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Background: Survival data regarding cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) patients according to the type and extent of tumor-associated vascular thrombus are scarce.
Objective: To test for survival differences in mRCC patients treated with CN according to the type and extent of tumor-associated vascular thrombus.
Design, setting, and participants: Within Surveillance, Epidemiology, and End Results Research Plus (2004–2017), we identified CN mRCC patients with renal vein (pT3a-TT) versus infradiaphragmatic inferior vena cava (IVC; pT3b) versus supradiaphragmatic IVC tumor thrombus/IVC invasion (pT3c).
Outcome measurements and statistical analysis: Overall survival (OS) was addressed in Kaplan-Meier and Cox regression analyses, in addition to 3-mo landmark analyses.
Results and limitations: Of 2170 mRCC patients, 1880 (87%), 204 (9%), and 86 (4%) harbored pT3a-TT, pT3b, and pT3c, respectively. The respective median OS periods were 21, 23, and 12 mo (p < 0.001). In multivariable Cox regression models, pT3c stage, but not pT3b stage, was an independent predictor of higher overall mortality (hazard ratio [HR]: 1.37; 95% confidence interval [CI]: 1.09–1.73; p = 0.007), as well as in 6-mo landmark analyses (HR: 1.36; 95% CI: 1.02–1.80; p = 0.04). In the sensitivity analysis, relying on all pT3a patients, the predictor status of pT3c stage remained unchanged (HR: 1.37; 95% CI: 1.09–1.71; p = 0.007). Limitations have to be addressed regarding the sample size and the retrospective design of the current study.
Conclusions: Although overall mortality is significantly higher in pT3c mRCC patients than in their pT3b and pT3a-TT counterparts, these individuals may still expect 12-mo or better OS after CN versus virtually 2-yr OS in their pT3a and pT3b counterparts.
Patient summary: In this study, we looked at the survival outcomes of metastatic renal cell carcinoma patients who presented with tumor thrombus at cytoreductive nephrectomy. Even though these patients with most advanced tumor thrombus stage demonstrated lower survival rates, the median overall survival was still 1 yr.
Middle-aged persons with multimorbidity have to take their illnesses into account in their daily work, family and leisure activities. The MuMiA project aims to identify early preventive measures that make it easier for those between 30 and 60 years of age with multiple chronic diseases to manage their illnesses in their everyday lives. An interdisciplinary workshop and interviews with multimorbid middle-aged adults and their principal healthcare providers will be used to collect information on the management of care in the contexts of patients’ daily work, family and leisure activities. Data obtained in the interviews will be coded inductively and analysed using content analysis. Workshop outputs will be transcribed and evaluated by the authors. This study has received ethical approval from the Faculty of Medicine Ethics Committee of Goethe University (2021-47). The project will generate prevention recommendations that reflect the experiences of middle-aged persons living with multimorbidity and the views of their principal healthcare providers. The findings will be disseminated via conferences and peer-reviewed publications.
Development of a multidimensional pain questionnaire in professional dance (MPQDA): a pilot study
(2022)
Background: Pain is part of the everyday life of professional dancers. It can indicate health risks and impair the ability to work. Suitable screening tools can be used to identify pain and its risk potential. A comprehensive, multidimensional, differentiated assessment tool for pain in professional dance does not currently exist.
Methods: An initial questionnaire was developed in German and English and was assessed in a qualitative pretest. In a field study with a cross-sectional design including n = 72 dancers from Germany (n = 36 responses each in the English and German language versions), the questionnaire was optimized by item analysis, its psychometric properties (dimensionality, construct validity, reliability) were examined and the ability of the pain dimensions to classify the subjective ability to work in training was analyzed (ROC analysis).
Results: The developed Multidimensional Pain Questionnaire in Professional Dance (MPQDA) was reduced and optimized in its psychometric properties. Following questions were reduced in their items or answer categories: pain localizations (from 20 to 15 regions), accompanying symptoms (from 6 to 3 items), sensory and affective pain quality (from 20 to 10 items), pain frequency (from 4 to 3 answer categories), and the motives of working with pain (from 14 to 12 items). Regarding the subjective ability to work in training, the variables of the ability to work in rehearsals and in performances, as well as the accompanying symptoms of tension and mobility restrictions, showed a relatively good classification ability (Area under the Curve (AUC) ≥ 0.7 in the 95% confidence interval) and significant, moderate to strong correlations (Somers' D > 0.25, p < 0.05). The classification ability of the other pain dimensions was largely absent or poor.
