Search

Introduction and Hypothesis: The objective was to assess intraoperative and postoperative complication rates, along with perioperative and surgical outcomes, following single-port robotics-assisted sacrocolpopexy. Methods: This retrospective case series included 200 patients who underwent single-port robotics-assisted sacrocolpopexy to treat Pelvic Organ Prolapse Quantification (POPQ) stage 2–4 symptomatic prolapse between April 2020 and August 2023 by a single surgeon. Intraoperative and postoperative complications and perioperative outcomes were evaluated for all the patients, whereas surgical outcomes for 74 patients were assessed at 1-year follow-up. Surgical failure was defined as the presence of any of the following: the presence of vaginal bulging symptoms, any prolapse beyond the hymen, or retreatment for prolapse. Results: During the study period, 200 single-port robotics-assisted sacrocolpopexies were performed. The median age and body mass index were 65.0 years and 24.6 kg/m2 respectively. Most patients had POPQ stage 3 or 4 prolapse and underwent concomitant total hysterectomy. The median total operation time was 212.0 min, and none of the patients required conversion to laparoscopy or laparotomy. The intraoperative cystotomy rate was 2.5%, and one patient had a blood transfusion owing to presacral vessel injury. Postoperative complications of mesh exposure and wound hernia were 0.5% and 2.0% respectively. At 1 year postoperatively, the rate of composite surgical failure was 9.5%, with a 5.4% anatomical recurrence rate. None of the patients experienced apical prolapse recurrence, and one received anterior colporrhaphy for anterior compartment prolapse recurrence. Conclusions: Single-port robotics-assisted sacrocolpopexy is safe and effective, with low complication rates and favorable perioperative and surgical outcomes. [ABSTRACT FROM AUTHOR]

Abstract This study explores the relationship between users and avatars, focusing on the degree of facial resemblance and the realism of fashion items as the main factors of avatar self-integration that affect consumers’ behavioral intentions. Through a contactless survey, this study empirically identified how avatar–user resemblance and fashion item realism influence consumers’ future spending intention on virtual fashion items and the continuous usage intention of the metaverse by mediating psychological identification. We also demonstrate the moderating role of users’ self-monitoring of the effect of avatar–user resemblance on psychological identification. We found a positive mediation role of psychological identification between avatar–user resemblance, fashion item realism, and users’ consumption intentions. Additionally, a higher self-monitoring tendency strengthens the positive effect of avatar–user resemblance on psychological identification. The study establishes an academic basis for metaverse retailing by uncovering connections between predictors contributing to users’ consumption intentions in the metaverse. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a prediction model for bothersome stress urinary incontinence after prolapse surgery and to compare it with an existing clinical prediction model (CUPIDO model). Design: Retrospective cohort study. Setting: Two tertiary hospitals in South Korea. Population: A total of 1142 patients who underwent prolapse surgery with or without a concomitant midurethral sling. Methods: To construct a prediction model, we performed logistic regression using both exhaustive and stepwise variable selection, validating the model both internally and externally. Main Outcome Measures: Bothersome stress urinary incontinence defined as the presence of bothersome symptoms of stress urinary incontinence and/or subsequent continence procedure one year after surgery. Results: Postoperative bothersome stress urinary incontinence occurred in 10% of patients. A model containing six predictors (age, diabetes mellitus, subjective urinary incontinence, prolapse reduction stress test result, type of prolapse surgery, and a concomitant midurethral sling) showed excellent performance for predicting bothersome stress urinary incontinence (area under the curve 0.74, 95% confidence interval 0.62–0.86) and outperformed the CUPIDO model (area under the curve 0.63, 95% confidence interval 0.49–0.76; DeLong's test P = 0.014). Conclusions: This prediction model might be a useful tool to guide patient decision making regarding a concomitant continence procedure at the time of prolapse surgery. The predictive value of this model needs to be validated further in cohorts with different characteristics. The proposed prediction model for bothersome stress urinary incontinence after prolapse surgery outperforms an existing model. The proposed prediction model for bothersome stress urinary incontinence after prolapse surgery outperforms an existing model. Linked article This article is commented on by J. Marinus van der Ploeg & Ewout W. Steyerberg, pp. 1165 in this issue. To view this minicommentary visit https://doi.org/10.1111/1471-0528.17067. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The aim of this study was to evaluate the impact of an adjuvant posterior repair (PR) on treatment outcomes of native tissue apical suspension. Materials and methods: This retrospective cohort study included 194 women who underwent iliococcygeus or uterosacral ligament suspension with or without PR for Pelvic Organ Prolapse Quantification (POPQ) stage 2–4 posterior vaginal wall prolapse that resolved under simulated preoperative apical support and who completed a 1-year follow-up. The primary outcome was composite surgical failure defined as the presence of vaginal bulge symptoms, descent of the vaginal apex more than one-third of the way into the vaginal canal (apical recurrence), anterior or posterior vaginal wall descent beyond the hymen (anterior or posterior recurrence), or retreatment for prolapse. Secondary outcomes included anatomical outcomes, perioperative outcomes, obstructed defecation, dyspareunia, and adverse events. Results: One hundred thirty women underwent concomitant PR, and 64 did not. Surgical failure rates were significantly higher in the group not receiving PR than in the group receiving PR (29.7% vs. 12.3%, p < 0.01). Anatomically, anterior and apical recurrence was more common in the group not receiving PR (p < 0.05). Concomitant PR was associated with a longer operating time and more blood loss (p < 0.01). However, there were few adverse events related to PR, and the rates of de novo obstructed defecation and dyspareunia were low in both groups, with no significant difference between the groups. Conclusion: Concomitant PR at the time of native tissue apical suspension may reduce the recurrence of symptomatic anterior and apical prolapse without significant morbidity. [ABSTRACT FROM AUTHOR]

