Search Results (70)

Taxane chemotherapy remains a durable backbone in advanced prostate cancer, but its clinical value is increasingly determined by timing, sequencing, and deliverability. We synthesize pivotal randomized trials and contemporary guidance to provide a chemotherapy-forward framework spanning metastatic castration-sensitive prostate cancer (mCSPC) and metastatic castration-resistant prostate cancer (mCRPC). In mCSPC, early docetaxel added to androgen deprivation therapy—often as part of triplet intensification with an androgen receptor pathway inhibitor (ARPI)—offers the greatest absolute benefit in fit patients with high disease burden or aggressive clinical tempo. In mCRPC, docetaxel remains foundational, while cabazitaxel is preferred over ARPI switching after prior docetaxel and one ARPI, supporting mechanism-based sequencing. Practical implementation requires proactive toxicity prevention (especially neutropenia), dose and schedule individualization, and preservation of functional status to maintain eligibility for subsequent life-prolonging therapies. Immunotherapy has a limited but important niche: sipuleucel-T may benefit selected patients with low symptom burden, whereas immune checkpoint inhibitors are best reserved for biomarker-defined subsets such as microsatellite instability-high or mismatch repair-deficient tumors; tumor mutational burden should be interpreted cautiously in prostate cancer. Ongoing trials and emerging antigen-directed platforms will clarify whether chemotherapy can act as an immune-enabling partner in defined settings. Full article

Background: Lyotropic liquid crystal (LLC) systems provide sustained release and convenient administration for peptide delivery. Octreotide, a first-line somatostatin analogue, has previously been formulated into LLC systems mainly using the hydrochloride salt. Here, we investigated the acetate salt, which is widely used in marketed products, but presents unique challenges in LLC formulation due to poor stability. Methods: We demonstrate that pH adjustment is a critical determinant for successfully incorporating octreotide acetate into a stable LLC system. By employing 3M HCl–EtOH to adjust pH to approximately 5.7, we obtained a formulation that maintained >90% drug content after 3 months at 40 °C and >98% after 12 months at 4 °C. Results: Structural analyses confirmed the coexistence of cubic and hexagonal mesophases, supporting controlled release. In vivo pharmacokinetic studies in rats further demonstrated sustained-release behavior, as evidenced by prolonged systemic exposure and an extended half-life. Pharmacokinetic profiles were comparable to those of an octreotide hydrochloride LLC. Conclusions: These findings highlight pH modulation as an essential strategy for stabilizing octreotide acetate in LLC systems, providing a foundation for extending LLC technology to clinically relevant salt forms of peptide therapeutics. Full article

