Adoption of robotic assisted partial nephrectomies: a population-based analysis of U.S. surgeons from 2004-2013

The advent of minimally invasive and robotic techniques has resulted in the rapid adoption of this novel technology, with the field of urology at the forefront. Since the first Robotic‐Assisted Laparoscopic Radical Prostatectomy (RALP) was performed in 2000 using  the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA, USA), surgeons have rapidly incorporated robotic technology for the use of radical prostatectomies for prostatic carcinoma. Prior to 2005, only a minority of surgeons‐‐fewer than 2.5%‐‐performing radical  prostatectomies utilized robotic assistance.  However, robotic assistance has become the predominant approach for radical prostatectomies, increasing from 22% to 85% between the years 2002 to 2013, representing a nearly five‐fold increase in utilization

HIMEG: HIERARCHICAL MEETING NOTE GENERATION USING TEXT SEGMENTATION AND ATTENTION CORRELATION

Techniques are presented herein that support a HiMEG system, a framework that helps create meeting notes of multiple granularities for meeting invitees so that they can refresh their memory or catch up on any meeting. Such a system comprises a Segmentation Engine that may divide a meeting transcript into separate sections representing the different topics that were covered during a meeting. Such a system also comprises an Attention Correlation Analyzing Model that may be used to capture the attention correlation between different meeting notes that were generated from the discovered topics, which is useful in a Meeting Note Summarization Model that may assess which meeting notes are most similar. Under such a system, one effective summary may be formed based on the most similar meeting notes and the process may be repeated until there is one overall summary of a meeting. In the end, a user may read the high-level summary of a meeting and then dive further into the specific contents of the general meeting note based on their interests and needs. While the above-described framework was originally developed for generating meeting notes, it may also be applied to any text input such as speeches, action scripts, and training scripts

STRATIFIED INVESTIGATION OF LOW-PERFORMING NETWORK ARCHITECTURE (SINA) USING GRAPH NEURAL NETWORKS AND PEER BENCHMARKING

Monitoring and troubleshooting networks to improve their performance and reliability is a complicated task, not only because it requires the checking of every single network device but also because it involves understanding the connections between those devices. To address that complexity, techniques are presented herein that support a Stratified Investigation of Low-Performing Network Architecture (SINA) system. Such a system is a framework that identifies any low-performing network architecture areas and makes improvements on a subnetwork level. Such a system may automatically identify low-performing areas of a customer’s network based on information about similar networks and expert knowledge with solutions. Such a system may employ a graph neural network (GNN) to identify areas of a customer’s network that need improvement based on a calculated performance score while considering the interaction between devices and the topology of networks. Further, such a system may leverage network performance metrics from many customers to create a performance benchmark and then evaluate where a customer’s network’s performance lies within that benchmark. Still further, such a system may employ a transformer-based natural language processing (NLP) model (that understands key semantic knowledge from documents, device configurations, and logs) to help generate solutions to network issues. Finally, based on high-performing customers relative to the benchmark and documents with best practices for configuring networks, a SINA system may provide solutions to a customer’s network that will help optimize network performance

A mouse polyomavirus-encoded microRNA targets the cellular apoptosis pathway through Smad2 inhibition

AbstractSome viruses and most eukaryotic cells have microRNAs that regulate the expression of many genes. Although many viral miRNAs have been identified, only a few have been included in in vivo functional studies. Here we show that a Py-encoded miRNA downregulates the expression of the pro-apoptotic factor Smad2, resulting in the suppression of the apoptosis pathway. To study the Py miRNA in an in vivo context, a miRNA-deficient mutant virus was created on the background of the LID virus strain which establishes a rapid and lethal infection in newborn mice. Apoptosis analysis on kidney tissues indicates that the pro-apoptotic pathway is targeted in the infected host as well. Suppression of apoptosis through targeting of Smad2 by the Py miRNA is expected to synergize with anti-apoptotic effects previously attributed to the polyoma tumor antigens in support of virus replication in the natural host

