Prioritizing precision: detection of prostate cancer using mri guided fusion needle biopsy across the pennsylvania urologic regional collaborative.

Purpose: Targeted prostate biopsies are increasingly being performed by urologists in the United States including those in the Pennsylvania Urologic Regional Collaborative, a physician-led data-sharing and quality improvement collaborative. To evaluate the performance of MRI guided fusion needle prostate biopsies in the collaborative, we analyzed the variability by practice in rates of detection of clinically significant prostate cancer and patient characteristics associated with detection of clinically significant prostate cancer.

Methods: We analyzed 857 first-time MRI fusion biopsy procedures performed at five practices (minimum 20 procedures) between 2015 and 2019.

Capturing Dynamic Assembly of Nanoscale Proteins During Network Formation.

The structural evolution of hierarchical structures of nanoscale biomolecules is crucial for the construction of functional networks in vivo and in vitro. Despite the ubiquity of these networks, the physical mechanisms behind their formation and self-assembly remains poorly understood. Here, this study uses photochemically cross-linked folded protein hydrogels as a model biopolymer network system, with a combined time-resolved rheology and small-angle x-ray scattering (SAXS) approach to probe both the load-bearing structures and network architectures respectively thereby providing a cross-length scale understanding of the network formation.

Kidney-Sparing Surgery for Upper Tract Urothelial Carcinoma-Modalities, Outcomes, and Limitations.

Upper tract urothelial carcinoma (UTUC) accounts for 5-10% of urothelial cancers and is associated with high morbidity and mortality. Increasing incidence of UTUC has been observed since the 1970's, alongside the evolution of advance imaging techniques, precision biopsy equipment, and risk stratification models. The high morbidity of radical nephroureterectomy (RNU) which is still the gold-standard treatment for high-risk UTUC, has driven the development of kidney-sparing surgery alternatives for low-risk UTUC.

Role of Cardiovascular Risk in Associations of Brain-Derived Neurotrophic Factor with Longitudinal Brain and Cognitive Trajectories in Older Adults.

Background: Higher levels of brain-derived neurotrophic factor (BDNF) have been associated with better neurocognitive outcomes. BDNF is present in cardiovascular tissue, and some evidence suggests it may benefit cardiovascular function. The current study assessed whether there is a mediating and/or moderating role of cardiovascular health in the relationship between BDNF and brain and cognitive outcomes.

Affective response to daily physical activity in younger and older adults.

Many older adults do not meet the physical activity recommendations of the American Heart Association; hence, it is important to understand the factors that can facilitate regular physical activity in older adults. Notably, the role of affective response has been understudied. Mixed findings have been reported in terms of age effects in affective response to daily physical activity.

Competition between cross-linking and force-induced local conformational changes determines the structure and mechanics of labile protein networks.

Folded protein hydrogels are emerging as promising new materials for medicine and healthcare applications. Folded globular proteins can be modelled as colloids which exhibit site specific cross-linking for controlled network formation. However, folded proteins have inherent mechanical stability and unfolded in response to an applied force.

Strategies to reduce bladder tumor recurrences following surgery for upper tract urothelial carcinoma.

The incidence of upper tract urothelial carcinoma (UTUC) has been on the rise and the malignancy is more commonly managed surgically as higher proportions of disease are being detected. One challenge facing urologists is the high rate of post-treatment intravesical recurrence (IVR) of UTUC (23 - 50%). Genomic research indicated that cells of recurrent bladder lesions are most often clonally derived from the primary UTUC and are likely to seed into the bladder after tumor manipulation.

Appropriateness of Imaging for Low-Risk Prostate Cancer-Real World Data from the Pennsylvania Urologic Regional Collaboration (PURC).

Imaging for prostate cancer defines the extent of disease. Guidelines recommend against imaging low-risk prostate cancer patients with a computed tomography (CT) scan or bone scan due to the low probability of metastasis. We reviewed imaging performed for men diagnosed with low-risk prostate cancer across the Pennsylvania Urologic Regional Collaborative (PURC), a physician-led data sharing and quality improvement collaborative.

