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Wu Z, Chen H, Chen Q, Ge S, Yu N, Campi R, Gómez Rivas J, Autorino R, Rouprêt M, Psutka SP, Mehrazin R, Porpiglia F, Bensalah K, Black PC, Mir MC, Minervini A, Djaladat H, Margulis V, Bertolo R, Caliò A, Carbonara U, Amparore D, Borregales LD, Ciccarese C, Diana P, Erdem S, Marandino L, Marchioni M, Muselaers CHJ, Palumbo C, Pavan N, Pecoraro A, Roussel E, Warren H, Pandolfo SD, Chen R, Zhou W, Zhai W, He M, Li Y, Han B, Wan J, Zeng X, Yan J, Fu Y, Ji C, Fan X, Zhang G, Zhao C, Jing T, Wang A, Feng C, Zhao H, Sun D, Wang L, Tai S, Zhang C, Chen S, Liu Y, Xu Z, Wang H, Gao J, Wang F, Cheng J, Miao H, Rao Q, Wang J, Xu N, Wang G, Liang C, Liu Z, Xia D, Jiang J, Zu X, Chen M, Guo H, Qin W, Wang Z, Xue W, Shi B, Zhou X, Wang S, Zheng J, Ge J, Feng X, Li M, Chen C, Qu L, Wang L. Prognostic Significance of Grade Discrepancy Between Primary Tumor and Venous Thrombus in Nonmetastatic Clear-cell Renal Cell Carcinoma: Analysis of the REMEMBER Registry and Implications for Adjuvant Therapy. Eur Urol Oncol 2024; 7:112-121. [PMID: 37468393 DOI: 10.1016/j.euo.2023.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/14/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Further stratification of the risk of recurrence of clear-cell renal cell carcinoma (ccRCC) with venous tumor thrombus (VTT) will facilitate selection of candidates for adjuvant therapy. OBJECTIVE To assess the impact of tumor grade discrepancy (GD) between the primary tumor (PT) and VTT in nonmetastatic ccRCC on disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS). DESIGN, SETTING, AND PARTICIPANTS This was a retrospective analysis of a multi-institutional nationwide data set for patients with pT3N0M0 ccRCC who underwent radical nephrectomy and thrombectomy. OUTCOMES MEASUREMENTS AND STATISTICAL ANALYSIS Pathology slides were centrally reviewed. GD, a bidirectional variable (upgrading or downgrading), was numerically defined as the VTT grade minus the PT grade. Multivariable models were built to predict DFS, OS, and CSS. RESULTS AND LIMITATIONS We analyzed data for 604 patients with median follow-up of 42 mo (excluding events). Tumor GD between VTT and PT was observed for 47% (285/604) of the patients and was an independent risk factor with incremental value in predicting the outcomes of interest (all p < 0.05). Incorporation of tumor GD significantly improved the performance of the ECOG-ACRIN 2805 (ASSURE) model. A GD-based model (PT grade, GD, pT stage, PT sarcomatoid features, fat invasion, and VTT consistency) had a c index of 0.72 for DFS. The hazard ratios were 8.0 for GD = +2 (p < 0.001), 1.9 for GD = +1 (p < 0.001), 0.57 for GD = -1 (p = 0.001), and 0.22 for GD = -2 (p = 0.003) versus GD = 0 as the reference. According to model-converted risk scores, DFS, OS, and CSS significantly differed between subgroups with low, intermediate, and high risk (all p < 0.001). CONCLUSIONS Routine reporting of VTT upgrading or downgrading in relation to the PT and use of our GD-based nomograms can facilitate more informed treatment decisions by tailoring strategies to an individual patient's risk of progression. PATIENT SUMMARY We developed a tool to improve patient counseling and guide decision-making on other therapies in addition to surgery for patients with the clear-cell type of kidney cancer and tumor invasion of a vein.
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Affiliation(s)
- Zhenjie Wu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China; European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands.
| | - Hui Chen
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Qi Chen
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Silun Ge
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Nengwang Yu
- Department of Urology, Qilu Hospital, Shandong University, Jinan, China
| | - Riccardo Campi
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Juan Gómez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, Chicago, IL, USA
| | - Morgan Rouprêt
- Department of Urology, GRC No. 5, Predictive ONCO-URO, Hospital Pitié-Salpêtrière, AP-HP, Sorbonne University, Paris, France
| | - Sarah P Psutka
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Reza Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Karim Bensalah
- Department of Urology, University of Rennes, Rennes, France
| | - Peter C Black
- Department of Urologic Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Maria C Mir
- Department of Urology; Hospital Universitario La Ribera; Valencia, Spain
| | - Andrea Minervini
- Departments of Urology and Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Hooman Djaladat
- Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Riccardo Bertolo
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Urology Unit, San Carlo di Nancy Hospital, Rome, Italy
| | - Anna Caliò
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Umberto Carbonara
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Daniele Amparore
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Leonardo D Borregales
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, NY, USA
| | - Chiara Ciccarese
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Medical Oncology Unit, Comprehensive Cancer Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Pietro Diana
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Selcuk Erdem
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urologic Oncology, Department of Urology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Laura Marandino
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Michele Marchioni
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Medical, Oral and Biotechnological Sciences, Urology Unit, University G. d'Annunzio, Chieti, Italy
| | - Constantijn H J Muselaers
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carlotta Palumbo
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Nicola Pavan
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Urology Clinic, Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Angela Pecoraro
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Pederzoli Hospital, Peschiera del Garda, Italy
| | - Eduard Roussel
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Hannah Warren
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Division of Surgery and Interventional Science, University College London, London, UK
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Rui Chen
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Wenquan Zhou
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Wei Zhai
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Miaoxia He
- Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yaoming Li
- Department of Urology, Daping Hospital, Army Medical University, Chongqing, China
| | - Bo Han
- Department of Pathology, Qilu Hospital, Shandong University, Jinan, China
| | - Jie Wan
- Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xing Zeng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junan Yan
- Department of Urology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yao Fu
- Department of Pathology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Changwei Ji
- Department of Urology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Xiang Fan
- Department of Pathology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Guangyuan Zhang
- Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Cheng Zhao
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Taile Jing
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Anbang Wang
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Chenchen Feng
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongwei Zhao
- Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Di Sun
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Liang Wang
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Sheng Tai
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Cheng Zhang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shaohao Chen
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yixun Liu
- Department of Urology, Anhui Provincial Hospital/The First Hospital of the University of Science and Technology of China, Hefei, China
| | - Zhipeng Xu
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Haifeng Wang
- Department of Urology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Jinli Gao
- Department of Pathology, Shanghai East Hospital, Tongji University, Shanghai, China
| | - Fubo Wang
- Center for Genomic and Personalized Medicine, Guangxi Medical University, Nanning, China
| | - Jiwen Cheng
- Department of Urology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - He Miao
- Department of Urology, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Qiu Rao
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Jianning Wang
- Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Ning Xu
- Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Gongxian Wang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Zhiyu Liu
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Dan Xia
- Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jun Jiang
- Department of Urology, Daping Hospital, Army Medical University, Chongqing, China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Ming Chen
- Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Hongqian Guo
- Department of Urology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Weijun Qin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Zhe Wang
- Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Xue
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Benkang Shi
- Department of Urology, Qilu Hospital, Shandong University, Jinan, China
| | - Xiaojun Zhou
- Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Shaogang Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junhua Zheng
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingping Ge
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
| | - Xiang Feng
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Minming Li
- Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Cheng Chen
- Department of Medical Oncology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China.
| | - Le Qu
- Department of Urology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China.
| | - Linhui Wang
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.
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Zhou L, Xu LL, Zheng LL, Chen C, Xu L, Zeng JL, Li SY. Predictors of Gleason Grading Group Upgrading in Low-Risk Prostate Cancer Patients From Transperineal Biopsy After Radical Prostatectomy. Acad Radiol 2024:S1076-6332(24)00012-6. [PMID: 38233258 DOI: 10.1016/j.acra.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
RATIONALE AND OBJECTIVES To investigate the predictors of Gleason Grading Group (GGG) upgrading in low-risk prostate cancer (Gleason score=3 + 3) from transperineal biopsy after radical prostatectomy (RP). MATERIALS AND METHODS The clinical data of 160 patients who underwent transperineal biopsy and RP from January 2017 to December 2022 were retrospectively analyzed. First, univariate and multivariate logistic regression analysis were used to obtain independent predictors of postoperative GGG upgrading. Then receiver operating characteristic curve was used to evaluate the diagnostic efficacy of predictors. Finally, Linear-by-Linear Association test was used to analyze the risk trends of patients in different predictor groups in the postoperative GGG. RESULTS In this study, there were 81 cases (50.6%) in the GGG concordance group and 79 cases (49.4%) in the GGG upgrading group. Univariate analysis showed age, free/total prostate-specific antigen (f/tPSA), proportion of positive biopsies, positive target of magnetic-resonance imaging (MRI) and positive target of contrast-enhanced ultrasound had significant effects on GGG upgrading (all P < .05). In multivariate logistic regression analysis, age (odds ratio [OR]=1.066, 95%CI=1.007-1.127, P = .027), f/tPSA (OR=0.001, 95%CI=0-0.146, P = .001) and positive target of MRI (OR=3.005, 95%CI=1.353-76.674, P = .007) were independent predictors. The prediction model (area under curve=0.751 P < .001) had higher predictive efficacy than all independent predictors. The proportion of patients in exposed group of different GGG increased with the level of GGG, but decreased in nonexposed group, and the linear trend was significantly different (all P < .001). CONCLUSION Age, f/tPSA, and positive target of MRI were independent predictors of postoperative GGG upgrading. The predictive model constructed had the best diagnostic efficacy.
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Affiliation(s)
- Ling Zhou
- Department of Ultrasound in Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3, East Qingchun Rd, Hangzhou 310016, Zhejiang, China (L.Z., L.X., L.Z., S.L.)
| | - Li-Long Xu
- Department of Ultrasound in Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3, East Qingchun Rd, Hangzhou 310016, Zhejiang, China (L.Z., L.X., L.Z., S.L.)
| | - Lin-Lin Zheng
- Department of Ultrasound in Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3, East Qingchun Rd, Hangzhou 310016, Zhejiang, China (L.Z., L.X., L.Z., S.L.)
| | - Chao Chen
- Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (C.C.)
| | - Li Xu
- Department of Urology Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (L.X.)
| | - Ji-Ling Zeng
- Department of Pathology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (J.Z.)
| | - Shi-Yan Li
- Department of Ultrasound in Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, No. 3, East Qingchun Rd, Hangzhou 310016, Zhejiang, China (L.Z., L.X., L.Z., S.L.).
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Aldaby ESE, Mahmoud AHA, El-Bery HM, Ali MM, Shoreit AA, Mawad AMM. Microalgal upgrading of the fermentative biohydrogen produced from Bacillus coagulans via non-pretreated plant biomass. Microb Cell Fact 2023; 22:190. [PMID: 37730554 PMCID: PMC10512583 DOI: 10.1186/s12934-023-02193-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Hydrogen is a promising source of alternative energy. Fermentative production is more feasible because of its high hydrogen generation rate, simple operating conditions, and utilization of various organic wastes as substrates. The most significant constraint for biohydrogen production is supplying it at a low cost with fewer impurities. RESULTS Leaf biomass of Calotropis procera was used as a feedstock for a dark fermentative production of hydrogen by Bacillus coagulans AH1 (MN923076). The optimum operation conditions for biohydrogen production were 5.0% substrate concentrationand pH 9.0, at 35 °C. In which the biohydrogen yield was 3.231 mmol H2/g dry biomass without any pretreatments of the biomass. A freshwater microalga Oscillatroia sp was used for upgrading of the produced biohydrogen. It sequestrated 97 and 99% % of CO2 from the gas mixture when it was cultivated in BG11 and BG11-N media, respectively After upgrading process, the residual microalgal cells exhibited 0.21mg/mL of biomass yield,high content of chlorophyll-a (4.8 µg/mL) and carotenoid (11.1 µg/mL). In addition to Oscillatroia sp residual biomass showed a lipid yield (7.5-8.7%) on the tested media. CONCLUSION Bacillus coagulans AH1 is a promising tool for biohydrogen production avoiding the drawbacks of biomass pretreatment. Oscillatroia sp is encouraged as a potent tool for upgrading and purification of biohydrogen. These findings led to the development of a multiproduct biorefinery with zero waste that is more economically sustainable.
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Affiliation(s)
- Eman S E Aldaby
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, 71515, Egypt
| | - Aya H A Mahmoud
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, 71515, Egypt
| | - Haitham M El-Bery
- Green Hydrogen Production Laboratory, Chemistry Department, Faculty of Science, Assiut University, Assiut, 71515, Egypt.
| | - Maysa M Ali
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, 71515, Egypt
| | - Ahmed A Shoreit
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, 71515, Egypt
| | - Asmaa M M Mawad
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, 71515, Egypt
- Department of Biology, College of Science, Taibah University, 42317-8599, Madinah, Saudi Arabia
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Yang J, Zhu X, Ai Z, Leng L, Li H. Deep dewatering of refinery oily sludge by Fenton oxidation and its potential influence on the upgrading of oil phase. Environ Sci Pollut Res Int 2023:10.1007/s11356-023-27773-w. [PMID: 37243768 DOI: 10.1007/s11356-023-27773-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/16/2023] [Indexed: 05/29/2023]
Abstract
Highly efficient dewatering is essential to the reduction and reclamation disposal of oily sludge, which is a waste from the extraction, transportation, and refining of crude oil. How to effectively break the water/oil emulsion is a paramount challenge for dewatering of oily sludge. In this work, a Fenton oxidation approach was adopted for the dewatering of oily sludge. The results show that the oxidizing free radicals originated from Fenton agent effectively tailored the native petroleum hydrocarbon compounds into smaller organic molecules, hence destructing the colloidal structure of oily sludge and decreasing the viscosity as well. Meanwhile, the zeta potential of oily sludge was increased, implying the decrease of repulsive electrostatic force to realize easy coalescence of water droplets. Thus, the steric and electrostatic barriers which restrained the coalescence of dispersed water droplets in water/oil emulsion were removed. With these advantages, the Fenton oxidation approach derived the significant decrease of water content, in which 0.294 kg water was removed from per kilogram oily sludge under the optimal operation condition (i.e., pH value of 3, solid-liquid ratio of 1:10, Fe2+ concentration of 0.4 g/L and H2O2/Fe2+ ratio of 10:1, and reaction temperature of 50 °C). In addition, the quality of oil phase was upgraded after Fenton oxidation treatment accompanying with the degradation of native organic substances in oily sludge, and the heating value of oily sludge was increased from 8680 to 9260 kJ·kg-1, which would facilitate to the subsequent thermal conversion like pyrolysis or incineration. Such results demonstrate that the Fenton oxidation approach is efficient for the dewatering as well as the upgrading of oily sludge.
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Affiliation(s)
- Jianping Yang
- School of Energy Science and Engineering, Central South University, Changsha, 410083, China
| | - Xiaolei Zhu
- School of Energy Science and Engineering, Central South University, Changsha, 410083, China
| | - Zejian Ai
- School of Energy Science and Engineering, Central South University, Changsha, 410083, China
| | - Lijian Leng
- School of Energy Science and Engineering, Central South University, Changsha, 410083, China
| | - Hailong Li
- School of Energy Science and Engineering, Central South University, Changsha, 410083, China.
