Conventional Radical Research Articles

Predictive factors of immediate continence after conventional robot-assisted radical prostatectomy: a single-institution retrospective study.

To assess the predictive factors of immediate urinary continence after robot-assisted radical prostatectomy. This study included 282 patients who underwent conventional robot-assisted radical prostatectomy at our institution from April 2019 to March 2024. The primary outcome was immediate urinary continence, defined as the absence of urine leakage immediately after urinary catheter removal on postoperative day 6 or 7. In addition, the immediate urine loss rate, defined as the 24-h urine loss volume divided by the total urine volume after catheter removal, was calculated. The multivariable logistic model was used to assess the possible predictive factors of immediate continence (urine loss rate of 0%). The factors included age, body mass index, Charlson Comorbidity Index, pre-existing lower urinary tract symptoms, presence of an inguinal hernia, prostate volume, membranous urethral length, stratified cancer risk, surgeon's experience, and nerve-sparing procedure. In addition, a multiple linear regression model was established to investigate the associations of the same predictors with immediate urine loss rate (%). We also presented our techniques to achieve immediate continence. The patients' median age was 70 (interquartile range: 63.0-73.0) years. Approximately 39% (n = 111) of patients presented with immediate continence. Age, inguinal hernia, membranous urethral length, and low risk for prostate cancer were associated with immediate continence. These were also statistically significant predictors of immediate urine loss rate. Our study identified factors predicting immediate urinary continence after conventional robot-assisted radical prostatectomy. This information is potentially valuable for preoperative counseling in patients undergoing robot-assisted radical prostatectomy.

Nickel-Catalyzed Reductive Alkenylation of Enol Derivatives: A Versatile Tool for Alkene Construction.

ConspectusKetone-to-alkene transformations are essential in organic synthesis, and transition-metal-catalyzed cross-coupling reactions involving enol derivatives have become powerful tools to achieve this goal. While substantial progress has been made in nucleophile-electrophile reactions, recent developments in nickel-catalyzed reductive alkenylation reactions have garnered increasing attention. These methods accommodate a broad range of functional groups such as aldehyde, ketone, amide, alcohol, alkyne, heterocycles, and organotin compounds, providing an efficient strategy to access structurally diverse alkenes. This Account primarily highlights the contributions from our laboratory to this growing field while also acknowledging key contributions from other researchers.Our early efforts in this area focused on coupling radical-active substrates, such as α-chloroboronates. This method follows the conventional radical chain mechanism, resulting in facile access to valuable allylboronates. Encouraged by these promising results, we subsequently expanded the substrate scope to encompass radical-inactive compounds. By developing new strategies for controlling cross-selectivity, we enabled the coupling of Csp3 electrophiles (e.g., alcohols and sulfonates), Csp2 electrophiles (e.g., bromoalkenylboronates and acyl fluorides), and heavier group-14 electrophiles like chlorosilanes and chlorogermanes with alkenyl triflates. These advances have provided efficient synthetic routes to a wide range of valuable products, including aliphatic alkenes, enones, dienylboronates, and silicon- and germanium-containing alkenes. Notably, these methods are particularly effective for synthesizing functionalized cycloalkenes, which are traditionally challenging to obtain through conventional methods involving alkenyl halide or organometallic couplings. We have also extended the scope of enol derivatives from triflates to acetates. These compounds are among the most accessible, stable, cost-effective, and environmentally friendly reagents, while their application in cross-coupling has been hampered by low reactivity and selectivity challenges. We showcased that by the use of a Ni(I) catalyst, alkenyl acetates could undergo reductive alkylation with a broad range of alkyl bromides, yielding diverse cyclic and acyclic aliphatic alkenes.Furthermore, our work has demonstrated that reductive coupling of enol derivatives with alkenes provides a highly appealing alternative for alkene synthesis. Particularly, this approach offers opportunity to address the regioselectivity challenges encountered in conventional alkene transformations. For instance, achieving regioselective hydrocarbonation of aliphatic 1,3-dienes has been a longstanding challenge in synthetic chemistry. By using a phosphine-nitrile ligand, we developed a nickel-catalyzed reductive alkenylation of 1,3-dienes with alkenyl triflates, delivering a diverse array of 1,4-dienes with high 1,2-branch selectivity (>20:1) while preserving the geometry of the C3-C4 double bond. Additionally, our investigations laid the foundation for enantioselective reductive alkenylation methodologies, offering new pathways for constructing enantioenriched diketones as well as complex carbo- and heterocyclic compounds. The introduced alkenyl functionality can be further diversified, enhancing molecular diversity and complexity.

