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This study aims to understand how pre-service mathematics teachers conduct prospective analyses comprehensively. A qualitative research method with a case study design was used. The participant was Mrs N, a pre-service mathematics teacher who conducted research using DDR methodology in a grade 9 junior high school in Sindang, Majalengka, involving 48 students. Data were collected by analyzing empirical evidence from Mrs. N's prospective analysis process by uncovering the various stages of a prospective analysis. An iterative approach was used to analyze the data by refining the research questions through discussions and regular meetings with Mrs. N. The process ensured adaptability to new insights and understandings from the empirical data. Our findings reveal that the teacher draws upon fundamental philosophical principles from didactical design research, including hermeneutics, phenomenology, and ethnomethodology. By embracing these approaches, the teacher gains valuable insights into conducting research within an interpretive paradigm, allowing for a deeper exploration of the meaning of concepts, the purpose of learning, and the cultural influences that shape the educational process. Additionally, our study sheds light on the emergence of transpositional didactics theory as the prospective teacher delves into understanding the meaning of the geometrics transformation concept.

The COVID-19 pandemic has disrupted sexual health services among those most vulnerable to HIV acquisition, such as adolescent men who have sex with men (AMSM). We sought to characterize the changes in sexual-risk behaviors, HIV and other STI testing, and pre-exposure prophylaxis (PrEP) use among a longitudinal cohort of AMSM aged 13 to 18 years before and during the COVID-19 pandemic. We observed a significant decline in HIV testing and a marginal decrease in other STI testing since the pandemic began in March 2020. Outreach efforts and innovative remote delivery of sexual health services are needed to support access to healthcare services among AMSM as the pandemic persists.

Copyright of Amazonia Investiga is the property of PRIMMATE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The policy-planned development in the new Indonesia Capital City (IKN) area must be accompanied by good planning to ensure the continued availability of forestry ecosystem services, especially forestry areas. These ecosystem services are strongly influenced by their ecological functions. Humans depend on essential ecosystem services to satisfy their inherent needs and enhance or preserve their quality of life. Natural resources are being overused to satisfy these demands, endangering biodiversity and putting more strain on ecosystems. Therefore, a multi-policy approach describes and visualizes the relationships between multi-aspect policies that provide and benefit from forestry ecosystem services. The method used in compiling this paper is multi-policy, part of the prospective analysis method. This method will map and create a model, the best policy scenario that can be applied to achieve the goal of a forest city in the new nation's capital. The results show that the presidential regulation implementation scenario is the best policy choice for the forest city model in the new state capital.

In this study, we explore how educational differences in demographic behavior – in particular, mating patterns and fertility – mediate the intergenerational reproduction of educational inequality in twelve European countries. Although this research interest itself is not new, we contribute to this debate by adopting a prospective approach and scaling it to include multiple countries and cohorts. To this end, we leverage a series of complementary datasets and the inferential method developed by Song and Mare (2015) and advanced by Skopek and Leopold (2020) to estimate the components of a stylized educational reproduction model. We then employ a simple decomposition analysis to quantify the contributions of different pathways to prospective educational reproduction rates across educational backgrounds and explore the differences across cohorts and countries. We report several findings. Most notably, (1) the intergenerational reproduction of educational inequality persists in all twelve countries and is barely offset by small (and declining) negative educational gradients in fertility, (2) educational differences in selection into partnership are small and do not account for much inequality, and (3) the role of assortative mating, where present, is ambiguous because it both reinforces inequality via its effects on resources within the family and offsets it via its effects on fertility. * This article belongs to a special issue on “Changes in Educational Homogamy and Its Consequences”.

This article delves into the intersection of generative AI and digital twins within drug discovery, exploring their synergistic potential to revolutionize pharmaceutical research and development. Through various instances and examples, we illuminate how generative AI algorithms, capable of simulating vast chemical spaces and predicting molecular properties, are increasingly integrated with digital twins of biological systems to expedite drug discovery. By harnessing the power of computational models and machine learning, researchers can design novel compounds tailored to specific targets, optimize drug candidates, and simulate their behavior within virtual biological environments. This paradigm shift offers unprecedented opportunities for accelerating drug development, reducing costs, and, ultimately, improving patient outcomes. As we navigate this rapidly evolving landscape, collaboration between interdisciplinary teams and continued innovation will be paramount in realizing the promise of generative AI and digital twins in advancing drug discovery.

Abstract Background CDK4/6 inhibitors in combination with traditional endocrine therapy (ET) have become the recommended first‐line therapy for HR‐positive/HER2‐negative metastatic breast cancer (MBC). The aim of this prospective study was to evaluate the relationship between HER2‐low expression and clinical outcomes in HR‐positive/HER2‐negative MBC patients receiving ET with or without CDK4/6 inhibitors. Methods Between April 2016 and November 2019, 233 women with HR‐positive/HER2‐negative MBC who received ET with or without CDK4/6 inhibitors were enrolled into the study. The primary endpoint was progression‐free survival (PFS). Statistical analysis included descriptive statistics, Kaplan–Meier curves, and Cox proportional hazards models. Results HER2‐low and HER2‐zero subgroups in the CDK4/6 inhibitor plus ET cohort showed no significant difference in the median PFS (10.9 vs. 8.0 months; hazard ratio: 0.92; 95% confidence interval [CI]: 0.64–1. 30; p = 0.65), while HER2‐low subgroup showed a significantly shorter median PFS compared to the HER2‐zero subgroup in the ET alone cohort (5.6 vs. 17.0 months; hazard ratio: 2.82; 95% CI: 1.34–5.93; p = 0.0044). Moreover, the objective response rate was significantly lower in the HER2‐low subgroup than the HER2‐zero subgroup in the ET alone cohort (10.5% vs. 40.0%, p = 0.047). Lastly, no significant difference was observed in the overall survival between the HER2‐low and HER2‐zero subgroups in both cohorts. Conclusion This study suggested that HER2‐low expression may predict the efficacy of ET but not that of CDK4/6 inhibitor plus ET in HR‐positive/HER2‐negative MBC patients. The results of this study highlight the importance of integrating HER2 status in tailoring personalized treatment strategies for HR‐positive MBC.

