Basic Studies Research Articles

Investigating heart rate variability measures during pregnancy as predictors of postpartum depression and anxiety: an exploratory study

Perinatal affective disorders are common, but standard screening measures reliant on subjective self-reports might not be sufficient to identify pregnant women at-risk for developing postpartum depression and anxiety. Lower heart rate variability (HRV) has been shown to be associated with affective disorders. The current exploratory study aimed to evaluate the predictive utility of late pregnancy HRV measurements of postpartum affective symptoms. A subset of participants from the BASIC study (Uppsala, Sweden) took part in a sub-study at pregnancy week 38 where HRV was measured before and after a mild stressor (n = 122). Outcome measures were 6-week postpartum depression and anxiety symptoms as quantified by the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Anxiety Inventory (BAI). In total, 112 women were included in a depression outcome analysis and 106 women were included in an anxiety outcome analysis. Group comparisons indicated that lower pregnancy HRV was associated with depressive or anxious symptomatology at 6 weeks postpartum. Elastic net logistic regression analyses indicated that HRV indices alone were not predictive of postpartum depression or anxiety outcomes, but HRV indices were selected as predictors in a combined model with background and pregnancy variables. ROC curves for the combined models gave an area under the curve (AUC) of 0.93 for the depression outcome and an AUC of 0.83 for the anxiety outcome. HRV indices predictive of postpartum depression generally differed from those predictive of postpartum anxiety. HRV indices did not significantly improve prediction models comprised of psychological measures only in women with pregnancy depression or anxiety.

Understanding the Interplay Between Skin, Fascia, and Muscles of the Midface in Facial Aging.

Surgical, minimally-invasive, and non-invasive aesthetic procedures try to ameliorate the signs of facial aging, but also focus on enhancing various individual features of beauty in each patient. Herein, the midface plays a central role due to its location but also its importance for the aesthetic perception and facial expression. To date, no study has investigated the interplay between facial muscles and its connecting subdermal architecture during facial aging to provide a more comprehensive understanding of the middle face. A total of 76 subjects, consisting of 30 males (39.5%) and 46 females (60.5%) with a mean age of 42.2 (18.7) years [range 19-80] and a mean BMI of 24.6 (3.7) kg/m2 [range 18-35], were enrolled in this investigation. Cutometry (skin aging), 3D skin displacement analyses (subdermal connective tissue aging), and sEMG (muscle aging) analyses were utilized. The results revealed that overall skin firmness increased, and skin elasticity decreased (p < 0.001), sEMG signal of the investigated muscles decreased (p < 0.001), whereas midfacial mobility remained unaltered (p = 0.722). The results of this study indicate that midfacial aging is a measurable effect when utilizing individual measurement modalities for assessing skin, subdermal fascia, and midfacial muscles. The function of midfacial muscles revealed a potential threshold effect, which is not reached during midfacial aging due to the unchanged soft tissue mobility at older age. However, to understand its clinical presentation all midfacial soft tissues need to be factored in and a holistic picture needs to be created. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes review articles, book reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to authors www.springer.com/00266 .

Botulinum Toxin-A Infiltration to Control Post-Operative Pain after Mastectomy and Expander Reconstruction as Potentially Useful Tool: A Narrative Review.

Botulinum toxin-A (BTX-A), a neurotoxin produced by Clostridium botulinum, was assessed for relieving implant-related pectoralis major muscle's painful spasms. In detail, 100 units of BTX-A can reduce muscle activity and, as a consequence, muscle spasms. The latter is considered the leading cause of post-operative pain after the sub-pectoral tissue expansion, sometimes leading to early expanders' removal. In addition, women choosing post-mastectomy reconstruction surgery seem to suffer worse post-operative pain than those who stop at the mastectomy stage. However, there is no unanimous consensus concerning the potential benefits of BTX-A in reducing pain related to the sub-pectoral placement of tissue expanders in breast reconstruction due to the exiguity of evidence. Therefore, this review aims to describe BTX-A-related evidence in this reconstruction setting. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

ALEKS in High School Mathematics Classrooms: Exploring Teachers’ Perceptions and Use of this Tool

AbstractThere has been a limited amount of research that has attempted to determine teaching strategies using adaptive learning systems. Most studies have attempted to measure success of the use of these technologies based on improvements in students’ test scores but have lacked to provide any information regarding the pedagogy implemented while using the tool or teachers’ perceptions of it. A basic qualitative study was conducted where five Chicagoland high school mathematics teachers, who used the Assessment and Learning in Knowledge Spaces (ALEKS) system, were interviewed three times during one academic school year. This study asked participants to share first-hand experiences and perceptions of using ALEKS as the main learning tool. Teachers used ALEKS for assessing student understanding through its quizzes and assignments, analyzing student progress, and allowing students to practice and receive feedback on mathematical concepts. The findings of this study indicate that teachers found ALEKS to be easy to use and useful in their teaching. Specifically, teachers cited the assessment tools, built-in feedback, ability to personalize learning, and the accessibility of learning tools for students as useful in their teaching.

