Hanover College

Urinary bladder hamartoma is an exceptionally rare benign lesion composed of disorganized yet mature tissue elements native to the bladder, including urothelium, fibrous stroma, smooth muscle, and occasionally adipose tissue. Unlike malignant tumors, it lacks cytological atypia, mitotic activity, or necrosis. Patients most often present with lower urinary tract symptoms (LUTS) or hematuria, though some cases are incidental findings. Associations with syndromic conditions such as Peutz-Jeghers, Beckwith-Wiedemann, Goldenhar, and Loeys-Dietz have been reported. Transurethral resection is the preferred treatment and has generally been curative. We report the first case in Germany-and the 16th worldwide-of urinary bladder hamartoma, occurring in a young adult male with bothersome LUTS. Because of its proximity to both ureteral orifices, only partial transurethral resection was performed, which provided durable symptom relief at 14 months of follow-up. This case highlights partial TUR as a pragmatic, organ-preserving alternative when complete resection is anatomically unsafe, while emphasizing that TURBT remains the standard of care. We provide a detailed discussion of the histopathological features, differential diagnosis, treatment considerations, and an updated narrative review of all reported cases.

Abstract Research Summary Studies on board interlock networks are divided into two streams, one examining their dynamics; the other, their consequences. We propose that both phenomena—board interlock dynamics and consequences—are interdependent. Applying structuration theory, we explain and empirically demonstrate how firms' corporate strategic actions (specifically, acquisitions and divestitures) influence the creation and dissolution of different types of board interlock network ties and how these interlock ties, in turn, influence firms' corporate strategic actions. Integrating the two research streams, we complement corporate governance literature by demonstrating how corporate strategic actions and certain types of board interlocks coevolve. We contribute to theory on strategic networks by explaining coevolution through a structuration theoretical lens. Lastly, we illustrate methodological advances by using multiplex stochastic actor‐oriented models to analyze coevolution processes. Managerial Summary The dynamics of board interlock networks—networks resulting from executive and non‐executive directors serving on multiple boards—and the consequences of such networks have been treated as disjunct topics in prior research. We argue and show empirically that certain types of a firm's board interlocks and its corporate strategic actions (specifically, acquisitions and divestitures) are mutually dependent. Applying network analysis to a longitudinal sample of large German firms, we find that firms adapt their actions to the actions of those firms they have directed interlocks with. Vice versa, corporate strategic actions influence the creation and dissolution of board interlocks. Our findings suggest that the dynamics of board interlock networks play a more prominent role in firms' corporate strategic decisions than commonly assumed.

Abstract Upper tract urothelial carcinoma (UTUC) and urinary bladder cancer (UBC), though histologically similar, differ molecularly, prompting interest in their biomarker profiles for targeted therapies like antibody-drug conjugates (ADCs) enfortumab vedotin (targeting Nectin-4) and sacituzumab govitecan (targeting TROP-2). This study investigated Nectin-4 and TROP-2 expression in 87 UTUC patients, including 54 with a history of concurrent UBC (UTUC + UBC) and 33 with UTUC alone. Immunohistochemical analysis revealed widespread TROP-2 expression (98.8% of samples), with high levels linked to low-grade UTUC (p = 0.043) and intense staining (mean H-score 227 ± 63) across both cohorts. Nectin-4 was expressed in 70.1% of samples overall but was more frequent in the UTUC + UBC group (88.8% vs. 63.6% in UTUC-only patients), though this difference lacked statistical significance (p = 0.340). Notably, Nectin-4 staining intensity was weak in both groups (mean H-score 66 ± 65), suggesting biological distinctions between UTUC with and without UBC. The findings imply that ADCs targeting TROP-2 and Nectin-4 may hold therapeutic promise in UTUC without requiring prior biomarker testing. Additionally, the elevated Nectin-4 expression in UTUC + UBC patients hints at divergent molecular pathways that could influence treatment strategies, warranting further clinical exploration.

