PURPOSEBenign prostatic hyperplasia (BPH) is a histologic diagnosis describing proliferation of smooth muscle and epithelial cells within the prostatic transition zone. The prevalence and severity of ...lower urinary tract symptoms (LUTS) in aging men are progressive and impact the health and welfare of society. This revised Guideline provides a useful reference on effective evidence-based management of male LUTS/BPH. See the accompanying algorithm for a summary of the procedures detailed in the Guideline (figures 1 and 2Figure: see textFigure: see text). MATERIALS AND METHODSThe Minnesota Evidence Review Team searched Ovid MEDLINE, Embase, Cochrane Library, and AHRQ databases to identify eligible English language studies published between January 2008 and April 2019, then updated through December 2020. Search terms included Medical Subject Headings (MeSH) and keywords for pharmacological therapies, drug classes, and terms related to LUTS or BPH. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, information is provided as Clinical Principles and Expert Opinions (table 1Table: see text). RESULTSNineteen guideline statements pertinent to evaluation, work-up, and medical management were developed. Appropriate levels of evidence and supporting text were created to direct both primary care and urologic providers towards streamlined and suitable practices. CONCLUSIONSThe work up and medical management of BPH requires attention to individual patient characteristics, while also respecting common principles. Clinicians should adhere to recommendations and familiarize themselves with standards of BPH management.
Surgical therapies for symptomatic bladder outlet obstruction (BOO) due to benign prostatic hyperplasia (BPH) are many, and vary from minimally invasive office based to high-cost operative ...approaches. This Guideline presents effective evidence-based surgical management of male lower urinary tract symptoms secondary/attributed to BPH (LUTS/BPH). See accompanying algorithm for a detailed summary of procedures (figureFigure: see text).
The Minnesota Evidence Review Team searched Ovid MEDLINE, Embase, Cochrane Library, and AHRQ databases to identify eligible studies published between January 2007 and September 2020, which includes the initial publication (2018) and amendments (2019, 2020). The Team also reviewed articles identified by Guideline Panel Members. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, information is provided as Clinical Principles and Expert Opinions (tableTable: see text).
Twenty-four guideline statements pertinent to pre-operative and surgical management were developed. Appropriate levels of evidence and supporting text were created to direct urologic providers towards suitable and safe operative interventions for individual patient characteristics. A re-treatment section was created to direct attention to longevity and outcomes with individual approaches to help guide patient counselling and therapeutic decisions.
Pre-operative and surgical management of BPH requires attention to individual patient characteristics and procedural risk. Clinicians should adhere to recommendations and familiarize themselves with criteria that yields the highest likelihood of surgical success when choosing a particular approach for a particular patient.
The purpose of this American Urological Association (AUA) Guideline amendment is to provide a useful reference on the effective evidence-based management of male lower urinary tract symptoms ...secondary/attributed to BPH (LUTS/BPH).
The Minnesota Evidence Review Team searched Ovid MEDLINE, the Cochrane Library, and the Agency for Healthcare Research and Quality (AHRQ) database to identify studies relevant to the management of BPH. The guideline was updated in 2023 to capture eligible literature published between September 2020 and October 2022. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions.
The BPH amendment resulted in changes to statements/supporting text on combination therapy, photoselective vaporization of the prostate (PVP), water vapor thermal therapy (WVTT), laser enucleation, and prostate artery embolization (PAE). A new statement on temporary implanted prostatic devices (TIPD) was added. In addition, statements on transurethral needle ablation (TUNA) and transurethral microwave thermotherapy (TUMT) were removed and information regarding these legacy technologies was added to the background section. References and the accompanying treatment algorithms were updated to align with the updated text.
This guideline seeks to improve clinicians' ability to evaluate and treat patients with BPH/LUTS based on currently available evidence. Future studies will be essential to further support these statements to improve patient care.
Abstract
The Arctic is warming faster than any other region on Earth. Putting this rapid warming into perspective is challenging because instrumental records are often short or incomplete in polar ...regions and precisely-dated temperature proxies with high temporal resolution are largely lacking. Here, we provide this long-term perspective by reconstructing past summer temperature variability at Yamal Peninsula – a hotspot of recent warming – over the past 7638 years using annually resolved tree-ring records. We demonstrate that the recent anthropogenic warming interrupted a multi-millennial cooling trend. We find the industrial-era warming to be unprecedented in rate and to have elevated the summer temperature to levels above those reconstructed for the past seven millennia (in both 30-year mean and the frequency of extreme summers). This is undoubtedly of concern for the natural and human systems that are being impacted by climatic changes that lie outside the envelope of natural climatic variations for this region.
