Preserving Renal Function without Compromising Oncological Outcomes: A Comparative Study of Partial and Total Nephrectomies in T3 Stage Renal Cell Carcinoma.

The utility of partial nephrectomy (PN) in locally advanced, stage T3 renal cell carcinoma (RCC) is controversial. This retrospective study aimed to review the oncological and functional outcomes of patients with T3a RCC who underwent PN. We included all patients with pT3a stage RCC undergoing either open, laparoscopic, or robotic PN at our center between January 2015 and 2023. A Wilcoxon rank sum test was utilized to compare nephrectomy types (radical nephrectomy [RN] vs PN). Survival analysis was conducted using Kaplan-Meier plots and a log-rank test. P-value < 0.05 indicated statistical significance. There were no significant differences in demographic characteristics between the RN and PN groups, except age (53.0 vs 6.5, respectively; P = 0.012) and body mass index (28.7 vs 34.3, respectively; P = 0.020). Furthermore, there were also no significant differences in the rates of local recurrence (P = 0.597), metastatic progression (P = 0.129), and chemotherapy use (P = 0.367) between nephrectomy types. Patient survival did not differ significantly based on the type of nephrectomy (log-rank P-value = 0.852). Together, our findings indicated that PN and RN yield near-equivalent oncological outcomes in terms of local recurrence, metastasis, and overall survival rates among pT3a RCC patients during a nearly 3-year follow-up period.

MAC protocol with grouping awareness GMAC for large scale Internet-of-Things network.

The development of Medium Access Control (MAC) protocols for Internet of Things should consider various aspects such as energy saving, scalability for a wide number of nodes, and grouping awareness. Although numerous protocols consider these aspects in the limited view of handling the medium access, the proposed Grouping MAC (GMAC) exploits prior knowledge of geographic node distribution in the environment and their priority levels. Such awareness enables GMAC to significantly reduce the number of collisions and prolong the network lifetime. GMAC is developed on the basis of five cycles that manage data transmission between sensors and cluster head and between cluster head and sink. These two stages of communication increase the efficiency of energy consumption for transmitting packets. In addition, GMAC contains slot decomposition and assignment based on node priority, and, therefore, is a grouping-aware protocol. Compared with standard benchmarks IEEE 802.15.4 and industrial automation standard 100.11a and user-defined grouping, GMAC protocols generate a Packet Delivery Ratio (PDR) higher than 90%, whereas the PDR of benchmark is as low as 75% in some scenarios and 30% in others. In addition, the GMAC accomplishes lower end-to-end (e2e) delay than the least e2e delay of IEEE with a difference of 3 s. Regarding energy consumption, the consumed energy is 28.1 W/h for GMAC-IEEE Energy Aware (EA) and GMAC-IEEE, which is less than that for IEEE 802.15.4 (578 W/h) in certain scenarios.

Seasonal variation in the incidence of acute renal colic.

Urolithiasis is a prevalent medical disease affecting the general population. Many epidemiological studies reported an association between a geographic area with a high mean daily temperature and urolithiasis disease. However, it is unclear if the seasonal variation in a high temperature geographical area will affect the acute presentation of renal colic to the emergency department. The aim of this study was to identify the effect of the seasonal variation on the presentation with acute urolithiasis disease. The design was a retrospective chart review, using the database in King Abdulaziz Medical City that was retrieved by the data management office in King Abdullah International Medical Research Center, Riyadh, Kingdom of Saudi Arabia. The study period was from January 26, 2016, to the end of December 2019. All patients who presented with renal colic, and diagnosed with urolithiasis using a noncontrast-enhanced computed tomography scan, have been included. A total of 1057 patients were included in this study. The majority (71.24%, n = 753) were male, and the mean age was 42.33 ± 16.12 years. The highest proportion presented in summer (31.22%), followed by spring (26.87%), fall (24.12%), and winter (17.79%). The majority of the sample (84.77%) presented with ureteral stones, and 15.23%with kidney stones. Most of the sample (78.33%) had no history of previous stone formation, with 21.67% being current stone former. The acute presentation with urolithiasis is higher during summer, followed by spring, fall, and winter. A public educational program is highly recommended to increase awareness about stone formation and the appropriate avoidance methods. To this end, additional research is required to understand the stone composition and appropriate methods to avoid developing urolithiasis.