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The aim of this observational, cross-sectional study is to evaluate potential differences in kinematics, specifically range of motion (ROM) and velocity, during planar cervical movements between patients with non-traumatic chronic neck pain and disability and asymptomatic controls, while accounting for potential influencing variables of age, sex and fear of movement. The influence of pain intensity, neck disability, age, sex or fear of motion on kinematics was analyzed through robust multivariate Bayesian regression models fitted using the brms library in R. Forty-three patients with neck pain (aged 36.70 ± 13.75 years; 10 men and 33 women) and 42 asymptomatic participants (aged 32.74 ± 13.24 years; 25 men and 17 women) completed the study protocol. The presence of neck pain/disability was associated with lower ROM and peak velocity during all planar movements when considering the influence of age, sex or fear of motion, with standardized regression coefficients that had a small effect size (ranged from 0.11 to 0.28) and estimated differences of less than 2.21° in ROM and 25.61°/s in peak velocity. Although patients with chronic mechanical neck pain showed reduced ROM and peak velocity, the small effect sizes and the low estimated differences between groups question the relevance and clinical usefulness of kinematic analysis of planar movements in samples of patients similar to those included in our study. It is probable that there are differences between the groups, but it is insufficient to rely solely on kinematic variables for patient discrimination. This limitation likely arises from the substantial variability in patient kinematics.

Abstract Background The nurse-patient therapeutic relationship is considered a pillar of mental health nursing, contributing to improved person-centered care and shared decision making with the patient. Given the importance of the nurse-patient therapeutic relationship, appropriate evaluation instruments are required to assess its quality. The aim of this study was to adapt and validate the Spanish version of the Therapeutic Relationship Assessment Scale-Nurse. Methods A translation and back-translation of the scale was carried out. To analyze the psychometric properties, the scale was administered to 213 nurses working in the field of mental health care. Temporal stability or test-retest was examined by means of the intraclass correlation coefficient (ICC) in a sample of 100 nurses. Results Confirmatory Factor Analysis revealed a four-factor structure identical to the original version, with some poor model fit indices. The ordinal alpha values for the total scale and the four factors were 0.939, 0.654, 0.798, 0.801, and 0.866, respectively. The intraclass correlation coefficient was 0.928 (95% CI: 0.893–0.952). Conclusions The results show that the Spanish version of the Therapeutic Relationship Assessment Scale-Nurse is reliable for determining the quality of the therapeutic relationship that mental health nurses can establish with their patients. However, more studies are needed to analyse the model fit of the instrument’s factor structure in the Spanish population.

PURPOSETo assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries.PATIENTS AND METHODSOf 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method.RESULTSOf 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58).CONCLUSIONOur study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.

In the present work, the use of the support vector machine (SVM) algorithm is proposed to generate models that allow predicting the geometrical accuracy of molds manufactured via single point incremental forming (SPIF) using aluminized steel sheets DX51D AS120 B CO. For this purpose, 27 molds were manufactured, using the dummy technique, and employing different process parameters (tool diameter, spindle speed, feed rate, step size) and toolpath strategies (contour-parallel, spiral, radial). The molds manufactured were geometrically characterized by means of a coordinate measuring machine: the transverse profile of each mold was measured and compared with the expected theoretical profile. Three geometrical values were extracted from this comparison: the area between the two profiles, the moment of inertia of this area with respect to the Y-axis and the difference in height between the two profiles at the mid-point of the mold. The geometrical accuracy of the mold increases if these values decrease. The model that achieved the best results is the one associated with the area between the theoretical and real profiles (correctly classified instances = 90%; kappa statistic = 0.8). This model was generated using the LibSVM (linear kernel) algorithm and evaluating only three of the five parameters (strategy, tool diameter and step size). In addition, process maps were drawn up to show briefly which values generate higher geometrical accuracy in the molds: contour-parallel strategy, tool diameter equal to 12 mm and small step size values.

