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Phonon antibunching, a phenomenon arising from the quantum statistics of mechanical vibrations, has attracted significant attention due to its potential applications in quantum information processing, sensing, and energy harvesting. Here, we present a comprehensive investigation of phonon antibunching in a system consisting of three weakly nonlinear coupled nanomechanical resonators. We analytically derive and study the antibunching behavior of phonons in the proposed system and bring insight into the underlying mechanisms. The optimal phonon blockade results from destructive quantum interference due to distinct two-phonon excitation pathways. Due to this quantum interference, these unconventional phonon blockade systems can achieve antibunched statistics even in weakly nonlinear regimes, in contrast to conventional phonon blockade systems that require strong nonlinearity. We show that with the inclusion of an additional resonator, there are multiple additional two-phonon excitation pathways compared to two resonator cases, which results in stronger phonon antibunching and supports single phonon for longer duration. These findings are interesting for practical phononics using coupled-resonator systems.

The origin of the secondary vortex street, observed in the far wake in the flow past a circular cylinder, is investigated. The Reynolds number, based on the diameter of the cylinder, is 150. The von Kármán vortex street, which originates in the near wake, decays exponentially downstream of the cylinder. Beyond the region of decay, a broad band of frequencies are selectively amplified, leading to the formation of a secondary vortex street consisting of packets of large-scale vortex structures. The streamwise location of the onset of the instability, frequency of the generation of packets and their convection speed are estimated via direct numerical simulation (DNS). Global linear stability analysis of the time-averaged flow reveals the presence of unstable convective modes that travel at almost the same speed and have a structure similar to the packet-like disturbances as observed in the DNS. Sensitivity analysis of the global convective modes to structural perturbations is carried out to locate the region of the wake that is most significant in generating the modes responsible for the appearance of the secondary vortex street. This information is utilized to control the flow. By placing a ‘slip’ splitter plate along the wake centre line, in the overlap region of the direct and the adjoint modes, the oscillations in the far wake are significantly reduced, though the oscillations related to the primary vortex shedding in the near wake are not. It is also found that suppression of the primary vortex shedding leads to annihilation of the secondary vortex street as well. Linear stability analysis of the steady-state flow does not yield any modes that can explain the appearance of the secondary vortex street. The steady and time-averaged wake profiles, for the $\\mathit{Re}= 150$ flow, are compared to bring out the differences in the two. The effect of free-stream oscillations on the evolution of the secondary vortex street is investigated. By reducing the amplitude of inlet excitation, a gradual transition from ordered shedding in the far wake to the appearance of a broad-band spectrum of frequencies, as in the unforced wake, is observed. All the computations have been carried out using a stabilized finite element method.

Flow past a spinning circular cylinder placed in a uniform stream is investigated via two-dimensional computations. A stabilized finite element method is utilized to solve the incompressible Navier–Stokes equations in the primitive variables formulation. The Reynolds number based on the cylinder diameter and free-stream speed of the flow is 200. The non-dimensional rotation rate, α (ratio of the surface speed and freestream speed), is varied between 0 and 5. The time integration of the flow equations is carried out for very large dimensionless time. Vortex shedding is observed for α < 1.91. For higher rotation rates the flow achieves a steady state except for 4.34 < α < 4:70 where the flow is unstable again. In the second region of instability, only one-sided vortex shedding takes place. To ascertain the instability of flow as a function of α a stabilized finite element formulation is proposed to carry out a global, non-parallel stability analysis of the two-dimensional steady-state flow for small disturbances. The formulation and its implementation are validated by predicting the Hopf bifurcation for flow past a non-rotating cylinder. The results from the stability analysis for the rotating cylinder are in very good agreement with those from direct numerical simulations. For large rotation rates, very large lift coefficients can be obtained via the Magnus effect. However, the power requirement for rotating the cylinder increases rapidly with rotation rate.

BackgroundThe Rezum system is one of the latest minimally invasive surgical treatments for benign prostatic hyperplasia.MethodsWe retrospectively reviewed all patients who underwent the Rezum treatment in seven different Italian institutions. A successful urinary outcome was defined as: ≥50% improvement in the IPSS <7, improvement in peak flow ≥50% and/or more than 15 ml/s, ≥1-point improvement in the QoL questionnaire and in the absence of perioperative major complications (AUR, transfusion) or postoperative incontinence. A successful sexual outcome was defined as postoperative (latest follow up consultation) antegrade ejaculation or no variation in ejaculatory function and an increase, or stability or max 1 class reduction, in IIEF-5.Results262 patients were enrolled with a follow-up period of 11 months (IQR 5–15). No early or late serious adverse events (Clavien III–IV) occurred. Early complications occurred in 39.3% of cases, with 4 cases of clot retention and one case of blood transfusion. Urge incontinence was reported by 6 patients (2.2%). A treatment failure requiring re-intervention occurred in 4 cases (1.5%). The preoperative antegrade ejaculation rate was 56.5%, and after the procedure it increased to 78.2%. The increase of ≥1-point in the QoL was achieved in 92.7% of the cases. Optimal urinary and sexual outcomes were achieved in 52.9% and 87.8%, respectively.ConclusionsIn our series, water vapor intraprostatic injections seem to be an effective and safe procedure.

Galectins are a family of galactoside-recognizing proteins involved in different galectin-subtype-specific inflammatory and tumor-promoting processes, which motivates the development of inhibitors that are more selective galectin inhibitors than natural ligand fragments. Here, we describe the synthesis and evaluation of 3-C-methyl-gulopyranoside derivatives and their evaluation as galectin inhibitors. Methyl 3-deoxy-3-C-(hydroxymethyl)-β-d-gulopyranoside showed 7-fold better affinity for galectin-1 than the natural monosaccharide fragment analog methyl β-d-galactopyranoside, as well as a high selectivity over galectin-2, 3, 4, 7, 8, and 9. Derivatization of the 3-C-hydroxymethyl into amides gave gulosides with improved selectivities and affinities; methyl 3-deoxy-3-C-(methyl-2,3,4,5,6-pentafluorobenzamide)-β-d-gulopyranoside had Kd 700 µM for galectin-1, while not binding any other galectin.