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Diamand R, Peltier A, Roche JB, Lievore E, Lacetera V, Chiacchio G, Beatrici V, Mastroianni R, Simone G, Windisch O, Benamran D, Fourcade A, Nguyen TA, Fournier G, Fiard G, Ploussard G, Roumeguère T, Albisinni S. Optimizing multiparametric magnetic resonance imaging-targeted biopsy and prostate cancer grading accuracy. World J Urol 2023; 41:77-84. [PMID: 36509932 DOI: 10.1007/s00345-022-04244-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/03/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess the most efficient biopsy method to improve International Society of Urological Pathology (ISUP) grade group accuracy with final pathology of the radical prostatectomy (RP) specimen in the era of magnetic resonance imaging (MRI)-driven pathway. METHODS A total of 753 patients diagnosed by transrectal MRI-targeted and systematic biopsies (namely "standard method"), treated by RP, between 2016 and 2021 were evaluated. Biopsy methods included MRI-targeted biopsy, side-specific systematic biopsies relative to index MRI lesion and combination of both. Number of MRI-targeted biopsy cores and positive cores needed per index MRI lesion were assessed. Multivariable analysis was performed to analyze predictive factors of upgrading using MRI targeted and ipsilateral systematic biopsies method. RESULTS Overall, ISUP grade group accuracy varied among biopsy methods with upgrading rate of 35%, 49%, 27%, and 24% for MRI targeted, systematic, MRI targeted and ipsilateral systematic biopsies and standard methods, respectively (p < 0.001). A minimum of two positive MRI-targeted biopsies cores per index MRI lesion were required when testing MRI targeted and ipsilateral systematic biopsies method to reach equivalent accuracy compared to standard method. Omitting contralateral systematic biopsies spared an average of 5.9 cores per patient. At multivariable analysis, only the number of positive MRI-targeted biopsy cores per index MRI lesion was predictive of upgrading. CONCLUSION MRI targeted and ipsilateral systematic biopsies allowed an accurate definition of ISUP grade group and appears to be an interesting alternative when compared with standard method, reducing total number of biopsy cores needed.
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Affiliation(s)
- Romain Diamand
- Department of Urology, Jules Bordet Institute-Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Rue Meylemeersch 90, 1070, Brussels, Belgium.
| | - Alexandre Peltier
- Department of Urology, Jules Bordet Institute-Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Rue Meylemeersch 90, 1070, Brussels, Belgium
| | | | - Elena Lievore
- Department of Urology, Clinique Saint-Augustin, Bordeaux, France.,Department of Urology, IRCCS IEO Istituto Europeo di Oncologia, Mila, Italy
| | - Vito Lacetera
- Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Giuseppe Chiacchio
- Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Valerio Beatrici
- Department of Urology, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | - Riccardo Mastroianni
- Department of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
| | - Giuseppe Simone
- Department of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
| | - Olivier Windisch
- Department of Urology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Daniel Benamran
- Department of Urology, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Alexandre Fourcade
- Department of Urology, Hôpital Cavale Blanche, CHRU Brest, Brest, France
| | - Truong An Nguyen
- Department of Urology, Hôpital Cavale Blanche, CHRU Brest, Brest, France
| | - Georges Fournier
- Department of Urology, Hôpital Cavale Blanche, CHRU Brest, Brest, France
| | - Gaelle Fiard
- Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | | | - Thierry Roumeguère
- Department of Urology, Jules Bordet Institute-Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Rue Meylemeersch 90, 1070, Brussels, Belgium
| | - Simone Albisinni
- Department of Urology, Jules Bordet Institute-Erasme Hospital, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Rue Meylemeersch 90, 1070, Brussels, Belgium
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6
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Fan J, Liang H, Fan J, Li L, Zhang G, Pei X, Yang T, He D, Wu K. Diagnostic accuracy of cystoscopic biopsy for tumour grade in outpatients with urothelial carcinoma of the bladder and the risk factors of upgrading. Asian J Urol 2023; 10:19-26. [PMID: 36721698 PMCID: PMC9875145 DOI: 10.1016/j.ajur.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 03/22/2021] [Accepted: 05/13/2021] [Indexed: 02/03/2023] Open
Abstract
Objective To assess the concordance of tumour grade in specimens obtained from diagnostic cystoscopic biopsy and transurethral resection of bladder tumour (TURBT) and explore the risk factors of upgrading. Methods The medical records of 205 outpatients who underwent diagnostic cystoscopic biopsy before initial TURBT were retrospectively reviewed. Comparative analysis of the tumour grade of biopsy and operation specimens was performed. Tumour grade changing from low-grade to high-grade with or without variant histology was defined as upgrading. Logistic regression analyses were performed to identify the risk factors of upgrading. Results For the 205 patients, the concordance of tumour grade between specimens obtained from biopsy and operation was 0.639. The concordance for patients who were preoperatively diagnosed with low-grade and high-grade was 0.504 and 0.912, respectively. Univariate and multivariate logistic regression analyses showed that older age, tumour multifocality, high neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and low lymphocyte-to-monocyte ratio (LMR) were significantly associated with upgrading (odds ratio ranging from 0.412 to 4.364). The area under the curve of the different multivariate models was improved from 0.752 to 0.821, and decision curve analysis demonstrated a high net benefit when NLR, LMR, and PLR were added. Conclusion Diagnostic cystoscopic biopsy may not accurately represent the true grade of primary bladder cancer, especially for outpatients with low-grade bladder cancer. Moreover, older age, tumour multifocality, high NLR, PLR, and low LMR are risk factors of upgrading, and systemic inflammatory markers improve the predictive ability.
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Affiliation(s)
- Junjie Fan
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,Department of Urology, Baoji Center Hospital, Baoji, China
| | - Hua Liang
- Department of Pathology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jinhai Fan
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lei Li
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Guanjun Zhang
- Department of Pathology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xinqi Pei
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tao Yang
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dalin He
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Kaijie Wu
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China,Corresponding author.
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7
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Fawzy MM, Sheta H, Abd El hafez A, Harb D, Zuhdy M, Alghandour R, Sakr DH. Accuracy and Upgrading of CNB and BI-RADS Diagnoses Compared to Excision: A Clinicopathological-Radiological Correlation of Papillary Breast Lesions and Neoplasms. Asian Pac J Cancer Prev 2022; 23:3959-3969. [PMID: 36444611 PMCID: PMC9930938 DOI: 10.31557/apjcp.2022.23.11.3959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Papillary breast lesions and neoplasms (PBLs/Ns) are diagnostically challenging lesions in both core needle biopsy (CNB) and radiology. AIM To determine the accuracy and upgrade rate of CNB and BI-RADS diagnosis of PBLs/Ns compared to final excision diagnosis and the factors linked to upgrade. METHODS The favored CNB diagnosis and BI-RADS category for 82 PBLs/Ns were assessed based on histopathology, myoepithelial marker immunohistochemistry, mammographic/ultrasonographic findings. The radiological findings were compared to the pathological diagnoses. The accuracies of CNB and BI-RADS were compared to the excision diagnosis of the corresponding PBLs/Ns. The upgrade rates to malignancy were evaluated for both CNB and BI-RADS. RESULTS The presence of solid, irregular masses in breasts with composition A/B with calcification in radiology was significantly associated with the diagnosis of suspicious/malignant CNB, and malignant excision specimens (p<0.05). CNB was more accurate (90%), sensitive and specific with high positive and negative predictive values than BI-RADS. Combined CNB/BI-RADS accuracy was 90.2%. Overall upgrade rate came up to 9.8%. Upgrade rates to carcinoma were 7.3% for CNB and 8.5% for BI-RADS. Factors linked to upgrade were the age, lesion-size, BI-RADS category 4A and C, and histopathological/radiological discordance. All the upgraded PBLs/Ns were diagnosed as benign lesions in CNB with present/focally present myoepithelial diagnosis reflecting a sampling error. CONCLUSION Up to 9.8% of PBLs/Ns diagnosed on CNB and BI-RADS undergo upgrading upon final excision, despite the high diagnostic accuracy. These evidences should be considered for final decision on whether to excise the lesion or not.
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Affiliation(s)
- Maha Mohamed Fawzy
- Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Heba Sheta
- Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Amal Abd El hafez
- Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt. ,Faculty of Medicine, Horus University-Egypt, New Damietta, Egypt. ,For Correspondence:
| | - Dina Harb
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Mohammad Zuhdy
- Surgical Oncology Department, Oncology Center Mansoura University (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Reham Alghandour
- Medical Oncology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
| | - Doaa H Sakr
- Medical Oncology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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8
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Flammia RS, Hoeh B, Hohenhorst L, Sorce G, Chierigo F, Panunzio A, Tian Z, Saad F, Leonardo C, Briganti A, Antonelli A, Terrone C, Shariat SF, Anceschi U, Graefen M, Chun FKH, Montorsi F, Gallucci M, Karakiewicz PI. Adverse upgrading and/or upstaging in contemporary low-risk prostate cancer patients. Int Urol Nephrol 2022. [PMID: 35838831 DOI: 10.1007/s11255-022-03250-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/08/2022] [Indexed: 11/06/2022]
Abstract
Background Upgrading and/or upstaging in low-risk prostate cancer (PCa) patients may represent an indication for active treatment instead of active surveillance (AS). We addressed contemporary upgrading and/or upstaging rates in a large population based-cohort of low-risk PCa patients. Materials and methods Whitin the SEER database (2010–2015), NCCN low-risk PCa patients were identified across management modalities: radical prostatectomy (RP), radiotherapy (RT) and non-local treatment (NLT). In RP patients, upgrading and/or upstaging rates were assessed in logistic regression models. Results Overall, of 27,901 low-risk PCa patients, 38% underwent RP vs 28% RT vs 34% NLT. RP patients were the youngest and harbored the highest percentage of positive cores and a higher rate of cT2a than NLT. At RP, 46.2% were upgraded to GGG ≥ 2, 6.0% to GGG ≥ 3 and 10.5% harbored nonorgan-confined stage (NOC, pT3-4 or pN1). Of NOC patients, 1.6% harbored GGG ≥ 3, 6.3% harbored GGG2 and 2.6% harbored GGG1. Of pT2 patients, 4.4% harbored GGG ≥ 3, 33.9% harbored GGG2 and 51.3% harbored GGG1. Age, PSA, percentage of positive cores and number of positive cores independently predicted the presence of NOC and/or GGG ≥ 3, but with low accuracy (63.9%). Conclusions In low-risk PCa, critical changes between tumor grade and stage at biopsy vs RP may be expected in very few patients: NOC with GGG ≥ 3 in 1.6% and NOC with GGG2 in 6.3%. Other patients with upgrading and/or upstaging combinations will invariably harbor either pT2 or GGG1 that far less critically affect PCa prognosis.
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9
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Diamand R, Hollans M, Lefebvre Y, Sirtaine N, Limani K, Hawaux E, Abou Zahr R, Mattlet A, Albisinni S, Roumeguère T, Peltier A. The role of perilesional and multiparametric resonance imaging-targeted biopsies to reduce the risk of upgrading at radical prostatectomy pathology: A retrospective monocentric study. Urol Oncol 2022; 40:192.e11-192.e17. [PMID: 35236622 DOI: 10.1016/j.urolonc.2022.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/18/2021] [Accepted: 01/17/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To evaluate histopathologic upgrading between biopsy methods and whole-mount prostatectomy specimens in International Society of Urological Pathology grade group. METHODS Overall, 134 patients, including 175 magnetic resonance imaging (MRI)-suspicious lesions, diagnosed on MRI-targeted (TB) and systematic (SB) biopsies before radical prostatectomy were retrospectively analyzed from a prospectively maintained database. Perilesional (PLB) and "extended" perilesional (ePLB) biopsies were defined as those taken within a circumferential zone of 5 and 10 mm around magnetic resonance imaging (MRI)-suspicious lesion respectively. Proportion of upgrading at prostatectomy pathology were compared between TB, TB + PLB, TP + ePLB and TB + SB. Uni- and multivariable logistic regressions assessed predictors of upgrading for TB + ePLB method. RESULTS Focusing on index lesion, median (interquartile range) number of cores taken was 4 (3-4) for TB, 5 (4-6) for TB + PLB, 6 (5-8) for TB + ePLB and 12 (12-15) for TB + SB. A higher upgrading proportion was detected upon comparing TB and TB + PLB methods to TB + SB (32 vs. 19%, P = 0.001, 26 vs. 19%, P = 0.04, respectively). Conversely, no significant difference was found between TB + ePLB compared to TB + SB (23 vs. 19%, P = 0.2). Proportion of downgrading was similar regardless of biopsy method (all P > 0.1). At multivariable analysis, Prostate Imaging-Reporting and Data System Steering score, total number of positive ePLB cores and International Society of Urological Pathology Grade Group were independent predictors of upgrading (all P ≤ 0.03). Similar results were found by adding data from non-index lesions. CONCLUSION Our finding suggest that MRI-targeted biopsies associated with perilesional sampling in a circumferential zone of 10 mm reduced upgrading proportion and showed similar accuracy as the current gold standard combination. Further prospective studies comparing biopsy methods are expected to validate this diagnostic strategy.
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Affiliation(s)
- Romain Diamand
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium.
| | - Marie Hollans
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Yoléne Lefebvre
- Department of Radiology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Sirtaine
- Department of Pathology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Ksenija Limani
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Eric Hawaux
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Rawad Abou Zahr
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Aurore Mattlet
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Simone Albisinni
- Department of Urology, University Clinics of Brussels, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Thierry Roumeguère
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium; Department of Urology, University Clinics of Brussels, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandre Peltier
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
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10
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Kretschmer A, Tutrone R, Alter J, Berg E, Fischer C, Kumar S, Torkler P, Tadigotla V, Donovan M, Sant G, Skog J, Noerholm M. Pre-diagnosis urine exosomal RNA (ExoDx EPI score) is associated with post-prostatectomy pathology outcome. World J Urol 2022; 40:983-989. [PMID: 35084544 PMCID: PMC8994717 DOI: 10.1007/s00345-022-03937-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE ExoDx Prostate IntelliScore (EPI) is a non-invasive urine exosome RNA-based test for risk assessment of high-grade prostate cancer. We evaluated the association of pre-biopsy test results with post-radical prostatectomy (RP) outcomes to understand the potential utility of EPI to inform invasive treatment vs active surveillance (AS) decisions. METHODS Urine samples were collected from 2066 men scheduled for initial biopsy with PSA between 2 and 10 ng/mL, no history of prostate cancer, and ≥ 50 years across multiple clinical studies. 310 men proceeded to RP, of which 111 patients had Gleason group grade 1 (GG1) at biopsy and would have been potential candidates for AS. We compared pre-biopsy urine scores with ERSPC and PCPT multivariate risk calculator scores for men with GG1 at biopsy to post-RP pathology. RESULTS Urine EPI scores were significantly lower in men with GG1 at biopsy than in men with > GG1 (p = 0.04), while there were no differences in multivariate risk scores used in standard clinical practice (p > 0.05). Further, EPI scores were significantly lower in men with GG1 at biopsy who remained GG1 post-RP compared to men upgraded to ≥ GG3 post-RP (p < 0.001). In contrast, none of the multiparametric risk calculators showed significant differences (p > 0.05). Men with GG1 at biopsy and EPI score < 15.6 had zero rate of upgrading to ≥ GG3 post-RP compared to 16.0% for EPI scores ≥ 15.6. CONCLUSIONS The EPI urine biomarker outperformed the multivariate risk calculators in a homogenous risk group of pre-biopsy men. The EPI score was associated with low-risk pathology post-RP, with potential implications on informing AS decisions. TRIAL REGISTRATION NCT02702856, NCT03031418, NCT03235687, NCT04720599.
