Search Results (520)

Background/Objectives: This study aimed to assess the feasibility and acceptability of a 3-month health coaching intervention to promote PNF and healthy diet for men on ADT for PCa. Methods: The study was carried out via a two-armed randomized controlled trial including 40 patients with PCa at a medical center in Philadelphia. During the 3-month period, the intervention group (PNF+) received health coaching utilizing an interactive text message system, and the control group received healthy eating text messages for the same duration. The outcome variables were feasibility and acceptability. Results: The PNF+ group (n = 27) had high adherence to health coaching (82%), picture response (85%) and moderate adherence to the PNF window (69%). The intervention was rated highly acceptable with no reported A/E associated with the intervention, and most participants planning to continue in some capacity. At 3 months, the PNF+ group had numerically lower BMI (29.1) and body weight (195.2 lbs) compared to the control group (n = 13; BMI 31.6, weight 223.3 lbs). Improvements in patient-reported outcomes were observed in both groups. FACIT-F scores (higher scores indicate less fatigue) increased in the PNF+ group (43.6 to 45.2) and in the control group (42.5 to 45.5). FACT-P scores (higher scores indicate better quality of life) increased in the PNF+ group (121.3 to 125.5) but decreased slightly in the control group (121.1 to 119.8). Between-group comparisons of change from baseline showed no statistically significant differences across outcomes (all p > 0.05). Conclusions: The intervention demonstrated partial feasibility and high acceptability. It was associated with numerically lower BMI and body weight and favorable changes in patient-reported outcomes, particularly quality of life; however, no statistically significant differences were observed between groups. These findings should be interpreted cautiously given the small sample size and require confirmation in larger, adequately powered trials. Full article

The significant differences in insects trapped by pest detection lamps lead to low classification accuracy of existing models for rice pests. To address this issue, this paper proposes a small pest target detection and classification model (ViT-YOLOv5p) by integrating the YOLO backbone and Transformer module. First, the number of training samples is expanded through data augmentation during model training. Furthermore, appropriate noise data are introduced to enhance the robustness and generalization ability of the model. Before detection and classification, image cutting and stitching strategies are adopted to improve the detection accuracy of small objects. The bounding box of the pest is determined by the YOLO backbone, and the corresponding region is fed into the Transformer model to obtain the classification result. Finally, YOLOv5, Faster R-CNN, YOLOv4, and the proposed ViT-YOLOv5p are trained on the same dataset, with average detection time (ADT) and classification accuracy employed as evaluative metrics. The results show that ViT-YOLOv5p achieves the highest classification accuracy of 91.89% with an ADT of 50.41 ms. Compared with the commonly used Faster R-CNN, YOLOv5, and YOLOv4 models, the accuracy is improved by 1.50%, 8.71%, and 9.74%, respectively. This study provides a reference for agricultural pest detection, automatic insect classification systems, and deep learning-based detection of small agricultural targets. Full article

Poly(ADP-ribose) polymerase inhibitors (PARPi) have reshaped therapy for advanced prostate cancer, yet durable benefit remains concentrated in BRCA1/2-altered tumors, especially BRCA2, and most responders eventually relapse. Here, we frame PARPi response and resistance through a unifying model in which DNA damage response (DDR) rewiring (e.g., homologous recombination repair (HRR) restoration, fork protection, checkpoint tolerance, and altered drug handling) converges with treatment-induced dormancy and quiescent therapy-tolerant residual states that sustain minimal residual disease (MRD) under androgen receptor pathway inhibition (ARPI) and PARP blockade. We synthesize clinical and translational evidence for PARPi monotherapy and PARPi-based combinations across disease states. In first-line metastatic castration-resistant prostate cancer (mCRPC), PARPi plus ARPI consistently prolongs radiographic progression-free survival, with the greatest benefit in HRR-altered tumors, and emerging overall-survival signals in selected subgroups. In later-line settings, monotherapy activity is most robust in BRCA2-mutated disease, whereas non-BRCA HRR alterations show heterogeneous and often modest responses, underscoring the need for biomarkers beyond gene panels. We also discuss combination strategies with DDR-targeting agents, radioligand therapies, and immunotherapy, and summarize ongoing phase III programs in metastatic castration-sensitive prostate cancer (mCSPC). Finally, we outline practical considerations for biomarker-informed patient selection, monitoring, sequencing, and toxicity management, with particular emphasis on intercepting MRD and resistance evolution. Full article

