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Dong Fang,1,* Nirmish Singla,2,* Zhengqing Bao,1,3,* Syed M Jafri,4 Xiaohong Su,1 Zhenpeng Cao,1 Gengyan Xiong,1 Lei Zhang,1 Solomon Woldu,2 Ryan Hutchinson,2 Arthur Sagalowsky,2 Yair Lotan,2 Xuesong Li,1 Jay D Raman,4 Vitaly Margulis,2 Liqun Zhou1 1Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, Beijing, People’s Republic of China; 2Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA; 3Department of Urology, Beijing Jishuitan Hospital, The Fourth Medical College of Peking University, Beijing, People’s Republic of China; 4Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA*These authors contributed equally to this workCorrespondence: Liqun ZhouDepartment of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku Street, Xicheng District, Beijing 100034, People’s Republic of ChinaTel +86-10-83575006Fax +86-10-66551726Email zhoulqmail@sina.comPurpose: To analyze the effect of preoperative serum sodium and hemoglobin on oncologic outcomes in upper tract urothelial carcinoma (UTUC) based on a multi-center cohort from China and the United States (U.S.).Methods: We retrospectively reviewed the records of 775 patients with UTUC treated surgically at tertiary care medical facilities in China or the US from 1998 to 2015. We analyzed associations of preoperative serum sodium and hemoglobin with clinicopathological characteristics, overall survival (OS), cancer-specific survival (CSS) and intravesical recurrence free survival (IVRFS).Results: The US patients had comparatively lower serum sodium and similar hemoglobin at baseline. Preoperative low serum sodium value was associated with tumor multifocality, lymph node metastasis (LNM) and lymphovascular invasion (LVI); preoperative anemia was associated with advanced age, tumor multifocality, high tumor grade and LVI. Preoperative low serum sodium was an independent predictor of worse OS in the entire cohort; preoperative anemia was an independent predictor of worse OS and CSS in the US cohort alone, Chinese cohort alone and the combined cohort. We developed a predictive nomogram for OS which exhibited better prognostic value when it included the values of sodium and anemia, and successfully validated it in different cohorts.Conclusion: Preoperative low serum sodium and anemia could be informative in predicting worse pathologic and survival outcomes in different UTUC patient ethnic groups.Keywords: upper tract urothelial carcinoma, serum sodium, anemia, survival, China, the United States

Architects and planners have been at the forefront of envisioning a future built environment for millennia. However, fragmental views that emphasize one facet of the built environment, such as energy, environment, or groundbreaking technologies, often do not achieve expected outcomes. Buildings are responsible for approximately one-third of worldwide carbon emissions and account for about 40% of primary energy consumption in the U.S. In addition to achieving the very ambitious goal of reducing building-associated greenhouse gas emissions by 75% by 2050, buildings must improve their functionality and performance to meet current and future human, societal, and environmental needs in a changing world. In this article, we introduce a new framework to guide potential evolution of the building stock in the next century, based on greenhouse gas emissions as the common thread to investigate the potential implications of new design paradigms, innovative operational strategies, and disruptive technologies. This framework emphasizes integration of multidisciplinary knowledge, scalability for mainstream buildings, and proactive approaches considering constraints and unknowns. The framework integrates the interrelated aspects of the built environment through a series of quantitative metrics that aim to improve environmental outcomes while optimizing building performance to achieve healthy, adaptive, and productive buildings.

This study explored the impact of sound-enriched audio descriptions (AD) on the experience and memorability of a digitally presented photography exhibition. Forty blind and partially blind (BPB) and forty sighted participants were presented with eight photographs from the Museum of London's archive. Four photos were presented with a standard audio descriptive guide (ADG) and four with a sound-enriched audio descriptive guide (EDG). Experience and memorability were assessed directly after the presentation, and approximately 4 weeks later. Results demonstrated that sighted people remembered more photos than BPB people did with ADG. However, when photos were presented with EDG, the BPB and sighted groups remembered equal number of photos and equal numbers of details. EDG was also enjoyed and preferred by both BPB and sighted participants. Findings suggest that EDGs could be used within mainstream museum offerings as inclusive audio interpretation, thus enhancing access and enjoyment for many visitors and facilitating shared experiences. [ABSTRACT FROM AUTHOR]