans women. Methods: This study is a cross-sectional survey of trans women in São Paulo, Brazil, recruited by respondent-driven sampling in 2017-2019. Results: Of 790 trans women, 36.8% were taking nonprescribed hormones. Nonprescribed hormone use was higher with younger age, lower education, homelessness, and using estrogen plus progesterone. Lower use was associated with accessing health care and having trans-specific health needs met. Conclusion: Marginalized Brazilian trans women exhibit high use of nonprescription hormones, which may have health consequences and requires further examination and research.

Final Results of the OPERA Experiment on ν_{τ} Appearance in the CNGS Neutrino Beam.

The OPERA experiment was designed to study ν_{µ}→ν_{τ} oscillations in the appearance mode in the CERN to Gran Sasso Neutrino beam (CNGS). In this Letter, we report the final analysis of the full data sample collected between 2008 and 2012, corresponding to 17.97×10^{19} protons on target. Selection criteria looser than in previous analyses have produced ten ν_{τ} candidate events, thus reducing the statistical uncertainty in the measurement of the oscillation parameters and of ν_{τ} properties. A multivariate approach for event identification has been applied to the candidate events and the discovery of ν_{τ} appearance is confirmed with an improved significance level of 6.1σ. |Δm_{32}^{2}| has been measured, in appearance mode, with an accuracy of 20%. The measurement of the ν_{τ} charged-current cross section, for the first time with a negligible contamination from ν[over ¯]_{τ}, and the first direct evidence for the ν_{τ} lepton number are also reported.

Discovery of τ Neutrino Appearance in the CNGS Neutrino Beam with the OPERA Experiment.

The OPERA experiment was designed to search for ν_{µ}→ν_{τ} oscillations in appearance mode, i.e., by detecting the τ leptons produced in charged current ν_{τ} interactions. The experiment took data from 2008 to 2012 in the CERN Neutrinos to Gran Sasso beam. The observation of the ν_{µ}→ν_{τ} appearance, achieved with four candidate events in a subsample of the data, was previously reported. In this Letter, a fifth ν_{τ} candidate event, found in an enlarged data sample, is described. Together with a further reduction of the expected background, the candidate events detected so far allow us to assess the discovery of ν_{µ}→ν_{τ} oscillations in appearance mode with a significance larger than 5σ.

Interaction of the acid soap of triethanolamine stearate and stearic acid with water.

Stearic acid and triethanolamine (TEA) in a molar ratio of 2:1 were mixed in aqueous solution at 80 degrees C and subsequently cooled to ambient temperature. The structural evolution of the resultant sample during storage was characterized by using light microscopy, Cryo-SEM, differential scanning calorimetery, pH, infrared spectroscopy, elemental analysis, and simultaneous small and wide-angle X-ray diffraction. It was found that a lamellar liquid crystalline phase was formed when stearic acid and TEA solution were mixed at 80 degrees C and multilamellar spheres of a few microns diameter were formed initially after cooling. A hydrolysis reaction (i.e., the reverse reaction of neutralization between stearic acid and TEA) occurred thereafter that caused the breakdown of the lamellar gel phase and the formation of platelet stearic acid crystals. Three polymorphs of stearic acid (defined following previous work as the A, C, and E forms) were formed as the result of hydrolysis reaction, which gave rise to a strong optically pearlescent appearance.

Acid soap and phase behavior of stearic acid and triethanolamine stearate.

Crystals of partially neutralized stearic acid with triethanolamine (TEA) were prepared by mixing these two materials above 80 degrees C and then cooling. The crystalline composition and the structure and melting behavior of the resultant products were characterized with small-angle and wide-angle X-ray diffraction, thermal analysis, microscopy, and infrared spectroscopy. It was discovered that an acid-soap complex of 2:1 fixed stoichiometric ratio exists between stearic acid and TEA stearate. A binary phase diagram of stearic acid and TEA soap is built based on the experimental results; this is the first published record of a binary phase diagram for amine-based soap. Its behavior is significantly different from that of binary systems of fatty acid and alkali soap.

Dynamic experimentation on the confocal laser scanning microscope: application to soft-solid, composite food materials.

