Age Times Research Articles

The Correlation between Core Muscular Endurance, Body Composition, and Back Pain in Firefighters: An Observational Study

Firefighters are at a higher risk for experiencing back pain due to the nature of their job, but physical fitness may help to reduce this risk. Therefore, the primary purpose of this study was to determine if a correlation between subjective back pain severity and core muscular endurance exists in firefighters. A secondary purpose was to determine if age or body composition were correlated with back pain severity. This cross-sectional study was performed at a fire department during their Physical Fitness Assessment Program and included 72 male firefighters. Measures included weight, body fat percentage, maximal plank hold times for core muscular endurance, and the Oswestry Low Back Pain Disability Questionnaire. A Pearson product correlation analysis was performed between back pain score and each of the following variables: body fat percentage, BMI, age, and plank hold times. A second set of correlation coefficient analyses was performed between the same variables exclusively in subjects who reported back pain. This study found that, within this population of firefighters, there was no significant correlation between back pain and plank times or body composition variables, although there was a trend toward significant correlations between BMI and body fat percentage when only subjects with back pain were considered.

A horse in the funeral rites of the Turks as an ethnocultural marker

The presented article is dedicated to such an element of funeral rites of various Turkic cultures as the accompanying burial of a horse and the use of horses in the funeral rites of nomadic and settled peoples of Central Asia. According to the author’s hypothesis, based on source study and own research, the presence of a horse in funeral rites is one of the ethnocultural markers uniting Turkic cultures, starting from the ancient Turkic time and ending in the late Middle Ages. Thus, the purpose of the article is to investigate the transformation of the Turkic funeral rite in the Middle Ages in order to substantiate the ritual of horse burial as a common cultural marker of the Turkic peoples. The research results propose a comprehensive periodisation of this phenomenon, critically analysing the unique attributes of each period. The materials under study span across several cultures from the Middle Ages to the New Age. Each period is scrutinized to elucidate its features and peculiarities that shaped its evolution and exerted influence on the subsequent progression of traditions. The research underscores the key determinants driving the trajectory of these traditions within specific historical epochs for each of the investigated peoples.

Is Injectable Platelet-Rich Fibrin Really Effective in Reducing Expected Side Effects of Removing Impacted Third Molar Surgery?

Common side effects of third molar (M3) operations including pain, edema, and trismus have an adverse effect on patient quality of life. Injectable platelet-rich fibrin (i-PRF) may ameliorate some of the side effects of the operation. The primary purpose of this study is to measure and compare differences in pain, swelling, trismus, and quality of life between i-PRF side and a control side of subjects undergoing M3 removal. This study is a single-center, split-mouth, randomized prospective clinical trial conducted at Ordu University Faculty of Dentistry. Patients who presented between March and August 2022 for the extraction of impacted third molars due to various reasons were included in the study. The exclusion criteria were local conditions and systematic comorbidities. Additionally, patients with differences that could cause bias between the sides were excluded from the study. The predictor variable is treatment i-PRF or control. The outcome variables of interest are the pain level and analgesic consumption values on the Visual Analog Scale, the distance between determined reference points, maximum mouth opening, and the Postoperative Symptom Severity scale data. A Postoperative Symptom Severity scale was created using questions commonly employed in the clinical evaluation of patients following the extraction of third molars. This scale was further divided into subscales corresponding to the 7 primary adverse effects identified in a prior study. Covariate variables, sex, age, and operation times. The normality of the distribution of the study data was assessed using the Kolmogorov-Smirnov test. Depending on whether the data exhibited a normal distribution or not, the data were analyzed using either the paired t-test or the Wilcoxon test. A P value < .05 was considered statistically significant. The study included 35 patients with a mean age of 19.97±2.07years. The i-PRF side significant success in postoperative edema measurements. There was a statistically significant difference observed between the control side and the i-PRF side on the second day (control: 9.74±0.57mm, i-PRF: 9.46±0.51mm) and seventh day (control: 9.33±0.59mm, i-PRF: 9.12±0.50mm) in lateral canthus-angulus measurements (P: .01 and P: .04, respectively). Additionally, on the second day, there was a statistically significant difference in tragus-commisura measurements (control: 11.53±0.62mm, i-PRF: 11.31±0.58mm) with a P value of .02. There was no significant difference observed between the sides in terms of postoperative pain (P>.05). However, analgesic consumption in the i-PRF side was significantly lower at the sixth hour (control: 1.8±0.58 dose, i-PRF: 1.14±0.35 dose), 24th hour (control: 1.77±0.54 dose, i-PRF: 1.14±0.35 dose), and second day (control: 1.8±0.47 dose, i-PRF: 1.4±0.73 dose) postoperatively (P: .000, P: .000, and P: .012). Mouth opening was significantly lower in the i-PRF side on the second day (control: 27.88±6.48mm, i-PRF: 25.51±5.56mm) (P: .025). However, i-PRF had no significant effect on postoperative quality of life (P>.05). According to the study results, i-PRF had a limited effect on the management of postoperative pain, but i-PRF was effective in reducing postoperative edema. Further studies with larger patient sides are now needed to yield more detailed findings on the subject.