O projeto Caracas Vinculada, vencedor do 1º lugar no Concurso de Projetos Participati-vos em Espaço Público, organizado pela CCS City 450, é proposto como um exercício crítico baseado no conceito de inoperância em “outras” maneiras de “ativar” o espaço público de intervenções temporárias que promovem a formação de relações e laços entre os cidadãos, a cidade e a natureza do bairro popular Santa Rosa em Caracas, Venezuela. O chamado “Ci-dade Hospital” inclui o encontro da Avenida Andrés Bello com a Rua San Julián, onde está lo-calizado o Hospital Ortopédico Infantil. Embora tradicionalmente muitas pessoas se reúnam neste setor, ele não possui espaços adequados para o tráfego de pedestres ou para acessibi-lidade universal, nem locais de recreação para os habitantes da comunidade. Nesse sentido, a proposta reuniu um grupo multidisciplinar de pessoas: arquitetos, artistas plásticos, ativistas sociais e até instituições, grupos e organizações comunitárias que, com o apoio dos próprios habitantes do setor, conseguiram “ativá-lo” por meio do trabalho participativo em diferentes instâncias. Esses tipos de intervenções efêmeras, em vez de resolver concretamente os pro-blemas de infraestrutura, equipamentos ou serviços dos setores urbanos mais vulneráveis, abrem instâncias para o diálogo, a reflexão e a crítica sobre “outras” maneiras e maneiras de fazer uso de espaços como esse em nossas cidades.

Introducción: el canfenol plus, es un derivado clorado del fenol empleado de forma habitual como medicación intraconducto durante los tratamientos pulporradiculares en Estomatología. Son escasos los estudios en relación con sus efectos sobre el músculo liso vascular arterial y la participación del endotelio en estos. Objetivo: determinar la dependencia endotelial del efecto de canfenol plus 3 % sobre el músculo liso vascular arterial. Material y Método: se realizó una investigación experimental preclínica utilizando 26 anillos de carótida externa desprovistos de endotelio vascular. Las preparaciones realizadas se colocaron en baño de órganos, registrándose la tensión desarrollada por el músculo liso vascular tras la adición de acetilcolina, así como de soluciones de canfenol plus 3 % durante diferentes intervalos de tiempo. La dependencia entre ambas tensiones, se determinó a través de un modelo de regresión lineal simple. Resultados: tras la preactivación con solución Krebs concentrada de iones potasio, la adición de 10 μl de acetilcolina y canfenol plus 3 %, indujeron una discreta, pero significativa vasorrelajación de la musculatura lisa vascular. El modelo de regresión lineal elaborado, demostró la dependencia entre las variables tensión producida por acetilcolina y tensión producida por el fármaco al décimo minuto, corroborando la implicación del endotelio vascular en dicho efecto relajante. Conclusiones: el canfenol plus 3 %, produjo in vitro, un efecto vasorrelajante sobre la musculatura lisa de anillos de carótida externa, dependiente de endotelio y a partir de un factor relajante o hiperpolarizante derivado de este.

Parsers are used in different software development scenarios such as compiler construction, data format processing, machine-level translation, and natural language processing. Due to the widespread usage of parsers, there exist different tools aimed at automizing their generation. Two of the most common parser generation tools are the classic Lex/Yacc and ANTLR. Even though ANTLR provides more advanced features, Lex/Yacc is still the preferred choice in many university courses. There exist different qualitative comparisons of the features provided by both approaches, but no study evaluates empirical features such as language implementor productivity and tool simplicity, intuitiveness, and maintainability. In this article, we present such an empirical study by conducting an experiment with undergraduate students of a Software Engineering degree. Two random groups of students implement the same language using a different parser generator, and we statistically compare their performance with different measures. Under the context of the academic study conducted, ANTLR has shown significant differences for most of the empirical features measured.

Abstract Objectives Advanced tools and resources are needed to efficiently and sustainably produce food for an increasing world population in the context of variable environmental conditions. The maize genomes to fields (G2F) initiative is a multi-institutional initiative effort that seeks to approach this challenge by developing a flexible and distributed infrastructure addressing emerging problems. G2F has generated large-scale phenotypic, genotypic, and environmental datasets using publicly available inbred lines and hybrids evaluated through a network of collaborators that are part of the G2F’s genotype-by-environment (G × E) project. This report covers the public release of datasets for 2014–2017. Data description Datasets include inbred genotypic information; phenotypic, climatic, and soil measurements and metadata information for each testing location across years. For a subset of inbreds in 2014 and 2015, yield component phenotypes were quantified by image analysis. Data released are accompanied by README descriptions. For genotypic and phenotypic data, both raw data and a version without outliers are reported. For climatic data, a version calibrated to the nearest airport weather station and a version without outliers are reported. The 2014 and 2015 datasets are updated versions from the previously released files [1] while 2016 and 2017 datasets are newly available to the public.

