Publications by authors named "Joseph A Smith"

259 Publications

The Next Chapter in a Good Story.

Authors:
Joseph A Smith

J Urol 2021 Dec 18;206(6):1356-1358. Epub 2021 Oct 18.

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http://dx.doi.org/10.1097/JU.0000000000002300DOI Listing
December 2021

Antiviral Efficacy of Metal and Metal Oxide Nanoparticles against the Porcine Reproductive and Respiratory Syndrome Virus.

Nanomaterials (Basel) 2021 Aug 20;11(8). Epub 2021 Aug 20.

School of Physics, Engineering and Computer Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.

Porcine reproductive and respiratory syndrome viruses (PRRSV) are responsible for one of the most economically important diseases affecting the global pig industry. On-farm high-efficiency particulate air (HEPA) filtration systems can effectively reduce airborne transmission of PRRSV and the incidence of PRRS, but they are costly, and their adoption is limited. Therefore, there is a need for low-cost alternatives, such as antimicrobial filters impregnated with antiviral nanoparticles (AVNP). During the past 10 years, tailored intermetallic/multi-elemental AVNP compositions have demonstrated effective performance against human viruses. In this study, a panel of five AVNP was evaluated for viricidal activity against PRRSV. Three AVNP materials: AVNP2, copper nanoparticles (CuNP), and copper oxide nanoparticles (CuONP), were shown to exert a significant reduction (>99.99%) in virus titers at 1.0% (/) concentration. Among the three, CuNP was the most effective at lower concentrations. Further experiments revealed that AVNP generated significant reductions in viral titers within just 1.5 min. For an optimal reduction in viral titers, direct contact between viruses and AVNP was required. This was further explained by the inert nature of these AVNP, where only negligible leaching concentrations of Ag/Cu ions (0.06-4.06 ppm) were detected in AVNP supernatants. Real-time dynamic light scatting (DLS) and transmission electron microscopic (TEM) analyses suggested that the mono-dispersive hydrodynamic behavior of AVNPs may have enhanced their antiviral activity against PRRSV. Collectively, these data support the further evaluation of these AVNP as candidate nanoparticles for incorporation into antimicrobial air-filtration systems to reduce transmission of PRRSV and other airborne pathogens.
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http://dx.doi.org/10.3390/nano11082120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398903PMC
August 2021

Prospective Multicenter Comparison of Open and Robotic Radical Prostatectomy: The PROST-QA/RP2 Consortium.

J Urol 2021 Aug 26:101097JU0000000000002176. Epub 2021 Aug 26.

Department of Urology, Emory University School of Medicine, Atlanta, Georgia.

Purpose: To evaluate the comparative effectiveness of robot-assisted laparoscopic prostatectomy (RALP) and open radical prostatectomy (ORP) in a multicenter study.

Materials And Methods: We evaluated men with localized prostate cancer at 11 high-volume academic medical centers in the United States from the PROST-QA (2003-2006) and the PROST-QA/RP2 cohorts (2010-2013) with a pre-specified goal of comparing RALP (549) and ORP (545). We measured longitudinal patient-reported health-related quality of life (HRQOL) at pre-treatment and at 2, 6, 12, and 24 months, and pathological and perioperative outcomes/complications.

Results: Demographics, cancer characteristics, and margin status were similar between surgical approaches. ORP subjects were more likely to undergo lymphadenectomy (89% vs 47%; p <0.01) and nerve sparing (94% vs 89%; p <0.01). RALP vs ORP subjects experienced less mean intraoperative blood loss (192 vs 805 mL; p <0.01), shorter mean hospital stay (1.6 vs 2.1 days; p <0.01), and fewer blood transfusions (1% vs 4%; p <0.01), wound infections (2% vs 4%; p=0.02), other infections (1% vs 4%; p <0.01), deep vein thromboses (0.5% vs 2%; p=0.04), and bladder neck contractures requiring dilation (1.6% vs 8.3%; p <0.01). RALP subjects reported less pain (p=0.04), less activity interference (p <0.01) and higher incision satisfaction (p <0.01). Surgical approach (RALP vs ORP) was not a significant predictor of longitudinal HRQOL change in any HRQOL domain.