Free Time in Old Age: Does Health Status Determine the Choice of Leisure Activities in Indonesia?

This paper examines which leisure activities appear more attractive to older people, considering health status, disability and demographic-socio-economic and environmental variables. It employed data from Survei Penduduk Antar Sensus (SUPAS), the nationwide survey, conducted in 2015 by Indonesia's national statistical office. The sample selected 228,718 individuals aged 60 years old and above. Leisure activities were differentiated between active, sedentary, and no leisure activities. Health is measured with both health status and disability. Disability measures were adopted from Washington Group Short Set on Functioning-Enhanced (WG-SS Enhanced). Our multinomial regression models confirmed that health status was correlated with the choice of leisure activities in old age. Compared to older persons in good health, those reported in poor health without disruption to daily life were more likely to participate in sedentary or active leisure, but those with disruption to daily life were less likely to do so. Older persons with disability were disadvantaged in participating in either passive or active leisure. However, among all selected variables, employment and source of finance had the highest odds ratios and confounded the relationship between health and leisure activity.

What adult patients prefer for reporting their pain levels, and frequency of reassessment when in the emergency department

ObjectivesThis study interviewed adult patients presenting to the emergency department (ED) for various pain conditions enquiring about their preferred tool for reporting pain severity and preferred time interval between initial assessment and subsequent pain reassessments. MethodsA prospective observational (cross-sectional) study was conducted in adult patients with acute pain in a tertiary care hospital ED setting. Patients' initial pain score was recorded using NRS (numerical rating scale) pain scale, and appropriate analgesia offered. Once the patient had been evaluated by an attending physician, a research team member interviewed the patient regarding the pain reassessment time and preferred pain assessment tool. The pain assessment tools evaluated in this study were NRS, PS (picture scale or face pain scale), VRS (verbal rating scale), and VAS (visual analogue scale). The patients were presented with the four pain assessment tools (in their primary language) through an audio-visual on an electronic tablet display. Results200 (138 male, mean age 36.5 ± 11.17) patients participated in the study. With increasing age, pain reassessment interval increased by 0.19 min (95% CI 0.03–0.36 min). Males requested pain reassessment 6.7 min (95% CI 2.2–10.8) faster than females. In this study, the preferred interval for pain reassessment was reported as a mean of 22.8 (SD + −13.6) minutes. There was no relationship reported between time reassessment and pain severity (P = 0.22). Out of 200 subjects, irrespective of the initial pain scores, 100 preferred NRS. NRS was preferred by patients with mild to moderated pain due to the perception of being faster. However, patients with severe pain choose a non-NRS scale to prioritize accuracy. ConclusionThere was no influence found between the initial pain severity scores and the desired frequency of pain reassessment. However, associations were identified between the time for pain reassessment interval and age, sex, and geographical region. Patients with severe pain preferred PS or VRS while patients with mild/moderate pain preferred the NRS.

