En bloc resection of large bladder tumor: is it feasible and reasonable?

Purpose Of Review: Transurethral resection of bladder tumor (TURBT) remains the basis of bladder tumor diagnosis and an effective means of treating nonmuscle invasive bladder cancer (NMIBC). There are several limitations to this procedure: TURBT may cause free floating of malignant cells in the bladder and as a result re-implantation and early recurrence. Also, it does not allow the pathologist to define the correct spatial orientation of the specimen.

Association between procedure duration and adverse events in congenital cardiac catheterization.

Background: Procedure duration is an important predictor of patient outcomes in surgery. However, the relationship between procedure duration and adverse events in congenital cardiac catheterization is largely unexplored.

Methods: All cases entered into the Congenital Cardiac Catheterization Project on Outcomes from 2014 to 2017 were included.

Perspectives of physicians on risk factors for patient aggression and violence against physicians in Chinese hospitals: a Q-methodology study.

Background: The prevalence of patient (and their relatives/friends) aggression and violence against healthcare professionals in general, and physicians in particular, is a recognized problem worldwide. While numerous risk factors for such aggression and violence from patients (and their relatives/friends) have been identified, little is known about which risk factors are perceived as relatively most important in a specific context and among a particular group, and about the potentially differing views on the relative importance. This lack of insight prohibits preventive measures being tailored to address the main risk factors.

Lower Urinary Tract Symptoms in Relation to Leiomyoma Volume, Location, and Position in Reproductive-aged Women in the USA.

Introduction And Hypothesis: Uterine leiomyomata are widely believed to contribute to lower urinary tract symptoms in women, but it is unclear whether leiomyoma size, position, and location have important implications for these symptoms. We assessed whether greater leiomyoma volume, anterior position, and subserosal location were associated with urinary incontinence and frequent urination in a racially diverse, nationwide sample of premenopausal women in the USA.

Methods: A cross-sectional analysis of 477 premenopausal women from 12 USA sites undergoing evaluation for laparoscopic radiofrequency ablation or myomectomy for leiomyomata was carried out.

Evaluating Young Children With Fractures for Child Abuse: Clinical Report.

Fractures are common injuries in childhood and can be caused by unintentional injury, medical conditions, and child abuse. Although the consequences of failing to diagnose an abusive injury in a child can be grave, the consequences of incorrectly diagnosing child abuse in a child whose fractures have another etiology are also significant. This report aims to review recent advances in the understanding of fracture specificity, fracture mechanisms, and other medical conditions that predispose infants and children to fracture.

Too busy with the "rat race" to have kids? Longitudinal evidence on the impact of peer grit on the fertility of reproductive-age women in China.

China is currently facing a notable decline in fertility rates. This research introduces a novel perspective on the factors influencing fertility among women of reproductive age, representing the first attempt to examine the impact of peer grit on female fertility. Analyzing nationally representative panel data from China and leveraging plausibly exogenous variations in peer exposure across cohorts, we find that peer grit is associated with a reduction in fertility behavior and intentions.

Closing the Gap: The Need for Fertility Intervention for Young Adult Cancer Survivors.

The current study identified the fertility-related needs of young adult (YA; ages 19-39) survivors. Participants ( = 94) completed the Adolescent and Young Adult Survivorship Psycho-Oncology Screening Tool-a screening tool developed to assess cancer-related concerns of YAs in survivorship. Approximately one-third of survivors endorsed fertility-related concerns.

A silicon rhodamine 1,2-dioxetane chemiluminophore for near-infrared imaging.

Near-infrared (NIR) chemiluminescent probes have attracted increasing attention in recent years due to their attractive properties for imaging. Herein, we developed a NIR chemiluminophore silicon rhodamine (SiRCL-1) based on the intramolecular energy transfer process from excited state benzoate to a silicon rhodamine emitter under aqueous conditions. SiRCL-1 exhibited dual emission peaks at 540 nm and 680 nm with a high signal penetration through tissue at 680 nm (>30 mm) and long-lasting luminescence (>50 min), demonstrating its significance as a chemiluminescence scaffold for biological application.