Ultrasound-guided renal artery balloon catheter occluded hybrid partial nephrectomy (UBo-HPN) with branch renal artery occlusion: a single arm trial

BackgroundOne key focus of partial nephrectomy is preserving renal function. Segmental renal artery occlusion with microdissection at the renal hilum confines ischemia, effectively reducing warm ischemic injury. Ultrasound-Guided Renal Artery Balloon Catheter Occluded Hybrid Partial Nephrectomy (UBo-HPN) can achieve branch occlusion without the need for dissecting the renal hilum.ObjectiveTo investigate the feasibility and safety of UBo-HPN of branch renal artery occlusion in the treatment of localized renal tumors.Subject and methodsA prospective single-arm analysis involving 20 patients with renal localized tumors underwent robot assisted UBo-HPN with branch renal artery occlusion from August 2021 to July 2023, with an average follow-up of 12 months.ResultsAll patient was successfully operated on without conversion to conventional arterial clamping or radical nephrectomy. One case (5%) of minor complication occurred in the whole cohort, which was bruising around the puncture site. The mean total operative time was 95.8 min, with a mean operative time of 21.25 min for vascular intervention. The mean warm ischemia time was 20.35 min, and the median estimated blood loss was 50 ml. The median eGFR preservation percentage at postoperative 48 h, 30 days, and the latest follow-up were 87.52%, 91.47%, and 92.2%, respectively. After a median follow-up of 10.2 (2.3–19.2) months, no patients had radiological tumor recurrence or died from tumor-related causes.ConclusionsUBo-HPN with renal artery branch occlusion emerges as an efficient alternative to partial nephrectomy (PN), which achieved branch artery occlusion without dissecting the renal hilum. Long-term follow-up is expected for functional outcomes.

Comparison of the effectiveness of open, laparoscopic, and robotic-assisted radical prostatectomies based on complication rates: a retrospective observational study with administrative data from Switzerland

BackgroundRadical prostatectomies can be performed using open retropubic, laparoscopic, or robot-assisted laparoscopic surgery. The literature shows that short-term outcomes (in particular, inpatient complications) differ depending on the type of procedure. To date, these differences have only been examined and confirmed in isolated cases based on national routine data.MethodsThe data was based on the Swiss Medical Statistics from 2016 to 2018 from a national survey of administrative data from all Swiss hospitals. Cases with the coded main diseases neoplasm of the prostate (ICD C61) and the main treatments of laparoscopic (CHOP 60.5X.20) or retropubic (CHOP 60.5X.30) radical prostatectomies were included, resulting in a total sample size of 8,593 cases.ResultsA procedure-related complication occurred in 998 cases (11.6%). By surgical procedure, complication rates were 10.1% for robotic-assisted laparoscopic radical prostatectomy 9.0% for conventional laparoscopic radical prostatectomy and 17.1% for open retropubic radical prostatectomy (p < 0.001). Conventional and robotic-assisted laparoscopic radical prostatectomies had a significantly lower risk of complications than retropubic procedures. Moreover, the risk of a procedure-related complication was almost twice as high in cases operated on retropubically; however, no significant difference was found between conventional and robotic-assisted laparoscopic cases.DiscussionThe use of a surgical robot showed no advantages in radical prostatectomies regarding procedure-related during the hospital stay. However, both conventional and robotic-assisted laparoscopically operated radical prostatectomies show better results than open retropubic procedures. Further studies on the long-term course of patients based on claims data are needed to confirm the inherent benefits of surgical robots in tandem with them being increasingly employed in hospitals.

