USNWR College Rankings Reexamined

This paper extends Webster's [2001] analysis of the accuracy of the weighting scheme utilized by U.S. News & World Report (USNWR) to rank colleges and universities according to "widely accepted indicators of national excellence," which he found to be plagued by severe and pervasive multicollinearity.  As in the Webster study, we employ principal component analysis to assess the relative contributions of thirteen criteria used by USNWR in 2004 to rank "top schools" in the national university category.  Although USNWR continues to assign the greatest weight to peer assessment, this study confirms Webster's findings that average SAT/ACT scores of enrolled students is the most significant ranking criterion.  This paper also extends Webster's study by examining the reliability of the USNWR rankings, which have come under repeated criticism for their lack of consistency.  When compared with simulations generated from an estimated principal component regression model, the 2004 USNWR rankings are found to be increasingly more unreliable for lower ranked institutions.  The source of this inconsistency appears to be peer assessment, which is the only subjective criterion used in the USNWR ranking methodology.  This suggests that the rankings might be improved by lowering (or removing entirely) the relative contribution of peer assessment from the USNWR ranking methodology

Vegetation height products between 60° S and 60° N from ICESat GLAS data.

We present new coarse resolution (0.5� ×0.5�)vegetation height and vegetation-cover fraction data sets between 60� S and 60� N for use in climate models and ecological models. The data sets are derived from 2003–2009 measurements collected by the Geoscience Laser Altimeter System (GLAS) on the Ice, Cloud and land Elevation Satellite (ICESat), the only LiDAR instrument that provides close to global coverage. Initial vegetation height is calculated from GLAS data using a development of the model of Rosette et al. (2008) with further calibration on desert sites. Filters are developed to identify and eliminate spurious observations in the GLAS data, e.g. data that are affected by clouds, atmosphere and terrain and as such result in erroneous estimates of vegetation height or vegetation cover. Filtered GLAS vegetation height estimates are aggregated in histograms from 0 to 70m in 0.5m intervals for each 0.5�×0.5�. The GLAS vegetation height product is evaluated in four ways. Firstly, the Vegetation height data and data filters are evaluated using aircraft LiDAR measurements of the same for ten sites in the Americas, Europe, and Australia. Application of filters to the GLAS vegetation height estimates increases the correlation with aircraft data from r =0.33 to r =0.78, decreases the root-mean-square error by a factor 3 to about 6m (RMSE) or 4.5m (68% error distribution) and decreases the bias from 5.7m to −1.3 m. Secondly, the global aggregated GLAS vegetation height product is tested for sensitivity towards the choice of data quality filters; areas with frequent cloud cover and areas with steep terrain are the most sensitive to the choice of thresholds for the filters. The changes in height estimates by applying different filters are, for the main part, smaller than the overall uncertainty of 4.5–6m established from the site measurements. Thirdly, the GLAS global vegetation height product is compared with a global vegetation height product typically used in a climate model, a recent global tree height product, and a vegetation greenness product and is shown to produce realistic estimates of vegetation height. Finally, the GLAS bare soil cover fraction is compared globally with the MODIS bare soil fraction (r = 0.65) and with bare soil cover fraction estimates derived from AVHRR NDVI data (r =0.67); the GLAS treecover fraction is compared with the MODIS tree-cover fraction (r =0.79). The evaluation indicates that filters applied to the GLAS data are conservative and eliminate a large proportion of spurious data, while only in a minority of cases at the cost of removing reliable data as well. The new GLAS vegetation height product appears more realistic than previous data sets used in climate models and ecological models and hence should significantly improve simulations that involve the land surface

Focal therapy for prostate cancer: Evolutionary parallels to breast cancer treatment. Letter.

To the Editor:We read with great interest the recentmanuscript by Labbate et al reviewing the develop-ment of focal therapy in breast and prostate cancer(PCa).1Breast focal therapy (bFT) represents a suc-cessful model for organ-sparing cancer treatment, soas urologists sensible to prostate focal therapy (pFT)we can learn much about the complex process of bFTrecognition by the scientific community

Association of diabetes, hypertension, and their combination with basal symptoms and treatment responses in overactive bladder patients

Introduction: Pelvic hypoperfusion caused by atherosclerosis has been proposed as a cause of lower urinary tract dysfunction including overactive bladder syndrome (OAB). Limited data indicate that OAB patients with concomitant diabetes or hypertension, known risk factors of atherosclerosis, may exhibit greater baseline OAB symptoms and slightly smaller therapeutic responses to treatment, but the impact of a combined presence of diabetes and hypertension has not been reported. Therefore, we have explored whether the combined presence of both comorbidities is associated with greater baseline OAB symptoms than that of either comorbidity alone. Secondary questions were exploration of the impact of either comorbidity on baseline symptoms, and of the impact of either comorbidity alone and their combination on therapeutic responses. Methods: Data from two non-interventional studies applying treatment with propiverine ER 30 or 45 mg/d for 12 weeks were analyzed. Results: Number of urgency episodes in the combination group was greater than with each comorbidity alone. The impact of comorbidities on baseline intensity of incontinence, frequency or nocturia or Patient Perception of Bladder Condition was less consistent or absent. Either comorbidity alone was associated with a smaller % improvement of symptoms, and their combination had a greater effect than either alone. However, all attenuations associated with comorbidity were small relative to the overall improvement. Conclusions: We conclude that comorbidities of diabetes and hypertension have detectable effects on OAB symptoms and treatment responses, but the small magnitude of these alterations does not justify changing existing paradigms for the clinical management of OAB

What are realistic expectations to become free of overactive bladder symptoms? Experience from non-interventional studies with propiverine