Conclusion: The MPQDA differentiates various pain dimensions in professional dancers and is available in a compatible manner in German and English. The clinical relevance needs to be explored further in the future.
We report results on an elastic cross section measurement in proton–proton collisions at a center-of-mass energy √𝑠 = 510 GeV, obtained with the Roman Pot setup of the STAR experiment at the Relativistic Heavy Ion Collider (RHIC). The elastic differential cross section is measured in the four-momentum transfer squared range 0.23 ≤ −𝑡 ≤ 0.67 GeV2. This is the only measurement of the proton-proton elastic cross section in this 𝑡 range for collision energies above the Intersecting Storage Rings (ISR) and below the Large Hadron Collider (LHC) colliders. We find that a constant slope 𝐵 does not fit the data in the aforementioned 𝑡 range, and we obtain a much better fit using a second-order polynomial for 𝐵(𝑡). This is the first measurement below the LHC energies for which the non-constant behavior 𝐵(𝑡) is observed. The 𝑡 dependence of 𝐵 is also determined using six subintervals of 𝑡 in the STAR measured 𝑡 range, and is in good agreement with the phenomenological models. The measured elastic differential cross section d𝜎∕dt agrees well with the results obtained at √𝑠 = 540 GeV for proton–antiproton collisions by the UA4 experiment. We also determine that the integrated elastic cross section within the STAR 𝑡-range is 𝜎f id el = 462.1 ± 0.9(stat.) ± 1.1(syst.) ± 11.6(scale) 𝜇b.
Up to the present, there has been a lack of studies on the skin health of professional and recreational dancers. Dancers are at risk of skin diseases due to contact with allergenic or irritating substances and working in humid environments. The aim of the present study was, therefore, to examine skin health in two different dance styles and training periods. Methods: Physical dermatological examination of professional dancers (PD; n = 35) and Latin American formation dancers (LD; n = 79) after a 4-week period of recovery (T0) and a period of high training or work load (T1). Results: PD are significantly more frequently affected by skin dermatoses than LD (T0, p = 0.004) (frontal traction alopecia, hair loss, facial seborrhoea, xerosis cutis of the trunk and extremities, and facial folliculitis). The following significant differences between the sexes were observed in the LD: more folliculitis of the trunk in male subjects (T0 and T1, p = 0.009), more frequent xerosis cutis of the extremities (p < 0.001) and perioral dermatitis in female subjects (T1, p = 0.043). Subjects with skin lesions trained more frequently, performed more times per year, and had longer dance experience. Discussion: Based on the findings, preventive measures for skin protection (especially informing dancers about skin health) are necessary. At the same time, further studies on this topic are important.
The deep fascia is intimately linked to skeletal muscle and may be involved in delayed onset muscle soreness (DOMS). The present study therefore explored the effect of eccentric exercise on fascia stiffness and its relation with DOMS. Healthy active male adults (n = 19, 27 ± 4 years) performed 6 x 10 maximal eccentric knee flexions using an isokinetic dynamometer. Before (baseline) as well as immediately (T0), 1 hour (T1), and each day up to 72 hours (T24 to T72) afterwards, shear wave elastography was used to measure the mechanical stiffness of the biceps femoris muscle and the overlying fascia. As a surrogate of DOMS, pain upon palpation was captured by means of a 100mm visual analogue scale. While muscle stiffness remained unchanged (p > 0.05), deep fascia stiffness increased from baseline to T24 (median: 18 kPa to 21.12 kPa, p = 0.017) and T72 (median: 18 kPa to 21.3 kPa, p = 0.001) post-exercise. Linear regression showed an association of stiffness changes at T24 and pressure pain at T72 (r2 = 0.22, p < 0.05). Maximal eccentric exercise leads to a stiffening of the fascia, which, in turn, is related to the magnitude of future DOMS. Upcoming research should therefore gauge the effectiveness of interventions modifying the mechanical properties of the connective tissue in order to accelerate recovery.
Background: Primary viral myocarditis associated with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection is a rare diagnosis.