Background: Radiotherapy (RT) combined with androgen deprivation therapy (ADT) is a standard treatment for non-metastatic high-risk (HR) prostate cancer (PC). However, the benefit of elective nodal irradiation (ENI) in clinically node-negative (cN0) patients, although suggested, remains controversial, particularly in the elderly. We report the outcomes of elderly HR PC patients treated with prostate-only RT (PORT) and ADT in a “real-word” setting. Methods: Between 2016 and 2022, 43 consecutive elderly patients (median age 76 years) with HR- or very HR-PC according to NCCN criteria version 1.2026 (cN0, cT3-cT4 and/or ISUP Grade Group 4–5 and/or PSA serum levels at diagnosis ≥ 20 ng/mL) were treated at our institution. All patients were staged with abdominal MRI or CT and bone scan; nineteen patients (44.2%) also underwent 68Ga-PSMA-11 or 18F-fluorocholine PET/CT. All patients received PORT (predominantly moderate hypofractionation, 67.5–70 Gy in 25–28 fractions) and ADT (median duration 24 months). To ensure consistency, all oncological endpoints—Biochemical Failure-Free Survival (BFFS; Phoenix criteria), Disease-Free Survival (DFS), Metastasis-Free Survival (MFS), Prostate Cancer-Specific Survival (PCSS), and Overall Survival (OS)—were calculated from a unified time-zero (initiation of first oncological treatment). DFS was defined as a composite endpoint including biochemical failure, radiological recurrence, or initiation of salvage therapy. Results: at a median follow-up of 60 months, no patient reached the Phoenix threshold, resulting in a 100% 5- and 7-year BFFS. However, 4 patients (9.3%) experienced radiological recurrence detected via PET/CT before reaching the nadir + 2 threshold, yielding an estimated 5-year and 7-year DFS of 94.7% and 71.8%, respectively. The 5- and 7-year MFS was of 97.6% and 88.7%, respectively. Seven deaths occurred, all non-PC related, resulting in a 5-year OS of 86.7% and a Prostate Cancer-Specific Survival of 100%. Gastrointestinal toxicity was notably low (no acute or late G3-G4 events). Conclusions: Our findings suggest that PORT, when combined with long-term ADT and modern staging, provides excellent disease control and a favorable safety profile in elderly HR PC patients. Given the high rate of competing mortality in this population, treatment de-escalation via PORT appears to be a clinically reasonable strategy. These results are hypothesis-generating and warrant validation in prospective randomized trials. Full article

Prostate cancer (PCa) is one of the most common malignancies in men, and growing evidence implicates the gut microbiome as a significant, modifiable contributor to disease evolution and management. Dysbiosis influences PCa biology through effects on inflammation, immune regulation, metabolism, and hormone signaling. Microbial imbalance can promote systemic inflammation and increase intestinal permeability, activating immune signaling pathways such as NF-κB–IL-6–STAT3. In parallel, microbiome-driven metabolic effects, including IGF-1 signaling and microbial androgen synthesis or recycling, may contribute to resistance to androgen deprivation therapy (ADT). Microbial metabolites, notably short-chain fatty acids (SCFAs) and trimethylamine N-oxide (TMAO), exert context-dependent effects on tumor growth, treatment resistance, and progression. Conversely, beneficial microbes have been associated with improved treatment sensitivity and immune regulation. Together, these insights support the gut microbiome as a potential biomarker and emerging therapeutic target in PCa. Modulation strategies, including diet, probiotics, antibiotics, and fecal microbiota transplantation (FMT), are being explored to improve treatment response and address resistance. As mechanistic evidence continues to grow, ongoing monitoring of the gut microbiome may help inform risk stratification and treatment optimization in prostate cancer. Full article