Confocal laser scanning microscopy (CLSM) is used to follow the dynamic structural evolution of several phase-separated mixed biopolymer gel composites. Two protein/polysaccharide mixed gel systems were examined: gelatin/maltodextrin and gelatin/agarose. These materials exhibit 'emulsion-like' structures, with included spherical particles of one phase (i.e. polymer A) within a continuous matrix of the second (i.e. polymer B). Compositional control of these materials allows the phase order to be inverted (i.e. polymer B included and polymer A continuous), giving four basic variants for the present composites. Tension and compression mechanical tests were conducted dynamically on the CLSM, with crack/microstructure interactions investigated using a notched compact tension geometry. Gelatin/maltodextrin composites exhibit a 'pseudo-yielding' stress/strain response in both tension and compression, when the gelatin-rich phase is continuous, which was attributed to debonding of the particle/matrix interface. This behaviour is significantly less apparent for both the gelatin/agarose composites, and the maltodextrin continuous gelatin/maltodextrin composites, with these materials responding in a nominally linear elastic manner. Values of the interfacial fracture energy for selected compositions of the two biopolymer systems were determined by 90 degrees peel testing, where a gelatin layer was peeled from either a maltodextrin or agarose substrate. For biopolymer layers 'cast' together, a value of 0.2 +/- 0.2 J m-2 was obtained for the fracture energy of a gelatin/maltodextrin interface, while a significantly higher value of 6.5 +/- 0.2 J m-2 was determined for a gelatin/agarose interface. The interfacial fracture energy of the two mixed systems was also determined following an indirect elastomer composite debonding model. An interfacial fracture energy of approximately 0.25 J m-2 was determined using this approach for the gelatin continuous gelatin/maltodextrin composite, which compares favourably with the value calculated directly by peel testing (i.e. approximately 0.2 J m-2). A somewhat higher value was estimated for the gelatin continuous gelatin/agarose system (1.0-2.0 J m-2), using this model, although there are severe limitations to this approach for this mixed gel system. In the present case, it is believed that the differing mechanical response of the two mixed biopolymer systems, when the gelatin phase is continuous, arises from the order of magnitude difference in interfacial fracture energy. It is postulated that polymer interdiffusion may occur across the interface for the gelatin/agarose system, to a significantly greater extent than for interfaces between gelatin and maltodextrin, resulting in a higher interfacial fracture energy.

Dynamic experimentation on the confocal laser scanning microscope: application to soft-solid, composite food materials.

Confocal laser scanning microscopy (CLSM) is used to follow the dynamic structural evolution of several phase-separated mixed biopolymer gel composites. Two protein/polysaccharide mixed gel systems were examined: gelatin/maltodextrin and gelatin/agarose. These materials exhibit 'emulsion-like' structures, with included spherical particles of one phase (i.e. polymer A) within a continuous matrix of the second (i.e. polymer B). Compositional control of these materials allows the phase order to be inverted (i.e. polymer B included and polymer A continuous), giving four basic variants for the present composites. Tension and compression mechanical tests were conducted dynamically on the CLSM, with crack/microstructure interactions investigated using a notched compact tension geometry. Gelatin/maltodextrin composites exhibit a 'pseudo-yielding' stress/strain response in both tension and compression, when the gelatin-rich phase is continuous, which was attributed to debonding of the particle/matrix interface. This behaviour is significantly less apparent for both the gelatin/agarose composites, and the maltodextrin continuous gelatin/maltodextrin composites, with these materials responding in a nominally linear elastic manner. Values of the interfacial fracture energy for selected compositions of the two biopolymer systems were determined by 90 degrees peel testing, where a gelatin layer was peeled from either a maltodextrin or agarose substrate. For biopolymer layers 'cast' together, a value of 0.2 +/- 0.2 J m-2 was obtained for the fracture energy of a gelatin/maltodextrin interface, while a significantly higher value of 6.5 +/- 0.2 J m-2 was determined for a gelatin/agarose interface. The interfacial fracture energy of the two mixed systems was also determined following an indirect elastomer composite debonding model. An interfacial fracture energy of approximately 0.25 J m-2 was determined using this approach for the gelatin continuous gelatin/maltodextrin composite, which compares favourably with the value calculated directly by peel testing (i.e. approximately 0.2 J m-2). A somewhat higher value was estimated for the gelatin continuous gelatin/agarose system (1.0-2.0 J m-2), using this model, although there are severe limitations to this approach for this mixed gel system. In the present case, it is believed that the differing mechanical response of the two mixed biopolymer systems, when the gelatin phase is continuous, arises from the order of magnitude difference in interfacial fracture energy. It is postulated that polymer interdiffusion may occur across the interface for the gelatin/agarose system, to a significantly greater extent than for interfaces between gelatin and maltodextrin, resulting in a higher interfacial fracture energy.

Inhibitory action of a truncated derivative of the amphibian skin peptide dermaseptin s3 on Saccharomyces cerevisiae.

