Background COVID-19 has disrupted the 2020–2021 residency application cycle with the cancellation of away rotations and in-person interviews. This study seeks to investigate the feasibility and utility of video conferencing technology (VCT) as an opportunity for applicants to interact with faculty from outside programs. Methods 18 prospective urology applicants were randomized to 6 urology programs to give a virtual grand rounds (VGR) talk. Presentations were recorded and analyzed to determine audience engagement. Students were surveyed regarding perceived utility of VGR. Faculty were surveyed to determine system usability of VCT and ability to evaluate the applicant. Results 17 students completed the survey, reporting a 100% satisfaction rate with VGR. A majority felt this was a useful way to learn about outside programs. 85 physicians completed the faculty survey, with nearly half feeling confident in their ability to evaluate the applicant. Video transcription data shows sessions were interactive with minimal distractions. Conclusions VGR can be a useful means for medical students to express interest in programs as well as an additional marker for faculty to evaluate applicants.

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Introduction: Annually the U.S. spends approximately $55.6 billion on malpractice and medical liability, with urology ranked 11th out of 25 specialties for number of malpractice claims. Our objective was to identify common causes for filing claims associated with cystectomy as well as corresponding payout outcomes.Methods: Using the WestlawÒ legal database, a search was conducted using the keywords, "cystectomy," "cystoprostatectomy" and "bladder removal" between January 1, 1990 and January 1, 2020. Each case was evaluated for plaintiff demographics, alleged malpractice claim, defendant specialty, resulting clinical outcome, resulting legal outcome including verdict and monetary award. Alleged malpractice claims were further subdivided based on whether the claimed negligence of duty was preoperative, perioperative or postoperative. Data were analyzed using MicrosoftÒ Office ExcelÒ.Results: After accounting for irrelevant and duplicate cases the Westlaw search returned 42 unique cases. The most common indication for cystectomy was bladder cancer (69%). Preoperative negligence resulted in the highest average payout ($2,062,204.00) and accounted for 76% of filed claims, with delay in diagnosis accounting for the most common complaint (47%). Urologists made up the highest percentage of defendants sued, at 62%. Conclusions:The bulk of alleged malpractice in cystectomy cases is due to preoperative negligence, most predominantly in the delay of cancer diagnosis. Alleged cases of preoperative negligence also return the highest award for the plaintiff. This study sheds light on areas of concern that urologists should be aware of associated with cystectomy litigation.

Background: Targeted magnetic resonance (MR) with ultrasound (US) fusion-guided biopsy has been shown to improve detection of prostate cancer. The implementation of this approach requires integration of skills from radiologists and urologists. Objective methods for assessment of learning curves, such as cumulative sum (CUSUM) analysis, may be helpful in identifying the presence and duration of a learning curve. The aim of this study is to determine the learning curve for MR/US fusion-guided biopsy in detecting clinically significant prostate cancer using CUSUM analysis. Materials and methods: Retrospective analysis was performed in this institutional review board-approved study. Two urologists implemented an MR/US fusion-guided prostate biopsy program between March 2015 and September 2017. The primary outcome measure was cancer detection rate (CDR) stratified by Prostate Imaging Reporting and Data System (PI-RADS) scores assigned on the MR imaging. Cumulative sum analysis quantified actual cancer detection versus a predetermined target satisfactory CDR of MR/US fusion biopsies in a sequential case-by-case basis. For this analysis, satisfactory performance was defined as >80% CDR in patients with PI-RADS 5, >50% in PI-RADS 4, and <20% in PI-RADS 1-3. Results: Complete data were available for MR/US fusion-guided biopsies performed on 107 patients. The CUSUM learning curve analysis demonstrated intermittent underperformance until approximately 50 cases. After this inflection point, there was consistently good performance, evidence that no further learning curve was being encountered. Conclusions: At a new center implementing MR/US fusion-guided prostate biopsy, the learning curve was approximately 50 cases before a consistently high performance for prostate cancer detection.

The magnetic label did not affect the physiological characteristics of the cells and did not change identity, purity and potency (therapeutic effect in vivo) of EVs. MRI phantom studies confirmed the in vitro/ex vivo detectability of labeled-EVs. Importantly, as expected MRI studies showed that EV homing to the kidney injected intra-cardiacally into Alport mice was more efficient vs the retro-orbital route, and Prussian blue staining of sections confirmed EV homing to the kidney.CONCLUSIONS: We have developed a clinically applicable novel magnetic nanoparticle agent that can be used to label and track the biodistribution of EVs in the kidney and other organs using noninvasive, safe, and effective MRI technology that's widely available. This technology is highly adaptable and can be deployed in both preclinical and clinical settings.