Conclusions: In high-volume academic centers, RALP and ORP patients may expect similar long-term HRQOL outcomes. Overall, RALP patients have less pain, shorter hospital stays, and fewer post-surgical complications such as blood transfusions, infections, deep venous thromboses, and bladder neck contractures.
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http://dx.doi.org/10.1097/JU.0000000000002176DOI Listing
August 2021

People Like Rankings.

Authors:
Joseph A Smith

J Urol 2021 Nov 25;206(5):1093-1094. Epub 2021 Aug 25.

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http://dx.doi.org/10.1097/JU.0000000000002192DOI Listing
November 2021

Determination of the Worthiness for Publication.

Authors:
Joseph A Smith

J Urol 2021 10 12;206(4):802-803. Epub 2021 Aug 12.

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http://dx.doi.org/10.1097/JU.0000000000002181DOI Listing
October 2021

Differential effect of body mass index by gender on oncological outcomes in patients with renal cell carcinoma.

J Cancer Res Ther 2021 Apr-Jun;17(2):420-425

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.

Objectives: To investigate the relationship between gender, body mass index (BMI), and prognosis in renal cell carcinoma (RCC) patients.

Materials And Methods: We retrospectively reviewed 1353 patients with RCC who underwent a partial or radical nephrectomy between 1988 and 2015. The association among sex, BMI, stage, grade, overall survival (OS), and recurrence-free survival (RFS) was analyzed.

Results: The median age of the patients was 59.4 ± 11.9 years. Female patients had proportionally lower grade tumors than male patients (Grade I-II in 75.5% vs. 69.3% in women and men, respectively, P = 0.022). There was no relationship between Fuhrman grade and BMI when substratified by gender (p > 0.05). There was a nonsignificant trend toward more localized disease in female patients (p = 0.058). There was no relationship between T stage and BMI when stratified by gender (p > 0.05). Patients with higher BMI had significantly better OS (p = 0.0004 and P = 0.0003) and RFS (P = 0.0209 and P =0.0082) whether broken out by lower 33 or 25 percentile. Male patients with higher BMI had significantly better OS and RFS rates. However, there was no relationship between BMI and OS or RFS for female patients (P > 0.05). Multivariate analysis of the entire cohort demonstrated that a BMI in the lower quartile independently predicts OS (hazard ratio 1.604 [95% confidence interval: 1.07-2.408], P = 0.022) but not RFS (P > 0.05). When stratified by gender, there was no relationship between BMI and either OS or RFS (P > 0.05).

Conclusions: Increasing BMI was associated with RCC prognosis. However, the clinical association between BMI and oncologic outcomes may be different between men and women.
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http://dx.doi.org/10.4103/jcrt.JCRT_546_18DOI Listing
June 2021

A Year of Change, with More to Come.

Authors:
Joseph A Smith

J Urol 2021 08 27;206(2):197-198. Epub 2021 May 27.

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http://dx.doi.org/10.1097/JU.0000000000001900DOI Listing
August 2021

A modified Delphi study to develop a practical guide for selecting patients with prostate cancer for active surveillance.

BMC Urol 2021 Feb 4;21(1):18. Epub 2021 Feb 4.

Department of Surgery, University of Melbourne, Melbourne, Australia.

Background: Active surveillance (AS) is a management option for men diagnosed with lower risk prostate cancer. There is wide variation in all aspects of AS internationally, from patient selection to investigations and follow-up intervals, and a lack of clear evidence on the optimal approach to AS. This study aimed to provide guidance for clinicians from an international panel of prostate cancer experts.

Methods: A modified Delphi approach was undertaken, utilising two rounds of online questionnaires followed by a face-to-face workshop. Participants indicated their level of agreement with statements relating to patient selection for AS via online questionnaires on a 7-point Likert scale. Factors not achieving agreement were iteratively developed between the two rounds of questionnaires. Draft statements were presented at the face-to-face workshop for discussion and consensus building.

