Evaluating the Role of LVI as an Indicator for Adverse Outcomes in Patients with Upper Tract Urothelial Carcinoma and its Histological Subtypes

Lymphvascular invasion (LVI) is recognized as an adverse prognostic factor in many cancers. Our aim is to assess the prognostic ability of LVI in UTUC urothelial carcinoma (UC) and micropapillary urothelial carcinoma (MPUC) subtypes as a predictor of overall survival (OS) using a large North American cohort. Our cohort included 9750 cM0 UTUC patients who underwent a radical nephroureterectomy (RNU), between 2004 and 2015, within the National Cancer Database (NCDB). The main variable of interest was LVI status, and its interaction with pathological nodal (pN) status. Kaplan-Meier curves were used to estimate the OS. Cox regression analysis tested the impact of LVI status on OS after accounting for covariates. In patients with UC at 5-years post-RNU, the OS rates were 60.2%, 29.9%, 28.9%, and 20.8% in patient with pN0 without LVI, pN0 with LVI, pN+ without LVI, and pN+ with LVI, respectively (p Our report is the first to examine the impact of LVI on OS in a large North American nationwide cohort. It indicates that LVI is associated with reduced OS in patients with UTUC treated surgically

Top 100 Urology Influences on Twitter: Is Social Media Influence Associated with Academic Impact?

Introduction: The purpose of this cross-sectional study is to identify and describe the top 100 urology influencers on the social media platform Twitter. Furthermore, we aim to correlate each individual\u27s Twitter influence with academic impact in urology. Materials and Methods: Twitter influence scores for the topic search “urology” were collected in April 2022 using the Right Relevance software, which accounts for the individual\u27s connections (followers/following) to other influencers in urology as well as engagement (likes, retweets, and views) on the platform. The top 100 personal accounts with the highest computed scores were linked to individuals’ names, all-time h-index, geographic location, specialty, sex, and board certification. We examined the Pearson correlation coefficient between influence rank and h-index. Results: We identified the top 100 Twitter influencers on the topic of “urology.” The majority are from the United States (63%), male (85%), and are practicing urologists (93%). Ninety-three percent (93%) of U.S. urology influencers are board certified. Only 22 out of the 50 states are represented. The second most common country is the United Kingdom with 11 urology influencers. The median all-time h-index is 41.5 (IQR: 27 – 55.5). There is a weak positive coefficient (r=0.26) between the influence rank and h-index (p=0.021). Conclusions: The top Twitter influencers in urology are mostly Board-certified U.S. urologists. Collectively, influencers have a relatively greater academic impact compared to the average urologist, although there is a weak positive correlation between Twitter influence and h-index among top Twitter influencers

Gender Gap in Industry Payments to Urologists

Background: The Open Payments Program (OPP) was established in 2013 under the Sunshine Act, which mandated that medical device and pharmaceutical manufacturers submit public records of any financial incentive given to physicians. The study aim is to characterize the gap in general and research payments between male and female urologists over the past 7 years. Methods: The study sample included all urologists in the US who received at least one general (GP) or research payment from 2015 to 2021. In order to identify urologists’ genders, the OPP was matched with the National Provider Index dataset. Payments to male versus female urologists were analyzed by geography, year, payment type, subspecialty, and industry payer with nominal payments adjusted to the base year’s US dollar using the Bureau of Labor Statistics’ Consumer Price Index – Urban (CPI-U). Results: 1,351,533 payments to 13,678 urologists were analyzed. Of them, 11,926 urologists were male, and 1,752 were female with an average general payment of $17,683.18 to male urologists compared to$5,825.09 to female urologists. Women not only received fewer consultant, royalty/license, speaker, and equity payments, but also received less per transaction in these categories. Conclusions: This study is the first to characterize differences in both research and general payments between male and female urologists. Further studies are needed to understand and interpret the unequal relationships between male and female urologists with industry. Industry should actively work to equitably engage female urologists in consultancies, speaking engagements, and research