Concomitant apical suspension should be performed at the time of hysterectomy for uterine prolapse to reduce the risk of recurrent prolapse. Native tissue repair (NTR) and sacrocolpopexy (SCP) are commonly used apical suspension procedures; however, it remains unclear which one is preferred. This study aimed to compare the treatment outcomes of NTR and SCP in terms of surgical failure, complication and reoperation rates. Surgical failure was defined as the presence of vaginal bulge symptoms, any prolapse beyond the hymen, or retreatment for prolapse. This retrospective cohort study included 523 patients who had undergone NTR (n = 272) or SCP (n = 251) along with hysterectomy for uterine prolapse and who had at least 4-month follow-up visits. During the median 3-year follow-up period, the surgical failure rate was higher in the NTR group (21.3% vs 6.4%, P < 0.01), with a low rate of retreatment in both groups. Overall complication rates were similar, but complications requiring surgical correction under anesthesia were more common in the SCP group (7.2% vs 0.4%, P < 0.01). As a result, the total reoperation rate was significantly higher in the SCP group (8.0% vs 2.6%, P = 0.02). Taken together, NTR may be a preferred option for apical suspension when hysterectomy is performed for uterine prolapse. [ABSTRACT FROM AUTHOR]

Ticks are vectors of disease‐causing pathogens and are found on domestic and wild animals; thus, they are also vectors of significant human diseases. For this reason, pre‐emptive measures to prevent tick‐borne diseases are necessary in the form of exploring their major habitats, population increase period, and factors affecting their population growth, all of which indicate the purpose of this study. In the study, a variation of Haemaphysalis longicornis, a major vector of fever‐causing conditions, was statistically analyzed to identify the spatial and climatic factors affecting the time‐dependent variations of its population. The survey occurred in different habitats (grassland, mixed forest, deciduous forest, and coniferous forest) in South Korea. In addition, we fitted a phenology model by using a probability function to find the peak occurrence time annually. As a result, the numbers of adults and nymphs were found to be related to temperature and relative humidity and their population peaked at the end of May in all habitats except deciduous forests. This study is expected to provide information on habitat types, times, and climate patterns that require attention to help control H. longicornis populations. [ABSTRACT FROM AUTHOR]

Background: Postoperative urinary retention (POUR), a common condition after prolapse surgery with potential serious sequelae if left untreated, lacks a clearly established optimal timing for catheter removal. This study aimed to develop and validate a predictive model for postoperative urinary retention lasting > 2 and > 4 days after prolapse surgery. Methods: We conducted a retrospective review of 1,122 patients undergoing prolapse surgery. The dataset was divided into training and testing cohorts. POUR was defined as the need for continuous intermittent catheterization resulting from a failed spontaneous voiding trial, with passing defined as two consecutive voids ≥ 150 mL and a postvoid residual urine volume ≤ 150 mL. We performed logistic regression and the predicted model was validated using both training and testing cohorts. Results: Among patients, 31% and 12% experienced POUR lasting > 2 and > 4 days, respectively. Multivariable logistic model identified 6 predictors. For predicting POUR, internal validation using cross-validation approach showed good performance, with accuracy lasting > 2 (area under the curve [AUC] 0.73) and > 4 days (AUC 0.75). Split validation using pre-separated dataset also showed good performance, with accuracy lasting > 2 (AUC 0.73) and > 4 days (AUC 0.74). Calibration curves demonstrated that the model accurately predicted POUR lasting > 2 and > 4 days (from 0 to 80%). Conclusions: The proposed prediction model can assist clinicians in personalizing postoperative bladder care for patients undergoing prolapse surgery by providing accurate individual risk estimates. [ABSTRACT FROM AUTHOR]

