Robotic-Assisted Surgery-a Highly Effective Modality for Vesicovaginal Fistula Repairs.

PURPOSE OF REVIEW: To summarize recent experience with robotic vesicovaginal fistula repair and describe the contemporary technique. RECENT FINDINGS: Robotic vesicovaginal repair has been tested at multiple centers, with similar outcomes to open surgery. It has benefits including decreased hospital stay, less blood loss, and similar long-term outcomes. As long as the surgeon is experienced in robotic surgery, this technique appears to be promising. Robotic vesicovaginal repair results in similar outcomes to open surgery with decreased morbidity.

The Role of Virtual Environment for Radiotherapy Training (VERT) in Medical Dosimetry Education.

Medical dosimetry is an important component in training of radiation therapist, yet it is not easy for student to understand the principle of treatment planning and to be familiar with the relationship of the clinical target volume (CTV), planned target volume (PTV), and the nearby organs at risk (OARs) by just imagination. This study is conducted to evaluate whether using VERT in teaching medical dosimetry can help student to improve their learning experience. Students of cohort 2015 and 2016 were taught under TPS mode and TPS + VERT mode respectively. Direct comparison was conducted through self-evaluation survey, between two groups of students, in terms of their understanding of the concept of medical dosimetry and their level of confidence in completing different types of plans after the course. Both groups of students were able to understand the concept of medical dosimetry and able to complete 3D conformal plans after taking the course. Though, the students received TPS mode reported that they had lower level of confidence in completing the planning and required longer time for self-study and practice compared to the students who received the TPS + VERT mode. This study demonstrated that including VERT into medical dosimetry education can improve students' learning experience, by improving their self-confidence, as well as reducing time required for their self-study and practice.

Dorsolateral fibromuscular tissue preservation during artificial urinary sphincter cuff placement is associated with low infection and erosion rates.

OBJECTIVES: To present a modified technique in artificial urinary sphincter (AUS) placement that is associated with low rates of erosion and infection in a high-risk population. PATIENTS AND METHODS: After Institutional Review Board approval, we identified patients who underwent primary AUS placement using the modified technique between January 2007 and November 2015. Our modification consists of preserving the dorsolateral fibromuscular tissue surrounding the bulbar urethra and horizontally transecting the ventral bulbospongiosus muscle during urethral cuff placement. Preoperative variables such as radiotherapy (RT) and bladder neck contractures were recorded. Effectiveness and complications including infections, erosions, and re-operations were recorded at follow-up. RESULTS: The new technique was used on 208 patients: 40% had a history of RT, including 15% who had had a salvage radical prostatectomy; 26% had had previous bladder neck contractures. No patients developed infection. Overall, erosion occurred in six (2.9%) patients and spontaneous erosions occurred in two (0.9%) during the study period. In all, 21 patients underwent re-operation for device failure. The probability of re-operation for 'any' reason was 7% (95% confidence interval [CI] 4-12%) at 1 year. The 1-year social continence rate was 74% (95% CI 67-81%). CONCLUSION: Preservation of dorsolateral fibromuscular tissue during AUS placement is an effective means to achieve a low risk of erosions. Our modified technique is safe with low infection and erosion rates, whilst maintaining good functional outcomes despite a high-risk population.

Change in moderate alcohol consumption and quality of life: evidence from 2 population-based cohorts.

BACKGROUND: Although the association of moderate alcohol consumption with specific disorders, such as cardiovascular disease and cancers, has been well documented, the evidence of the broader impact of alcohol consumption on health-related quality of life is less clear. Our objective was to examine the association of drinking patterns with changes in physical and mental well-being across populations. METHODS: We conducted a multilevel analysis with multivariate responses in the population-representative FAMILY Cohort in the Hong Kong Special Administrative Region, China, to examine the association between alcohol drinking patterns across 2 waves (2009-2013) (i.e., quitters, initiators, persistent drinkers, persistent former drinkers and lifetime abstainers) and changes in physical and mental well-being (Physical and Mental Component Summary of the 12-Item Short Form Health Survey [SF-12]). Analyses were stratified by sex. We validated findings using a nationally representative cohort in the United States, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, 2001-2005). RESULTS: In the FAMILY Cohort (n = 10 386; median follow-up 2.3 yr), the change in mental well-being was more favourable in female quitters than in lifetime abstainers (ß = 1.44, 95% confidence interval [CI] 0.43 to 2.45; mean score change of +2.0 for quitters and +0.02 for lifetime abstainers). This association was validated in the NESARC (n = 31 079; median follow-up 3.1 yr) (ß = 0.83, 95% CI 0.08 to 1.58; mean score change of -1.1 for quitters and -1.6 for lifetime abstainers). INTERPRETATION: The change in mental well-being was more favourable in female quitters, approaching the level of mental well-being of lifetime abstainers within 4 years of quitting in both Chinese and American populations.