In Situ Formation of Acidic Comonomer during Thermal Treatment of Copolymers of Acrylonitrile and Its Influence on the Cyclization Reaction.

Binary and ternary copolymers of acrylonitrile (AN), tert-butyl acrylate (TBA), and n-butyl acrylate (BA) are synthesized through conventional radical polymerization in DMSO in the presence of 2-mercaptoethanol. The thermal behavior of binary and ternary copolymers is studied under argon atmosphere and in air. It is demonstrated that the copolymers of AN contain 1-10 mol.% of TBA split isobutylene upon heating above 160 °C, resulting in the formation of the units of acrylic acid in the chain. The carboxylic groups formed in situ are responsible for the ionic mechanism of cyclization, which starts at lower temperatures compared with pure polyacrylonitrile (PAN) or AN copolymer with BA. The activation energy of cyclization through ionic and radical mechanisms depends on copolymer composition. For the ionic mechanism, the activation energy lies in the range ca. 100-130 kJ/mole, while for the radical mechanism, it lies in the range ca. 150-190 kJ/mole. The increase in the TBA molar part in the copolymer is followed by faster consumption of nitrile groups and the evolution of a ladder structure in both binary and ternary copolymers. Thus, the incorporation of a certain amount of TBA in PAN or its copolymer with BA allows tuning the temperature range of cyclization. This feature seems attractive for applications in the production of melt-spun PAN by choosing the appropriate copolymer composition and heating mode.

Exploring the impact of poly(sodium styrene sulfonate) dispersants’ architecture on their performance in coal water slurry preparation

In this work, the architecture of poly(sodium styrene sulfonate) (PSSNa) dispersants were flexibly tailored by various strategies. Three categories of PSSNa dispersants with different topologies were obtained, namely, linear structured PSSNa (1-A-PSSNa), three-arm star PSSNa (3-AS-PSSNa) and six-arm star PSSNa (6-AS-PSSNa). The molecular weights (Mn) of these dispersants were adjusted in the range of 3200–26,200 g/mol by varying the feeding ratio of monomer to initiator. In addition, the polydispersity index (PDI) of resultant dispersants were also varied by using different polymerization technologies, such as atom transfer radical polymerization (ATRP) and conventional free radical polymerization technique (RP). Fourier transform infrared (FTIR) spectroscopy, nuclear magnetic resonance (NMR) spectroscopy and gel permeation chromatography (GPC) verified these architecture parameters of resultant PSSNa dispersants. Afterwards, the impact of these architectural factors on the performance of PSSNa dispersants in coal water slurry (CWS) preparation were evaluated. The results revealed that with the Mn of dispersants increased from 9800 to 26,200 g/mol, the apparent viscosity of CWS increased by around 11 %. The comparison between dispersants with approximate Mn (26,200 and 26,900 g/mol) and very different PDI (1.27 and 2.25) indicated that wide PDI are favourable for the performance. This work also confirmed that the topology of dispersants has a significant impact on their performance. The maximum coal loaded can increase from 63.9 % to 64.3 % when 1-A-PSSNa dispersant was replaced by 6-AS-PSSNa. Meanwhile, these architectural factors have a limited impact on the fluid type of CWSs, as all CWSs obtained in this work were pseudoplastic fluids regardless of the used dispersants. The potential mechanism was investigated using various technologies, such as the measurements of zeta potentials, contact angles, and low-field nuclear magnetic resonance spectra. The results revealed that topologizing did not alter the interaction between dispersant and coal surface. However, due to the special features of topological polymers, they can grant adsorbed coal particles with enhanced electrostatic repulsion and steric hindrance, which facilitated the dispersion of coal particles.