Simple Summary: Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer, but effective biomarkers has yet been developed. Here, we identified ATP1A1 as prognostic marker and therapeutic target via integrated analysis of DNA methylome and transcriptome of TNBC. These data will provide new insight into not only developing specific biomarker for TNBC but also understanding TNBC pathogenesis. Dysregulated DNA methylation in cancer is critical in the transcription machinery associated with cancer progression. Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype, but no treatment targeting TNBC biomarkers has yet been developed. To identify specific DNA methylation patterns in TNBC, methyl-binding domain protein 2 (MBD) sequencing data were compared in TNBC and the three other major breast cancer subtypes. Integrated analysis of DNA methylation and gene expression identified a gene set showing a correlation between DNA methylation and gene expression. ATPase Na+/K+-transporting subunit alpha 1 (ATP1A1) was found to be specifically hypomethylated in the coding sequence (CDS) region and to show increased expression in TNBC. The Cancer Genome Atlas (TCGA) database also showed that hypomethylation and high expression of ATP1A1 were strongly associated with poor survival in patients with TNBC. Furthermore, ATP1A1 knockdown significantly reduced the viability and tumor-sphere formation of TNBC cells. These results suggest that the hypomethylation and overexpression of ATP1A1 could be a prognostic marker in TNBC and that the manipulation of ATP1A1 expression could be a therapeutic target in this disease. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer is a heterogeneous disease that has complex causes and mechanisms of development. Currently, patient treatment options depend on the breast cancer molecular subtype, which is classified based on the presence or absence of hormone receptors and HER2. However, this classification system has limitations in terms of predicting responsiveness to anticancer drugs and patient outcomes. In this study, we present a new approach to classifying molecular breast cancer subtypes: it is based on changes in histone modifications in the promoter region of the MAGEA12 locus, which we found related closely to MAGEA12 expression and MAGEA12-associated malignancy of breast cancer cells. After decades-long efforts to diagnose and treat breast cancer, the management strategy that has proved most successful to date is molecular-subtype-specific inhibition of the hormone receptors and HER2 that are expressed by individual cancers. Melanoma-associated antigen (MAGE) proteins comprise >40 highly conserved members that contain the MAGE homology domain. They are often overexpressed in multiple cancers and contribute to cancer progression and metastasis. However, it remains unclear whether the biological activity arising from MAGE gene expression is associated with breast cancer subtypes. In this study, we analyzed the RNA-sequencing (RNA-seq) data of 70 breast cancer cell lines and found that MAGEA12 and MAGEA3 were highly expressed in a subset of these lines. Significantly, MAGEA12 and MAGEA3 expression levels were independent of hormone receptor expression levels but were closely associated with markers of active histone modifications. This indicates that overexpression of these genes is attributable to epigenetic deregulation. RNA-seq of MAGEA12-depleted cells was then used to identify 382 candidate targets of MAGEA12 that were downregulated by MAGEA12 depletion. Furthermore, our gain-of-function experiments showed that MAGEA12 overexpression promoted aggressive behaviors of malignant breast cancer cells, including enhancing their cell migration and invasion. These changes were associated with increased epigenetic deregulation of the MAGEA12 signature genes. Thus, MAGEA12 may play an important role in breast cancer malignancy. Taken together, our findings suggest that MAGEA12 could be a promising therapeutic target in breast cancer, and its overexpression and epigenetic changes could serve as subtype classification biomarkers. [ABSTRACT FROM AUTHOR]