Background: Kidney cancer is a prevalent malignancy with an increasing incidence worldwide. Blood cell indices and inflammation-related markers have shown huge potential as biomarkers for predicting cancer incidences, but that is not clear in kidney cancer. Our study aims to investigate the correlations of blood cell indices and inflammation-related markers with kidney cancer risk. Methods: We performed a population-based cohort prospective analysis using data from the UK Biobank. A total of 466,994 participants, free of kidney cancer at baseline, were included in the analysis. The hazard ratios (HRs) and 95% confidence intervals (CIs) for kidney cancer risk were calculated using Cox proportional hazards regression models. Restricted cubic spline models were used to investigate nonlinear longitudinal associations. Stratified analyses were used to identify high-risk populations. The results were validated through sensitivity analyses. Results: During a mean follow-up of 12.4 years, 1,710 of 466,994 participants developed kidney cancer. The Cox regression models showed that 13 blood cell indices and four inflammation-related markers were associated with kidney cancer incidence. The restricted cubic spline models showed non-linear relationships with kidney cancer. Finally, combined with stratified and sensitivity analyses, we found that the mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width (RDW), platelet distribution width (PDW), systemic immune-inflammation index (SII), and product of platelet count and neutrophil count (PPN) were related to enhanced kidney cancer risk with stable results. Conclusion: Our findings identified that three blood cell indices (MCHC, RDW, and PDW) and two inflammation-related markers (SII and PPN) were independent risk factors for the incidence of kidney cancer. These indexes may serve as potential predictors for kidney cancer and aid in the development of targeted screening strategies for at-risk individuals. [ABSTRACT FROM AUTHOR]

The aim of the research was to propose probable scenarios for the year 2030 for the cocoa value chain in the department of Antioquia (Colombia), based on functional approach to analysing territorial innovation systems (TIS). TIS in the cocoa value chain was analysed by comparing two rural municipalities as case studies, where different actors respectively participated. Prospective analysis approach, Delphi method, MICMAC program and morphological analysis were combined for the construction of scenarios. Case study comparison indicates that analysis at the territorial level is an appropriate perspective to identify key aspects of the TIS functions that lead to different scenarios for promoting local innovation in agri-food value chains. The results provide specific scenarios including short-, medium- and long-term strategies for the promotion of territorial innovation systems. This approach has the potential for multiple heterogeneous TIS actors to explore different innovation pathways and prospective scenarios that contribute to action planning to reduce uncertainty and promote innovation in TIS. This study contributes with a new way of approaching the functions of TIS, where dynamics that occur in the local geography are highlighted. Also based on the prospective analysis, scenarios are configured that arise from a set of aspects analysed by local and external actors of the territories. The study generates important knowledge about TIS and the functional approach regarding the design of prospective scenarios to promote innovation in agri-food value chains. [ABSTRACT FROM AUTHOR]

This article delves into the intersection of generative AI and digital twins within drug discovery, exploring their synergistic potential to revolutionize pharmaceutical research and development. Through various instances and examples, we illuminate how generative AI algorithms, capable of simulating vast chemical spaces and predicting molecular properties, are increasingly integrated with digital twins of biological systems to expedite drug discovery. By harnessing the power of computational models and machine learning, researchers can design novel compounds tailored to specific targets, optimize drug candidates, and simulate their behavior within virtual biological environments. This paradigm shift offers unprecedented opportunities for accelerating drug development, reducing costs, and, ultimately, improving patient outcomes. As we navigate this rapidly evolving landscape, collaboration between interdisciplinary teams and continued innovation will be paramount in realizing the promise of generative AI and digital twins in advancing drug discovery. [ABSTRACT FROM AUTHOR]

Background: CDK4/6 inhibitors in combination with traditional endocrine therapy (ET) have become the recommended first‐line therapy for HR‐positive/HER2‐negative metastatic breast cancer (MBC). The aim of this prospective study was to evaluate the relationship between HER2‐low expression and clinical outcomes in HR‐positive/HER2‐negative MBC patients receiving ET with or without CDK4/6 inhibitors. Methods: Between April 2016 and November 2019, 233 women with HR‐positive/HER2‐negative MBC who received ET with or without CDK4/6 inhibitors were enrolled into the study. The primary endpoint was progression‐free survival (PFS). Statistical analysis included descriptive statistics, Kaplan–Meier curves, and Cox proportional hazards models. Results: HER2‐low and HER2‐zero subgroups in the CDK4/6 inhibitor plus ET cohort showed no significant difference in the median PFS (10.9 vs. 8.0 months; hazard ratio: 0.92; 95% confidence interval [CI]: 0.64–1. 30; p = 0.65), while HER2‐low subgroup showed a significantly shorter median PFS compared to the HER2‐zero subgroup in the ET alone cohort (5.6 vs. 17.0 months; hazard ratio: 2.82; 95% CI: 1.34–5.93; p = 0.0044). Moreover, the objective response rate was significantly lower in the HER2‐low subgroup than the HER2‐zero subgroup in the ET alone cohort (10.5% vs. 40.0%, p = 0.047). Lastly, no significant difference was observed in the overall survival between the HER2‐low and HER2‐zero subgroups in both cohorts. Conclusion: This study suggested that HER2‐low expression may predict the efficacy of ET but not that of CDK4/6 inhibitor plus ET in HR‐positive/HER2‐negative MBC patients. The results of this study highlight the importance of integrating HER2 status in tailoring personalized treatment strategies for HR‐positive MBC. [ABSTRACT FROM AUTHOR]

In this study, we explore how educational differences in demographic behavior - in particular, mating patterns and fertility - mediate the intergenerational reproduction of educational inequality in twelve European countries. Although this research interest itself is not new, we contribute to this debate by adopting a prospective approach and scaling it to include multiple countries and cohorts. To this end, we leverage a series of complementary datasets and the inferential method developed by Song and Mare (2015) and advanced by Skopek and Leopold (2020) to estimate the components of a stylized educational reproduction model. We then employ a simple decomposition analysis to quantify the contributions of different pathways to prospective educational reproduction rates across educational backgrounds and explore the differences across cohorts and countries. We report several findings. Most notably, (1) the intergenerational reproduction of educational inequality persists in all twelve countries and is barely offset by small (and declining) negative educational gradients in fertility, (2) educational differences in selection into partnership are small and do not account for much inequality, and (3) the role of assortative mating, where present, is ambiguous because it both reinforces inequality via its effects on resources within the family and offsets it via its effects on fertility. [ABSTRACT FROM AUTHOR]