Background: Polysaccharide-based dynamic hydrogels are promising for wound management due to their biocompatibility, injectability, and tunable biofunctionality. The integration of therapeutic gasotransmitter donors offers a strategy to modulate the wound microenvironment. Objectives: This study aimed to develop an injectable, self-healing carbohydrate hydrogel capable of sustained hydrogen sulfide (H₂S) release for burn wound therapy, and to evaluate its physicochemical properties, in vivo efficacy, and mechanism of action. Methods: A dynamic hydrogel (ACMOD) was fabricated via Schiff-base crosslinking between oxidized dextran (OD) and carboxymethyl chitosan (CMCS), incorporating the H₂S donor 5-(4-hydroxyphenyl)-3H-1,2-dithiole-3-thione (ADT-OH). Rheological and recovery tests characterized its mechanical and self-healing properties. Efficacy and mechanisms were assessed in a rat full-thickness burn model, analyzing wound closure, histology, oxidative stress, macrophage polarization, angiogenesis, and collagen deposition. Results: ACMOD exhibited shear-thinning, rapid self-healing, and strong tissue adherence. Sustained H₂S release from ACMOD significantly accelerated wound closure and improved tissue regeneration compared to controls. Mechanistically, H₂S attenuated oxidative stress, promoted a pro-regenerative M2 macrophage phenotype, enhanced angiogenesis via VEGF upregulation, and fostered organized collagen deposition and extracellular matrix remodeling. Conclusions: This work demonstrates a versatile, carbohydrate-based dynamic hydrogel platform that synergizes polymer network dynamics with bioactive H₂S delivery to effectively promote burn wound healing. The findings underscore the potential of polysaccharide hydrogels with integrated gasotransmitter release for regenerative therapy and biomaterials applications. Full article

Prostate cancer (PCa) is a prevalent malignancy in men worldwide, and both androgen deprivation therapy (ADT) and radiotherapy (RT) are key components of its management. However, these treatments significantly affect bone health by inducing bone mineral density (BMD) loss, osteopenia, osteoporosis and increased fracture risk. ADT promotes a high bone turnover state through hormonal suppression and molecular mechanisms involving increased RANKL expression and osteoclast activation. RT generates direct cytotoxic damage and inflammatory changes that compromise bone microarchitecture. Combined ADT + RT exerts synergistic detrimental effects. This narrative review synthesizes the molecular basis, clinical evidence, preventive strategies and emerging technologies related to bone health in men with PCa undergoing ADT and/or RT. Full article

In recent years, the gut microbiome has been increasingly recognized as an important factor in regulating treatment responses and disease progression in prostate cancer (PCa). We synthesized literature published over the past five years, focusing on preclinical and clinical studies linking the microbiome to PCa treatment outcomes. There is accumulating evidence that gut microbiota dysbiosis and its associated metabolites can modulate key biological processes, such as androgen metabolism, inflammatory signaling pathways, and antitumor immune responses. These processes affect the sensitivity of PCa patients to androgen deprivation therapy (ADT) and other systemic treatments. The available evidence suggests that the gut microbiome has the potential to serve as a predictive biomarker for treatment response and could represent a novel target for interventional precision therapy in PCa. This narrative review summarizes the latest research on the “gut–prostate axis”, focusing on the role of the gut microbiome in regulating therapeutic responses in PCa and the underlying mechanisms. Finally, we address current limitations, including the predominance of preclinical evidence, methodological heterogeneity, and the critical need for longitudinal clinical validation to distinguish causality from association. Full article

