Automated Upper Tract Urothelial Carcinoma Tumor Segmentation During Ureteroscopy Using Computer Vision Techniques.

Endoscopic tumor ablation of upper tract urothelial carcinoma (UTUC) allows for tumor control with the benefit of renal preservation but is impacted by intraoperative visibility. We sought to develop a computer vision model for real-time, automated segmentation of UTUC tumors to augment visualization during treatment. We collected 20 videos of endoscopic treatment of UTUC from two institutions.

Immobilization of Cyanines in DNA Produces Systematic Increases in Fluorescence Intensity.

Cyanines are useful fluorophores for a myriad of biological labeling applications, but their interactions with biomolecules are unpredictable. Cyanine fluorescence intensity can be highly variable due to complex photoisomerization kinetics, which are exceedingly sensitive to the surrounding environment. This introduces large errors in Förster resonance energy transfer (FRET)-based experiments where fluorescence intensity is the output parameter.

Conversion between triplet pair states is controlled by molecular coupling in pentadithiophene thin films.

In singlet fission (SF) the initially formed correlated triplet pair state, (TT), may evolve toward independent triplet excitons or higher spin states of the (TT) species. The latter result is often considered undesirable from a light harvesting perspective but may be attractive for quantum information sciences (QIS) applications, as the final exciton pair can be spin-entangled and magnetically active with relatively long room temperature decoherence times. In this study we use ultrafast transient absorption (TA) and time-resolved electron paramagnetic resonance (TR-EPR) spectroscopy to monitor SF and triplet pair evolution in a series of alkyl silyl-functionalized pentadithiophene (PDT) thin films designed with systematically varying pairwise and long-range molecular interactions between PDT chromophores.

Large reduction in opioid prescribing by a multipronged behavioral intervention after major urologic surgery.

Background: Surgeons play a pivotal role in combating the opioid crisis that currently grips the United States. Changing surgeon behavior is difficult, and the degree to which behavioral science can steer surgeons toward decreased opioid prescribing is unclear.

Methods: This was a single-institution, single-arm, pre- and postintervention study examining the prescribing of opioids by urologists for adult patients undergoing prostatectomy or nephrectomy.

Poststimulation Block of Pudendal Nerve Conduction by High-Frequency (kHz) Biphasic Stimulation in Cats.

Objective: To determine the relationship between various parameters of high-frequency biphasic stimulation (HFBS) and the recovery period of post-HFBS block of the pudendal nerve in cats.

Materials And Methods: A tripolar cuff electrode was implanted on the pudendal nerve to deliver HFBS in ten cats. Two hook electrodes were placed central or distal to the cuff electrode to stimulate the pudendal nerve and induce contractions of external urethral sphincter (EUS).

Pudendal Nerve Block by Low-Frequency (≤1 kHz) Biphasic Electrical Stimulation.

Objectives: To test the hypothesis that poststimulation block of nerve conduction can be achieved by low-frequency (≤1 kHz) biphasic stimulation (LFBS).

Materials And Methods: A tripolar cuff electrode was placed around the pudendal nerve in cats to deliver LFBS (1 kHz, 500 Hz, and 100 Hz). Two bipolar hook electrodes were placed central and distal to the cuff electrode to induce external urethral sphincter (EUS) contractions.

Sacral Neuromodulation: Determining Predictors of Success.

Objective: To determine predictors of success for sacral neuromodulation in women with overactive bladder, urinary retention, and fecal incontinence.

Methods: A retrospective chart review was performed on women who underwent a staged sacral neuromodulation implantation between 2007 and 2018. Clinical and procedural characteristics were recorded.

Thermal block of mammalian unmyelinated C fibers by local cooling to 15-25°C after a brief heating at 45°C.

The purpose of this study was to examine the changes in cold block of unmyelinated C fibers in the tibial nerve by preconditioning with heating and to develop a safe method for thermal block of C-fiber conduction. In seven cats under α-chloralose anesthesia, C-fiber-evoked potentials elicited by electrical stimulation were recorded on the tibial nerve during block of axonal conduction induced by exposing a small segment (9 mm) of the nerve to cooling (from 35°C to ≤5°C) or heating (45°C). Before heating, partial, reproducible, and reversible cold block was first detected at a threshold cold block temperature of 15°C and complete cold block occurred at a temperature of ≤5°C.

