Tomorrow's Practice Research Articles

IJU this issue

This issue of International Journal of Urology contains two Review Articles, 13 Original Articles, three Urological Notes, nine Editorial Comments, one Letter to the Editor, and three Author's Replies. Prostate biopsy is one of the most frequently performed urological procedures. Despite being generally safe and well-tolerated, it is sometimes associated with complications including acute bacterial prostatitis especially in transrectal approach. In the last decade, an increased number of fluoroquinolone-resistant and extended-spectrum beta-lactamase-producing Escherichia coli have been reported in cases of acute prostatitis. In the Review Article by Acosta et al. (Okayama, Japan), the authors emphasized the clinical value of the isolation of these pathogens from rectal bio-flora samples, which can be easily obtained through the fingertip of a sterile glove or a cotton swab, with selective media before transrectal prostate biopsy. As the authors described, this preventive measure may allow us to offer a tailored prophylactic treatment that benefits patients and reduces the economic burden for the hospital. The treatment paradigm for metastatic renal cell carcinoma (mRCC) has been dramatically changed by the introduction of immune checkpoint inhibitors (ICIs). Recent clinical trials have demonstrated the survival advantages of several kinds of the first-line ICI combination therapy compared with sunitinib, suggesting that substantial improvements in survival for patients with mRCC could be achieved during the ICI era compared with the tyrosine kinase inhibitor (TKI) era. Besides the advancement of systemic anticancer therapy, surgical resection of the primary tumor or metastases remains an important option in the management of mRCC although the clinical implications of these surgeries have changed in the TKI era. In the Review Article by Naito et al. (Yamagata, Japan), the authors provided an excellent overview about cytoreductive nephrectomy, metastatectomy, and radiotherapy for metastatic lesions in the ICI era. At present, this topic has minimal evidence and further investigations are needed. This review will give some hints to the readers for tomorrow's practice. A difficult ureter (DU) is defined as a ureter that requires prestenting because a ureteroscope or a ureteral access sheath needed for treatment cannot be inserted during retrograde intervention. In the Original Article by Waseda et al. (Tokyo, Japan), the authors focused on risk factors and predictive models for ureteral difficulty during retrograde ureteroscopic lithotripsy in clinical practice. It is meaningful and important to predict DU prior to surgery because the presence or absence of DU is related to the success of the procedure. Interestingly, the absence of stone history was the greatest risk factor for developing DU, followed by age 45 years or younger and renal stones only. As the authors suggested, preoperative assessment of the risk of DU may be helpful in the informed consent for patients requiring retrograde lithotripsy. Surgical resection of RCC with inferior vena cava (IVC)–tumor thrombus (TT) is the standard of care for nonmetastatic patients and confers long-term survival. However, it is a technically challenging procedure with a high risk of morbidity (40–50%) and mortality (5–10%). One of the serious complications is intraoperative tumor embolism (iTE) of pulmonary artery. Currently, there is no consensus on whether it is optimal to perform thrombectomy before kidney mobilization (“thrombus first”) or vice versa (“thrombus last”). In the Original Article by Ishiyama et al. (Tokyo, Japan), the authors compared these two techniques focusing on iTE prevalence and other early surgical outcomes in 130 patients with RCC and IVC-TT. In this retrospective study, there were four cases (3.1%) of iTE, all from the thrombus-last group. Additionally, those who underwent the thrombus-first technique experienced shorter operation time, smaller estimated blood loss, fewer complications, and shorter in-hospital stay. “Thrombus-first” approach may be preferred when performing nephrectomy and caval thrombectomy under open procedures. Unfortunately, the limited space does not allow me to introduce all the articles. However, all the papers are interesting, informative, and well-illustrated. I hope you enjoy this issue of International Journal of Urology. None declared.

Today's Challenges and Tomorrow's Practice: Impact of COVID-19 on the Future of GI Practices.

1Division of Gastroenterology, Alta Bates Summit Medical Center, Oakland, California, USA; 2East Bay Center for Digestive Health, Oakland, California, USA; 3Akron Digestive Disease Consultants, Inc., Akron, Ohio, USA. Correspondence: Neil Stollman, MD, FACG. E-mail: [email protected].