Abstract PO5-25-07: A research impact assessment method to evaluate Susan G. Komen’s research funding impact on drugs approved for breast cancer treatment

Abstract Susan G. Komen (Komen) is the largest private funder of breast cancer research, having invested nearly $1.1 billion in cutting edge breast cancer research with a focus on conquering deadly metastatic and aggressive breast cancers, advancing precision medicine, and addressing disparities in breast cancer care and outcomes. There is a growing demand on Komen and other research funders from patients, donors, and other constituents to understand how investments in biomedical research translate into clinical impact that is meaningful to patients, the public, and others beyond academic publications and other bibliometrics. Komen uses a variety of approaches to evaluate the impact of our research investments, including a recently developed method to determine how Komen’s funding has impacted discovery and development of breast cancer drugs approved by the FDA from 2012-2022. Utilizing bibliometric analysis derived from the Dimensions for Funders platform, we systematically identified links between Komen-funded research, Komen-funded researchers, and FDA approved drugs. First, we identified fundamental clinical trials that led to initial and expanded FDA approval of each drug from prescribing information labels and press releases. Using API technology, we then performed a bibliometric linkage analysis and analyzed citation results from fundamental clinical trial studies, working backwards to capture fundamental pre-clinical and basic research studies that identified each drug’s target and its functions in the context of breast cancer biology. After collecting and curating publications in an unbiased manner, we evaluated each published study and contributing authors for Komen support. We identified specific “touchpoints” for fundamental studies including direct Komen funding for the published study and/or Komen support of key personnel. Early results revealed direct and indirect Komen research touchpoints across the research pipeline for several drugs, including direct touchpoints for basic, pre-clinical, and clinical trial studies that led to FDA approval of the PI3K inhibitor alpelisib, basic research and pre-clinical studies that led to FDA approval of CDK4/6 inhibitors, and basic research studies that led to FDA approval of PARP inhibitors olaparib and talazoparib. By adopting this approach, we can demonstrate the impact of Komen’s research investment across the full development timeline for each drug. This will allow us to measure and communicate how Komen’s investment in innovative research from discovery to clinical development is driving advances in breast cancer clinical care that improves outcomes. Citation Format: Dana Brantley-Sieders, Lauren Leslie, Amy Dworkin, Kimberly Sabelko, Kari Wojtanik. A research impact assessment method to evaluate Susan G. Komen’s research funding impact on drugs approved for breast cancer treatment [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-25-07.

Basic Experimental Study on a 1 kW-Class WPT System Using HTS and Copper Coils for EVs

Basic Experimental Study on a 1 kW-Class WPT System Using HTS and Copper Coils for EVs

Developing Primary School Students' Views on the Nature of Science by Storytelling

The study aimed to explore the development of third graders' nature of science views by using children's literature. The participants of the study was 18 third graders (12 F, 6 M) aged to 8-9 years old. The method of the study was a basic interpretive qualitative study and data were collected by means of open-ended questionnaires, reflective journals, and semi-structured interviews. The implementation of the study was taken for seven weeks and students enrolled in explicit -reflective nature of science activities coupled with childrens’ literature highlighting stories including nature of science. The results of the study showed that, primary students improved their NOS views mostly categırized as adequate or informed view.Our research findings revealed that, story telling could be a strong pedagogical tool in developing children’s nature of science views.

Establishment of two serological methods for detecting IgG and neutralizing antibodies against Crimean-Congo hemorrhagic fever virus glycoprotein.