An evaluation of mitomycin-containing reverse thermal gel for the treatment of low-grade upper tract urothelial carcinoma.

Introduction: Endoscopic management of upper tract urothelial carcinoma (UTUC) is increasingly relevant with greater detection of low-grade disease and guidelines recommending kidney preservation for low-risk disease. Historically, laser or thermal ablation has served as the primary tool for endoscopic management of UTUC, however, chemoablation is rapidly being developed to serve as a primary or adjuvant treatment option, which warrants review.

Areas Covered: The current literature was reviewed to compare the outcomes and clinical utility of endoscopic treatment modalities for low-grade UTUC, with a focus on mitomycin-containing reverse thermal gel (UGN-101).

Unmasking Ureteral Polyps: Insights From a Case Series.

Fibroepithelial polyps in the urinary tract are a rare cause of obstructive uropathy with fewer than 130 cases reported in the literature. In our series, we describe polyps that were missed on preoperative imaging and later found in the operating room during pyeloplasty. It is critical for urologists to be aware of polyps as a potential source of obstruction as they can increase the complexity of a reconstruction and, if missed, may result in a failed repair and persistent obstruction.

Multiplex imaging reveals spatially resolved DNA-damage response neighborhoods in TP53-mutated myelodysplastic neoplasms.

While increased DNA damage is a well-described feature of myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), it is unclear whether all lineages and all regions of the marrow are homogeneously affected. In this study, we performed immunohistochemistry on formalin-fixed, paraffin-embedded whole-section bone marrow biopsies using a well-established antibody to detect pH2A.X (phosphorylated histone variant H2A.

Alzheimer disease biomarkers are associated with decline in subjective memory, attention, and spatial navigation ability in clinically normal adults.

Objective: Subtle changes in memory, attention, and spatial navigation abilities have been associated with preclinical Alzheimer disease (AD). The current study examined whether baseline AD biomarkers are associated with self- and informant-reported decline in memory, attention, and spatial navigation.

Method: Clinically normal (Clinical Dementia Rating Scale (CDR®) = 0) adults aged 56-93 ( = 320) and their informants completed the memory, divided attention, and visuospatial abilities (which assesses spatial navigation) subsections of the Everyday Cognition Scale (ECog) annually for an average of 4 years.

Building block aspect ratio controls assembly, architecture, and mechanics of synthetic and natural protein networks.

Fibrous networks constructed from high aspect ratio protein building blocks are ubiquitous in nature. Despite this ubiquity, the functional advantage of such building blocks over globular proteins is not understood. To answer this question, we engineered hydrogel network building blocks with varying numbers of protein L domains to control the aspect ratio.

Clinical utility of self- and informant-reported memory, attention, and spatial navigation in detecting biomarkers associated with Alzheimer disease in clinically normal adults.

Objective: Preclinical Alzheimer disease (AD) has been associated with subtle changes in memory, attention, and spatial navigation abilities. The current study examined whether self- and informant-reported domain-specific cognitive changes are sensitive to AD-associated biomarkers.

Method: Clinically normal adults aged 56-93 and their informants completed the memory, divided attention, and visuospatial abilities (which assesses spatial navigation) subsections of the Everyday Cognition Scale (ECog).

Effect of exercise engagement and cardiovascular risk on neuronal injury.

Introduction: Neuronal health as a potential underlying mechanism of the beneficial effects of exercise has been understudied in humans. Furthermore, there has been limited consideration of potential moderators (e.g.

During Water Stress, Fertility Modulated by ROS Scavengers Abundant in Arabidopsis Pistils.