A retrospective evaluation of the effect of oclacitinib (Apoquel) administration on development of surgical site infection following clean orthopedic stifle surgery.

The aim of this study was to determine the effect of oclacitinib (Apoquel) on development of surgical site infections in canines following clean orthopedic stifle surgery. Medical records of dogs undergoing unilateral, clean orthopedic stifle procedures were retrospectively examined for development of post-operative surgical site infections. Data collected for statistical analysis included age, sex, body weight, current medications, anesthesia and surgery times, white blood cell count, and neutrophil count. Surgical site infections were identified in 8.7% (34/390) of stifle procedures- 8.0% (29/364) in dogs not treated with oclacitinib and 19.2% (5/26) in dogs treated with oclacitinib (p = 0.053). There was a significant difference in development of surgical site infection in dogs with longer anesthesia times (p = 0.003) and higher body weights (p = 0.037). Dogs being treated with oclacitinib at the time of clean, orthopedic stifle surgery did not have a significantly higher incidence of surgical site infections. However, client education regarding risk of infection and increased patient monitoring post-operatively are recommended, especially in patients with increased body weight or longer anesthetic times.

Aging-Aware Timing Model of CMOS Inverter: Path Level Timing Performance and Its Impact on the Logical Effort

A static timing analysis (STA) methodology based on an effective current source model (ECSM) is proposed for the first time for estimating the aging aware path-level timing performance and its impact on the logical effort of a CMOS inverter for digital timing closure in pre-stress and post-stress conditions. Degradation in the threshold voltage (Vth) of PMOS occurs due to temporal variability mechanisms (aging), such as negative bias temperature instability, resulting in delay degradation of a standard cell. Therefore, we proposed a technique to make the STA process aware of this degradation by developing device-level variation aware (with aging) timing models of CMOS inverters to represent threshold-crossing points (TCPs) in an ECSM.libs file as a function of stress time (t). A device-level approach for Vth degradation into different aging conditions, such as static and dynamic, is developed for a given process design kit to update TCPs in a (.libs) file as a function of t. A python-based tool is being developed to estimate the path-level timing performance of digital circuits in pre-and post-stress conditions. Again, we developed a technique for relating the inverter’s logical effort with t to resize a near-critical path in pre-stress conditions for achieving digital timing closure in pre-and post-stress conditions. The verification and validation of the proposed model with different benchmark circuits are performed using a parasitic extracted netlist in Eldo SPICE environment with 65 nm CMOS process technology. Finally, our model reduces the number of SPICE/Stress simulations by 98.13% compared to the previously reported only simulation-based techniques.

Physical, Psychological and Social Effects of Mobile Phone Use in Children: A Prospective Cohort Study

The screen whether it is mobile, computer and tablet is a symbol of our modern age. For our children the” digital natives” who have grown up surrounded by digital information and entertainment on screens. Screen Time has become major part of contemporary life. There has been growing concern about the impact of screens on children and young people’s health. So, we plan to study the pattern of mobile phone use and reason behind the mobile use along with the various effects of mobile phones amongst the urban children and follow up after 3 months. Physical inactivity and sedentary behavior have been independently associated with wide range of negative health indicator including obesity, poor cardio metabolic and psycho social health. Total sedentary time can be classified by variety of specific sedentary behavior such as reading, playing quietly, watching television. Mobile phones use which comes under screen time takes almost 1/3rd of total sedentary time. Mobile phone use has become the major part of screen time use. Pediatric organizations recommend no more than 1-2 hour of daily screen time for age 2-5 years and discourage screen time below 2 years of age. Our aim is to systematically examine the pattern of mobile phone use and reason behind the use along with the effect on children in urban population and follow up after 3 months either in person or telephonically.