Response of hypogastric afferent fibers to bladder distention or irritation in cats.

The goal of this study in anesthetized cats was to identify silent hypogastric nerve (HGN) afferent fibers that do not respond to bladder distention but become responsive after chemical irritation of the bladder. The HGN was split into multiple filaments small enough for recording action potentials from single or multiple afferent fibers. The bladder was distended by infusion of either saline or 0.

Strong Conflict of Interest Policies are not Associated With Decreased Industry Payments to Academic Urology Departments.

Objective: To identify whether institutions with strong conflicts of interest (COI) policies receive less industry payments than those with weaker policies. While industry-physician interactions can have collaborative benefits, financial COI can undermine preservation of the integrity of professional judgment and public trust. To address this concern, academic institutions have adopted COI policies.

Additive Inhibition of Reflex Bladder Activity Induced by Bilateral Pudendal Neuromodulation in Cats.

Objective: To determine the inhibitory effect on bladder activity induced by bilateral pudendal neuromodulation.

Methods: In 10 cats under anesthesia, two tripolar cuff electrodes were implanted bilaterally on the pudendal nerves for stimulation. A double lumen catheter was inserted into the bladder through the urethra to infuse saline and measure bladder pressure.

Gender Gap in Industry Relationships and Scholarly Impact Among Academic Urologists in the United States.

Objectives: To examine the distribution of industry payments to male and female academic urologists and the relationship between industry funding, academic rank, and scholarly impact.

Material And Methods: Academic urologists from 131 programs with publicly available websites were compiled. Gender, rank, fellowship training, and scholarly impact metrics were recorded.

Slow charge transfer from pentacene triplet states at the Marcus optimum.

Singlet fission promises to surpass the Shockley-Queisser limit for single-junction solar cell efficiency through the production of two electron-hole pairs per incident photon. However, this promise has not been fulfilled because singlet fission produces two low-energy triplet excitons that have been unexpectedly difficult to dissociate into free charges. To understand this phenomenon, we study charge separation from triplet excitons in polycrystalline pentacene using an electrochemical series of 12 different guest electron-acceptor molecules with varied reduction potentials.

Carotenoid Nuclear Reorganization and Interplay of Bright and Dark Excited States.

We report quantum chemical calculations using multireference perturbation theory (MRPT) with the density matrix renormalization group (DMRG) plus photothermal deflection spectroscopy measurements to investigate the manifold of carotenoid excited states and establish their energies relative to the bright state (S) as a function of nuclear reorganization. We conclude that the primary photophysics and function of carotenoids are determined by interplay of only the bright (S) and lowest-energy dark (S) states. The lowest-lying dark state, far from being energetically distinguishable from the lowest-lying bright state along the entire excited-state nuclear reorganization pathway, is instead computed to be either the second or first excited state depending on what equilibrium geometry is considered.

Low pressure voiding induced by a novel implantable pudendal nerve stimulator.

Aim: To validate the functionality of an implantable pudendal nerve stimulator under development for Food and Drug Administration approval to restore bladder function after spinal cord injury.

Methods: In nine cats under anesthesia, two tripolar cuff electrodes were implanted bilaterally on the pudendal nerves and one bipolar cuff electrode was implanted on the right pudendal nerve central to the tripolar cuff electrode. The pudendal nerve stimulator was implanted subcutaneously on the left lower back along the lumbosacral spine and connected to the cuff electrodes.

Sympathetic afferents in the hypogastric nerve facilitate nociceptive bladder activity in cats.

This study in α-chloralose-anesthetized cats revealed a role of hypogastric nerve afferent axons in nociceptive bladder activity induced by bladder irritation using 0.25% acetic acid (AA). In cats with intact hypogastric and pelvic nerves, AA irritation significantly ( P < 0.

Dynamics of singlet fission and electron injection in self-assembled acene monolayers on titanium dioxide.

We employ a combination of linear spectroscopy, electrochemistry, and transient absorption spectroscopy to characterize the interplay between electron transfer and singlet fission dynamics in polyacene-based dyes attached to nanostructured TiO. For triisopropyl silylethynyl (TIPS)-pentacene, we find that the singlet fission time constant increases to 6.5 ps on a nanostructured TiO surface relative to a thin film time constant of 150 fs, and that triplets do not dissociate after they are formed.

