The Weiss nocturia indices have structured clinical thinking about nocturia for over 2 decades. By deriving simple ratios from the frequency-volume chart, they classify nocturia into nocturnal polyuria, reduced nocturnal bladder capacity, and mixed etiology. The arithmetic is sound. But the framework rests on an unexamined assumption: that the maximum voided volume, almost always the first morning void, represents "bladder capacity," and that the gap between this value and daytime voided volumes reflects normal physiology. We propose that what the frequency-volume chart measures during wakefulness is not capacity but a personal adaptive afferent threshold-a neurally determined set-point at which the individual initiates voiding, always below the structural capacity the detrusor permits. The first morning void approximates true structural capacity, revealed when sleep suppresses the cortical circuits that enforce the waking threshold. This reframing unifies the entire overactive bladder spectrum-normal voiding, frequency, urgency, urge incontinence-as positions on a single threshold continuum. It reveals nocturia from "reduced nocturnal bladder capacity" as the intrusion of the waking threshold into sleep when central afferent gating fails. The Weiss parameters captured the output of this system with numerical precision but encoded the threshold artifact as the reference norm, directing a generation of research toward the bladder in patients whose problem may be the brain.

Chemical signalling and endocrine state are known to covary with social environment, but the speed of their response to social transitions under natural conditions remains unclear. We examined how major urinary proteins (MUPs) and faecal steroid hormone metabolites respond to shifts between solitary housing and a complex social setting in two house mouse subspecies, Mus musculus musculus and M. m. domesticus. Using repeated sampling in semi-natural enclosures, we measured MUP, testosterone, and corticosterone metabolite concentrations across three contexts: before social exposure, during the social phase, and after return to isolation. Reproductive output was quantified within a 44-day window around each sampling event. Entry into the enclosures triggered a strong, coordinated response: urinary MUP concentrations increased in both sexes and subspecies, paralleled by rises in testosterone and corticosterone metabolites during early social exposure. In males, this pattern reversed quite quickly after removal, with MUPs and both hormone metabolites declining within 24 h of renewed isolation. Under stable social conditions, urinary MUP concentrations increased with current reproductive output, whereas testosterone and corticosterone metabolites showed no such association. MUP concentrations were also unrelated to either hormone, suggesting that socially responsive MUP investment is not directly coupled to steroid levels. Despite baseline differences between subspecies and the expected male bias in MUP production, the main context-dependent patterns were consistent across taxa. Our results demonstrate pronounced social plasticity in chemical signalling and endocrine state, and indicate that MUP concentrations more closely reflect reproductive outcomes than steroid metabolite concentrations.

The anti-inflammatory activity of Cotula cinerea essential oil (EO) was evaluated using integrated chemical, in vivo, histological, and computational approaches. Gas chromatography-mass spectrometry (GC-MS) identified trans-thujone (51.86%), santolina triene (10.60%), and sabinene (6.17%) as the most abundant constituents. In benzylthiouracil (BTU)-treated Wistar rats, EO administration reduced the liver and kidney indices from 4.36% to 2.70% and from 0.65% to 0.52%, respectively; red blood cell count increased from 4.90 to 7.17 × 10[12]/L and hemoglobin from 9.40 to 15.40 g/dL. Aspartate aminotransferase decreased from 226.06 to 111.10 U/L and alanine aminotransferase from 116.00 to 71.56 U/L. C-reactive protein and renal markers also moved toward control values, and histological examination showed improved liver and kidney architecture. Computational analyses were used as hypothesis-generating complements to the experimental findings. Molecular docking predicted the most favorable cyclooxygenase-2 (COX-2) scores for cis-verbenyl acetate (CVA; -7.01 kcal/mol) and camphor (CAM; -6.66 kcal/mol). Molecular dynamics (MD) trajectories and molecular mechanics/Poisson-Boltzmann surface area (MM-PBSA) estimates indicated persistent simulated interactions, with COX-2 binding free energies of -43.67 ± 3.80 and -39.93 ± 2.59 kcal/mol, respectively. Absorption, distribution, metabolism, excretion, and toxicity (ADMET) outputs were favorable for CVA and CAM but remain predictive.