The Crimean-Congo hemorrhagic fever virus (CCHFV), the most geographically widespread tick-borne virus, is endemic in Africa, Eastern Europe and Asia, with infection resulting in mortality in up to 30% of cases. Currently, there are no approved vaccines or effective therapies available for CCHF. The CCHFV should only be manipulated in the BSL-4 laboratory, which has severely hampered basic seroprevalence studies. In the present study, two antibody detection methods in the forms of an enzyme-linked immunosorbent assay (ELISA) and a surrogate virus neutralization test (sPVNT) were developed using a recombinant glycoprotein (rGP) and a vesicular stomatitis virus (VSV)-based virus bearing the CCHFV recombinant glycoprotein (rVSV/CCHFV) in a biosafety level 2 (BSL-2) laboratory, respectively. The rGP-based ELISA and rVSV/CCHFV-based sVNT were established by using the anti-CCHFV pre-GC mAb 11E7, known as a broadly cross-reactive, potently neutralizing antibody, and their applications as diagnostic antigens were validated for the specific detection of CCHFV IgG and neutralizing antibodies in experimental animals. In two tests, mAb clone 11E7 (diluted at 1:163840 or 512) still displayed positive binding and neutralization, and the presence of antibodies (IgG and neutralizing) against the rGP and rVSV/CCHFV was also determined in the sera from the experimental animals. Both mAb 11E7 and animal sera showed a high reactivity to both antigens, indicating that bacterially expressed rGP and rVSV/CCHFV have good immunoreactivity. Apart from establishing two serological testing methods, their results also demonstrated an imperfect correlation between IgG and neutralizing antibodies. Within this limited number of samples, the rGP and rVSV/CCHFV could be safe and convenient tools with significant potential for research on specific antibodies and serological samples.

A Study on the Development of the Educational Materials of the 〈General Korean Language〉 for International Undergraduate Students inan Intermediate Level of the Korean Language

This is a basic study to develop the educational materials for general Korean language learning for international undergraduate students in the intermediate level. It aims to survey the needs of learners and thereby establish some developmental directions. To achieve this, Iconducted a survey with 306 international students at A University. The results showed that many learners recognized the necessity of textbook development, and that although there was a high preference for e-books, ademand for paper books still existed. Regarding preferred media types, demands were observed not only for familiar media such as movies, dramas and social media, but also for other types of media like newspaper articles and the news in general. Regarding the topics demanded, they included daily life, hobbies, personalities, travel, and social and academic subjects. As for the desired functions to be enhanced, there were high demands for speaking, vocabulary, and grammar, and the balanced demands for listening, reading, and writing. Accordingly, this study proposed that educational materials should be composed in such a way that e-books and paper books coexist, and that the materials should be developed by maximizing the educational value of each. Furthermore, this study suggested that a comprehensive textbook that develops all language functions evenly would be more suitable than educational materials specialized in one function, given the characteristics of learners who need to not only expand their learning experiences with the use of various media, but to also cultivate their communication skills and academic task performance abilities.

Thyroid hormone changes in critical surgical illness: a narrative review

The systemic response to stress caused by a critical surgical illness is characterized by a series of events that precede metabolic and neuroendocrine dysregulation. However, the relevance of theclassically described 'stress response' is now highly questionable in an era where profound physiological deconditioning is common in critically ill, surgical and non-surgical patients. Common assessment techniques do not accurately reflect the integrity of the hypothalamic-pituitary-thyroid axis in the course of a critical chronic disease state. The clinical presentation ismostly masked by symptoms of the underlying critical illness when plasma thyroid hormone concentrations are altered. The frequent development of multimorbidity in critically ill patients is the reason for the need for a more detailed analysis of the neuroendocrine model of activation. Basic scientific studies suggest that low levels of circulating thyroid hormones in the acute phase are an adaptive process, but the chronic condition could directly cause organ damage. Here, we review factors that have emerged to challenge the conventional model of euthyroid sick syndrome (ESS) in the surgically critically ill as an adaptive process, and suggest that the stage of the critical illness is an important consideration in the critically ill. Examining the stressresponse in the critically ill presents opportunities to improve outcomes through improved understanding of the neuroendocrine aspects.    

Chondral lesion of the patella in a junior football player: chondral-only fragment fixation

Chondral lesions of the patella are a relatively common pathology that can cause pain and impairment in active young individuals. These lesions can have lifelong consequences, with increased risk of osteoarthritis in some cases. Surgical excision of medium to large fragments is associated with poor long-term outcomes. There is a general belief that fixation of purely chondral lesions in the absences of subchondral bone is associated with low integration rates, however recent case reports and basic science studies have been challenging this belief. In this case report, we describe a young patient with a chondral lesion of the patella and a fragment without subchondral bone, who underwent open fragment reduction and fixation using bioabsorbable pins. The patient had a successful outcome with significant fast improvement in pain and function and full return to practice. This case highlights the potential benefits of conservative surgical management with preservation of the native cartilage, even in the absence of subchondral bone, especially in the young active patient.  