Adolescent Resilience and Self-Esteem in Nicaragua

In the present study, we explored the role of resilience in predicting self-esteem in Nicaraguan adolescents, as well as the impact of poverty on the relationship between self-esteem and resilience for this unique population. Our sample consisted of 1,673 high school students (863 females, 810 males) who completed self-report surveys measuring various aspects of wellbeing, self-esteem, resilience, and general socioeconomic class. For the entire sample, social skills was the strongest predictor of self-esteem (β = .18, p \u3c .001), followed by family (β = .13, p \u3c .001), and belonging (β = .12, p \u3c .001). For those above the poverty line, social skills, family, and belonging still contributed most to self-esteem, however coefficients for each factor were stronger for this subgroup (β = .21, p \u3c .001, β = .18, p \u3c .001, and β = .18, p \u3c .001, respectively). For those self-reported below the poverty line, while social skills (β = .19, p \u3c .001) and belonging (β = .14, p \u3c .001) remained strong predictors of self-esteem, family was not included in the model. This could suggest that adolescents living in poverty are relying more on peer relationships and less on family for self-esteem, as poverty is known to disrupt family cohesiveness (Vázquez et al., 2007). Ultimately, more research is needed to investigate the relationship between self-esteem and resilience for adolescents and families living in Nicaragua

Diffusion MR Characteristics Following Concurrent Radiochemotherapy Predicts Progression-Free and Overall Survival in Newly Diagnosed Glioblastoma.

The standard of care for newly diagnosed glioblastoma (GBM) is surgery, then radiotherapy (RT) with concurrent temozolomide (TMZ), followed by adjuvant TMZ. We hypothesized patients with low diffusivity measured using apparent diffusion coefficient (ADC) histogram analysis evaluated after RT+TMZ, prior to adjuvant TMZ, would have a significantly shorter progression-free (PFS) and overall survival (OS). To test this hypothesis we evaluated 120 patients with newly diagnosed GBM receiving RT+TMZ followed by adjuvant TMZ. MRI was performed after completion of RT+TMZ, prior to initiation of adjuvant TMZ. A double Gaussian mixed model was used to describe the ADC histograms within the enhancing tumor, where ADCL and ADCH were defined as the mean ADC value of the lower and higher Gaussian distribution, respectively. An ADCL value of 1.0 um2/ms and ADCH value of 1.6 um2/ms were used to stratify patients into high and low risk categories. Results suggest patients with low ADCL had significantly shorter PFS (Cox Hazard Ratio = 0.12, P = 0.0006). OS was significantly shorter with low ADCL tumors, showing a median OS of 407 vs. 644 days (Cox Hazard Ratio = 0.31, P = 0.047). ADCH was not predictive of PFS or OS when accounting for age and ADCL. In summary, newly diagnosed glioblastoma patients with low ADCL after completion of RT+TMZ are likely to progress and die earlier than patients with higher ADCL. Results suggest ADC histogram analysis may be useful for patient risk stratification following completion of RT+TMZ

Atmosphere of Callisto

During the Galileo flybys of Callisto in 1999, a CO_2 atmosphere and an ionosphere were detected. Using the Caltech/Jet Propulsion Laboratory one-dimensional KINETICS model, we have successfully simulated the observed electron density within a factor of 2, while satisfying the observational constraints on carbon and oxygen atoms. We conclude that photoionization of CO_2 alone is insufficient to produce the observed electron density. An atmosphere 20–100 times denser than the CO_2 atmosphere must be introduced, as suggested by Kliore et al. (2002). We show that an O_2-rich atmosphere is highly probable. However, the atomic oxygen produced from O_2 photodissociation is 2 orders of magnitude greater than the upper limit given by Strobel et al. (2002). The introduction of reactive hydrogen chemistry assuming a surface abundance of H_2O of ∼2 × 10^9 cm^(−3) (4 × 10^(−8) mbar) is required to reduce the excess atomic O abundance. The calculated atomic O column density is >5 × 10^(12) cm^(−2), which is about the observed upper limit, suggesting we should be able to detect O in the atmosphere of Callisto

Long Penetration Mode Counterflowing Jets for Supersonic Slender Configurations - A Numerical Study