Intrinsiccone adaptation modulates feedback efficiency from horizontal cells to cones

Processing of visual stimuli by the retina changes strongly during light/dark adaptation. These changes are due to both local photoreceptor-based processes and to changes in the retinal network. The feedback pathway from horizontal cells to cones is known to be one of the pathways that is modulated strongly during adaptation. Although this phenomenon is well described, the mechanism for this change is poorly characterized. The aim of this paper is to describe the mechanism for the increase in efficiency of the feedback synapse from horizontal cells to cones. We show that a train of flashes can increase the feedback response from the horizontal cells, as measured in the cones, up to threefold. This process has a time constant of ∼3 s and can be attributed to processes intrinsic to the cones. It does not require dopamine, is not the result of changes in the kinetics of the cone light response and is not due to changes in horizontal cells themselves. During a flash train, cones adapt to the mean light intensity, resulting in a slight (4 mV) depolarization of the cones. The time constant of this depolarization is ∼3 s. We will show that at this depolarized membrane potential, a light-induced change of the cone membrane potential induces a larger change in the calcium current than in the unadapted condition. Furthermore, we will show that negative feedback from horizontal cells to cones can modulate the calcium current more efficiently at this depolarized cone membrane potential. The change in horizontal cell response properties during the train of flashes can be fully attributed to these changes in the synaptic efficiency. Since feedback has major consequences for the dynamic, spatial, and spectral processing, the described mechanism might be very important to optimize the retina for ambient light conditions

Contesting longstanding conceptualisations of urban green space

Ever since the Victorian era saw the creation of “parks for the people,” health and wellbeing benefits have been considered a primary benefit of urban parks and green spaces. Today, public health remains a policy priority, with illnesses and conditions such as diabetes, obesity and depression a mounting concern, notably in increasingly urbanised environments. Urban green space often is portrayed as a nature-based solution for addressing such health concerns. In this chapter, Meredith Whitten investigates how the health and wellbeing benefits these spaces provide are limited by a narrow perspective of urban green space. Whitten explores how our understandings of urban green space remain rooted in Victorian ideals and calls into question how fit for purpose they are in twenty-first-century cities. Calling on empirical evidence collected in three boroughs in London with changing and increasing demographic populations, she challenges the long-held cultural underpinnings that lead to urban green space being portrayed “as a panacea to urban problems, yet treating it as a ‘cosmetic afterthought’” (Whitten, M, Reconceptualising green space: planning for urban green space in the contemporary city. Doctoral thesis, London School of Economics and Political Science, London, U.K. http://etheses.lse.ac.uk/. Accessed 12 Jun 2019, 2019b, p 18)

The DIRC Particle Identification System for the BABAR Experiment

A new type of ring-imaging Cherenkov detector is being used for hadronic particle identification in the BABAR experiment at the SLAC B Factory (PEP-II). This detector is called DIRC, an acronym for Detection of Internally Reflected Cherenkov (Light). This paper will discuss the construction, operation and performance of the BABAR DIRC in detail

Gothic Revival Architecture Before Horace Walpole's Strawberry Hill

The Gothic Revival is generally considered to have begun in eighteenth-century Britain with the construction of Horace Walpole’s villa, Strawberry Hill, Twickenham, in the late 1740s. As this chapter demonstrates, however, Strawberry Hill is in no way the first building, domestic or otherwise, to have recreated, even superficially, some aspect of the form and ornamental style of medieval architecture. Earlier architects who, albeit often combining it with Classicism, worked in the Gothic style include Sir Christopher Wren, Nicholas Hawksmoor, William Kent and Batty Langley, aspects of whose works are explored here. While not an exhaustive survey of pre-1750 Gothic Revival design, the examples considered in this chapter reveal how seventeenth- and eighteenth-century Gothic emerged and evolved over the course of different architects’ careers, and how, by the time that Walpole came to create his own Gothic ‘castle’, there was already in existence in Britain a sustained Gothic Revivalist tradition