Low Retention Rates Research Articles

OPT-In For Life: A Mobile Technology-Based Intervention to Improve HIV Care Continuum for Young Adults Living With HIV.

Young adults living with HIV (YALH) have lower rates of retention in care and HIV viral suppression. Multiple barriers exist to engage YALH in care. We developed and implemented a multifaceted, mobile application-based intervention, "OPT-In for Life," by targeting YALH to encourage retention in care and eventually viral suppression. The app integrated multiple user-friendly features for YALH to manage their HIV care, including a two-way secure messaging function, HIV-related laboratory results, and appointment or medication reminders. We recruited 92 YALH who were 18 to 34 years old and were newly diagnosed with HIV, had a history of falling out of care, or had a detectable HIV viral load into this intervention. Study participants used the app to manage their HIV care and to communicate and interact with their HIV care team. During the intervention period, the retention rate among our study participants increased from 41.3% at baseline to 78.6% at 6-month follow-up, maintained at 12-month follow-up (79.8%), and slightly decreased to 73.4% at 18-month follow-up but it was still significantly higher than the baseline retention rate (p < .0001). The viral suppression rate (HIV RNA <200 copies/ml) increased from 64.1% at baseline to about 85% at 6-month and at 12-month follow-up and reached 91.4% at 18-month (p = .0002) among participants who were retained in care. Our study demonstrated using a HIPAA-compliant mobile application as an effective intervention to engage YALH in care. This mobile technology-based intervention can be incorporated into routine clinical practice to improve HIV care continuum.

“First meetings”: constructive first encounters between pre-service teachers and their mentors

PurposeThe purpose of this paper is to report the findings from an action research project in which the researchers sought to develop a set of questions for use by mentors (experienced teachers) and mentees (pre-service teachers) on a course of initial teacher education (ITE) when they first met – the “initial encounter”.Design/methodology/approachThe researchers used an action research approach in order to address the lower retention rate of pre-service teachers from different backgrounds, such as Black and Minority ethnic (BAME) and the issues around mentoring which may exacerbate this problem. Discussions between the course team and participating mentors and mentees suggested that the initial encounter between mentor and mentee was significant, and an action research methodology would allow for developing questions that might structure such encounters.FindingsThe researchers found that a useful and effective set of questions could be developed and used by mentors and mentees. Additionally, this process gave researchers insights into the nature of the first encounters between mentors and mentees on an ITE course and how both groups see their roles. In several cycles of action research, the participants produced a number of iterations of such questions, which were refined across a two-year period.Research limitations/implicationsWhile it is too early to tell if the issues leading to the lower retention rate of pre-service teachers that prompted the project have been reduced in any significant way, the researchers suggest that thinking about these initial encounters can have an impact on the way mentors and mentees go on to build a relationship.Originality/valueThe authors found that there is very little research in the field of teacher education which looks at initial encounters between mentors and mentees, and thus make an original contribution to the mentoring literature.

Minorities and culture of learning: an anthropological study of the Muslim community in Telangana state in India

ABSTRACT What are the factors hindering educational development among Muslims in India in general and the newly born Telangana state in particular, is the key sociological question confronting the educationists and policymakers? The current paper based on empirical study provides an anthropological perspective to understand a number of socio-cultural factors responsible for lower retention and higher dropout rates among Muslims in public schools across the class and gender lines. It highlights that with positive state interventions, the enrolment and retention levels of Muslim working-class children have increased enormously besides a significant improvement in the same among Muslim girls also. Thus the paper argues that a relaxation in school protocols facilitates Muslim children integrating the academic demands and socio-cultural obligations they deem necessary while addressing culturally sensitive issues in curriculum and pedagogic practices foster attitudinal changes together which contribute immensely to the educational advancement among them.

New Mechanical Fat Separation Technique: Adjustable Regenerative Adipose-tissue Transfer (ARAT) and Mechanical Stromal Cell Transfer (MEST).