Hours after watering plants with 75 mM NaCl, the water potential of reproductive structures precipitously decreases. In flowers with mature gametes, this change in water potential did not alter the rate of fertilization but caused 37% of the fertilized ovules to abort. We hypothesize that the accumulation of reactive oxygen species (ROS) in ovules is an early physiological manifestation associated with seed failure.

Modelling network formation in folded protein hydrogels by cluster aggregation kinetics.

Globular folded protein-based hydrogels are becoming increasingly attractive due to their specific biological functionality, as well as their responsiveness to stimuli. By modelling folded proteins as colloids, there are rich opportunities to explore network formation mechanisms in protein hydrogels that negate the need for computationally expensive simulations which capture the full complexity of proteins. Here we present a kinetic lattice-based model which simulates the formation of irreversibly chemically crosslinked, folded protein-based hydrogels.

Determinants of physical activity engagement in older adults.

In order to increase engagement in physical activity, it is important to determine which factors contribute to physical activity engagement in older adults. The current study examined the relative predictive ability of several potential determinants, in terms of both the concurrent level as well as longitudinal trajectories. Clinically normal adults aged 61-92 completed the Physical Activity Scale for the Elderly (n = 189 for cross-sectional models; n = 214 for longitudinal models).

Effects of Mindfulness Training and Exercise on Cognitive Function in Older Adults: A Randomized Clinical Trial.

Importance: Episodic memory and executive function are essential aspects of cognitive functioning that decline with aging. This decline may be ameliorable with lifestyle interventions.

Objective: To determine whether mindfulness-based stress reduction (MBSR), exercise, or a combination of both improve cognitive function in older adults.

Associations of environmental and lifestyle factors with spatial navigation in younger and older adults.

Objective: Advanced age is associated with prominent impairment in allocentric navigation dependent on the hippocampus. This study examined whether age-related impairment in allocentric navigation and strategy selection was associated with sleep disruption or circadian rest-activity fragmentation. Further, we examined whether associations with navigation were moderated by perceived stress and physical activity.

Viscoelastic Scaling Regimes for Marginally Rigid Fractal Spring Networks.

A family of marginally rigid (isostatic) spring networks with fractal structure up to a controllable length was devised, and the viscoelastic spectra G^{*}(ω) calculated. Two nontrivial scaling regimes were observed, (i) G^{'}≈G^{''}∝ω^{Δ} at low frequencies, consistent with Δ=1/2, and (ii) G^{'}∝G^{''}∝ω^{Δ^{'}} for intermediate frequencies corresponding to fractal structure, consistent with a theoretical prediction Δ^{'}=(ln3-ln2)/(ln3+ln2). The crossover between these two regimes occurred at lower frequencies for larger fractals in a manner suggesting diffusivelike dispersion.

NCCN Guidelines® Insights: Myelodysplastic Syndromes, Version 3.2022.

The NCCN Guidelines for Myelodysplastic Syndromes (MDS) provide recommendations for the evaluation, diagnosis, and management of patients with MDS based on a review of clinical evidence that has led to important advances in treatment or has yielded new information on biologic factors that may have prognostic significance in MDS. The multidisciplinary panel of MDS experts meets on an annual basis to update the recommendations. These NCCN Guidelines Insights focus on some of the updates for the 2022 version of the NCCN Guidelines, which include treatment recommendations both for lower-risk and higher-risk MDS, emerging therapies, supportive care recommendations, and genetic familial high-risk assessment for hereditary myeloid malignancy predisposition syndromes.

In Silico Modeling of Hyposalivation and Biofilm Dysbiosis in Root Caries.

Root caries progression is aggravated by hyposalivation, which can accelerate the conversion of a dental biofilm from having a symbiotic microbial relationship with the host (predominance of nonaciduric species) to a dysbiotic one (dominated by aciduric species). Using a mathematical model previously employed to investigate factors associated with biofilm dysbiosis, we systematically explored the deleterious effect of hyposalivation on the composition of the biofilm and the risk of root dentin demineralization. By varying the clearance half-times of sugar (i.