Objective: We evaluate the performance and relevance of MRI to detect csPC in men with normal PSA. Methods: Out of our database of patients referred for prostate MRI, we selected men with PSA < 4 ng/mL for whom histopathology or at least 2 years of clinical follow-up data were available as standard of reference. Subgroup analyses were performed for the patients with PSA < 3 ng/mL, <2 ng/mL, and 2–3.9 ng/mL. The reasons for prostate MRI referral despite their normal PSA level were retrieved by exploring the patients’ files. The prostate MRIs were reported according to the Prostate Imaging and Reporting Data System (PI-RADS), and the overall assessment score was registered. For evaluation of the performance, PI-RADS ≥ 3 was set as a threshold for a positive exam. The patients without PC or only International Society of Urological Pathology (ISUP) grade group 1 PC (Gleason 3+3) were considered as one category having no csPC. The performance of prostate MRI was separately evaluated for detection of ISUP ≥ 2 and for ISUP ≥ 3 csPC. Results: A total of 148 men were included, with PSA ranging from 0.42 to 3.99 ng/mL (median 2.95, IQR 1.68–3.50) and age ranging from 36 to 84 years (median 58, IQR 52–66). A total of 74 men (50.0%) had a PSA level < 3 ng/mL, 42 (28.4%) had a PSA level < 2 ng/mL, and 106 (71.6%) had a PSA level of 2–3.9 ng/mL. They were referred for prostate MRI for a wide variety, and usually a combination of, reasons, such as younger age (<60 years in 55.4%, N = 82; <50 years in 17.6%, N = 26), abnormal digital rectal examination in 31.8% of cases (N = 47), suspicious PSA dynamics in 29.7% (N = 44), positive familial history in 27.0% (N = 40), clinical signs of prostatitis in 18.2% (N = 27), suspicious findings on Transrectal Ultrasound (TRUS) in 16.9% (N = 25), hematospermia in 7.4% (N = 11), hematuria in 4.1% (N = 6), incidental hot spot in the prostate on Fluoro-Deoxy-Glucose (FDG) Positron Emission Tomography (PET)–Computed Tomography (CT) in 4.1% (N = 6), lymphadenopathies on CT in 2.7% (N = 4), or severe patient anxiety in 3.4% (N = 5). Overall, ISUP ≥ 2 PC was present in 18.9% (N = 28) of cases, and MRI detected this with a sensitivity of 92.9%, a specificity of 66.7%, and a positive predictive value of 39.4%. ISUP ≥ 3 PC was present in 9.5% (N = 14) of cases, and prostate MRI detected this with a sensitivity of 100%, a specificity of 61.2%, and a positive predictive value of 21.2%. In patients with PSA < 2 ng/mL (N = 42), no csPC was found, but MRI generated false positives in 33.3%. Conclusions: Performing prostate MRI in men with normal PSA (<4 ng/mL) seems useful if there are other reasons that increase the clinical suspicion of csPC. In about one-fifth of these patients, csPC is present and MRI has high sensitivity for its detection. Prostate MRI has, however, low positive predictive value in this patient group, and clinicians should be aware of the risk of false-positive MRI. Below a PSA level of 2 ng/mL, no csPC was found and prostate MRI generated only false positives, suggesting limited value in this subgroup. Full article

Background and Objectives: Overweight and obesity is defined as a Body Mass Index (BMI) of 25.0–29.9 kg/m² and ≥30.0 kg/m². The prognostic significance of obesity in metastatic prostate cancer is still unclear, especially between the castration-sensitive (CSPC) and castration-resistant (CRPC) disease states. New evidence suggests that obese patients who get androgen receptor–targeted therapies may have an unexpected survival advantage. This study examined the correlation between body mass index (BMI) and survival outcomes in patients administered androgen receptor pathway inhibitors. Materials and Methods: A retrospective analysis was conducted on a cohort of 167 patients with metastatic prostate cancer treated between 2015 and 2024. BMI was analyzed as both a continuous variable and a categorical variable, which was classified as normal weight, overweight or obese. The primary goal of this study is to compare PFS and OS among BMI groups. We employed Kaplan–Meier survival analysis and Cox regression modeling to evaluate prognostic indicators. The CSPC and CRPC groups were evaluated separately. Results: PFSs for normal, overweight and obese CSPC patients were 11.3, 15.1, 19.5 months, respectively; p = 0.03 but the OS did not differ significantly between BMI groups. OS for normal, overweight and obese CRPC patients were 32.8, 47.6 and 43.4 months, respectively; p = 0.01. There was also a trend toward better PFS, but it was not statistically significant. Multivariate analysis found that obesity (BMI ≥ 30) was a separate protective factor for PFS in CSPC, while high-volume disease was a bad prognostic factor for OS in CRPC. A high Gleason score and ECOG-PS 2 were consistently associated with poor outcomes. Conclusions: Obesity has a phase-dependent prognostic influence in metastatic prostate cancer, providing a PFS advantage in CSPC and an OS benefit in CRPC. These results suggest that there may be an obesity paradox in people who are getting androgen receptor–targeted therapy. Further prospective studies are required to gain a better understanding of the biological reasons for this association. Full article