BackgroundAdipose tissue is not only a very important source of filler but also the body’s greatest source of regenerative cells.ObjectivesIn this study, adipose tissue was cut to the desired dimensions using ultra-sharp blade systems to avoid excessive blunt pressure and applied to various anatomical areas—a procedure known as adjustable regenerative adipose-tissue transfer (ARAT). Mechanical stromal cell transfer (MEST) of regenerative cells from fat tissue was also examined.MethodsARAT, MEST, or a combination of these was applied in the facial area of a total of 24 patients who were followed for at least 24 months. The integrity of the fat tissue cut with different diameter blades is shown histopathologically. The number and viability of the stromal cells obtained were evaluated and secretome analyses were performed. Patient and surgeon satisfaction were assessed with a visual analog scale.ResultsWith the ARAT technique, the desired size fat grafts were obtained between 4000- and 200-micron diameters and applied at varying depths to different aesthetic units of the face, and a guide was developed. In MEST, stromal cells were obtained from 100 mL of condensed fat using different indication-based protocols with 93% mean viability and cell counts of 28.66 to 88.88 × 106.ConclusionsThere are 2 main complications in fat grafting: visibility in thin skin and a low retention rate. The ARAT technique can be used to prevent these 2 complications. MEST, on the other hand, obtains a high rate of fat and viable stromal cells without applying excessive blunt pressure.Level of Evidence: 4

Early College High School/Dual Enrollment 2.0

Urban and Metropolitan Colleges and Universities often serve a population that can benefit from an early college strategy. Colleges serving first-generation and low-income students often have lower retention and graduation rates than their peer institutions, as students from large urban public high schools can struggle to navigate the college classrooms and support system. While students may have achieved respectable GPAs and test scores in their high school buildings, they can fail to translate these skills at the college level, finding themselves on academic probation or worse. As researcher Anthony Jack has described in his landmark study, The Privileged Poor, students coming from large, urban districts are doubly disadvantaged by their experiences in schools; the skills that have allowed these students to get through their high schools are counterproductive at the college level (Jack, 2019).&#x0D; Using an evidence-based approach, programs being launched now by colleges and universities focus on the core missions of early college and dual enrollment programs, connecting youth less likely to attend college directly out of high school with powerful programming that propels them towards successful completion of degrees and to the start of their career. This article presents perspectives from a range of institutions (high school, two-year institutions, four-year institutions, and philanthropic investors) that are rethinking these models to maximize community impact and affordability to students and families.

Enhancing output performances and output retention rates of triboelectric nanogenerators via a design of composite inner-layers with coupling effect and self-assembled outer-layers with superhydrophobicity

Abstract Low output performances and output retention rates in high humid environments represent serious challenges that have interrupted the large-scale application of triboelectric nanogenerators (TENGs) as portable power supplies and self-powered sensors. Existing approaches of tribo-material optimization and device structure design remain limited in solving the problems of low electrical outputs and output retention rates for TENGs. Here, achieving high electrical outputs and output retention rate in a TENG based on a multi-effect inner-layer and a superhydrophobic outer-layer is first proposed by an organic-inorganic composite and simple self-assembly electrospinning. The inner-layer consisting of polyimide (PI) and 0.85Na0.5Bi0.5TiO3-0.15SrTiO3 (NBT-15ST) ceramic particles (CPs) can distinctly enhance the electrical performances of the device by coupling charge storage effect and hysteretic dielectric polarization. Under a maximum instantaneous force of 50 N, the device delivers a voltage of 1020 V and a current density of 32.5 μA cm−2. Meanwhile, the superhydrophobic outer-layer with novel biomimetic multilevel structures endowing the device with a superior output retention rate of 50% at a high relative humidity of 80%. This work provides a new strategy to optimize the electrical outputs of the TENG and extends its application in humid conditions.

Long-term outcomes in patients with polyarticular juvenile idiopathic arthritis receiving adalimumab with or without methotrexate

ObjectivesLong-term safety and efficacy of adalimumab among patients with juvenile idiopathic arthritis (JIA) was evaluated through 6 years of treatment.MethodsChildren aged 4–17 years with polyarticular JIA were enrolled in a...