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Affiliation(s)
| | | | - Jason Alter
- Exosome Diagnostics, 266 2nd Ave #200, Waltham, MA, 02451, USA
| | - Elena Berg
- Deparment of Urology, LMU-Klinikum der Universität München, Munich, Germany
| | | | - Sonia Kumar
- Exosome Diagnostics, 266 2nd Ave #200, Waltham, MA, 02451, USA
| | | | | | - Michael Donovan
- Department of Pathology, The University of Miami, Miami, FL, USA
| | - Grannum Sant
- Exosome Diagnostics, 266 2nd Ave #200, Waltham, MA, 02451, USA
| | - Johan Skog
- Exosome Diagnostics, 266 2nd Ave #200, Waltham, MA, 02451, USA.
| | - Mikkel Noerholm
- Exosome Diagnostics, 266 2nd Ave #200, Waltham, MA, 02451, USA
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11
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Eliopoulos C, Arapoglou D, Chorianopoulos N, Markou G, Haroutounian SA. Conversion of brewers' spent grain into proteinaceous animal feed using solid state fermentation. Environ Sci Pollut Res Int 2022; 29:29562-29569. [PMID: 34302241 DOI: 10.1007/s11356-021-15495-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
Brewers' spent grain (BSG) represents the 85% of the total residue produced during the beer brewing process, with a global annual production volume exceeding 30 Mtons. The current study concerns the application of solid state fermentation (SSF) as a bioprocess where the nutritional value of BSG is improved for further use as animal feed with increased value. The investigated SSF procedure was initiated by the edible fungi Pleurotus ostreatus, which constitutes a natural source of proteins, β-glucans, and various metabolites (vitamins, nutrients, etc.). Herein, the SSF of BSG resulted in a significant increase of protein content by 49.49%, a 10-fold increase of 1,3-1,6 β-glucans, and a respective reduction of cellulose by 11.42%. The application of this method is expected to provide some useful information on the utilization of BSG as substrate for fungi-initiated SSF, a bioprocess allowing the significant reduction of the environmental impact caused by the beer brewing industry and simultaneously producing animal feed with higher protein content and improved nutritional characteristics. Such studies contribute to confront the unavailability of proteinaceous animal feed observed in the last decade.
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Affiliation(s)
- Christos Eliopoulos
- Institute of Technology of Agricultural Products, ELGO DIMITRA, Sof. Venizelou 1, 14123, Athens, Greece
- Laboratory Nutritional Physiology & Feeding, Department of Animal Science, Agricultural University of Athens, Iera Odos 75, 11855, Athens, Greece
| | - Dimitrios Arapoglou
- Institute of Technology of Agricultural Products, ELGO DIMITRA, Sof. Venizelou 1, 14123, Athens, Greece.
| | - Nikos Chorianopoulos
- Institute of Technology of Agricultural Products, ELGO DIMITRA, Sof. Venizelou 1, 14123, Athens, Greece
| | - Giorgos Markou
- Institute of Technology of Agricultural Products, ELGO DIMITRA, Sof. Venizelou 1, 14123, Athens, Greece
| | - Serkos A Haroutounian
- Laboratory Nutritional Physiology & Feeding, Department of Animal Science, Agricultural University of Athens, Iera Odos 75, 11855, Athens, Greece
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12
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Piccinelli ML, Luzzago S, Marvaso G, Laukhtina E, Miura N, Schuettfort VM, Mori K, Colombo A, Ferro M, Mistretta FA, Fusco N, Petralia G, Jereczek-Fossa BA, Shariat SF, Karakiewicz PI, de Cobelli O, Musi G. Association between previous negative biopsies and lower rates of progression during active surveillance for prostate cancer. World J Urol 2022; 40:1447-1454. [PMID: 35347414 PMCID: PMC9166841 DOI: 10.1007/s00345-022-03983-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 02/27/2022] [Indexed: 11/04/2022] Open
Abstract
Purpose To test any-cause discontinuation and ISUP GG upgrading rates during Active Surveillance (AS) in patients that underwent previous negative biopsies (PNBs) before prostate cancer (PCa) diagnosis vs. biopsy naive patients. Methods Retrospective analysis of 961 AS patients (2008–2020). Three definitions of PNBs were used: (1) PNBs status (biopsy naïve vs. PNBs); (2) number of PNBs (0 vs. 1 vs. ≥ 2); (3) histology at last PNB (no vs. negative vs. HGPIN/ASAP). Kaplan–Meier plots and multivariable Cox models tested any-cause and ISUP GG upgrading discontinuation rates. Results Overall, 760 (79.1%) vs. 201 (20.9%) patients were biopsy naïve vs. PNBs. Specifically, 760 (79.1%) vs. 138 (14.4%) vs. 63 (6.5%) patients had 0 vs. 1 vs. ≥ 2 PNBs. Last, 760 (79.1%) vs. 134 (13.9%) vs. 67 (7%) patients had no vs. negative PNB vs. HGPIN/ASAP. PNBs were not associated with any-cause discontinuation rates. Conversely, PNBs were associated with lower rates of ISUP GG upgrading: (1) PNBs vs. biopsy naïve (HR:0.6, p = 0.04); (2) 1 vs. 0 PNBs (HR:0.6, p = 0.1) and 2 vs. 0 PNBs, (HR:0.5, p = 0.1); (3) negative PNB vs. biopsy naïve (HR:0.7, p = 0.3) and HGPIN/ASAP vs. biopsy naïve (HR:0.4, p = 0.04). However, last PNB ≤ 18 months (HR:0.4, p = 0.02), but not last PNB > 18 months (HR:0.8, p = 0.5) were associated with lower rates of ISUP GG upgrading. Conclusion PNBs status is associated with lower rates of ISUP GG upgrading during AS for PCa. The number of PNBs and time from last PNB to PCa diagnosis (≤ 18 months) appear also to be critical for patient selection. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-022-03983-8.
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Affiliation(s)
- Mattia Luca Piccinelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy. .,Università degli Studi di Milano, Milan, Italy.
| | - Stefano Luzzago
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Giulia Marvaso
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Noriyoshi Miura
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Victor M Schuettfort
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Alberto Colombo
- Division of Radiology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy
| | - Matteo Ferro
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy
| | - Francesco A Mistretta
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Nicola Fusco
- Department of Pathology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Giuseppe Petralia
- Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, 20141, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Barbara A Jereczek-Fossa
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Shahrokh F Shariat
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Department of Urology, Medical University of Vienna, Vienna, Austria.,Research Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan.,Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,European Association of Urology Research Foundation, Arnhem, Netherlands
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
| | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Giuseppe Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università Degli Studi Di Milano, 20122, Milan, Italy
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13
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Kusenberg M, Eschenbacher A, Djokic MR, Zayoud A, Ragaert K, De Meester S, Van Geem KM. Opportunities and challenges for the application of post-consumer plastic waste pyrolysis oils as steam cracker feedstocks: To decontaminate or not to decontaminate? Waste Manag 2022; 138:83-115. [PMID: 34871884 PMCID: PMC8769047 DOI: 10.1016/j.wasman.2021.11.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 10/11/2021] [Accepted: 11/07/2021] [Indexed: 05/15/2023]
Abstract
Thermochemical recycling of plastic waste to base chemicals via pyrolysis followed by a minimal amount of upgrading and steam cracking is expected to be the dominant chemical recycling technology in the coming decade. However, there are substantial safety and operational risks when using plastic waste pyrolysis oils instead of conventional fossil-based feedstocks. This is due to the fact that plastic waste pyrolysis oils contain a vast amount of contaminants which are the main drivers for corrosion, fouling and downstream catalyst poisoning in industrial steam cracking plants. Contaminants are therefore crucial to evaluate the steam cracking feasibility of these alternative feedstocks. Indeed, current plastic waste pyrolysis oils exceed typical feedstock specifications for numerous known contaminants, e.g. nitrogen (∼1650 vs. 100 ppm max.), oxygen (∼1250 vs. 100 ppm max.), chlorine (∼1460vs. 3 ppm max.), iron (∼33 vs. 0.001 ppm max.), sodium (∼0.8 vs. 0.125 ppm max.)and calcium (∼17vs. 0.5 ppm max.). Pyrolysis oils produced from post-consumer plastic waste can only meet the current specifications set for industrial steam cracker feedstocks if they are upgraded, with hydrogen based technologies being the most effective, in combination with an effective pre-treatment of the plastic waste such as dehalogenation. Moreover, steam crackers are reliant on a stable and predictable feedstock quality and quantity representing a challenge with plastic waste being largely influenced by consumer behavior, seasonal changes and local sorting efficiencies. Nevertheless, with standardization of sorting plants this is expected to become less problematic in the coming decade.
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Affiliation(s)
- Marvin Kusenberg
- Laboratory for Chemical Technology (LCT), Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering & Architecture, Ghent University, B-9052 Zwijnaarde, Belgium
| | - Andreas Eschenbacher
- Laboratory for Chemical Technology (LCT), Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering & Architecture, Ghent University, B-9052 Zwijnaarde, Belgium
| | - Marko R Djokic
- Laboratory for Chemical Technology (LCT), Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering & Architecture, Ghent University, B-9052 Zwijnaarde, Belgium
| | - Azd Zayoud
- Laboratory for Chemical Technology (LCT), Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering & Architecture, Ghent University, B-9052 Zwijnaarde, Belgium
| | - Kim Ragaert
- Center for Polymer and Material Technologies (CPMT), Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering and Architecture, Ghent University, B-9052 Zwijnaarde, Belgium
| | - Steven De Meester
- Laboratory for Circular Process Engineering (LCPE), Department of Green Chemistry and Technology, Faculty of Bioscience Engineering, Ghent University, B-8500 Kortrijk, Belgium
| | - Kevin M Van Geem
- Laboratory for Chemical Technology (LCT), Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering & Architecture, Ghent University, B-9052 Zwijnaarde, Belgium
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Xu YH, Li MF. Hydrothermal liquefaction of lignocellulose for value-added products: Mechanism, parameter and production application. Bioresour Technol 2021; 342:126035. [PMID: 34592454 DOI: 10.1016/j.biortech.2021.126035] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/21/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
Abundant, environmentally friendly, and sustainable lignocellulose is a promising feedstock for replacing fossil fuels, and hydrothermal liquefaction is an effective technology to convert it into liquid fuels and high-value chemicals. This review summarizes and discusses the reaction mechanism, main influence factor and the production application of hydrothermal liquefaction. Particular attention has been paid to the reaction mechanism of the structural components of lignocellulose, i.e., cellulose, hemicellulose, and lignin. In addition, the influence factors including types of lignocellulose, temperature, heating rate, retention time, pressure, solid-to-liquid ratio, and catalyst are discussed in detail. The limitations in the hydrothermal liquefaction of lignocellulose and the prospects are proposed. This provides deep knowledge for understanding the process as well as the development of advanced products from lignocellulose.
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Affiliation(s)
- Ying-Hong Xu
- Beijing Key Laboratory of Lignocellulosic Chemistry, Beijing Forestry University, Beijing 100083, China
| | - Ming-Fei Li
- Beijing Key Laboratory of Lignocellulosic Chemistry, Beijing Forestry University, Beijing 100083, China.
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15
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Al-Kailani Z, Linxweiler J, Siemer S, Stöckle M, Saar M. [Deferred prostatectomy after active surveillance-results from a single center]. Urologe A 2021. [PMID: 34748022 DOI: 10.1007/s00120-021-01705-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Follow-up during Active Surveillance (AS) may result in psychological burden and discomfort due to the constant clinical monitoring. Therefore, successful implementation of AS is to some extent a challenge for the patient and the caregiver. MATERIALS AND METHODS In this monocentric study, we analyzed the reasons for termination of AS and the rate of the postoperative adverse pathology (AP) in patients who underwent deferred radical prostatectomy (RP) after AS. These results were compared with AS candidates who underwent immediate RP. P-values were calculated with the Χ2 test. RESULTS After 21 months of follow-up during AS, a deferred RP was performed in 74 patients. On the other hand, 214 patients underwent immediate RP. AP (Gleason score ≥7b, ≥pT3a, R1 and N+) was common in the AS group and this was statistically significant (45% vs. 29%, P-value <0.001). CONCLUSION These findings reflect many deficits in the current AS protocols. Using the available tools to apply AS in the routine clinical practice setting may be not adequate to afford oncological safety. This requires the development of new diagnostic tools like new imaging techniques and innovative biomarkers that provide the clinician with more accurate data about disease progression and subsequent help to achieve better outcomes in active surveillance candidates.
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16
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Luzzago S, Piccinelli ML, Marvaso G, Laukhtina E, Miura N, Schuettfort VM, Mori K, Aydh A, Ferro M, Mistretta FA, Fusco N, Petralia G, Jereczek-Fossa BA, Shariat SF, Karakiewicz PI, de Cobelli O, Musi G. Active surveillance for prostate cancer: comparison between incidental tumors vs. tumors diagnosed at prostate biopsies. World J Urol 2021; 40:443-451. [PMID: 34687344 DOI: 10.1007/s00345-021-03864-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/09/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To test discontinuation rates during Active Surveillance (AS) in patients diagnosed with incidental prostate cancers (IPCa) vs. tumors diagnosed at prostate biopsies (BxPCa). METHODS Retrospective single center analysis of 961 vs. 121 BxPCa vs. IPCa patients (2008-2020). Kaplan-Meier plots and multivariable Cox regression models tested four different outcomes: (1) any-cause discontinuation; (2) discontinuation due to ISUP GG upgrading; (3) biopsy discontinuation due to ISUP GG upgrading or > 3 positive cores; (4) biopsy discontinuation or suspicious extraprostatic extension at surveillance mpMRI. Then, multivariable logistic regression models tested rates of clinically significant PCa (csPCa) (ISUP GG ≥ 3 or pT ≥ 3a or pN1) after radical prostatectomy (RP). RESULTS Median time follow-up was 35 (19-64) months. IPCa patients were at lower risk of any-cause (3-year survival: 79.3 vs. 66%; HR: 0.5, p = 0.001) and biopsy/MRI AS discontinuation (3-year survival: 82.3 vs. 72.7%; HR: 0.5, p = 0.001), compared to BxPCa patients. Conversely, IPCa patients exhibited same rates of biopsy discontinuation and ISUP GG upgrading over time, relative to BxPCa. In multivariable logistic regression models, IPCa patients were associated with higher rates of csPCa at RP (OR: 1.4, p = 0.03), relative to their BxPCa counterparts. CONCLUSION AS represents a safe management strategy for IPCa. Compared to BxPCa, IPCa patients are less prone to experience any-cause and biopsy/MRI AS discontinuation. However, the two mentioned groups present similar rates of biopsy discontinuation and ISUP GG upgrading over time. In consequence, tailored AS protocols with scheduled repeated surveillance biopsies should be offered to all newly diagnosed IPCa patients.
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Affiliation(s)
- Stefano Luzzago
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy. .,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122, Milan, Italy.
| | - Mattia Luca Piccinelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.,Università degli Studi di Milano, Milan, Italy
| | - Giulia Marvaso
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Noriyoshi Miura
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Victor M Schuettfort
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Abdulmajeed Aydh
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, King Faisal Medical City, Abha, Saudi Arabia
| | - Matteo Ferro
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Francesco A Mistretta
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy
| | - Nicola Fusco
- Department of Pathology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122, Milan, Italy
| | - Giuseppe Petralia
- Precision Imaging and Research Unit, Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCCS, 20141, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122, Milan, Italy
| | - Barbara A Jereczek-Fossa
- Department of Radiotherapy, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122, Milan, Italy
| | - Shahrokh F Shariat
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Department of Urology, Medical University of Vienna, Vienna, Austria.,Research Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan.,Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,European Association of Urology Research Foundation, Arnhem, The Netherlands
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122, Milan, Italy
| | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Haemato-Oncology, Università degli Studi di Milano, 20122, Milan, Italy
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17
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Karadağ S, Ekşi M, Özdemir O, Akkaş F, Arikan Y, Özlü DN, Çolakoğlu Y, Aliş D, Şahin S, Tuğcu V. Is neutrophile to lymphocyte ratio a predictor of Gleason score upgrading according to risk classifications in patients with prostate cancer. ARCH ESP UROL 2021; 74:599-605. [PMID: 34219063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVES We aimed to determine the parameters that predict Gleason Score (GS) upgrading in patients undergoing robot-assisted laparoscopic radical prostatectomy (RARP) and especially the ability of neutrophile to lymphocyte ratio (NLR) in predicting the upgrading. METHODS Patients who underwent RARP for prostate cancer in our clinic between January 2013 and January 2018 were retrospectively analyzed. Patients' demographic data, preoperative and postoperative parameters were all recorded in the database. NLR was calculated by dividing the absolute neutrophil count (NC) by the absolute lymphocyte count (LC). Patients were classified as low, moderate and high risk according to the National Comprehensive Cancer Network (NCNN) Guidelines. Any increase in GS between biopsy results and radical prostatectomy specimens were consideredas an GS upgrading. RESULTS After applying the inclusion and exclusion criteria, a total of 571 patients, 205 patients without GS upgrading (Group 1) and 366 patients with GS upgrading (Group 2), were included. The mean preoperative PSA values and prostate volumes were 10.8 ± 8 ng/dL and 45 ± 18.8 ml, respectively. Group 2 had a significantly high NC and NLR, significantly low platelet count (PC) and LC, (p=0.0001, 0.0001, 0.001 and0.002, respectively). Group 2 was found to have significantly higher positive surgical margin (PSM), extraprostatic extension (EPE) and seminal vesical invasion (SVI) (p<0.001). There was no significant correlation between the parameters of NLR and PSM, EPE, SVI, and lymph node invasion (LNI). Binomial logistic regression showed patients with increased NLR had 1.68 times higher odds to exhibit an upgrade in GS in the post-surgical histopathological analysis. CONCLUSIONS NLR calculated preoperatively is an easy diagnostic method that can predict GS upgrading in patients scheduled for radical prostatectomy for prostate cancer.