Abstract
We present observations of five stellar occultations for (11351) Leucus and reports from two efforts on (21900) Orus. Both objects are prime mission candidate targets for the Lucy Discovery ...mission. Combined results for Leucus indicate a very dark surface with
p
V
= 0.037 ± 0.001, which is derived from the average of the multichord occultations. Our estimate of the triaxial ellipsoidal shape is for axial diameters of 63.8 × 36.6 × 29.6 km assuming that the spin pole is normal to the line of sight. The actual shape of the object is only roughly elliptical in profile at each epoch. Significant topography is seen with horizontal scales up to 30 km and vertical scales up to 5 km. The most significant feature is a large depression on the southern end of the object as seen from a terrestrial viewpoint. For this work we developed a method to correct for differential refraction, accounting for the difference in color between the target object and the reference stars for astrometry derived from ground-based images.
In 2019, the Research and Education Collaborative Occultation Network (RECON) obtained multiple-chord occultation measurements of two Centaur objects: 2014 YY49 on 2019 January 28 and 2013 NL24 on ...2019 September 4. RECON is a citizen-science telescope network designed to observe high-uncertainty occultations by outer solar system objects. Adopting circular models for the object profiles, we derive a radius km and a geometric albedo for 2014 YY49 and a radius km and a geometric albedo for 2013 NL24. To the precision of these measurements, no atmosphere or rings are detected for either object. The two objects measured here are among the smallest distant objects measured with the stellar occultation technique. In addition to these geometric constraints, the occultation measurements provide astrometric constraints for these two Centaurs at a higher precision than has been feasible by direct imaging. To supplement the occultation results, we also present an analysis of color photometry from the Pan-STARRS surveys to constrain the rotational light curve amplitudes and spectral colors of these two Centaurs. We recommend that future work focus on photometry to more deliberately constrain the objects' colors and light curve amplitudes and on follow-on occultation efforts informed by this astrometry.
Abstract
In 2019, the Research and Education Collaborative Occultation Network (RECON) obtained multiple-chord occultation measurements of two Centaur objects: 2014 YY
49
on 2019 January 28 and 2013 ...NL
24
on 2019 September 4. RECON is a citizen-science telescope network designed to observe high-uncertainty occultations by outer solar system objects. Adopting circular models for the object profiles, we derive a radius
km and a geometric albedo
for 2014 YY
49
and a radius
km and a geometric albedo
for 2013 NL
24
. To the precision of these measurements, no atmosphere or rings are detected for either object. The two objects measured here are among the smallest distant objects measured with the stellar occultation technique. In addition to these geometric constraints, the occultation measurements provide astrometric constraints for these two Centaurs at a higher precision than has been feasible by direct imaging. To supplement the occultation results, we also present an analysis of color photometry from the Pan-STARRS surveys to constrain the rotational light curve amplitudes and spectral colors of these two Centaurs. We recommend that future work focus on photometry to more deliberately constrain the objects’ colors and light curve amplitudes and on follow-on occultation efforts informed by this astrometry.
With an increase in the longevity of the global population, care of the functional, cognitive, and physical health of older adults is essential. The dramatic demographic shift toward a growing aging ...population and an increase in osteoporotic fractures that has occurred over the last few decades especially in Western countries, has clearly shown the need for a comprehensive approach to treating fragility fractures by surgeons, geriatricians, and care staff. Osteoporotic Fracture Care: Medical and Surgical Management is the first book of its kind to offer a well-rounded and comprehensive resource on fragility fractures and orthogeriatric care designed to help new and experienced surgeons, geriatricians, physicians, and care personnel to better work together and develop interprofessional and interdisciplinary systems so as to treat patients more effectively. The book contains 44 chapters and is divided into three sections: "Principles," "Improving system of care," and the case-based part "Decision making and special considerations in surgical care." The book's key features are: In-depth insight into the needs of older adults and how to best improve patient care, patient outcome, and reduce system costs. Twenty detailed and illustrative case-based chapters giving the reader a wide array of options to improve the patient care and outcomes. More than 1,000 high-quality x-rays, clinical images, and illustrations. Print book comes with bundled ebook.
As metal–organic frameworks (MOFs) gain traction for applications, such as hydrogen storage, it is essential to form the as-synthesized powder materials into shaped bodies with high packing densities ...to maximize their volumetric performance. Mechanical compaction, which involves compressing the materials at high pressure, has been reported to yield high monolith density but often results in a significant loss in accessible porosity. Herein, we sought to systematically control (1) crystal size, (2) solvation, and (3) compacting pressure in the pelletization process to achieve high packing density without compromising the porosity that makes MOFs functional. It was determined that solvation is the most critical factor among the three factors examined. Solvation that exceeds the pore volume prevents the framework from collapsing, allowing for porosity to be maintained through pelletization. Higher pelletization pressure results in higher packing density, with extensive loss of porosity being observed at a higher pressure if the solvation is below the pore volume. Lastly, we observed that the morphology and size of the MOF particles result in variation in the highest achievable packing efficiency, but these numbers (75%) are still greater than many existing techniques used to form MOFs. We concluded that the application of pressure through pelletization is a suitable and widely applicable technique for forming high-density MOF-monoliths.
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