Compassionate Society

India’s economic growth story of the past two decades has a recurrent theme, of accentuating insecurities for millions. Yet, there is a deep divide over how to distribute the fruits of its economic growth. How best to plough back the gains to achieve equality and social protection for everyone? Despite India’s status as a middle-income country, close to 350 million people live in absolute poverty. According to an affidavit presented to the Supreme Court in 2011, an estimated 30 percent of the people are poor. This calculation was based on the Tendulkar Committee Report; a government body tasked with the definition of an adequate poverty line for India. A great deal of debate followed thereafter, on this definition; screening the more critical questions. How do these 350 million people survive on INR 32 per person per day in urban areas and INR 26 per person per day in rural areas? how do they find resources in times of illness, old age, disability and death? And how can they protect themselves from slipping into deeper poverty?

Evaluation of Salivary Alkaline Phosphatase Levels in Passive Smokers of Different Age Groups.

Background The smoke inhaled by a nonsmoker from the smoldering end of a cigarette is referred to as passive smoke. The nicotine present in smoke is known to cause tissue damage and alter the enzymatic composition of the body. Alkaline phosphatase (ALP) is a group of intracellular hydrolytic enzymes known to partake in cellular metabolism. ALP levels are affected by smoking as well as passive smoking (PS) with a change in the pH of the oral cavity. The association of salivary alkaline phosphatase (S-ALP) levels in different age groups, gender, and times of exposure is not thoroughly explored yet, which was the primary aim of this study. Material and methods A total of 64 samples were collected from passive smokers and non-smokers. Unstimulated saliva (2-2.5 mL) was collected from each subject after obtaining their consent, followed by centrifuging and mixing with ALP reagent in a semi-autoanalyzer to obtain the S-ALP levels. Results Higher S-ALP levels were seen in passive smokers (34.70 IU/L) compared to healthy individuals (12 IU/L), which came to be statistically significant (p<0.01). S-ALP levels, when compared to different age groups and gender, were statistically insignificant (p>0.05). However, higher levels were seen in association with time of exposure in passive smokers where the data was statistically significant (p<0.01), suggesting tissue damage possibly due to oxidative stresses and tissue inflammation on continuous exposure for a minimum of 30-60 minutes daily as per our study. Conclusion Significantly high levels of S-ALP were found in passive smokers in comparison to non-smokers. This suggests that passive smoking has negative effects on the body tissues. Age, gender, and time of exposure of a non-smoker to tobacco smoke can lead to alterations in S-ALP levels. High levels of S-ALP were seen in individuals with prolonged exposure to tobacco smoke on a daily basis. Salivaomics can thus be used as a non-invasive, economical, and accurate alternative in tissue damage diagnosis.

About this title - Ice Ages, Climate Dynamics and Biotic Events: the Late Pennsylvanian World

The Middle through Late Pennsylvanian was a time of ice ages, climate dynamics and a turning point in terrestrial biotic evolution. This provides a laboratory for studying changes in a glacial world. This book focuses on a dynamic Late Pennsylvanian world that bears close comparison to the late Cenozoic world.

Gestational age-related changes in relaxation times of neonatal brain by quantitative synthetic magnetic resonance imaging.

This study aimed to explore the correlation between T1 and T2 relaxation times of synthetic MRI (SyMRI) and gestational age (GA) in each hemisphere of preterm and term newborns at the initial 28 days of birth. Seventy preterm and full-term infants were prospectively included in this study. All subjects completed 3.0 T routine MRI and SyMRI (MAGiC) one-stop scanning within 28 days of birth (aged 34-42 W at examination). The SyMRI postprocessing software (v8.0.4) was used to measure the T1 and T2 relaxation values of each brain region. The linear regression equations of quantitative relaxation values with GA were established to compare the variation speed in each brain region. A significant linear and negative correlation was found between relaxation times and GA in the neonate cerebral cortex and subcortical gray and white matter regions (All p<.05). The relaxation time of the left centrum semiovale decreased with maximum variance with increasing GA among all white matter regions (T1: b = -51.45, β = -0.65, p < .0001; T2: b = -8.77, β = -0.71, p < .0001), whereas the right posterior limb of internal capsule showed minimal variance (T1: b = -27.94, β = -0.60, p < .0001; T2: b = -3.25, β = -0.68, p < .0001). Among all gray matter regions, the right globus pallidus and thalamus indicated the most significant decreasing degree of T1 and T2 relaxation values with GA (right globus pallidus T1: b = -33.14, β = -0.64, p < .0001; right thalamus T2: b = -3.94, β = -0.81, p < .0001), and the right and left occipital lobes indicated the least significant decreasing degree of T1 and T2 relaxation values with GA, respectively (right occipital lobes T1: b = -11.18, β = -0.26, p = .028; left occipital lobes T2: b = -1.22, β = -0.27, p = .024). SyMRI could quantitatively evaluate the linear changes of T1 and T2 relaxation values with GA in brain gray and white matter of preterm and term neonates.