Singapora shinshana is a leafhopper native to mid‐Asia with a specific host range and is one of the least studied species within the genus. Recently, the species has been found to cause significant damage to host plants including ornamental trees, normally inflicted by its sucking behavior. This study uncovered more details on host and season preference of S. shinshana, damage potential and symptoms caused by its feeding behavior on ornamental trees in Korea, in addition to other records of other leafhoppers of economic importance. During the sticky trap survey period from 2017 to 2019, 12 leafhopper species were recovered from the eight selected ornamental tree species. Singapora shinshana was the most dominant species, constituting 94.8% of the total collected leafhopper population; with its highest incidence observed on Prunus serrulata, followed by Elaeagnus umbellata and Pseudocydonia sinensis. The high abundance on P. serrulata correlated with high damaged leaf percentages of 94.2%, 95.2%, and 98.1% in October 2017, 2018, and 2019, respectively. Interestingly, in terms of damaged leaf percentage, Rosa hybrida and Zelkova serrata were the second and third most damaged hosts despite the significantly lower population of the leafhopper on these trees. Furthermore, S. shinshana counts increased from late‐July to late‐September, with the peak evident during early August. Prunus serrulata can therefore be taken as one of the main host plants of S. shinshana. However, the potential of the host to suffer damage is not limited to population densities of the pest alone but also susceptibility and tolerance of the host plant. [ABSTRACT FROM AUTHOR]

The sole purpose of the mammary gland is the production of milk and during lactation more than 95% of the mRNA in secreting epithelial cells is contributed by less than 10 genes. Control relays regulating these genes are characterized by two astounding features, their ability to activate expression more than 10,000-fold during pregnancy and prevent regulatory spillover to neighboring genes. Studies in our laboratory focus on the critical roles of the common cytokine-inducible transcription factor (TF) STAT5 and the chromatin factor CTCF in the establishment of mammary-specific enhancers and the organization of regulatory chromatin domains that prevent regulatory spillover of these powerful enhancers to neighboring genetic loci. Through ChIP-seq experiments we defined the entirety of mammary enhancers in the mouse genome. These enhancers are characterized by the presence of H3K27ac and the joint binding of the TFs STAT5, GR, NFIB and MED1. CRISPR/CAS9 gene editing in mice was used to explore the role of defined STAT5 binding sites in the establishment and function of mammary-specific enhancers. Notably, STAT5 is the pioneer factor in the establishment and function of a subset of mammary enhancers. CTCF ChIP-seq experiments established putative chromatin boundaries of mammary-specific genetic islands. Using CRISPR/CAS9 CTCF sites within and surrounding mammary-specific islands were mutated in mice and their functional significance in establishing mammary-restricted gene regulation was investigated. [ABSTRACT FROM AUTHOR]

Psychological sense of community within psychosocial rehabilitation clubhouse programs was examined using concept mapping with 18 members and 18 staff from 10 programs. Members identified four concepts: Recovery, social connections, membership, and tasks and roles. Members described hope and healing as aspects of recovery. Members' views on sense of community focused on the rehabilitation and social nature of the program. Staff also identified four concepts: Affiliation and support for members, shared experiences, clubhouse organization, and task and roles. The staff concept of clubhouse organization, which incorporated the ideas of leadership and organization of physical space and the concept of task and roles, was based on ideas of shared responsibility and clubhouse procedures. Staffs' views on sense of community strongly reflected their formal training in clubhouse principles. The relation of these concepts to McMillan and Chavis' theoretical framework for sense of community is discussed and recommendations for practice provided. [ABSTRACT FROM AUTHOR]

Cancer metastasis is the primary cause of cancer-related death and metastatic cancer has circulating-tumor cells (CTCs), which circulate in the bloodstream before invading other organs. Thus, understanding the precise role of CTCs may provide new insights into the metastasis process and reduce cancer mortality. However, the molecular characteristics of CTCs are not well understood due to a lack of number of CTCs. Therefore, suspension cells were generated from MDA-MB-468 cells to mimic CTCs, and we investigate the microRNA (miRNA)-dependent molecular networks and their role in suspension cells. Here, we present an integrated analysis of mRNA and miRNA sequencing data for suspension cell lines, through comparison with adherent cells. Among the differentially regulated miRNA–mRNAs axes, we focus on the miR-146a-Neuropilin2 (NRP2) axis, which is known to influence tumor aggressiveness. We show that miR-146a directly regulates NRP2 expression and inhibits Semaphorin3C (SEMA3C) signaling. Functional studies reveal that miR-146a represses SEMA3C-induced invasion and proliferation by targeting NRP2. Finally, high-NRP2 is shown to be associated with poor outcomes in breast cancer patients. This study identifies the key role of the miR-146a–NRP2 signaling axis that is critical for the regulation of migration and invasion in CTC-mimicking cells. [ABSTRACT FROM AUTHOR]