Ensuring worker safety compliance and secure cargo transportation in complex port environments is critical for modern logistics hubs. However, conventional supervision methods, including manual inspection and passive video monitoring, suffer from limited coverage, poor real-time responsiveness, and low robustness under frequent occlusion, scale variation, and cross-camera transitions, leading to unstable target association and missed risk events. To address these challenges, this paper proposes CSPC-BRS, a real-time multi-object detection and tracking framework for open-channel port scenarios. CSPC (Coordinated Spatial Perception Cascade) enhances the YOLOv8 backbone by integrating CASAM, SPPELAN-DW, and CACC modules to improve feature representation under cluttered backgrounds and degraded visual conditions. Meanwhile, BRS (Bounding Box Reduction Strategy) mitigates scale distortion during tracking, and a Multi-Dimensional Re-identification Scoring (MDRS) mechanism fuses six perceptual features—color, texture, shape, motion, size, and time—to achieve stable cross-camera identity consistency. Experimental results demonstrate that CSPC-BRS outperforms the YOLOv8-n baseline by improving the mAP@0.5:0.95 by 9.6% while achieving a real-time speed of 132.63 FPS. Furthermore, in practical deployment, it reduces the false capture rate by an average of 59.7% compared to the YOLOv8 + Bot-SORT tracker. These results confirm that CSPC-BRS effectively balances detection accuracy and computational efficiency, providing a practical and deployable solution for intelligent safety monitoring in complex industrial logistics environments. Full article

Cadmium (Cd), a toxic and mobile heavy metal, poses significant risks to agricultural systems due to industrial pollution. Tea plants (Camellia sinensis L.) efficiently absorb and accumulate Cd from soil, leading to contamination in leaves. Chronic consumption of Cd-laden tea can cause severe health issues, including neurological, reproductive, and immunological disorders, as well as increased cancer risk. Despite growing concerns, the molecular mechanisms of Cd stress response in tea plants remain poorly understood. Current research highlights key physiological adaptations, including activation of antioxidant defenses and modulation of secondary metabolite pathways, which influence tea quality. Cd disrupts photosynthesis, induces oxidative stress, and alters the biosynthesis of flavor-related compounds. Several critical genes involved in Cd transport (e.g., CsNRAMP5, CsHMA3, CsZIP1), sequestration (CsPCS1), and stress regulation (CsMYB73, CsWRKY53, CsbHLH001) have been identified, offering insights into molecular responses. This review systematically examines Cd dynamics in the soil-tea plant system, its effects on growth, photosynthesis, and quality, and the physiological and biochemical mechanisms underlying Cd tolerance. By consolidating recent findings on Cd-responsive genes and regulatory pathways, this study provides a theoretical foundation for breeding Cd-resistant tea varieties and ensuring production safety. Furthermore, it identifies future research directions, emphasizing the need for deeper mechanistic insights and practical mitigation strategies. These advancements will contribute to safer tea consumption and sustainable cultivation practices in Cd-contaminated regions. Full article

Background/Objectives: Multiparametric MRI (mpMRI) and targeted biopsies have revolutionized prostate cancer (PC) detection through the Prostate Imaging Reporting and Data System (PIRADS). However, the effect of prostate volume on cancer detection and the predictive accuracy of PIRADS in the mpMRI-guided biopsy era remains unclear. The aim was to assess whether prostate volume affects detection rates of clinically significant prostate cancer (CSPC) and high-risk prostate cancer (HRPC) and modifies the predictive performance of the PIRADS score. Methods: We retrospectively analyzed 361 biopsy-naïve men who underwent mpMRI-fusion transperineal biopsies between 2016 and 2023. Lesions graded PIRADS ≥ 3 were targeted alongside systematic sampling. A receiver-operating characteristic (ROC) curve (AUC = 0.74) defined a 44 mL cutoff separating small (<44 mL; n = 160) and large (≥44 mL; n = 193) prostates. Logistic regression and cubic-spline analyses evaluated associations between prostate volume, PIRADS, and cancer outcomes. Results: Any cancer was detected in 74.3% of small versus 35.5% of large prostates (p < 0.001); CSPC in 42.5% vs. 19.6% (p < 0.001); HRPC in 14.3% vs. 5.5% (p < 0.001). Small prostate volume independently predicted any cancer (OR 7.31; 95% CI 4.22–12.7), CSPC (OR 5.08; 95% CI 2.87–8.99), and HRPC (OR 4.50; 95% CI 1.80–11.3). Between 40 and 70 mL, each 10 mL increase in volume reduced CSPC risk by 61% (p = 0.008). Prostate volume significantly modified PIRADS accuracy: in large glands, PIRADS 3 lesions carried only 2% risk for CSPC and 0% for HRPC, while in small prostates, PIRADS 3 conferred a 16.9-fold increased CSPC risk. Conclusions: Prostate volume inversely correlates with cancer detection and aggressiveness. PIRADS performance is volume-dependent; PIRADS 3 lesions in large prostates rarely represent significant cancer and may not warrant biopsy. Full article