Guidance on Writing for the AORN Journal

Guidance on Writing for the <i><scp>AORN</scp> Journal</i>

COVID-19 - A Covert Catalyst for Pedagogical Stocktake and Transformation: Perspectives of a Global Hub.

This article was migrated. The article was marked as recommended. Education in Hong Kong was shifted online on an abrupt and massive scale as the city faced unprecedented disruptions, first from social unrest in 2019 and then again with the COVID-19 pandemic. Concurrent modernization initiatives since early 2019 in The University of Hong Kong's Medical Faculty (HKUMed), conferred a fortuitous head start for this rapid change. Pre-clinical and clinical teaching were restructured for online delivery through e-learning solutions for didactic teaching, and new innovative approaches were developed to convert bedside to"webside" teaching. E-learning in the current circumstances provided necessary social distancing while being pedagogically sound. Students were also able to develop key communication and collaboration skills via online platforms, developing digital skills critical to their future profession. However, unforeseen issues including socioeconomic inequality, privacy concerns, and social isolation became apparent and should be addressed as medical education progresses further down the digital path. The goal must entail a sustainable and scholarly approach towards optimizing medical education in an increasingly online environment. This will help safeguard the medical curriculum against disruption and empower future medical professionals for tomorrow's practice. Here, we share experiences and perspectives from educators in a global city characterised by land scarcity and income inequality.

Become the leading practice of tomorrow

Become the leading practice of tomorrow

Tomorrow's Practice Changing Abstracts

Tomorrow's Practice Changing Abstracts

The future of geriatric medicine

The old adults of today have benefited during their lifetime from tremendous public health successes, including the control of communicable diseases as well as outstanding progress in acute medicine, leading to a rise in chronic and disabled diseases. These important paradigm changes will be reinforced in future generations of elders by the introduction of informatics, biological innovations, high technology, DNA sequencing, nanotechnology, advances in cognitive sciences and artificial intelligence. Today, natural ageing with all its social inequities and insecure surroundings (war, natural catastrophes and climatic changes) constitutes an enormous challenge for the world countries. These widely varying conditions will be further exacerbated by the possible access to more sophisticated prosthetic devices and medical technology for the richest compared to the poorest countries. “Modified” ageing already exist but will benefit more of high technology, which will leads to “improved” and perhaps “immortal” humans. Radical changes in society will deeply influence the practice of medicine. Undoubtedly, the practice of tomorrow's medicine will be wireless, from home to the hospitals and institutions. Miniature epidermal captures or “electronic skin” will transmit all the recorded health information to your mobile phone and your exhaustive and constantly updated medical chart will be sent to a “cloud computer”. Whatever all of these discoveries and their applications in daily life it is impossible to imagine the individual ageing process without considering the affective surroundings of the person. This “informal network of care” will be increasingly important in the context and will not be replaced soon by “companion” robots.

Induced Pluripotent Stem Cells: Reprogrammed without a Trace

“...technological advances driving the science of induced pluripotency will be increasingly essential for realizing the opportunities of patient-specific, cell-based treatments, thereby translating the discoveries of today into the practice of tomorrow.” Timothy J Nelson Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA Andre Terzic Author for correspondence: Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA Tel.: +1 507 284 5514; Fax: +1 507 266 9936; E-mail: terzic.andre@ mayo.edu Induced pluripotent stem cells: reprogrammed without a trace

