Search Results (8)

Background: Prostate cancer (PCa) is one of the most frequently occurring malignancies. Although most cases are not life-threatening, approximately 20% endure an unfavorable outcome. PSA-based screening reduced mortality but at the cost of an increased overdiagnosis/overtreatment of low-risk (lrPCa) and favorable intermediate-risk (firPCa) PCa. PCa risk-groups are usually identified based on serum Prostate-Specific Antigen (PSA), the Gleason score, and clinical T stage, which have consistent although variable specificity or subjectivity. Thus, more effective and specific tools for risk assessment are needed, ideally making use of minimally invasive methods such as liquid biopsies. In this systematic review we assessed the clinical potential and analytical performance of liquid biopsy-based biomarkers for pre-treatment risk stratification of PCa patients. Methods: Studies that assessed PCa pre-treatment risk were retrieved from PubMed, Scopus, and MedLine. PCa risk biomarkers were analyzed, and the studies’ quality was assessed using the QUADAS-2 tool. Results: The final analysis comprised 24 full-text articles, in which case-control studies predominated, mostly reporting urine-based biomarkers (54.2%) and biomarker quantification by qPCR (41.7%). Categorization into risk groups was heterogeneous, predominantly making use of the Gleason score. Conclusion: This systematic review unveils the substantial clinical promise of using circulating biomarkers in assessing the risk for prostate cancer patients. However, the standardization of groups, categories, and biomarker validation are mandatory before this technique can be implemented. Circulating biomarkers might represent a viable alternative to currently available tools, obviating the need for tissue biopsies, and allowing for faster and more cost-effective testing, with superior analytical performance, specificity, and reproducibility. Full article

Background: We retrospectively analyzed the 5-year biochemical disease-free survival (bDFS) and occurrence of late toxicity in prostate cancer patients treated with pencil beam scanning (PBS) proton radiotherapy. Methodology: In the period from January 2013 to June 2018, 853 patients with prostate cancer were treated with an ultra-hypofractionated schedule (36.25 GyE/five fractions). The mean PSA value was 6.7 (0.7–19.7) µg/L. There were 318 (37.3%), 314 (36.8%), and 221 (25.9%) patients at low (LR), favorable intermediate (F-IR), and unfavorable intermediate risk (U-IR), respectively. Neoadjuvant hormonal therapy was administered to 197 (23.1%) patients, and 7 (0.8%) patients had adjuvant hormonal therapy. The whole group of patients reached median follow-up time at 62.7 months, and their mean age was 64.8 (40.0–85.7) years. The bDFS rates and late toxicity profile were evaluated. Results: Median treatment time was 10 (7–38) days. Estimated 5-year bDFS rates were 96.5%, 93.7%, and 91.2% for low-, favorable intermediate-, and unfavorable intermediate-risk groups, respectively. Cumulative late toxicity (CTCAE v4.0) of G2+ was as follows: gastrointestinal (GI)—G2: 9.1%; G3: 0.5%; genitourinary (GU)—G2: 4.3%, and no G3 toxicity was observed. PSA relapse was observed in 58 (6.8%) patients: 16 local, 22 lymph node, 4 bone recurrences, and 10 combined sites of relapse were detected. Throughout the follow-up period, 40 patients (4.7%) died, though none due to prostate cancer. Conclusion: Ultra-hypofractionated proton beam radiotherapy is an effective treatment for low- and favorable intermediate-risk prostate cancer, with long-term bDFS rates comparable to other techniques. It is promising for unfavorable intermediate-risk prostate cancer and has acceptable long-term GI and favorable GU toxicity. Full article

