The Impact of the Extent of Lymphadenectomy on Oncologic Outcomes in Patients Undergoing Radical Cystectomy for Bladder Cancer : A Systematic Review

Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.Peer reviewedPostprin

Localized instabilities of the Wigner equation as a model for the emergence of Rogue Waves

In this paper, we model Rogue Waves as localized instabilities emerging from homogeneous and stationary background wavefields, under NLS dynamics. This is achieved in two steps: given any background Fourier spectrum P(k), we use the Wigner transform and Penrose’s method to recover spatially periodic unstable modes, which we call unstable Penrose modes. These can be seen as generalized Benjamin–Feir modes, and their parameters are obtained by resolving the Penrose condition, a system of nonlinear equations involving P(k). Moreover, we show how the superposition of unstable Penrose modes can result in the appearance of localized unstable modes. By interpreting the appearance of an unstable mode localized in an area not larger than a reference wavelength λ0 as the emergence of a Rogue Wave, a criterion for the emergence of Rogue Waves is formulated. Our methodology is applied to δ spectra, where the standard Benjamin–Feir instability is recovered, and to more general spectra. In that context, we present a scheme for the numerical resolution of the Penrose condition and estimate the sharpest possible localization of unstable modes. Keywords: Rogue Waves; Wigner equation; Nonlinear Schrodinger equation; Penrose modes; Penrose conditio

Assessing variability in carbon footprint throughout the food supply chain: a case study of Valencian oranges

[EN] Purpose This study aims to analyse the variability in the carbon footprint (CF) of organically and conventionally produced Valencian oranges (Spain), including both farming and post-harvest (PH) stages. At the same time, two issues regarding sample representativeness are addressed: how to determine confidence intervals from small samples and how to calculate the aggregated mean CF (and its variability) when the inventory is derived from different sources. Methods The functional unit was 1 kg of oranges at a European distribution centre. Farming data come from a survey of two samples of organic and conventional farms; PH data come from one PH centre; and data on exportation to the main European markets were obtained from official secondary sources. To assess the variability of the farming subsystem, a bootstrap of the mean CF was performed. The variability of the PH subsystem was assessed through a Monte Carlo simulation and a subsequent subsampling bootstrap. A weighted discrete distribution of the CF of distribution and end-of-life (EoL) was built, which was also bootstrapped. The empirical distribution of the overall CF was obtained by summing all iterations of the three bootstrap procedures of the subsystems. Results and discussion The CF of the baseline scenarios for conventional and organic production were 0.82 and 0.67 kg CO2 equivalent·kg orange¿1, respectively; the difference between their values was due mainly to differences in the farming subsystem. Distribution and EoL was the subsystem contributing the most to the CF (59.3 and 75.7% of the total CF for conventional and organic oranges, respectively), followed by the farming subsystem (34.1 and 19.8% for conventional and organic oranges, respectively). The confidence intervals for the CF of oranges were 0.72¿0.92 and 0.61¿0.82 kg CO2 equivalent·kg orange¿1 for conventional and organic oranges, respectively, and a significant difference was found between them. If organic production were to reach 50% of the total exported production, the CF would be reduced by 5.4¿8.4%. Conclusions The case study and the methods used show that bootstrap techniques can help to test for the existence of significant differences and estimate confidence intervals of the mean CF. Furthermore, these techniques allow several CF sources to be combined so as to estimate the uncertainty in the mean CF estimate. Assessing the variability in the mean CF (or in other environmental impacts) gives a more reliable measure of the mean impact.The Spanish Ministerio de Economia y Competitividad for provided financial support in the project Design of a life-cycle indicator for sustainability in agricultural systems (CTM2013-47340-R).Ribal, J.; Estruch, V.; Clemente, G.; Loreto Fenollosa, M.; Sanjuan, N. (2019). Assessing variability in carbon footprint throughout the food supply chain: a case study of Valencian oranges. 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Usefulness of bone turnover markers as predictors of mortality risk, disease progression and skeletal-related events appearance in patients with prostate cancer with bone metastases following treatment with zoledronic acid: TUGAMO study