Effect of Precise Dissection and Reconstruction of the Prostate Apex and Bladder Neck in Radical Prostatectomy on Urinary Control Improvement

To investigate the impact of the precise dissection and reconstruction of the prostate apex and bladder neck urethra during radical prostatectomy on the improvement in postoperative urinary control in patients with prostate cancer. A retrospective study was conducted. A total of 131 prostate cancer patients who underwent robot-assisted radical prostatectomy at our institution between January 1, 2023 and December 31, 2023 were enrolled. The subjects were divided into two groups, with 64 in the experimental group and 67 in the control group. Patients in the experimental group underwent radical prostatectomy in a modified approach, while those in the control group underwent conventional radical prostatectomy. Propensity score matching was employed to match the two groups at a 1-to-1 ratio based on age, body mass index (BMI), preoperative prostate specific antigen (PSA), prostate volume, Prostate Imaging Reporting and Data System (PI-RADS) scores, biopsy Gleason score, and preoperative urinary control status. After matching, we compared the preoperative baseline data, surgical margin positivity rates, and urinary control status at 3 months post operation between the two groups. Urinary control was assessed before and after surgery using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) scale. A total of 56 pairs of patients were successfully matched between the experimental group and the control group through 1-to-1 propensity score matching. At 3 months after surgery, the median score for ICIQ-SF scale of the experimental group was 7.0 points, while that of the control group was 9.5 points, with the difference being statistical significant (P<0.05). There was no significant difference in the positive rate of incision margins between the experimental group and the control group. Multiple linear regression analysis showed that both the prostate volume and the Gleason score in the experimental group were positively correlated with the ICIQ-UI SF scores 3 months after surgery (P<0.05), while the age of patients in the control group was positively correlated with ICIQ-UI SF score 3 months after surgery (P<0.05). Precise dissection and reconstruction of the prostate apex and bladder neck urethra during radical prostatectomy significantly improve the postoperative urinary control of patients at 3 months after surgery.

Peroxide free radical grafting of maleic anhydride onto polyethylene under high melt temperature: A comprehensive approach

“Flash Reactive Extrusion” under very high temperatures (T=200–420°C) allowed to graft maleic anhydride onto polyethylene (PE) without the use of conventional free radical initiators such as peroxides. Herein, the use of unusual temperatures induced the formation of radicals through degradation/chain scission of the PE backbone and the latter radicals were able to react with maleic anhydride (MA) and yielding a MA grafting degree close to 1.4 wt% at 390°C. Moreover, the MA grafting mechanistic scheme was deeply discussed with the help of 1H NMR and 13C NMR analysis and it was pointed out that β-scissions reactions are favoured in comparison with the cross-linking ones at very high temperatures for the thermal initiation step with a MA grafting mainly onto the PE side chain.

Synthesis of Well-Defined Poly(vinyl alcohol-co-vinyl acetate) Copolymers by Alcoholysis of Poly(vinyl acetate) Synthesized by Macromolecular Design via Interchange of Xanthate Polymerization, and Their Use as a Stabilizer in Emulsion (Co)polymerization of Vinyl Acetate.

This work aims at synthesizing tailor-made poly(vinyl alcohol-co-vinyl acetate) (PVA) amphiphilic copolymers, obtained by alcoholysis of poly(vinyl acetate) (PVAc) that could display improved properties as stabilizers compared to commercially available PVAs. Well-defined PVAs with different alcoholysis degrees were produced from a library of PVAc homopolymers synthesized by macromolecular design via interchange of xanthate polymerization and exhibiting different degrees of polymerization degrees. Subsequently, these PVAs were evaluated as stabilizers in the emulsion copolymerization of VAc and vinyl neodecanoate (VERSA 10, referred to as V10) and compared to a commercially available reference PVA obtained by alcoholysis of PVAc formed by conventional radical polymerization. In all cases, stable latexes were obtained and compared in terms of their colloidal characteristics. To identify the best stabilizer candidate, the amount of PVA remaining in water and not participating to the particle stabilization was evaluated in each case.