Case presentation: We report the case of an unvaccinated, healthy patient with cardiogenic shock in the context of a COVID-19-associated myocarditis and therapy with simultaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and percutaneous left ventricular decompression therapy with an Impella. The aim of this review is to provide an overview of therapeutic options for patients with COVID-19-associated myocarditis.
Conclusions: The majority of patients required a combination of two assist devices to achieve sufficient cardiac output until recovery of left ventricular ejection fraction. Due to the rapid onset of this fulminant cardiogenic shock immediate invasive bridging therapy in a specialized center was lifesaving.
Introduction: Studies of vocational ballet students are sparce. In particular, there is a lack of gender comparisons. The aim of the present study, therefore, was to give a musculoskeletal and sociodemographic description of the typical vocational ballet student in gender comparison. Methods: In this study, n = 414 female and n = 192 male students of the John Cranko School (JCS), aged between 5 and 22 years (Mean ± SD: 13.9 ± 3.5), were examined by an experienced orthopedist and dance physician. Results: Males started ballet (5.8/8.2 years, p < 0.001) and training at later age than females (13.5/14.6 years, p < 0.05). There was a high prevalence of low body weight among both sexes; however, particularly among female participants (58.4/16.2%, p < 0.001). Both sexes showed a large external rotation of the hip (f/m: 59/62°, p < 0.001), a large turnout (f/m: 82/86°, p < 0.01), high values for plantarflexion of the ankle joint (f/m: 72/68°, p < 0.001) and dorsiflexion of the metatarsophalangeal joint of the big toe (f/m: 90/87°, p < 0.001). Discussion: Differences in ballet-specific characteristics between genders (f/m) are converging and are smaller than described in the past. The particularly high prevalence of low body weight among students in the vocational training sector, particularly among females, highlights the need for deeper diagnostic investigation.
Mit einem Stadtbegriff tue ich mich schwer. Städte zu verstehen ist gleichbedeutend damit, Wandel zu verstehen. Städte haben sich über die Jahrhunderte, über die Kontinente und Gesellschaftsformationen hinweg so häufig gehäutet, dass an einem geronnenen Zustand orientierte Definitionen zum Scheitern verurteilt sind. So hat es immer wieder Versuche gegeben, Stadt aus ihrer Bevölkerungsgröße, ihrer Siedlungsstruktur oder ihrer Wirtschafts- und Bauweise abzuleiten, also aus ihren besonderen räumlich-physischen Eigenschaften, die aber allenfalls zeithistorischen Wert haben.
Observation of directed flow of hypernuclei Λ³H and Λ⁴H in √sNN = 3 GeV Au+Au collisions at RHIC
(2023)
We report here the first observation of directed flow (v1) of the hypernuclei 3ΛH and 4ΛH in mid-central Au+Au collisions at sNN−−−√ = 3 GeV at RHIC. These data are taken as part of the beam energy scan program carried out by the STAR experiment. From 165 × 106 events in 5%-40% centrality, about 8400 3ΛH and 5200 4ΛH candidates are reconstructed through two- and three-body decay channels. We observe that these hypernuclei exhibit significant directed flow. Comparing to that of light nuclei, it is found that the midrapidity v1 slopes of 3ΛH and 4ΛH follow baryon number scaling, implying that the coalescence is the dominant mechanism for these hypernuclei production in such collisions.
Observation of directed flow of hypernuclei Λ³H and Λ⁴H in √sNN = 3 GeV Au+Au collisions at RHIC
(2022)
We report here the first observation of directed flow (v1) of the hypernuclei 3ΛH and 4ΛH in mid-central Au+Au collisions at sNN−−−√ = 3 GeV at RHIC. These data are taken as part of the beam energy scan program carried out by the STAR experiment. From 165 million good events in 5-40% centrality, about 8400 3ΛH and 5200 4ΛH candidates are reconstructed through two- and three-body decay channels. We observe that these hypernuclei exhibit significant directed flow. Comparing to that of light nuclei, it is found that the mid-rapidity v1 slopes of 3ΛH and 4ΛH follow baryon number scaling, implying that the coalescence is the dominant mechanism for these hypernuclei production in such collisions.
