Segmental resection for ureter urothelial carcinoma is safe as radical nephroureterectomy

Introduction & Objectives: Kidney-sparing surgery (KSS) seems inferior to radical nephroureterectomy (RNU) in recurrence-free survival (RFS). However, there is limited data regarding the potential influence of the location of the upper tract urothelial carcinoma (UTUC). The current study aims to provide further evidence by the largest UTUC registry

Vorton Formation

In this paper we present the first analytic model for vorton formation. We start by deriving the microscopic string equations of motion in Witten's superconducting model, and show that in the relevant chiral limit these coincide with the ones obtained from the supersonic elastic models of Carter and Peter. We then numerically study a number of solutions of these equations of motion and thereby suggest criteria for deciding whether a given superconducting loop configuration can form a vorton. Finally, using a recently developed model for the evolution of currents in superconducting strings we conjecture, by comparison with these criteria, that string networks formed at the GUT phase transition should produce no vortons. On the other hand, a network formed at the electroweak scale can produce vortons accounting for up to 6% of the critical density. Some consequences of our results are discussed.Comment: 41 pages; color figures 3-6 not included, but available from authors. To appear in Phys. Rev.

DYRK1A promotes dopaminergic neuron survival in the developing brain and in a mouse model of Parkinson's disease

In the brain, programmed cell death (PCD) serves to adjust the numbers of the different types of neurons during development, and its pathological reactivation in the adult leads to neurodegeneration. Dual-specificity tyrosine-(Y)-phosphorylation regulated kinase 1A (DYRK1A) is a pleiotropic kinase involved in neural proliferation and cell death, and its role during brain growth is evolutionarily conserved. Human DYRK1A lies in the Down syndrome critical region on chromosome 21, and heterozygous mutations in the gene cause microcephaly and neurological dysfunction. The mouse model for DYRK1A haploinsufficiency (the Dyrk1a +/− mouse) presents neuronal deficits in specific regions of the adult brain, including the substantia nigra (SN), although the mechanisms underlying these pathogenic effects remain unclear. Here we study the effect of DYRK1A copy number variation on dopaminergic cell homeostasis. We show that mesencephalic DA (mDA) neurons are generated in the embryo at normal rates in the Dyrk1a haploinsufficient model and in a model (the mBACtg Dyrk1a mouse) that carries three copies of Dyrk1a. We also show that the number of mDA cells diminishes in postnatal Dyrk1a +/− mice and increases in mBACtg Dyrk1a mice due to an abnormal activity of the mitochondrial caspase9 (Casp9)-dependent apoptotic pathway during the main wave of PCD that affects these neurons. In addition, we show that the cell death induced by 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP), a toxin that activates Casp9-dependent apoptosis in mDA neurons, is attenuated in adult mBACtg Dyrk1a mice, leading to an increased survival of SN DA neurons 21 days after MPTP intoxication. Finally, we present data indicating that Dyrk1a phosphorylation of Casp9 at the Thr125 residue is the mechanism by which this kinase hinders both physiological and pathological PCD in mDA neurons. These data provide new insight into the mechanisms that control cell death in brain DA neurons and they show that deregulation of developmental apoptosis may contribute to the phenotype of patients with imbalanced DYRK1A gene dosage

Heart Rate Variability Analysis Guided by Respiration in Major Depressive Disorder

In this study a Heart Rate Variability (HRV) analysis guided by respiration to evaluate different patterns of Autonomic Nervous System (ANS) in response to a cognitive stressor between Major Depressive Disorder (MDD) and control (CT) subjects is presented. Cardiorespiratory Time Frequency Coherence (TFC) reveals the local coupling of HRV and respiration signal which is essential and usually not included in estimation of ANS measures derived by HRV. Parasympathetic activity of ANS is measured as the power at the frequencies where TFC between HRV and respiration is significant, whereas sympathetic dominance is measured as the normalized power in the low frequency band [0.04,0.15] Hz of HRV excluding the power of those frequencies related to respiration. Results showed significantly lower (p <; 0.05) sympathetic dominance in MDD with respect to CT subjects during stress, suggesting that ANS reactivity as response to stress stimuli is lower in MDD patients. The study of ANS reactivity to a stressor may serve as a biomarker useful for the early diagnosis and monitoring of MDD patients