Facilitation strategies for enhancing the learning and engagement of online students

The opening up of online education in the Australian tertiary sector has made higher education accessible for a wide range of students, including those living in rural and regional areas. While student numbers continue to grow as a result of this opportunity, there are increasing concerns regarding low student retention and progression rates for online students in comparison with on-campus students. Reasons for this vary, however, online students report a sense of isolation and disconnection with their studies highlighting the need for educators to utilise effective facilitation to enhance student connections to an online community. In this paper, we investigated facilitation strategies using two case studies. This illustrated how two online instructors used design-based research to evaluate the impact of facilitation strategies on instructor presence, instructor connection, engagement and learning in maths education and human biology subjects. Findings indicate that focusing on social, managerial and technical facilitation strategies resulted in an increased instructor presence and active involvement, which in turn were influential in motivating students to engage with learning online. The findings have implications for higher education providers and instructors who are tasked with engaging online students. This identifies the importance of targeted online facilitation to enhance learner-instructor and learner-content engagement.

Can cover sheath model influence semen retention in AI-gun trials and pregnancy rates of cows inseminated at a fixed-time?

The achievement of satisfactory results in fixed-time artificial insemination (FTAI) protocols depends on several factors, such as the quality of the materials used to perform the artificial insemination (AI). In this context, three experiments were conducted to evaluate the effect of the cover sheath model on the residual retention of semen during AI and the pregnancy rates of cows submitted to FTAI. In Experiment 1, 400 straws of cryopreserved bovine semen were thawed and repacked in samples with similar weight and volume characteristics. Each new dose of semen (n = 300) was mounted using one of three AI cover sheath models (n = 100 semen/sheath doses): the main brand in the global market (G1), the main model in the Brazilian market (G2), and a model marketed as having a low residual semen retention rate (G3), to determine the percentages of seminal elimination (PSEs) during AI. In Experiment 2, 464 Nelore cows were synchronized through intravaginal progesterone implants and inseminated using the same cover sheaths as those tested in Experiment 1, which were grouped into classes (conventional: G1 and G2 [n = 225]; and low reflux: G3 [n = 239]). In Experiment 3, 859 Nelore cows were synchronized and inseminated as described above, using the same cover sheaths previously tested. After each AI, cover sheaths were visually inspected for the presence of residual semen and pregnancy diagnosis was performed 35 days after FTAI (Experiments 2 and 3). The PSEs in Experiment 1 were 91.7%, 90.6% and 96.5% for groups G1, G2 and G3, respectively (P = 0.05). The pregnancy rates in Experiment 2 were 53.33% and 58.16% for the conventional and low reflux model, respectively (P > 0.05), but there were differences (P = 0.05) among the cover sheath models employed for AI (G1 - 57.72% [71/123]; G2 - 48.04% [49/102]; G3 - 58.16% [139/239]). Additionally, a lower semen reflux incidence (P < 0.05) was observed in the low residual sperm retention model (0.72%) in Experiment 3, compared to the main international (10.42%) and national (22.99%) market models. In conclusion, residual semen retention occurs regardless of the cover sheath model used for AI. However, the PSE is influenced by the model and quality of cover sheath used. According to the results, the cover sheath represents a factor that may compromise the pregnancy rates of synchronized cows for FTAI.

A Critical Analysis of Factors Accounting for Low Pupil Retention Rate in Public Primary Schools in Zambia

A Critical Analysis of Factors Accounting for Low Pupil Retention Rate in Public Primary Schools in Zambia

A Novel Approach to Depression Care: Efficacy of an Adapted Interpersonal Therapy in a Large, Urban Primary Care Setting.