A novel approach of using counterflowing jets positioned strategically on the aircraft and exploiting its long penetration mode (LPM) of interaction towards sonic-boom mitigation forms the motivation for this study. Given that most previous studies on the counterflowing LPM jet have all been on blunt bodies and at high supersonic or hypersonic flow conditions, exploring the feasibility to obtain a LPM jet issuing from a slender body against low supersonic freestream conditions is the main focus of this study. Computational fluid dynamics computations of axisymmetric models (cone-cylinder and quartic geometry), of relevance to NASA's High Speed project, are carried out using the space-time conservation element solution element viscous flow solver with unstructured meshes. A systematic parametric study is conducted to determine the optimum combination of counterflowing jet size, mass flow rate, and nozzle geometry for obtaining LPM jets. Details from these computations will be used to assess the potential of the LPM counterflowing supersonic jet as a means of active flow control for enabling supersonic flight over land and to establish the knowledge base for possible future implementation of such technologies

Association of ambient fine particulate matter air pollution with kidney transplant outcomes

Importance: Increased levels of ambient fine particulate matter (PM2.5) air pollution are associated with increased risks for detrimental health outcomes, but risks for patients with kidney transplants (KTs) remain unknown. Objective: To investigate the association of PM2.5 exposure with KT outcomes. Design, Setting, and Participants: This retrospective cohort study was conducted using data on patients who received KTs from 2004 to 2016 who were identified in the national US transplant registry and followed up through March 2021. Multiple databases were linked to obtain data on PM2.5 concentration, KT outcomes, and patient clinical, transplant, and contextual factors. Data were analyzed from April 2020 through July 2021. Exposures: Exposures included post-KT time-dependent annual mean PM2.5 level (in 10 μg/m3) and mean PM2.5 level in the year before KT (ie, baseline levels) in quartiles, as well as baseline annual mean PM2.5 level (in 10 μg/m3). Main Outcomes and Measures: Acute kidney rejection (ie, rejection within 1 year after KT), time to death-censored graft failure, and time to all-cause death. Multivariable logistic regression for kidney rejection and Cox analyses with nonlinear assessment of exposure-response for death-censored graft failure and all-cause death were performed. The national burden of graft failure associated with PM2.5 levels greater than the Environmental Protection Agency recommended level of 12 μg/m3 was estimated. Results: Among 112 098 patients with KTs, 70 522 individuals (62.9%) were older than age 50 years at the time of KT, 68 117 (60.8%) were men, and the median (IQR) follow-up was 6.0 (3.9-8.9) years. There were 37 265 Black patients (33.2%), 17 047 Hispanic patients (15.2%), 48 581 White patients [43.3%]), and 9205 patients (8.2%) of other race or ethnicity. The median (IQR) baseline PM2.5 level was 9.8 (8.3-11.9) μg/m3. Increased baseline PM2.5 level, compared with quartile 1 baseline PM2.5 level, was not associated with higher odds of acute kidney rejection for quartile 2 (adjusted odds ratio [aOR], 0.99; 95% CI, 0.92-1.06) but was associated with increased odds for quartile 3 (aOR, 1.11; 95% CI, 1.04-1.20) and quartile 4 (aOR, 1.13; 95% CI, 1.05-1.23). Nonlinear assessment of exposure-response for graft failure and death showed no evidence for nonlinearity. Increased PM2.5 levels were associated with increased risk of death-censored graft failure (adjusted hazard ratio [aHR] per 10 μg/m3 increase, 1.17; 95% CI, 1.09-1.25) and all-cause death (aHR per 10 μg/m3 increase, 1.21; 95% CI, 1.14-1.28). The national burden of death-censored graft failure associated with PM2.5 above 12 μg/m3 was 57 failures (95% uncertainty interval, 48-67 failures) per year among patients with KTs. Conclusions and Relevance: This cohort study found that PM2.5 level was an independent risk factor associated with acute rejection, graft failure, and death among patients with KTs. These findings suggest that efforts toward decreasing levels of PM2.5 concentration may be associated with improved outcomes after KT