Kozmološka rješenja teorije gravitacije s promjenljivom masom mirovanja

We have obtained cosmological solutions in five-dimensional space-time-mass theory of gravitation by assuming components of energy momentum tensor, pressure p=0 and the role of p4 as a cosmological constant. The behaviour of the solution is discussed for the cases in which k=-1,0,+1.Izveli smo kozmološka rješenja u petdimenzijskoj prostor-vrijeme-masa teoriji gravitacije pretpostavljajući komponente tenzora energije-impulsa, tlak p = 0, te uzevši p4 u ulozi kozmološke konstante. Raspravljamo značajke rješenja za k = +1, 0, −1

ATMOSPHERIC CO2 GAS AND TEMPERATURE MEASUREMENT ROBOT

In the age of industrial revolution the atmosphere is disturbed by the human acts one of which is the global warming, a major threat of this century. Thus in order to control these adverse effects an monitoring of atmospheric CO2 and temperature robotic system is developed the system to collect data through various sensors. It gives a review of these systems based on existing technologies and also proposes an economical and generic automatic environment pollution control system based on wireless sensors with GSM for environment pollution control system controller and remote monitoring system. This system has simpler features of low cost and effective with less power consumption using sensors for remote monitoring and controlling devices which are controlled via SMS using a GSM module. The system informs user about any abnormal conditions like temperature rise, even concentration of CO2 via SMS from the GSM module to the higher authority mobile and actions are taken accordingly by the authority personnel. In future, the industry will be able to monitor and control the parameter by GSM technologies, and to provide safety and security for humans

Safety and feasibility of early single-dose mitomycin C bladder instillation after robot-assisted radical nephroureterectomy

Objectives: To assess the safety and feasibility of early single‐dose mitomycin C (MMC) bladder instillation after robot‐assisted radical nephroureterectomy (RARNU) at a tertiary kidney cancer centre. RARNU with bladder cuff excision and subsequent MMC bladder instillation to reduce recurrence risk is the ‘gold standard’ for high‐risk upper urinary tract urothelial carcinoma (UUTUC). We adapted a RARNU technique with precise distal ureteric dissection, bladder cuff excision and watertight bladder closure. Patients and Methods: We retrospectively reviewed all patients undergoing RARNU for UUTUC at our centre performed as a standardised transperitoneal procedure comprising of: bladder cuff excision, two‐layer watertight closure and intraoperative bladder leak test; without re‐docking/re‐positioning of the robotic surgical system. Patient demographics, the timing of MMC instillation, adverse events (surgical and potentially MMC‐related) and length of stay (LOS) were assessed according to the Clavien–Dindo classification. Results: A total of 69 patients underwent a RARNU with instillation of MMC. The median (interquartile range [IQR]) age was 70 (62–78) years. The median (IQR) day of MMC instillation was 2 (1–3) days and the median (IQR) LOS was 2 (2–4) days, with urethral catheter removal on day of discharge in all cases. Only Grade I Clavien–Dindo complications occurred in seven patients (10%); five had ileus, one a wound infection and one a self‐limiting delirium, all managed conservatively. No adverse events potentially related to MMC instillation were noted within 30 days postoperatively. Conclusion: The use of intravesical MMC instillation given in the immediate postoperative period appears feasible and safe in patients undergoing RARNU with intraoperative confirmation of a water‐tight closure ensuring early catheter‐free discharge, with no significant adverse events. The potential reduction in intravesical recurrence in patients receiving early MMC needs to be assessed with longitudinal follow‐up studies

Robot-assisted surgery in horseshoe kidneys: A safety and feasibility multi-centre case series

OBJECTIVE: We assessed the safety and feasibility of minimally invasive robot-assisted surgery for horseshoe kidney (HSK). METHOD: A prospectively maintained data set for consecutive patients undergoing robotic kidney surgery was reviewed for patients with HSK. Cases were performed by experienced robotic surgeons, across two high-volume centres between 2016 and 2020. RESULTS: A prospectively maintained data set for consecutive patients undergoing robotic kidney surgery was reviewed for patients with HSK. Cases were performed by experienced robotic surgeons, across two high-volume centres between 2016 and 2020. CONCLUSION: We report one the largest series of robot-assisted surgery on HSK. Robotic surgery is safe and feasible for HSK in centralised high-volume centres with acceptable perioperative outcomes. Established benefits of minimally invasive surgery, such as reduced LOS and low complication rates, were demonstrated. LEVEL OF EVIDENCE: 4

Interactive virtual 3D image reconstruction to assist renal surgery in patients with fusion anomalies of the kidney

Objective: Renal fusion anomalies are rare and usually present as horseshoe kidneys or crossed fusion ectopia. The complex renal anatomy seen in patients with these anomalies can present a challenge. Pre-operative planning is therefore paramount in the surgical management of these cases. Herein we report the use of interactive virtual three-dimensional (3D) reconstruction to aid renal surgery in patients with fusion anomalies of the kidney. / Materials and Methods: A total of seven cases were performed between May 2016 and October 2020. 3D reconstruction was rendered by Innersight Labs using pre-operative computed tomography (CT) scans. / Results: Five patients had malignant disease and two patients had benign pathology. Robotic and open operations were performed in four and three patients, respectively. / Conclusion: The use of 3D reconstruction in the cases reported in this series allowed for the identification of variations in renal vasculature, and this informed the choice of operative approach. / Oxford Centre for Evidence-Based Medicine Evidence Level: 4