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Affiliation(s)
- Serdar Karadağ
- Department of Urology. Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Istanbul. Turkey
| | - Mithat Ekşi
- Department of Urology. Arnavutkoy State Hospital. Istanbul, Turkey
| | - Osman Özdemir
- Department of Urology. Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Istanbul. Turkey
| | - Fatih Akkaş
- Department of Urology. Erzurum Bölge Training and Research Hospital. Erzurum. Turkey
| | - Yusuf Arikan
- Department of Urology. Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Istanbul. Turkey
| | - Deniz Noyan Özlü
- Department of Urology. Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Istanbul. Turkey
| | - Yunus Çolakoğlu
- Department of Urology. Başakşehir Çam & Sakura City Hospital. İstanbul. Turkey
| | - Deniz Aliş
- Deparment of Radiology. Mehmet Ali Aydınlar Acibadem University. Istanbul. Turkey
| | - Selçuk Şahin
- Department of Urology. Bakirkoy Dr. Sadi Konuk Training and Research Hospital. Istanbul. Turkey
| | - Volkan Tuğcu
- Department of Urology. Bahçelievler Memorial Hospital. Istanbul. Turkey
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18
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Rajwa P, Pradere B, Quhal F, Mori K, Laukhtina E, Huebner NA, D'Andrea D, Krzywon A, Shim SR, Baltzer PA, Renard-Penna R, Leapman MS, Shariat SF, Ploussard G. Reliability of Serial Prostate Magnetic Resonance Imaging to Detect Prostate Cancer Progression During Active Surveillance: A Systematic Review and Meta-analysis. Eur Urol 2021; 80:549-563. [PMID: 34020828 DOI: 10.1016/j.eururo.2021.05.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022]
Abstract
CONTEXT Although magnetic resonance imaging (MRI) is broadly implemented into active surveillance (AS) protocols, data on the reliability of serial MRI in order to help guide follow-up biopsy are inconclusive. OBJECTIVE To assess the diagnostic estimates of serial prostate MRI for prostate cancer (PCa) progression during AS. EVIDENCE ACQUISITION We systematically searched PubMed, Scopus, and Web of Science databases to select studies analyzing the association between changes on serial prostate MRI and PCa progression during AS. We included studies that provided data for MRI progression, which allowed us to calculate diagnostic estimates. We compared Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) accuracy with institution-specific definitions. EVIDENCE SYNTHESIS We included 15 studies with 2240 patients. Six used PRECISE criteria and nine institution-specific definitions of MRI progression. The pooled PCa progression rate, which included histological progression to Gleason grade ≥2, was 27%. The pooled sensitivity and specificity were 0.59 (95% confidence interval [CI] 0.44-0.73) and 0.75 (95% CI 0.66-0.84) respectively. There was significant heterogeneity between included studies. Depending on PCa progression prevalence, the pooled negative predictive value for serial prostate MRI ranged from 0.81 (95% CI 0.73-0.88) to 0.88 (95% CI 0.83-0.93) and the pooled positive predictive value ranged from 0.37 (95% CI 0.24-0.54) to 0.50 (95% CI 0.36-0.66). There were no significant differences in the pooled sensitivity (p = 0.37) and specificity (p = 0.74) of PRECISE and institution-specific schemes. CONCLUSIONS Serial MRI still should not be considered a sole factor for excluding PCa progression during AS, and changes on MRI are not accurate enough to indicate PCa progression. There was a nonsignificant trend toward improved diagnostic estimates of PRECISE recommendations. These findings highlight the need to further define the optimal triggers and timing of biopsy during AS, as well as the need for optimizing the quality, interpretation, and reporting of serial prostate MRI. PATIENT SUMMARY Our study suggests that serial prostate magnetic resonance imaging (MRI) alone in patients on active surveillance is not accurate enough to reliably rule out or rule in prostate cancer progression. Other clinical factors and biomarkers along with serial MRI are required to safely tailor the intensity of follow-up biopsies.
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Affiliation(s)
- Pawel Rajwa
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Benjamin Pradere
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Fahad Quhal
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Keiichiro Mori
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Ekaterina Laukhtina
- Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Nicolai A Huebner
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - David D'Andrea
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Aleksandra Krzywon
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Sung Ryul Shim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Pascal A Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Raphaële Renard-Penna
- Department of Radiology, Pitié-Salpétrière Hospital, Paris-Sorbonne University, Paris, France
| | | | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
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19
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Struhs E, Hansen S, Mirkouei A, Ramirez-Corredores MM, Sharma K, Spiers R, Kalivas JH. Ultrasonic-assisted catalytic transfer hydrogenation for upgrading pyrolysis-oil. Ultrason Sonochem 2021; 73:105502. [PMID: 33652291 PMCID: PMC7921008 DOI: 10.1016/j.ultsonch.2021.105502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 01/15/2021] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Recent interest in biomass-based fuel blendstocks and chemical compounds has stimulated research efforts on conversion and upgrading pathways, which are considered as critical commercialization drivers. Existing pre-/post-conversion pathways are energy intense (e.g., pyrolysis and hydrogenation) and economically unsustainable, thus, more efficient process solutions can result in supporting the renewable fuels and green chemicals industry. This study proposes a process, including biomass conversion and bio-oil upgrading, using mixed fast and slow pyrolysis conversion pathway, as well as sono-catalytic transfer hydrogenation (SCTH) treatment process. The proposed SCTH treatment employs ammonium formate as a hydrogen transfer additive and palladium supported on carbon as the catalyst. Utilizing SCTH, bio-oil molecular bonds were broken and restructured via the phenomena of cavitation, rarefaction, and hydrogenation, with the resulting product composition, investigated using ultimate analysis and spectroscopy. Additionally, an in-line characterization approach is proposed, using near-infrared spectroscopy, calibrated by multivariate analysis and modeling. The results indicate the potentiality of ultrasonic cavitation, catalytic transfer hydrogenation, and SCTH for incorporating hydrogen into the organic phase of bio-oil. It is concluded that the integration of pyrolysis with SCTH can improve bio-oil for enabling the production of fuel blendstocks and chemical compounds from lignocellulosic biomass.
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Affiliation(s)
- Ethan Struhs
- Department of Mechanical Engineering, University of Idaho, Idaho Falls, ID 83402, USA
| | - Samuel Hansen
- Department of Mechanical Engineering, University of Idaho, Idaho Falls, ID 83402, USA
| | - Amin Mirkouei
- Department of Mechanical Engineering, University of Idaho, Idaho Falls, ID 83402, USA.
| | | | - Kavita Sharma
- Department of Chemistry, Idaho State University, Pocatello, ID 83204, USA
| | - Robert Spiers
- Department of Chemistry, Idaho State University, Pocatello, ID 83204, USA
| | - John H Kalivas
- Department of Chemistry, Idaho State University, Pocatello, ID 83204, USA
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20
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Yin H, Chen M, Qiu X, Qiu L, Gao J, Li D, Fu Y, Huang H, Guo S, Zhang Q, Ai S, Wang F, Guo H. Can 68Ga-PSMA-11 PET/CT predict pathological upgrading of prostate cancer from MRI-targeted biopsy to radical prostatectomy? Eur J Nucl Med Mol Imaging 2021. [PMID: 33813594 DOI: 10.1007/s00259-021-05217-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/24/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE Prostate-specific membrane antigen (PSMA) positron emission tomography (PSMA-PET) is an ideal tool for staging and restaging of prostate cancer (PCa). This study was designed to investigate the prognostic role of preoperative 68Ga-PSMA-11 PET/CT in predicting pathological upgrading from multiparametric magnetic resonance imaging-targeted biopsy (mpMRI-TB) to final radical prostatectomy (RP) specimens in patients with localized PCa. METHODS A total of 67 biopsy-confirmed localized PCa patients with mpMRI and 68Ga-PSMA-11 PET/CT prior to RP were included. Clinical and imaging characteristics derived from mpMRI and PET/CT were compared in patients with or without pathological upgrading. Predictors for pathological upgrading were evaluated by using univariate and multivariable analyses. A prediction model was developed based on the identified parameters and validated using internal validation. RESULTS Pathological upgrading from mpMRI-TB to final RP specimens occurred in 38.8% (26/67) of the patients. Multivariable logistic regression analysis showed SUVmax (OR: 1.223, 95% CI 1.068-1.399, p = 0.003); highest tumor grade at mpMRI-TB, ISUP grade group (ISUP GG) 1 vs. 4 (OR: 0.11, 95% CI 0.000-0.452, p = 0.018) and ISUP GG 2 vs. 4 (OR: 0.16, 95% CI 0.001-0.252, p = 0.003); and multifocality on PET/CT (OR: 9.821, 95% CI 1.438-67.085, p = 0.02) were independent risk factors for pathological upgrading. Our developed prediction model based on the identified parameter showed good calibration at internal validation (mean absolute error = 0.033). CONCLUSION 68Ga-PSMA-11 PET/CT was found to be an ideal biomarker for the prediction of pathological upgrading from mpMRI-TB to RP, especially for patients with lower tumor grade at mpMRI-TB.
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21
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Sayyid RK, Reed WC, Benton JZ, Lodh A, Woodruff P, Lambert JH, Terris MK, Wallis CJD, Klaassen Z. Pathologic upgrading in favorable intermediate risk active surveillance patients: Clinical heterogeneity and implications for active surveillance decision. Urol Oncol 2021; 39:782.e7-782.e14. [PMID: 33766466 DOI: 10.1016/j.urolonc.2021.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/18/2021] [Accepted: 02/21/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Current guidelines support active surveillance (AS) for select patients with favorable intermediate risk (FIR) prostate cancer (CaP). A significant proportion of FIR CaP patients undergoing surgical treatment are found to have evidence of adverse pathology. Our objective was to determine the incidence and predictors of pathologic upgrading in FIR AS patients undergoing radical prostatectomy. MATERIALS AND METHODS The Surveillance, Epidemiology, and End Results Prostate with Watchful Waiting (WW) database was used to identify men younger than 80 years with National Comprehensive Cancer Network FIR CaP initially opting for AS and/or WW between 2010 and 2015 and subsequently underwent radical prostatectomy at least one year following diagnosis. Patients were assigned into one of three subgroups based on their intermediate risk factor: Gleason Score 7(3 + 4) (Group 1), prostate specific antigen level of 10-20 ng/ml (Group 2), and cT2b-c (Group 3). Pathologic upgrading was present in Group 1 if pathologic GS was 7 (4 + 3) or worse. For patients in Groups 2 and 3, upgrading occurred if pathologic GS was 7 (3 + 4) or worse. Oncologic and sociodemographic predictors of pathologic upgrading were evaluated univariable and multivariable logistic regression analysis. RESULTS 18,760 patients were identified. Pathologic upgrading occurred in 138 (13.3%), 59 (25.0%), and 8,011 (45.8%) patients in groups 1, 2, and 3 respectively. Pathologic downgrading occurred in 226 (21.7%) patients in group 1. Significant predictors of pathologic upgrading on multivariable analysis included older age at diagnosis: 70 to 79 vs. 40 to 49 years (Groups 1 and 3, P < 0.05), a more recent diagnosis: 2014 to2015 vs. 2010-2011 (Groups 2 and 3, P < 0.005), higher volume disease: 37.5% to 49.9% vs. 0% to 12.4% (Groups 2 and 3, P < 0.005), and clinically palpable disease (Groups 1 and 2, P < 0.05). Additional risk factors for upgrading included uninsured or Medicaid status, diagnosis in a Western region (Group 2), African American ethnicity and higher socioeconomic status (Group 3) CONCLUSIONS: FIR CaP is a clinically heterogeneous risk group with incidence of pathologic upgrading ranging from 13.3% in those with GS 7 (3 + 4) to 45.8% in those with cT2b-c disease. Risk of pathologic upgrading in FIR CaP patients initially managed with AS and/or WW is significantly associated with multiple patient-level oncologic and sociodemographic variables.
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Affiliation(s)
- Rashid K Sayyid
- Section of Urology, Department of Surgery, Medical College of Georgia-Augusta University, Augusta, GA
| | | | | | - Atul Lodh
- Medical College of Georgia, Augusta, GA
| | - Phillip Woodruff
- Section of Urology, Department of Surgery, Medical College of Georgia-Augusta University, Augusta, GA
| | - Joshua H Lambert
- Section of Urology, Department of Surgery, Medical College of Georgia-Augusta University, Augusta, GA
| | - Martha K Terris
- Section of Urology, Department of Surgery, Medical College of Georgia-Augusta University, Augusta, GA; Georgia Cancer Center, Augusta, GA
| | | | - Zachary Klaassen
- Section of Urology, Department of Surgery, Medical College of Georgia-Augusta University, Augusta, GA; Georgia Cancer Center, Augusta, GA.
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22
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Abstract
There is a growing literature on the impact of Covid-19 on commercial and labour conditions at suppliers in apparel global value chains (GVCs). Yet much less is known about the implications for suppliers operating in regional value chains (RVCs) in the global South. In this article, we focus on Eswatini, which has grown to become the largest African manufacturer and exporter of apparel to the region. We draw on a combination of firm-level export data and interviews with stakeholders before and after the Covid-19 lockdown to shed light on the influence of private and public governance on suppliers' economic and social upgrading and downgrading. We point to the coexistence of two separate private governance structures: the first characterised by direct contracts between South African retailers and large manufacturers (direct suppliers); the second operating through indirect purchasing via intermediaries from relatively smaller producers (indirect suppliers). While direct suppliers enjoyed higher levels of economic and social upgrading than indirect suppliers before Covid-19, the pandemic reinforced this division, with severe price cuts for indirect suppliers. Furthermore, while retailers provided some direct suppliers with support throughout the crisis, this was not the case for indirect suppliers, who remain comparatively more vulnerable. In terms of public governance, the negative consequences of the lockdown on firms' income and workers' livelihoods have been compounded by the state's ineffective response. Our paper contributes to the research on RVCs in the global South, enhancing our understanding of how different governance structures and external shocks affect firms' and workers' upgrading and downgrading prospects.
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Affiliation(s)
- Giovanni Pasquali
- The Global Development Institute, University of Manchester, Arthur Lewis Building, Room 2.037, Oxford Road, Manchester, M13 9PL UK
| | - Shane Godfrey
- Institute of Development and Labour Law, University of Cape Town, Cape Town, South Africa
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23
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van Huellen S, Abubakar FM. Potential for Upgrading in Financialised Agri-food Chains: The Case of Ghanaian Cocoa. Eur J Dev Res 2021; 33:227-252. [PMID: 33558793 PMCID: PMC7859721 DOI: 10.1057/s41287-020-00351-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
We revisit functional upgrading opportunities for developing and emerging market companies in the context of highly financialised food systems. We argue that the assessment of upgrading potential within the global value chain literature lacks consideration of constraints posed by financialisation, not only of the sector within which upgrading takes place but also by the global financial architecture more broadly. For the Ghanaian cocoa-chocolate sector, we show that financialisation acts as limiting factor to upgrading, with contradicting tendencies. First, financialisation of lead firms, eager to outsource non-core activities, has promoted cocoa processing in Ghana, but the resulting consolidation of power hinders further functional upgrading. Second, Ghana's dependency on cocoa for foreign exchange earnings necessitates upgrading into higher value-added segments, while also undermining feasible upgrading strategies that build on domestic or regional markets first. These contradicting tendencies constitute a middle value-added trap, which is difficult but not impossible to overcome.