Ferrate (VI) oxidation of sulfamethoxazole enhanced by magnetized sludge-based biochar: Active sites regulation and degradation mechanism analysis

Developing non radical systems for antibiotic degradation is crucial for addressing the inefficiency of conventional radical systems. In this study, novel magnetic-modified sludge biochar (MASBC) was synthesized to significantly enhance the oxidative degradation of sulfamethoxazole (SMX) by ferrate (Fe (VI)). In the Fe (VI)/MASBC system, 90.46% of SMX at a concentration of 10 μM and 49.34% of the total organic carbon (TOC) could be removed under optimal conditions of 100 μM of Fe (VI) and 0.40 g/L of MASBC within 10 min. Furthermore, the Fe (VI)/MASBC system was demonstrated with broad-spectrum removal capability towards sulfonamides in single or mixture. Quenching experiments, EPR analyses, and electrochemical experiments revealed that direct electron transfer (DET) and •O2− were mainly responsible for the removal of SMX, with functional groups (e.g., -OH, C=O) and Fe-O (redox of Fe (III)/Fe (II)) acting as the active sites, while the probe experiments showed that Fe (IV)/Fe (V) made a minor contribution to the degradation of SMX. Benefiting from the DET, the Fe (VI)/MASBC system exhibited a wide pH adaptation range (e.g., from 5.0 to 10.0) and strong anti-interference ability. The N atoms and their neighboring atoms in SMX were the prior degradation sites, with the cleavage of bond and ring opening. The degradation products showed low or non-toxicity according to ECOSAR program assessment. The removal of SMX remained within a reasonable range of 71.33%–90.46% over five consecutive cycles. Also, the Fe (VI)/MASBC system was demonstrated to be effectively applied for successful SMX removal in various water matrices, including ultrapure water, tap water, lake water, Yangtze River water, and wastewater. Therefore, this study offered new insights into the mechanism of Fe (VI) oxidation and would contribute to the efficient treatment of organic pollutants.

Solution-state self-assembly of novel poly(carbamoyl methacrylate)s synthesized via combining Passerini three-component reactions and free radical polymerizations

Coupling multicomponent reactions (MCRs) with other polymerizations has excellent advantages in inducing multifunctionality and syntheses of complex macromolecular structures. Herein, a straightforward combination method using aqueous Passerini three-component reaction (P3CR(aq)) and conventional free radical polymerization (FRP) (termed as P3CR(aq)-Є-FRP) was applied using mild conditions. Firstly, an environmental-friendly and efficient aqueous P3CR was applied to synthesize various carbamoyl methacrylate (CMA) monomers from methacrylic acid, cyclohexyl isocyanide, and four different aldehydes with high yield (ca. 90 %) and purity. This is plausibly prompted by the key factors of high cohesive energy density of water and facile isolation by the poor solubility of CMAs in aqueous. Then, poly(carbamoyl methacrylate)s (PCMAs) were obtained via FRP with 2,2′-azobis(isobutyronitrile) (AIBN) in dimethylformamide (DMF). Characterizations of both synthesized noble monomers, polymers, solubilities in different solvents, and thermal properties, as well as the solution-state self-assembly behaviors of the polymers by dynamic light scattering (DLS), scanning electron microscope (SEM), and small-angle X-ray scattering (SAXS), including micellized particle sizes, critical micelle concentrations (CMCs), and micelle morphology, were investigated. PCMAs can self-assemble into stable globular micellar nanoparticles (ca. 170–310 nm) with low CMC values (1.6 × 10−5–4.0 × 10−9 mg/mL).

Statistical Copolymerization-Induced Self-Assembly.

Statistical copolymers have been extensively used in chemical industries and our daily lives, owing to their ease of synthesis and functionalization. However, self-assembly based on statistical copolymers has been haunted by high interfacial energy, poor stability, and low concentration. We proposed the statistical copolymerization-induced self-assembly (stat-PISA) as a general strategy for one-step preparing stable statistical copolymer assemblies with high solids content. The concept was demonstrated through a model dispersion polymerization system comprising a charged hydrophilic monomer and a core-forming monomer, producing spherical micelles via a spinodal decomposition mechanism with an interconnected network intermediate. The stat-PISA was tunable by varying the fraction of charged monomer, the polymer chain length, and the solids content. The statistical copolymer micelles were demonstrated to be a potential Pickering emulsifier with superior stabilizing performances compared to their block copolymer counterparts. The general applicability of stat-PISA was demonstrated by preparing statistical copolymer assemblies with varying surface charges and chemical compositions. Particularly, this strategy is feasible for conventional free radical polymerization, promising for industrial scale-up.