Voiding Dysfunction After Non-urologic Pelvic Surgery.

PURPOSE OF REVIEW: Urinary dysfunction is a common entity in patients undergoing radical pelvic surgery for non-urologic malignancies. These dysfunctions may manifest as lower urinary tract symptoms (LUTS) or signs such as urinary retention or leakage. Review of current literature is performed to describe the differing urinary dysfunctions that manifest after colorectal resection, hysterectomy, and sacrectomy. RECENT FINDINGS: Conventional radical surgery for pelvic malignancies often will result in debilitating functional problems. As advances in surgical techniques and management options become more available, patients can have better functional outcomes, specifically in the lower urinary tract. Nerve-sparing techniques as well as vascular preservation are becoming more important to preserve function as patient survival is improving. Additionally, newer methods are being explored, such as nerve stimulation for those who are unable to empty adequately. This article also addresses different management options for specific voiding dysfunction that may result from pelvic surgery. Preventative strategies such as nerve preservation during surgery are an important concept to prevent urinary dysfunction. The goal to good functional outcomes includes maintaining reservoir compliance and capacity as well as allowing proper outlet for voiding. We discuss different modalities to help achieve a functional lower urinary tract for patients with lower urinary tract dysfunction after pelvic surgery.

Assessing the validity of single-item life satisfaction measures: results from three large samples.

PURPOSE: The present paper assessed the validity of single-item life satisfaction measures by comparing single-item measures to the Satisfaction with Life Scale (SWLS)-a more psychometrically established measure. METHODS: Two large samples from Washington (N = 13,064) and Oregon (N = 2,277) recruited by the Behavioral Risk Factor Surveillance System and a representative German sample (N = 1,312) recruited by the Germany Socio-Economic Panel were included in the present analyses. Single-item life satisfaction measures and the SWLS were correlated with theoretically relevant variables, such as demographics, subjective health, domain satisfaction, and affect. The correlations between the two life satisfaction measures and these variables were examined to assess the construct validity of single-item life satisfaction measures. RESULTS: Consistent across three samples, single-item life satisfaction measures demonstrated substantial degree of criterion validity with the SWLS (zero-order r = 0.62-0.64; disattenuated r = 0.78-0.80). Patterns of statistical significance for correlations with theoretically relevant variables were the same across single-item measures and the SWLS. Single-item measures did not produce systematically different correlations compared to the SWLS (average difference = 0.001-0.005). The average absolute difference in the magnitudes of the correlations produced by single-item measures and the SWLS was very small (average absolute difference = 0.015-0.042). CONCLUSIONS: Single-item life satisfaction measures performed very similarly compared to the multiple-item SWLS. Social scientists would get virtually identical answer to substantive questions regardless of which measure they use.

Atypical growth on MRI in a case of Ewing's sarcoma despite lower SUV on PET.

Ewing's sarcoma is a rare primary bone malignancy of small round blue cells. Treatment typically consists of neoadjuvant chemotherapy, surgical resection, and adjuvant chemotherapy. The disease response to chemotherapy can be followed with fluorodeoxyglucose (FDG) positron emission tomography (PET), which measures the metabolic activity of the tumor, and by magnetic resonance imaging (MRI), which measures tumor size. We present a unique case in which the tumor grew in size following neoadjuvant chemotherapy but decreased in metabolic activity, making it difficult to judge efficacy of the chemotherapy. An atypical response to chemotherapy in this case caused tumor growth due to a fibrotic reaction while viable tumor cells were eradicated. This case highlights the ability of FDG-PET scan to identify the uncommon situation in which a tumor that increased in size may have had a favorable response to chemotherapy. This possibility should be considered in similar cases in which FDG-PET scan shows diminishing metabolic activity despite tumor growth.

Twitter (X) use predicts substantial changes in well-being, polarization, sense of belonging, and outrage.

In public debate, Twitter (now X) is often said to cause detrimental effects on users and society. Here we address this research question by querying 252 participants from a representative sample of U.S. Twitter users 5 times per day over 7 days (6,218 observations). Results revealed that Twitter use is related to decreases in well-being, and increases in political polarization, outrage, and sense of belonging over the course of the following 30 minutes. Effect sizes were comparable to the effect of social interactions on well-being. These effects remained consistent even when accounting for demographic and personality traits. Different inferred uses of Twitter were linked to different outcomes: passive usage was associated with lower well-being, social usage with a higher sense of belonging, and information-seeking usage with increased outrage and most effects were driven by within-person changes.