Results: 12 prostate cancer experts (9 urologists, 2 academics, 1 radiation oncologist) participated in this study from a range of geographical regions (4 USA, 4 Europe, 4 Australia). Complete agreement on statements presented to the participants was 29.4% after Round One and 69.0% after Round Two. Following robust discussions at the face-to-face workshop, agreement was reached on the remaining statements. PSA, PSA density, Multiparametric MRI, and systematic biopsy (with or without targeted biopsy) were identified as minimum diagnostic tests required upon which to select patients to recommend AS as a treatment option for prostate cancer. Patient factors and clinical parameters that identified patients appropriate to potentially receive AS were agreed. Genetic and genomic testing was not recommended for use in clinical decision-making regarding AS.

Conclusions: The lack of consistency in the practice of AS for men with lower risk prostate cancer between and within countries was reflected in this modified Delphi study. There are, however, areas of common practice and agreement from which clinicians practicing in the current environment can use to inform their clinical practice to achieve the best outcomes for patients.
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http://dx.doi.org/10.1186/s12894-021-00789-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863517PMC
February 2021

The prevention of extraction site incisional hernia after robotic-assisted radical prostatectomy.

J Robot Surg 2021 Apr 2;15(2):315-317. Epub 2021 Feb 2.

Department of Urologic Surgery, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, USA.

Extraction site incisional hernia (IH) has been recognized as an important complication in minimally invasive procedures but has not been as well characterized following robotic-assisted laparoscopic prostatectomy (RALP). Approximately 29% of IH required surgical repair. A number of techniques have been utilized to reduce the rates of IH following minimally invasive procedures. First, off-midline extraction was investigated, this did not demonstrate a reduction in incisional hernia rates. Recently, supra-umbilical transverse incisions have been utilized to extract prostate specimen and this method decreased the extraction site IH rate compared to the vertical midline incision. In addition, the choice of fascial closure technique and choice of the suture may influence the incidence of extraction site IH. For example, studies showed that abdominal fascial closure using a nonabsorbable suture and a continuous running suture technique decreased IH rate from 32 to 17%. Finally, "the small bites technique" has been recommended to reduce hernia incidence after midline fascial closure following a randomized controlled trial (RCT) which demonstrated the superiority of the small-bite technique. In summary, a supra-umbilical transverse incision to extract the specimen was shown to decrease the rate of extraction site IH. In vertical midline incisional closure, the small bites technique with slowly- or non-absorbable suture, such as #0 or 2-0 PDS II with SH or CT-2 needle (26 mm arch length), reduces the IH rate. Urologists should consider this data to reduce the risk of IH following RALP.
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http://dx.doi.org/10.1007/s11701-021-01204-9DOI Listing
April 2021

A green wave of saltmarsh productivity predicts the timing of the annual cycle in a long-distance migratory shorebird.

Sci Rep 2020 11 26;10(1):20658. Epub 2020 Nov 26.

Georgetown University, Washington, DC, 20057, USA.

Understanding how migratory animals respond to spatial and temporal variation in habitat phenology is critical for identifying selection pressures and tradeoffs at different life history stages. We examined the influence of breeding habitat phenology on life history timing of the eastern willet (Tringa semipalmata semipalmata) across a latitudinal gradient of breeding sites on the east coast of North America. To describe migration and life history timing, we deployed light-level geolocators on willets at breeding sites in New Jersey, Massachusetts and Maine, USA and evaluated additional data on life history timing and migratory connectivity from previous studies, eBird and band recoveries. Willets from Nova Scotia to Georgia winter exclusively on the Atlantic coast of northern South America and share common stopover sites. The timing of wintering site departure, breeding site arrival, nesting and southbound departure was later for birds breeding at higher latitudes while the duration of all life phases was similar across sites. Regardless of latitude, nesting corresponded with a consistent stage of seasonal salt marsh biomass accumulation and with peak spring temperature acceleration (GDD jerk). Temperature acceleration and salt marsh biomass were closely correlated with each other across the 11° latitudinal gradient we examined and with the timing of nest initiation across the northern 6° of this gradient. For this northern 6° of latitude, these results suggest that the timing of migration and breeding events in the annual cycle of eastern willets is constrained by a phenological "green wave" of spring salt marsh productivity at breeding sites.
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http://dx.doi.org/10.1038/s41598-020-77784-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693269PMC
November 2020

Author Friendly Publication in The Journal.

