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Purpose: The aim of this study was to investigate the association between angiolymphatic invasion (ALI) and bladder cancer in patients who underwent radical cystectomy (RC).Materials and Methods: Multicenter retrospective data from 495 bladder cancer patients who underwent RC between 2007 and 2019 were enrolled in this study. Patients were stratified into 2 groups according to the presence of ALI. The effect of ALI was analyzed by the Kaplan-Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS), overall survival (OS), and recurrence-free survival (RFS).Results: The median age of the 495 patients in the study was 65 years, with median and mean follow-up durations of 23.3 months and 37.1 months, respectively. ALI was present in 182 patients (36.8%). ALI was significantly associated with worse RFS as well as CSS and OS (p

Evapotranspiration (ET) is the amount of water lost from the global surface, and it represents water and Earth's energy cycle. The intensity and frequency of climate variables have been changed because of the ongoing climate crisis, leading to increased climate disasters, such as heat waves and droughts. The abrupt climate crisis affects the variation of ET because climate variables highly influence ET. However, the future potential ET (PET) estimates include various uncertainty resulted from the variations in the projection of climate variables. In this context, the uncertainty in the projected future PETs should be quantified for the high reliability. Therefore, this study projected future global PET using Penman-Monteith (PM) for the near (2031-2065) and far (2066-2100) futures and quantified the corresponding uncertainty. The six climate variables of 14 CMIP6 GCMs were used for estimating historical PET which were compared to those from the NCEP/NCAR reanalysis data using the five evaluation metrics. The changes in PETs for four Shared Socio-economic Pathways (SSPs) scenarios were calculated for the near and far futures compared to the historical period (1980-2014). Subsequently, the uncertainties of PETs were quantified using the reliability ensemble average method. As a result, the future PET in high latitudes showed the most significant variability compared to the other latitudes. The future PET in the southern hemisphere was higher than the historical PET. Especially the PET in the mid-latitudes of southern hemisphere was the highest among the other latitudes. In addition, the uncertainty of PET was the highest in the high latitudes of the northern hemisphere while the mid-latitude in the northern was the lowest. This study provides insight into evaluating the global water cycle based on PET and helps establish appropriate policies for climate impact assessment.

This study evaluated the inherent uncertainty of future runoff prediction using eleven Coupled Model Intercomparison Project 6 (CMIP6) global climate models (GCMs) and a hydrological model (HM). The soil and water assessment tool (SWAT) model was used as a hydrologic model, and SWAT-CUP was used for parameter calibration. The future runoff projection was simulated utilizing two shared socioeconomic pathways (SSPs) scenarios, SSP2-4.5 and SSP5-8.5, for near (2021–2060) and far (2061–2100) futures. Jensen-Shannon divergence (JS-D) was used to quantify the uncertainties between the past and future probability distributions considering different GCMs and calibrated parameter sets of HM. The JS-D value for each GCM and calibrated HM parameter set was calculated at the range of 0.026–0.075 and 0.035–0.058, respectively. As a result, the uncertainty in the selection of GCMs was found to be greater than in the determination of values for HM parameters. Bayesian model averaging (BMA), which is a statistical approach that can combine estimations from multiple models and produce reliable probabilistic predictions, was applied to quantify the uncertainty by each GCM and HM parameters. When estimating the future runoff, INM-CM4-8 caused the greatest uncertainty, and the calibrated set of HM parameters using the year of high runoff caused the greatest uncertainty. This approach can help the uncertainty analysis in the future runoff estimation.

Purpose: To compare perioperative outcomes according to surgical methods among bladder cancer patients who underwent radical cystectomy (RC) with neobladder urinary diversion.Materials and Methods: Between June 2007 and January 2020, 89 bladder cancer patients who received RC with neobladder urinary diversion were enrolled in this study. Patients were stratified into surgical methods – (1) open RC with neobladder (ONB) reconstruction, (2) robotassisted RC (RARC) with extracorporeal neobladder (ECNB) reconstruction, and (3) RARC with intracorporeal neobladder (ICNB) reconstruction. Perioperative outcomes were compared among the 3 groups, with major complications defined according to Clavien-Dindo grades III–V within 90 days. Logistic regression analysis was performed to identify significant factors for postoperative complications.Results: Of 89 patients, 28 (31%) had ONB, 31 (35%) had ECNB, and 30 (34%) had ICNB. The median operative time was 471 minutes, and the ICNB group (424.5 minutes) was significantly less than ONB (444.5 minutes) and ECNB groups (542.9 minutes) (p=0.001). Transfusion rate was also significantly less in the ICNB group (13%) (p=0.001). Complications were recorded in 67 patients (75%) and major complications in 22 of all patients (25%). The major complication rate was significantly less in ICNB (13.4%) than in ONB (25%) and ECNB (35%) (p=0.003). Multivariate analysis showed surgical methods (ICNB) (odds ratio [OR], 0.709; p=0.003) and age (OR, 1.150; p=0.001) were significant factors related to occurrence of major postoperative complications.Conclusions: RARC with ICNB reduces postoperative complications compared to ONB and ECNB.

Hydrological drought is assessed through river flow, which depends on river runoff and water withdrawal. This study proposed a framework to project future hydrological droughts considering agricultural water withdrawal (AWW) for shared socioeconomic pathway (SSP) scenarios. The relationship between AWW and potential evapotranspiration (PET) was determined using a deep belief network (DBN) model and then applied to estimate future AWW using projections of the twelve global climate models (GCMs). 12 GCMs were bias-corrected using the quantile mapping method, climate variables were generated, and river flow was estimated using the soil and water assessment tool (SWAT) model. The standardized runoff index (SRI) was used to project the changes in hydrological drought characteristics. The results revealed a higher occurrence of severe droughts in the future. Droughts would be more frequent in the near future (2021-2060) than in the far future (2061-2100) and more severe when AWW is considered. Droughts would also be more severe for SSP5-8.5 than for SSP2-4.5. The study revealed that the increased PET due to rising temperatures is the primary cause of the increased drought frequency and severity. The AWW will accelerate the drought severities in the future in the Yeongsan River basin.