Trans Oblique Ileal Conduit Technique Has a Low Risk of Parastomal Hernias.

OBJECTIVE: To outline our surgical technique and outcomes of a ipsilateral "transoblique" ileal conduit performed during pelvic exenteration with a Vertical Rectus Abdominis Myocutaneous flap. We report hernia rates in a transrectus group as reference. METHODS: We identified patients from January 2007 to August 2020. The transoblique conduit is placed on the ipsilateral side as the VRAM, through the internal, external oblique, and transverse abdominis muscles. Stomal hernias were assessed radiologically. Transrectus patients were those undergoing radical cystectomy matched based on surgery date, age, and sex in a 3:1 ratio. We employed a Kaplan-Meier plot to visualize the duration between surgery and hernia. We calculated the hernia rate 2 years after surgery. Additionally, we present the 30-day postoperative complication rate. RESULTS: Fifty underwent transoblique conduits and we matched them to 190 transrectus patients. Sixty-seven percent were men with a median age of 62. Exactly 10/50 patients in the transoblique and 44/190 in the transrectus group developed a hernia, with a median follow-up of 2.2 years (IQR 0.8, 4.0). The 2-year KM-estimated parastomal hernia rate was 14% (95% CI 1.6%, 25%) for the transoblique conduits, 21% (95% CI 15%, 28%) for the transrectus and 24% (95% CI 6.5%, 39%) for colostomies. Among the transoblique patients, 22 (44%) experienced at least 1 postoperative complication. CONCLUSION: A transoblique ileal conduit is safe in patients undergoing a right VRAM flap during a pelvic exenteration with a low parastomal hernia and complication rates.

Global trends in cross-cultural endorsement of social mobility: Evidence from 167 countries.

The American Dream-the perception that upward social mobility depends on effort-is a central cultural ethos in the United States. The belief in upward social mobility is not unique to Americans, and cultural groups across the world endorse it to varying degrees. The current study aims to examine cross-cultural trends in perceived mobility and to test possible mechanisms that may explain changes in perceived mobility. Using a dataset of over 1.4 million participants across 167 countries from 2005 to 2019, we comprehensively document cultural variations in perceived mobility. Citizens in Bhutan, Qatar, and Uzbekistan reported the highest levels of perceived mobility, and the United States ranked 107. We further examined the trajectories of perceived mobility across a 15-year timespan and found rapid declines in perceived mobility in countries experiencing sociopolitical crises (e.g., in Syria and Hong Kong). Multilevel analyses revealed high-income individuals are 32% (95% confidence interval, CI [24%, 39%]) more likely to perceive mobility than low-income individuals, and the level of disparity did not decrease over time. Preregistered time-series analyses showed education privatization and economic condition Granger-cause perceived mobility, but these temporal associations showed heterogeneity across countries. Overall, we performed the world's largest global monitor of perceived mobility and discussed how the cultural value of perceived mobility unfolds in social, economic, and political contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Why Has Personality Psychology Played an Outsized Role in the Credibility Revolution?

Personality is not the most popular subfield of psychology. But, in one way or another, personality psychologists have played an outsized role in the ongoing "credibility revolution" in psychology. Not only have individual personality psychologists taken on visible roles in the movement, but our field's practices and norms have now become models for other fields to emulate (or, for those who share Baumeister's (2016, https://doi.org/10.1016/j.jesp.2016.02.003) skeptical view of the consequences of increasing rigor, a model for what to avoid). In this article we discuss some unique features of our field that may have placed us in an ideal position to be leaders in this movement. We do so from a subjective perspective, describing our impressions and opinions about possible explanations for personality psychology's disproportionate role in the credibility revolution. We also discuss some ways in which personality psychology remains less-than-optimal, and how we can address these flaws.

The impact of the Syrian conflict on population well-being.

The United Nations described the Syrian conflict as the worst man-made disaster since World War II. We adopted a global perspective in examining the impact of the Syrian conflict on Syrians' physical, mental, and social well-being using the Gallup World Poll. Face-to-face interview data of 11,452 Syrian participants from 2008 to 2015 show that Syrians' physical (e.g., access to shelter), mental (e.g., life satisfaction), and social (e.g., social support) well-being decline substantially. Syrians who reported being exposed to the conflict are similarly affected compared to those without direct exposure, suggesting country-wide spillover effects. Global data covering 1.7 million participants across 163 countries from 2006 to 2016 show during the conflict, Syria's precipitous decline in well-being is unparalleled in the world, even when compared to countries similarly experiencing war, protests, and disasters. Our findings reinforce the vital importance of an accelerated peace process to restore well-being in Syria.

