Prostate-Specific Antigen Density to Select Magnetic Resonance Imaging-Targeted Versus Combined Biopsy for Prostate Cancer Diagnosis: A Secondary Analysis of the Trio Study.

Purpose: The addition of systematic prostate biopsy enhances the detection of clinically significant prostate cancer compared with MRI-targeted biopsy alone. However, there is growing interest in using only MRI-targeted biopsy. We sought to evaluate PSA density (PSAD) as an adjunctive predictor of clinically significant prostate cancer detection in men undergoing combined biopsy and as a potential metric to stratify which patients may reasonably avoid systematic biopsies in favor of MRI-targeted biopsy only.

Human AI collaboration for unsupervised categorization of live surgical feedback.

Formative verbal feedback during live surgery is essential for adjusting trainee behavior and accelerating skill acquisition. Despite its importance, understanding optimal feedback is challenging due to the difficulty of capturing and categorizing feedback at scale. We propose a Human-AI Collaborative Refinement Process that uses unsupervised machine learning (Topic Modeling) with human refinement to discover feedback categories from surgical transcripts.

Patient preferences for life expectancy cutoffs for aggressive treatment in clinically localized prostate cancer.

Background: Guidelines for prostate cancer treatment in men with limited life expectancy are based on expert opinion. Patient preferences for when to defer treatment based on longevity are unknown. We sought to define life expectancy thresholds at which men are more likely to choose conservative management in the context of varying risks of cancer death and treatment-related side effects.

Biomarkers of treatment response in bladder cancer.

Introduction: There have been many recent advancements in the treatment of bladder cancer including the approval of novel intravesical agents for non-muscle-invasive disease and systemic-targeted therapeutics for muscle-invasive and advanced disease. However, treatment strategies for bladder cancer are still largely based on clinicopathologic characteristics.

Areas Covered: Based on primary literature sourced from PubMed, Embase, and Cochrane Library, we review the current status of molecular markers and biomarker panels with respective to their value in predicting response to standard chemotherapeutics and novel agents in non-muscle-invasive, muscle-invasive, and advanced bladder cancer.

Overtreatment of Prostate Cancer Among Men With Limited Longevity in the Active Surveillance Era.

Importance: Men with limited life expectancy (LE) have historically been overtreated for prostate cancer despite clear guideline recommendations. With increasing use of active surveillance, it is unclear if overtreatment of men with limited LE has persisted and how overtreatment varies by tumor risk and treatment type.

Objective: To determine if rates of overtreatment of men with limited LE have persisted in the active surveillance era and whether overtreatment varies by tumor risk or treatment type.

Noninvasive Tests for Bladder Cancer Detection and Surveillance: A Systematic Review of Commercially Available Assays.

Background: An important reason for the high health care costs associated with bladder cancer is the need for frequent cystoscopy for detection and surveillance of this disease. Cytologic analysis of voided urine specimens can assist, but is too inaccurate to replace cystoscopy. In an effort to create reliable, objective, noninvasive mechanisms for detecting bladder cancer, a number of urine-based molecular tests have been developed with the ultimate goal of reducing the frequency of cystoscopy.

Implementation and Validation of a High-fidelity Simulation Model for Surgical Resident Training: Management of Acute Intraoperative Hemorrhage during Robot-assisted Surgery.

Objective: To improve our previous simulation-based training module by using sustainable material to mold an anatomically accurate terrain and reproducing major vascular injuries encountered during robot-assisted nephrectomy.

Methods: The simulator was built with a pump, gauge, and valve linked via silicone tubing. Artificial blood was made from cornstarch, water, and red dye, and pumped through 3D-Med artificial vessels with the dimensions of an average renal artery.

The New Urology Match: How Recent Innovations Including Virtual Interviews and Preference Signaling Have Changed Match Outcomes.

Objectives: To determine how recent changes in the urology match occurring from 2021 to 2023, including virtual interviews (VIs) and preference signals (PS), affected match outcomes.

Methods: The American Urological Association (AUA) match data from 2021 to 2023 was compared to the 15 years prior. This was obtained from the AUA website and a previous study of public AUA match data.

The value of residency program characteristics changes throughout urology training.

Introduction: The purpose of this study was to determine which characteristics of urology residency programs are most highly valued by medical students and residents, and how these change during training.

Materials And Methods: We distributed a survey to urology residents and medical students interested in urology via program director email and social media. The survey collected demographic data, future career plans, and asked respondents to rank the relative importance of six categories of residency program characteristics and specific characteristics within each category.

Female sexual health digital resources: women and health care providers need more options.

Introduction: Female sexual health and female sexual dysfunction (FSD) are usually poorly diagnosed and treated because of the numerous barriers providers and patients face. Internet platforms, such as mobile applications (apps) are potential tools that help overcome these barriers and improve patient access to education and management options for FSD.

Objectives: The aim of this review was to identify existing applications on female sexual health and evaluate their educational content and services.

Clinical and Preclinical Therapies for Bladder Cancer Following Bacillus Calmette-Guérin Failure.