Authors:
Joseph A Smith

J Urol 2020 Oct 12;204(4):645-646. Epub 2020 Aug 12.

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http://dx.doi.org/10.1097/JU.0000000000001326DOI Listing
October 2020

Intersection of Scientific Publication and Society.

Authors:
Joseph A Smith

J Urol 2020 08 9;204(2):206-207. Epub 2020 Jun 9.

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http://dx.doi.org/10.1097/JU.0000000000001189DOI Listing
August 2020

2019 Peer Reviewer Awards.

Authors:
Joseph A Smith

J Urol 2020 Jul 7;204(1):20-21. Epub 2020 Apr 7.

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http://dx.doi.org/10.1097/JU.0000000000001062DOI Listing
July 2020

8q24 genetic variation and comprehensive haplotypes altering familial risk of prostate cancer.

Nat Commun 2020 03 23;11(1):1523. Epub 2020 Mar 23.

Department of Medicine, Division of Genetic Medicine, Vanderbilt-Ingram Cancer Center, and Vanderbilt Genetics Institute, Vanderbilt University Medical Center, 507 Light Hall, 2215 Garland Avenue, Nashville, TN, 37232, USA.

The 8q24 genomic locus is tied to the origin of numerous cancers. We investigate its contribution to hereditary prostate cancer (HPC) in independent study populations of the Nashville Familial Prostate Cancer Study and International Consortium for Prostate Cancer Genetics (combined: 2,836 HPC cases, 2,206 controls of European ancestry). Here we report 433 variants concordantly associated with HPC in both study populations, accounting for 9% of heritability and modifying age of diagnosis as well as aggressiveness; 183 reach genome-wide significance. The variants comprehensively distinguish independent risk-altering haplotypes overlapping the 648 kb locus (three protective, and four risk (peak odds ratios: 1.5, 4, 5, and 22)). Sequence of the near-Mendelian haplotype reveals eleven causal mutation candidates. We introduce a linkage disequilibrium-based algorithm discerning eight independent sentinel variants, carrying considerable risk prediction ability (AUC = 0.625) for a single locus. These findings elucidate 8q24 locus structure and correlates for clinical prediction of prostate cancer risk.
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http://dx.doi.org/10.1038/s41467-020-15122-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089954PMC
March 2020

Predictors of Recurrence, and Progression-Free and Overall Survival following Open versus Robotic Radical Cystectomy: Analysis from the RAZOR Trial with a 3-Year Followup.

J Urol 2020 03 24;203(3):522-529. Epub 2019 Sep 24.

Division of Urologic Oncology, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.

Purpose: The RAZOR (Randomized Open versus Robotic Cystectomy) trial revealed noninferior 2-year progression-free survival for robotic radical cystectomy. This update was performed with extended followup for 3 years to determine potential differences between the approaches. We also report 3-year overall survival and sought to identify factors predicting recurrence, and progression-free and overall survival.

Materials And Methods: We analyzed the per protocol population of 302 patients from the RAZOR study. Cumulative recurrence was estimated using nonbladder cancer death as the competing risk event and the Gray test was applied to assess significance in differences. Progression-free survival and overall survival were estimated by the Kaplan-Meier method and compared with the log rank test. Predictors of outcomes were determined by Cox proportional hazard analysis.

Results: Estimated progression-free survival at 36 months was 68.4% (95% CI 60.1-75.3) and 65.4% (95% CI 56.8-72.7) in the robotic and open groups, respectively (p=0.600). At 36 months overall survival was 73.9% (95% CI 65.5-80.5) and 68.5% (95% CI 59.8-75.7) in the robotic and open groups, respectively (p=0.334). There was no significant difference in the cumulative incidence rates of recurrence (p=0.802). Patient age greater than 70 years, poor performance status and major complications were significant predictors of 36-month progression-free survival. Stage and positive margins were significant predictors of recurrence, and progression-free and overall survival. Surgical approach was not a significant predictor of any outcome.

Conclusions: This analysis showed no difference in recurrence, 3-year progression-free survival or 3-year overall survival for robotic vs open radical cystectomy. It provides important prospective data on the oncologic efficacy of robotic radical cystectomy and high level data for patient counseling.
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http://dx.doi.org/10.1097/JU.0000000000000565DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487279PMC
March 2020

Peer Review 2018.