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24
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Herkommer K, Maier N, Ankerst DP, Schiele S, Gschwend JE, Meissner VH. No detrimental effect of a positive family history on postoperative upgrading and upstaging in men with low risk and favourable intermediate-risk prostate cancer: implications for active surveillance. World J Urol 2021; 39:2499-506. [PMID: 33048258 DOI: 10.1007/s00345-020-03485-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 10/03/2020] [Indexed: 01/14/2023] Open
Abstract
Purpose To assess whether a first-degree family history or a fatal family history of prostate cancer (PCa) are associated with postoperative upgrading and upstaging among men with low risk and favourable intermediate-risk (FIR) PCa and to provide guidance on clinical decision making for active surveillance (AS) in this patient population. Methods Participants in the German Familial Prostate Cancer database diagnosed from 1994 to 2019 with (1) low risk (clinical T1c–T2a, biopsy Gleason Grade Group (GGG) 1, PSA < 10 ng/ml), (2) Gleason 6 FIR (clinical T1c–T2a, GGG 1, PSA 10–20 ng/ml), and (3) Gleason 3 + 4 FIR (clinical T1c–T2a, GGG 2, PSA < 10 ng/ml) PCa who were subsequently treated with radical prostatectomy (RP) were analysed for upgrading, defined as postoperative GGG 3 tumour or upstaging, defined as pT3–pT4 or pN1 disease at RP. Logistic regression analysis was used to assess whether PCa family history was associated with postoperative upgrading or upstaging. Results Among 4091 men who underwent RP, mean age at surgery was 64.4 (SD 6.7) years, 24.7% reported a family history, and 3.4% a fatal family history. Neither family history nor fatal family history were associated with upgrading or upstaging at low risk, Gleason 6 FIR, and Gleason 3 + 4 FIR PCa patients. Conclusion Results from the current study indicated no detrimental effect of family history on postoperative upgrading or upstaging. Therefore, a positive family history or fatal family history of PCa in FIR PCa patients should not be a reason to refrain from AS in men otherwise suitable. Electronic supplementary material The online version of this article (10.1007/s00345-020-03485-5) contains supplementary material, which is available to authorized users.
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25
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Liu H, Tang K, Xia D, Peng E, Wang L, Chen Z. Combined multiple clinical characteristics for prediction of discordance in grade and stage in prostate cancer patients undergoing systematic biopsy and radical prostatectomy. Pathol Res Pract 2020; 216:153235. [PMID: 33035728 DOI: 10.1016/j.prp.2020.153235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The present study aimed to develop three nomograms by incorporating multiple clinical characteristics to identify those prostate cancer (PCa) patients with high probability of incorrect biopsy Gleason grade group (GG) before making treatment decisions. METHODS We retrospectively collected data from PCa patients who underwent systematic biopsy and radical prostatectomy from January 2015 to December 2019 at Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology. Univariable and multivariable logistic regression analyses were preformed to identify independent risk factors associated with upgrading, upstaging and downgrading. By incorporating selected clinical parameters with high predictive value, we constructed three nomograms to predict the probability of upgrading, upstaging and downgrading. Discrimination of nomograms was evaluated by receiver operating characteristic (ROC) analysis with corresponding area under the curve (AUC). Decision curve analysis (DCA) and calibration curves were performed to evaluate calibration and the clinical usefulness of nomograms. Performance of the three nomograms was validated in the testing dataset. RESULTS There were 585 PCa patients in total enrolled in this study who met the inclusion criteria. Of the 585 patients, the disease of 262 (44.8 %) was upgraded and 68 (11.6 %) was downgraded, and the disease of 67 (11.5 %) was upstaged. With regard to findings of multivariable analyses, patients' age and biopsy GG (GG 2, GG 3, GG 4 versus GG 1) were significantly associated with upgrading. Moreover, maximum diameter of the index lesion (D-max), clinical T stage (cT3a, cT3b versus cT1-2), number of positive cores and total tumor length were significantly associated with upstaging. Furthermore, d-max, %fPSA (> 0.16 versus ≤ 0.16) and biopsy GG (GG 3, GG 4, GG 5 versus GG 2) were independent predictors of downgrading. The three nomograms displayed good calibration in respective calibration plots. ROC analyses showed good discrimination with satisfactory AUC values and DCA plots demonstrated that the upgrading-risk nomogram, upstaging-risk nomogram and downgrading-risk nomogram were all clinically useful. CONCLUSIONS The upgrading-risk nomogram, upstaging-risk nomogram, and downgrading-risk nomogram were developed and correctly predicted the probability of incorrect Gleason grade group assigned to patients undergoing systematic biopsy.
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Affiliation(s)
- Hailang Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Kun Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ding Xia
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ejun Peng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Liang Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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26
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Collà Ruvolo C, Stolzenbach LF, Nocera L, Deuker M, Mistretta FA, Luzzago S, Tian Z, Longo N, Graefen M, Chun FKH, Saad F, Briganti A, De Cobelli O, Mirone V, Karakiewicz PI. Comparison of Mexican-American vs Caucasian prostate cancer active surveillance candidates. Urol Oncol 2020; 39:74.e1-74.e7. [PMID: 32950397 DOI: 10.1016/j.urolonc.2020.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/26/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND We compared upgrading and upstaging rates in low risk and favorable intermediate risk prostate cancer (CaP) patients according to racial and/or ethnic group: Mexican-Americans and Caucasians. METHODS Within Surveillance, Epidemiology and End Results database (2010-2015), we identified low risk and favorable intermediate risk CaP patients according to National Comprehensive Cancer Network guidelines. Descriptives and logistic regression models were used. Furthermore, a subgroup analysis was performed to test the association between Mexican-American vs. Caucasian racial and/or ethnic groups and upgrading either to Gleason-Grade Group (GGG II) or to GGG III, IV or V, in low risk or favorable intermediate risk CaP patients, respectively. RESULTS We identified 673 (2.6%) Mexican-American and 24,959 (97.4%) Caucasian CaP patients. Of those, 14,789 were low risk (434 [2.9%] Mexican-Americans vs. 14,355 [97.1%] Caucasians) and 10,834 were favorable intermediate risk (239 [2.2%] Mexican-Americans vs. 10,604 [97.8%] Caucasians). In low risk CaP patients, Mexican-American vs. Caucasian racial and/or ethnic group did not result in either upgrading or upstaging differences. However, in favorable intermediate risk CaP patients, upgrading rate was higher in Mexican-Americans than in Caucasians (31.4 vs. 25.5%, OR 1.33, P = 0.044), but no difference was recorded for upstaging. When comparisons focused on upgrading to GGG III, IV or V, higher rate was recorded in Mexican-American relative to Caucasian favorable intermediate risk CaP patients (20.4 vs. 15.4%, OR 1.41, P = 0.034). CONCLUSION Low risk Mexican-American CaP patients do not differ from low risk Caucasian CaP patients. However, favorable intermediate risk Mexican-American CaP patients exhibit higher rates of upgrading than their Caucasian counterparts. This information should be considered at treatment decision making.
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Affiliation(s)
- Claudia Collà Ruvolo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Italy; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
| | - Lara Franziska Stolzenbach
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Luigi Nocera
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
| | - Marina Deuker
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Stefano Luzzago
- Department of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Nicola Longo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Italy
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Alberto Briganti
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
| | - Ottavio De Cobelli
- Department of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy; Dipartimento di Oncologia ed Ematoncologia - DIPO- Univeristà degli Studi di Milano, Milan, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Italy
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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27
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Ferro M, Lucarelli G, de Cobelli O, Vartolomei MD, Damiano R, Cantiello F, Crocerossa F, Perdonà S, Del Prete P, Cordima G, Musi G, Del Giudice F, Busetto GM, Chung BI, Porreca A, Ditonno P, Battaglia M, Terracciano D. Circulating preoperative testosterone level predicts unfavourable disease at radical prostatectomy in men with International Society of Urological Pathology Grade Group 1 prostate cancer diagnosed with systematic biopsies. World J Urol 2020; 39:1861-1867. [PMID: 32683462 PMCID: PMC8217017 DOI: 10.1007/s00345-020-03368-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/13/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose The association between circulating total testosterone (T) levels and clinically significant PCa is still a matter of debate. In this study, we evaluated whether serum testosterone levels may have a role in predicting unfavorable disease (UD) and biochemical recurrence (BCR) in patients with clinically localized (≤ cT2c) ISUP grade group 1 PCa at biopsy. Methods 408 patients with ISUP grade group 1 prostate cancer, undergone to radical prostatectomy and T measurement were included. The outcome of interest was the presence of unfavourable disease (UD) defined as ISUP grade group \documentclass[12pt]{minimal}
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\begin{document}$$\ge$$\end{document}≥ 3a. Results Statistically significant differences resulted between serum testosterone values and ISUP grade groups (P < 0.0001). Significant correlation was found analyzing testosterone values versus age (P < 0.0001), and versus PSA (P = 0.008). BCR-free survival was significantly decreased in patients with low levels of testosterone (P = 0.005). These findings were confirmed also in the ISUP 1–2 subgroups (P = 0.01). ROC curve analysis showed that T outperformed PSA in predicting UD (AUC 0.718 vs AUC 0.525; P < 0.001) and was and independent risk factor for BCR. Conclusion Our findings suggested that circulating total T was a significant predictor of UD at RP in patients with preoperative low- to intermediate-risk diseases, confirming the potential role of circulating androgens in preoperative risk assessment of PCa patients.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO), IRCCS, via Ripamonti 435, 20141, Milan, Italy.
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy.
| | - Ottavio de Cobelli
- Division of Urology, European Institute of Oncology (IEO), IRCCS, via Ripamonti 435, 20141, Milan, Italy.,Department of Oncology and Hematology-Oncology, Università Degli Studi Di Milano, Milan, Italy
| | - Mihai Dorin Vartolomei
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.,Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology, Targu-Mures, Romania
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Sisto Perdonà
- Division of Urology, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy
| | - Paola Del Prete
- Scientific Directorate, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale", Naples, Italy
| | - Giovanni Cordima
- Division of Urology, European Institute of Oncology (IEO), IRCCS, via Ripamonti 435, 20141, Milan, Italy
| | - Gennaro Musi
- Division of Urology, European Institute of Oncology (IEO), IRCCS, via Ripamonti 435, 20141, Milan, Italy
| | | | | | - Benjamin I Chung
- Department of Urology, Stanford University Medical Center, Palo Alto, CA, USA
| | - Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy.,National Cancer Institute "Giovanni Paolo II", Bari, Italy
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Piazza G. Cesare 11, 70124, Bari, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples "Federico II", 8031, Naples, Italy
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Soenens C, Dekuyper P, De Coster G, Van Damme N, Van Eycken E, Quackels T, Roumeguère T, Van Cleynenbreugel B, Joniau S, Ameye F. Concordance Between Biopsy and Radical Prostatectomy Gleason Scores: Evaluation of Determinants in a Large-Scale Study of Patients Undergoing RARP in Belgium. Pathol Oncol Res 2020; 26:2605-2612. [PMID: 32632897 DOI: 10.1007/s12253-020-00860-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 06/23/2020] [Indexed: 11/29/2022]
Abstract
To determine whether Gleason scores were concordant between prostate biopsies (bGS) and the definitive resection specimen (pGS) excised with robot-assisted radical prostatectomy (RARP); to identify clinical and pathological factors that might predict upgrading; and to evaluate how upgrading affected outcome. Between 2009 and 2016, 25 Belgian centers participated in collecting prospective data for patients that underwent RARP. We analyzed the concordance rate between the bGS and the pGS in 8021 patients with kappa statistics, and we compared concordance rates from different centers. We assessed the effect of several clinical and pathological factors on the concordance rate with logistic regression analysis. The concordance rate for the entire population was 62.9%. Upgrading from bGS to pGS occurred in 27.3% of patients. The number of biopsies was significantly associated with concordance. Older age (>60 y), a higher clinical T stage (≥cT2), a higher PSA value at the time of biopsy (>10 ng/ml), and more time between the biopsy and the radical prostatectomy were significantly associated with a higher risk of upgrading. Positive margins and PSA relapse occurred more frequently in upgraded patients. Center size did not significantly affect the concordance rate (p = 0.40).This prospective, nationwide analysis demonstrated a Gleason score concordance rate of 62.9%. Upgrading was most frequently observed in the non-concordant group. We identified clinical and pathological factors associated with (non)-concordance. Upgrading was associated with a worse oncological outcome. Center volume was not associated with pathological accuracy.
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Affiliation(s)
- C Soenens
- Department of Urology, AZ Maria Middelares, Ghent, Belgium.
| | - P Dekuyper
- Department of Urology, AZ Maria Middelares, Ghent, Belgium
| | | | | | | | - T Quackels
- Department of Urology, Erasmus Hospital, Brussels, Belgium
| | - T Roumeguère
- Department of Urology, Erasmus Hospital, Brussels, Belgium
| | | | - S Joniau
- Department of Urology, University Hospital of Leuven, Leuven, Belgium
| | - F Ameye
- Department of Urology, AZ Maria Middelares, Ghent, Belgium
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Baccaglini W, Glina FA, Pazeto CL, Medina LG, Korkes F, Bernardo WM, Sotelo R, Glina S, Marra G, Moschini M, Cathelineau X, Sanchez-Salas R. Accuracy of MRI-guided Versus Systematic Prostate Biopsy in Patients Under Active Surveillance: A Systematic Review and Meta-analysis. Clin Genitourin Cancer 2020; 19:3-11.e1. [PMID: 32839133 DOI: 10.1016/j.clgc.2020.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/23/2020] [Accepted: 06/23/2020] [Indexed: 12/11/2022]
Abstract
This meta-analysis focuses on the accuracy of upgrading to clinically significant prostate cancer (PCa) by multiparametric magnetic resonance imaging-targeted biopsy (MRI-TB) versus systematic biopsy (SB). We searched the Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and Literatura Latino Americana em Ciências da Saúde databases through January 2020 for comparative, retrospective/prospective, paired-cohort, and randomized clinical trials with paired comparisons. The population consisted of patients with low-risk PCa in active surveillance with at least 1 index lesion on imaging. We evaluated the quality of evidence by using the Quality Assessment of Diagnostic Accuracy Studies-2 score. Group comparisons considered the differences between the area under the curve summary receiver operating characteristic curve in a 2-tailed method. We also compared the positive predictive value of the best single method (MRI-TB or SB) and the referral study test (combined biopsy, a combination of MRI-TB and SB). The meta-analysis included 6 studies enrolling 741 patients. The pooled sensitivity for the 2 groups was 0.79 (95% confidence interval, 0.74-0.83; I2 = 75%) and 0.67 (95% confidence interval, 0.63-0.74; I2 = 55.4%), respectively. The area under the curve for the MRI-TB and SB groups were 0.99 and 0.92 (P < .001), respectively. The positive predictive value for the MRI-TB and combined biopsy groups were similar. The accumulated evidence suggests better results for MRI-TB compared with SB. Therefore, use of MRI-TB alone may be preferable in patients in active surveillance harboring low-risk PCa.