Although source code programs are commonly written as textual information, they enclose syntactic and semantic information that is usually represented as graphs. This information is used for many different purposes, such as static program analysis, advanced code search, coding guideline checking, software metrics computation, and extraction of semantic and syntactic information to create predictive models. Most of the existing systems that provide these kinds of services are designed ad hoc for the particular purpose they are aimed at. For this reason, we created ProgQuery, a platform to allow users to write their own Java program analyses in a declarative fashion, using graph representations. We modify the Java compiler to compute seven syntactic and semantic representations, and store them in a Neo4j graph database. Such representations are overlaid, meaning that syntactic and semantic nodes of the different graphs are interconnected to allow combining different kinds of information in the queries/analyses. We evaluate ProgQuery and compare it to the related systems. Our platform outperforms the other systems in analysis time, and scales better to program sizes and analysis complexity. Moreover, the queries coded show that ProgQuery is more expressive than the other approaches. The additional information stored by ProgQuery increases the database size and associated insertion time, but these increases are significantly lower than the query/analysis performance gains obtained.

Introducción: Uno de los derivados de los clorofenoles más utilizado en Estomatología, lo constituye el p-clorofenol (4-clorofenol), empleado como agente antibacteriano en la desinfección del conducto radicular durante el tratamiento pulporradicular. Son escasos los reportes científicos sobre sus efectos en la musculatura lisa vascular arterial y la regulación del flujo sanguíneo local. Objetivo: Determinar el efecto del 4-clorofenol sobre el músculo liso vascular arterial. Método: Se realizó una investigación experimental preclínica, utilizando 30 anillos de aorta abdominal (porción superior) obtenidos de ratas Wistar adultas. Las preparaciones de unos 5 mm se colocaron en baño de órganos, registrándose la tensión desarrollada por el músculo liso vascular tras la adición de 4-clorofenol en diferentes concentraciones y durante diferentes intervalos de tiempo. Resultados: El 4-clorofenol, tras la preactivación del musculo liso vascular de anillos de aorta abdominal, indujo vasorelajación, la que se incrementó durante todo el tiempo de estudio y al aumento de la concentración del medicamento. Existieron diferencias significativas entre los valores de tensión promedios registrados en los diferentes intervalos de tiempo con los de la tensión base inicial. Conclusiones: El p-clorofenol, indujo “in vitro”, relajación del músculo liso vascular arterial de ratas Wistar.

Quality Protein Popcorn (QPP) BC2F5 inbred lines were produced through an interpopulation breeding system between Quality Protein Maize dent (QPM) and elite popcorn germplasm. In 2019, five QPP F1 hybrids were selected for further evaluation due to superior agronomics, endosperm protein quality, and popping quality traits. Though these BC2F5 QPP hybrids were phenotypically similar to their popcorn parents, the QPP cultivars conveyed slightly inferior popping characteristics when compared to the original popcorn germplasm. The objective of this study was twofold. First, BC2F5 inbred lines were crossed to their popcorn parents and BC3F4 inbred lines were produced for hybridization to test the agronomic, protein, and popping trait effects from an additional QPP by popcorn backcross. Second, BC2- and BC3-hybrids were simultaneously evaluated alongside ConAgra Brands® elite cultivars and ranked for potential commercialization in the spring of 2020. These 10 QPP hybrids were grown alongside five ConAgra Brands® elite popcorn cultivars in three locations and agronomic, protein quality, and popping quality traits were evaluated. Significant improvements in popcorn quality traits were observed in the QPP BC3 cultivars compared to their BC2 counterparts, and yield averages were significantly lower in BC3-derived QPP hybrids compared to the BC2 population. Protein quality traits were not significantly different between QPP backcrossing populations and significantly superior to ConAgra elite popcorn varieties. Utilizing a previously published ranking system, six QPP hybrids, three from the BC2F5 population and three from the BC3F4 population, were evaluated as candidates for final selection. The successful evaluation and ranking system methodology employed is transferable to other hybrid production and testing programs. Incorporating this analysis with concurrent sensory studies, two QPP hybrids were chosen as premier cultivars for potential commercialization.