HOW CAN SOCIAL MEDIA REVOLUTIONIZE INFORMAL ENGLISH LEARNING? UNVEILING LEARNING GOALS, ADVANTAGES, AND DISADVANTAGES

Previous studies have revealed that social media (SM) was implemented in EFL (hereafter, EFL) students’ online informal learning of English (OILE). However, the information about learning goals, pros, and cons of doing these activities remains unclear. Thus, this study aimed to explore (1) the learning goals of online informal learning of English via SM and (2) the students' perceptions of the advantages and disadvantages of using SM to facilitate OILE. This basic qualitative study recruited 14 EFL students at a university in Indonesia to join in semi-structured interviews. The interview results were analyzed using inductive thematic analysis. The findings revealed that EFL students engaged in OILE via SM for various goals (mostly for form-focused and meaning-focused goals), focusing on learning and practicing language skills. However, those learning goals primarily focused on form than meaning. In addition, the participants confessed that doing OILE brought advantages to cognitive and affective domains. Unfortunately, the participants also perceived that doing such OILE also brought some disadvantages. From the findings, we offered some implications to advance EFL learning through OILE via SM.

Heavy Metal Exposure and Cardiovascular Disease.

Heavy metals are harmful environmental pollutants that have attracted widespread attention due to their health hazards to human cardiovascular disease. Heavy metals, including lead, cadmium, mercury, arsenic, and chromium, are found in various sources such as air, water, soil, food, and industrial products. Recent research strongly suggests a connection between cardiovascular disease and exposure to toxic heavy metals. Epidemiological, basic, and clinical studies have revealed that heavy metals can promote the production of reactive oxygen species, which can then exacerbate reactive oxygen species generation and induce inflammation, resulting in endothelial dysfunction, lipid metabolism distribution, disruption of ion homeostasis, and epigenetic changes. Over time, heavy metal exposure eventually results in an increased risk of hypertension, arrhythmia, and atherosclerosis. Strengthening public health prevention and the application of chelation or antioxidants, such as vitamins and beta-carotene, along with minerals, such as selenium and zinc, can diminish the burden of cardiovascular disease attributable to metal exposure.

Current trends in retraction of plastic surgery and reconstruction research

Various studies regarding retractions of publications have determined the rate of retraction has increased in recent years. Although this trend may apply to any field, there is a paucity of literature exploring the publication of erroneous studies within plastic and reconstructive surgery. The present study aims to identify trends in frequency and reasons for retraction of plastic and reconstructive surgery studies, with analysis of subspecialty and journals. A database search was conducted for retracted papers within plastic and reconstructive surgery. The initial search yielded 2347 results, which were analyzed by two independent reviewers. 77 studies were jointly identified for data collection. The most common reasons for retractions were duplication (n=20, 25.9%), request of author (n=15, 19.5%), plagiarism (n=9, 11.6%), error (n=9, 11.6%), fraud (n=2, 2.6%), and conflict of interest (n=1, 1.3%). 15 were basic science studies (19.4%), 58 were clinical science studies (75.3%), and 4 were not categorized (5.2%). Subspecialties of retracted papers were maxillofacial (n=29, 37.7%), reconstructive (n=17, 22.0%), wound healing (n=8, 10.4%), burn (n=6, 7.8%), esthetics (n=5, 6.5%), breast (n=3, 3.9%), and trauma (n=1, 1.3%). Mean impact factor was 2.9 and average time from publication to retraction was 32 months. Analysis of retracted plastic surgery studies revealed a recent rise in frequency of retractions, spanning a wide spectrum of journals and subspecialties.

Histological Changes of Porcine Animal Skin with Micro-focused Ultrasound.