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Affiliation(s)
- Willy Baccaglini
- Department of Urology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; Department of Urology, L'Institut Mutualiste Montsouris, Paris, France; Department of Urology, Hospital Albert Einstein, São Paulo, Brazil
| | - Felipe A Glina
- Department of Urology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; Department of General Surgery, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
| | - Cristiano Linck Pazeto
- Department of Urology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; Department of Urology, L'Institut Mutualiste Montsouris, Paris, France.
| | - Luis G Medina
- Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Fernando Korkes
- Department of Urology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil; Department of Urology, Hospital Albert Einstein, São Paulo, Brazil
| | - Wanderley M Bernardo
- Department of Medicine, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Rene Sotelo
- Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Sidney Glina
- Department of Urology, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil
| | - Giancarlo Marra
- Department of Urology, L'Institut Mutualiste Montsouris, Paris, France
| | - Marco Moschini
- Department of Urology, L'Institut Mutualiste Montsouris, Paris, France
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Mosnier I, Sterkers O, Nguyen Y, Lahlou G. Benefits in noise from sound processor upgrade in thirty-three cochlear implant users for more than 20 years. Eur Arch Otorhinolaryngol 2020; 278:827-831. [PMID: 32588171 DOI: 10.1007/s00405-020-06144-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 06/16/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Some oldest patients rehabilitated with a cochlear implant more than 20 years ago could still be upgraded with new generations of speech processor (SP). The aim of this study was to show the benefit of a recent generation of SP in this population. METHODS A monocentric prospective study was designed to evaluate the performance of 33 ancient CI22M users implanted between 1989 and 1997 and upgraded with the late compatible sound processor CP900. Performance was evaluated in quiet and noise with Framatix, an automated adaptative test. RESULTS Performance using Framatix significantly improved with the CP900, with a decrease of the median speech perception threshold of 6 dB in quiet (p < 0.05) and 5,3 dB in noise (p < 0.0005). No subjective benefit using the APHAB questionnaire was observed. CONCLUSION Upgrading of cochlear implant recipients who were implanted more than 20 years ago with recent compatible and new technological SP provide benefit in speech recognition in noise.
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Affiliation(s)
- Isabelle Mosnier
- UF Implants Auditifs et Explorations Fonctionnelles, Service ORL, Assistance Publique-Hôpitaux de Paris Sorbonne Université, GHU Pitié-Salpêtrière Boulevard de l'Hôpital, Bâtiment Paul Castaigne, 47-83 Bd de l'Hôpital, 75013, Paris, France.
| | - Olivier Sterkers
- UF Implants Auditifs et Explorations Fonctionnelles, Service ORL, Assistance Publique-Hôpitaux de Paris Sorbonne Université, GHU Pitié-Salpêtrière Boulevard de l'Hôpital, Bâtiment Paul Castaigne, 47-83 Bd de l'Hôpital, 75013, Paris, France
| | - Yann Nguyen
- UF Implants Auditifs et Explorations Fonctionnelles, Service ORL, Assistance Publique-Hôpitaux de Paris Sorbonne Université, GHU Pitié-Salpêtrière Boulevard de l'Hôpital, Bâtiment Paul Castaigne, 47-83 Bd de l'Hôpital, 75013, Paris, France
| | - Ghizlene Lahlou
- UF Implants Auditifs et Explorations Fonctionnelles, Service ORL, Assistance Publique-Hôpitaux de Paris Sorbonne Université, GHU Pitié-Salpêtrière Boulevard de l'Hôpital, Bâtiment Paul Castaigne, 47-83 Bd de l'Hôpital, 75013, Paris, France
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Soullier G, Demont M, Arouna A, Lançon F, Mendez Del Villar P. The state of rice value chain upgrading in West Africa. Glob Food Sec 2020; 25:100365. [PMID: 32566470 PMCID: PMC7299077 DOI: 10.1016/j.gfs.2020.100365] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 11/30/2022]
Abstract
Following the food price crisis in 2008, African governments implemented policies aiming at crowding in investment in rice value chain upgrading to help domestic rice compete with imports. We assess the state of rice value chain upgrading in West Africa by reviewing evidence on rice millers’ investment in semi-industrial and industrial milling technologies, contract farming and vertical integration during the post-crisis period 2009–2019. We find that upgrading is more dynamic in countries with high rice production and import bills and limited comparative advantage in demand. However, scaling of upgrading faces several challenges in terms of vertical coordination, technology, finance and policies. Our assessment can help value chain actors and policy makers refine upgrading strategies and policies to increase food security in West Africa. Rice value chain upgrading in West Africa is heterogeneous among countries. Upgrading involves milling technologies, contract farming and vertical integration. In 2019, 57 industrial and semi-industrial rice mills were operating in West Africa. Import bill, rice production and cultural heritage jointly explain 89% of heterogeneity. Challenges include vertical coordination, technology, finance and policies.
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Affiliation(s)
- Guillaume Soullier
- CIRAD, UMR ART-DEV, F-34398, Montpellier, France.,ART-DEV, Univ Montpellier, CIRAD, CNRS, Univ Montpellier 3, Univ Perpignan Via Domitia, Montpellier, France
| | - Matty Demont
- International Rice Research Institute (IRRI), Los Baños, Laguna, Philippines
| | - Aminou Arouna
- Africa Rice Center (AfricaRice), 01 BP 2551, Bouake 01, Cote d'Ivoire
| | - Frédéric Lançon
- CIRAD, UMR ART-DEV, F-34398, Montpellier, France.,ART-DEV, Univ Montpellier, CIRAD, CNRS, Univ Montpellier 3, Univ Perpignan Via Domitia, Montpellier, France
| | - Patricio Mendez Del Villar
- CIRAD, UMR TETIS, F-34398, Montpellier, France.,TETIS, Univ Montpellier, AgroParisTech, CIRAD, CNRS, IRSTEA, Montpellier, France
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Sanguedolce F, Falagario UG, Castellan P, Di Nauta M, Silecchia G, Bruno SM, Russo D, Treacy PJ, Tewari AK, Montironi R, Carrieri G, Cormio L. Bioptic intraprostatic chronic inflammation predicts adverse pathology at radical prostatectomy in patients with low-grade prostate cancer. Urol Oncol 2020; 38:793.e19-793.e25. [PMID: 32220548 DOI: 10.1016/j.urolonc.2020.02.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 02/02/2020] [Accepted: 02/22/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE To determine the potential role of bioptic inflammation (Irani score) in predicting adverse pathology (AP) at radical prostatectomy (RP) in patients with low-grade (ISUP Gleason Group [ISUP GG] 1 and 2) prostate cancer (CaP). METHODS After institutional review board-approval, we identified patients who underwent prostate biopsy, had bioptic Irani score assessment, were diagnosed with low-grade CaP (ISUP GG 1-2, prostate-specific antigen [PSA] <20 ng/ml), and underwent RP. The impact of standard clinicopathological variables and bioptic Irani Score (G = grade and A = aggressiveness) on AP at RP, defined as stage ≥T3 and/or ISUP GG ≥3, was assessed by univariate and multivariate logistic regression analysis. RESULTS A total of 282 patients were eligible for this study. AP at RP occurred in 37 of 214 (17.3%) patients with ISUP GG 1, and 26 of 68 (38.2%) with ISUP GG 2. At univariate analysis, serum PSA, PSA density, bioptic ISUP GG, number of positive cores, total percentage of core involvement and Irani G score emerged as significant risk factors of AP. At multivariate analysis, however, only PSA density, bioptic ISUP GG, total percentage of core, and Irani G score kept statistical significance. The area under the curve for the resulting model was 0.75. CONCLUSIONS This is the first study demonstrating that low-grade inflammation is associated with a significantly increased risk of AP at RP. These findings would support the concept of prostatic inflammation being inversely correlated with presence and aggressiveness of CaP. Further studies are needed to externally validate the role of this readily available parameter in the decision-making process of patients with low-grade CaP.
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Affiliation(s)
| | - Ugo Giovanni Falagario
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy; Department of Urology, Icahn school of medicine at Mount Sinai, New York City, NY.
| | | | - Michele Di Nauta
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Giovanni Silecchia
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Salvatore M Bruno
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Davide Russo
- Department of Pathology, University of Foggia, Foggia, Italy
| | | | - Ashutosh K Tewari
- Department of Urology, Icahn school of medicine at Mount Sinai, New York City, NY
| | - Rodolfo Montironi
- Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, Ancona, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
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Kong Z, He L, Shi Y, Guan Q, Ning P. A review of thermal homogeneous catalytic deoxygenation reactions for valuable products. Heliyon 2020; 6:e03446. [PMID: 32123767 PMCID: PMC7036526 DOI: 10.1016/j.heliyon.2020.e03446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/08/2019] [Accepted: 02/14/2020] [Indexed: 11/19/2022] Open
Abstract
To remove high oxygen content is important to make high quality oil and valuable products. In this paper, the research on homogeneous catalytic deoxygenation reactions, including decarboxylation (DCX)/decarbonylation (DCN), hydrodeoxygenation (HDO) is reviewed. Based on DCX/DCN, the classic radical reactions such as the Barton decarboxylation, Henkel, Hunsdiecker and Kochi reactions were introduced, the practice and overall performance are also discussed. In addition, the different reaction pathways and mechanisms were demonstrated and the key chemical processes have been selected from the literature as examples to elaborate the critical emphasis on the mechanistic understanding. The applications of the catalytic deoxygenation reactions for high-value products have also been highlighted. Overall, this review provides insight discussions on the DO issues and progresses in homogeneous catalytic aspects.
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Affiliation(s)
- Zhaoni Kong
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Liang He
- Faculty of Chemical Engineering, Kunming University of Science and Technology, Kunming, 650500, China
| | - Yuzheng Shi
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
| | - Qingqing Guan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
- Corresponding author.
| | - Ping Ning
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming 650500, China
- Corresponding author.
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Wang N, Qian K, Chen D, Zhao H, Yin L. Upgrading gas and oil products of the municipal solid waste pyrolysis process by exploiting in-situ interactions between the volatile compounds and the char. Waste Manag 2020; 102:380-390. [PMID: 31733562 DOI: 10.1016/j.wasman.2019.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 10/15/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
The gas and oil product derived from municipal solid waste (MSW) pyrolysis was upgraded by utilizing the interaction between the volatile compounds and the char and the mechanism involved is explored. The influences of operation parameters, including interaction temperature, char/volatiles mass ratio (C/V) and gas hourly space velocity (GHSV) of the volatiles on the distribution and property of the upgraded products were investigated. The results showed that the higher interaction temperature, higher C/V and lower GHSV favored the conversion of condensable volatiles into gas products, thus increasing the gas yield in the outlet stream. The highest gas yield (44.14 wt%) was obtained at 700 °C with the natural C/V ratio (0.8) and GHSV, which was twice of the gas yield in the volatiles. The chemical energy portion of gas increased to 8065 kJ/kgMSW from 3209 kJ/kgMSW at this condition. Syngas with H2/CO molar ratio of around 2 can be obtained at 700 °C with C/V ratio of 0.8 or at 600 °C with higher C/V ratios (C/V = 1.5-2.2). Oxygenates and acidity of the reformed oil products decreased; but monoaromatics and light polyaromatics concentration increased greatly. Heavy polycyclic aromatic hydrocarbons (PAHs) in the liquid products were degraded after volatiles/hot char interaction. Suitable conditions can be varied and recommended for obtaining different desired high-quality products based on this process.
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Affiliation(s)
- Na Wang
- Thermal and Environmental Engineering Institute, School of Mechanical Engineering, Tongji University, 1239 Siping Road, Shanghai 200092, China
| | - Kezhen Qian
- Thermal and Environmental Engineering Institute, School of Mechanical Engineering, Tongji University, 1239 Siping Road, Shanghai 200092, China.
| | - Dezhen Chen
- Thermal and Environmental Engineering Institute, School of Mechanical Engineering, Tongji University, 1239 Siping Road, Shanghai 200092, China.
| | - Hengzhen Zhao
- Thermal and Environmental Engineering Institute, School of Mechanical Engineering, Tongji University, 1239 Siping Road, Shanghai 200092, China
| | - Lijie Yin
- Thermal and Environmental Engineering Institute, School of Mechanical Engineering, Tongji University, 1239 Siping Road, Shanghai 200092, China
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Sawarkar AN. Cavitation induced upgrading of heavy oil and bottom-of-the-barrel: A review. Ultrason Sonochem 2019; 58:104690. [PMID: 31450381 DOI: 10.1016/j.ultsonch.2019.104690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/29/2019] [Accepted: 07/13/2019] [Indexed: 06/10/2023]
Abstract
Heavy and extra-heavy oil upgrading has become an indispensable activity in the prevailing scenario in petroleum refineries. Petroleum refiners have been exploring new options in tandem with conventional upgrading processes to efficiently utilize heavy and extra heavy crude oils. Cavitation (acoustic and/or hydrodynamic) induced chemical and physical transformations have generated lot of curiosity and opportunities in various fields of science and technology. Of late, hydrocarbon cracking especially related to complex components of crude oil and petroleum residua via cavitation is receiving tremendous attention. The present communication overviews the past investigations related to heavy oil and bottom-of-the-barrel upgrading facilitated by acoustic and hydrodynamic cavitation. The investigations with regard to the upgrading of heavy oil and bottom-of-the-barrel via acoustic and hydrodynamic cavitation have touched upon various aspects, viz. viscosity reduction, enhancement in °API, reduction in asphaltenes aggregation, incremental yield in light and middle distillates, reduction in sulfur, nitrogen, and metals etc. Further, heavy oil upgrading efficacy of thermal cracking, acoustic cavitation, and hydrodynamic cavitation has been analyzed in the form of a case study. The present study revealed that hydrodynamic cavitation is a potentially attractive option as a process intensifying technique for heavy oil upgrading in conjunction with established processes. Recommendations to make further inroads in heavy oil and bottom-of-the barrel upgrading via cavitation have also been made. The present communication is expected to be a single point source for further researches in cavitation assisted upgrading of heavy oil and petroleum residua.
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Affiliation(s)
- Ashish N Sawarkar
- Department of Chemical Engineering, Motilal Nehru National Institute of Technology Allahabad, Prayagraj 211004, Uttar Pradesh, India.
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Mannu GS, Groen EJ, Wang Z, Schaapveld M, Lips EH, Chung M, Joore I, van Leeuwen FE, Teertstra HJ, Winter-Warnars GAO, Darby SC, Wesseling J. Reliability of preoperative breast biopsies showing ductal carcinoma in situ and implications for non-operative treatment: a cohort study. Breast Cancer Res Treat 2019; 178:409-418. [PMID: 31388937 PMCID: PMC6797705 DOI: 10.1007/s10549-019-05362-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/15/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE The future of non-operative management of DCIS relies on distinguishing lesions requiring treatment from those needing only active surveillance. More accurate preoperative staging and grading of DCIS would be helpful. We identified determinants of upstaging preoperative breast biopsies showing ductal carcinoma in situ (DCIS) to invasive breast cancer (IBC), or of upgrading them to higher-grade DCIS, following examination of the surgically excised specimen. METHODS We studied all women with DCIS at preoperative biopsy in a large specialist cancer centre during 2000-2014. Information from clinical records, mammography, and pathology specimens from both preoperative biopsy and excised specimen were abstracted. Women suspected of having IBC during biopsy were excluded. RESULTS Among 606 preoperative biopsies showing DCIS, 15.0% (95% confidence interval 12.3-18.1) were upstaged to IBC and a further 14.6% (11.3-18.4) upgraded to higher-grade DCIS. The risk of upstaging increased with presence of a palpable lump (21.1% vs 13.0%, pdifference = 0.04), while the risk of upgrading increased with presence of necrosis on biopsy (33.0% vs 9.5%, pdifference < 0.001) and with use of 14G core-needle rather than 9G vacuum-assisted biopsy (22.8% vs 7.0%, pdifference < 0.001). Larger mammographic size increased the risk of both upgrading (pheterogeneity = 0.01) and upstaging (pheterogeneity = 0.004). CONCLUSIONS The risk of upstaging of DCIS in preoperative biopsies is lower than previously estimated and justifies conducting randomized clinical trials testing the safety of active surveillance for lower grade DCIS. Selection of women with low grade DCIS for such trials, or for active surveillance, may be improved by consideration of the additional factors identified in this study.