Autonomic nervous system assessment in critically ill patients undergoing a cognitive rehabilitation therapy

Recent clinical and electrophysiological studies reveal a high incidence of autonomic nervous system (ANS) dysfunction in patients treated in Intensive Care Units (ICUs). Cognitive rehabilitation (CR) is a behavioral therapy that has proven to be effective improving cognitive deficits in clinical populations with abnormalities in brain activation patterns. A total of 17 critically ill patients received CR aimed to improve the ANS status, which was quantified in terms of HRV. The CR included cognitive exercises aimed to improve prefrontal activation. HRV was obtained during pre-CR, CR and post-CR. Power in the low (PLF) and high (PHF) frequency bands related to sympathetic and parasympathetic systems was computed. PHF was obtained within a band centered at respiratory rate. Comparing with baseline values, 7 patients showed an increased PHF in post-CR, suggesting an increase of parasympathetic activity

Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) in predicting systemic inflammatory response syndrome (SIRS) and sepsis after percutaneous nephrolithotomy (PNL)

The objective of this prospective observational study was to assess the clinical significance of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) as potential biomarkers to identify post-PNL SIRS or sepsis. Demographic data and laboratory data including hemoglobin (Hb), total leucocyte count (TLC), serum creatinine, urine microscopy and culture were collected. The NLR, LMR and PLR were calculated by the mathematical division of their absolute values derived from routine complete blood counts from peripheral blood samples. Stone factors were assessed by non-contrast computerized tomography of kidneys, ureter and bladder (NCCT KUB) and included stone burden (Volume = L x W x D x pi x 0.167), location and Hounsfield value and laterality. Intraoperative factors assessed were puncture site, tract size, tract number, operative time, the need for blood transfusion and stone clearance. Of 517 patients evaluated, 56 (10.8%) developed SIRS and 8 (1.5%) developed sepsis. Patients developing SIRS had significantly higher TLC (10.4 +/- 3.5 vs 8.6 +/- 2.6, OR 1.19, 95% CI 1.09-1.3, p = 0.000002), higher NLR (3.6 +/- 2.4 vs 2.5 +/- 1.04, OR 1.3, 95% CI = 1.09-1.5, p = 0.0000001), higher PLR (129.3 +/- 53.8 vs 115.4 +/- 68.9, OR 1.005, 95% CI 1.001-1.008, p = 0.005) and lower LMR (2.5 +/- 1.7 vs 3.2 +/- 1.8, OR 1.18, 95% CI 1.04-1.34, p = 0.006). Staghorn stones (12.8 vs 3.24%, OR 4.361, 95% CI 1.605-11.846, p = 0.008) and long operative times (59.6 +/- 14.01 vs 55.2 +/- 16.02, OR 1.01, 95% CI 1.00-1.03, p = 0.05) had significant association with postoperative SIRS. In conclusion, NLR, PLR and LMR can be useful independent, easily accessible and cost-effective predictors for early identification of post-PNL SIRS/sepsis.Manipal Academy of Higher Education, Manipa

Oral processing of hydrogels: Influence of food material properties versus individuals' eating capability