Determinants of peak bone mass

The old adults of today have benefited during their lifetime from tremendous public health successes, including the control of communicable diseases as well as outstanding progress in acute medicine, leading to a rise in chronic and disabled diseases. These important paradigm changes will be reinforced in future generations of elders by the introduction of informatics, biological innovations, high technology, DNA sequencing, nanotechnology, advances in cognitive sciences and artificial intelligence. Today, natural ageing with all its social inequities and insecure surroundings (war, natural catastrophes and climatic changes) constitutes an enormous challenge for the world countries. These widely varying conditions will be further exacerbated by the possible access to more sophisticated prosthetic devices and medical technology for the richest compared to the poorest countries. “Modified” ageing already exist but will benefit more of high technology, which will leads to “improved” and perhaps “immortal” humans. Radical changes in society will deeply influence the practice of medicine. Undoubtedly, the practice of tomorrow's medicine will be wireless, from home to the hospitals and institutions. Miniature epidermal captures or “electronic skin” will transmit all the recorded health information to your mobile phone and your exhaustive and constantly updated medical chart will be sent to a “cloud computer”. Whatever all of these discoveries and their applications in daily life it is impossible to imagine the individual ageing process without considering the affective surroundings of the person. This “informal network of care” will be increasingly important in the context and will not be replaced soon by “companion” robots.

Today's science - tomorrow's practice: basic mechanisms of allergy and their clinical implications

The current therapeutic perspective for the treatment of allergic disorders has shifted from mediators of allergy, such as histamine, to focus on cytokines and their interactions with cells involved in allergic inflammation. Although eosinophils are involved in the genesis of allergy in animal models, their role in human asthma has been questioned. On the other hand, immunoglobulin E (IgE) appears to play a key role in allergic reactions and is therefore the focus of therapeutic attention. Similarly, the relationship between allergic reactions and T-helper 1 (Th1) and Th2 cells has been the subject of intensive investigation. In addition to the inflammation that characterizes the allergic response, there are structural changes in the airways that may precede any obvious clinical disease. These structural changes, affecting the epithelial–mesenchymal trophic unit, may in part be genetically determined and will require treatment at the molecular biological level.

About this title

This volume highlights a range of pressing research issues in natural construction materials. It is of direct relevance to the civil engineering industry, which faces growing pressures to sustain the natural and built environment while demanding a standardized high-quality construction product across Europe. Advances in Aggregates and Armourstone Evaluation provides an authoritative selection of research papers including overviews and case histories. The book examines a range of aggregate and armourstone specifications and new tests, including clear examples of how the statistical significance of test results can affect producers and users. Papers on rock source evaluation procedures and the opening of a new quarry are of particular practical value to engineering geologists serving the extractive industries. In addition, construction material availability, future demand and sustainability are examined, emphasizing new data for marine sand and gravel, armourstone, shingle durability, and concrete made from 9 alternative aggregates. The book contains North American and European research with international relevance. It will stimulate new ideas that feed into the best practice of tomorrow's engineering geologists.

Gastroenterology, research, and the American Gastroenterological Association: Today's investigation, tomorrow's practice

Gastroenterology, research, and the American Gastroenterological Association: Today's investigation, tomorrow's practice

The future is… teamwork

With GP morale at an all-time low, the dynamics of the primary health care team could be set to change. Ann-Marie Clough looks at where this could leave tomorrow's practice nurse.

Today's preparation for tomorrow's practice: the Lehman College nursing programme

This paper is based on a speech given at the twenty‐second annual convention of the Massachusetts League for Nursing, Boston, USA, on 24 September 1975. The author looks at the changing trends in nursing education in the USA, the importance of agreement on the level of entry into nursing and the need for a clear conceptual educational model. The Lehman College nursing programme is used as a prototype for such a model and its curriculum and the role of its nursing graduates as primary care practitioners are discussed and evaluated.

Current problems in tourism education at the St. Gall Graduate School of Economics

The theory of today is the practice of tomorrow, and the study of tourism, if the expression science of tourism is to be avoided, must largely be based on practical experience. Therefore, extremely close collaboration is called for between universities and those engaged in the tourist trade. Implementation of an optimum tourism policy thus depends on the active co‐operation of both sides.

