Noninferiority Randomized Clinical Trial: KIM Sling With Reusable Trocars Versus TVT Exact Sling.

Importance: The Neomedic Knotless Incontinence Mesh (KIM) sling with sterilizable trocars decreases medical waste versus midurethral slings with disposable trocars. Limited comparative data exist.

Objective: The aim of the study was to assess to the success of the retropubic KIM sling compared to the Gynecare TVT Exact sling.

Comparison of Diagnostic Accuracies of Commonly Used Trial of Void Parameters.

Importance: Understanding the diagnostic accuracy of postoperative trial of void (TOV) parameters is important for decision making related to postoperative catheterization.

Objective: The aim of the study was to compare the diagnostic accuracies of common postoperative TOV parameters.

Design: The study population comprised a prospective cohort undergoing outpatient urogynecologic procedures at a tertiary referral center from September 2018 to June 2021.

Minimally Invasive Sacrocolpopexy: Impact on Sexual Function.

Introduction And Hypothesis: Sacrocolpopexy (SCP) is the gold standard surgical management of apical pelvic organ prolapse (POP), and increasingly, minimally invasive SCP is being adopted as a primary treatment for advanced uterovaginal prolapse. Patients undergoing surgery for POP consider postoperative improvement in sexual function to be a highly important outcome, and sexual dysfunction and dyspareunia severe adverse events. Therefore, it is crucial to understand the impact of minimally invasive SCP on postoperative sexual function.

A Randomized Clinical Trial: Patient Satisfaction of Paper Versus Electronic Provider Feedback.

Importance: Minimal data compare patient satisfaction with completing paper versus electronic evaluations.

Objectives: This study aimed to compare patient satisfaction with completing paper versus electronic evaluations. Secondary objectives were assessing age, education, and socioeconomic status with comfort with technology; preference for evaluation type; and timeliness of completing evaluations.

Massively parallel disruption of enhancers active in human neural stem cells.

Changes in gene regulation have been linked to the expansion of the human cerebral cortex and to neurodevelopmental disorders, potentially by altering neural progenitor proliferation. However, the effects of genetic variation within regulatory elements on neural progenitors remain obscure. We use sgRNA-Cas9 screens in human neural stem cells (hNSCs) to disrupt 10,674 genes and 26,385 conserved regions in 2,227 enhancers active in the developing human cortex and determine effects on proliferation.

Patient Removal of Urinary Catheters After Urogynecologic Surgery: A Randomized Controlled Trial.

Objective: To compare postoperative urinary retention rates in the early postoperative period between home and office catheter removal. Secondary outcomes included pain, difficulty, satisfaction, likelihood to use again, and health care utilization.

Methods: We conducted a nonblinded, randomized controlled, noninferiority trial of women undergoing surgery for stress incontinence and prolapse from March 2021 to June 2022.

Racial and ethnic disparity in national practice patterns for stress urinary incontinence surgery.

Introduction And Hypothesis: There is a paucity of information assessing whether race/ethnicity is associated with differences in surgical treatment of stress urinary incontinence (SUI). The primary objective was to assess for racial/ethnic disparities in SUI surgeries. Secondary objectives were to assess for surgical complication differences and trends over time.

Long-Term Pain After Minimally Invasive Total Hysterectomy and Sacrocolpopexy.

Importance: There are limited long-term data on patient-reported pain after surgical treatment of uterovaginal prolapse.

Objective: This study aimed to evaluate pain in women undergoing minimally invasive total hysterectomy and sacrocolpopexy with a lightweight polypropylene Y-mesh (Upsylon) >2 years after surgery.

Study Design: This is a planned secondary analysis of a 5-site randomized trial comparing permanent versus absorbable suture for vaginal attachment of a lightweight polypropylene Y-mesh during total laparoscopic hysterectomy and sacrocolpopexy in women with stage ≥2 uterovaginal prolapse.

Examining Age and Postoperative Opioid Use in the Urogynecology Population: A Prospective Study.

Importance: Surgeons must individualize postoperative pain management while also reducing the amount of unused prescribed opioids.

Objectives: This study compared postoperative opioid use in younger versus older women following urogynecologic surgery. We also assessed the likelihood of women returning unused opioids for safe disposal.

"I'm Not Going Home With a Catheter": Patient-Perceived Outcomes Associated With Perioperative Intermittent Catheterization.

Importance: Indwelling catheters are a known source of dissatisfaction for postoperative patients. There is a paucity of data describing patient-perceived outcomes associated with the alternative of intermittent self-catheterization (ISC).

Objectives: The aim of this study was to describe patient satisfaction and outcomes associated with ISC after outpatient female pelvic reconstructive surgery.

Long-term mesh exposure after minimally invasive total hysterectomy and sacrocolpopexy.

Introduction And Hypothesis: The objective was to evaluate total and incident mesh exposure rates at least 2 years after minimally invasive total hysterectomy and sacrocolpopexy. Secondary aims were to evaluate surgical success and late adverse events.

Methods: This extension study included women previously enrolled in the multicenter randomized trial of permanent vs delayed-absorbable suture with lightweight mesh for > stage II uterovaginal prolapse.

Accuracy of Visual Assessment of Urimeter Bag Volumes: The Whiz Quiz.

Importance: Although visual estimate of urine output via urimeter bag is common, data on accuracy are limited.

Objective: This study aimed to assess the accuracy of a visual estimate of urine output in standard urimeter bags by health care workers.

Study Design: This is a prospective observational study.