Background/Objectives: This study analyzed the impact of operator experience on the detection of PC and csPC using a standardized MRI/TRUS-fusion biopsy protocol in an experienced high-volume center. Methods: Men with mpMRI and subsequent combined TB and SB (2019–2024) using transrectal, software-assisted MRI/TRUS-fusion were retrospectively included. Operators were stratified by experience subgroups (<100 vs. ≥100 procedures). Clinical, MRI, and biopsy data have been assessed. The primary objective was the analysis of the effect of biopsy experience on patient-level PC detection. The secondary objective was the PC detection of PI-RADS and DRE. Results: A total of 683 consecutive patients were included (median age 63 years, median PSA 6.5 ng/mL, and median prostate volume 41 mL). Overall, PC and csPC detection were 67% and 51%, with no significant difference in the operator experience subgroups (p = 0.63; p = 0.23). There were no significant differences for additional csPC detection by SB (7% vs. 5%; p = 0.31) or TB (9% vs. 10%; p = 0.93) in both subgroups. DRE showed limited diagnostic value (SEN 32%, SPE 88%, PPV 74%, NPV 55%) with no significant variation regarding the experience (p = 0.12–1.0). Limitations include a single-center, retrospective design and a lack of a radical prostatectomy specimen. Conclusions: In a standardized MRI-targeted biopsy setting, operator experience seems to have a lower influence on PC or csPC detection. High csPC detection in PI-RADS 4–5 supports a TB-only approach, while low rates in PI-RADS 3 suggest follow-up MRI over immediate biopsy. Limited DRE accuracy highlights its declining role in PC assessment. Full article

Background and Objectives: Prostate cancer (PC) is largely a disease of elderly men, and de novo metastatic presentations are increasingly reported in this population. Yet older patients remain underrepresented in clinical trials, limiting the applicability of guideline-based treatments. Materials and Methods: We retrospectively analyzed 90 patients aged ≥75 years with de novo metastatic castration-sensitive PC (mCSPC) to describe clinical features, treatment patterns, and survival outcomes. Results: Median age was 81 years; high-volume disease and Gleason grade 9–10 tumors predominated. A substantial portion of patients received androgen deprivation therapy (ADT) alone or with bicalutamide despite recommendations for intensified therapy. Enzalutamide was associated with the longest median progression-free survival (PFS, 25.4 months) and overall survival (OS, 30.5 months), though between-group differences were not significant. Castration resistance occurred only in the high-volume group (22.4%). Absence of hypertension was associated with a lower risk of progression (HR 0.46, 95% CI 0.23–0.92, p = 0.028). Conclusions: Elderly patients with de novo mCSPC often have aggressive forms of the disease. Enzalutamide was associated with numerically longer survival compared to other treatments, although the difference was not statistically significant. Additionally, the absence of hypertension appeared to be linked with a lower risk of progression, suggesting that comorbid conditions such as hypertension may influence treatment outcomes in elderly patients. Full article