Purpose: Intravesical bacillus Calmette-Guérin is the current first-line treatment for high-grade nonmuscle-invasive bladder cancer; however, a substantial proportion of patients are unresponsive to bacillus Calmette-Guérin treatment. While cystectomy is often recommended in bladder cancer following bacillus Calmette-Guérin failure, there are numerous established therapeutic agents and pre-commercialized trials describing treatments for nonmuscle-invasive bladder cancer following failed bacillus Calmette-Guérin treatment. Our objective in this systematic review is to characterize the efficacy of these therapeutic agents by reporting their corresponding complete response rates and toxicity profiles.

Definitive treatment choice among Black immigrants with prostate cancer: Analysis of patient surveys distributed at a single safety-net institution.

Background: Large-scale prostate cancer (PCa) database reviews have found a consistent discrepancy in the mortality rate in Black patients compared to their White counterparts. Furthermore, differences in PCa treatment and outcomes among Black men of different ethnic origins have also been identified. Due to the heterogeneity of PCa-impacted communities and the unclear impact of patient immigration status on treatment outcomes, we sought to determine the demographic factors associated with treatment choice for definitive treatment of PCa in our single institution's patient population of Black immigrants.

Focal prostate cancer therapy in the era of multiparametric MRI: a review of options and outcomes.

Background: The goal of prostate cancer focal therapy is to achieve oncologic control while reducing the rate of adverse events associated with whole-gland treatments. Numerous focal therapy modalities are currently available with early data demonstrating highly variable rates of cancer control and preservation of sexual/urinary function.

Methods: All English language clinical trial publications evaluating various focal therapies for localized prostate cancer were reviewed.

Perspectives of Residency Applicants and Program Directors on the Role of Social Media in the 2021 Urology Residency Match.

Objectives: To perform a survey assessing the use of, attitudes towards, and perceived utility of social media (SoMe) in the 2021 urology residency match.

Methods: We distributed surveys to urology residency applicants and program directors (PDs) via the Urology Match 2021 Google Spreadsheet and email. The survey collected demographic information as well as SoMe activity, perceived pressure to use SoMe, match results, and attitudes regarding the utility of SoMe in the match process.

Catching a Big Fish with a Small Net: Factors Associated with First-Choice Match from Urology Residency Applicants' Self-Reported Data.

Introduction: We sought to determine the accuracy of self-reported urology applicant match data and determine which factors were most influential on successful application outcomes.

Methods: A publicly accessible Google spreadsheet entitled "Urology Residency Applicant Spreadsheet" containing self-reported urology residency applicant characteristics and match outcomes was analyzed for differences across the years 2017+2018 (pre-aggregated)-2020. These data were compared to published data from the American Urological Association and the Association of American Medical Colleges.

Pathological downstaging as a novel endpoint for the development of neoadjuvant chemotherapy for upper tract urothelial carcinoma.

Objectives: To evaluate whether pathological downstaging (pDS) was more informative in predicting overall survival (OS) than pathological complete response (pCR) in patients treated with neoadjuvant chemotherapy (NAC) for upper tract urothelial carcinoma (UTUC).

Patients And Methods: The National Cancer Database was queried for patients with high-grade cN0M0 disease who had received NAC. pDS was defined as a decrease of at least one stage from cT to pT stage along with pN0, including pCR.

Homologous recombination is an intrinsic defense against antiviral RNA interference.

RNA interference (RNAi) is the major antiviral defense mechanism of plants and invertebrates, rendering the capacity to evade it a defining factor in shaping the viral landscape. Here we sought to determine whether different virus replication strategies provided any inherent capacity to evade RNAi in the absence of an antagonist. Through the exploitation of host microRNAs, we recreated an RNAi-like environment in vertebrates and directly compared the capacity of positive- and negative-stranded RNA viruses to cope with this selective pressure.

Hippocampal-dependent neurocognitive impairment following cranial irradiation observed in pre-clinical models: current knowledge and possible future directions.

We reviewed the literature for studies pertaining to impaired adult neurogenesis leading to neurocognitive impairment following cranial irradiation in rodent models. This compendium was compared with respect to radiation dose, converted to equivalent dose in 2 Gy fractions (EQD2) to allow for direct comparison between studies. The effects of differences between animal species and the dependence on animal age as well as for time after irradiation were also considered.

A mouse model replicating hippocampal sparing cranial irradiation in humans: A tool for identifying new strategies to limit neurocognitive decline.

Cancer patients undergoing cranial irradiation are at risk of developing neurocognitive impairments. Recent evidence suggests that radiation-induced injury to the hippocampi could play an important role in this cognitive decline. As a tool for studying the mechanisms of hippocampal-dependent cognitive decline, we developed a mouse model replicating the results of the recent clinical RTOG 0933 study of hippocampal sparing whole-brain irradiation.

A 300 GHz collective scattering diagnostic for low temperature plasmas.

A compact and portable 300 GHz collective scattering diagnostic employing a homodyne detection scheme has been constructed and installed on the hot helicon experiment (HELIX). Verification of the homodyne detection scheme was accomplished with a rotating grooved aluminum wheel to Doppler shift the interaction beam. The HELIX chamber geometry and collection optics allow measurement of scattering angles ranging from 60 degrees to 90 degrees.