The Collaborative Care Model (CoCM), in which social workers, primary care physicians, and a consulting psychiatrist work as a team, is an established approach to the treatment of common mental health conditions in primary care settings. Following implementation of a CoCM depression care program at our hospital-based academic primary care practice, we observed a low rate of retention with the use of problem solving therapy/behavioral activation (PST/BA). Our aim in this study was to evaluate the effectiveness of interpersonal psychotherapy (IPT), an evidence-based, flexible strategy that focuses on the relationship between depression and interpersonal challenges, compared to PST/BA. In 2015, most patients enrolled in our CoCM received PST/BA. In 2016, most patients received IPT. Patients who were enrolled and discharged from our CoCM depression care program in the years 2015 and 2016 and received either PST/BA or IPT, were included. Our primary measure was the difference in change in PHQ-9 score between the PST/BA and the IPT groups. Secondary outcomes included the difference in the change in GAD-7 score and measures of glycemic and blood pressure control between the two groups. Two hundred thirty four patients were included in our analysis. One hundred sixty five received PST/BA and 69 received IPT. There was no difference between groups in baseline demographics or measures of depression, anxiety, presence of hypertension, or presence of prediabetes/diabetes. Our primary analysis demonstrated a greater decrease in PHQ-9 score in patients receiving IPT (9.93) compared to those receiving PST/BA (5.41) (p< 0.0001). The proportion of patients achieving a clinical response (PHQ-9 < 10) was also greater in the IPT group (71%) compared to the PST/BA group (44%). In a CoCM depression care program, IPT was a more effective strategy in improving depression symptoms as measured by PHQ-9 scores than PST/BA.

State Capacity and the Soft Budget Constraint: Fiscal Federalism, Indian Style

In this paper, we explore the effects of India’s federal structure on state-level fiscal responsibility. Drawing from a dataset that covers the period from 1991 to 2019, we argue that a low marginal retention rate, a high level of transfer dependence and a high level of borrowing dependence (soft budget constraints) from the central government facilitates lower levels of fiscal responsibility in intergovernmental relations. Our hypothesis is tested using random effects, and fixed effects panel estimations of regressions on fiscal responsibility outcomes across Indian states. We also account for the effects of the world’s largest employment program, the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA), on subnational fiscal responsibility. We find that the fulfillment of rural public employment measures is conducive to lower levels of fiscal responsibility. Moreover, we argue for the persistence of soft budget constraints as a key structural feature of Indian federalism.

Is Urinary Retention Following Extravesical Ureteral Reimplantation Still a Concern?

Transient urinary retention is a known complication of bilateral extravesical ureteral reimplantations. Recent studies have shown that the robotic-assisted bilateral extravesical reimplantation may have lower transient urinary retention rates than previously reported for the open approach. The purpose of this review is to compare urinary retention incidence in patients undergoing open versus robotic-assisted extravesical reimplantations. In some of the larger series, open bilateral extravesical ureteral reimplantation was noted to have a temporary urinary retention rate of 4–15%. In our recent experience with the open approach, we have noted a 2% incidence of transient urinary retention. In recent series of robotic-assisted bilateral extravesical reimplantations, transient retention was seen in 0–22%, with larger series favoring lower urinary retention rates. The incidence of transient urinary retention following open or robotic-assisted approaches in recent series is 0–2%, which is almost negligible. Dysfunctional elimination syndrome symptoms and constipation need to be aggressively treated preoperatively. Families of patients who undergo bilateral extravesical ureteral reimplantations, regardless of whether it is performed via the open or robotic-assisted approach, should not only be counseled of the small risk of transient urinary retention but should also be told that this can also be seen with any other surgical approach for the repair of primary vesicoureteral reflux.

The occupational attractiveness of the built environment and the roles of individualism and collectivism: a hidden source of conflict and gender imbalance?