Determinants of physical, mental and social well-being: a longitudinal environment-wide association study.

BACKGROUND: Although the World Health Organization (WHO) has defined health as a state of physical, mental and social well-being, public health strategies have primarily focused on one domain of well-being. We sought to systematically and simultaneously identify and validate associations of behavioural patterns, psychosocial factors, mental and physical health conditions, access to and utilization of health care and anthropometrics with physical, mental and social well-being. METHODS: We conducted a longitudinal environment-wide association study (EWAS) with a training and testing set approach, accounting for multiple testing using a false discovery rate control. We used multivariate multilevel regression to examine the association of each exposure at wave 1 with the three outcomes at wave 2 in the Hong Kong FAMILY Cohort (n = 10 484). RESULTS: Out of 194 exposures, we identified and validated 14, 5 and 5 exposures that were individually associated with physical, mental and social well-being, respectively. We discovered three factors, namely depressive symptoms, life satisfaction and happiness, that were simultaneously associated with the three domains that define health. CONCLUSIONS: These associations, if verified to be causal, could become intervention targets to holistically improve population health. Our findings provide empirical support for placing mental health at the forefront of the public health agenda, and also support recent calls to use life satisfaction and happiness to guide public policy.

Crowdsourcing hypothesis tests: Making transparent how design choices shape research results.

To what extent are research results influenced by subjective decisions that scientists make as they design studies? Fifteen research teams independently designed studies to answer five original research questions related to moral judgments, negotiations, and implicit cognition. Participants from 2 separate large samples (total N > 15,000) were then randomly assigned to complete 1 version of each study. Effect sizes varied dramatically across different sets of materials designed to test the same hypothesis: Materials from different teams rendered statistically significant effects in opposite directions for 4 of 5 hypotheses, with the narrowest range in estimates being d = -0.37 to + 0.26. Meta-analysis and a Bayesian perspective on the results revealed overall support for 2 hypotheses and a lack of support for 3 hypotheses. Overall, practically none of the variability in effect sizes was attributable to the skill of the research team in designing materials, whereas considerable variability was attributable to the hypothesis being tested. In a forecasting survey, predictions of other scientists were significantly correlated with study results, both across and within hypotheses. Crowdsourced testing of research hypotheses helps reveal the true consistency of empirical support for a scientific claim. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The association between PM2.5 exposure and neurological disorders: A systematic review and meta-analysis.

BACKGROUND: Recent systematic review and meta-analyses have tried to identify an association between PM2.5 exposure and stroke, but few could find a conclusive and comprehensive evidence. Moreover, the associations between PM2.5, neurodegenerative diseases and neurodevelopmental disorders have never been reviewed. We aimed to assess the effects of PM2.5 exposure on stroke, dementia, Alzheimer's disease, autism spectrum disorder (ASD), Parkinson's disease, and mild cognitive impairment (MCI). METHODS: We searched PubMed and CNKI databases for articles published until June 2018. Studies were eligible for analysis if they were human studies and provided risk estimates with 95% CI. We screened 1645 articles and identified 80 eligible studies covering 26 countries across all continents except Antarctica. Risks of incidence and mortality were extracted and stratified by types of neurological disorders, PM2.5 concentration and duration of PM2.5 exposure. RESULTS: We found significant association between PM2.5 exposure and stroke, dementia, Alzheimer's disease, ASD, Parkinson's disease. The risks of ischemic and hemorrhagic stroke were higher than that of stroke in general, and that hemorrhagic stroke had by far the highest mortality. The risk of stroke for heavily polluted countries was significantly higher than that of lightly polluted countries. Short- and long-term PM2.5 exposure was associated with increased risks of stroke (short-term odds ratio 1.01 [per 10 µg/m3 increase in PM2.5 concentrations], 95% CI 1.01-1.02; long-term 1.14, 95% CI 1.08-1.21) and mortality (short-term 1.02, 95% CI 1.01-1.04; long-term 1.15, 95% CI 1.07-1.24) of stroke. Long-term PM2.5 exposure was associated with increased risks of dementia (1.16, 95% CI 1.07-1.26), Alzheimer's disease (3.26, 95% 0.84-12.74), ASD (1.68, 95% CI 1.20-2.34), and Parkinson's disease (1.34, 95% CI 1.04-1.73). CONCLUSIONS: There is a strong association between PM2.5 exposure and neurological disorders. National governments should exert greater efforts to improve air quality given its health implications.