Removal models were proposed over 80 years ago as a tool to estimate unknown population size. More recently, they are used as an effective tool for management actions for the control of non desirable species, or for the evaluation of translocation management actions. Although the models have evolved over time, in essence, the protocol for data collection has remained similar: at each sampling occasion attempts are made to capture and remove individuals from the study area. Within this paper we review the literature of removal modelling and highlight the methodological developments for the analysis of removal data, in order to provide a unified resource for ecologists wishing to implement these approaches. Models for removal data have developed to better accommodate important features of the data and we discuss the shift in the required assumptions for the implementation of the models. The relative simplicity of this type of data and associated models mean that the method remains attractive and we discuss the potential future role of this technique.

Popcorn varieties are agronomically sub-optimal and genetically limited compared to other maize subspecies. To increase genetic diversity and improve popcorn agronomics, dent germplasm has been introduced to popcorn with limited success and generally, major loss of popping. Between 2013 and 2018, 12 Quality Protein Popcorn (QPP) inbreds containing Quality Protein Maize (QPM) and popcorn germplasm were produced that maintained popping while carrying the opaque-2 allele conferring elevated kernel lysine. This is an opportune trait in the growing market for healthier snacks and a model for mining QPM traits into popcorn. We crossed QPP inbreds to explore the effects of heterosis on popcorn protein, popping quality, and plant agronomics and selected hybrids for further production. To rank and intermediately prescreen hybrids, we utilized a novel hybrid-ranking model adapted from a rank summation index while examining the inbred general combining ability and hybrid specific combining ability estimates for all traits. We observed a biological manifestation of heterosis by categorizing hybrids by pedigree that resulted in a stepwise progression of trait improvement. These results corroborated our hybrid selection and offered insight in basic heterosis research. Estimates for popcorn quality and agronomic trait covariances also suggest the synergistic introgression of highly vitreous dent maize (QPM) into popcorn, providing a likely explanation for the successfully maintained vitreous endosperm, protein quality and popping traits in line with a remodeled proteome. QPP hybrids maintained improved amino acid profiles although different popping methods variably affected popcorn’s protein bound and free amino acid levels. This preliminary screening of QPP hybrids is enabling further quantitative selection for large-scale, complex trait comparison to currently marketed elite popcorn varieties.

Abstract Objectives Crop improvement relies on analysis of phenotypic, genotypic, and environmental data. Given large, well-integrated, multi-year datasets, diverse queries can be made: Which lines perform best in hot, dry environments? Which alleles of specific genes are required for optimal performance in each environment? Such datasets also can be leveraged to predict cultivar performance, even in uncharacterized environments. The maize Genomes to Fields (G2F) Initiative is a multi-institutional organization of scientists working to generate and analyze such datasets from existing, publicly available inbred lines and hybrids. G2F’s genotype by environment project has released 2014 and 2015 datasets to the public, with 2016 and 2017 collected and soon to be made available. Data description Datasets include DNA sequences; traditional phenotype descriptions, as well as detailed ear, cob, and kernel phenotypes quantified by image analysis; weather station measurements; and soil characterizations by site. Data are released as comma separated value spreadsheets accompanied by extensive README text descriptions. For genotypic and phenotypic data, both raw data and a version with outliers removed are reported. For weather data, two versions are reported: a full dataset calibrated against nearby National Weather Service sites and a second calibrated set with outliers and apparent artifacts removed.

Delirium is associated with circadian rhythm disruption. In this study we have explored whether circadian variation of melatonin is an indicator for delirium. Melatonin levels were determined from the first day of hospitalization and up to three days after the onset of delirium. Patients who did not developed delirium exhibited a daily melatonin rhythm, while in patients that developed delirium, the melatonin rhythm was lost and mean melatonin levels were found decreased as early as three days before the diagnosis of delirium, indicating that on arrival to the hospital circadian melatonin disruption can be used as an indicator of delirium.

This paper presents a device that, in final connection with presses, allows toothed gear (with a crown similar to a toothed wheel with right teeth) to be achieved by hot deformation starting from a cylindrical steel bar. For this, finite element simulations were performed in Forge software. The proposed device has 23 rollers, so for the simulation process, a slice representing a part (the 23rd) of a circle which simplifies the essential functionality of this device was taken into consideration.