The Role of the University in Research and Research Training

When the first sputnik orbited in 1957 the Free World was startled from complacency. The effectiveness of American scientific and technical education became a subject of burning controversy. We had assumed that the United States and the United Kingdom were ahead in scientific and engineering achievement; this image was shattered rudely. Criticism and evaluation of all education became of widespread interest as facts were sought. We were startled to find that the Soviet Union is producing annually two-to-three times as many scientific and technical professional graduates as the United States. Although presently the number of annual recipients of the doctorate is about the same in the Soviet Union as in the United States, 75 per cent of the Soviet degrees are in science and engineering as compared with only 55 per cent in the United States. About half of all Soviet engineers are in managerial positions in industry-in the management of research and development or in government administration. Many higher officials of the Soviet Union are engineers and scientists. One-third of all Soviet professionals are members of the Communist party as compared with only 4 per cent of the Soviet population at large. The conclusion is inevitable; the process of making decisions in the Soviet is geared much more to technical considerations than in the United States. With respect to research, one-seventh of all professionals in the Soviet Union worked in research and research development in 1960. One-third of these, some 120,000, worked in engineering research and development alone. As we are becoming aware of these facts, or more properly, the implication of these facts, a new emphasis upon science and technology and a new concern for quality and excellence is developing. The general public is more aware of the fundamental importance of scientific progress now than it was in 1957. Graduate Education This discussion properly leads us to some evaluation of the university in its job of education-particularly with respect to graduate education. Graduate education in this country is only some 85 years old. Although attempts to initiate it had begun earlier, the founding of Johns Hopkins U. in 1876 marks the real beginning of graduate work in the United States. Despite various academic and social pressures, the graduate school has become the chief and primary home for scholarship and research in America. Subject to ever-continuing controversy (controversy essentially the same in character 85 years ago as today), graduate education and its "hand-maidens", scholarship and research, have had incalculable influence on the course of modern society. Graduate schools brought research into the university-the dominant objectives at the doctoral level being research and training for research. This was a joint victory, for science and the university in the modern way of life. The eternal controversy remains, of course, between learning for learning's sake or learning for practical use. In science and technology the argument is one of "pure" or "basic" or "fundamental" research vs research which may be applied. A great teacher said many years ago that nothing is more practical than theory, because the theory of today is the practice of tomorrow. We agree whole-heartedly with this belief. Nevertheless, the argument goes on and probably always will. Perhaps, the real argument is simply one of determining proper balance in graduate work. Recounting the history of the beginning of graduate work in this country, Berelson tells of early controversy. The controversy and conflict involved in getting graduate study under way exhibited the resistance to change that traditionally characterizes educational institutions (and other institutions, too, for that matter). Many of the arguments used today against innovations in graduate study were used then against starting it at all: e.g., the always applicable position that scarce resources should not be put into new ventures when existing undertaking need to be improved; or the argument made in 1816 b the President of Harvard College to the effect that young men "must not be detained from active life, professions, etc., longer than now, nor may the expenses of our education be much increased"; or the argument that there would be no market for the product. The tension between undergraduate education and the proposed graduate variety was strong and persuasive, especially since there was no experience with which to judge or work out the problems. P. 855^

The removable partial denture in the general practice of tomorrow

The removable partial denture in the general practice of tomorrow

EDITORIAL - Theory Today is the Practice of Tomorrow

EDITORIAL - Theory Today is the Practice of Tomorrow

The Classroom Teacher as Practitioner

The aim of professional education is to convey knowledge in such a way that the student may not merely possess it but use it. Furthermore, its aim is to train for tomorrow's practice. From its very nature social work education operates under fast-changing conditions which continuously challenge its content and its processes. It follows, therefore, that students in a school of social work are not to be regarded as so many jugs to be filled with a content that is to be preserved for all time. Instead they must learn to use certain knowledge in an ongoing way. Hence the educator's constant concern is that stu-

Medical Practice and Its Future

I UNDERSTAND that my place in this symposium is to tell you something of medical practice as it is today and something of its past, and to speak of those forces within and outside of medicine whose influences point toward the medical practice of tomorrow. You are approaching the end of your medical-school training. Except for minor digressions, your thoughts and efforts have been on the scientific aspect of your chosen profession. What you may know of the actual practice of this profession cannot have come from personal experience. Clinical medicine is not a science. It is the utilization of . . .