Authors:
Joseph A Smith

J Urol 2019 06;201(6):1067-1069

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http://dx.doi.org/10.1097/JU.0000000000000232DOI Listing
June 2019

There are Lies, Damned Lies and Statistics.

Authors:
Joseph A Smith

J Urol 2019 03;201(3):457-458

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http://dx.doi.org/10.1097/JU.0000000000000058DOI Listing
March 2019

Perioperative Oral Nutrition Supplementation Reduces Prevalence of Sarcopenia following Radical Cystectomy: Results of a Prospective Randomized Controlled Trial.

J Urol 2019 03;201(3):470-477

Tennessee Valley Health Care System, Nashville, Tennessee.

Purpose: We designed a prospective randomized, controlled pilot trial to investigate the effects of an enriched oral nutrition supplement on body composition and clinical outcomes following radical cystectomy.

Materials And Methods: A total of 61 patients were randomized to an oral nutrition supplement or a multivitamin multimineral supplement twice daily during an 8-week perioperative period. Body composition was determined by analyzing abdominal computerized tomography images at the L3 vertebra. Sarcopenia was defined as a skeletal muscle index of less than 55 cm/m in males and less than 39 cm/m in females. The primary outcome was the difference in 30-day hospital free days. Secondary outcomes included hospital length of stay, complications, readmissions and mortality.

Results: The oral nutrition supplement group lost less weight (-5 vs -6.5 kg, p = 0.04) compared to the multivitamin multimineral supplement group. The proportion of patients with sarcopenia did not change in the oral nutrition supplement group but increased 20% in the multivitamin multimineral supplement group (p = 0.01). Mean length of stay and 30-day hospital free days were similar in the groups. The oral nutrition supplement group had a lower rate of overall and major (Clavien grade 3 or greater) complications (48% vs 67% and 19% vs 25%, respectively) and a lower readmission rate (7% vs 17%) but the differences did not reach statistical significance.

Conclusions: Patients who undergo radical cystectomy after consuming an oral nutrition supplement perioperatively have a reduced prevalence of sarcopenia and may also experience fewer and less severe complications and readmissions. A larger blinded, randomized, controlled trial is necessary to determine whether oral nutrition supplement interventions can improve outcomes following radical cystectomy.
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http://dx.doi.org/10.1016/j.juro.2018.10.010DOI Listing
March 2019

Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR): an open-label, randomised, phase 3, non-inferiority trial.

Lancet 2018 06;391(10139):2525-2536

Department of Urology, Division of Urologic Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

Background: Radical cystectomy is the surgical standard for invasive bladder cancer. Robot-assisted cystectomy has been proposed to provide similar oncological outcomes with lower morbidity. We aimed to compare progression-free survival in patients with bladder cancer treated with open cystectomy and robot-assisted cystectomy.

Methods: The RAZOR study is a randomised, open-label, non-inferiority, phase 3 trial done in 15 medical centres in the USA. Eligible participants (aged ≥18 years) had biopsy-proven clinical stage T1-T4, N0-N1, M0 bladder cancer or refractory carcinoma in situ. Individuals who had previously had open abdominal or pelvic surgery, or who had any pre-existing health conditions that would preclude safe initiation or maintenance of pneumoperitoneum were excluded. Patients were centrally assigned (1:1) via a web-based system, with block randomisation by institution, stratified by type of urinary diversion, clinical T stage, and Eastern Cooperative Oncology Group performance status, to receive robot-assisted radical cystectomy or open radical cystectomy with extracorporeal urinary diversion. Treatment allocation was only masked from pathologists. The primary endpoint was 2-year progression-free survival, with non-inferiority established if the lower bound of the one-sided 97·5% CI for the treatment difference (robotic cystectomy minus open cystectomy) was greater than -15 percentage points. The primary analysis was done in the per-protocol population. Safety was assessed in the same population. This trial is registered with ClinicalTrials.gov, number NCT01157676.