Delayed graft function (DGF) is a rare complication following living-donor kidney transplantation, most commonly caused by ischemic acute tubular necrosis (ATN). We report a case in a 51-year-old woman with diabetic nephropathy who underwent an ABO-compatible living-donor kidney transplant from her younger brother. Although the procedure was completed without major complications, the patient developed persistent oliguria postoperatively. Serial allograft biopsies on postoperative days 1, 3, and 13 consistently showed findings of ATN without evidence of acute rejection or calcineurin inhibitor toxicity. Imaging studies revealed no vascular abnormalities or urinary tract obstruction. Despite adequate fluid management and stable hemodynamics, urine output remained below 500 ml/day for 26 days, and dialysis was required. On postoperative day 27, urine output gradually increased, allowing for withdrawal from dialysis by day 29. The patient was discharged on postoperative day 44, and renal function remained stable with a serum creatinine of 1.0 mg/dl at 9 months post-transplant. Intraoperative review of the donor nephrectomy video revealed purplish discoloration of the graft surface, raising suspicion of transient ischemia potentially caused by venous congestion during renal mobilization. This case emphasizes the importance of gentle vascular handling during donor nephrectomy and vigilant postoperative monitoring. Even in cases of prolonged DGF, recovery may be achieved with continued supportive therapy and repeated biopsies to rule out rejection. This report highlights that timely diagnosis and conservative management can lead to successful graft recovery, even after extended periods of oliguria.

Automated peritoneal dialysis (APD) is a widely used dialysis modality for patients with end-stage kidney disease (ESKD). However, controversy remains regarding the rate of residual kidney function (RKF) decline between patients treated with APD and continuous ambulatory peritoneal dialysis (CAPD). This study aimed to investigate the effect of peritoneal dialysis modality on the rate of RKF decline in Chinese patients with new-onset ESKD. We conducted a single-center retrospective study to explore the association between PD modalities and RKF decline. A total of 53 patients with new-onset ESKD were enrolled. Of these, 19 patients started with APD and 34 with CAPD. The rates of RKF decline were compared between two groups. Multivariate linear regression was performed to identify risk factors for rapid decline of RKF. Baseline RKF and urine output were comparable between the APD and CAPD groups. At 6 months after PD initiation, RKF was 1.9 ± 1.6 mL/min/1.73 m[2] in the APD group, significantly lower than 3.0 ± 1.7 mL/min/1.73 m[2] in the CAPD group (p = 0.043). The APD group had a significantly faster mean rate of RKF decline (-6.6 ± 2.5 vs. -4.3 ± 2.3 mL/min/1.73 m[2]/year, p = 0.002). In multivariate linear regression adjusted for established risk factors, APD use (vs. CAPD) (β = 0.93; p = 0.004) and baseline RKF (β = 0.38; p < 0.001) were significantly associated with accelerated RKF decline. Our findings indicate that Chinese patients initiating dialysis with APD experience faster RKF decline within the first 6 months compared with those starting PD with CAPD. Furthermore, high baseline RKF is associated with rapid RKF decline.

Objective This study aimed to evaluate changes in the International Prostate Symptom Score (IPSS) as the primary functional outcome following Optilume drug-coated balloon dilatation for recurrent male urethral stricture disease. Secondary outcomes included maximum urinary flow rate, post-void residual (PVR) volume, patient satisfaction, adverse events, and repeat intervention. An exploratory manufacturer-supplied cost-impact projection was also described separately. Materials and methods This retrospective single-centre study included 10 men treated during the early implementation of the Optilume drug-coated balloon (Urotronic, Inc., Plymouth, MN). Routinely recorded IPSS, maximum urinary flow rate (Qmax), PVR, satisfaction, complications, and repeat intervention data were reviewed. An exploratory cost-impact projection was generated using a manufacturer-supplied model and interpreted alongside economic guidance from the National Institute for Health and Care Excellence (NICE). This illustrative single-year projection was not a formal budget-impact analysis and was not based on audited, patient-level local cost data. Results The mean age of the cohort was 62.5 ± 6.5 years. All 10 patients (100%) had bulbar urethral strictures. Median IPSS decreased from 15.0 (interquartile range (IQR): 13.3-16.0) before treatment to 2.0 (IQR: 2.0-3.5) at follow-up (Wilcoxon signed-rank test, W = 1, p = 0.0039). Median Qmax increased from 7.5 (IQR: 5.3-9.0) mL/s to 18.8 (IQR: 15.4-19.8) mL/s (W = 0, p = 0.0020), and median PVR decreased from 211.5 (IQR: 150.0-239.0) mL to 20.0 (IQR: 11.3-26.8) mL (W = 0, p = 0.0020). Nine of 10 patients reported satisfaction with treatment. No urinary tract infection, urinary retention, haematuria requiring intervention, unplanned admission, or repeat stricture procedure was recorded at the latest follow-up. In the manufacturer-supplied model for 30 annual procedures, projected initial-procedure expenditure was £11,430 lower with Optilume after applying an assumed £1,500 reimbursement. Projected retreatment expenditure was approximately £17,252 lower. These figures were model-derived outputs and did not represent observed or audited local savings. Conclusions Drug-coated balloon dilatation was associated with early symptomatic and objective improvement in this selected cohort, although the uncontrolled study design does not allow conclusions regarding causation, comparative effectiveness, or durability. No major adverse events were documented, but the cohort was insufficient to assess uncommon complications. The exploratory cost-impact projection illustrates possible expenditure differences under the stated assumptions but does not demonstrate actual or realised savings.