Rationale and design of a multicenter randomized clinical trial of vestibulodynia: understanding pathophysiology and determining appropriate treatments (vestibulodynia: UPDATe).

Background: Limited data are available to establish evidence-based management protocols for vestibulodynia (VBD), a chronic vulvar pain condition that affects approximately 14 million women in the U.S. For the purposes of the study, our group subdivided VBD subtypes that may benefit from different types of treatment: 1) VBD peripheral (VBD-p), characterized by pain localized to the vulvar vestibule and 2) VBD central (VBD-c), characterized by VBD alongside one or more other chronic overlapping pain conditions (e.

A Randomized Clinical Trial Comparing the Efficacy and Safety of 2% Versus 4% Chlorohexidine Gluconate for Surgical Preparation of the Vagina.

Importance: There have been no studies comparing 2% and 4% chlorhexidine gluconate (CHX) for vaginal surgical site preparation despite both commonly being used.

Objectives: The primary objective was to assess the noninferiority of 2% CHX versus 4% CHX to reduce bacterial contamination rates at 60 minutes after surgical preparation of the vagina. Secondary objectives were to assess differences in colony-forming units and the sensation of postoperative vaginal burning and pain.

Vaginal repair of vesicovaginal fistula: comparison of national practice patterns by surgeon specialty.

Introduction And Hypothesis: There are limited data comparing patient and operative characteristics for vaginal repair of vesicovaginal fistula (VVF) by surgeon specialty. Our objective was to compare national practice patterns by surgeon specialty for vaginal repair of VVF.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database, we conducted a retrospective cohort analysis of women who underwent vaginal repair of VVF from 2010 to 2019.

Randomized Clinical Trial of Gabapentin Versus Placebo for Pain After Sacrospinous Ligament Fixation.

Objectives: Given the risk of postoperative pain and specifically neuropathic gluteal pain after a sacrospinous ligament suspension, we conducted a randomized trial to compare a 2-week course of gabapentin versus placebo on postoperative pain after a sacrospinous ligament fixation.

Methods: This double-blinded, randomized, placebo-controlled trial compared 2 weeks of gabapentin (300 mg nightly for 3 days and then 300 mg twice a day for 11 days) versus identical-appearing placebo after a sacrospinous ligament fixation procedure. The primary outcome was participant-reported average pain during normal activity in the past 24 hours (score 0-10 on the validated Surgical Pain Scale) assessed on postoperative day (POD) 7.

The utility of university fitness facilities: Environmental vs. psychological determinants of their use.

Objective: It is important for college students to engage regularly in physical activity. While psychological factors, such as motivation, are likely to increase attendance at fitness facilities, positive perceptions of the fitness facility (e.g.

Chemokine receptor antagonists enhance morphine's antinociceptive effect but not respiratory depression.

Aims: We have shown that chemokines injected into the periaqueductal gray region of the brain blocks opioid-induced analgesia in the rat cold-water tail flick test (CWTF). The present experiments tested whether chemokine receptor antagonists (CRAs), in combination with sub-analgesic doses of morphine, would provide maximal analgesia in the CWTF test and the mouse formalin pain assay. The effect of CRAs on respiratory depression was also evaluated.

Total and partial posterior quadrant disconnection for medically refractory epilepsy: A systematic review.

Purpose: Posterior quadrant disconnection (PQD) is a surgical procedure for medically refractory epilepsy (MRE) involving diffuse regions of the temporo-parieto-occipital lobes. We sought to compare factors and efficacy according to PQD extent.

Methods: We performed a systematic review of the literature reporting the use of PQD since 2004.

Association of Missense Variants With Genetic Epilepsy With Febrile Seizures Plus.

Objective: To identify the causative gene in a large unsolved family with genetic epilepsy with febrile seizures plus (GEFS+), we sequenced the genomes of family members, and then determined the contribution of the identified gene to the pathogenicity of epilepsies by examining sequencing data from 2,772 additional patients.

Methods: We performed whole genome sequencing of 3 members of a GEFS+ family. Subsequently, whole exome sequencing data from 1,165 patients with epilepsy from the Epi4K dataset and 1,329 Australian patients with epilepsy from the Epi25 dataset were interrogated.

Profiling the genetic determinants of chromatin accessibility with scalable single-cell CRISPR screens.

CRISPR screens have been used to connect genetic perturbations with changes in gene expression and phenotypes. Here we describe a CRISPR-based, single-cell combinatorial indexing assay for transposase-accessible chromatin (CRISPR-sciATAC) to link genetic perturbations to genome-wide chromatin accessibility in a large number of cells. In human myelogenous leukemia cells, we apply CRISPR-sciATAC to target 105 chromatin-related genes, generating chromatin accessibility data for ~30,000 single cells.

Sexual Function after Minimally Invasive Total Hysterectomy and Sacrocolpopexy.

Study Objective: To evaluate sexual function in women undergoing minimally invasive total hysterectomy and sacrocolpopexy (TLH + SCP) with a lightweight polypropylene Y-mesh 1 year after surgery.

Design: This was a planned secondary analysis of a 5-site randomized trial comparing permanent (2-0 Gore-Tex; W. L.

The Actively Caring for People Movement: A Synergistic Integration of Behaviorism, Humanism, and Positive Psychology.

This article reviews the Actively Caring for People (AC4P) Movement, initiated in 2007 to increase occurrences of interpersonal acts of kindness worldwide. Resources to support the AC4P Movement, including research-based training manuals and AC4P wristbands for adults and children, are available at www.ac4p.