Food material properties play an important role in sensory perception and consumer acceptance of foods. However, the actual oral processing behavior may depend on both the material properties of the food that is being consumed and individuals' oral capabilities. This study aimed to examine the relationships between intrinsic (oral capabilities of healthy participants) and extrinsic (food material properties of a set of hydrogels) variables to the real oral processing behavior. Three κ‐carrageenan hydrogels (κC), differing in fracture mechanics and oral tribology properties, were prepared: native κC, κC with added Na‐alginate, and a κC matrix with added Ca‐alginate beads of 300 μm. A composite score of eating capability (EC) was measured with non‐invasive techniques (maximum bite force and tongue pressure) using a panel of 28 untrained consumers. The oral processing behaviors (number of chews, oral residence time, and chewing rate) were analyzed with the same participants using frame‐by‐frame video analysis. It was found that the EC scores did not correlate with any of the oral processing behaviors. The number of chews and oral residence time showed a strong correlation with the fracture force and friction force at orally relevant speeds (10–100 mm/s), whereas chewing rate did not vary with these properties. The results from this study indicate that oral processing in healthy adults seems mainly motivated by food material properties, and the chewing rate seems to relate more to individual differences and EC than to food properties. Insights from this study, using model hydrogels, have helped to promote knowledge on oral processing behavior in healthy individuals; could bridge the gap between consumer science, psychology, and food science; and may be of interest to product developers in designing foods with pleasant texture properties

Euclidean Black Hole Vortices

We argue the existence of solutions of the Euclidean Einstein equations that correspond to a vortex sitting at the horizon of a black hole. We find the asymptotic behaviours, at the horizon and at infinity, of vortex solutions for the gauge and scalar fields in an abelian Higgs model on a Euclidean Schwarzschild background and interpolate between them by integrating the equations numerically. Calculating the backreaction shows that the effect of the vortex is to cut a slice out of the Euclidean Schwarzschild geometry. Consequences of these solutions for black hole thermodynamics are discussed.Comment: 24 page

Entanglement hamiltonian and entanglement contour in inhomogeneous 1D critical systems

Inhomogeneous quantum critical systems in one spatial dimension have been studied by using conformal field theory in static curved backgrounds. Two interesting examples are the free fermion gas in the harmonic trap and the inhomogeneous XX spin chain called rainbow chain. For conformal field theories defined on static curved spacetimes characterised by a metric which is Weyl equivalent to the flat metric, with the Weyl factor depending only on the spatial coordinate, we study the entanglement hamiltonian and the entanglement spectrum of an interval adjacent to the boundary of a segment where the same boundary condition is imposed at the endpoints. A contour function for the entanglement entropies corresponding to this configuration is also considered, being closely related to the entanglement hamiltonian. The analytic expressions obtained by considering the curved spacetime which characterises the rainbow model have been checked against numerical data for the rainbow chain, finding an excellent agreement

Utilization of multiparametric prostate magnetic resonance imaging in clinical practice and focal therapy: report from a Delphi consensus project

To codify the use of multiparametric magnetic resonance imaging (mpMRI) for the interrogation of prostate neoplasia (PCa) in clinical practice and focal therapy (FT). An international collaborative consensus project was undertaken using the Delphi method among experts in the field of PCa. An online questionnaire was presented in three consecutive rounds and modified each round based on the comments provided by the experts. Subsequently, a face-to-face meeting was held to discuss and finalize the consensus results. mpMRI should be performed in patients with prior negative biopsies if clinical suspicion remains, but not instead of the PSA test, nor as a stand-alone diagnostic tool or mpMRI-targeted biopsies only. It is not recommended to use a 1.5 Tesla MRI scanner without an endorectal or pelvic phased-array coil. mpMRI should be performed following standard biopsy-based PCa diagnosis in both the planning and follow-up of FT. If a lesion is seen, MRI-TRUS fusion biopsies should be performed for FT planning. Systematic biopsies are still required for FT planning in biopsy-naïve patients and for patients with residual PCa after FT. Standard repeat biopsies should be taken during the follow-up of FT. The final decision to perform FT should be based on histopathology. However, these consensus statements may differ for expert centers versus non-expert centers. The mpMRI is an important tool for characterizing and targeting PCa in clinical practice and FT. Standardization of acquisition and reading should be the main priority to guarantee consistent mpMRI quality throughout the urological communit