Two-week Paramedic Hospital Training Augments Blood Pressure Response to Isometric Handgrip Exercise in Healthy Young Men.

Persistent stressful situations can have detrimental cardiovascular effects; however, effects on the blood pressure (BP) response to exercise have not been fully examined. This study investigated the impact of a 2-week stressful situation on the exercise pressor response. Eight healthy male university paramedic trainees underwent a 2-week paramedic hospital training and a control period study.

Age and Sex-Related Differences in Neuroprotective Effects of Cardiovascular Endurance on Cortical Thickness and Brain Volume in Adults Across Age.

Background: Higher cardiorespiratory fitness and cardiovascular endurance (CE) have been shown to be neuroprotective in older adulthood, but the mechanisms underlying this neuroprotection across the adult lifespan are poorly understood. The current study sought to examine the neuroprotective effects of CRF on gray matter (GM) and white matter (WM) volumes, and mean cortical thickness (MCT), using a large sample across the adult lifespan. We also examined sex differences in these relationships.

Mental Health-Related Disability Days and Costs Among Patients with Treatment-Resistant Depression Initiated on Esketamine Nasal Spray and Conventional Therapies in the USA.

Introduction: Treatment-resistant depression (TRD) is related to disproportionate unemployment and productivity burden in the USA. The current study describes real-world mental health (MH)-related disability days and costs of patients with TRD initiated on esketamine nasal spray or conventional therapies in the USA.

Methods: Adults with TRD were selected from Merative™ MarketScan Commercial database (from January 2016 to January 2023) and classified into four cohorts (esketamine, ECT [electroconvulsive therapy], TMS [transcranial magnetic stimulation], and SGA [second-generation antipsychotics] augmentation) based on therapy initiated (index date) on/after 5 March 2019 (esketamine approval date for TRD).

Proposed resources required for a comprehensive program for CCT CHD imaging.

Background: Cardiac Computed Tomography (CCT) is increasingly used for evaluation of congenital heart disease (CHD) in patients of all ages. Pediatric and adult congenital heart disease (ACHD) surgical programs require high quality CCT imaging as part of the multimodality imaging support expected of comprehensive care centers. Despite these expectations, there are no benchmarks or defined programmatic elements specific to the performance of CCT in patients with CHD.

Neratinib Efficacy in Patients With EGFR Exon 18-Mutant Non-Small-Cell Lung Cancer: Findings From the SUMMIT Basket Trial.

Background: Activating mutations in the epidermal growth factor receptor (EGFR) gene occur in 7% to 23% of patients with non-small-cell lung cancer (NSCLC). A small proportion of these (3-5%) are exon 18 mutations. Neratinib, an irreversible pan-HER tyrosine kinase inhibitor (TKI), had activity in the phase II SUMMIT basket study.

Carcinogenic air pollutants and breast cancer risk in the Arkansas rural community health study: A nested case-control study.

Background: Previous epidemiological studies on the associations between hazardous air pollutants (HAPs) and breast cancer (BC) have largely neglected rural, medically underserved areas in the United States, which differ in exposures and disparities compared to urban areas.

Objectives: We aimed to examine the associations between carcinogenic HAPs and BC risk in a rural population.

Methods: Using a nested case-control design, 574 cases and 2295 incidence density-sampled controls matched 1:4 on index age and race were included from the Arkansas Rural Community Health study.

Five new bisabolane-type sesquiterpenoids with oxygen-containing heterocyclic systems from Curcuma longa.

Five new bisabolane-type sesquiterpenoids (1-5) were isolated from the rhizomes of Curcuma longa, and all of them were oxygen-containing heterocyclic compounds. The structures of the compounds were elucidated using comprehensive spectroscopic techniques, and their absolute configurations were confirmed through electronic circular dichroism (ECD) calculations. All of the compounds were evaluated for their vasorelaxant and anti-inflammatory activities.