Acrylamide Cross‐Linked Psyllium Polysaccharide with Improved Flocculation Performance for the Removal of Microplastics from Water

AbstractThis article presents a novel material of acrylamide (AM) cross‐linked psyllium polysaccharides (PLP) derivative, PLP‐AM, which can be used as an effective polymeric flocculant for the removal of microplastics (MP) from water. PLP‐AM was produced by radical polymerization of PLP and AM using microwave irradiation instead of conventional radical initiators. The characterization of PLP‐AM was carried out by FT‐IR spectroscopy, elemental analysis, intrinsic viscosity measurement and thermogravimetric analysis (TG). Polystyrene (PS), polyethylene terephthalate (PET) and polyvinyl chloride (PVC) were utilized to examine the flocculation performance of PLP‐AM. The optimum flocculation conditions were obtained by the comprehensive exploration of flocculant concentration, solution pH and temperature. In a solution with a pH 6 at 30 °C, the maximum removal percentages of PS and PVC by 60 mg/L of PLP‐AM were 92.55 % and 94.31 %, respectively, while 93.85 % of the maximum removal of PET percentage could be obtained by 80 mg/L of PLP‐AM. The results of zeta potential measurement revealed that there was adsorption electric neutralization between MP and PLP‐AM besides the adsorption bridging mechanism. These results suggest that PLP‐AM may bring an inspiration for the development of polymer flocculant to remove MP from water.

Remarkable Enhancement of Antioxidant Activity of the Ovalbumin-EGCG Conjugate through a Novel Preceding Selective Protection Grafting Strategy.

Conventional radical grafting of proteins with catechins consumed the most antioxidant-active hydroxyls during grafting, thus failing to effectively retain antioxidant activity in conjugates. In this study, a novel strategy of selective protection of the most reactive hydroxyls before grafting was developed to preserve the most reactive hydroxyls and effectively retain antioxidant activity in conjugates. Selective protection of the most reactive hydroxyls of (-)-epigallocatechin-3-gallate (EGCG) was successfully realized in a yield of 87% applying trimethyl orthopropionate and catalytic calcium triflate at 40 °C. The novel ovalbumin (OVA)-EGCG conjugate with 93% grafting ratio was prepared by radical grafting with the selectively protected EGCG and subsequent deprotection. Substantially enhanced antioxidant performance of the novel OVA-EGCG conjugate in liposomes was unveiled with notably reduced curcumin degradation and leakage. The strategy and approaches developed in this study will be valuable to effectively improve the antioxidant activities of protein-catechin grafting conjugates.

Clinical Anatomy of the Superficial Preprostatic Vein and Accessory Pudendal Artery in Robot-Assisted Radical Prostatectomy.

Purpose: We herein describe the superficial preprostatic vein (SPV) anatomy and determine its relationship with the accessory pudendal artery (APA). Materials and Methods: We reviewed 500 patients with localized prostate cancer who underwent conventional robot-assisted radical prostatectomy between April 2019 and March 2023 at our institution. SPV was defined as "any vein coming from the space between the puboprostatic ligaments and running within the retropubic adipose tissue anterior to the prostate toward the vesical venous plexus or pelvic side wall." While APA was defined as "any artery located in the periprostatic region running parallel to the dorsal vascular complex and extending caudal toward the anterior perineum." The intraoperative anatomy of each SPV and APA was described. Results: SPVs had a prevalence rate of 88%. They were preserved in 252 men (58%) and classified as I-, reversed-Y (rY)-, Y-, or H-shaped (64%, 22%, 12%, and 2%, respectively) based on their intraoperative appearance. Overall, 214 APAs were found in 142 of the 252 men with preserved SPV (56%; 165 lateral and 50 apical APAs in 111 and 41 men, respectively). SPVs were pulsatile in 39% men perhaps due to an accompanying tiny artery functioning as a median APA. Pulsations seemed to be initially absent in most SPVs but become apparent late during surgery possibly due to increased arterial and venous blood flow after prostate removal. Pulsations were common in men with ≥1 APA. Conclusions: This study, which described the anatomical variations in arteries and veins around the prostrate and their preservation techniques, revealed that preserving this vasculature may help preserve postprostatectomy erection. ClinicalTrials: The Clinical Research Registration Number is 230523D.