Owing to the limited validity of clinical data on the treatment of prostate cancer (PCa) and bone metastases, biochemical markers are a promising tool for predicting survival, disease progression and skeletal-related events (SREs) in these patients. The aim of this study was to evaluate the predictive capacity of biochemical markers of bone turnover for mortality risk, disease progression and SREs in patients with PCa and bone metastases undergoing treatment with zoledronic acid (ZA). Methods: This was an observational, prospective and multicenter study in which ninety-eight patients were included. Patients were treated with ZA (4mg every 4 weeks for 18 months). Data were collected at baseline and 3, 6, 9, 12, 15 and 18 months after the beginning of treatment. Serum levels of bone alkaline phosphtase (BALP), aminoterminal propeptide of procollagen type I (P1NP) and beta-isomer of carboxiterminal telopeptide of collagen I (b-CTX) were analysed at all points in the study. Data on disease progression, SREs development and survival were recorded. Results: Cox regression models with clinical data and bone markers showed that the levels of the three markers studied were predictive of survival time, with b-CTX being especially powerful, in which a lack of normalisation in visit 1 (3 months after the beginning of treatment) showed a 6.3-times more risk for death than in normalised patients. Levels of these markers were also predictive for SREs, although in this case BALP and P1NP proved to be better predictors. We did not find any relationship between bone markers and disease progression. Conclusion: In patients with PCa and bone metastases treated with ZA, b-CTX and P1NP can be considered suitable predictors for mortality risk, while BALP and P1NP are appropriate for SREs. The levels of these biomarkers 3 months after the beginning of treatment are especially importantThis study was supported by Novartis Oncology Spai

The Vascular Impairment of Cognition Classification Consensus Study

Introduction: Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates and in turn prevalence estimates, research, and treatment. / Methods: The Vascular Impairment of Cognition Classification Consensus Study (VICCCS) involved participants (81% academic researchers) from 27 countries in an online Delphi consensus study. Participants reviewed previously proposed concepts to develop new guidelines. / Results: VICCCS had a mean of 122 (98–153) respondents across the study and a 67% threshold to represent consensus. VICCCS redefined VCI including classification of mild and major forms of VCI and subtypes. It proposes new standardized VCI-associated terminology and future research priorities to address gaps in current knowledge. / Discussion: VICCCS proposes a consensus-based updated conceptualization of VCI intended to facilitate standardization in research

The Effect of Adverse Surgical Margins on the Risk of Biochemical Recurrence after Robotic-Assisted Radical Prostatectomy

Positive surgical margins (PSM) after radical prostatectomy are associated with a greater risk of biochemical recurrence (BCR). However, not all PSM harbour the same prognosis for recurrence. We aim to determine the impact of different PSM characteristics and their coexistence on the risk of BCR. This retrospective study included 333 patients that underwent robotic-assisted radical prostatectomy for prostate cancer between 2015-2020 at a single institution. The effect of PSM and their adverse characteristics on the risk of BCR was assessed using Cox proportional hazard models. Kaplan-Meier was used to represent BCR-free survival stratified by margin status. With a median follow-up of 34.5 months, patients with PSM had a higher incidence of BCR, higher risk of relapse and lower BCR-free survival than negative margins (p < 0.001). We established as adverse characteristics: PSM length ≥ 3 mm, multifocality and Gleason at margin > 3. PSM ≥ 3 mm or multifocal PSM were associated with an increased risk for BCR compared to favourable margins (HR 3.50; 95% CI 2.05-5.95, p < 0.001 and HR 2.18; 95% CI 1.09-4.37, p = 0.028, respectively). The coexistence of these two adverse features in the PSM also conferred a higher risk for biochemical relapse and lower BCR-free survival. Adverse Gleason in the margin did not confer a higher risk for BCR than non-adverse margins in our models. We concluded that PSM are an independent predictor for BCR and that the presence of adverse characteristics, such as length and focality, and their coexistence in the PSM are associated with a greater risk of recurrence. Nevertheless, subclassifying PSM with adverse features did not enhance the model's predictive performance in our cohort

Influences on androgen deprivation therapy prescribing before surgery in high-risk prostate cancer

