Gender-specific Differences in Clinicopathologic Outcomes Following Radical Cystectomy: An International Multi-institutional Study of More Than 8000 Patients

Background

The impact of gender on the staging and prognosis of urothelial carcinoma of the bladder (UCB) is insufficiently understood.

Objective

To assess gender-specific differences in pathologic factors and survival of UCB patients treated with radical cystectomy (RC).

Design, setting, and participants

Data from 8102 patients treated with RC (6497 men [80%] and 1605 women [20%]) for UCB between 1971 and 2012 were analyzed.

Outcome measurements and statistical analysis

Multivariable competing-risk regression analyses were performed to evaluate the relationship of gender on disease recurrence (DR) and cancer-specific mortality (CSM). We also tested the interaction of gender and tumor stage, nodal status, and lymphovascular invasion (LVI).

Results and limitations

Female patients were older at the time of RC (p = 0.033) and had higher rates of pathologic stage T3/T4 disease (p < 0.001). In univariable, but not in multivariable analysis, female gender was associated with a higher risk of DR (p = 0.022 and p = 0.11, respectively). Female gender was an independent predictor for CSM (p = 0.004). We did not find a significant interaction between gender and stage, nodal metastasis, or LVI (all p values >0.05).

Conclusions

We found female gender to be associated with a higher risk of CSM following RC. However, these findings do not appear to be explained by gender differences in pathologic stage, nodal status, or LVI. This gender disparity may be due to differences in care and/or the biology of UCB.     

Brief Report: Precise stellarator quasi-symmetry can be achieved with electromagnetic coils

Magnetic fields with quasi-symmetry are known to provide good confinement of charged particles and plasmas, but the extent to which quasi-symmetry can be achieved in practice has remained an open question. Recent work [M. Landreman and E. Paul, Phys. Rev. Lett. 128, 035001, 2022] reports the discovery of toroidal magnetic fields that are quasi-symmetric to orders-of-magnitude higher precision than previously known fields. We show that these fields can be accurately produced using electromagnetic coils of only moderate engineering complexity, that is, coils that have low curvature and that are sufficiently separated from each other. Our results demonstrate that these new quasi-symmetric fields are relevant for applications requiring the confinement of energetic charged particles for long time scales, such as nuclear fusion. The coils’ length plays an important role for how well the quasi-symmetric fields can be approximated. For the longest coil set considered and a mean field strength of 1 T, the departure from quasi-symmetry is of the order of Earth’s magnetic field. Additionally, we find that magnetic surfaces extend far outside the plasma boundary used by Landreman and Paul, providing confinement far from the core. Simulations confirm that the magnetic fields generated by the new coils confine particles with high kinetic energy substantially longer than previously known coil configurations. In particular, when scaled to a reactor, the best found configuration loses only 0.04% of energetic particles born at midradius when following guiding center trajectories for 200 ms.     

Assessment of Woodcrete Using Destructive and Non-Destructive Test Methods

Utilizing solid wastes and industrial by-products as a partial replacement for raw materials has become an acceptable practice among researchers and scientists in the civil engineering field. Sawdust and wood shavings are not an exception; they are being used in concrete as a partial or total replacement for some of its constituents. The main goal of this research is to establish a relation between destructive and non-destructive testing for concrete containing wood shavings as a partial replacement of sand (woodcrete). With this type of material existing, thus the need to understand the behavior of such material becomes urgent and evokes the need to ease the process of the assessment and the evaluation of such materials and therefore provide more understanding of its behavior. In addition to the conventional concrete mix, five mixes of woodcrete were made by replacing fine aggregate by volume with wood shavings at different replacement levels varied from 5% to 50%. Cubic samples were tested at the age of 90 days using nondestructive tests (NDT), namely, rebound hammer test and ultrasonic pulse velocity test. Then, the specimens were tested using a conventional compressive test using a universal compression testing machine. Statistical analysis was performed to establish empirical relations between destructive and non-destructive results. The dynamic modulus of elasticity was calculated, and some formulas to estimate the (compressive) strength of woodcrete using NDT results were proposed and tested against experimental results and showed acceptable results.     

Conditional analyses of recurrence and progression in patients with TaG1 non–muscle-invasive bladder cancer

Objective

To determine conditional recurrence-free survival (RFS) and progression-free survival (PFS) and improve decision-making toward surveillance protocols and scheduling. Furthermore, evaluating the evolution of predictors for disease recurrence over time, because TaG1 non–muscle-invasive bladder cancer harbors a risk of disease recurrence and progression.