Background/Objectives: Cancer is predicted to become the leading cause of premature mortality worldwide within this century. Among the hallmarks of cancer, metabolic reprogramming has received growing attention, and arginine deprivation therapy (ADT) represents a potential treatment strategy for tumors exhibiting arginine auxotrophy. Colorectal cancer cells frequently suppress the expression of argininosuccinate synthetase 1 (ASS1), rendering them dependent on extracellular arginine. However, how CRC cells adapt to and resist ADT remains largely unknown. Methods: We combined ATAC-seq and RNA-seq analyses with multiple functional assays—including CCK-8 viability, apoptosis detection, wound-healing, and transwell migration tests—to investigate the molecular basis of ADT response in cancer cells. Results: ADT markedly inhibited cancer cell proliferation (p < 0.001) and motility (p < 0.05) across three cell lines. Integrative multi-omics analyses revealed substantial chromatin remodeling and transcriptional reprogramming under ADT, with differentially expressed genes enriched in autophagy and cell-growth-related pathways. Among these, the motif CGTTTCCGGT was identified as an arginine deficiency-responsive DNA element in cancer cells, and C11orf54 showed pronounced downregulation accompanied by reduced chromatin accessibility at its genomic locus. Conclusions: These findings suggest that ADT restricts cancer cell proliferation and migration through chromatin remodeling mediated by the motif CGTTTCCGGT and the downregulation of C11orf54, identifying C11orf54 as a potential target for enhancing the efficacy of arginine deprivation therapy in cancer cells. Full article

Background/Objectives: We assessed the changes in the quality of life (QOL) of patients with localized prostate cancer who were treated with IMRT, either with or without Androgen Deprivation Therapy (ADT), using the Expanded Prostate Index Composite (EPIC). Methods: Changes in EPIC summary and subdomain scores were evaluated using longitudinal analyses at eight time points up to three years after IMRT. Results: The urinary score and four subdomain scores decreased significantly four weeks after the start of IMRT but returned to the baseline level three months after IMRT. This pattern of change remained consistent, regardless of whether ADT was administered or not. The longitudinal changes in bowel score were the same as those in the urinary score. The recovery of the bowel bother subdomain score was rapid, occurring as early as one month after IMRT. Regardless of whether ADT was administered, there was no difference in longitudinal changes in bowel scores. The sexual score remained consistently low throughout the survey period, ranging from 33 to 35. The baseline score for the sexual bother subdomain was 94.44, but the score for the sexual function subdomain was extremely low at 8.24. The hormonal score at the start of IMRT was 87.37 but increased significantly at two and three years after IMRT. The hormonal bother subdomain score decreased significantly six months after IMRT initiation but subsequently increased, becoming significantly higher three years after IMRT. Conclusions: IMRT has made it possible to minimize deterioration in the quality of life of patients with localized prostate cancer by reducing adverse events. Full article

Accurate acquisition of low-observable targets with a minimal radar cross-section (RCS) poses a significant challenge for multi-source remote sensing systems, such as integrated radar–electro-optical (REO) platforms, particularly in complex electromagnetic environments characterized by strong noise interference and a high false-alarm rate. Conventional methods, which often treat data association and fusion from heterogeneous sensors as separate, offline processes, struggle with the dynamic uncertainties and real-time decision requirements of such scenarios. To address these limitations, this paper proposes a novel Evidence–Reinforcement Learning-based Decision and Control (ERL-DC) framework. It operates through a closed-loop architecture consisting of three core modules: A static assessment model for initial target prioritization, a Dempster–Shafer (D–S) evidence-based multi-source data decision generator for dynamic information fusion and uncertainty-aware target selection, and a Deep Reinforcement Learning (DRL) controller for noise-robust sensor steering. A high-fidelity simulation environment was developed to model the multi-source data stream, encompassing radar detection with clutter and false targets, as well as the physical constraints of the electro-optical (EO) servo system. Based on the averaged results from multiple Monte Carlo simulations, the proposed ERL-DC framework reduced the Average Decision Time (ADT) from 7.51 s to 4.53 s, corresponding to an absolute reduction of 2.98 s when compared to the conventional method integrating threshold logic with Model Predictive Control (MPC). Furthermore, the Net Discrimination Accuracy (NDA), derived from the statistical outcomes across all the simulation runs, exhibited an absolute increase of 37.8 percentage points, rising from 57.8% to 95.6%. These results indicate that ERL-DC achieves a more favorable trade-off in terms of scheduling efficiency, decision robustness, and resource utilization. The primary contribution is an intelligent, closed-loop architecture that tightly couples high-level evidential reasoning for multi-source data fusion with low-level adaptive control. Within the simulated environment characterized by clutter, false targets, and angular measurement noise, ERL-DC demonstrates improved target discrimination accuracy and decision efficiency compared to conventional methods. Future work will focus on online parameter adaptation and validation on physical platforms. Full article