Background/Objectives: Prostate cancer is a leading cause of cancer-related morbidity and mortality. While prostate-specific antigen (PSA) is crucial for monitoring, its static levels are limited in predicting outcomes precisely. The Kinetics of Elimination of PSA (KELIM PSA) has recently emerged as a dynamic biomarker of treatment response. This research sought to determine the predictive power of KELIM PSA in castration-resistant prostate cancer (CRPC) on androgen receptor pathway inhibitors (ARPI). Methods: This study retrospectively analyzed 98 CRPC patients treated with enzalutamide or abiraterone. The patients were categorized as either unfavorable (KELIM < 1) or favorable (KELIM ≥ 1). Demographic and clinical characteristics were compared, and survival outcomes were evaluated using Kaplan–Meier curves and Cox regression. Results: Of the cohort, 42 (42.9%) patients had favorable and 56 (57.1%) unfavorable KELIM values. The unfavorable group had a higher mortality rate (62.5% vs. 38.1%, p = 0.029). Univariate analysis showed that poor KELIM results increased mortality risk twofold (hazard ratio [HR]: 2.30, 95% confidence interval [CI]: 1.26–4.19, p = 0.006). In multivariable analysis, unfavorable KELIM remained independently associated with worse overall survival (HR: 2.09, 95% CI: 1.12–3.89, p = 0.020), together with second-line ARPI (HR: 3.19, 95% CI: 1.71–5.93, p < 0.001) and ADT + docetaxel during CSPC (HR: 2.14, 95% CI: 1.11–4.12, p = 0.022). Kaplan–Meier curves revealed that the unfavorable group had notably reduced overall survival and progression-free survival (log-rank p = 0.018). Conclusions: KELIM PSA is an independent predictor in ARPI-treated CRPC. By integrating PSA kinetics into prognostic models, risk stratification may be improved, and this may guide individualized treatment. Prospective multicenter validation is warranted. Full article

Prostate cancer (PCa) is the second most common cancer in men, and it is frequently diagnosed at an advanced stage of the disease. Androgen Deprivation Therapy (ADT) has traditionally represented the backbone of therapy for high-risk, recurrent, and metastatic disease; however, in the last ten years a new group of molecules known as androgen receptor pathway inhibitors (ARPIs) have been demonstrated to improve outcomes in metastatic patients when added to ADT. Developed and validated originally in the setting of castration-resistant disease, ARPIs have been implemented progressively earlier in the natural history of PCa, involving patients who have never received ADT before or that are still responsive to this treatment. Considering the strong evidence for treatment intensification in patients with high-risk features, with this review we aim to provide a complete overview of the current indications for the use of ARPIs through all the stages of castration-sensitive prostate cancer (CSPC). Full article

Accurate and comprehensive characterization of high-steep slopes is crucial for real-time risk prediction, disaster assessment, and damage evolution monitoring. The study focused on a high-steep rocky slope along the Yanjiang Expressway in Sichuan Province, China. A novel digital reconstruction method was introduced, which integrates terrestrial laser scanning (TLS) and unmanned aerial vehicle (UAV) photogrammetry through a Transformer-based method combining GeoTransformer with the Maximal Cliques (MAC) algorithm. The results indicated that TLS excels in capturing fine-scale features, whereas UAV demonstrates superior performance in large-scale terrain reconstruction. However, multi-sensor data exhibit heterogeneity in terms of partial overlap, large outliers, and density differences. To address these challenges, the GeoTransformer-MAC framework extracts geometrically invariant features from cross-source point cloud (CSPC) to establish initial correspondences, followed by rigorous screening of high-quality locally consistent correspondences to optimize transformation parameters. This method achieves accurate digital reconstruction of the high-steep rock slope. Global and local error analyses verify the model’s superiority in both overall slope characterization and fine-scale feature representation. Compared with the TLS-only model and the conventional method, the Transformer-based method improves the slope model integrity by 85.58%, increases the data density by 9.71%, and improves the accuracy by nearly threefold. This study provides a novel approach for the digital modeling of complex terrains, which serves the refined identification and modeling of geohazards for high-steep slopes in complex mountainous regions. Full article

