关键词： Surgery   Abdominal Surgery   Cardiac Surgery   General Surgery   Thoracic Surgery   Vascular Surgery  

关键词： robotic surgical procedures   ureteral neoplasms   urinary bladder neoplasms  

摘要： Purpose: Intravesical recurrence (IVR) after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC) has an incidence of approximately 20%-50%. Studies to date have been composed of mixed treatment cohorts-open, laparoscopic and robotic. The objective of this study is to assess clinicopathological risk factors for intravesical recurrence after RNU for UTUC in a completely minimally invasive *** and Methods: We performed a multicenter, retrospective analysis of 485 patients with UTUC without prior or concurrent bladder cancer who underwent robotic or laparoscopic RNU. Patients were selected from an international cohort of 17 institutions across the United States, Europe and Asia. Univariate and multiple Cox regression models were used to identify risk factors for bladder ***: A total of 485 (396 robotic, 89 laparoscopic) patients were included in analysis. Overall, 110 (22.7%) of patients developed IVR. The average time to recurrence was 15.2 months (SD 15.5 months). Hypertension was a significant risk factor on multiple regression (HR 1.99, CI 1.06; 3.71, p=0.030). Diagnostic ureteroscopic biopsy incurred a 50% higher chance of developing IVR (HR 1.49, CI 1.00; 2.20, p=0.048). Treatment specific risk factors included positive surgical margins (HR 3.36, CI 1.36; 8.33, p=0.009) and transurethral resection for bladder cuff management (HR 2.73, CI 1.10; 6.76, p=0.031).Conclusions: IVR after minimally invasive RNU for UTUC is a relatively common event. Risk factors include a ureteroscopic biopsy, transurethral resection of the bladder cuff, and positive surgical margins. When possible, avoidance of transurethral resection of the bladder cuff and alternative strategies for obtaining biopsy tissue sample should be considered.(C) 2021 by the American Urological Association, Inc.

关键词： 3D-HEVC   Depth intra skip   Hardware design   Similarity criterion  

摘要： 3D-HEVC is the state-of-the-art standard to compress three-dimensional videos. One of the 3D-HEVC novel tools is the DIS tool, which is used to efficiently compress smooth and homogeneous areas of depth maps by using four different prediction modes. The decision of which DIS mode will be used is done through the SVDC similarity criterion in the DIS original definition. This article proposes the substitution of the complex SVDC criterion for simpler and more hardware friendly criteria as SATD, SSE, and SAD. These alternative criteria were evaluated in terms of encoding efficiency and hardware impacts in comparison with the SVDC. Dedicated DIS hardware were designed using each one of each criterion and these designs were described in VHDL and synthesized for TSMC 40 nm. The best results were found with SAD criteria, with losses of only 0.2% in coding efficiency and with expressive gains of more than 50 times in power and more than 35 times in area, when compared with SVDC. The reached results showed that the use of a simpler similarity criterion is an important alternative to be used in DIS tool, mainly if an efficient hardware design is required.

摘要： Introduction:There are no available low-burden, point-of-care tests to diagnose, grade, and predict hepatic encephalopathy (HE). Methods:We evaluated speech as a biomarker of HE in 76 English-speaking adults with cirrhosis. Results:Three speech features significantly correlated with the following neuropsychiatric scores: speech rate, word duration, and use of particles. Patients with low neuropsychiatric scores had slower speech (22 words/min, P = 0.01), longer word duration (0.09 seconds/word, P = 0.01), and used fewer particles (0.85% fewer, P = 0.01). Patients with a history of overt HE had slower speech (23 words/min, P = 0.005) and longer word duration (0.09 seconds/word, P = 0.005). Discussion:HE is associated with slower speech. [GRAPHICS] .

关键词： genetics   genome-wide association study   genomics   urinary incontinence, stress   urinary incontinence, urge  

摘要： Purpose: Genome-wide association studies have not identified replicable genetic risk loci for stress or urgency urinary *** and Methods: We carried out a discovery stage, case control, genome-wide association study in 3 independent discovery cohorts of European women (8,979) for stress incontinence, urgency incontinence, and any incontinence phenotypes. We conducted replication in 6 additional studies of European ancestry (4,069). We collected bladder biopsies from women with incontinence (50) to further investigate bladder expression of implicated genes and pathways and used symptom questionnaires for phenotyping. We conducted meta-analyses using inverse variance fixed effects models and whole transcriptome analyses using Affymetrix(R) arrays with replication with TaqMan(R) polymerase chain ***: In the discovery stage, we identified 16 single nucleotide polymorphisms genotyped or imputed at 5 loci that reached genome-wide significance (p <5x10-8). In replication, rs138724718 on chromosome 2 near the macrophage receptor with collagenous structure (MARCO) gene (replication p=0.003) was associated with stress incontinence. In addition, rs34998271 on chromosome 6 near the endothelin 1 (EDN1) gene (replication p=0.0008) was associated with urgency incontinence. In combined meta-analyses of discovery and replication cohorts, associations with genome-wide significance for these 2 single nucleotide polymorphisms were confirmed. Transcriptomics analyses showed differential expression of 7 of 19 genes in the endothelin pathway between stress and urgency incontinence (p <0.0001).Conclusions: We uncovered 2 new risk loci near the genes endothelin 1 (EDN1), associated with urgency incontinence, and macrophage receptor with collagenous structure (MARCO), associated with stress incontinence. These loci are biologically plausible given their roles in smooth muscle contraction and innate host defense, respectively.(C) 2021 by the American Urological

关键词： boswellic acid   cannabis   complementary and alternative medicine (CAM)   curcumin   diffuse intrinsic pontine glioma (DIPG)  

摘要： Introduction Diffuse intrinsic pontine glioma (DIPG) is a rare and aggressive childhood brainstem malignancy with a 2-year survival rate of <10%. This international survey study aims to evaluate the use of complementary and alternative medicine (CAM) in this patient population. Methods Parents and physicians of patients with DIPG were asked to participate in a retrospective online survey regarding CAM use during time of illness. Results Between January and May 2020, 120 parents and 75 physicians contributed to the online survey. Most physicians estimated that <50% of their patients used CAM, whereas 69% of the parents reported using CAM to treat their child during time of illness. Cannabis was the most frequently used form of CAM, followed by vitamins and minerals, melatonin, curcumin, and boswellic acid. CAM was mainly used with the intention of direct antitumor effect. Other motivations were to treat side effects of chemotherapy or to increase comfort of the child. Children diagnosed from 2016 onwards were more likely to use CAM (chi(2 )= 6.08, p = .014). No significant difference was found between CAM users and nonusers based on ethnicity (chi(2 )= 4.18, p = .382) or country of residence (chi(2 )= 9.37, p = .154). Almost 50% of the physicians do not frequently ask their patients about possible CAM use. Conclusion This survey demonstrates that worldwide, a considerable number of patients with DIPG use CAM. Physicians should be more aware of potential CAM use and actively discuss the topic. In addition, more research is needed to gain knowledge about possible anticancer effects of CAM and (positive/negative) interactions with conventional therapies.