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Purpose of reviewTo discuss role of different diagnostic imaging modalities in differentiation of benign testicular masses from seminomatous germ cell tumors (SGCTs) and non-seminomatous GCTs (NSGCTs).Recent findingsNew modalities of ultrasonography, including contrast enhancement and shear wave elastography, may help differentiate between benign and malignant intratesticular lesions. Ultrasonography remains the recommended imaging modality for initial evaluation of testicular masses. However, MRI can be used to better define equivocal testicular lesions on US.

Introduction Extirpative bladder surgery for bladder cancer requires urinary diversion which causes cosmetic and functional changes that affect a patient’s body image and quality of life. Current health-related quality of life (HRQOL) surveys validated for use in bladder cancer patients have no dedicated domain evaluating body image. We sought to validate the ten-item Body Image Scale (BIS) for use in bladder cancer patients. The BIS is scored on a 4-point Likert scale with a maximum score of 30. Higher scores represent increasing distress. Methods With Institutional Review Board approval, native English or Spanish speaking patients who had undergone radical cystectomy and urinary diversion with either ileal conduit formation or orthotopic neobladder creation within the past 5 years for muscle-invasive bladder cancer were identified. The survey was conducted via telephone or e-mail. Surveys were scored and analyzed for reliability and validity. Results 32 patients were identified (22 men, 10 women). 25 patients had ileal conduits and 7 had orthotopic neobladders. Cronbach’s alpha reliability coefficient measuring internal consistency for the BIS instrument in this group was 0.926. All ten items met the response criteria (score of >0 by >30% respondents) in our study population. Though the ileal conduit group mean (17.4) and median (16) scores were lower than the neobladder (mean=19.1 and median=22), there was no statistically significant difference in BIS scores between the two cohorts (p=0.755). Conclusions We present a validation study for use of BIS in bladder cancer patients to be utilized in future clinical trials or psycho-oncology research.

Sohail Dhanji, Luke Wang, Franklin Liu, Margaret F Meagher, Ava Saidian, Ithaar H Derweesh Department of Urology, University of California San Diego School of Medicine, La Jolla, CA, USACorrespondence: Ithaar H Derweesh, Department of Urology, University of California San Diego School of Medicine, 3855 Health Sciences Drive, Mail Code: 0987, La Jolla, CA, 92037, USA, Tel +1 (858) 249-0900, Fax +1 (858) 822-6188, Email iderweesh@gmail.comPurpose: To review the current status of surgical and procedural treatments for renal cell carcinoma (RCC), focusing on oncological and functional outcomes, and the use of techniques for advanced disease over the last 10 years.Findings: Partial nephrectomy (PN) has become the reference standard for most T1 and T2 masses. In cT2 RCC, PN exhibits oncological equivalence and improved functional outcomes compared to radical nephrectomy (RN). Additionally, emerging data suggest that PN may be used to treat cT3a RCC. The robot-assisted platform is increasingly used to treat locally advanced RCC. Studies suggest safety and feasibility of robotic RN and robotic inferior vena cava tumor thrombectomy. Additionally, single-port robot-assisted laparoscopic approaches are comparable to multiport approaches in select patients. Long-term data show that cryoablation, radiofrequency ablation, and microwave ablation are equipotent in management of small renal masses. Emerging data suggest that microwave may effectively treat cT1b masses.Keywords: renal cell carcinoma, cryoablation, nephrectomy, microwave ablation, partial nephrectomy, radiofrequency ablation