Digital twins, dynamic, patient-specific virtual replicas of physical systems are gaining momentum across various medical fields. Their capacity to simulate and predict biological behavior offers unprecedented opportunities for personalized care. While their utility has been demonstrated in oncology, their application in urology remains nascent, and there is still a significant gap in literature findings. This review explores the theoretical framework, current evidence, and future potential of digital twins technology in managing urological conditions such as urolithiasis, benign prostatic hyperplasia (BPH), and nonmuscle invasive bladder cancer. A narrative literature review, guided by SANRA criteria, was conducted using PubMed and Scopus databases to identify relevant studies on the application of digital twins in healthcare, with a focus on urology and related fields. Additional sources from AI, imaging, and computational modelling were incorporated to support technological and theoretical concepts. Real-world use cases and clinical scenarios were constructed to illustrate the conceptual application of digital twins in endourology. Although limited in number, preliminary studies have shown promising results in uro-oncology, particularly for prostate and renal cancers. No models have yet been developed for benign urological diseases. Hypothetical applications in endourology include personalized procedural planning, dynamic follow-up, prediction of obstruction or recurrence, and real-time intraoperative guidance. Integration of imaging, functional data, and AI algorithms could create continuously adaptive simulations to support decision-making and improve treatment outcomes. However, barriers such as data complexity, cost, lack of validation frameworks, and clinician trust persist. Digital twins hold transformative potential for the future of urology, promising to personalize care across diagnosis, treatment, and surveillance. While the path to clinical integration is challenged by technical, ethical, and infrastructural hurdles, collaborative efforts and real-world validation studies are critical to realizing their full potential in clinical practice. Digital twin in urology Digital twins consist in a virtual computer model of a real patient, created using medical scans, test results, and clinical information. It can be updated as new data become available. In urology, digital twins could help doctors plan operations, predict whether kidney stones will return, estimate how prostate treatments will work, or determine which bladder cancer patients need more frequent monitoring. Although digital twins are increasingly used in engineering and some medical fields, they are still new in urology and require further research.

A clear understanding of the potential complications or adverse events (AEs) of diagnostic endoscopy is an essential component of being an endoscopist. Creating a culture of safety and prevention of AEs should be part of routine endoscopy practice. Appropriate patient selection for procedures, informed consent, periprocedure risk assessments and a team approach, all contribute to reducing AEs. Early recognition, prompt management and transparent communication with patients are essential for the holistic and optimal management of AEs. In this review, we discuss the complications of diagnostic upper gastrointestinal endoscopy, including their recognition, treatment and prevention.

Objective: Overuse of antibiotics has led to an increase in antimicrobial resistance (AMR) worldwide, with a negative impact on the healthcare system and the patients. In this context, our study aims to assess the current AMR patterns of urinary tract infections (UTIs) associated to Gram-negative bacteria. Thus, we provide useful information for doctors dealing with prophylactic and therapeutic empiric therapies. Materials and methods: We retrospectively analysed more than 650,000 urine cultures collected in the Microbiology Department of a referral University Hospital of Southern England from January 2014 to December 2022. Results: AMR spectra for 164,059 Gram-negative associated (UTIs) were analysed. The lowest percentage of resistance was found for Amikacin (2.30%), Gentamicin (5.89%) and Co-Amoxiclav (10.49%). Over a 9-year time, there was no significant change in resistance to Amikacin (2.04% in 2014 compared to 2.18% in 2022; p = 0.602) and to Fosfomycin (11.50% in 2014 versus 16.65% in 2022; p = 0.577). Overall, the trend of AMR significantly rose for Cefalexin (17.96–18.42%; p < 0.0001), Co-amoxiclav (9.46–12.69%; p < 0.0001), Nitrofurantoin (10.20–14.18%; p < 0.0001) and Piperacillin/Tazobactam (14.52–18.96%; p < 0.0001). Gram-negative resistance spectrum towards Ciprofloxacin (11.83–9.01%; p < 0.0001), Gentamicin (6.29–5.26%; p < 0.0001), Pivmecillinam (26.88–11.02%; p < 0.0001), Trimethoprim (36.72–29.23%; p < 0.0001) and Ampicillin/Amoxicillin (65.20–57.99%; p < 0.0001) significantly decreased. Conclusion: Despite the application of national and international guidelines for prophylaxis and treatment of UTIs, the spectrum of resistance for the most common antibiotics is still changing. Clinicians in primary and secondary care must keep that in mind when prescribing antibiotics for suspected UTI and sepsis associated with Gram-negative infections Up-to-date therapeutic strategies can help implement treatment of UTI, reducing selection of multi-resistant pathogens and providing more accurate care for patients. Future studies will be required to help clinicians and keep the guidelines updated. Plain language summary Gram negative bacteria related urinary tract infections: spectrum of antimicrobial resistance over 9 years in a University tertiary referral Hospital Despite the application of national and international guidelines for prophylaxis and treatment of urinary tract infections, the spectrum of resistance for the most common antibiotics is still changing. Clinicians in primary and secondary care must keep that in mind when prescribing antibiotics for suspected urinary tract infections and sepsis associated with gram-negative bacteria. Up-to-date therapeutic strategies can help implement treatment of urinary tract infection, reducing selection of multi-resistant pathogens and providing more accurate care for patients. Future studies will be required to help clinicians and keep the guidelines updated.