As a noninvasive alternative therapy, microfocused ultrasound (MFU) has become a research hotspot in recent years for its potential to enhance skin laxity. While several clinical studies have explored the effects of MFU on improving skin laxity, there is limited literature available on the histological changes resulting from MFU treatments. It has been established that the skin structure and composition of the Bama miniature pigs closely resembles that of humans, including collagen content, type I collagen distribution, and elastin distribution. This study primarily focuses on examining the histological alterations in the skin tissue of Bama miniature pigs following MFU application. We also selected some typical clinical photographs of patients treated with MFU and compared the clinical effects with histological changes observed in porcine skin. The MFU device utilized in this study incorporates ultra-pulse technology and large focal area technology. Following the standard operating procedures provided by the manufacturer, different handles were used in different skin area of pigs. Biopsies were obtained immediately after treatment and 1 month after treatment. Significant histological changes were observed in the Bama miniature pigs skin, including collagen contraction and fragmentation, dilation and congestion of superficial dermal capillaries immediately after MFU treatment; dermal thickening, increased thickness and density of collagen fibers, elevated levels of elastin and type I collagen, as well as thickened fiber septa in the adipose layer 1 month later. These histological results corresponded to clinical findings in human, such as facial redness and swelling immediately after treatment, and improvement in facial relaxation after approximately 1 month after treatment. Collectively, these histological findings provide valuable evidence supporting the clinical application of MFU for enhancing skin laxity. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Visual Analysis of Sanyinjiao(SP6) Studies Based on CiteSpace

Objective To conduct a visual analysis of literature around the Sanyinjiao (SP6), and to explore the research process, hot spots and future development trend of the Sanyinjiao (SP6) in the past 20 years. Methods CNKI was used as the data source, and the basic and clinical research literature collected from January 2000 to December 2022 were visually analyzed by using citespace software, and the relevant maps of keywords, authors and institutions were drawn. Results  In the basic study, 287 articles were included, and 9 keywords were clustered, with the highest acupuncture centrality (0.46), the author with the highest number of publications was Zhu Jiang (33 articles), and the institution with the largest number of publications was the School of Acupuncture and Tuina of Beijing University of Chinese Medicine (42 articles). The clinical study included 1794 articles, and 9 keyword clusters were obtained, Yinlingquan had the highest centrality (0.46), the authors with the most publications were Zhu Jiang, Wang Pei, Hu Shangqing, Ma Yuxia (7 articles), and the institution with the largest number of publications was Guangzhou University of Chinese Medicine (59 articles). Conclusion   The dynamics and trends of the number of literature changes in basic and clinical research are revealed, and the research content and research hotspots of Sanyinjiao(SP6) in basic and clinical applications are analyzed.

Growth of diamond in liquid metal at 1 atm pressure.

Natural diamonds were (and are) formed (thousands of million years ago) in the upper mantle of Earth in metallic melts at temperatures of 900-1,400 °C and at pressures of 5-6 GPa (refs. 1,2). Diamond is thermodynamically stable under high-pressure and high-temperature conditions as per the phase diagram of carbon3. Scientists at General Electric invented and used a high-pressure and high-temperature apparatus in 1955 to synthesize diamonds by using molten iron sulfide at about 7 GPa and 1,600 °C (refs. 4-6). There is an existing model that diamond can be grown using liquid metals only at both high pressure and high temperature7. Here we describe the growth of diamond crystals and polycrystalline diamond films with no seed particles using liquid metal but at 1 atm pressure and at 1,025 °C, breaking this pattern. Diamond grew in the subsurface of liquid metal composed of gallium, iron, nickel and silicon, by catalytic activation of methane and diffusion of carbon atoms into and within the subsurface regions. We found that the supersaturation of carbon in the liquid metal subsurface leads to the nucleation and growth of diamonds, with Si playing an important part in stabilizing tetravalently bonded carbon clusters that play a part in nucleation. Growth of (metastable) diamond in liquid metal at moderate temperature and 1 atm pressure opens many possibilities for further basic science studies and for the scaling of this type of growth.

The molecular characteristics of recurrent/metastatic HPV-positive head and neck squamous cell carcinoma: A systematic review of the literature.

About 17% of patients with human papillomavirus (HPV)-positive head and neck squamous cell carcinoma (HNSCC), which is mainly comprised of oropharyngeal SCC (OPSCC), will experience disease recurrence, which is often considered incurable when manifested at a metastatic and/or recurrent stage. We conducted a critical qualitative systematic review. Our objectives were to provide an overview of the molecular landscape of recurrent/metastatic HPV-positive HNSCC as well as novel molecular biomarkers. A literature review was conducted to identify studies reporting on the molecular characteristics of recurrent/metastatic HPV-positive HNSCC, novel molecular biomarkers and treatment options. The reviews of abstracts, full articles, and revision of the included studies, followed by data extraction and quality assessment were performed by three independent assessors. All primary literature, such as retrospective, prospective, and clinical trials as well as basic research studies were considered, and the final search was conducted at the end of February 2023. The level of evidence was rated using the guidelines published by the Oxford Centre for Evidence-based Medicine and quality was assessed using the Newcastle-Ottawa Scale criteria. The literature search resulted in the identification of 1991 articles. A total of 181 full articles were screened, and 66 articles were included in this analysis. Several studies reported that recurrent/metastatic HPV-positive HNSCC had higher rates of TP53 mutation and were genomically similar to HPV-negative HNSCC. The detection of circulating tumour tissue-modified HPV DNA (ctHPVDNA) as a specific biomarker has shown promising results for monitoring treatment response and recurrence in the subset of HPV-positive HNSCC. In addition, evidence for targeted therapy in recurrent/metastatic HPV-positive HNSCC has emerged, including agents that inhibit overexpressed EGFR. Studies of combination immunotherapy are also underway. Our review outlines the latest evidence on the distinct molecular profiles of recurrent/metastatic HPV-positive HNSCC as well as the clinical potential of ctHPVDNA testing in routine practice. More controlled and longitudinal studies are needed to identify additional molecular targets and to assess the performance and benefits of novel molecular biomarkers in clinical practice.