Objectives: To understand how best to further reduce the inappropriate use of pre-surgical androgen deprivation therapy (ADT), we investigated the determinants (influences) of ADT prescribing in urologists in two European countries using an established behavioural science approach. Additionally, we sought to understand how resource limitations caused by COVID-19 influenced this practice. Identification of key determinants, of undistributed and disrupted practice, will aid development of future strategies to reduce inappropriate ADT prescribing in current and future resource-limited settings. Participants and Methods: We conducted semi-structured qualitative interviews with urologists practicing in Italy and the UK from February to July 2022. Interviews focussed on undisrupted (usual) practice and disrupted practice (changes made during COVID-19 restrictions). Codes were generated inductively and were mapped to the 14 domains of the Theoretical Domains Framework. Relevant domains of influence were identified, and the similarities and differences between the UK and Italy were distinguished. Results: We identified 10 domains that were influential to ADT prescribing in the UK and eight in Italy. The role of guidance and evidence, the cancer care setting, the patients and the urologist's beliefs and experiences were identified as areas that were influential to ADT prescribing before surgery. Twenty-one similarities and 22 differences between the UK and Italy, for usual and COVID-19 practice, were identified across these 10 domains. Conclusion: Similarities and differences influencing ADT prescribing prior to surgery should be considered in behavioural strategy development and tailoring to reduce inappropriate ADT use. We gained an understanding of usual, undistributed care and resource-limited or disrupted care due to COVID-19 in two European countries. This gives an indication of how influences on ADT prescribing may change in future resource-limited circumstances and where efforts can be focused now and in future

Influence of Management Practices on Economic and Enviromental Performance of Crops. A Case Study in Spanish Horticulture

This article assesses the effect of management practices on the environmental and economic performance of tigernut production. Tigernut is a horticultural crop grown in a very limited and homogeneous area. Results show that the environmental variability among farms was greater than variability in costs. A selection of practices can reduce impacts per kilogram tigernut by factors 252.5 (abiotic depletion), 33 (aquatic ecotoxicity), or 6 (global warming) and costs by factors of between 2 and 3. The analysis shows a positive relationship between economic and environmental performance. Results highlight how proper management leads to both relatively low environmental impacts and costs.The authors acknowledge the support of the Conselleria d'Empresa, Universitat i Ciencia de la Generalitat Valenciana (GV/2007/211) and the Universitat Politecnica de Valencia (PAID05-08-316).Fenollosa Ribera, ML.; Ribal Sanchis, FJ.; Lidón Cerezuela, AL.; Bautista Carrascosa, I.; Juraske, R.; Clemente Polo, G.; Sanjuán Pellicer, MN. (2014). Influence of Management Practices on Economic and Enviromental Performance of Crops. A Case Study in Spanish Horticulture. Agroecology and Sustainable Food Systems. 38(6):635-659. https://doi.org/10.1080/21683565.2014.896302635659386De Backer, E., Aertsens, J., Vergucht, S., & Steurbaut, W. (2009). Assessing the ecological soundness of organic and conventional agriculture by means of life cycle assessment (LCA). British Food Journal, 111(10), 1028-1061. doi:10.1108/00070700910992916Basset-Mens, C., Anibar, L., Durand, P., & van der Werf, H. M. G. 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Fully automated contrast selection of joint bright- and black-blood late gadolinium enhancement imaging for robust myocardial scar assessment.

Joint bright- and black-blood MRI techniques provide improved scar localization and contrast. Black-blood contrast is obtained after the visual selection of an optimal inversion time (TI) which often results in uncertainties, inter- and intra-observer variability and increased workload. In this work, we propose an artificial intelligence-based algorithm to enable fully automated TI selection and simplify myocardial scar imaging. The proposed algorithm first localizes the left ventricle using a U-Net architecture. The localized left cavity centroid is extracted and a squared region of interest ("focus box") is created around the resulting pixel. The focus box is then propagated on each image and the sum of the pixel intensity inside is computed. The smallest sum corresponds to the image with the lowest intensity signal within the blood pool and healthy myocardium, which will provide an ideal scar-to-blood contrast. The image's corresponding TI is considered optimal. The U-Net was trained to segment the epicardium in 177 patients with binary cross-entropy loss. The algorithm was validated retrospectively in 152 patients, and the agreement between the algorithm and two magnetic resonance (MR) operators' prediction of TI values was calculated using the Fleiss' kappa coefficient. Thirty focus box sizes, ranging from 2.3mm <sup>2</sup> to 20.3cm <sup>2</sup> , were tested. Processing times were measured. The U-Net's Dice score was 93.0 ± 0.1%. The proposed algorithm extracted TI values in 2.7 ± 0.1 s per patient (vs. 16.0 ± 8.5 s for the operator). An agreement between the algorithm's prediction and the MR operators' prediction was found in 137/152 patients (κ= 0.89), for an optimal focus box of size 2.3cm <sup>2</sup> . The proposed fully-automated algorithm has potential of reducing uncertainties, variability, and workload inherent to manual approaches with promise for future clinical implementation for joint bright- and black-blood MRI

Defects in CD4+ T cell LFA‐1 integrin‐dependent adhesion and proliferation protect Cd47−/− mice from EAE

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141316/1/jlb0493.pd