Hygrothermal Performance of Salt (NaCl) for Internal Surface Applications in the Building Envelope

Salt (NaCl), as a by-product from the potash and desalination industry, can be the solution to the scarcity of building materials and might replace more energy-consuming materials. However, salt carries the risk of deliquescence in humid environments. This study conducted fundamental research on the hygrothermal performance of salt for internal surface applications in the building envelope in six different climate conditions. In addition, salt’s performance was also compared with that of gypsum in similar applications. The simulation models (using WUFI^®Pro, WUFI^®Plus) and in situ measurements were applied to investigate the hygrothermal consequences of the incorporation of salt on the thermal envelope, indoor environment, and energy consumption. Our studies revealed that salt provided the best hygrothermal responses without Heating, Ventilation, and Air Conditioning (HVAC) in very hot-dry and the worst in very hot-humid climates. With an energy-efficient thermal envelope and HVAC, salt can also find an indoor application in temperate, continental, and subpolar climates. In comparison to gypsum, salt has a slightly higher energy demand (heating, cooling, and dehumidification) due to its higher thermal conductivity and moisture resistance. This study fills the knowledge gap on salt’s hygrothermal performance and shows the potential in its utilization.     

In the Shadow of Hemagglutinin: A Growing Interest in Influenza Viral Neuraminidase and Its Role as a Vaccine Antigen

Despite the availability of vaccine prophylaxis and antiviral therapeutics, the influenza virus continues to have a significant, annual impact on the morbidity and mortality of human beings, highlighting the continued need for research in the field. Current vaccine strategies predominantly focus on raising a humoral response against hemagglutinin (HA)—the more abundant, immunodominant glycoprotein on the surface of the influenza virus. In fact, anti-HA antibodies are often neutralizing, and are used routinely to assess vaccine immunogenicity. Neuraminidase (NA), the other major glycoprotein on the surface of the influenza virus, has historically served as the target for antiviral drug therapy and is much less studied in the context of humoral immunity. Yet, the quest to discern the exact importance of NA-based protection is decades old. Also, while antibodies against the NA glycoprotein fail to prevent infection of the influenza virus, anti-NA immunity has been shown to lessen the severity of disease, decrease viral lung titers in animal models, and reduce viral shedding. Growing evidence is intimating the possible gains of including the NA antigen in vaccine design, such as expanded strain coverage and increased overall immunogenicity of the vaccine. After giving a tour of general influenza virology, this review aims to discuss the influenza A virus neuraminidase while focusing on both the historical and present literature on the use of NA as a possible vaccine antigen.     

Concomitant MDS with isolated 5q deletion and MGUS: case report and review of molecular aspects

Patients with monoclonal gammopathy of undetermined significance (MGUS) have a higher risk for the development of concomitant primary cancers such as multiple myeloma (MM) and myelodysplastic syndrome (MDS). We report the case of patient initially suffering from MGUS of the IgG lambda subtype for more than 10 yr, which evolved to MM and MDS with deletion (5q) with severe pancytopenia. Due to pancytopenia, he received dose‐reduced treatment with lenalidomide and dexamethasone. He achieved an ongoing transfusion independency after about 1 month of treatment. Bone marrow taken 14 months after start of treatment showed a complete cytogenetic response of the del(5q) clone and a plasma cell infiltration below 5%. In contrast to the development of MM in MGUS patients, the subsequent occurrence of MDS after diagnosis of MGUS is infrequent. Moreover, the biological association of MDS with MGUS is not sufficiently understood, but the non‐treatment‐related occurrence supports the pathogenetic role of pre‐existing alterations of stem cells. Here, we summarize data on concomitant MDS and MGUS/MM with particular emphasis on molecular aspects.     

Adoptive immunotherapy of metastatic breast cancer: present and future

Breast cancer is a systemic disease with a primarily local component. Besides surgical resection and irradiation of the locoregional tumor setting, central therapeutic aim is the elimination of disseminated micrometastatic tumor cells using cytostatic and/or hormonal treatment. Nevertheless, in the course of time a majority of patients suffer from systemic recurrence in the form of distant metastases. Intriguingly, in this connection, intratumoral cytotoxic T lymphocytes might serve as independent predictors of treatment efficacy and clinical outcome. Loss of immune balance (tumor dormancy) during intensive cross talk between T cells and tumor cells in the bone marrow microenvironment is suggested one reason for distant metastatic relapse. In this clinical context, further supportive therapies become increasingly attractive, taking immunological features of breast cancer cells into special account. The present review aims to dissect bone marrow-derived cellular antitumor immune responses and translational immunologic treatment options regarding their actual relevance to patients’ clinical benefit and their future directions in breast cancer management.