Introduction: Multiple programmed death-ligand 1 (PD-L1) immunohistochemistry assays performed using different antibodies including DAKO 22C3, DAKO 28-8, and Ventana SP142 PD-L1—predictive markers for response to various immune checkpoint inhibitors in NSCLC—have been approved in several countries. The differences in multiple PD-L1 immunohistochemistry assay results in predicting the therapeutic response to combined chemoimmunotherapy in patients with NSCLC remain unclear. Methods: In this multicenter prospective observational study, we monitored 70 patients with advanced NSCLC treated with combined chemoimmunotherapy at 10 institutions in Japan. The expression of PD-L1 in pretreatment tumors was evaluated using the 22C3, 28-8, and SP142 assays in all patients. Results: The PD-L1 level in tumor cells determined using the 22C3 assay was the highest among the three assays performed with different antibodies. According to the 22C3 assay results, the PD-L1 tumor proportion score greater than or equal to 50% group had a significantly longer progression-free survival period than the PD-L1 tumor proportion score less than 50% group. Nevertheless, the other assays did not reveal remarkable differences in the objective response rate or progression-free survival. Conclusions: In our study, PD-L1 expression determined using the 22C3 assay was more correlated with the therapeutic response of patients with NSCLC treated with combined chemoimmunotherapy than that determined using the 28-8 and SP142 assays. Therefore, the 22C3 assay may be useful for clinical decision-making for patients with NSCLC treated with combined chemoimmunotherapy. Trial registration number: UMIN 000043958.

Context and issues: Forecasting the nature and characteristics of training courses offered to healthcare students at the start of the academic year in 2037, in 15 years' time, is a complex and partly speculative exercise. However, some key trends seem to be anticipated. Analysis: The author examines the factors identified as likely to be influential in the healthcare sector by 2040. These cover a wide range of fields: political, economic, social, technological, organizational and managerial, environmental, legal and ethical. In educational terms, he postulates that curricular and pedagogical devices should evolve from a teaching approach to one focused on learning activities, aiming at mastering competencies, appropriating a professional culture and developing a professional identity. [ABSTRACT FROM AUTHOR]

Copyright of Revista El Directivo al Día is the property of Centro de Informacion y Gestion Tecnologica (CIGET) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Recent studies have shown that bile acids are essential in irritable bowel syndrome (IBS) pathology, and cholecystectomy has direct effects on bile acid metabolism. However, whether cholecystectomy increases the risk of IBS remains unclear. We aimed to investigate the association between cholecystectomy and IBS risk in the UK Biobank (UKB).Methods: This study is a prospective analysis of 413,472 participants who were free of IBS, inflammatory bowel disease, cancer, or common benign digestive tract diseases. We identified incidents of IBS through self-reporting or links to primary healthcare and hospitalization data. We evaluated hazard ratios (HRs) adjusted for sociodemographic characteristics, health behaviours, comorbidities, and medications.Results: During a median follow-up period of 12.7 years, we observed 15,503 new cases of IBS. Participants with a history of cholecystectomy had a 46% higher risk of IBS than those without (HR = 1.46, 95% CI: 1.32–1.60), and further subtype analysis showed that the risk of IBS with diarrhoea was significantly higher than the risk of IBS without diarrhoea (HR = 1.71, 95% CI: 1.30–2.25 vs. HR = 1.42, 95% CI: 1.28–1.58). The overall covariate-adjusted HRs for IBS were similar between the group with both cholecystectomy and gallstones (HR = 1.45, 95% CI: 1.32–1.58) and the group with cholecystectomy without gallstones (HR = 1.50, 95% CI: 1.36–1.67) when the group without both cholecystectomy and gallstones was used as a reference. The overall covariate-adjusted HR was not significantly different in the group without cholecystectomy with gallstones (HR = 1.18, 95% CI: 0.95–1.47). The positive association of cholecystectomy with IBS risk did not change when stratifying the data based on age, sex, BMI, smoking, alcohol consumption, healthy diet, quality sleep, physical activity, type 2 diabetes, hypertension, hyperlipidaemia, mental illness, NSAID intake, or acid inhibitor intake. Sensitivity analyses, including propensity score matching analysis and lagging the exposure for two or four years, indicated that the effects were robust.Conclusion: Cholecystectomy was associated with a higher risk of IBS, especially IBS with diarrhoea. Additional prospective randomized controlled and experimental studies are warranted to further validate the association and to explore the relevant biological mechanisms.

Background Excessive daytime sleepiness (EDS), experienced in 10% to 20% of the population, has been associated with cardiovascular disease and death. However, the condition is heterogeneous and is prevalent in individuals having short and long sleep duration. We sought to clarify the relationship between sleep duration subtypes of EDS with cardiovascular outcomes, accounting for these subtypes. Methods and Results We defined 3 sleep duration subtypes of excessive daytime sleepiness: normal (6–9 hours), short (9 hours), and compared these with a nonsleepy, normal‐sleep‐duration reference group. We analyzed their associations with incident myocardial infarction (MI) and stroke using medical records of 355 901 UK Biobank participants and performed 2‐sample Mendelian randomization for each outcome. Compared with healthy sleep, long‐sleep EDS was associated with an 83% increased rate of MI (hazard ratio, 1.83 [95% CI, 1.21–2.77]) during 8.2‐year median follow‐up, adjusting for multiple health and sociodemographic factors. Mendelian randomization analysis provided supporting evidence of a causal role for a genetic long‐sleep EDS subtype in MI (inverse‐variance weighted β=1.995, P=0.001). In contrast, we did not find evidence that other subtypes of EDS were associated with incident MI or any associations with stroke (P>0.05). Conclusions Our study suggests the previous evidence linking EDS with increased cardiovascular disease risk may be primarily driven by the effect of its long‐sleep subtype on higher risk of MI. Underlying mechanisms remain to be investigated but may involve sleep irregularity and circadian disruption, suggesting a need for novel interventions in this population.