In relativistic heavy-ion collisions, a global spin polarization, PH, of Λ and Λ¯ hyperons along the direction of the system angular momentum was discovered and measured across a broad range of collision energies and demonstrated a trend of increasing PH with decreasing sNN−−−√. A splitting between Λ and Λ¯ polarization may be possible due to their different magnetic moments in a late-stage magnetic field sustained by the quark-gluon plasma which is formed in the collision. The results presented in this study find no significant splitting at the collision energies of sNN−−−√=19.6 and 27 GeV in the RHIC Beam Energy Scan Phase II using the STAR detector, with an upper limit of PΛ¯−PΛ<0.24% and PΛ¯−PΛ<0.35%, respectively, at a 95% confidence level. We derive an upper limit on the naïve extraction of the late-stage magnetic field of B<9.4⋅1012 T and B<1.4⋅1013 T at sNN−−−√=19.6 and 27 GeV, respectively, although more thorough derivations are needed. Differential measurements of PH were performed with respect to collision centrality, transverse momentum, and rapidity. With our current acceptance of |y|<1 and uncertainties, we observe no dependence on transverse momentum and rapidity in this analysis. These results challenge multiple existing model calculations following a variety of different assumptions which have each predicted a strong dependence on rapidity in this collision-energy range.
In relativistic heavy-ion collisions, a global spin polarization, PH, of Λ and Λ¯ hyperons along the direction of the system angular momentum was discovered and measured across a broad range of collision energies and demonstrated a trend of increasing PH with decreasing sNN−−−√. A splitting between Λ and Λ¯ polarization may be possible due to their different magnetic moments in a late-stage magnetic field sustained by the quark-gluon plasma which is formed in the collision. The results presented in this study find no significant splitting at the collision energies of sNN−−−√=19.6 and 27 GeV in the RHIC Beam Energy Scan Phase II using the STAR detector, with an upper limit of PΛ¯−PΛ<0.24% and PΛ¯−PΛ<0.35%, respectively, at a 95% confidence level. We derive an upper limit on the naïve extraction of the late-stage magnetic field of B<9.4⋅1012 T and B<1.4⋅1013 T at sNN−−−√=19.6 and 27 GeV, respectively, although more thorough derivations are needed. Differential measurements of PH were performed with respect to collision centrality, transverse momentum, and rapidity. With our current acceptance of |y|<1 and uncertainties, we observe no dependence on transverse momentum and rapidity in this analysis. These results challenge multiple existing model calculations following a variety of different assumptions which have each predicted a strong dependence on rapidity in this collision-energy range.
In relativistic heavy-ion collisions, a global spin polarization, PH, of Λ and Λ¯ hyperons along the direction of the system angular momentum was discovered and measured across a broad range of collision energies and demonstrated a trend of increasing PH with decreasing sNN−−−√. A splitting between Λ and Λ¯ polarization may be possible due to their different magnetic moments in a late-stage magnetic field sustained by the quark-gluon plasma which is formed in the collision. The results presented in this study find no significant splitting at the collision energies of sNN−−−√=19.6 and 27 GeV in the RHIC Beam Energy Scan Phase II using the STAR detector, with an upper limit of PΛ¯−PΛ<0.24% and PΛ¯−PΛ<0.35%, respectively, at a 95% confidence level. We derive an upper limit on the naïve extraction of the late-stage magnetic field of B<9.4⋅1012 T and B<1.4⋅1013 T at sNN−−−√=19.6 and 27 GeV, respectively, although more thorough derivations are needed. Differential measurements of PH were performed with respect to collision centrality, transverse momentum, and rapidity. With our current acceptance of |y|<1 and uncertainties, we observe no dependence on transverse momentum and rapidity in this analysis. These results challenge multiple existing model calculations following a variety of different assumptions which have each predicted a strong dependence on rapidity in this collision-energy range.
In relativistic heavy-ion collisions, a global spin polarization, PH, of Λ and Λ¯ hyperons along the direction of the system angular momentum was discovered and measured across a broad range of collision energies and demonstrated a trend of increasing PH with decreasing sNN−−−√. A splitting between Λ and Λ¯ polarization may be possible due to their different magnetic moments in a late-stage magnetic field sustained by the quark-gluon plasma which is formed in the collision. The results presented in this study find no significant splitting at the collision energies of sNN−−−√=19.6 and 27 GeV in the RHIC Beam Energy Scan Phase II using the STAR detector, with an upper limit of PΛ¯−PΛ<0.24% and PΛ¯−PΛ<0.35%, respectively, at a 95% confidence level. We derive an upper limit on the naïve extraction of the late-stage magnetic field of B<9.4⋅1012 T and B<1.4⋅1013 T at sNN−−−√=19.6 and 27 GeV, respectively, although more thorough derivations are needed. Differential measurements of PH were performed with respect to collision centrality, transverse momentum, and rapidity. With our current acceptance of |y|<1 and uncertainties, we observe no dependence on transverse momentum and rapidity in this analysis. These results challenge multiple existing model calculations following a variety of different assumptions which have each predicted a strong dependence on rapidity in this collision-energy range.