Plain Language Summary Unmet expectations are a major reason why patients with overactive bladder syndrome discontinue treatment. To enable evidence-based counselling of patients on realistic expectations, we have determined the chance that patients with overactive bladder become free of urgency, incontinence, voiding frequency, and nocturia. Two non-interventional studies included 1335 and 745 patients, respectively, who received 30 or 45 mg q.d. propiverine ER for 12 weeks. Analyses were also performed in subgroups defined by basal symptom severity, age, and gender. The probability of becoming symptom-free was largest for incontinence and voiding frequency (about 50%), but lesser for urgency and nocturia (about 20%). Greater basal severity of a symptom reduced the chance to become free of that symptom upon treatment, but the chance to become free of incontinence and frequency was still considerable. Age and gender had only minor if any effects on the chance of becoming symptom-free. These data provide an evidence base for the counselling of patients with overactive bladder on realistic expectations of treatment outcomes. We propose that realistic expectations can lead to greater long-term adherence. Introduction Unmet expectations are a major cause of perceived treatment failure and discontinuation of treatment. To enable evidence-based counselling of patients on realistic expectations, we determined the chance of patients with overactive bladder becoming free of a given symptom upon treatment with a muscarinic antagonist in a non-interventional setting. Methods Two non-interventional studies included 1335 and 745 patients, respectively, who received 30 or 45 mg q.d. propiverine ER for 12 weeks. They were monitored for becoming free of urgency, urinary incontinence, frequency, or nocturia. Analyses were also performed in subgroups defined by basal symptom severity, age, and gender. Categorical data are shown as a percentage of the respective population. Continuous data are expressed as means or as median depending on whether the variability was considered to exhibit a normal distribution. Results The probability of becoming symptom-free was largest for incontinence and frequency (about 50%), but lesser for urgency (about 20%) and nocturia (about 10%). Greater basal severity of a symptom reduced the chance to become free of that symptom upon treatment, but the chance to become free of incontinence and frequency was still considerable. Age and gender had only minor if any effects on the chance of becoming symptom-free. These findings are in line with those of a limited number of randomized controlled trials. Conclusion These data provide an evidence base for the counselling of patients with overactive bladder on realistic expectations of treatment outcomes. We propose that realistic expectations can lead to greater long-term adherence.Apogeph

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

Medical expulsive therapy for pediatric ureteral stones: A meta-analysis of randomized clinical trials

To evaluate the efficacy and safety of medical expulsive therapy (MET) for ureteral stones in pediatric patients, Cochrane, PubMed, Web of Science, Scopus, and the reference list of retrieved studies were searched up to September 2022 to identify RCTs on the efficacy of MET. The protocol was prospectively registered at PROSPERO (CRD42022339093). Articles were reviewed, data were extracted by two reviewers, and the differences were resolved by the third reviewer. The risk of bias was assessed using the RoB2. The outcomes, including the stone expulsion rate (SER), stone expulsion time (SET), episode of pain, analgesic consumption, and adverse effects, were evaluated. Six RCTs enrolling 415 patients were included in the meta-analysis. The duration of MET ranged from 19 to 28 days. The investigated medications included tamsulosin, silodosin, and doxazosin. The stone-free rate after 4 weeks in the MET group was 1.42 times that of the control group (RR: 1.42; 95% CI: 1.26–1.61, p < 0.001). The stone expulsion time also decreased by an average of 5.18 days (95% CI: −8.46/−1.89, p = 0.002). Adverse effects were more commonly observed in the MET group (RR: 2.18; 95% CI: 1.28–3.69, p = 0.004). The subgroup analysis evaluating the influence of the type of medication, the stone size, and the age of patients failed to reveal any impact of the aforementioned factors on the stone expulsion rate or stone expulsion time. Alpha-blockers as medical expulsive therapy among pediatric patients are efficient and safe. They increase the stone expulsion rate and decrease the stone expulsion time; however, this included a higher rate of adverse effects, which include headache, dizziness, or nasal congestion

The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Nephrolithotomy in 189 Patients with Solitary Kidneys

Abstract Background and Purpose: The study compared characteristics and outcomes in patients with solitary and bilateral kidneys who were treated with percutaneous nephrolithotomy (PCNL) in the Clinical Research Office of the Endourological Society (CROES) PCNL Global Study. Patients and Methods: Data from consecutively treated patients from 96 centers worldwide were collated after a 1-year period. The following variables in patients undergoing PCNL with solitary or bilateral kidneys were compared: Prevalence, patient characteristics, intraoperative differences and outcomes, including bleeding and transfusion rates, renal function, and stone-free rates. Results: Data from 5803 patients were collated; 189 (3.3%) with solitary and 5556 (96.7%) with bilateral kidneys. Patient characteristics were well matched generally with the exception of cardiovascular disease and American Society of Anesthesiologists (ASA) risk scores, which were significantly greater in patients with solitary than with bilateral kidneys (P<0.0001 and P=0.004, respectively). Patients with solitary kidneys had also undergone significantly more procedures to remove calculi before this survey than bilateral patients (P= 00.049 ?<0.0001). Levels of renal impairment were significantly greater (P<0.0001) and stone-free rates were significantly lower (P=0.001) post-PCNL in solitary than bilateral kidney patients. Although bleeding rates were the same in both groups, transfusion rates were significantly greater in solitary kidney patients (P=0.014). Conclusions: Patients with a solitary kidney had a higher cardiovascular risk and ASA score. Outcomes related to morbidity and stone-free rate were less favorable for solitary kidneys.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98444/1/end%2E2011%2E0169.pd

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