The success of built environment projects is closely dependent on strong collective cooperation. Yet abundant anecdotal and academic evidence attests to weak collective cooperation within the industry. To date, no research in the built environment has investigated either the individual-level differences in individualism/collectivism that affect cooperativeness, or how gender may interact with these individual-level traits. In this research we seek to make a positive contribution by using the individual rather than organization as the unit of analysis. We first test the possibility that the built environment may in fact attract uncooperative individuals who are more individualistic than collectivist with respect to two specimen subsectors, i.e. construction management and architecture. At the same time we also employ a nuanced distinction between horizontal and vertical facets of individualism/collectivism, and assess potential interactions with gender. Using individual-level data (N=548), we find that both the architecture and construction management subsectors are occupationally attractive to individuals from opposing ends of the horizontal and vertical individualism/collectivism spectrums, and that these traits interact with gender. We argue that our findings both expose an individual-level source of poor collective cooperation in the built environment industry, and underscore the need to address persistently low female recruitment and retention rates.

The Effect of Hyaluronidase on the Fat Graft.

Fat grafting has been widely used for facial rejuvenation and soft tissue reconstruction. However, it is associated with a lower retention rate than expected and complications such as fat necrosis or calcification. Several techniques that may increase the survival rate of fat grafts have been proposed. The techniques that promote the recipient sites vascularity to increase the survival rate of fat grafts include administration of growth factors, platelet- rich plasma, and adipose derived-stem cells or preconditioning of the recipient fat graft site. In this study, the authors evaluated the effect of hyaluronidase on autologous fat graft survival by pretreatment with hyaluronidase at the recipient site by using an animal model. In the experimental group, the recipient site of the fat graft was pretreated with hyaluronidase before fat grafting, whereas the control group was pretreated with normal saline. After 8 weeks of fat grafting, the average volume retention was 78.2% in the experimental group and 68.6% in control group. Considerable fibrosis between the fat globules in the control group was confirmed with Masson trichrome staining. CD31 immunofluorescence staining was performed and stained vessels were counted. Counted vessel number was significantly greater in the experimental group than in the control group. Pretreatment of hyaluronidase on the fat graft recipient site is a good option to enhance the outcome of the fat graft in the clinical setting.

Carer administration of as-needed subcutaneous medication for breakthrough symptoms in people dying at home: the CARiAD feasibility RCT

Most people who are dying want to be cared for at home, but only half of them achieve this. The likelihood of a home death often depends on the availability of able and willing lay carers. When people who are dying are unable to take oral medication, injectable medication is used. When top-up medication is required, a health-care professional travels to the dying person's home, which may delay symptom relief. The administration of subcutaneous medication by lay carers, although not widespread UK practice, has proven to be key in achieving better symptom control for those dying at home in other countries. To determine if carer administration of as-needed subcutaneous medication for common breakthrough symptoms in people dying at home is feasible and acceptable in the UK, and if it would be feasible to test this intervention in a future definitive randomised controlled trial. We conducted a two-arm, parallel-group, individually randomised, open pilot trial of the intervention versus usual care, with a 1 : 1 allocation ratio, using convergent mixed methods. Home-based care without 24/7 paid care provision, in three UK sites. Participants were dyads of adult patients and carers: patients in the last weeks of their life who wished to die at home and lay carers who were willing to be trained to give subcutaneous medication. Strict risk assessment criteria needed to be met before approach, including known history of substance abuse or carer ability to be trained to competency. Intervention-group carers received training by local nurses using a manualised training package. Quantitative data were collected at baseline and 6-8 weeks post bereavement and via carer diaries. Interviews with carers and health-care professionals explored attitudes to, experiences of and preferences for giving subcutaneous medication and experience of trial processes. The main outcomes of interest were feasibility, acceptability, recruitment rates, attrition and selection of the most appropriate outcome measures. In total, 40 out of 101 eligible dyads were recruited (39.6%), which met the feasibility criterion of recruiting > 30% of eligible dyads. The expected recruitment target (≈50 dyads) was not reached, as fewer than expected participants were identified. Although the overall retention rate was 55% (22/40), this was substantially unbalanced [30% (6/20) usual care and 80% (16/20) intervention]. The feasibility criterion of > 40% retention was, therefore, considered not met. A total of 12 carers (intervention, n = 10; usual care, n = 2) and 20 health-care professionals were interviewed. The intervention was considered acceptable, feasible and safe in the small study population. The context of the feasibility study was not ideal, as district nurses were seriously overstretched and unfamiliar with research methods. A disparity in readiness to consider the intervention was demonstrated between carers and health-care professionals. Findings showed that there were methodological and ethics issues pertaining to researching last days of life care. The success of a future definitive trial is uncertain because of equivocal results in the progression criteria, particularly poor recruitment overall and a low retention rate in the usual-care group. Future work regarding the intervention should include understanding the context of UK areas where this has been adopted, ascertaining wider public views and exploring health-care professional views on burden and risk in the NHS context. There should be consideration of the need for national policy and of the most appropriate quantitative outcome measures to use. This will help to ascertain if there are unanswered questions to be studied in a trial. Current Controlled Trials ISRCTN11211024. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 25. See the NIHR Journals Library website for further project information.