Background: Evidence for neoadjuvant androgen deprivation therapy (ADT) before radical prostatectomy (RP) remains inconclusive, and current guidelines do not endorse its routine use. Objective: We aimed to evaluate the impact of neoadjuvant ADT on surgical and oncologic outcomes in a Singaporean cohort undergoing radical prostatectomy. Design, setting, and participants: In this retrospective study, 1091 men underwent RP between 2013 and 2024; a total of 105 received neoadjuvant ADT and 986 did not. A 1:1 propensity score-matched analysis was performed on age, PSA, PSA density, Gleason score, clinical T-stage, and receipt of adjuvant therapies, yielding 105 matched pairs. Outcome measurements and statistical analysis: The primary outcome was biochemical recurrence (BCR). Secondary surgical outcomes included operative time, estimated blood loss, length of stay, catheter duration, and postoperative complications. Secondary oncologic outcomes included extracapsular extension, margin status, seminal vesicle invasion, lymph node involvement, clinical-to-pathological T-stage downstaging, Gleason score decrease, and PSA decrease. Kaplan–Meier survival and univariable linear and logistic regression analyses were used. Subgroup analysis was performed using stratified odds ratios to identify clinical subgroups that derived the greatest benefit from neoadjuvant ADT in terms of biochemical recurrence reduction. Results and limitations: After matching, neoadjuvant ADT was associated with a lower rate of extracapsular extension (30.8% vs. 51.4%, p = 0.004), positive surgical margins (18.4% vs. 39.4%, p = 0.002), lymph node involvement (1.0% vs. 13.0%, p = 0.002), and biochemical recurrence (4.8% vs. 18.1%, p = 0.005). There were no significant differences in operative time, blood loss, length of stay, or complication rates. Before matching, 2-year biochemical recurrence-free survival (BCR-FS) did not differ significantly (93.0% vs. 88.2%, log-rank p = 0.26), but after matching, BCR-FS favored ADT (93.0% vs. 81.8%, log-rank p = 0.02). Subgroup analysis showed that the reduction in biochemical recurrence with neoadjuvant ADT was more pronounced in patients with PSA density ≥ 0.20 ng/mL², Gleason score ≥ 8, and clinical T3 disease. Limitations include the retrospective design and potential residual confounding. Conclusions: Neoadjuvant ADT prior to RP significantly reduces locoregional spread and biochemical recurrence without increasing perioperative morbidity. Prospective trials are needed to confirm its benefit in high-risk prostate cancer. Full article

Accurate assignment of International Classification of Diseases (ICD) codes is essential for healthcare analytics, billing, and clinical research. However, manual coding remains time-consuming and error-prone due to the scale and complexity of the ICD taxonomy. While hierarchical deep learning approaches have improved automated coding, their deployment across large taxonomies raises scalability and efficiency concerns. To address these limitations, we introduce the Augmented Decision Tree (ADT) framework, which integrates deep learning with symbolic rule-based logic for automated medical coding. ADT employs an automated lexical screening mechanism to dynamically select the most appropriate modeling strategy for each decision node, thereby minimizing manual configuration. Nodes with high keyword distinctiveness are handled by symbolic rules, while semantically ambiguous nodes are assigned to deep contextual models fine-tuned from PubMedBERT. This selective design eliminates the need to train a deep learning model at every node, significantly reducing computational cost. A case study demonstrates that this hybrid and adaptive ADT approach supports scalable and efficient ICD coding. Experimental results show that ADT outperforms a pure decision tree baseline and achieves accuracy comparable to that of a full deep learning-based decision tree, while requiring substantially less training time and computational resources. Full article

