Radiomics to better characterize small renal masses

Purpose: Radiomics is a specific field of medical research that uses programmable recognition tools to extract objective information from standard images to combine with clinical data, with the aim of improving diagnostic, prognostic, and predictive accuracy beyond standard visual interpretation. We performed a narrative review of radiomic applications that may support improved characterization of small renal masses (SRM). The main focus of the review was to identify and discuss methods which may accurately differentiate benign from malignant renal masses, specifically between renal cell carcinoma (RCC) subtypes and from angiomyolipoma without visible fat (fat-poor AML) and oncocytoma. Furthermore, prediction of grade, sarcomatoid features, and gene mutations would be of importance in terms of potential clinical utility in prognostic stratification and selecting personalised patient management strategies. / Methods: A detailed search of original articles was performed using the PubMed–MEDLINE database until 20 September 2020 to identify the English literature relevant to radiomics applications in renal tumour assessment. In total, 42 articles were included in the analysis in 3 main categories related to SRM: prediction of benign versus malignant SRM, subtypes, and nuclear grade, and other features of aggressiveness. / Conclusion: Overall, studies reported the superiority of radiomics over expert radiological assessment, but were mainly of retrospective design and therefore of low-quality evidence. However, it is clear that radiomics is an attractive modality that has the potential to improve the non-invasive diagnostic accuracy of SRM imaging and prediction of its natural behaviour. Further prospective validation studies of radiomics are needed to augment management algorithms of SRM

Cytoreductive nephrectomy in the current treatment algorithm

The two recent prospective randomized trials CARMENA and SURTIME have changed the therapy paradigm of metastatic renal cell carcinoma. The CARMENA trial was conducted to investigate whether cytoreductive nephrectomy (CN) is required in the targeted therapy area, whereas SURTIME studied whether deferred CN in combination with sunitinib can be used to identify patients with inherent targeted therapy resistance. In the current review, we provide a comprehensive discussion of two randomized studies and the current evidence with up-do-date algorithms for treating primary metastatic clear-cell renal cell carcinoma in the era of targeted therapy and immune-checkpoint inhibition

Scientific Twitter: The flow of Paleontological Communication Across a Topic Network

The field of paleontology, which is based principally on observations of the natural world, includes an active community that is engaged across multiple social media platforms, consisting of museums, academic researchers, amateur fossil collectors, paleontological artists, and commercial fossil dealers. As such, it represents an ideal environment for examining the people, interactions, and flow of scientific information. Using interactions involving the four most popular Twitter hashtags for paleontology, this embedded mixed methods study defined the members of this social world and investigated how they influenced and controlled the flow of information, as well as how their expression of scientific practice was related to their identity. Results provide further evidence for the diversity of people and practice involved in this domain of science and indicate that the magnitude and breadth of the public’s impact may be larger than previously projected. Certain types of messages were shown to be effective for different segments of the community, but news posts, essentially media outlet stories, were ineffective for generating any form of engagement. This study adds to our understanding of the important scientific contribution being made by members of the public as they interact with professional scientists and educators as peers in an open social media platform that supports a diverse and active community

Social Media Interaction as Informal Science Learning: a Comparison of Message Design in Two Niches

Social media provides science learners opportunities to interact with content-specific messages. However, most science-specific social media content is designed to disseminate information instead of encouraging dialog. In this novel, ex post facto exploratory study of a science social media community, we sought to understand the relationships among community member interaction, design elements of messages, and post type on two digital niches (i.e., Facebook and Twitter). Framed by the theory of symbolic interactionism, we conducted a content analysis of 1370 messages that were systematically created by an informal science learning project and found that usage frequency of messaging elements varied by niche; interaction within each niche differed, varying by messaging element; and differential interaction was found to be associated with post types within Facebook only. This study suggests a pathway for developing and examining social media as an educational component of informal science learning

Profiles in Practice: Stories of Paleontology Within an Online, Scientific Community

The Community of Practice framework has been used theoretically and empirically to describe the diverse ways people learn from one another through social interaction in a variety of specific contexts. To date, most research of this genre has favored investigating the community and domain constructs of the theory over the authentic practice construct. Those interested in recognizing and supporting science learning in non-school contexts across a lifespan are then limited in efforts to delineate how communities engage in domain-specific practice. This is especially relevant in the study of online environments which afford more democratic forms of participation. With the goal of adding to both theoretical and practical knowledge, this study explored practices that members enacted on a community-based website specific to the domain of paleontology. We used a multiple case study approach to provide comparative and contrasting narratives concerning the development of practice within an online, scientific community. Methods consisted of downloading data from the website, including members’ self-described attributes within member profiles, followed by their contributions to three of the website’s features: the forums, activity feed, and messages. An analytical framework which typified members based on their self-described attributes was applied, then members’ contributions were coded using an empirically based Communities of Practice framework. For one of the first times, we identified practice within an online, scientific community through comparing the contributions of three community members, finding that practice consisted of providing social support to other community members and having domain-based conversations

The adjuvant treatment of kidney cancer: a multidisciplinary outlook

Approximately 70% of cases of kidney cancer are localized or locally advanced at diagnosis. Among patients who undergo surgery for these cancers, 30–35% will eventually develop potentially fatal metachronous distant metastases. Effective adjuvant treatments are urgently needed to reduce the risk of recurrence of kidney cancer and of dying of metastatic disease. To date, almost all of the tested adjuvant agents have failed to demonstrate any benefit. Only two trials of an autologous renal tumour cell vaccine and of the vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitor sunitinib have shown positive results, but these have been criticized for methodological reasons and conflicting data, respectively. The results of two additional trials of targeted agents as adjuvant therapies have not yet been published. Novel immune checkpoint inhibitors are promising approaches to adjuvant therapy in kidney cancer, and a number of trials are now underway. An important component of the management of patients with kidney cancer, particularly those who undergo radical resection for localized renal cell carcinoma, is the preservation of kidney function to reduce morbidity and mortality. The optimal management of these patients therefore requires a multidisciplinary approach involving nephrologists, oncologists, urologists and pathologists

Statistical mechanics of lossy data compression using a non-monotonic perceptron

The performance of a lossy data compression scheme for uniformly biased Boolean messages is investigated via methods of statistical mechanics. Inspired by a formal similarity to the storage capacity problem in the research of neural networks, we utilize a perceptron of which the transfer function is appropriately designed in order to compress and decode the messages. Employing the replica method, we analytically show that our scheme can achieve the optimal performance known in the framework of lossy compression in most cases when the code length becomes infinity. The validity of the obtained results is numerically confirmed.Comment: 9 pages, 5 figures, Physical Review

ESMO Clinical Practice Guideline update on the use of immunotherapy in early stage and advanced renal cell carcinoma

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