Ten-Year Clinical Survival of Anterior Cantilever Resin-Bonded Fixed Dental Prostheses: A Retrospective Study.

To assess the 10-year clinical retention and survival rates of metal-ceramic (MC) and all-ceramic (AC) cantilever resin-bonded fixed dental prostheses (CRBFDPs). Forty CRBFDPs constructed from either cobalt-chromium ceramic (MC group; n = 20) or glass-infiltrated alumina ceramic (AC group; n = 20) were placed in 40 patients between August 2007 and December 2009. After baseline recordings, the patients were followed up using modified United States Public Health Services (USPHS) criteria after 6 months and thereafter annually for 10 years. Data were statistically analyzed using Kaplan-Meier estimation with log-rank (Mantel-Cox) test. The 10-year clinical retention rate was 95.0% in the MC group and 70% in the AC group. The difference was statistically significant (P = .02, log-rank test). Three all-ceramic CRBFDPs fractured at 6, 12, and 84 months after insertion. No statistically significant difference in survival rate was observed between the MC and AC groups over the 10 years of clinical observation (MC: 100%; AC: 85%; P = .075) (Kaplan-Meier method, confidence interval = 92.5% to 97.5%). Although glass-infiltrated alumina ceramic anterior CRBFDPs exhibited a lower clinical retention rate compared to metal-ceramic CRBFDPs, the debonded prostheses were recemented and continued in function over the observation period. Additionally, an acceptable 10-year clinical longevity was recorded.

Buprenorphine Versus Methadone in Pregnant Women With Opioid Use Disorder: A Cost-Effectiveness Analysis [06E

INTRODUCTION: Opioid use disorder (OUD) during pregnancy has increased more than fourfold since 1999. Methadone is the longstanding treatment of choice for OUD in pregnancy, but recent data demonstrate benefits of buprenorphine, as it is associated with improved neonatal outcomes despite increased drug cost and rates of discontinuation of therapy. This model compares cost-effectiveness of buprenorphine versus methadone in management of OUD during pregnancy. METHODS: We used a theoretical cohort of 22,400 pregnant women to approximate the number of pregnancies affected by OUD per year in the United States. Outcomes included maternal retention in maintenance treatment, maternal overdose, neonatal abstinence syndrome, preterm birth, intrauterine growth restriction, and cerebral palsy in addition to cost and quality-adjusted life-years. The cost-effectiveness threshold was set at $100,000/QALY. Model inputs were derived from the literature and varied in sensitivity analyses to assess robustness of the model. RESULTS: Despite lower rates of retention and higher associated overdoses, buprenorphine treatment during pregnancy saved over $102 million healthcare dollars and 563 QALYs, making it the dominant strategy over methadone treatment. In our cohort, buprenorphine treatment resulted in 2,886 fewer cases of NAS, 1,006 fewer preterm births, 299 fewer cases of IUGR, 32 fewer stillbirths, and 12 fewer cases of CP. Sensitivity analyses showed that our results were robust over a wide range of assumptions. CONCLUSION: Buprenorphine treatment should be considered a first-line option for opioid dependence in pregnancy, as it leads to improved neonatal outcomes compared to methadone despite increased drug cost and risk of treatment discontinuation.