Further developments of pubourethral ligament surgery for stress urinary incontinence.

Midurethral slings (MUS) have revolutionized the treatment of stress urinary incontinence (SUI). MUS operations work by creating a collagenous pubourethral ligament (PUL). Since 1996, more than 10 million operations have been performed worldwide. Early complications with the MUS included bowel perforations, massive retropubic hemorrhages, nerve injuries, even death. Though the invention of the transobturator tape (TOT) operation, and later, minislings, has eliminated many such complications, the most frequent complication, post-operative urinary retention, remains. MUS operations are unavailable in many countries because of expense. Low-cost surgical options discussed include the tension-free artisan minisling which uses a 10 cm × 1 cm tape inserted as a "U" below the urethra; 91% cure was achieved at 5.7 years in a study of 90 women, though it was accompanied by a 4.2% erosion rate. The more recent urethral ligament plication (ULP) is based on transperineal ultrasound studies which showed that the main cause of the SUI was elongation of weak PULs. This allowed the posterior pelvic muscles to open out the posterior urethral wall to cause SUI. Basic science collagen studies indicated that suturing PULs with No. 2 wide-bore polyester sutures would provide sufficient collagen to repair weakened PULs. Cure of SUI, when it occurred, was immediate. Reference to the original experimental animal studies indicated that collagen 1, the key structural support of PUL, had formed by 3 months. This is an optimistic sign for longer term cure, substantiated by very little deterioration after 3 months over a 12-month period in the first surgical trial (unpublished data). In conclusion, the ULP operation can be performed under local anesthesia/sedation. If it fulfils its promise for longer-term cure, SUI cure will be available for hundreds of millions of women in underdeveloped countries for a few dollars per case.

High-Grade Glioma Recurrence Is Delayed in Hispanic Patients despite Severe Social Vulnerability: A Retrospective Cohort Study.

High-grade gliomas (HGGs; WHO grade III or IV) are the most common and lethal brain malignancy. Patients of Hispanic ethnicity are diagnosed with HGGs earlier than non-Hispanic patients, but they exhibit improved HGG survival following diagnosis. Either environmental or biological factors could explain this survival benefit. We aimed to determine if post-diagnosis advantages would still be present in Hispanic patients with high social vulnerability, an environmental condition predisposing patients to poor oncologic outcomes. HGG outcomes were retrospectively assessed in a cohort of 22 Hispanic patients and 33 non-Hispanic patients treated for HGGs from 2015 to 2020 at a single institution that serves a highly vulnerable region. Compared to non-Hispanic patients, Hispanic patients demonstrated higher social vulnerability index scores (96.8 + 0.7 vs. 76.3 + 4.6; *** p = 0.0002) and a 14-month longer interval between diagnosis and recurrence (19.7 + 5.9 (n = 13) vs. 5.5 + 0.6 months (n = 19); ** p = 0.001). In only those patients with more aggressive IDH-1 wildtype tumors (glioblastoma), Hispanic ethnicity still related to a longer time before recurrence (15.8 + 5.9 months (n = 9); 5.5 + 0.6 months (n = 18); * p = 0.034), and in a multivariate analysis, Hispanic ethnicity predicted time-to-recurrence (* p = 0.027) independent of patient age, functional status, MGMT gene methylation, or treatments received. Therefore, environmental factors, specifically social vulnerability, did not obscure the post-diagnosis benefits associated with Hispanic ethnicity. In future experiments, basic studies should be prioritized which investigate the cellular or genetic mechanisms underlying this ethnicity effect on HGG progression in the hopes of improving care for these devastating malignancies.