Objective To investigate the prognosis of patients with early-stage laryngeal squamous cancer who received radiotherapy alone in order to provide a reference for optimizing the treatment plan in the era of precise radiation. Methods Patients diagnosed with T1-2N0M0 laryngeal squamous cell carcinoma who received radical radiation in our department were retrospectively analyzed from January 1, 2010 to December 31, 2018 and prospectively analyzed from January 1, 2019 to December 31, 2021. Patients’ basic information including age, gender stage, radiation methods, immunohistochemical markers were collected. Results A total of 95 patients were retrospectively enrolled, with 76 patients in T1 disease and 19 in T2 disease. Ninetythree patients received 3-dimensional conformal radiotherapy (3-DCRT), and two patients received intensity modulated radiotherapy (IMRT). The 1-year, 2-year, and 5-year overall survival (OS) were 98.9%±1.1%, 95.5%±2.2%, and 85.9%±4.0%, respectively. Sixty-six patients were prospectively enrolled, with 31 patients in T1 stage and 35 patients in T2 stage. More than half of the patients received volumetric-modulated arc therapy (VMAT). The 1-year and 2-year OS rates were 100.0% and 97.2%±2.7%, respectively (both better than that in the retrospective group). Age, stage, and Ki67 expression level did not affect long-term prognosis. Conclusions For laryngeal cancer patients with T1-2N0M0 disease, radiation alone produced an excellent prognosis. With improvement in radiotherapy techniques, patients in prospective group obtained a better prognosis compared with patients in the retrospective group. [ABSTRACT FROM AUTHOR]

Aim: To examine the association between a pro‐inflammatory diet, estimated using the energy‐adjusted dietary inflammatory index (E‐DII), and the risk of periodontitis. Materials and Methods: Study subjects from the Korean Genome and Epidemiology Study Health Examinee (KoGES_HEXA) cohort were included for cross‐sectional analysis (n = 168,378) using multivariate logistic regression and prospective analysis (n = 160,397) using Cox proportional hazard models respectively. DII and E‐DII scores were calculated based on the intake reported on a validated semi‐quantitative food frequency questionnaire (SQ‐FFQ). Results: Cox proportional hazard models revealed a significantly increased risk of incident periodontitis in individuals consuming high E‐DII (more pro‐inflammatory) diets in the total population (HRquartile4vs1 = 1.29; 95% CI: 1.13–1.48; ptrend <.001) and in both men (HRquartile4vs1 = 1.36; 95% CI: 1.07–1.73; ptrend = 0.02) and women (HRquartile4vs1 = 1.27; 95% CI: 1.08–1.50; ptrend =.002). The association remained significant even after excluding cases diagnosed early in the follow‐up. In the cross‐sectional analysis, a significant association was observed between the E‐DII score and the prevalence of periodontitis among all study subjects (ORquartile4vs1 = 1.17; 95% CI: 1.03–1.34; ptrend = 0.01) and men (ORquartile4vs1 = 1.28; 95%CI: 1.01–1.63; ptrend <.001); however, the association did not reach statistical significance in women (ORquartile4vs1 = 1.13; 95% CI: 0.96–1.33; ptrend <.001). Conclusions: Findings from the current study support the hypothesis that diets with high pro‐inflammatory potential increase the risk of periodontitis. [ABSTRACT FROM AUTHOR]

A number of principal investigators may have limited access to biostatisticians, a lack of biostatistical training, or no requirement to complete a timely statistical analysis plan (SAP). SAPs completed early will identify design or implementation weak points, improve protocols, remove the temptation for p-hacking, and enable proper peer review by stakeholders considering funding the trial. An SAP completed at the same time as the study protocol might be the only comprehensive method for at once optimizing sample size, identifying bias, and applying rigor to study design. This ordered corpus of SAP sections with detailed definitions and a variety of examples represents an omnibus of best practice methods offered by biostatistical practitioners inside and outside of industry. The article presents a protocol template for clinical research design, enabling statisticians, from beginners to advanced.

The COVID-19 pandemic has had an impact on MSMEs, especially in the food and beverage sector, creative industries and agriculture, both in terms of sales, financing, distribution of goods and the difficulty of raw materials. In 2019, the Creative Economy Agency established Denpasar City (the capital city of Bali Province) as one of ten Creative Regencies/Cities in Indonesia with the leading sub-sector of fashion. The development of the leading fashion sub-sector in Denpasar City is certainly inseparable from the role of MSMEs in the fashion sector, where MSME fashion in Denpasar City is the largest compared to other sectors. The purpose of this study was to analyze the mitigation strategy of fashion SMEs affected by the COVID-19 pandemic. This research is exploratory research, where data is collected through FGD instruments. Furthermore, the collected data is analyzed using prospective analysis techniques with MULTIPOL tools that can help develop a policy path based on scenarios, policies, criteria, and actions. The scenario of fashion SMEs in Bali is divided into ethnic fashion SMEs and non-ethnic fashion SMEs. In ethnic fashion SMEs, the superior policy is the policy of strengthening capital, followed by establishing partnerships. use of digital technology, and finally market orientation outside Bali. Meanwhile, for non-ethnic fashion SMEs, what is superior is the policy of establishing partnerships, followed by market orientation policies outside Bali, the use of digital technology and strengthening capital. Online marketing action excels in all policies, followed by product development and forward and backward integration. [ABSTRACT FROM AUTHOR]

The concept and application of nature-based solutions (NBS) have been rapidly progressing in Europe and Latin America, reflecting a transition in the way that urban governance is perceived. There is a large call for the collaborative, polycentric, and interdisciplinary governance of NBS. However, research on options for operationalising these governance processes in different contexts is still insufficient. This study explores and analyses the operationalisation of NBS adaptive governance in Europe and Latin America. Seven cities that are part of the project EU-H2020 CONEXUS have been selected as case studies: Barcelona, Bogotá, Buenos Aires, Lisbon, Santiago de Chile, São Paulo, and Turin. This contribution aims to (i) understand how NBS governance processes are managed; (ii) identify the main positive and negative factors that influence NBS adaptive governance; and (iii) understand common factors and relationships that can hinder or drive forward adaptive governance for NBS in the investigated contexts. The results revealed common priorities indicating a shared pathway for Europe and Latin America; however, context-dependent specificities were also observed. These findings can be used to support cities in both European and American contexts in developing plans and actions for the more efficient enabling of NBS implementation and governance through adaptive governance. [ABSTRACT FROM AUTHOR]

Background Previous studies had limited power to assess the associations of circulating insulin-like growth factors (IGFs) and IGF-binding proteins (IGFBPs) with clinically relevant prostate cancer as a primary endpoint, and the association of genetically predicted IGF-I with aggressive prostate cancer is not known. We aimed to investigate the associations of IGF-I, IGF-II, IGFBP-1, IGFBP-2 and IGFBP-3 concentrations with overall, aggressive and early-onset prostate cancer. Methods Prospective analysis of biomarkers using the Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group dataset (up to 20 studies, 17 009 prostate cancer cases, including 2332 aggressive cases). Odds ratios (OR) and 95% confidence intervals (CI) for prostate cancer were estimated using conditional logistic regression. For IGF-I, two-sample Mendelian randomization (MR) analysis was undertaken using instruments identified using UK Biobank (158 444 men) and outcome data from PRACTICAL (up to 85 554 cases, including 15 167 aggressive cases). Additionally, we used colocalization to rule out confounding by linkage disequilibrium. Results In observational analyses, IGF-I was positively associated with risks of overall (OR per 1 SD = 1.09: 95% CI 1.07, 1.11), aggressive (1.09: 1.03, 1.16) and possibly early-onset disease (1.11: 1.00, 1.24); associations were similar in MR analyses (OR per 1 SD = 1.07: 1.00, 1.15; 1.10: 1.01, 1.20; and 1.13; 0.98, 1.30, respectively). Colocalization also indicated a shared signal for IGF-I and prostate cancer (PP4: 99%). Men with higher IGF-II (1.06: 1.02, 1.11) and IGFBP-3 (1.08: 1.04, 1.11) had higher risks of overall prostate cancer, whereas higher IGFBP-1 was associated with a lower risk (0.95: 0.91, 0.99); these associations were attenuated following adjustment for IGF-I. Conclusions These findings support the role of IGF-I in the development of prostate cancer, including for aggressive disease. [ABSTRACT FROM AUTHOR]