Background The interest in and use of mechanical percussive massage treatment devices have grown immensely among clinicians and athletes. One purported benefit of these devices is the improvement of range of motion but whether these devices are more effective than traditional means of increasing muscle extensibility remains unexplored. Purpose To examine the effect of mechanical percussive massage therapy applied to the hamstrings versus static stretching of the hamstrings on passive knee extension (PKE) range of motion. Study Design Randomized control trial Methods Male Division II NAIA and Division III NCAA football players were recruited. Subjects were randomly assigned to one of three groups: control, mechanical percussive massage therapy, or static stretching. Passive hamstring extensibility was quantified in all groups using standard goniometric measurements before and after the intervention by measuring PKE three times in a 90-90 supine position. The mechanical percussive massage therapy group received five minutes of treatment to the hamstrings. The static stretching group received manual stretching of the hamstrings performed in the 90-90 supine position (3 repetitions of 30 seconds with 10-second rest between repetitions). The control group received no treatment. An ANOVA was used to investigate effects of the random interventions. Results Seventy-nine male collegiate football players, 37 NCAA Division III and 42 NAIA Division II (mean age 19.8 years +/- 1.2) participated in this study. A significant difference (p < .001) in pre- and post-PKE range of motion was noted for both the percussive mechanical massage therapy (5.8 degrees, SD+/- 3.32) and static stretching (6 degrees, SD+/- 3.29) groups. No significant difference was noted between the two treatment groups. The control group did not demonstrate a significant difference in pre and post-PKE (1.1 degrees, SD +/- 3.62). Conclusions Static stretching and mechanical percussive massage therapy applied to the hamstrings produce significant immediate increases in PKE compared to a control group suggesting that static hamstring stretching, and mechanical percussive massage therapy are both viable options for acutely increasing hamstring extensibility. Level of Evidence II

The present study aims to explore the impact of unreported concussions of former contact football players' short-term management, and lifelong functioning. The purpose is to understand the prevalence of unreported concussions, acute healthcare management of these injuries, and the long-term implications of former players' neurologic health. We surveyed 282 former high school and college contact football players. The survey retrospectively assessed diagnosed, self-reported head injuries, nonfootball concussions, acute healthcare management, acute unreported concussion, concealing long-term symptoms, and long-term neurologic implications. Analyses revealed that 36.5% of the participants did not report a head injury to their peers or their sport leadership. Respondents who did not report a head injury, characterized as meeting one or more of the criteria for a concussion were 4 times more likely to experience acute neurologic symptoms and 3.3 times more likely to have late-onset neurologic symptoms compared to respondents who did not report concealing their head injuries. The most at-risk group of respondents with head injuries that may have resulted in concussion are those who conceal their symptoms. This study demonstrates the prevalence of unreported concussions among football players and the need for improved healthcare management. Policy changes are required to reduce the number of athletes who are concealing their symptoms.

Organisms may simultaneously face thermal, desiccation and nutritional stress under climate change. Understanding the effects arising from the interactions among these stressors is relevant for predicting organisms' responses to climate change and for developing effective conservation strategies. Using both dynamic and static protocols, we assessed for the first time how sublethal desiccation exposure (at 16.7%, 50.0% and 83.3% of LD50) impacts the heat tolerance of foragers from two social bee species found on the Greek island of Lesbos: the managed European honey bee, Apis mellifera, and the wild, ground-nesting sweat bee Lasioglossum malachurum. In addition, we explored how a short-term starvation period (24 h), followed by a moderate sublethal desiccation exposure (50% of LD50), influences honey bee heat tolerance. We found that neither the critical thermal maximum (CTmax) nor the time to heat stupor was significantly impacted by sublethal desiccation exposure in either species. Similarly, starvation followed by moderate sublethal desiccation did not affect the average CTmax estimate, but it did increase its variance. Our results suggest that sublethal exposure to these environmental stressors may not always lead to significant changes in bees' heat tolerance or increase vulnerability to rapid temperature changes during extreme weather events, such as heat waves. However, the increase in CTmax variance suggests greater variability in individual responses to temperature stress under climate change, which may impact colony-level performance. The ability to withstand desiccation may be impacted by unmeasured hypoxic conditions and the overall effect of these stressors on solitary species remains to be assessed.

Gendered archaeology in Asia has been studied by archaeologists since the 1990s and scholars have posed questions such as the role and construction of gendered identities in ancient societies. In this Element, the authors review secondary literature, report on to what stage the research has evolved, evaluate methodologies, and use the concept of networking to examine the issues across East Asia, including China, Mongolia, Korea, Japan, and Taiwan. Interestingly, those literatures are not entirely parallel with each other – the authors found, for example, that archaeological investigation was largely bound by national guidelines, by local intellectual traditions, and by changing historiographic interpretations of past events, as well as funding. The complexion of recent studies on gender and archaeology in Asia has often been focused on providing a framework for a grand narrative of each national 'civilization' as the emergence of institutional political structures, including traditional values placed on men and women.