Backgrounds: High-volume (HV) metastatic castration-sensitive prostate cancer (mCSPC) is an aggressive disease. Despite this, we aimed to assess the metastatic patterns associated with a favorable prognosis in HV disease with bone metastasis (BM), including BM’s coexistence with lung metastasis (LM). Methods: We retrospectively analyzed 379 patients with synchronous mCSPC. They were categorized using the CHAARTED criteria as low-volume (LV) or HV with BM, classified based on extent of the disease from 1 to 4 (HV-EOD1–4) with or without LM. Multivariate Cox models for overall survival and castration-resistance-free survival assessed the prognostic values of HV-EOD1–4 compared with LV disease and the presence of LM. Site-specific radiographic progression at the time of castration-resistant prostate diagnosis was assessed in patients with BM and LM. Results: Multivariate analyses for overall survival showed no prognostic value of HV-EOD1 (hazard ratio [HR] 0.90; 95% confidence interval [CI] 0.43–1.85; p = 0.77), HV-EOD2 (HR 1.17; 95% CI 0.69–1.99; p = 0.57), and LM (HR 1.29; 95% CI 0.80–2.07; p = 0.29). In the analyses, HV-EOD ≤ 2 and LM did not influence castration resistance-free survival. LM showed a significantly lower incidence of radiographic progression to castration-resistant prostate cancer than BM (6.0% vs. 29.9%, p < 0.001). Conclusions: This study indicates the prognostic heterogeneity of HV disease considering BM and LM. These findings may aid in determining the treatment intensity for mCSPC. Full article

This study aims to investigate the role of exogenous spermidine (Spd) in mitigating the adverse effects of cadmium (Cd) stress on the growth and development of cucumber (Cucumis sativus). The cucumber cultivar “Xintaimici” was used as the experimental material, and a hydroponic experiment was carried out. Based on a baseline Cd concentration of 10 mg·L⁻¹, Spd was supplemented at concentrations of 0.05, 0.1, 0.2, 0.4, and 0.5 mM, resulting in seven treatment groups: control group (CK), S0 group (Cd-only treatment, 10 mg·L⁻¹ Cd + 0 mM Spd), S1+ Cd group (10 mg·L⁻¹ Cd + 0.05 mM Spd), S2+ Cd group (10 mg·L⁻¹ Cd + 0.1 mM Spd), S3+ Cd group (10 mg·L⁻¹ Cd + 0.2 mM Spd), S4+ Cd group (10 mg·L⁻¹ Cd + 0.4 mM Spd), and S5+ Cd group (10 mg·L⁻¹ Cd + 0.5 mM Spd). This study analyzed the regulatory effects of Spd on the growth and development, antioxidant capacity and cadmium accumulation characteristics of cucumber seeds and seedlings. It was found that cadmium stress significantly inhibited their growth process and led to a decline in multiple physiological indicators. Under a Cd concentration of 10 mg·L⁻¹, the application of 0.2 mM Spd significantly improved these parameters. During the seedling stage, the application of 0.2 mM Spd under Cd stress significantly enhanced the activities of superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and ascorbate peroxidase (APX), as well as the content of soluble proteins, while significantly reducing malondialdehyde (MDA) levels. Cd content analysis revealed that 0.2 mM Spd promoted Cd accumulation in roots while suppressing its translocation to young leaves, thereby reducing Cd accumulation in aboveground tissues. Gene expression analysis demonstrated that this treatment significantly upregulated the expression levels of the phytochelatin synthase gene (CsPCS1) and the gene associated with reduced glutathione synthesis (CsGSHS). In conclusion, the exogenous application of 0.2 mM Spd effectively alleviates oxidative damage and osmotic stress induced by Cd stress in cucumber, promotes plant growth, and significantly enhances Cd tolerance. Full article

At diagnosis, metastatic prostate cancer (PC) is sensitive to androgen deprivation therapy (ADT), and patients are usually referred to as having castration-sensitive prostate cancer (mCSPC). The combination of ADT and androgen receptor pathway inhibitors (ARPI) is the current standard of care for mCSPC. This study aimed to review the literature on economic evaluations and health economic models related to mCSPC. A literature search was performed covering Medline, Embase, and Scopus with additional grey literature sources. Studies with data on health economic evaluations focusing on Europe or North America were relevant. 18 peer-reviewed articles and 10 grey literature documents were included. The majority (n = 23) had a deterministic Markov structure and applied either Markov cohort or partitioned survival models. Evaluations investigated various types of ADT-based combinations, comparing the addition of ARPI, chemotherapy agents, or radiation therapy to ADT alone. We concluded that economic evaluations in the field of PC are widely published, and there are a large number of publications even in the specific subgroup of mCSPC. Regardless of the investigated interventions, most studies applied similar methodologies and simulated patients from the mCSPC state until the development of mCRPC or death. Full article