Observational studies have suggested a positive association between gastroesophageal reflux disease and lung cancer, but due to the existence of confounders, it remains undetermined whether gastroesophageal reflux disease (GERD) has a causal association with lung cancer. Therefore, Mendelian randomization (MR) analyses were applied to investigate the relationship between the two conditions. Two-sample Mendelian randomization analysis was utilized with summary genetic data from the European Bioinformatics Institute (602,604 individuals) and International Lung Cancer Consortium, which provides information on lung cancer and its histological subgroups. Furthermore, we used two-step Mendelian randomization and multivariable Mendelian randomization to estimate whether smoking initiation (311,629 cases and 321,173 controls) and alcohol intake frequency (n = 462,346) mediate any effect of gastroesophageal reflux disease on lung cancer risk. The Mendelian randomization analyses indicated that gastroesophageal reflux disease was associated with and significantly increased the risk of lung cancer (ORIVW = 1.35, 95% CI = 1.18-1.54; p = 1.36 × 10-5). Smoking initiation and alcohol intake frequency mediated 35% and 3% of the total effect of gastroesophageal reflux disease on lung cancer, respectively. The combined effect of these two factors accounted for 60% of the total effect. In conclusion, gastroesophageal reflux disease is associated with an increased risk of lung cancer, and interventions to reduce smoking and alcohol intake may reduce the incidence of lung cancer. [ABSTRACT FROM AUTHOR]

Improving livelihoods in Rwanda requires overcoming food insecurity and malnutrition. Vision 2050 is Rwanda's long-term development strategy, yet little is known about its potential trade-offs for the country's biodiversity, forest cover, and greenhouse gas (GHG) emissions. Scenario analysis can provide insights into how to achieve such goals more sustainably. Here, we use the Food, Agriculture, Biodiversity, Land-Use, and Energy (FABLE) Calculator, a simple integrated assessment tool, to explore potential sustainability implications by 2050 through two scenarios: (1) Current Trends and (2) Vision 2050. The Vision 2050 pathway incorporates components of the government's long-term development strategy and associated national agricultural policy targets. It includes greater increases in crop productivity and decreases in post-harvest losses, and shifts to more sustainable diets, compared to the Current Trends pathway. Results show that the Vision 2050 pathway would, relative to Current Trends, lead to a greater decrease in agricultural land area and an increase in non-forested natural land-cover area, with consequent decreases in GHG emissions from agriculture, increases in carbon sequestration, and increases in the share of land that can support biodiversity conservation. Shifts to a healthier diet in the Vision 2050 pathway would only be compatible with national agricultural priorities if these diets favor consumption of foods that underpin sustainable livelihoods in Rwanda, such as beans, cassava, potatoes, sweet potatoes, banana, and corn. We discuss the potential for integrated land-use planning and adoption of agroecological farming practices to help Rwanda achieve food security, livelihood, biodiversity, and climate mitigation goals in tandem. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates potential failure modes and conducts failure mode and effects analysis (FMEA) and fault tree analysis (FTA) on the administration of 177 Lu $^{177}{\rm Lu}$ DOTATATE (LUTATHERA) and 177 Lu $^{177}{\rm Lu}$ PSMA-617 (PLUVICTO). The quality management (QM) process in radiopharmaceutical therapies (RPTs) requires collaboration between nuclear medicine (NM) and radiation oncology (RO) departments. As part of a multi-institutional study, we surveyed various departments to identify and analyze failure modes, leading to a proposed comprehensive QM program. RPT teams in RO or NM clinics can benefit from this study by continually improving their practice., Methods: We reviewed the literature to investigate the administration of Pluvicto and Lutathera, focusing on prospective procedural failures and potential failure modes (PFMs) and their outcomes. We distributed an FMEA survey to multiple experienced centers in 177 Lu $^{177}{\rm Lu}$ -based RPTs and calculated risk priority number (RPN) for various PFM. We conducted an FTA using this information to pinpoint the root causes of potential failures., Results: The findings from the literature review and survey responses on the prospective study have identified several critical areas at risk of failure. These areas include non-optimized treatment delivery, inadequate patient monitoring, and lack of safety training, leading to radiation contamination from the dose excreted by the patients after treatment administration. A segmented FTA was created based on the FMEA results, focusing on radiation contamination with a high RPN value., Conclusion: By identifying the root causes of failures and proposing targeted improvements to the existing QM measures, this analysis enhances safety in treatment delivery of 177 Lu $^{177}{\rm Lu}$ -based RPTs. Given the limited number of prospective risk analysis studies in RPTs, our research addresses the necessity for more such studies and recommends methods to apply this study to other RPTs., (© 2024 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

Introduction. Rotavirus infection is the leading cause of acute gastroenteritis in young children. Due to the lack of etiotropic treatment of viral gastroenteritis, the interest of scientists and practitioners in the use of antiviral drugs is increasing. Studies of domestic authors have proven that the low molecular weight interferon inductor – meglumine acridonacetate has antiviral, immunoregulatory and anti-inflammatory activity.Aim. Evaluation of the efficacy and safety of the antiviral drug meglumine acridonacenate in the treatment of acute gastroenteritis of rotavirus etiology in children aged 4–7 years in a hospital setting.Materials and methods. A prospective analysis of cases of treatment with meglumine acridonacetate for moderately severe rotavirus gastroenteritis in preschool children (n = 29, group I) was carried out. The comparison group consisted of patients receiving standard therapy (n = 31, group II). The presence of rotavirus infection was confirmed by the detection of the pathogen antigen in the feces. Meglumine acridonacetate was prescribed according to the scheme, parenterally, every other day.Results and discussion. The effectiveness of therapy with an antiviral drug on the 3rd day of treatment of moderately severe rotavirus gastroenteritis was 79.3% (p < 0.05). The elimination of the main clinical symptoms of the disease was noted on days 2–3: a decrease in the symptoms of intoxication, fever, a significant decrease in the duration of vomiting and diarrhea (p < 0.05), a reduction in the pathogen elimination period by 2.67 days (p < 0.01), meglumine acridonacetate was well tolerated, no side effects of the drug were detected.Conclusions. Meglumine acridonacetate can be recommended for the complex treatment of moderate rotavirus infection from the first days of the disease.