Assessing Stress Induced by Fluid Shifts and Reduced Cerebral Clearance during Robotic-Assisted Laparoscopic Radical Prostatectomy under Trendelenburg Positioning (UroTreND Study).

In addition to general anesthesia and mechanical ventilation, robotic-assisted laparoscopic radical prostatectomy (RALP) necessitates maintaining a capnoperitoneum and placing the patient in a pronounced downward tilt (Trendelenburg position). While the effects of the resulting fluid shift on the cardiovascular system seem to be modest and well tolerated, the effects on the brain and the blood-brain barrier have not been thoroughly investigated. Previous studies indicated that select patients showed an increase in the optic nerve sheath diameter (ONSD), detected by ultrasound during RALP, which suggests an elevation in intracranial pressure. We hypothesize that the intraoperative fluid shift results in endothelial dysfunction and reduced cerebral clearance, potentially leading to transient neuronal damage. This prospective, monocentric, non-randomized, controlled clinical trial will compare RALP to conventional open radical prostatectomy (control group) in a total of 50 subjects. The primary endpoint will be the perioperative concentration of neurofilament light chain (NfL) in blood using single-molecule array (SiMoA) as a measure for neuronal damage. As secondary endpoints, various other markers for endothelial function, inflammation, and neuronal damage as well as the ONSD will be assessed. Perioperative stress will be evaluated by questionnaires and stress hormone levels in saliva samples. Furthermore, the subjects will participate in functional tests to evaluate neurocognitive function. Each subject will be followed up until discharge. Conclusion: This trial aims to expand current knowledge as well as to develop strategies for improved monitoring and higher safety of patients undergoing RALP. The trial was registered with the German Clinical Trials Register DRKS00031041 on 11 January 2023.

Modified Retzius-sparing robot-assisted radical prostatectomy for cases with anterior tumor: a propensity score-matched analysis

ObjectiveTo compare the outcomes between a modified Retzius-sparing robot-assisted radical prostatectomy (mRS-RARP) technique and conventional robot-assisted radical prostatectomy (Con-RARP) technique for cases with anterior prostate cancer (PCa), especially positive surgical margin (PSM) rates and urinary continence (UC).Patients and methodsWe retrospectively included 193 mRS-RARP and 473 Con-RARP consecutively performed by a single surgeon for anterior PCa. Perioperative complications, pathology, and continence were compared after propensity score matching using 9 variables.ResultsAfter matching (n = 193 per group), PSM were not significantly different in the two groups (16.1% in mRS-RARP group vs. 15.0% in Con-RARP group, p = 0.779). The UC at catheter removal and at 1-month was significantly higher in the mRS-RARP (24.9% vs. 9.8%, p < 0.001; 29.0% vs. 13.5%, p < 0.001, respectively), but not at 3-, 6-, and 12-month follow-ups (p = 0.261, 0.832, and 0.683, respectively).ConclusionmRS-RARP seems to be an oncologically safe approach for patients with anterior PCa. Compared with the conventional approach, mRS-RARP approach shows benefits in the short-term postoperative UC recovery.