The objective of this study was to evaluate the effects of additive and non-additive genes on the efficiency of nitrogen (N) use and N responsiveness in inbred popcorn lines. The parents, hybrids and reciprocal crosses were evaluated in a 10x10 triple lattice design at two sites and two levels of N availability. To establish different N levels in the two experiments, fertilization was carried out at sowing, according to soil analysis reports. However, for the experiments with ideal nitrogen availability, N was sidedressed according to the crop requirement, whereas for the N-poor experiments sidedressing consisted of 30% of that applied in the N-rich environment. Two indices were evaluated, the Harmonic Mean of the Relative Performance (HMRP) and Agronomic Efficiency under Low Nitrogen Availability (AELN), both based on grain yield at both N levels. Both additive and non-additive gene effects were important for selection for N-use efficiency. Moreover, there was allelic complementarity between the lines and a reciprocal effect for N-use efficiency, indicating the importance of the choice of the parents used as male or female. The best hybrids were obtained from inbred popcorn lines with contrasting N-use efficiency and N responsiveness.

Introducing traits from dent corn to popcorn is challenging because it is difficult to recover adequate popping characteristics. QPM (Quality Protein Maize) is a dent corn variety carrying the opaque-2 (o2) mutation, specifying increased amounts of normally limiting essential amino acids, and modifier genes which restore the wild type vitreous kernel phenotype. In this study, we introgressed o2 and selected for endosperm modification using vitreousness and high 27-kD gamma zein content. In this way, we recovered high-lysine, fully poppable Quality Protein Popcorn (QPP). BC2F4 individuals with vitreous kernels were confirmed to be o2 mutants by both genotyping and SDS-PAGE. Amino acid profiling of BC2F4 individuals showed that they all have significantly increased lysine compared with popcorn parental lines. Principal Component Analysis of the amino acid profiles showed that all introgressions were grouped with corresponding QPM parental lines. Popping analysis of the BC2F5 individuals showed that while there is variability in popping volume between lines, some lines show equivalent popping to the popcorn parent. In this proof-of-concept study for QPP, we have shown that it is possible to rapidly recover sufficient popcorn characteristics in a modified o2 background using simple phenotypic, biochemical and genetic selection. Furthermore, this shows increased γ-zein is an acceptable substitute for α-zein for full poppability. Since we have developed multiple QPP introgressions, this gives good scope for ongoing hybrid production and future evaluation of agronomic performance and selection of elite hybrids. In a wider context, this study shows the potential for breeding beneficial traits into popcorn for agronomic improvement.

Network analysis can make variant analysis better. There are existing tools like HotNet2 and dmGWAS that can provide various analytical methods. We developed a prototype of a pipeline called MetaNetVar that allows execution of multiple tools. The code is published at https://github.com/NCBI-Hackathons/Network_SNPs. A working prototype is published as an Amazon Machine Image - ami-4510312f .

PURPOSE: Describe morbidity and survival in patients older than 80 years with muscle invasive bladder cancer (MIBC) treated with radical cystectomy (RC) or transurethral resection (TUR) in our institution. MATERIALS AND METHODS: We reviewed our database of all patients older than 80 years treated with RC and TUR for MIBC between 1993 and 2005 in our institution. Twenty-seven patients were submitted to RC, with mean age of 82 years and mean follow-up of 16.4 months. RC was carried out following diagnosis of previous MIBC in 14 cases (51.9%). The American Society of Anesthesiology (ASA) score was III or IV in 23 patients (85.1%). Seventy-two patients with a mean age of 84 years and mean follow-up of 33 months, diagnosed with MIBC, were managed by means of TUR. The ASA score was III-IV in 64 (88.8%) patients. RESULTS: Pathological stage of the RC specimen was pT3 in 18 cases (66.7%). Mean hospital stay was 16 days. Early complications were assessed in 8 patients (29.6%), with an overall survival (OS) of 42.94%, and cancer-specific survival (CSS) of 60.54%. In patients submitted to TUR, clinical stage was T2 in 36 cases (50%). The mean hospital stay was 7 days, with a readmission rate (RR) of 87.5%. OS and CSS was less than 20%. CONCLUSIONS: RC in octogenarian patients is a safe procedure, with complication and survival rates comparable to RC series in general population. Transurethral resection (TUR) for patients with MIBC within this age range is a much less morbid procedure, but disease specific survival is lower.