Systematic Review and Meta-Analysis: The Association Between Newer Generation Antidepressants and Insomnia in Children and Adolescents With Major Depressive Disorder.

Objective: To examine the association between newer generation antidepressants and insomnia as an adverse event (AE) in the treatment of children and adolescents with major depressive disorder (MDD).

Method: A systematic search was performed in major databases (inception to August 31, 2023) to retrieve double-blind, placebo-controlled, randomized controlled trials (RCTs) evaluating the safety of 19 antidepressants in the acute treatment (initial 6 to 12 weeks) of children and adolescents aged ≤ 18 years with MDD (primary analyses). RCTs in anxiety disorders and obsessive-compulsive disorder (OCD) were retrieved from a recent meta-analysis and included in complementary analyses.

Advancing precision psychiatry and targeted treatments: Insights from immunopsychiatry.

Despite tremendous advancements in neuroscience, there has been limited impact on patient care. Current psychiatric treatments are largely non-specific, and drug development is hindered by outdated, overinclusive diagnostic categories and a "one-size-fits-all" approach. Additionally, mechanisms underlying psychiatric illnesses and their treatments with conventional medications remain poorly understood.

The ACTION VAD registry: A collective five-year experience.

Background: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) began in 2018 as a collaborative learning health system committed to improving outcomes in pediatric heart failure, including children and adults with congenital heart disease, supported with ventricular assist devices (VADs). This report describes patient and device characteristics, and outcomes through 1-year post-implant.

Methods: The ACTION VAD registry report was created from data submitted to the ACTION learning network from April 2018 to June 2023.

Artificial Urinary Sphincter Placement Before or After Radiation Therapy: Does Timing of Radiation Impact Surgical Complications and Continence?

Objective: To evaluate the impact of radiation timing on artificial urinary sphincter (AUS) outcomes. AUS is the gold standard treatment for post-prostatectomy incontinence. Radiation history has been associated with worse outcomes, including higher rates of erosion and infection.

Mammalian nucleophagy: process and function.

The nucleus is a highly specialized organelle that houses the cell's genetic material and regulates key cellular activities, including growth, metabolism, protein synthesis, and cell division. Its structure and function are tightly regulated by multiple mechanisms to ensure cellular integrity and genomic stability. Increasing evidence suggests that nucleophagy, a selective form of autophagy that targets nuclear components, plays a critical role in preserving nuclear integrity by clearing dysfunctional nuclear materials such as nuclear proteins (lamins, SIRT1, and histones), DNA-protein crosslinks, micronuclei, and chromatin fragments.

Comparison of Postoperative Antibiotic Protocols for Pediatric Complicated Appendicitis: A Western Pediatric Surgery Research Consortium Study.

Background: There is no consensus on the appropriate duration of postoperative antibiotics for complicated appendicitis in children. Commonly used antibiotic endpoints include normalization of white blood cell count (WBC) or completion of a minimum number of prespecified treatment days. We compared clinical outcomes resulting from varying postoperative antibiotic protocols for complicated appendicitis in children.

Evolving Paradigms in the Treatment of Oligometastatic Pancreatic Ductal Adenocarcinoma.

Multiple randomized trials have suggested that the addition of comprehensive metastasis-directed therapy to best systemic therapy improves disease control and survival among patients with oligometastatic disease, even for histologies with a high propensity for rapid spread. Here, we review the growing literature supporting the oligometastatic paradigm in pancreatic ductal adenocarcinoma. We summarize key details from nascent institutional series and reflect on the recently reported phase II randomized EXTEND trial.

The Human Urinary Microbiome and Its Potential Role in Urinary Tract Infections.

After identifying a urinary microbiota, new insights have emerged into how urinary tract infections (UTIs) develop and recur in women. This review explores factors influencing the urinary microbiome, and its role in UTI susceptibility and recurrence. Age, menopausal status, estrogen, and prior UTIs can impact the urinary microbiome significantly, with estrogen promoting predominance of beneficial Lactobacillus species in women.