Designing magnetic catalysts based on gold nanoparticles supported by ethylenediamine tetraacetic acid functionalized amino‐modified poly(N‐isopropyl acrylamide) for reduction of nitro compounds in water

AbstractA novel smart catalyst was developed with amino‐modified thermo‐responsive poly(N‐isopropyl acrylamide) (PNIPAM) grafts on silica‐coated magnetic nanoparticles using the conventional free radical polymerization process. By this methodology, the polymer was successfully grafted mainly onto silica‐modified iron oxide nanoparticles (Fe3O4@Si). The PNIPAM‐grafted Fe3O4@Si was then subjected to ethylenediamine treatment to produce the amino‐functionalized support (Fe3O4@Si@PNIPAM‐NH2), which was subsequently modified with carboxyl functional groups by using EDTA (ethylenediaminetetraacetic acid) to create Fe3O4@Si@PNIPAM‐NH2‐EDTA. Au nanoparticles were then decorated on this support through its two amines and four carboxylates. Different methods were used to study this novel catalyst, including inductively coupled plasma, Fourier transport infrared spectroscopy, TGA, dynamic light scattering, SEM, energy‐dispersive X‐ray analysis, vibrating sample magnetometry, XRD and elemental CHN analysis. The reduction of several aryl‐nitro derivatives demonstrated a significant catalytic activity for the as‐synthesized gold catalyst (Fe3O4@Si@PNIPAM‐NH2‐EDTA‐Au). The Au catalyst can be successfully removed from the reaction components using a magnetic field and used again in eight successive reduction reactions without significant gold leaching and loss of catalytic activity. © 2024 Society of Industrial Chemistry.

Endoscopic resection and laparoscopic lymph node dissection for early gastric cancer beyond conventional endoscopic treatment indications: a 10-year outcome study.

Endoscopic full-thickness gastric resection (EFTGR) with laparoscopic regional lymph node dissection (LLND) and endoscopic submucosal dissection (ESD) with LLND have been investigated as treatment options for early gastric cancer beyond the absolute indications for ESD. However, comparative studies on the long-term outcomes of these procedures are lacking. This study aimed to analyze and compare the 10-year outcomes of both procedures in a real clinical setting. Between January 2009 and December 2013, 28 and 37 patients diagnosed with EGC beyond the absolute indications for ESD were treated with EFTGR with LLND and ESD with LLND, respectively. In both procedures, the dye was injected into the tumor. However, after injection and LLND, EFTGR was performed immediately in the EFTGR with LLND group, whereas LLND was followed by ESD in the ESD with LLND group. The primary endpoint was the 10-year survival rate. The EFTGR with LLND group had one case of local recurrence (3.6%) and mortality (3.6%) each, while the ESD with LLND group had none (0.0% for both); however, the differences were not statistically significant (P = 0.247 for each). Furthermore, there was no significant difference in complications such as ischemia and anastomosis leakage between the groups (P = 0.247). When the procedures were properly applied, EFTGR with LLND and ESD with LLND did not increase the 10-year mortality in patients with EGC beyond the absolute ESD indications compared with conventional radical gastrectomy.

Role of stereotactic radiosurgery for recurrent skull base acinic cell carcinoma: illustrative case.

Acinic cell carcinomas (AcCCs), rare malignancies of the salivary glands, often recur and metastasize, particularly in the skull base. Conventional radical resection can be invasive for skull base AcCCs adjacent to cranial nerves and major vasculature, and the effectiveness of stereotactic radiosurgery (SRS) as an alternative is not well established. This case report details the application of SRS for recurrent skull base AcCCs. A 71-year-old male with a history of resection for a right mandibular AcCC 23 years earlier experienced tumor recurrence involving the right cavernous sinus and nasal cavity. He underwent endoscopic transnasal surgery followed by SRS targeting different tumor locations-the cavernous sinus to the pterygopalatine fossa, maxillary sinus, and clivus-each with a prescribed dose of 20 Gy to the 40% to 50% isodose line. After the first skull base metastasis, additional sessions of localized SRS after endoscopic surgery led to a 12-year survival without sequela. This is a report indicating that SRS for skull base AcCCs can achieve favorable local control, functional preservation, and long-term survival. SRS may be suitable for skull base AcCC given the lesion's tendency toward multiple local recurrences. Further investigation is needed to validate the treatment's efficacy.