Findings: Between July 1, 2011, and Nov 18, 2014, 350 participants were randomly assigned to treatment. The intended treatment was robotic cystectomy in 176 patients and open cystectomy in 174 patients. 17 (10%) of 176 patients in the robotic cystectomy group did not have surgery and nine (5%) patients had a different surgery to that they were assigned. 21 (12%) of 174 patients in the open cystectomy group did not have surgery and one (1%) patient had robotic cystectomy instead of open cystectomy. Thus, 302 patients (150 in the robotic cystectomy group and 152 in the open cystectomy group) were included in the per-protocol analysis set. 2-year progression-free survival was 72·3% (95% CI 64·3 to 78·8) in the robotic cystectomy group and 71·6% (95% CI 63·6 to 78·2) in the open cystectomy group (difference 0·7%, 95% CI -9·6% to 10·9%; p=0·001), indicating non-inferiority of robotic cystectomy. Adverse events occurred in 101 (67%) of 150 patients in the robotic cystectomy group and 105 (69%) of 152 patients in the open cystectomy group. The most common adverse events were urinary tract infection (53 [35%] in the robotic cystectomy group vs 39 [26%] in the open cystectomy group) and postoperative ileus (33 [22%] in the robotic cystectomy group vs 31 [20%] in the open cystectomy group).

Interpretation: In patients with bladder cancer, robotic cystectomy was non-inferior to open cystectomy for 2-year progression-free survival. Increased adoption of robotic surgery in clinical practice should lead to future randomised trials to assess the true value of this surgical approach in patients with other cancer types.

Funding: National Institutes of Health National Cancer Institute.
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http://dx.doi.org/10.1016/S0140-6736(18)30996-6DOI Listing
June 2018

JU Forum.

Authors:
Joseph A Smith

J Urol 2018 09 18;200(3):467. Epub 2018 Jun 18.

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http://dx.doi.org/10.1016/j.juro.2018.06.021DOI Listing
September 2018

Peer Review 2017.

Authors:
Joseph A Smith

J Urol 2018 06 21;199(6):1411-1414. Epub 2018 Mar 21.

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http://dx.doi.org/10.1016/j.juro.2018.03.030DOI Listing
June 2018

Is Comparison of Robotic to Open Radical Prostatectomy Still Relevant?

Eur Urol 2018 05 3;73(5):672-673. Epub 2018 Feb 3.

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.

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http://dx.doi.org/10.1016/j.eururo.2018.01.011DOI Listing
May 2018

The Null Effect of Bladder Neck Size on Incontinence Outcomes after Radical Prostatectomy.

J Urol 2017 12 24;198(6):1404-1408. Epub 2017 Jun 24.

Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Urology, Mayo Clinic Hospital (MDT), Phoenix, Arizona.

Purpose: We sought to determine whether bladder neck size is associated with incontinence scores after robot-assisted laparoscopic radical prostatectomy.

Materials And Methods: Consecutive eligible patients undergoing robot-assisted laparoscopic radical prostatectomy between July 19 and December 28, 2016 were enrolled in a prospective, longitudinal, observational cohort study. The primary outcome was patient reported urinary incontinence on the EPIC (Expanded Prostate Cancer Index Composite) scale 6 and 12 weeks postoperatively. The relationship between the EPIC score of urinary incontinence and bladder neck size was evaluated by multiple regression. Predicted EPIC scores for incontinence were displayed graphically after using restricted cubic splines to model bladder neck size.

Results: A total of 107 patients were enrolled. The response rate was 98% and 87% at 6 and 12 weeks, respectively. Bladder neck size was not significantly associated with incontinence scores at 6 and 12 weeks. Comparing the 90th percentile for bladder neck size (18 mm) with the 10th percentile (7 mm) revealed no significant difference in adjusted EPIC scores for incontinence at 6 weeks (β coefficient 0.88, 95% CI -10.92-12.68, p = 0.88) or at 12 weeks (β coefficient 5.80, 95% CI -7.36-18.97, p = 0.39).

Conclusions: These findings question the merit of creating an extremely small bladder neck during robot-assisted laparoscopic radical prostatectomy. We contend that doing so increases the risk of positive margins at the bladder neck without facilitating early recovery of continence.
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http://dx.doi.org/10.1016/j.juro.2017.06.084DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693618PMC
December 2017

The Importance of Peer Review.