COVID-19 Vaccine Rollout Plans Should Consider Spatial Distribution of Age-Specific Population

In the early phases of COVID-19 vaccine distribution, most countries adopted age-based rollout plans due to vaccine shortages. The plans, however, might overlook different spatial distributions of each age group. In this study, we first examine separate spatial accessibility to vaccine sites varying by different age groups, transportation modes, and times to find differences in spatial patterns of accessibility scores based on the enhanced two-step floating catchment area method. We also investigate spatial inequality in measured accessibility through the Gini coefficient. Finally, we scrutinize to what extent spatial accessibility to vaccine sites is overestimated or underestimated by different age groups. Results showed that there is spatial disparity in accessibility scores between the total population and multiple age-stratified groups. We also found that transportation modes play a significant role in determining spatial patterns of accessibility to vaccine locations, whereas time was not a major factor making differences in spatial accessibility patterns. Our findings suggest that vaccine rollout plans should incorporate age-specific population distribution to maximize accessibility and minimize spatial disparity.

Sex Differences in Marathon Running: Physiology and Participation

ABSTRACT Introduction Males are faster than females in the marathon, largely due to sex differences in physiology, but sociological factors influencing lower participation rates of females than males may also contribute. Purpose This study aimed to determine whether the sex difference in marathon performance is predicted by the proportion of male to female runners and how this prediction changes among lower-placed runners across age groups. Methods The number of male and female finishers within 5-yr age groups (20–79 yr) and times of the first 10 age-group runners in the Chicago (CHI; 1996–2018) and New York City (NYC; 1980–2019) marathons were analyzed. Results The male/female participation ratio declined across years for the CHI (1996–2018: 2.19–1.16, P &lt; 0.001) and NYC (1980–2019: 6.76–1.36, P &lt; 0.001) marathons, but increased with age (P &lt; 0.001) and place (1st–10th place, P &lt; 0.001). Male runners were faster than female runners across all age groups for the CHI (17.2% ± 6.8%, n = 2328) and NYC (18.8% ± 7.4%, n = 4226) marathons. The sex difference in performance was smallest for 1st-place and largest for 10th-place finishers for both marathons. The ratio of the number of male to female runners was associated with the sex difference in velocity for NYC (r 2 = 0.32, P &lt; 0.001) and CHI (r 2 = 0.28, P &lt; 0.001). The strength of the associations increased between 1st and 10th places. Conclusions Fewer female relative to male runners in an age group predicted a larger sex difference in performance in two world-class marathons. Low participation rates of female runners mask an accurate understanding of the sex differences in marathon performance due to physiology, with broader implications for women’s health in biomedical research.

Slowest first passage times, redundancy, and menopause timing.

Biological events are often initiated when a random "searcher" finds a "target," which is called a first passage time (FPT). In some biological systems involving multiple searchers, an important timescale is the time it takes the slowest searcher(s) to find a target. For example, of the hundreds of thousands of primordial follicles in a woman's ovarian reserve, it is the slowest to leave that trigger the onset of menopause. Such slowest FPTs may also contribute to the reliability of cell signaling pathways and influence the ability of a cell to locate an external stimulus. In this paper, we use extreme value theory and asymptotic analysis to obtain rigorous approximations to the full probability distribution and moments of slowest FPTs. Though the results are proven in the limit of many searchers, numerical simulations reveal that the approximations are accurate for any number of searchers in typical scenarios of interest. We apply these general mathematical results to models of ovarian aging and menopause timing, which reveals the role of slowest FPTs for understanding redundancy in biological systems. We also apply the theory to several popular models of stochastic search, including search by diffusive, subdiffusive, and mortal searchers.