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Affiliation(s)
- Gurdeep S. Mannu
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
| | - Emma J. Groen
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Zhe Wang
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
| | - Michael Schaapveld
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Esther H. Lips
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Monica Chung
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Ires Joore
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Flora E. van Leeuwen
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Hendrik J. Teertstra
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Sarah C. Darby
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF UK
| | - Jelle Wesseling
- Antoni van Leeuwenhoek – Netherlands Cancer Institute, Amsterdam, The Netherlands
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Morselli S, Sebastianelli A, Campi R, Liaci A, Gabellini L, Tasso G, Fantechi R, Venturini S, Spatafora P, Cito G, Vignolini G, Raspollini MR, Gacci M, Serni S. Adverse pathology after radical prostatectomy: the prognostic role of cumulative cancer length >6-mm threshold in prostate cancer-positive biopsies. Prostate Int 2019; 7:143-149. [PMID: 31970139 PMCID: PMC6962732 DOI: 10.1016/j.prnil.2019.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/17/2019] [Accepted: 09/24/2019] [Indexed: 12/19/2022] Open
Abstract
Background To investigate the role of Cumulative Cancer Length (CCL) and PCa positive core number (PCapcn) in random prostate biopsies as predictors of Adverse Pathology (AP) at definitive pathology. Methods We prospectively enrolled patients submitted to random ultrasound guided prostate biopsies for suspect PCa in our center since 2016. Inclusion criteria were PSA <20 ng/ml or >3 ng/ml and age<71 years. Data on CCL and Grade Group (GG) at biopsy and pathology after Radical Prostatectomy (RP) were collected. AP was defined as pT3 or higher TNM, Positive Surgical Margin (>2mm) or PCa Positive Lymph Node. ROC curve was used to establish an appropriate CCL and PCapcn thresholds that were then investigated as predictors of AP at definitive pathology. Results Among 882 eligible biopsies, 344 had PCa and underwent RP. Mean age was 64 years (SD 5). Mean PSA was 7.75 (SD: 3.66). At definitive pathology there were AP features in 196 (56.9%) RP. PCapcn and CCL were statistically significantly associated with AP (p<0.0001). At multivariate age-adjusted logistic regression only PCapcn had an OR of 1.513 (CI95% 1.140-2.007) p=0.004. Through ROC curve a CCL>6mm and PCapcn >3 thresholds for AP were established (Area: 0.769; p<0.0001 CI 95% 0.698-0.840 and Area: 0.767; p<0.0001 CI 95% 0.696-0.837). When considering CCL>6mm AP had OR 5.462 (CI 95% 2.717-10.978) p<0.0001 and PCapcn >3 had OR 7.127 (CI 95% 3.366-15.090) p<0.0001. In particular, for GG 1 and 2, CCL>6mm had OR 3.989 (CI 95% 1.839-8.652) p<0.0001, while PCapcn >3 had OR 5.541 (CI 95% 2.390-12.849) p<0.0001. Conclusions At present time, random prostate biopsies might carry useful information regarding tumor extension and aggressiveness. A CCL>6mm or PCapcn >3 might be associated with AP features, in particular for low and favorable intermediate risk PCa.
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Affiliation(s)
- Simone Morselli
- Department of Urology, Careggi University Hospital, Florence, Italy
| | | | - Riccardo Campi
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - Andrea Liaci
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - Linda Gabellini
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - Giovanni Tasso
- Department of Urology, Careggi University Hospital, Florence, Italy
| | | | | | - Pietro Spatafora
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - Gianmartin Cito
- Department of Urology, Careggi University Hospital, Florence, Italy
| | | | | | - Mauro Gacci
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - Sergio Serni
- Department of Urology, Careggi University Hospital, Florence, Italy
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Gandaglia G, Ploussard G, Valerio M, Mattei A, Fiori C, Roumiguié M, Fossati N, Stabile A, Beauval JB, Malavaud B, Scuderi S, Barletta F, Moschini M, Zamboni S, Rakauskas A, Tian Z, Karakiewicz PI, De Cobelli F, Porpiglia F, Montorsi F, Briganti A. The Key Combined Value of Multiparametric Magnetic Resonance Imaging, and Magnetic Resonance Imaging-targeted and Concomitant Systematic Biopsies for the Prediction of Adverse Pathological Features in Prostate Cancer Patients Undergoing Radical Prostatectomy. Eur Urol 2020; 77:733-41. [PMID: 31547938 DOI: 10.1016/j.eururo.2019.09.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 09/02/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND The combined role of multiparametric magnetic resonance imaging (mp-MRI), and magnetic resonance imaging (MRI)-targeted and concomitant systematic biopsies in the identification of prostate cancer (PCa) patients at a higher risk of adverse pathology at radical prostatectomy (RP) is still unclear. OBJECTIVE To develop novel models to predict extracapsular extension (ECE), seminal vesicle invasion (SVI), or upgrading in patients diagnosed with MRI-targeted and concomitant systematic biopsies. DESIGN, SETTING, AND PARTICIPANTS We included 614 men with clinical stage≤T2 at digital rectal examination who underwent MRI-targeted biopsy with concomitant systematic biopsy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSES Logistic regression analyses predicting ECE, SVI, and upgrading (ie, a shift from biopsy International Society of Urological Pathology grade group to any higher grade at RP) based on clinical variables with or without mp-MRI features and systematic biopsy information (the percentage of cores with grade group ≥2 PCa) were developed and internally validated. The area under the curve (AUC) was used to identify the models with the highest discrimination. Decision-curve analyses (DCAs) determined the net benefit associated with their use. RESULTS AND LIMITATIONS Overall, 333 (54%), 88 (14%), and 169 (27%) patients had ECE, SVI, and upgrading at RP, respectively. The inclusion of mp-MRI data improved the discrimination of clinical models for ECE (67% vs 70%) and SVI (74% vs 76%). Models including mp-MRI, and MRI-targeted and concomitant systematic biopsy information achieved the highest AUC at internal validation for ECE (73%), SVI (81%), and upgrading (73%) and represented the basis for three risk calculators that yield the highest net benefit at DCA. CONCLUSIONS Not only mp-MRI and MRI-targeted sampling, but also concomitant systematic biopsies provide significant information to identify patients at a higher risk of adverse pathology. Although omitting systematic prostate sampling at the time of MRI-targeted biopsy might be associated with a reduced risk of detecting insignificant PCa and lower patient discomfort, it reduces the ability to accurately predict pathological features. PATIENT SUMMARY The combination of multiparametric magnetic resonance imaging (mp-MRI) with accurate biopsy information on MRI-targeted and systematic biopsies improves the accuracy of multivariable models based on clinical and mp-MRI data alone. Correct mp-MRI interpretation and proper extensive prostate sampling are both needed to predict adverse pathology accurately at radical prostatectomy.
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Bakavicius A, Daniunaite K, Zukauskaite K, Barisiene M, Jarmalaite S, Jankevicius F. Urinary DNA methylation biomarkers for prediction of prostate cancer upgrading and upstaging. Clin Epigenetics 2019; 11:115. [PMID: 31383039 PMCID: PMC6683454 DOI: 10.1186/s13148-019-0716-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/22/2019] [Indexed: 12/13/2022] Open
Abstract
Background Significant numbers of prostate cancer (PCa) patients experience tumour upstaging and upgrading in surgical specimens that cause serious problems in timely and proper selection of the treatment strategy. This study was aimed at the evaluation of a set of established epigenetic biomarkers as a noninvasive tool for more accurate PCa categorization before radical prostatectomy (RP). Methods Quantitative methylation-specific PCR was applied for the methylation analysis of RARB, RASSF1, and GSTP1 in 514 preoperatively collected voided or catheterized urine samples from the single-centre cohort of 1056 treatment-naïve PCa patients who underwent RP. The rates of biopsy upgrading and upstaging were analysed in the whole cohort. Results Pathological examination of RP specimens revealed Gleason score upgrading in 27.2% and upstaging in 20.3% of the patients with a total misclassification rate of 39.0%. DNA methylation changes in at least one gene were detected in more than 80% of urine samples. Combination of the PSA test with the three-gene methylation analysis in urine was a significant predictor of pathological upstaging and upgrading (P < 0.050), however, with limited increase in overall accuracy. The PSA test or each gene alone was not informative enough. Conclusions The urinary DNA methylation assay in combination with serum PSA may predict tumour stage or grade migration post-RP aiding in improved individual risk assessment and appropriate treatment selection. Clinical utility of these biomarkers should be proven in larger multi-centre studies. Electronic supplementary material The online version of this article (10.1186/s13148-019-0716-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Arnas Bakavicius
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,National Cancer Institute, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Kristina Daniunaite
- National Cancer Institute, Vilnius, Lithuania.,Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Kristina Zukauskaite
- National Cancer Institute, Vilnius, Lithuania.,Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Marija Barisiene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | | | - Feliksas Jankevicius
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,National Cancer Institute, Vilnius, Lithuania
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Hoo PY, Hashim H, Ho WS, Yunus NA. Spatial-economic optimisation of biomethane injection into natural gas grid: The case at southern Malaysia. J Environ Manage 2019; 241:603-611. [PMID: 30616893 DOI: 10.1016/j.jenvman.2018.11.092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 06/09/2023]
Abstract
Energy is widely used in industry for heating and cooling, with natural gas (NG) being the largest primary energy source in Malaysia, closely followed by coal. Renewable energy, such as biogas upgrading to biomethane, could cut the use of fossil fuels by supplementing NG usage due to their similar physicochemical and thermochemical characteristics. Biogas production plants in Malaysia are more commonly seen in waste-to-energy scenarios, with the technology anaerobic digestion, and their deployment is supported via feed-in tariffs (FiT) for power generation. Other potential applications such as the conversion of biogas into biomethane, injection into the natural gas grid or transportation through a virtual pipeline may still need further technical development. This paper presents spatial techno economic optimisation modelling using BeWhere to determine decentralised biomethane production plants using feedstock from multiple sources of biogas, including palm oil mill effluent (POME), food waste, cattle manure and chicken manure. This model considered potential configurations and sizes of the biomethane plants, the transportation of biomethane using a virtual pipeline (at 250 psig) and demand in one of the states in Malaysia, namely Johor. It was found that two to four biomethane plants with capacities ranging between 125 and 700 m3/h were located in densely populated areas or heavier industrial consumers when the carbon tax was implemented at 167.71 EUR/tCO2 (800 MYR/tCO2). Sensitivity analysis suggested that biomethane production increases with the increasing country renewable energy share target to beyond 2080 MW. It is recommended that specific policy regulations and Feed-in Tariff (FiT) mechanisms are used to expand the biomethane market share in the country.
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Affiliation(s)
- Poh Ying Hoo
- Process Systems Engineering Centre (PROSPECT), School of Chemical and Energy Engineering, Faculty of Chemical, Universiti Teknologi Malaysia (UTM), 81310 Skudai, Johor, Malaysia
| | - Haslenda Hashim
- Process Systems Engineering Centre (PROSPECT), School of Chemical and Energy Engineering, Faculty of Chemical, Universiti Teknologi Malaysia (UTM), 81310 Skudai, Johor, Malaysia.
| | - Wai Shin Ho
- Process Systems Engineering Centre (PROSPECT), School of Chemical and Energy Engineering, Faculty of Chemical, Universiti Teknologi Malaysia (UTM), 81310 Skudai, Johor, Malaysia
| | - Nor Alafiza Yunus
- Process Systems Engineering Centre (PROSPECT), School of Chemical and Energy Engineering, Faculty of Chemical, Universiti Teknologi Malaysia (UTM), 81310 Skudai, Johor, Malaysia.
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Sebastianelli A, Morselli S, Vitelli FD, Gabellini L, Tasso G, Venturini S, Cito G, Vignolini G, Raspollini MR, Gacci M, Serni S. The role of prostate-specific antigen density in men with low-risk prostate cancer suitable for active surveillance: results of a prospective observational study. Prostate Int 2019; 7:139-142. [PMID: 31970138 PMCID: PMC6962752 DOI: 10.1016/j.prnil.2019.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/10/2019] [Accepted: 02/14/2019] [Indexed: 01/29/2023] Open
Abstract
Background Low-risk prostate cancer (PCa) is currently managed also with active surveillance (AS). However, up to 40% of patients in AS may require radical treatment at a long-term follow-up. The aim of our study is to further investigate the role of prostate-specific antigen (PSA) density in AS. Methods A prospective observational study on PCa naïve patients with PSA<20 ng/ml submitted to prostate biopsy was conducted. Data on family history of PCa, PSA at biopsy, and digitorectal examination were collected. Prostate volume was calculated during TRUS. Bioptic cores number, Gleason Score, and International Society of Urological Pathology (ISUP) Grade Group were recorded. Patients who subsequently underwent radical prostatectomy (RP) were selected and stratified in low, intermediate, and high Risk based on the D'Amico risk classification at biopsy and after RP. Results A total of 746 patients were enrolled. PCa was found in 320 patients (42.9%), of whom 252 underwent RP (78.8% of positive biopsies). At biopsy, patients were stratified based on the D'Amico risk classification in low, intermediate, and high risk and were 20.6%, 66.7%, and 12.7%, respectively. Definitive pathology after RP showed PCa change in the risk group in 52.4% of patients (n = 132) and PCa upgrading in 46.8% of patients (n = 118). At Student t test and logistic regression, PSA density was significantly correlated with change in the risk group and upgrading in low-risk PCa (p = 0.024) with an age adjusted odds ratio of 10.01 and 7.53, respectively. Conclusion PSA density is a strong instrument in AS to decide whether to treat. However, further larger studies are needed to strongly assess this correlation.
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Affiliation(s)
| | - Simone Morselli
- Department of Urology, Careggi University Hospital, Florence, Italy
- Corresponding author. Largo Brambilla, 3, 50134 Florence, FI, Italy.
| | | | - Linda Gabellini
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - Giovanni Tasso
- Department of Urology, Careggi University Hospital, Florence, Italy
| | | | - Gianmartin Cito
- Department of Urology, Careggi University Hospital, Florence, Italy
| | | | | | - Mauro Gacci
- Department of Urology, Careggi University Hospital, Florence, Italy
| | - Sergio Serni
- Department of Urology, Careggi University Hospital, Florence, Italy
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42
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Lombardi L, Costa G, Spagnuolo R. Accelerated carbonation of wood combustion ash for CO 2 removal from gaseous streams and storage in solid form. Environ Sci Pollut Res Int 2018; 25:35855-35865. [PMID: 29748811 DOI: 10.1007/s11356-018-2159-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 04/26/2018] [Indexed: 06/08/2023]
Abstract
In this work, ash generated by the combustion of wood in a central heating plant was used to remove and permanently store by accelerated carbonation CO2 contained in a gas mixture simulating biogas. The process was studied as an alternative treatment to the ones currently available on the market for biogas upgrading. The process was investigated at laboratory scale by setting up a facility for directly contacting the wood ash and the synthetic biogas in a fixed bed reactor. The process was able to completely remove CO2 during its initial phase. After about 30 h, CO2 started to appear again in the outlet stream and its concentration rapidly increased. The specific CO2 uptake achieved in solid carbonate form was of about 200 g/kg of dry wood ash. This value is an order of magnitude higher than the ones found for waste incineration bottom ash carrying out similar experiments. The difference was ascribed to the physicochemical properties of the ash, characterized by a fine particle size (d50 < 0.2 mm) and high content of reactive phases with CO2 (e.g., Ca hydroxides). The leaching behavior of the wood ash was examined before and after the accelerated carbonation process showing that the release of several elements was lower after the treatment; Ba leaching in particular decreased by over two orders of magnitude. However, the release of the critical elements for the management of this type of residues (especially Cr and sulfates) appeared not to be significantly affected, while V leaching increased.