Major complications of diabetes lead to inflammation and oxidative stress, delayed wound healing, and persistent ulcers. The high morbidity, mortality rate, and associated costs of management suggest a need for non-invasive methods that will enable the early detection of at-risk tissue. We have compared the wound-healing process that occurs in streptozotocin (STZ)-treated diabetic rats with non-diabetic controls using contrast changes in colour photography (ie, Weber Contrast) and the non-invasive optical method Spatial Frequency Domain Imaging (SFDI). This technology can be used to quantify the structural and metabolic properties of in-vivo tissue by measuring oxyhaemoglobin concentration (HbO2 ), deoxyhaemoglobin concentration (Hb), and oxygen saturation (StO2 ) within the visible boundaries of each wound. We also evaluated the changes in inducible nitric oxide synthase (iNOS) in the dermis using immunohistochemistry. Contrast changes in colour photographs showed that diabetic rats healed at a slower rate in comparison with non-diabetic control, with the most significant change occurring at 7 days after the punch biopsy. We observed lower HbO2 , StO2 , and elevated Hb concentrations in the diabetic wounds. The iNOS level was higher in the dermis of the diabetic rats compared with the non-diabetic rats. Our results showed that, in diabetes, there is higher level of iNOS that can lead to an observed reduction in HbO2 levels. iNOS is linked to increased inflammation, leading to prolonged wound healing. Our results suggest that SFDI has potential as a non-invasive assessment of markers of wound-healing impairment.

The swift expansion of urban areas in OPEC member countries and the great reliance their economy has on the consumption of crude oil have led to drastic environmental changes in these states. Therefore, it is important to investigate the factors influencing the emission of CO2 such as economic growth, energy consumption, and urbanization in these countries. Economic growth and energy consumption are among the other influential factors. In this article, the effect of economic growth, energy consumption, and urbanization on the emission of CO2 has been studied. Thus, a sample of eight OPEC members was chosen for the duration of 2008 to 2018. Due to the effects of proximity, a spatial econometric approach was taken to investigate the spillover effects of neighboring countries. The results showed the existence of spatial reliance between the countries under study. The separate analysis of the spillover demonstrated that the effect of both economic and local urban population growth (direct) and spillover (indirect) increased the emission of CO2 in each country and its neighboring state, but the amount of direct effect was more than the indirect on other countries. The reality that environmental pollution resulting from economic growth and the development of urban areas and the increase of the consumption of nonrenewable energy in each of the studied countries also influence the environment of their neighboring states has laid the foundation for cooperation between neighboring OPEC countries to develop the technology to produce clean, renewable energy.

Background Even though cytoreductive nephrectomy (CN) was once the standard of care for patients with advanced renal cell carcinoma (RCC), its role in treatment has not been well analyzed or defined in the era of immunotherapy (IO). Materials and Methods This study analyzed pathological outcomes in patients with advanced or metastatic RCC who received IO prior to CN. This was a multi-institutional, retrospective study of patients with advanced or metastatic RCC. Patients were required to receive IO monotherapy or combination therapy prior to radical or partial CN. The primary endpoint assessed surgical pathologic outcomes, including American Joint Committee on Cancer (AJCC) staging and frequency of downstaging, at the time of surgery. Pathologic outcomes were correlated to clinical variables using a Wald-chi squared test from Cox regression in a multi-variable analysis. Secondary outcomes included objective response rate (ORR) defined by response evaluation criteria in solid tumors (RECIST) version 1.1 and progression-free survival (PFS), which were estimated using the Kaplan-Meier method with reported 95% CIs. Results Fifty-two patients from 9 sites were included. Most patients were male (65%), 81% had clear cell histology, 11% had sarcomatoid differentiation. Overall, 44% of patients experienced pathologic downstaging, and 13% had a complete pathologic response. The ORR immediately prior to nephrectomy was stable disease in 29% of patients, partial response in 63%, progressive disease in 4%, and 4% unknown. Median follow-up for the entire cohort was 25.3 months and median PFS was 3.5 years (95% CI, 2.1-4.9). Conclusions IO-based interventions prior to CN in patients with advanced or metastatic RCC demonstrates efficacy, with a small fraction of patients showing a complete response. Additional prospective studies are warranted to investigate the role of CN in the modern IO-era. [ABSTRACT FROM AUTHOR]