Amyloid-β accumulation in relation to functional connectivity in aging: A longitudinal study

The brain undergoes many changes at pathological and functional levels in healthy aging. This study employed a longitudinal and multimodal imaging dataset from the OASIS-3 study (n = 300) and explored possible relationships between amyloid beta (Aβ) accumulation and functional brain organization over time in healthy aging. We used positron emission tomography (PET) with Pittsburgh compound-B (PIB) to quantify the Aβ accumulation in the brain and resting-state functional MRI (rs-fMRI) to measure functional connectivity (FC) among brain regions. Each participant had at least 2 to 3 follow-up visits. A linear mixed-effect model was used to examine longitudinal changes of Aβ accumulation and FC throughout the whole brain. We found that the limbic and frontoparietal networks had a greater annual Aβ accumulation and a slower decline in FC in aging. Additionally, the amount of the Aβ deposition in the amygdala network at baseline slowed down the decline in its FC in aging. Furthermore, the functional connectivity of the limbic, default mode network (DMN), and frontoparietal networks accelerated the Aβ propagation across their functionally highly connected regions. The functional connectivity of the somatomotor and visual networks accelerated the Aβ propagation across the brain regions in the limbic, frontoparietal, and DMN networks. These findings suggested that the slower decline in the functional connectivity of the functional hubs may compensate for their greater Aβ accumulation in aging. The Aβ propagation from one brain region to the other may depend on their functional connectivity strength.

Sex and Age Differences in Association between Physical Activity and Metabolic Syndrome: Results from NHANES 2003-2006.

To examine whether and how sex and age modify the association between accelerometer-based physical activity (PA) and metabolic syndrome (MetS) among American (US) adults. Adults aged ≥20 years old who participated in the mobile center examination during 2003-2006 in the National Health and Nutrition Examination Survey were included for analysis. The total minutes per day of moderate-to-vigorous PA (MVPA) was estimated using ActiGraph. Multivariable logistic regression was used to estimate the odds ratio (OR) of having MetS at an increasing MVPA time. The modification effects of gender and age on the association between MetS and MVPA time were examined by testing for two-way and three-way interaction terms of MVPA time, sex, and age in the model after adjusting for relevant covariates. The prevalence of MetS generally decreased with the MVPA time and was lower in females than in males, although the sex difference varied across age groups. After adjusting for demographic and lifestyle covariates, there was a significant sex difference in how an increased MVPA time lowered the odds of MetS. This interactive effect also varied with age. MVPA benefitted young and middle-age populations up until about 65 years old for both sexes, and the protective effect weakened with age. Although the effect of MVPA was stronger for males than females at young ages, the rate at which it attenuated was quicker in males. The OR of MetS between males and females per unit change of MVPA time was 0.73 (95% CI: [0.57, 0.93]) at age = 25 years, compared to OR = 1.00 (95% CI: [0.88, 1.16]) at age = 60 years. Before the age of 50, the gender difference in the protective effect on MetS was larger at low MVPA levels and became smaller at higher MVPA levels. The male advantage was quite stable with an increasing MVPA time for ages 50-60, and no longer significant at older ages. Young and middle-age populations benefitted from MVPA, lowering the risk of MetS for both sexes. A longer MVPA time was associated with a greater decrease in the risk of MetS in young men than in women, but the sex difference reduced with age and was no longer apparent in older populations.