Shear fracture frequently occurs in timber beams and panels subjected to transverse loads. At elevated temperatures, wood will undergo complex physical and chemical processes which significantly affect the shear properties. In this paper, the v-notched Douglas-fir specimens with three different shear planes: (a) Radial-Tangential (RT); (b) Radial-Longitudinal (RL), and (c) Longitudinal-Radial (LR), were fabricated and tested under the elevated temperatures from 20 °C to 180 °C. The digital image correlation (DIC) technique was used to measure the shear strain. It was found that the shear plane had a significant effect on the failure modes, shear strength, and shear modulus. The shear strength and shear modulus generally decreased with the increase of temperature. However, the shear strength was significantly improved when the hardening of the dry lignin occurred between 100 °C and 140 °C. Moreover, the design curve for the shear strength in Eurocode 5 is conservative for all the specimens with different shear planes. Full article

Few studies have focused on the link between active surveillance (AS) and Gleason score upgrade (GSU) and its impact on the prognosis of patients with prostate cancer (PCa). This study aimed to analyze the effect of AS duration on GSU and prognostic value based on risk stratification. All eligible patients were risk-stratified according to AUA guidelines into low-risk (LR), favorable intermediate-risk (FIR), and unfavorable intermediate-risk (UIR) PCa. Within the Surveillance, Epidemiology, and End Results Program (SEER) database, 28,368 LR, 27,243 FIR, and 12,210 UIR PCa patients were included. The relationship between AS duration and GSU was identified with univariate and multivariate logistic regression. Discrimination according to risk stratification of AS duration and GSU was tested by Kaplan–Meier analysis and competing risk regression models. The proportion of patients who chose AS was the highest among LR PCa (3434, 12.1%), while the proportion in UIR PCa was the lowest (887, 7.3%). The AS duration was only associated with GSU in LR PCa, with a high Gleason score (GS) at diagnosis being a strong predictor of GSU for FIR and UIR PCa. Kaplan–Meier analysis indicated that long-term surveillance only made a significant difference in prognosis in UIR PCa. The competing risk analysis indicated that once GS was upgraded to 8 or above, the prognosis in each group was significantly worse. AS is recommended for LR and FIR PCa until GS is upgraded to 8, but AS may not be suitable for some UIR PCa patients. Full article

Introduction: The COVID-19 pandemic has delayed screening, diagnostic workup, and treatment in prostate cancer (PCa) patients. Our purpose was to review PCa screening, diagnostic workup, active surveillance (AS), radical prostatectomy (RP), radiotherapy (RT), androgen deprivation therapy (ADT) and systemic therapy during the COVID-19 pandemic. Materials and Methods: We performed a systematic literature search of MEDLINE, EMBASE, Scopus, LILACS, and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols (PRISMA-P) statement for relevant material published from December 2019 to February 2021. Results: Prostate biopsy can be delayed, except when high-risk PCa is suspected or the patient is symptomatic. Active surveillance is appropriate for patients with very low risk, low risk (LR) and favorable intermediate risk (FIR). RP and RT for high risk and very high risk can be safely postponed up to 3 months. Hypofractionated external beam RT (EBRT) is recommended when RT is employed. ADT should be used according to standard PCa-based indications. Chemotherapy should be postponed until the pandemic is contained. Conclusions: The international urological community was not prepared for such an acute and severe pandemic. PCa patients can be adequately managed according to risk stratification. During the COVID-19 pandemic, LR and FIR patients can be followed with active surveillance. Delaying RP and RT in high risk and locally advanced disease is justified. Full article