Keeping College Students in the Game: A Review of Academic Advising

Amidst declining state revenues, high transfer rates, and low student retention rates, academic advisors play increasingly crucial roles in attracting and retaining students at their institutions. Using a blend of structural functionalism and professionalism frameworks, the purpose of this literature review is to inform student affairs professionals and college administrators about the importance of academic advisors in their roles to encourage students to persist through their education at their postsecondary institutions. The findings from this review are intended to inform academic advisors and administrators at institutions of higher education on the roles academic advisors play in student retention efforts.

MP70-12 SALVAGE FOCAL CRYOTHERAPY OFFERS SIMILAR SHORT-TERM ONCOLOGICAL CONTROL AND IMPROVED URINARY FUNCTION COMPARED TO SALVAGE WHOLE GLAND CRYOTHERAPY FOR RADIATION RESISTANT/RECURRENT PROSTATE CANCER

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (MP70)1 Apr 2020MP70-12 SALVAGE FOCAL CRYOTHERAPY OFFERS SIMILAR SHORT-TERM ONCOLOGICAL CONTROL AND IMPROVED URINARY FUNCTION COMPARED TO SALVAGE WHOLE GLAND CRYOTHERAPY FOR RADIATION RESISTANT/RECURRENT PROSTATE CANCER Wei Phin Tan*, Ahmed Elshafei, Alireza Aminsharifi, and Thomas Polascik Wei Phin Tan*Wei Phin Tan* More articles by this author , Ahmed ElshafeiAhmed Elshafei More articles by this author , Alireza AminsharifiAlireza Aminsharifi More articles by this author , and Thomas PolascikThomas Polascik More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000950.012AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The treatment of radiation-persistent prostate cancer remains a challenge and should be tailored to the individual patient. We aim to compare short-term oncological and functional outcomes of salvage focal cryotherapy (SFC) to salvage total cryotherapy (STC) for radiation persistent/recurrent prostate cancer. METHODS: We queried the COLD registry for men who underwent SFC and STC of the prostate for radiation persistent/recurrent disease. Propensity score weighting was used to match age at time of treatment, pre-salvage therapy PSA, Gleason sum, and pre-salvage cryotherapy androgen deprivation therapy status. Primary outcome was progression-free survival (PFS). RESULTS: A total of 385 men with biopsy-proven persistent/recurrent prostate cancer after primary radiotherapy were included in the study. Median follow-up, age, PSA and Gleason sum pre-salvage cryotherapy was 24.4 months (1st/3rd quartile: 9.8/60.3), 70 years (1st/3rd quartile: 66/74), 4 ng/dl (1st/3rd quartile: 2.7/5.6) and 7 (1st/3rd quartile: 6/8), respectively. After propensity score weighting, patients who were treated with STC did not have a significant difference test in PFS compared to patients treated with SFC on weighted log-rank test (79.8% vs. 76.98%, p= 0.11). SFC was associated with a lower probability of post-treatment transient urinary retention (5.6% vs 22.4%. p<0.001). There were no significant differences in rectal fistula (1.4% vs 3.8, p=0.30), new onset urinary incontinence within 12 months (9.3% vs 15.1%, p=0.19) or new-onset erectile dysfunction within 12 months (52.6% vs 59.6, p=0.47) in the SFC vs STC group, respectively. CONCLUSIONS: STC has similar 2-year oncological outcome compared to SFC in the radiation- persistent/recurrent disease population, but patients who underwent SFC have a lower urinary retention rate compared to STC. Source of Funding: WPT is supported by the Ruth L. Kirschstein NRSA Institutional Research Training Grant (T32-CA093245). © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1059-e1060 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wei Phin Tan* More articles by this author Ahmed Elshafei More articles by this author Alireza Aminsharifi More articles by this author Thomas Polascik More articles by this author Expand All Advertisement PDF downloadLoading ...