Beards and Texts. Images of Masculinity in Medieval German Literature

Beards and Texts. Images of Masculinity in Medieval German Literature

MP19-10 FEASIBILITY AND COMPLICATIONS OF OUTPATIENT ROBOTIC RADICAL PROSTATECTOMY WITH LYMPH NODE DISSECTION

You have accessJournal of UrologyCME1 Apr 2023MP19-10 FEASIBILITY AND COMPLICATIONS OF OUTPATIENT ROBOTIC RADICAL PROSTATECTOMY WITH LYMPH NODE DISSECTION Spencer Liem, Dhaval Jivanji, Timothy Demus, Shuwei Peter Chang, Shimron Brown, and Jorge Pereira Spencer LiemSpencer Liem More articles by this author , Dhaval JivanjiDhaval Jivanji More articles by this author , Timothy DemusTimothy Demus More articles by this author , Shuwei Peter ChangShuwei Peter Chang More articles by this author , Shimron BrownShimron Brown More articles by this author , and Jorge PereiraJorge Pereira More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003244.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer is one of most common cancers in men. Outpatient robotic radical prostatectomy (RRP) is currently a topic of interest because of its ability to minimize costs while minimizing complications. However, few studies have analyzed the differences in outpatient RRP in patients undergoing concurrent lymph node dissections (LND) versus those without. As such, we compare the complication rates of inpatient versus outpatient RRP both with and without LND. METHODS: Using the National Surgical Quality Improvement Program Database (NSQIP), we identified total RRP with and without LND by current procedural terminology code, and reported patient co-morbidities, intra-operative or post-operative complications, and 30-day complication events from 2010-2020. We further divided this data into inpatient and outpatient surgeries. RESULTS: Between 2010-2020, a total of 79381 RRP were performed, 98.2% inpatient and 1.7% outpatient, of which 50% and 54% had LND respectively. Comparing patients undergoing outpatient RRP with LND versus those without LND, patients with LND had an average age of 63±7 years while patients without LND averaged 62±7 years. Mean operative time was 180.5±63.2 minutes and 187.6±72.9 minutes respectively. Patients undergoing outpatient RRP with LND were less likely to have an active smoking history (7.5% vs. 10.7%), or a history of hypertension (45.1% vs. 50.6%) but had higher rates of sepsis (0.8% vs. 0%) and superficial incisional infection (1.4% vs. 0.2%) when compared those without LND. All other complications and 30-day events such as unplanned readmission, reoperation rates, and mortality were similar in both groups. CONCLUSIONS: Patients undergoing outpatient RRP with LND had similar overall age and operative times as outpatient RRP without LND. Patients that had outpatient RRP with LND were less likely to have an active smoking history and hypertension but had higher rates of sepsis and superficial incisional infections. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e268 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Spencer Liem More articles by this author Dhaval Jivanji More articles by this author Timothy Demus More articles by this author Shuwei Peter Chang More articles by this author Shimron Brown More articles by this author Jorge Pereira More articles by this author Expand All Advertisement PDF downloadLoading ...

Idiopathic Hypersomnia: Neurobiology, Diagnosis, and Management

Idiopathic hypersomnia is a chronic neurologic sleep disorder that manifests as excessive daytime sleepiness despite normal or prolonged sleep times for age. Frequently, idiopathic hypersomnia is clinically characterized by marked sleep inertia, long and unrefreshing naps, and a high sleep efficiency. Since the initial description, there has been an ongoing evolution of its nomenclature, approach to diagnosis, characterization of symptoms, and determination of the burden of disease. In addition, an increased attention to and study of its epidemiology, neurobiology, and potential therapeutic strategies has begun to contribute to a better approach to identifying and treating it. At present, idiopathic hypersomnia is considered an orphan disease with unknown frequency and the cause is unknown; however, there is evidence to suggest circadian and sleep structure differences, structural brain changes, and neurochemical changes may contribute to the development and expression of this disease. The approach to treatment can be challenging owing to a limited number of approved treatments (calcium, magnesium, potassium, and sodium oxybates) in idiopathic hypersomnia. However, consideration of therapies shown to improve excessive daytime sleepiness in other disorders is frequently employed. Future directions require a clear consensus on the defining characteristics of idiopathic hypersomnia to enhance the opportunity for improved recognition, diagnosis, and treatment strategies to be established. This article provides a historical review of the evolving diagnostic classification of idiopathic hypersomnia, potential insights to the underlying pathophysiology, and a summary of proposed approaches for diagnosis and therapeutic intervention.