Aim. To study the changes of the major risk factors (RFs) and vascular status in students over six years of their education at a medical university.Material and methods. A total of 667 students aged 17,8±1,2 years were examined in the 1st year and 6th year (162 men, 505 women). Students who entered in the same year were combined into one cohort, while in total 5 cohorts were recruited. The screening examination was carried out as part of the annual intra-university events "Freshman Week", "Graduate Week" by staff of the University Health Center and included the collection of complaints and history, height, body weight, the measurement of peripheral and central blood pressure, as well as the assessment vascular stiffness and metabolic status. Statistical analysis of the material was carried out using SPSS Statistics 23.0.Results. Analysis of RFs in medical students over 6 years showed a significant increase of the prevalence of hypertension/prehypertension, resting tachycardia, obesity/overweight, malnutrition and physical inactivity. An assessment of cen­tral and peripheral hemodynamics, as well as vascular stiffness of students, revealed an increase in the level of aortic systolic pressure, combined with an increase in peripheral systolic blood pressure and pulse. At the same time, there was no significant increase in some parameters of vascular stiffness, against the background of a 2-fold increase in the prevalence of overweight. Analysis of the metabolic status reveals a significant change in total cholesterol and triglycerides but no alterations in capillary blood glucose.Conclusion. The data obtained indicate an increase in the prevalence of not only behavioral, but also biological RFs among medical students, as well as the development of preclinical vascular remodeling in them during a six-year education, which can later lead to early cardiovascular diseases. Therefore, widespread screening system of risk factors among students should be developed.

Introduction: Whereas the interpersonal theory of suicide entails the assumption that thwarted belongingness and perceived burdensomeness are equally important, mutually moderating, proximal causes of active ideation, evidence suggests these may not be co‐moderating processes. We tested an alternative perspective, hypothesizing that burden mediates the longitudinal relationship of thwarted belonging with active ideation. Methods: A 6‐week, four‐wave prospective online survey was completed by 298 undergraduates. We tested cross‐sectional and cross‐lagged panel models (CLPM, with and without random effects) with belonging, burden, and ideation at 2‐week lags, and post hoc models with burden as a concurrent mediator of ideation. Results: Approximately 28% of undergraduates reported active ideation at baseline. Cross‐sectionally, thwarted belonging had no direct influence on ideation but indirectly affected ideation via burden. This result was not confirmed in the 2‐week CLPM analyses. In post hoc analyses, we found belonging operated indirectly via later burden to influence contemporaneous ideation. Conclusions: Findings suggest thwarted belonging influences active ideation indirectly via perceived burden. The effect of burden as a mediator appears to depend on its temporal proximity to ideation. Future research should delimit the period during which perceived burden is an active mediator, accommodate dual‐process approaches, and explore other mediation alternatives to co‐moderation. [ABSTRACT FROM AUTHOR]

The BLd regimen, which is a triplet regimen of bortezomib (Bor), lenalidomide (Len), and dexamethasone (Dex), is effective against newly diagnosed multiple myeloma (NDMM). However, non-hematological toxicities, such as peripheral neuropathy (PN), often hamper long-term continuation of the regimen, particularly in older adult patients. In this study, we examined the efficacy and safety of the modified BLd regimen with reduced-intensity Bor and standard-dose Len. The chemotherapy regimen consisted of 1.3 mg/m2 Bor administered subcutaneously on days 1 and 8, 25 mg Len administered on days 1–14, and 20 mg Dex on days 1–2 and 8–9 of a 3 week cycle for 8 cycles, followed by a 4 week cycle of Dex (40 mg weekly). Among the 30 patients enrolled, 60.0% (95% CI 40.6–77.3) had a very good partial response or better, and the best overall response rate was 96.7% (95% CI 82.8–99.9). Eight patients (26.7%) achieved a complete response. Grade 3 or higher PN was not observed and hematological toxicity was the most common adverse event. The modified BLd regimen showed favorable efficacy with a manageable safety profile, which suggests it could be a treatment option for transplant-ineligible NDMM. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to assess the association between baseline symptoms and changes in depressive symptoms and stroke incidents. Methods We used data from the Chinese Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. In total, 10,100 individuals aged ≥45 years and without a history of stroke in 2013 were included. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (elevated depressive symptoms cutoff ≥10). Changes of depressive symptoms were assessed by two successive surveys (stable low/no, recent onset, recently remitted, and stable high depressive symptoms). We assessed whether baseline depressive symptoms and changes of them were associated with stroke incidents reported through 2018. Logistic regression analyses adjusted for age, gender, education, marital status and other potential confounders were performed. Results For the analysis of baseline depressive symptoms and stroke (n = 10,100), 545 (5.4%) reported stroke incidents in the following 5-year period. Individuals with elevated depressive symptoms in 2013 experienced a markedly higher stroke risk (odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.28–1.84) compared with those without elevated depressive symptoms. In the analysis of changes in depressive symptoms (n = 8491, 430 (5.1%) stroke events), participants with stable high (OR = 2.01, 95% CI = 1.58–2.56) and recent-onset (OR = 1.39, 95% CI = 1.04–1.85) depressive symptoms presented higher stroke risk compared to those with stable low/no depressive symptoms, while recently remitted symptoms (OR = 1.12, 95% CI = 0.80–1.57) were not associated with stroke risk. Conclusions In conclusion, stable high and newly started depressive symptoms were associated with increased stroke risk, whereas the improvement of depressive symptoms was not related to increase in stroke risk, suggesting that stroke risk may be decreased by effective management of depressive symptoms.

For a value-chain to be sustainable, the main challenge is sometimes its durability. When stakeholders are lost in the shifting maze of economic, social and environmental issues, participatory foresight methods help them consider the options and choose a strategy to follow. The aim is to create several scenarios of evolution of the value-chain and select desirable scenarios. Because of the global context in 2020 and 2021, implementing methodological and organizational adaptations in the classic “scenario method” from Michel Godet was necessary. These adaptations are exemplified by the case study of the prospective for the French pork value-chain in the next 5 years. Indeed, this value-chain touches particularly on certain contemporary concerns, with much discussion about its environmental footprint, its human resource challenge and its social acceptability, as is the case for most food value-chains in developed countries.