In the context of difficulty in detection problems and the limited computing resources of various fault scales in aerial images of transmission line UAV inspections, this paper proposes a TD-YOLO algorithm (YOLO for transmission detection). Firstly, the Ghost module is used to lighten the model’s feature extraction network and prediction network, significantly reducing the number of parameters and the computational effort of the model. Secondly, the spatial and channel attention mechanism scSE (concurrent spatial and channel squeeze and channel excitation) is embedded into the feature fusion network, with PA-Net (path aggregation network) to construct a feature-balanced network, using channel weights and spatial weights as guides to achieving the balancing of multi-level and multi-scale features in the network, significantly improving the detection capability under the coexistence of multiple targets of different categories. Thirdly, a loss function, NWD (normalized Wasserstein distance), is introduced to enhance the detection of small targets, and the fusion ratio of NWD and CIoU is optimized to further compensate for the loss of accuracy caused by the lightweightedness of the model. Finally, a typical fault dataset of transmission lines is built using UAV inspection images for training and testing. The experimental results show that the TD-YOLO algorithm proposed in this article compresses 74.79% of the number of parameters and 66.92% of the calculation amount compared to YOLOv7-Tiny and increases the mAP (mean average precision) by 0.71%. The TD-YOLO was deployed into Jetson Xavier NX to simulate the UAV inspection process and was run at 23.5 FPS with good results. This study offers a reference for power line inspection and provides a possible way to deploy edge computing devices on unmanned aerial vehicles.

We previously reported on the lack of utility of the 1 mg overnight dexamethasone (DEX) test in mild and/or periodic Cushing's syndrome, as most patients with the condition suppressed to 1 mg DEX. It is possible that a lower dose of DEX as part of an overnight DEX test might be able to distinguish between mild and/or periodic Cushing's syndrome and those without the condition. The objective of the current study is to determine the sensitivity and specificity of a 0.25 mg overnight DEX suppression test, the standard 1 mg overnight DEX suppression test, and the two-day low-dose (Liddle test) DEX suppression test with and without correction for DEX levels in patients evaluated for mild and/or periodic Cushing's syndrome. Thirty patients determined to have Cushing's syndrome by biochemical testing and 14 patients determined not to have the condition had the 0.25 mg and standard 1 mg overnight DEX suppression test and the two-day low-dose DEX suppression tests. Our results show that morning serum cortisol and cortisol/DEX ratios following an overnight dexamethasone suppression test were similar in patients with Cushing's syndrome and those not having Cushing's syndrome. However, a morning cortisol value above 7.6 μg/dl following a dose of DEX of 0.25 mg was found in 12 patients with Cushing's syndrome and none in those not having Cushing's syndrome, suggesting that a high cortisol value after this low dose of dexamethasone can indicate that further testing for Cushing's syndrome is warranted. Our data suggest that the traditional 1 mg overnight or the 2 mg/2 day DEX suppression testing should no longer be used as a screening test in patients who could have mild and/or periodic Cushing's syndrome, while the 0.25 mg dose of DEX may pick up some patients with mild Cushing's syndrome.

BackgroundSeveral markers of inflammation have been associated with oncologic outcomes. Prognostic markers are not well-defined for renal cell carcinoma (RCC). We sought to investigate the association of preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and De Ritis ratio with mortality in RCC.MethodsMulti-center retrospective analysis of patients undergoing surgery for RCC. Primary outcome of interest was all-cause mortality (ACM). Secondary outcomes were non-cancer mortality (NCM) and cancer-specific mortality (CSM). Elevated NLR was defined as ≥2.27, elevated PLR as ≥165, and elevated De Ritis ratio as ≥ 2.72. Multivariable cox regression analysis (MVA) was conducted to elucidate risk factors for primary and secondary outcomes, and Kaplan-Meier analysis (KMA) was used to evaluate survival outcomes comparing elevated and non-elevated NLR, PLR, and De Ritis ratio.Results2656 patients were analyzed (874 patients had elevated NLR; 480 patients had elevated PLR and 932 patients had elevated De Ritis). Elevated NLR was a significant predictor of ACM (HR 1.32, 95% CI: 1.07-1.64, p=0.003) and NCM (HR 1.79, 95% CI: 1.30-2.46, p