We report the first measurements of cumulants, up to 4th order, of deuteron number distributions and proton-deuteron correlations in Au+Au collisions recorded by the STAR experiment in phase-I of Beam Energy Scan (BES-I) program at the Relativistic Heavy Ion Collider (RHIC). Deuteron cumulants, their ratios, and proton-deuteron mixed cumulants are presented for different collision centralities covering a range of center of mass energy per nucleon pair sNN−−−√ = 7.7 to 200 GeV. It is found that the cumulant ratios at lower collision energies favor a canonical ensemble over a grand canonical ensemble in thermal models. An anti-correlation between proton and deuteron multiplicity is observed across all collision energies and centralities, consistent with the expectation from global baryon number conservation. The UrQMD model coupled with a phase-space coalescence mechanism qualitatively reproduces the collision-energy dependence of cumulant ratios and proton-deuteron correlations.
We report results on an elastic cross section measurement in proton-proton collisions at a center-of-mass energy s√=510 GeV, obtained with the Roman Pot setup of the STAR experiment at the Relativistic Heavy Ion Collider (RHIC). The elastic differential cross section is measured in the four-momentum transfer squared range 0.23≤−t≤0.67 GeV2. We find that a constant slope B does not fit the data in the aforementioned t range, and we obtain a much better fit using a second-order polynomial for B(t). The t dependence of B is determined using six subintervals of t in the STAR measured t range, and is in good agreement with the phenomenological models. The measured elastic differential cross section dσ/dt agrees well with the results obtained at s√=546~GeV for proton--antiproton collisions by the UA4 experiment. We also determine that the integrated elastic cross section within the STAR t-range is σfidel=462.1±0.9(stat.)±1.1(syst.)±11.6(scale) μb.
We report results on an elastic cross section measurement in proton-proton collisions at a center-of-mass energy s√=510 GeV, obtained with the Roman Pot setup of the STAR experiment at the Relativistic Heavy Ion Collider (RHIC). The elastic differential cross section is measured in the four-momentum transfer squared range 0.23≤−t≤0.67 GeV2. We find that a constant slope B does not fit the data in the aforementioned t range, and we obtain a much better fit using a second-order polynomial for B(t). The t dependence of B is determined using six subintervals of t in the STAR measured t range, and is in good agreement with the phenomenological models. The measured elastic differential cross section dσ/dt agrees well with the results obtained at s√=546 GeV for proton--antiproton collisions by the UA4 experiment. We also determine that the integrated elastic cross section within the STAR t-range is σfidel=462.1±0.9(stat.)±1.1(syst.)±11.6(scale) μb.
The longitudinal and transverse spin transfers to Λ (Λ¯¯¯¯) hyperons in polarized proton-proton collisions are expected to be sensitive to the helicity and transversity distributions, respectively, of (anti-)strange quarks in the proton, and to the corresponding polarized fragmentation functions. We report improved measurements of the longitudinal spin transfer coefficient, DLL, and the transverse spin transfer coefficient, DTT, to Λ and Λ¯¯¯¯ in polarized proton-proton collisions at √s = 200 GeV by the STAR experiment at RHIC. The data set includes longitudinally polarized proton-proton collisions with an integrated luminosity of 52 pb−1, and transversely polarized proton-proton collisions with a similar integrated luminosity. Both data sets have about twice the statistics of previous results and cover a kinematic range of |ηΛ(Λ¯¯¯¯)| < 1.2 and transverse momentum pT,Λ(Λ¯¯¯¯) up to 8 GeV/c. We also report the first measurements of the hyperon spin transfer coefficients DLL and DTT as a function of the fractional jet momentum z carried by the hyperon, which can provide more direct constraints on the polarized fragmentation functions.