Introduction: Depressive symptoms are highly prevalent in adolescence, highlighting the need for early identification of precursors. Research into psychopathological symptoms predicting depressive psychopathology in adolescents is therefore of great relevance. Moreover, given that the prevalence of depressive symptomatology in adolescence shows marked differences between girls and boys, insight into potential sex-specific differences in precursors is important. Methods: This study examined the relationships between emotional problems, conduct problems, hyperactivity/inattention, peer problems, and difficulties in prosocial behaviour at age 10 (Strengths and Difficulties Questionnaire), and the presence of depressive symptoms at age 15 (Depression Screener for Teenagers). Using data from 2824 participants of the GINIplus and LISA birth cohorts, the association of each SDQ subscale at age 10 years with the presence of depressive symptoms at age 15 years was analyzed using sex-specific logistic regression, adjusting for potential confounders. Results: Emotional problems [odds ratio (OR) 1.99, p = 0.002 for boys and OR 1.77, p < 0.001 for girls] and peer problems (OR 2.62, p < 0.001 for boys, OR 1.91, p = 0.001 for girls) at age 10 showed an increased risk for the presence of depressive symptoms at age 15. Additionally, boys with conduct problems at age 10 were at greater risk of showing depressive symptoms in adolescence (OR 2.50, p < 0.001). Discussion: Based on the identified prospective relationships in our study, it might be of particular importance to tailor prevention approaches during childhood to peer and emotional problems to reduce the risk of depressive psychopathology in adolescence. Moreover, particularly in boys, it seems important to also target conduct problems in childhood as a precursor of depressive symptoms in the adolescent period. [ABSTRACT FROM AUTHOR]

In Latin America, water resource management in some areas is difficult when all parts of a system are not considered (including its dynamism). Therefore, it becomes necessary to prepare instruments that facilitate management using a comprehensive approach. This study aimed to develop a methodology that allows one to conduct a prospective analysis of water management over delimited territories. The Zamora Huayco basin was chosen as the study area. This work included a survey of physical-natural, socioeconomic, and political-institutional variables, as well as a system structural analysis. Also, the generation of future scenarios and the strategic and tactical orientation for the integrated management of water resources. The results show that, of the 23 variables used, 19 were classified as key system variables. Most of the variables had strong impacts on each other, but at the same time these were highly receptive to changes. The behavior of change, proposed for the different uses and land cover in the basin for 2029, was considered as the objective scenario, highlighting the gain in forest areas and shrub vegetation. The strategic plans proposed in this methodology consider the structuring and collecting information in a single repository, creating communication channels between stakeholders and decision-makers. [ABSTRACT FROM AUTHOR]

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Purpose: Topoisomerase II alpha (TOP2A) has been identified as a proliferation marker, of which the most common method for detection is immunohistochemistry (IHC). However, the optimal cut-off of TOP2A expression regarding prognostic value remains controversial. This study was to identify the optimal cut-off value of TOP2A expression and its correlation with clinicopathological variables and prognosis in early stage breast cancer in China. Methods: Between January 2013 and January 2015, a total of 1084 early breast cancer patients were enrolled. The optimal cut-off of TOP2A expression was assessed using the minimum P value approach. Correlations between TOP2A expression and clinicopathological characteristics were explored by the Spearman's correlation analysis, while the impact of TOP2A expression on disease-free survival (DFS) and overall survival (OS) was evaluated by the Kaplan–Meier methods. Univariate and multivariate Cox regression analyses were executed to identify statistically significant prognostic factors. Results: The optimal cut-off value of TOP2A was recommended as 15%. Overall, 603 (55.6%) patients were TOP2A over-expression and 481 (44.4%) patients were TOP2A low expression. TOP2A over-expression was in positive associations with a higher Ki67 index (r = 0.83, P < 0.001), HER2 positive (r = 0.26, P < 0.001), a larger tumor size (r = 0.14, P < 0.001), and a higher histologic grade (r = 0.59, P < 0.001), and in a significantly negative correlation with hormone receptor (HR) positive expression (r = − 0.40, P < 0.001) in early breast cancer. TOP2A over-expression significantly associated with worse DFS (P = 0.001) and OS (P < 0.001) and was an independent prognostic factor for both DFS (hazard ratio [HR] = 2.04; 95% confidence interval [95% CI] 1.30–3.18, P = 0.0018) and OS (HR = 3.54; 95%CI 1.53–8.23, P = 0.003) in stage I-II breast cancer patients. Conclusion: To our knowledge, this is the first study to recommend the optimal cut-off value of TOP2A expression in breast cancer. The TOP2A expression is significantly correlated with HER2 status, Ki67 index, tumor size, histologic grade and HR status, and could be a surrogate indicator for poor prognosis of early breast cancer. [ABSTRACT FROM AUTHOR]

Abstract Background Infant anemia is prevalent in low- and middle-income countries. Maternal body mass index (BMI) is associated with serum ferritin in cord blood, but as yet has not been linked to infant anemia. The objective of this study was to examine the association of maternal BMI during early pregnancy with infant hemoglobin levels and anemia at 6 and 12 months in a Chinese birth cohort. Methods The prospective cohort included 17,193 mother-infant pairs. Maternal weight and height prior to 20 gestational weeks as well as infant hemoglobin at 6 and 12 months were measured following standard procedures, and BMI was calculated as weight in kilograms divided by the square of height in meters. Women were categorized into underweight, normal weight (reference), overweight, and obesity. Infant anemia was defined as hemoglobin

BackgroundIt remains undetermined whether neuroticism affects the risk of lung cancer. Therefore, we performed complementary observational and Mendelian randomization (MR) analyses to investigate the association between neuroticism and lung cancer risk.MethodsWe included 364,451 UK Biobank participants free of cancer at baseline. Neuroticism was ascertained using the 12-item of Eysenck Personality Inventory Neuroticism Scale. Multivariable Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Two-sample MR analysis was carried out with summary genetic data from UK Biobank (374,323 individuals) and International Lung Cancer Consortium (29,266 lung cancer cases and 56,450 controls). Furthermore, we calculated a polygenic risk score of lung cancer, and examined the joint-effect and interaction between neuroticism and genetic susceptibility on lung cancer risk.ResultsDuring a median follow-up of 7.13 years, 1573 lung cancer cases were documented. After adjusting for smoking and other confounders, higher neuroticism was associated with an increased risk of lung cancer (HR per 1 SD=1.07, 95% CI: 1.02-1.12). Consistently, MR analysis suggested a causal effect of neuroticism on lung cancer risk (OR IVW=1.10, 95% CI: 1.03-1.17). Compared to individuals with low neuroticism and low PRS, those with both high neuroticism and high PRS had the greatest risk of lung cancer (HR=1.82, 95%CI: 1.51-2.20). Furthermore, there was a positive additive but no multiplicative interaction between neuroticism and genetic risk.ConclusionsOur findings suggest that neuroticism is associated with an elevated risk of incident lung cancer, which is strengthened by the genetic susceptibility to lung cancer. Further studies are necessary to elucidate underlying mechanisms.