ObjectiveAccidental or intentional cyanide ingestion is an-ever present danger. Rapidly acting, safe, inexpensive oral cyanide antidotes are needed that can neutralize large gastrointestinal cyanide reservoirs. Since humans cannot be exposed to cyanide experimentally, we studied oral cyanide poisoning in rabbits, testing oral sodium thiosulfate with and without gastric alkalization.SettingUniversity research laboratory.SubjectsNew Zealand white rabbits.InterventionsSeven animal groups studied; Groups 1-5 received high dose oral NaCN (50 mg, >LD100) and were treated immediately with oral (via nasogastric tube): 1) saline, 2) glycine, 3) sodium thiosulfate or 4) sodium thiosulfate and glycine, or 5) after 2 min with intramuscular injection of sodium nitrite and sodium thiosulfate plus oral sodium thiosulfate and glycine. Groups 6-7 received moderate dose oral NaCN (25 mg, LD70) and delayed intramuscular 6) saline or 7) sodium nitrite-sodium thiosulfate.Measurements and main resultsAll animals in the high dose NaCN group receiving oral saline or glycine died very rapidly, with a trend towards delayed death in glycine-treated animals; saline versus glycine-treated animals died at 10.3+3.9 and 14.6+5.9 min, respectively (p=0.13). In contrast, all sodium thiosulfate-treated high dose cyanide animals survived (p

Aims Methods Results Conclusion The COVID‐19 pandemic altered the pattern of many paediatric infections. We aimed to assess the incidence and characteristics of children hospitalised with gastroenteritis during the early and the late pandemic, relative to previous years.In a retrospective study, we collected data from patient files of children aged 1 month to 5 years, admitted with gastroenteritis to a paediatric department in Denmark during January–June, of 2017 to 2021, comparing incidence rates and clinical features in the early pandemic (March to June 2020), and late pandemic period (January to June 2021), to similar pre‐pandemic months.In the early pandemic, admission rates per 1000 children/month declined to 0.5 (95% CI: 0.3–0.6) from pre‐pandemic rates of 1.6 (95% CI: 1.4–1.7) (p < 0.0001) and increased in the late pandemic to 2.2 (95% CI: 1.9–2.6) (p = 0.006). Children admitted in the late pandemic period were older than those admitted previously.A resurgence of gastroenteritis in children occurred in the spring of 2021, with higher hospital admission rates of children, who were older, but not more severely ill than previously. [ABSTRACT FROM AUTHOR]

Purpose: Since obesity and overweight have dramatically increased in recent years, the purpose of this study was to compare the effects of aerobic exercise training in normobaric hypoxia and normoxia conditions on the resting levels of the VEGF, body composition, and the VO2max among Overweight / Obesity Women. Methods: Twenty-four overweight women voluntarily agreed to take part in the study following the related announcement. The Mean±SD of their age, height, and weight were, respectively, 28.25 ± 3.7 (years), 161.8 ± 3.01 (cm), and 78.64 ± 7.18 (kg). The normobaric hypoxic training group performed aerobic training in hypoxic tents for six weeks, three sessions per week (with 60% of the maximum heart rate), and the normoxic group (control group) performed aerobic training for the same period of time as the hypoxic group. The training program included a 5-minute warm-up following 20 minutes of exercise at 60% of the maximum heart rate for the first week; every week, five minutes were added to the total exercise time. Results: The results of comparing pre- and post-exercise changes in body composition indexes for the normobaric hypoxic and normoxic groups indicated that changes in weight (p=0.165) and BMI (p= 0.191) were not significantly different, but the changes in fat percentage (p=0.022) and waist (p = 0.031) were significantly different between the two groups. The changes in the maximal oxygen consumption (p= 0.008) and the VEGF (p < 0.001) following six weeks of training also differed across groups. Conclusion: The significanlty larger increase in the resting levels of the VEGF in normobaric hypoxia conditions could indicate the importance of physical activity in such conditions in reducing the risk of cardiovascular diseases and vascular endothelial function among overweight people.