The machining of cavities for blow molding is a long and costly process, with the objective of obtaining an excellent surface finish with the minimal possible electrical energy consumption (EEC). This work has studied which combination of cutting parameters and cutting strategies to use to achieve an optimum surface finish on the mold using the minimal associated EEC: in roughing operation, tool path strategy and axial depth of cut were studied; in finishing operation, tool path strategy, spindle-speed, feed-rate, and step-over were evaluated. Thirty-two molds were machined in blocks of aluminium alloy EN-AW 7075 T6 in a machining center of a three-axis, following an orthogonal design of experiments. The analysis of results demonstrates that: a roughing strategy has influence on the surface roughness on the bottom of the mold; a finishing strategy is an influential factor on the surface roughness on the walls of the mold; certain parameters have no relevance on the surface roughness but have an influence on the EEC; an adequate selection of cutting strategies and cutting parameters permit an improvement of surface roughness of up to 70%, and a reduction of 40% in EEC, compared to the less favorable tests.

The process of single point incremental formation (SPIF) awakens interest in the industry of mold manufacturing for the food industry. By means of SPIF, it is possible to generate short series of molds or mold prototypes at low cost. However, these industries require such molds to be functional (non-sticky) and to have an adequate geometry accuracy. This study presents a technique that enables direct manufacturing of molds from pre-coated sheets with non-stick resins. It has also studied the influence of two technological variables in the process (feed-rate and pitch) for different geometrical parameters of the mold. Low values of these variables result in a lower overall error in the profile obtained. However, in order to obtain greater detail in particular parameters (angles, depth), it is necessary to use higher values of feed-rate and pitch.

En este artículo se presenta el desarrollo de un sistema de plataforma virtual para la enseñanza del control automático basado en el péndulo invertido sobre carro deslizante, el cual se desarrolla herramientas didácticas sobre un prototipo virtual, simulando el modelo no lineal en matlab y presentado en un entorno amigable basado en easy-java. Para el diseño de los controladores, se tienen en cuenta dos aspectos principales como los son el “swing up” (llevar el péndulo a posición vertical) y el balanceo (mantener el péndulo en la posición vertical). La interfaz al usuario busca facilitar el aprendizaje de los conceptos básicos de un sistema de control automático para estudiantes de pregrado y posgrado, buscando minimizar costos y tiempo en la enseñanza e implementación de sistemas de control.

Root cause analysis (RCA) pertains to causal inference science. Simplified methods aid in uncovering root causes and solving issues. This review was conducted to explore core RCA methods, identify components beneficial to hazard analysis and critical control point (HACCP) systems, and assess publications proposing supplementing HACCP with failure mode and effects analysis (FMEA). RCA methods differ in their approaches to defining factors and uncovering causal chains. A general RCA model was used to illustrate commonalities. An understanding of causal mechanisms aids in identifying root causes. Root causes also can be found at failures in detection and system performance. Ishikawa categories of causes were used to organize information, potentially aiding in managing prerequisite programs and corrective actions. Criticality analysis, a key FMEA element, enhances hazard analysis. Ishikawa categories such as work elements can help identify causes and establish more effective controls. Aligning contributing factors from environmental assessment with work elements further enhances HACCP, simplifying epidemiological data integration. Utilizing principles of FMEA and special causes of variation can potentially improve the management of critical control points. [ABSTRACT FROM AUTHOR]

BackgroundRenal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort.MethodsThe records of 413 patients collected by the International Renal Cell Carcinoma-Venous Thrombus Consortium were retrospectively analyzed. All patients underwent radical nephrectomy and tumor thrombectomy. Kaplan-Meier estimate and Cox regression analyses investigated the impact of TC on CSS in addition to established clinicopathological predictors.ResultsVTT was solid in 225 patients and friable in 188 patients. Median CSS was 50 months in solid and 45 months in friable VTT. TC showed no significant association with metastatic spread, pT stage, perinephric fat invasion, and higher Fuhrman grade. Survival analysis and Cox regression rejected TC as prognostic marker for CSS.ConclusionsIn the largest cohort published so far, TC seems not to be independently associated with survival in RCC patients and should therefore not be included in risk stratification models. J. Surg. Oncol. 2016;114:764-768. © 2016 Wiley Periodicals, Inc.