Background and Objectives: The increasing number of patients with prostate cancer receiving long-term androgen deprivation therapy (ADT) underscores the importance of maintaining quality of life during treatment. Lower urinary tract symptoms (LUTS), influenced by prostate size, represent significant determinants of quality of life in this population. This study aimed to investigate the impact of ADT on LUTS in patients with prostate cancer, particularly focusing on how ADT, which reduces prostate volume (PV), affects quality of life, and to identify factors influencing changes in LUTS. Materials and Methods: The study included 104 patients with prostate cancer undergoing ADT. Changes in the International Prostate Symptom Score (IPSS), PV, maximal uroflow rate (Qmax), post-void residual urine volume (RU), and prostate-specific antigen (PSA) levels were compared before treatment initiation and at 12 and 24 weeks after treatment. Association between these variables and patient age, body mass index (BMI), Gleason score (GS), and T stage were also assessed. Results: After 12 and 24 weeks of ADT, prostate size decreased by 16.69 cm³ (32.03%) and 25.36 cm³ (48.68%), respectively, with PSA levels decreasing by 7.63 ng/mL and 22.03 ng/mL. Qmax improved by 3.19 mL/s and 5.57 mL/s, and RU decreased by 42.31 mL and 60.68 mL, respectively (p < 0.001). The IPSS decreased by 13.09 and 14.69 points at 12 and 24 weeks, respectively (p < 0.001). Notably, patients with moderate-to-severe LUTS (baseline IPSS ≥ 8) showed a significantly greater reduction in IPSS (p < 0.001). Additionally, patient age and PSA levels were significantly associated with changes in Qmax (p < 0.001). Conclusions: ADT demonstrated a positive effect on LUTS improvement in patients with prostate cancer, particularly among those with moderate-to-severe LUTS, elevated PSA levels, or older age. Full article

Background: PC is the second most common malignancy in men, and progression to metastatic castration-resistant prostate cancer (mCRPC) after androgen deprivation therapy (ADT) remains incurable. Current treatments for mCRPC include chemotherapy, immunotherapy, radiopharmaceuticals, and second-line androgen receptor signaling inhibitors (ARSIs) such as Abiraterone. PARP inhibitors (PARPis) have recently shown clinical benefits in tumors with homologous recombination repair (HRR) deficiencies, particularly BRCA1/2 mutations. Combining PARPi with ARSIs has improved progression-free (PFS) and overall survival (OS), especially in ARSI-naïve patients, but limited data exist for resistant disease. Objectives: This work focuses on intrinsically hormone-insensitive, AR-negative, BRCA-wildtype models, representing a clinically distinct population with limited therapeutic options. We thus investigated the therapeutic potential of combining Abiraterone with PARPis (Niraparib or Olaparib) in Abiraterone-resistant prostate cancer. Methods: Resistant PC3 and DU145 cell lines were analyzed using 2D and 3D cultures and cell-derived xenograft (CDX) mouse models. Results: Cytotoxicity assays revealed significantly reduced cell viability with combination therapy compared to single agents. These findings were supported by RT-qPCR, Western blot, and immunofluorescence analyses of xenograft tumors, demonstrating enhanced antitumor activity with the combination. Conclusions and significance: Overall, the results indicate that maintaining Abiraterone treatment in combination with PARPis after resistance develops provides superior therapeutic efficacy compared to PARP inhibition alone, offering a promising strategy for managing Abiraterone-resistant prostate cancer. Combining Abiraterone with PARPis enhances therapeutic efficacy and overcomes the acquired insensitivity in mCRPC with BRCA1/2 or HRR mutations. These results support continued use of PARPis with Abiraterone to improve clinical outcomes. Full article