Controlling Long-Lived Triplet Generation from Intramolecular Singlet Fission in the Solid State.

The conjugated polymer poly(benzothiophene dioxide) (PBTDO1) has recently been shown to exhibit efficient intramolecular singlet fission in solution. We investigate the role of intermolecular interactions in triplet separation dynamics after singlet fission. We use transient absorption spectroscopy to determine the singlet fission rate and triplet yield in two polymers differing only by side-chain motif in both solution and the solid state.

Utility of recorded guided imagery and relaxing music in reducing patient pain and anxiety, and surgeon anxiety, during cutaneous surgical procedures: A single-blinded randomized controlled trial.

Background: Guided imagery and music can reportedly reduce pain and anxiety during surgery, but no comparative study has been performed for cutaneous surgery to our knowledge.

Objectives: We sought to determine whether short-contact recorded guided imagery or relaxing music could reduce patient pain and anxiety, and surgeon anxiety, during cutaneous surgical procedures.

Methods: Subjects were adults undergoing excisional surgery for basal and squamous cell carcinoma.

Measuring stigma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Stigma item bank and short form.

Objective: To develop a calibrated item bank and computer adaptive test (CAT) to assess the effects of stigma on health-related quality of life in individuals with spinal cord injury (SCI).

Design: Grounded-theory based qualitative item development methods, large-scale item calibration field testing, confirmatory factor analysis, and item response theory (IRT)-based psychometric analyses.

Setting: Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States.

Measuring psychological trauma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Psychological Trauma item bank and short form.

Objective: To describe the development and psychometric properties of the SCI-QOL Psychological Trauma item bank and short form.

Design: Using a mixed-methods design, we developed and tested a Psychological Trauma item bank with patient and provider focus groups, cognitive interviews, and item response theory based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision.

Setting: We tested a 31-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J.

Multicenter prospective cohort study of the incidence of adverse events associated with cosmetic dermatologic procedures: lasers, energy devices, and injectable neurotoxins and fillers.

Importance: Common noninvasive to minimally invasive cosmetic dermatologic procedures are widely believed to be safe given the low incidence of reported adverse events, but reliable incidence data regarding adverse event rates are unavailable to date.

Objective: To assess the incidence of adverse events associated with noninvasive to minimally invasive cosmetic dermatologic procedures, including those involving laser and energy devices, as well as injectable neurotoxins and fillers.

Design, Setting, And Participants: A multicenter prospective cohort study (March 28, 2011, to December 30, 2011) of procedures performed using laser and energy devices, as well as injectable neurotoxins and soft-tissue augmentation materials, among 8 geographically dispersed US private and institutional dermatology outpatient clinical practices focused on cosmetic dermatology, with a total of 23 dermatologists.

Efficacy of a needling device for the treatment of acne scars: a randomized clinical trial.

Importance: Neocollagenesis can be achieved using a dermal rolling needle device, thereby reducing the appearance of acne scars.

Objective: To determine the efficacy of a needling device for treatment of acne scars.

Design, Setting, And Participants: We performed a single-center, rater-blinded, balanced (1:1), split-face, placebo-controlled, parallel-group randomized clinical trial at an urban academic institution.

Pain in naïve and non-naïve subjects undergoing nonablative skin tightening dermatologic procedures: a nested randomized control trial.

Background: Pain is expected during noninvasive skin tightening and can be anxiety provoking, especially for those who have not had prior treatments.

Objective: To compare pain reported by patients naïve to nonablative skin tightening energy devices with those who were not naive.

Methods And Materials: The non-naïve group at least three nonablative laser procedures or one nonablative skin tightening procedure, and the naïve group no previous treatments.

Adverse events associated with mohs micrographic surgery: multicenter prospective cohort study of 20,821 cases at 23 centers.

Importance: Detailed information regarding perioperative risk and adverse events associated with Mohs micrographic surgery (MMS) can guide clinical management. Much of the data regarding complications of MMS are anecdotal or report findings from single centers or single events.

Objectives: To quantify adverse events associated with MMS and detect differences relevant to safety.