There is no information about whether fetal growth restriction (FGR) is an independent risk factor for low-grade fetal inflammatory response (FIR), and which is more valuable for the prediction of early-onset neonatal sepsis (EONS) between low-grade FIR or fetal inflammatory response syndrome (FIRS) in the context of human early preterm sterile intrauterine environment. We examined FIR (umbilical cord plasma (UCP) CRP concentration at birth) according to the presence or absence of FGR (birth weight < 5th percentile for gestational age (GA)) and EONS in 81 singleton preterm births (GA at delivery: 24.5~33.5 weeks) within 72 h after amniocentesis and with sterile intrauterine environment. A sterile intrauterine environment was defined by the presence of both a sterile amniotic fluid (AF) (AF with both negative culture and MMP-8 < 23 ng/mL) and inflammation-free placenta. Median UCP CRP (ng/mL) was higher in cases with FGR than in those without FGR (63.2 vs. 34.5; p = 0.018), and FGR was an independent risk factor for low-grade FIR (UCP CRP ≥ 52.8 ng/mL) (OR 3.003, 95% CI 1.024–8.812, p = 0.045) after correction for confounders. Notably, low-grade FIR (positive likelihood-ratio (LR) and 95% CI, 2.3969 (1.4141–4.0625); negative-LR and 95% CI, 0.4802 (0.2591–0.8902)), but not FIRS (positive-LR and 95% CI, 2.1071 (0.7526–5.8993); negative-LR and 95% CI, 0.8510 (0.6497–1.1145)), was useful for the identification of EONS. In conclusion, FGR is an independent risk factor for low-grade FIR, and low-grade FIR, but not FIRS, has a value for the identification of EONS in the context of the early preterm sterile intrauterine environment. Full article

In this paper, an e-Learning toolbox based on a set of fuzzy logic data mining techniques is presented. The toolbox is mainly based on the fuzzy inductive reasoning (FIR) methodology and two of its key extensions: (i) the linguistic rules extraction algorithm (LR-FIR), which extracts comprehensible and consistent sets of rules describing students’ learning behavior, and (ii) the causal relevance approach (CR-FIR), which allows to reduce uncertainty during a student’s performance prediction stage, and provides a relative weighting of the features involved in the evaluation process. In addition, the presented toolbox enables, in an incremental way, detecting and grouping students with respect to their learning behavior, with the main goal to timely detect failing students, and properly provide them with suitable and actionable feedback. The proposed toolbox has been applied to two different datasets gathered from two courses at the Latin American Institute for Educational Communication virtual campus. The introductory and didactic planning courses were analyzed using the proposed toolbox. The results obtained by the functionalities offered by the platform allow teachers to make decisions and carry out improvement actions in the current course, i.e., to monitor specific student clusters, to analyze possible changes in the different evaluable activities, or to reduce (to some extent) teacher workload. Full article

Litterfall is the primary source of carbon and nutrients that determine soil fertility in forest ecosystems. Most current studies have focused on foliar litter, but the seasonal dynamics and allometric scaling relationships among different litter components (e.g., foliar litter, woody litter, reproductive litter, and epiphytic litter) are poorly understood. Here, we investigated the litter production of various litter components in a sub-alpine spruce-fir forest on the eastern Tibetan Plateau based on one year of observations (from August 2015 to July 2016). Our results showed that total litter production (L_T) was 2380 kg·ha⁻¹·year⁻¹ (3% of the aboveground forest biomass), of which 73.6% was foliar litter (L_F), 15.6% was woody litter (L_W), 3.0% was reproductive litter (L_R), 1.3% was epiphytic litter (L_E), and 6.5% was miscellaneous material (L_M). The total litterfall was bimodal (with peaks occurring in April and October) and was dominated by tree species (85.4% of L_T, whereas shrubs accounted for 6.8% of L_T). The litter production of evergreen species (68.4% of L_T) was higher than that of deciduous species (23.8% of L_T). Isometric relationships were observed between litter components and the total litter (i.e., L_F∝L_T^0.99≈1 and L_R∝L_T^0.98≈1), and allometric relationships were also found (i.e., L_W∝L_T^1.40>1 and L_M∝L_T^0.82<1). However, because some components did not exhibit obvious seasonal dynamics (i.e., L_E), some relationships could not be expressed using allometric equations (i.e., L_E versus L_T, L_F versus L_E, L_W versus L_E, and L_E versus L_M). Thus, the different litter components showed different seasonal dynamics, and the total litter dynamics were primarily determined by the variation in foliar litter. In addition, the allometric relationships of the forest litterfall varied with the litter components, functional types (evergreen versus deciduous) and vertical structures (tree versus shrub). This study provides basic data and a new insight for future plant litter studies. Full article