The inhibitory activity of a truncated derivative of the natural amphibian skin peptide dermaseptin s3-(1-16)-NH2 [DS s3 (1-16)] against Saccharomyces cerevisiae was studied. Significant growth inhibition was observed after exposure to 3.45 microgram of the peptide per ml at pH 6.0 and 7.0, with complete growth inhibition occurring at 8.63 microgram of peptide per ml for all pH values tested. Using confocal scanning laser microscopy, we have shown that DS s3 (1-16) disrupted the yeast cell membrane resulting in the gross permeabilization of the cell to the nuclear stain ethidium bromide. However, the principal inhibitory action of the peptide was not due to disruption of intracellular pH homeostasis. Instead, growth inhibition by the peptide correlated with the efflux of important cellular constituents such as ADP, ATP, RNA, and DNA into the surrounding medium. The combination of DS s3 (1-16) with mild heating temperatures as low as 35 degreesC significantly enhanced the inhibitory effect of the peptide (8.63 microgram/ml), and at 45 degreesC greater than 99% of the population was killed in 10 min. In summary, a derivative of a natural antimicrobial peptide has potential, either alone or in combination with mild heating, to prevent the growth of or kill spoilage yeast.

The epidermal nerve fibre network: characterization of nerve fibres in human skin by confocal microscopy and assessment of racial variations.

As a first line of defence, the skin is equipped with a complex and interactive nerve fibre system to detect irritants and maintain homeostasis. The dermal component of this fibre network has been well characterized and fibres are known to extend throughout the viable epidermis as free nerve endings. To date, this epidermal component remains poorly characterized. We have visualized human volar forearm epidermal nerve fibres by laser-scanning confocal microscopy using the pan-neuronal marker, protein gene-product 9.5 and specific antibodies to substance P. calcitonin gene-related peptide and nerve growth factor. In addition to the varicose free nerve endings, there is a 3-D fibre network in normal human epidermis, with frequent branching of fibres. Branching can be seen to converge on a central trunk apparently extending to the dermis. Thin unmyelinated fibres can be seen in all layers of the viable epidermis. Substance P staining is rarely observed and is much less intense than the protein gene-product 9.5 staining. Calcitonin gene-related peptide and nerve growth factor were not detected in volar forearm epidermis by this method. Pretreatment of the skin in vivo with the neuropharmacological agent, capsaicin, resulted in loss of epidermal fibre staining indicating that these are sensory fibres of the primary C-afferent type. Epidermal innervation in racial and ethnic skin types was also assessed. No apparent difference in innervation was observed between European caucasian and Japanese/Chinese skin at the architectural or biochemical level, i.e. the presence, properties and biochemical content of fibres was similar in all cases tested.

Activity of the plasma membrane H(+)-ATPase is a key physiological determinant of thermotolerance in Saccharomyces cerevisiae.

The role of membrane integrity and the membrane ATPase in the mechanism of thermotolerance in Saccharomyces cerevisiae was investigated. The resistance to lethal heat of a mutant strain with reduced expression of the membrane ATPase was significantly less than that of the wild-type parent. However, prior exposure to sub-lethal temperatures resulted in the induction of similar levels of thermotolerance in the mutant compared to the parent strain, suggesting that the mechanism of sub-lethal heat-induced thermotolerance is independent of ATPase activity. Supporting this, exposure to sub-lethal heat stress did not result in increased levels of glucose-induced acid efflux at lethal temperatures and there was little correlation between levels of acid efflux and levels of heat resistance. ATPase activity in crude membrane preparations from sub-lethally heat-stressed cells was similar to that in preparations from unstressed cells. Study of net acid flux during heating revealed that pre-stressed cells were able to protect the proton gradient for longer. This may confer an 'advantage' to these cells that results in increased thermotolerance. This was supported by the observation that prior exposure to sub-lethal heat resulted in a transient protection against the large increase in membrane permeability that occurs at lethal temperatures. However, no protection against the large drop in intracellular pH was detected. Sub-lethal heat-induced protection of membrane integrity also occurred to the same extent in the reduced-expression membrane ATPase mutant, further implying that the mechanism of induced thermotolerance is independent of ATPase activity. To conclude, although the membrane ATPase is essential for basal heat resistance, thermotolerance induced by prior exposure to stress is largely conferred by a mechanism that is independent of the enzyme.

Application of X-ray microanalysis to cell suspensions of oil palm (Elaeis guineensis Jacq.).

X-ray microanalysis has been used to determine the elemental composition of oil-palm (Elaeis guineesis) cell suspensions without the use of cryoprotectants. Results based on individual cells were gathered over a typical growth cycle of 14 d. During the log phase (5-7 d) there is an increase in the number of cells containing high concentrations of both K (400 mmol kg(-1) dry weight) and P (400 mmol kg(-1) dry weight). Morphologically these cells had thin cell walls and were frequently joined to other cells (two to five cells per clump).