Accurately Defining the Incidence and Associations of 90-Day Complications after Urethroplasty: Adverse Impact of Patient Comorbidities, Preoperative Bacteriuria and Prior Urethroplasty.

PURPOSE: The purpose of this study was to determine the incidence of 90-day complications after urethroplasty and identify factors associated with them. MATERIALS AND METHODS: A single-institution, 2-surgeon retrospective review was performed on patients undergoing urethroplasty from August 2003-June 2020. Variables included the incidence, type and Clavien-Dindo grade of complications, patient age, individual comorbidities, comorbidity component of the Charlson Comorbidity Index (CCI), smoking status, obesity (body mass index ≥35 kg/m2), bacteriuria, type of urethroplasty, stricture etiology, length, location, prior endoscopic procedures, previous urethroplasty and preoperative suprapubic catheterization. The primary outcome was the incidence of significant 90-day complications defined as Clavien grade ≥2. Descriptive statistics were used to summarize the results and binary logistic regression was used to examine the factors associated with 90-day complications. RESULTS: Of the 1,611 patients included in the analysis, 90-day complications (Clavien ≥2) occurred in 7.9% (128/1,611) and were wound related (3.5%), urinary tract infection (3.4%), cardiovascular (0.4%), catheter-related (0.2%), hematuria (0.1%) or retention (0.1%). On univariable binary logistic regression stricture location (p=0.04), stricture length (p=0.009), CCI (p <0.0001), prior urethroplasty (p=0.01) and bacteriuria (p=0.002) were associated with complications, while age (p=0.3), etiology (p=0.2), smoking (p=0.2), obesity (p=0.3), failed endoscopic treatment (p=0.8), indwelling suprapubic catheter (p=0.7) and type of urethroplasty (p=0.09) were not. On multivariable analysis, increasing CCI (Odds Ratio 1.31, 95% CI 1.10-1.56; p=0.003), prior urethroplasty (OR 1.86, 95% CI 1.09-3.17; p=0.02) and preoperative bacteriuria (OR 1.67, 95% CI 1.14-2.45; p=0.009) remained associated with 90-day complications. CONCLUSIONS: Patients with increased comorbidities, prior urethroplasty and preoperative bacteriuria are at higher risk for complications after urethroplasty and should be counseled accordingly in a shared decision-making model of care.

Evidence for fungi and gold redox interaction under Earth surface conditions.

Microbial contribution to gold biogeochemical cycling has been proposed. However, studies have focused primarily on the influence of prokaryotes on gold reduction and precipitation through a detoxification-oriented mechanism. Here we show, fungi, a major driver of mineral bioweathering, can initiate gold oxidation under Earth surface conditions, which is of significance for dissolved gold species formation and distribution. Presence of the gold-oxidizing fungus TA_pink1, an isolate of Fusarium oxysporum, suggests fungi have the potential to substantially impact gold biogeochemical cycling. Our data further reveal that indigenous fungal diversity positively correlates with in situ gold concentrations. Hypocreales, the order of the gold-oxidizing fungus, show the highest centrality in the fungal microbiome of the auriferous environment. Therefore, we argue that the redox interaction between fungi and gold is critical and should be considered in gold biogeochemical cycling.

Bacterial communities associated with a mineral weathering profile at a sulphidic mine tailings dump in arid Western Australia.

We investigated bacterial community assemblages and functions down a hill slope contaminated by tailings from a volcanogenic massive sulphide mine in arid Western Australia. Weathering of waste rock, high in S and Fe, had resulted in a varying elemental dispersal down a face of the tailings hill. Bacterial community assemblage, characterised by PCR-DGGE fingerprinting, was significantly associated with electrical conductivity (E.C.) (ρ = 0.664; P < 0.01). Analysis of mobile salts showed that E.C. values were driven by ionic S, Zn, Cl and Al. The bacterial community assemblage was directly characterised across an E.C. gradient using an oligonucleotide microarray (PhyloChip). The dominant taxa at the site were Proteobacteria, Actinobacteria and Firmicutes; however, 37 phyla were detected. The most responsive taxa to variation in E.C. was Acidobacteria (negative correlation). Patterns of heterotrophic processes (BioLog analysis) were also best explained by variation in E.C. (ρ = 0.53; P < 0.01), showing a link between primary mineral weathering by lithotrophic bacteria and abiotic processes, and secondary biogeochemical processes by heterotrophic taxa. These data significantly broaden our knowledge of the bacteria present in metallomorphic ecosystems, establish that mobile phase elements are key drivers of community structure, and that primary biogeochemical cycling is directly influencing other geochemical interactions in the samples.

Enrichment and exposure assessment of As, Cr and Pb of the soils in the vicinity of Stawell, Victoria, Australia.

Stawell Gold Mine in NW Victoria, Australia, mines ores that contain large concentrations of As and significant quantities of the metals Pb and Cr. The aim of this research was to understand the dispersion, enrichment and probable exposure of these potentially hazardous elements around the mine site. Fifty-five surface soil samples were collected near the mine (<15 km) and analysed by ICP-MS/OES following bioavailable and four-acid extractions. Soils near the mine show greater concentrations of As, Cr and Pb than those near a regionally determined background. This is attributed to the combination of a natural geochemical halo around mineralization and anthropogenic dispersion due to mining and urbanization. Total As concentrations were between 16 and 946 mg kg(-1) near the mine in a regional background of 1-16 mg kg(-1). Total Cr concentrations were between 18 and 740 mg kg(-1) near the mine in a regional background of 26-143 mg kg(-1). Total Pb concentrations were between 12 and 430 mg kg(-1) near the mine in a regional background of 9-23 mg kg(-1). Dispersion of contaminant elements from the present ore processing is <500 m. The most enriched soils occur close to the town and are unrelated to present mining practices. The bioavailable As, Cr and Pb, soil ingestion rates and Risk Reference Doses were used to estimate health risks. An average toddler (12 kg) would need to consume at least 1.5 g, and most likely 12 g, of soil per day to show some symptoms of As toxicity. The maximum measured bioavailable As would pose a risk at average ingestion rates of 200 mg per day. Individuals with soil-eating disorders would exceed the safe daily consumption limits for As, and potentially Cr and Pb. Small children are not typically exposed to soil everyday, very few have soil eating disorders, and, therefore, the health risk from the soils around the mine is minimal.