COMPARISON OF POST-OPERATIVE COMPLICATIONS OF COLONIC INTERPOSITION AND GASTRIC PULL UP SURGERY AMONG CORROSIVE ESOPHAGEAL STRICTURE PATIENTS

Introduction: The objective of the study to compare outcome and complications of Colonic interposition and Gastric pull-up in treatment of corrosive esophageal stricture. Methodology: This cohort study was conducted on the patients admitted in the surgical wards of SMIMER hospital, Surat with clinically diagnosed corrosive esophageal stricture. The cases were then followed for a period of 6 months from the date of commencement of surgical procedure. Results: The study included 25 patients of corrosive oesophageal stricture, 12 were operated by colonic interposition and 13 were operated by gastric pull up method. Most common reason for indication of surgery was failure to dilatation. Mean duration of surgery of patients operated by colonic interposition method was 5.41 hours while it was 3.57 hours for patients operated by gastric pull-up method. Mean post-operative pain score of patients operated by colonic interposition method was 4 while it was 2.77 for patients operated by gastric pull-up method. Conclusion: Gastric pull up was better method compared to colonic interposition in the management of corrosive oesophageal stricture due to the relative technical ease, excellent healing power of the anastomosis, wide anastomotic stoma at the neck and only one single anastomosis is required.

Epigenome-Wide Association Study of Metabolic Syndrome in African-American Adults

Background: The high prevalence of obesity among US adults has resulted in significant increases in associated metabolic disorders such as diabetes, dyslipidemia, and high blood pressure. Together, these disorders constitute metabolic syndrome, a clinically defined condition highly prevalent among African-Americans. Identifying epigenetic alterations associated with metabolic syndrome may provide additional information regarding etiology beyond current evidence from genome-wide association studies. Methods: Data on metabolic syndrome and DNA methylation was assessed on 614 African-Americans from the Hypertension Genetic Epidemiology Network (HyperGEN) study. Metabolic syndrome was defined using the joint harmonized criteria, and DNA methylation was assessed using the Illumina HumanMethylation450K Bead Chip assay on DNA extracted from buffy coat. Linear mixed effects regression models were used to examine the association between CpG methylation at \u3e 450,000 CpG sites and metabolic syndrome adjusted for study covariates. Replication using DNA from a separate sample of 69 African-Americans, as well as meta-analysis combining both cohorts, was conducted. Results: Two differentially methylated CpG sites in the IGF2BP1 gene on chromosome 17 (cg06638433; p value = 3.10 × 10−7) and the ABCG1 gene on chromosome 21 (cg06500161; p value = 2.60 × 10−8) were identified. Results for the ABCG1 gene remained statistically significant in the replication dataset and meta-analysis. Conclusion: Metabolic syndrome was consistently associated with increased methylation in the ABCG1 gene in the discovery and replication datasets, a gene that encodes a protein in the ATP-binding cassette transporter family and is involved in intra- and extra-cellular signaling and lipid transport

A Systematic Review of Patient Race, Ethnicity, Socioeconomic Status, and Educational Attainment in Prostate Cancer Treatment Randomised Trials—Is the Evidence Base Applicable to the General Patient Population?

Context: Prostate cancer (PC) disproportionately affects men of Black race, and lower educational and socioeconomic status. Guidelines are based on randomised controlled trials (RCTs); however, the representation of different races, educations, and socioeconomic backgrounds in these trials is unclear. Objective: To assess reporting of equality, diversity, and inclusion characteristics (Equality, Diversity and Inclusion [EDI]) and differences in treatment effects between different races, and educational or socioeconomic status. Evidence acquisition: We conducted a systematic review of CENTRAL, MEDLINE, and Embase in April 2020 examining RCTs investigating treatments for PC. Outcomes collected were race/ethnicity, educational attainment, and socioeconomic status. RCTs investigating PC treatment in any population or setting were included. Data extraction of characteristics was performed independently by pairs of reviewers and checked by a senior author. The Cochrane risk of bias tool assessed the quality of included papers. Evidence synthesis: A total of 265 trials were included, and 138 of these were available as full-text articles. Fifty-four trials including 19 039 participants reported any EDI data. All 54 trials reported race, 11 reported ethnicity, three reported educational attainment, and one reported socioeconomic status. Patients of White race were the majority of the recruited population (82.6%), while the minority prevalence was as follows: Black 9.8% and Asian 5.7%. Three studies reported mortality outcomes depending on the participant's race. All three studies investigated different treatments, so a meta-analysis was not performed. No studies reported outcomes stratified by the educational or socioeconomic status of participants. Conclusions: There is poor reporting of patient race, ethnicity, socioeconomic background, and educational attainment in RCTs for PC treatments between 2010 and 2020. Addressing this for future studies will help explain differences in the incidence of and mortality from PC and improve the generalisability of results. Patient summary: In this study, we reviewed prostate cancer treatment trials to see whether these reported race, education, and socioeconomic backgrounds of their patient populations. We conclude that reporting of these characteristics is poor. This needs to be improved in future to improve outcomes for patients with prostate cancer of all ethnical, racial, and socioeconomic groups