Authors:
Joseph A Smith

J Urol 2017 06 22;197(6):1374-1376. Epub 2017 Mar 22.

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http://dx.doi.org/10.1016/j.juro.2017.03.115DOI Listing
June 2017

Foreword.

Authors:
Joseph A Smith

J Urol 2017 02 20;197(2S):S1. Epub 2016 Dec 20.

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http://dx.doi.org/10.1016/j.juro.2016.11.099DOI Listing
February 2017

Unexpected diversity in socially synchronized rhythms of shorebirds.

Nature 2016 12 23;540(7631):109-113. Epub 2016 Nov 23.

Conservation Ecology Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh 7, Groningen 9747 AG, The Netherlands.

The behavioural rhythms of organisms are thought to be under strong selection, influenced by the rhythmicity of the environment. Such behavioural rhythms are well studied in isolated individuals under laboratory conditions, but free-living individuals have to temporally synchronize their activities with those of others, including potential mates, competitors, prey and predators. Individuals can temporally segregate their daily activities (for example, prey avoiding predators, subordinates avoiding dominants) or synchronize their activities (for example, group foraging, communal defence, pairs reproducing or caring for offspring). The behavioural rhythms that emerge from such social synchronization and the underlying evolutionary and ecological drivers that shape them remain poorly understood. Here we investigate these rhythms in the context of biparental care, a particularly sensitive phase of social synchronization where pair members potentially compromise their individual rhythms. Using data from 729 nests of 91 populations of 32 biparentally incubating shorebird species, where parents synchronize to achieve continuous coverage of developing eggs, we report remarkable within- and between-species diversity in incubation rhythms. Between species, the median length of one parent's incubation bout varied from 1-19 h, whereas period length-the time in which a parent's probability to incubate cycles once between its highest and lowest value-varied from 6-43 h. The length of incubation bouts was unrelated to variables reflecting energetic demands, but species relying on crypsis (the ability to avoid detection by other animals) had longer incubation bouts than those that are readily visible or who actively protect their nest against predators. Rhythms entrainable to the 24-h light-dark cycle were less prevalent at high latitudes and absent in 18 species. Our results indicate that even under similar environmental conditions and despite 24-h environmental cues, social synchronization can generate far more diverse behavioural rhythms than expected from studies of individuals in captivity. The risk of predation, not the risk of starvation, may be a key factor underlying the diversity in these rhythms.
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http://dx.doi.org/10.1038/nature20563DOI Listing
December 2016

The Journal of Urology®: 100 Years of Progress, Accomplishments and Contributions.

Authors:
Joseph A Smith

J Urol 2017 02 12;197(2):276-277. Epub 2016 Nov 12.

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http://dx.doi.org/10.1016/j.juro.2016.11.080DOI Listing
February 2017

The Impact of Health Literacy on Surgical Outcomes Following Radical Cystectomy.

J Health Commun 2016 23;21(sup2):99-104. Epub 2016 Sep 23.

a Department of Urologic Surgery , Vanderbilt University Medical Center , Nashville , Tennessee , USA.

Health literacy is the ability to obtain, comprehend, and act on medical information and is an independent predictor of health outcomes in patients with chronic health conditions. However, little has been reported regarding the potential association of health literacy and surgical outcomes. We hypothesized that patient complications after radical cystectomy would be associated with health literacy. In a sample of 368 patients, we found that higher health literacy scores (as determined by the Brief Health Literacy Screen) were associated with decreased odds of developing minor complications (odds ratio = 0.90, 95% confidence interval [0.83, 0.97]). Health literacy should be considered when caring for patients undergoing radical cystectomy and should serve as a potential indicator of the need for additional resources to improve postoperative outcomes.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080660PMC
http://dx.doi.org/10.1080/10810730.2016.1193916DOI Listing
October 2017

Re: Samaratunga et al: Consensus Guidelines for Reporting Prostate Cancer Gleason Grade.

Urology 2016 10 18;96:179. Epub 2016 Jul 18.

Cleveland Clinic, Glickman Urologic and Kidney Institute, Cleveland, OH.

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http://dx.doi.org/10.1016/j.urology.2016.07.005DOI Listing
October 2016
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