To further improve the accuracy of bird nest model detection on transmission towers in aerial images without significantly increasing the model size and to make detection more suitable for edge-end applications, the lightweight model YOLOv5s is improved in this paper. First, the original backbone network is reconfigured using the OSA (One-Shot Aggregation) module in the VOVNet and the CBAM (Convolution Block Attention Module) is embedded into the feature extraction network, which improves the accuracy of the model for small target recognition. Then, the atrous rates and the number of atrous convolutions of the ASPP (Atrous Spatial Pyramid Pooling) module are reduced to effectively decrease the parameters of the ASPP. The ASPP is then embedded into the feature fusion network to enhance the detection of the targets in complex backgrounds, improving the model accuracy. The experiments show that the mAP (mean-Average Precision) of the fusion-improved YOLOv5s model improves from 91.84% to 95.18%, with only a 27.4% increase in model size. Finally, the improved YOLOv5s model is deployed into the Jeston Xavier NX, resulting in a model that runs well and has a substantial increase in accuracy and a speed of 10.2 FPS, which is only 0.7 FPS slower than the original YOLOv5s model.

The aim of this study was to determine the relationship between state and trait anxiety with career indecision of Iranian undergraduate students. According to the literature anxiety has a strong impact on career indecision among students. However, there is controversy in research findings regarding the contribution of state and trait anxiety to career indecision. Despite many studies on the relationship between state and trait anxiety with career indecision, very limited research has been conducted in this area among Iranian students. For this purpose, 150 undergraduate undecided students from 3 universities in Khozestan Iran, completed the career decision scale (CDS), and the State Trait Anxiety Inventory (STAI). Results of regression analysis showed that trait anxiety had a stronger impact on career indecision than did state anxiety. In addition, the relationship between anxiety components and career indecision was reported as positive. Implications for further research are discussed in the paper.

Introduction: Due to the increasing prevalence of patients with hypertension in Iran and the world as well as the adverse impact of this disease on quality of life, there is an urgent need to develop effective and empirically supported psychological interventions in this population. This study aimed to evaluate the effectiveness of compassion-focused therapy on blood pressure and the quality of life in women with hypertension. Materials & Methods: This quasi-experimental study was of pretest-posttest control group design which included a total of 30 women with hyprtension. After initial clinical assessment, the patients who met the inclusion criteria were assigned into two groups of compassion-focused and control group (n=15) using non-probability sampling. In addition to medical treatment, the experimental group received 8 sessions of compassion-focused health care. However, the control group received only medication. The data were collected using a sphygmomanometer (digital type) and the World Health Organization's Quality of Life Questionnaire. In addition, multivariate analysis of covariance (MANCOVA) was utilized in order to analyze the data. Findings: The results showed the effectiveness of compassion-focused therapy on lowering systolic hypertension and the quality of life in women who referred to the health centers. In other words, compassion-focused therapy reduced systolic blood pressure (0.018) and increased the quality of life (P

Hexagonal mesoporous silica (SBA-15) was prepared and then functionalized by(3-mercaptopropyl)trimethoxysilane. The obtained 3-mercaptopropyl functionalized SBA-15 (SBA-Pr-SH) was then oxidized using H2O2 in methanol under an acidic condition to give sulfonic acid functionalized mesoporous silica (SBA-Pr-SO3H). The latter was characterized using different techniques (including TGA, BET, BJH, CHN, SEM, and TEM) and then used as a catalyst in organic synthesis. In the next step, SBA-Pr-SO3H catalyzed the three-component reaction of pyrazolone, salicylaldehydes, and barbituric acid in water under reflux condition. Through this procedure various pyrazolchromeno[2,3-d]pyrimidinone derivatives were obtained. The reaction conditions were completely green due to the use of water as a solvent and the presence of an environmentally benign catalyst.

Youth period is very important in life. This is a time of fundamental decision-makings. These decision-makings have deep influence on life of young peoples. In this investigation, the instructional plan of self-management with emphasis on components of consciousess and choice is codificated and then it,s effectiveness on improvement in self-management of young peoples in Tehran is studied. In this research, the assumption is that instruction of instructional plan of self-management with emphasis on components of consciousness and choice is influential on self-management of such young peoples. This research was quasi-experimental with pre-post test and control group. The statistical population of this research consisted of all young peoples between 20-30years old living in areas of 1, 5, 12 and 17 of Tehran. The sample consisted of 32 young peoples. Constructed self-management questionnaire is used in this study. Covariance test has been used for the analysis of the aggregate data. The results showed that instructional plan of self-management has a meaningful influence on the self-management and self-efficacy of young peoples. Therefore this instructional plan can be effective on increase of self-management of young people.