The accumulation of plastic waste in nature and the oceans results from management policies that have not been able to find efficient and sustainable solutions. The circular economy is the basis of the current political will, willing to be the most virtuous. However, its implementation still seems conceptual, especially in the case of island territories. The work proposed in this paper assesses different waste management policy scenarios, screened against the global requirements of the Sustainable Development Goals (SDGs), the needs of the circular economy (CEs), and the challenges of local development (LCIs). The results highlight the lack of transversality of some policies as well as the inadequacy of their applicability or efficiency in an island environment. The importance of the diagnostic scale is pointed out, especially in elaborating territorial policies on waste management. The cross reading of the territory’s needs and the potential of the nature of the waste, such as plastic, allowed to propose a new management plan wishing to answer the territorial challenges and stakes, such as those of Reunion Island.

Background: It remains undetermined whether neuroticism affects the risk of lung cancer. Therefore, we performed complementary observational and Mendelian randomization (MR) analyses to investigate the association between neuroticism and lung cancer risk. Methods: We included 364,451 UK Biobank participants free of cancer at baseline. Neuroticism was ascertained using the 12-item of Eysenck Personality Inventory Neuroticism Scale. Multivariable Cox regression models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Two-sample MR analysis was carried out with summary genetic data from UK Biobank (374,323 individuals) and International Lung Cancer Consortium (29,266 lung cancer cases and 56,450 controls). Furthermore, we calculated a polygenic risk score of lung cancer, and examined the joint-effect and interaction between neuroticism and genetic susceptibility on lung cancer risk. Results: During a median follow-up of 7.13 years, 1573 lung cancer cases were documented. After adjusting for smoking and other confounders, higher neuroticism was associated with an increased risk of lung cancer (HR per 1 SD=1.07, 95% CI: 1.02-1.12). Consistently, MR analysis suggested a causal effect of neuroticism on lung cancer risk (OR IVW=1.10, 95% CI: 1.03-1.17). Compared to individuals with low neuroticism and low PRS, those with both high neuroticism and high PRS had the greatest risk of lung cancer (HR=1.82, 95%CI: 1.51-2.20). Furthermore, there was a positive additive but no multiplicative interaction between neuroticism and genetic risk. Conclusions: Our findings suggest that neuroticism is associated with an elevated risk of incident lung cancer, which is strengthened by the genetic susceptibility to lung cancer. Further studies are necessary to elucidate underlying mechanisms. [ABSTRACT FROM AUTHOR]

Purpose: To test the efficacy and safety profile of robotic radical nephroureterectomy compared to the open approach. Methods: We enrolled 45 consecutive patients who suffered from non-metastatic, upper urinary tract urothelial carcinoma from September 2019 to March 2021 and underwent radical nephroureterectomy. Patients were divided in two groups: group A consisted of 29 patients (open approach) and group B consisted of 16 patients (robotic approach). The factors which were taken into consideration were age, sex, body mass index, tumour size, side and grade, cancer stage, ASA score, operation time, drain removal time, foley time, hospitalization time, estimated blood loss, surgical margins, preoperative and postoperative creatinine, Hct and bladder recurrences. Statistical analysis was performed with the use of SPSS version 26 and p < 0.05 was the cut-off for reaching statistical significance. Results: The mean age in group 1 was 67.12 years and in group 2 68.12 years, whereas the mean body mass index (BMI) in group 1 was 26.54 kg/m2 and in group 2 25.20 kg/m2. Operative time was better in group A (124 vs 186 mins p < 0.001) and estimated blood loss were better in group B compared to group A (137 vs 316 ml p < 0.001). Length of stay (LOS) was significantly less in the robotic group (5.75 vs 4.3 days p = 0.003) and the same applied for time required for drain removal (4.5 vs 3.3 days p = 0.006). Conclusions: Robotic radical nephroureterectomy is a safe and efficient alternative to open approach. It provides a favorable perioperative profile in patients suffering from upper urinary tract carcinoma without metastasis.

Background: This study aimed to assess the association between baseline symptoms and changes in depressive symptoms and stroke incidents. Methods: We used data from the Chinese Health and Retirement Longitudinal Study conducted in 2013, 2015, and 2018. In total, 10,100 individuals aged ≥45 years and without a history of stroke in 2013 were included. Depressive symptoms were measured using the 10-item version of the Center for Epidemiological Studied Depression scale (elevated depressive symptoms cutoff ≥10). Changes of depressive symptoms were assessed by two successive surveys (stable low/no, recent onset, recently remitted, and stable high depressive symptoms). We assessed whether baseline depressive symptoms and changes of them were associated with stroke incidents reported through 2018. Logistic regression analyses adjusted for age, gender, education, marital status and other potential confounders were performed. Results: For the analysis of baseline depressive symptoms and stroke (n = 10,100), 545 (5.4%) reported stroke incidents in the following 5-year period. Individuals with elevated depressive symptoms in 2013 experienced a markedly higher stroke risk (odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.28–1.84) compared with those without elevated depressive symptoms. In the analysis of changes in depressive symptoms (n = 8491, 430 (5.1%) stroke events), participants with stable high (OR = 2.01, 95% CI = 1.58–2.56) and recent-onset (OR = 1.39, 95% CI = 1.04–1.85) depressive symptoms presented higher stroke risk compared to those with stable low/no depressive symptoms, while recently remitted symptoms (OR = 1.12, 95% CI = 0.80–1.57) were not associated with stroke risk. Conclusions: In conclusion, stable high and newly started depressive symptoms were associated with increased stroke risk, whereas the improvement of depressive symptoms was not related to increase in stroke risk, suggesting that stroke risk may be decreased by effective management of depressive symptoms. [ABSTRACT FROM AUTHOR]