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Affiliation(s)
- Lidia Lombardi
- Niccolò Cusano University, via don Carlo Gnocchi 3, 00166, Rome, Italy.
| | - Giulia Costa
- Department of Civil Engineering and Computer Science Engineering, University of Roma Tor Vergata, via del Politecnico 1, 00133, Rome, Italy
| | - Riccardo Spagnuolo
- Department of Civil Engineering and Computer Science Engineering, University of Roma Tor Vergata, via del Politecnico 1, 00133, Rome, Italy
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Liu R, Zhao Y, Wang T, Shen C. Long-term operation with an insight into a newly established green bio-sorption reactor: Can it achieve "1 + 1 > 2"? Bioresour Technol 2018; 255:96-103. [PMID: 29414179 DOI: 10.1016/j.biortech.2018.01.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/16/2018] [Accepted: 01/22/2018] [Indexed: 06/08/2023]
Abstract
An eco-friendly system of green bio-sorption reactor (GBR), constructed by embedding alum sludge-based constructed wetland (AlCW) into a conventional activated sludge process to achieve "1 + 1 > 2", was evaluated under a long-term operation basis. Insight into the pollutants removal, particularly the role of the AlCW in the GBR, was explored and discussed. The results showed that the GBR could achieve 90% and 95% removal for TN and TP (Stage 4), respectively, under the hydraulic and nitrogen loading rate of 2.07 m3/(m3·d) and 166.2 gN/(m3·d), respectively. Intriguingly, despite the P adsorption, the AlCW enlarged the size of the activated sludge flocs which benefited the simultaneous nitrification and denitrification. Subversively, the embedding AlCW brings about dual-intensification in both capacity and efficiency. In addition, the GBR as an ecological engineering system can be employed closely to residential area in line with its green and pleasing appearance.
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Affiliation(s)
- Ranbin Liu
- Institute of Water Resources and Hydro-electric Engineering, Xi'an University of Technology, Xi'an 710048, PR China; UCD Dooge Centre for Water Resources Research, School of Civil Engineering, University College Dublin, Belfield, Dublin 4, Ireland
| | - Yaqian Zhao
- Institute of Water Resources and Hydro-electric Engineering, Xi'an University of Technology, Xi'an 710048, PR China; UCD Dooge Centre for Water Resources Research, School of Civil Engineering, University College Dublin, Belfield, Dublin 4, Ireland; Key Laboratory of Subsurface Hydrology and Ecology in Arid Areas (Ministry of Education), School of Environmental Science and Engineering, Chang'an University, Xi'an 710054, PR China.
| | - Tong Wang
- School of Civil Engineering, Chang'an University, Xi'an 710061, PR China
| | - Cheng Shen
- UCD Dooge Centre for Water Resources Research, School of Civil Engineering, University College Dublin, Belfield, Dublin 4, Ireland
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Nakou ES, Simantirakis EN, Kallergis EM, Nakos KS, Vardas PE. Cardiac resynchronization therapy (CRT) device replacement considerations: upgrade or downgrade? A complex decision in the current clinical setting. Europace 2018; 19:705-711. [PMID: 28011795 DOI: 10.1093/europace/euw317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 09/19/2016] [Indexed: 11/13/2022] Open
Abstract
There are limited data about the management of patients presenting for elective generator replacements in the setting of previously implanted cardiac resynchronization therapy (CRT) devices that are nearing end-of-life. The individual patient's clinical status and concomitant morbidities may evolve so that considerations may include not only replacement of the pulse generator, but also potentially changing the type of device [e.g. downgrading CRT-defibrillator (CRT-D) to CRT-pacemaker (CRT-P) or ICD or upgrading of CRT-P to CRT-D]. Moreover, the clinical evidence for CRT-D/CRT-P implantation may change over time, with ongoing research and availability of new trial data. In this review we discuss the ethical, clinical and financial implications related to CRT generator replacements and the need for additional clinical trials to better understand which patients should undergo CRT device downgrading or upgrading at the time of battery depletion.
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Affiliation(s)
- Eleni S Nakou
- University Hospital of Heraklion, PO box 1352, Stavrakia, Heraklion Crete, Greece
| | | | | | - Konstantinos S Nakos
- University Hospital of Heraklion, PO box 1352, Stavrakia, Heraklion Crete, Greece
| | - Panos E Vardas
- University Hospital of Heraklion, PO box 1352, Stavrakia, Heraklion Crete, Greece
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Ye H, Sowalsky AG. Molecular correlates of intermediate- and high-risk localized prostate cancer. Urol Oncol 2018; 36:368-374. [PMID: 30103901 DOI: 10.1016/j.urolonc.2017.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/13/2017] [Accepted: 12/24/2017] [Indexed: 12/22/2022]
Abstract
Clinicopathologic parameters, including Gleason score, remain the most validated prognostic factors for patients diagnosed with localized prostate cancer (PCa). However, patients of the same risk groups have exhibited heterogeneity of disease outcomes. To improve risk classification, multiple molecular risk classifiers have been developed, which were designed to inform beyond existing clinicopathologic classifiers. Alterations affecting tumor suppressors and oncogenes, such as PTEN, MYC, BRCA2, and TP53, which have been long associated with aggressive PCa, demonstrated grade-dependent frequency of alterations in localized PCas. In addition to these genetic hallmarks, several RNA-based commercial tests have been recently developed to help identify men who would benefit from earlier interventions. Large genomic studies also correlate germline genetic alterations and epigenetic features with adverse outcomes, further strengthening the link between the risk of metastasis and a stepwise accumulation of driver molecular lesions.
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Affiliation(s)
- Huihui Ye
- Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Adam G Sowalsky
- Prostate Cancer Genetics Section, Laboratory of Genitourinary Cancer Pathogenesis, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD.
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Fan L, Zhang Y, Liu S, Zhou N, Chen P, Cheng Y, Addy M, Lu Q, Omar MM, Liu Y, Wang Y, Dai L, Anderson E, Peng P, Lei H, Ruan R. Bio-oil from fast pyrolysis of lignin: Effects of process and upgrading parameters. Bioresour Technol 2017; 241:1118-1126. [PMID: 28578807 DOI: 10.1016/j.biortech.2017.05.129] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 05/18/2017] [Accepted: 05/19/2017] [Indexed: 06/07/2023]
Abstract
Effects of process parameters on the yield and chemical profile of bio-oil from fast pyrolysis of lignin and the processes for lignin-derived bio-oil upgrading were reviewed. Various process parameters including pyrolysis temperature, reactor types, lignin characteristics, residence time, and feeding rate were discussed and the optimal parameter conditions for improved bio-oil yield and quality were concluded. In terms of lignin-derived bio-oil upgrading, three routes including pretreatment of lignin, catalytic upgrading, and co-pyrolysis of hydrogen-rich materials have been investigated. Zeolite cracking and hydrodeoxygenation (HDO) treatment are two main methods for catalytic upgrading of lignin-derived bio-oil. Factors affecting zeolite activity and the main zeolite catalytic mechanisms for lignin conversion were analyzed. Noble metal-based catalysts and metal sulfide catalysts are normally used as the HDO catalysts and the conversion mechanisms associated with a series of reactions have been proposed.
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Affiliation(s)
- Liangliang Fan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China; Engineering Research Center for Biomass Conversion, Ministry of Education, Nanchang University, Nanchang 330047, China; Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Yaning Zhang
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States; School of Energy Science and Engineering, Harbin Institute of Technology, Harbin 150001, China
| | - Shiyu Liu
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Nan Zhou
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Paul Chen
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Yanling Cheng
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Min Addy
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Qian Lu
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Muhammad Mubashar Omar
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States; Department of Farm Machinery and Power, University of Agriculture, Faisalabad, Pakistan
| | - Yuhuan Liu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China; Engineering Research Center for Biomass Conversion, Ministry of Education, Nanchang University, Nanchang 330047, China
| | - Yunpu Wang
- Engineering Research Center for Biomass Conversion, Ministry of Education, Nanchang University, Nanchang 330047, China
| | - Leilei Dai
- Engineering Research Center for Biomass Conversion, Ministry of Education, Nanchang University, Nanchang 330047, China
| | - Erik Anderson
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Peng Peng
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Hanwu Lei
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States
| | - Roger Ruan
- Center for Biorefining and Department of Bioproducts and Biosystems Engineering, University of Minnesota, 1390 Eckles Ave., St. Paul, MN 55108, United States.
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Jazayeri SB, Kwon YS, McBride R, Leapman M, Collingwood S, Hobbs A, Samadi DB. The Modulating Effects of Benign Prostate Enlargement Medications on Upgrading Predictors in Patients with Gleason 6 at Biopsy. Curr Urol 2017; 10:97-104. [PMID: 28785195 DOI: 10.1159/000447159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/15/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Upgrading following prostate biopsy is very common in clinical practice. This study investigated whether the use of 5-alpha reductase inhibitors (ARI) and alpha blockers affect known clinical predictors of Gleason score upgrading or not. MATERIALS AND METHODS A retrospective study on 998 patients treated with robotic assisted laparoscopic prostatectomy for clinically localized biopsy Gleason score 6 prostate cancer were studied. The logarithm of prostate specific antigen concentration, prostate size and tumor volume were compared on the basis of the medication history of 5-ARIs and alpha blockers in the cohort of biopsy Gleason 6 patients with benign prostatic hyperplasia history, and patients whose prostate sizes fall in the top quartile. We compared known clinical and pathologic characteristics associated with upgrading in regression models with and without the addition of medications. RESULTS Alpha blockers, but not 5-ARI were associated with a bigger prostate. Upgrading was associated with older age (OR 1.03, 95% CI 1.01-1.06), higher BMI (OR 1.00 CI 1.01-1.08), higher log prostate specific antigen (OR 7.32, CI 3.546-15.52), smaller prostate size (OR 0.97, CI 0.96-0.98), fewer biopsy cores (OR 0.96 CI 0.92-0.99), more positive cores (OR 1.20, CI 1.08-1.34), and higher percentage of tumor at biopsy (OR 1.02, CI 1.01-1.03). Neither of the two medication classes were a significant predictor of upgrading. Medications made minimal changes in the multivariate predictive models. CONCLUSION Although, alpha blockers were associate with bigger prostate size, the modulating effects of alpha blockers and 5-ARIs on common predictors of Gleason score upgrading was not significant.
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Affiliation(s)
| | - Young S Kwon
- Department of Urology, Mercer University School of Medicine, Macon, Ga., USA
| | - Russell McBride
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, N.Y, USA
| | - Michael Leapman
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, N.Y, USA
| | - Shemille Collingwood
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, N.Y, USA
| | - Adele Hobbs
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, Calif., USA
| | - David B Samadi
- Department of Urology, Lenox Hill Hospital, New York, N.Y, USA
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Herlemann A, Buchner A, Kretschmer A, Apfelbeck M, Stief CG, Gratzke C, Tritschler S. Postoperative upgrading of prostate cancer in men ≥75 years: a propensity score-matched analysis. World J Urol 2017; 35:1517-1524. [PMID: 28493044 DOI: 10.1007/s00345-017-2045-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 05/02/2017] [Indexed: 01/15/2023] Open
Abstract
PURPOSE Gleason score upgrading should be considered when indicating surgery in prostate cancer (PCa) patients. In elderly patients, definitive treatment of low-risk PCa must be weighed with the risks of overtreatment. Our aim was to evaluate rates of Gleason score upgrading in patients ≥75 years undergoing radical prostatectomy (RP) for localized PCa and to identify predictors associated with upgrading. METHODS 3296 patients undergoing RP were retrospectively evaluated and categorized into age groups: <70 years (n = 2971) vs. ≥75 years (n = 325). We analyzed prostate-specific antigen (PSA), biopsy counts, Gleason score, pathologic T- and N-stage, and surgical margin. Propensity score matching was performed to compare rates of up- and downgrading on surgical specimen using the new five-tier pathologic grading system. Logistic regression was used to identify independent predictors of upgrading. RESULTS Preoperatively, patients ≥75 years had higher PSA (8.8 vs. 7.3 ng/mL) and lower proportion of grade group 1 (Gleason score 6) at biopsy (29.2 vs. 47.9%; both p < 0.001) compared to patients <70 years. At RP, patients ≥75 years were more likely to have extraprostatic disease (50 vs. 30%) and lower rates of grade group 1 (14.1 vs. 34.8%; both p < 0.001). Postoperative downgrading was similar (15.1 vs. 19.5%). However, patients ≥75 years had higher rates of postoperative upgrading (46.6 vs. 27.9%; p < 0.001). Age ≥75 years, higher PSA levels at RP, and an increased number of positive biopsy cores were associated with upgrading. CONCLUSIONS Patients ≥75 years not only demonstrated higher rates of advanced disease but more frequent upgrading on RP specimen. Age ≥75 years, higher PSA levels at RP, and an increased number of positive biopsy cores were predictive for upgrading. The increased risk of upgrading should be taken into consideration when discussing optimal treatment for this specific cohort.
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Affiliation(s)
- Annika Herlemann
- Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Alexander Buchner
- Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Alexander Kretschmer
- Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Maria Apfelbeck
- Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Christian Gratzke
- Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Stefan Tritschler
- Department of Urology, Ludwig-Maximilians-University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
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Lipar L, Srivathsan K, Scott LR. Short-term outcome of cardiac resynchronization therapy - a comparison between newly implanted and chronically right ventricle-paced patients. Int J Cardiol 2016; 219:195-9. [PMID: 27327506 DOI: 10.1016/j.ijcard.2016.06.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/13/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. METHODS One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed. Clinical and echocardiographic response to CRT was evaluated. Mean follow-up time was 290±250days. RESULTS Baseline characteristics did not differ between the two groups of patients. Clinical response rate was identical in Groups I and II (65 vs. 65%, respectively; P=0.98) and echocardiographic response rate was similar in both groups of patients (64 vs. 62%; P=0.80). Post-implant QRS increased in group I and was reduced in group II (5 (27.4) vs. -20.0 (33.9) ms; P<0.001). NYHA class improvement (-0.7 (0.6) vs. -0.7 (0.6), P=0.81), LV ejection fraction increase (9.2 (12.9) vs. 8.2 (9.9)%; P=0.55) and LV end-systolic volume reduction (-34.5 (50.7) vs. -25.7 (47.4)%; P=0.28) were comparable in both groups. CONCLUSIONS Chronically RV-paced patients who receive CRT have similar short-term benefits when compared with patients with new CRT implantations.
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Affiliation(s)
- Luka Lipar
- Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, United States.
| | - Komandoor Srivathsan
- Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, United States.
| | - Luis Roberto Scott
- Mayo Clinic Hospital, 5777 East Mayo Boulevard, Phoenix, AZ 85054, United States.
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Elamin S, Bhatt NR, Davis NF, Sweeney P. Validation of Selection Criteria for Active Surveillance in Prostate Cancer. J Clin Diagn Res 2016; 10:PC01-3. [PMID: 27190877 DOI: 10.7860/jcdr/2016/16401.7589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/28/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Considerable Proportion of Prostate Cancer (PCa) patients suitable for Active Surveillance (AS) harbour aggressive disease at surgical histopathology. Identification of truly indolent prostate cancer at diagnosis is difficult. AIM Of this study was to evaluate the accuracy of current AS protocols in identifying low risk PCa by comparing the histopathology at biopsy and surgery. MATERIALS AND METHODS A retrospective study was performed on all patients who underwent Radical Prostatectomy (RP) between 2008 and 2012. We identified patients who fulfilled inclusion criteria of five different established AS protocols. Histopathology at biopsy was compared with final surgical histopathology to identify upgrading or upstaging of disease. The biochemical recurrence rate in the cohort was also determined. RESULTS A total of 59 patients (24%) met criteria of at least one protocol. Sixteen patients (28%) were eligible for AS based on all studied criteria. Overall 24 patients (40.6%) were upgraded in their final histopathology while 12 patients (20%) upstaged from their original TRUS biopsy. Two patients (3%) had PSA failure, both had salvage radiotherapy. CONCLUSION There is considerable discrepency in current AS selection criteria which makes it necessary to introduce novel markers to identify indolent disease as a part of AS protocol for PCa.
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Affiliation(s)
- Saif Elamin
- Registrar, Department of Urology, Mercy University Hospital , Cork, Ireland
| | | | - Niall F Davis
- Specialist Regiatrar, Department of Urology, St. Vincent's University Hospital , Dublin, Ireland
| | - Paul Sweeney
- Consultant Urologist, Department of Urology, Mercy University Hospital , Cork, Ireland
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