Data on the incidence, mortality and burden of prostate cancer as well as changing trends are necessary to provide policy makers with the evidence needed to allocate resources appropriately. This ...study presents estimates of prostate cancer incidence, mortality and burden from 1990 to 2015 by patient age, country and developmental status using the results of the Global Burden of Disease 2015 study.
Data from vital registration systems and cancer registries were used to generate mortality estimates. Cause specific mortality served as the basis for estimating incidence, prevalence and disability adjusted life years. The global number of incident cases, deaths and disability adjusted life years attributable to prostate cancer are reported as well as age standardized rates.
Incident cases of prostate cancer increased 3.7-fold from 1990 to 2015. The age standardized incidence rate also increased 1.7-fold during the study period and in 2015 it reached 56.71/100,000 person-years (95% uncertainty interval 45.86-78.45). Global estimates of the age standardized death rate decreased slightly to 14.24 deaths (95% uncertainty interval 11.8-17.95) per 100,000 person-years in 2015. The decline in the age standardized death rate was more prominent in high income countries. Disability adjusted life years attributable to prostate cancer increased by 90% during the study period.
The prostate cancer mortality rate is decreasing in high income countries. However, the incidence and burden of disease are steadily increasing globally, resulting in further challenges in the allocation of limited health care resources. The current study provides comprehensive knowledge of the local burden of disease and help with appropriate allocation of resources for prostate cancer prevention, screening and treatment.
Tumor-associated macrophages (TAMs) which are often referred to as immunosuppressive cells (M2 macrophage), constitute a subset of tumor microenvironment cells and affect tumor progression in solid ...tumors. Recently, these cells have gained remarkable importance as therapeutic candidates for solid tumors. In bladder cancer, major studies have focused on evaluating TAMs in response to Bacillus Calmette-Guerin (BCG) therapy. M2 macrophages may directly impact the BCG-induced immune responses against tumor in bladder cancer. They are the main inhibitors of the tumor microenvironment that promotes growth and metastasis of the tumor. However, the clinical significance of M2 macrophages in bladder cancer is controversial. In this review, we will discuss the clinical significance of M2 macrophages in prognosis of bladder cancer as well as worth of their potential targeting in bladder cancer treatment. In the following, we will introduce important factors resulting in M2 macrophage promotion and also experimental therapeutic agents that may cause the inhibition of bladder cancer tumor growth.
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•Macrophages are plastic cells which can be activated through receiving microenvironmental signals and obtain functionally divers phenotypes.•Classically activated or M1 macrophages are typically stimulated by infection or tissue damage and exhibit pro-inflammatory properties which are central for tumor inhibition.•Alternative activation of macrophages leads to phenotype differentiation to anti-inflammatory M2 macrophages with a suppressing effect of immunity against tumors.•One of the major problems in cancer therapy is the immunosuppressive property of the tumor microenvironment. The polarization of macrophages into tumoricidal M1 or tumorigenic M2 macrophage is an important event in the establishing the tumor microenvironment.•Most of studies shows a positive association between M2 macrophages with the progression of cancer and metastasis, as well as its association with BCG therapy failure, but there are few studies have shown that TAMs with M2 phenotype may have a protective effect on bladder cancer.
Diagnosis and risk stratification are cornerstones of therapeutic decisions in the management of patients with upper tract urothelial carcinoma (UTUC). Diagnostic modalities provide data that can be ...integrated, to provide nomograms and stratification tools to predict survival and adverse outcomes. This study reviews cytology, ureterorenoscopy and the novel tools and techniques used with it (including photodynamic diagnosis, narrow-band imaging, optical coherence tomography, and confocal laser endomicroscopy), and biopsy. Imaging modalities and novel biomarkers are discussed in another article. Patient- and tumor-related prognostic factors, their association with survival indices, and their roles in different scores and predictive tools are discussed. Patient-related factors include age, sex, ethnicity, tobacco consumption, surgical delay, sarcopenia, nutritional status, and several blood-based markers. Tumor-related prognosticators comprise stage, grade, presentation, location, multifocality, size, lymphovascular invasion, surgical margins, lymph node status, mutational landscape, architecture, histologic variants, and tumor-stroma ratio. The accuracy and validation of pre-operative predictive tools, which incorporate various prognosticators to predict the risk of muscle-invasive or non-organ confined disease, and help to decide on the surgery type (radical nephroureterectomy, or kidney-sparing procedures) are also investigated. Post-operative nomograms, which help decide on adjuvant chemotherapy and plan follow-up are explored. Finally, a revision of the current stratification of UTUC patients is endorsed.
Ocean wave energy is a broadly accessible renewable energy source; however, it is not fully developed. Further studies on wave energy converter (WEC) technologies are required in order to achieve ...more commercial developments. In this study, four CETO6 spherical WEC arrangements have been investigated, in which a fully submerged spherical converter is modelled. The numerical model is applied using linear potential theory, frequency-domain analysis, and irregular wave scenario. We investigate a parametric study of the distance influence between WECs and the effect of rotation regarding significant wave direction in each arrangement compared to the pre-defined layout. Moreover, we perform a numerical landscape analysis using a grid search technique to validate the best-found power output of the layout in real wave models of four locations on the southern Australian coast. The results specify the prominent role of the distance between WECs, along with the relative angle of the layout to dominant wave direction, in harnessing more power from the waves. Furthermore, it is observed that a rise in the number of WECs contributed to an increase in the optimum distance between converters. Consequently, the maximum exploited power from each buoy array has been found, indicating the optimum values of the distance between buoys in different real wave scenarios and the relative angle of the designed layout with respect to the dominant in-site wave direction.
The significance of spillways is to allow the flood to be safely discharged from downstream. There is a strong correlation between the poor design of spillways and the failures of dams. In order to ...address this concern, the present study investigates the flow over the Nazloo-ogee spillway using the CFD 3D numerical model and an artificial intelligence method called Gene Expression Programming (GEP). In a physical model, discharge and flow depths were calculated for 21 different total heads. Among different turbulence models, the RNG turbulence model achieved the maximum compatibility in computational fluid dynamic simulation. In addition, GEP was used to estimate Q, in which 70% of collected data was dedicated to training and 30% to testing. R2, RMSE, and MAE were obtained as performance criteria, and the new mathematical equation for the prediction of discharge was obtained using this model. Finally, the numerical model and GEP outputs were compared with the experimental data. According to the results, the numerical model and GEP exhibited a high level of correspondence in simulating flow over an ogee-crested spillway.
Introduction
Bladder cancer (BCa) is the second most common genitourinary cancer and among the leading causes of cancer-related deaths. We aimed to assess BCa quality of care (QOC) utilizing a novel ...multi-variable quality of care index (QCI).
Materials and methods
Data were retrieved from the Global Burden of Disease 1990–2019 database. QCI scores were calculated using four indices of prevalence-to-incidence ratio, Disability-Adjusted Life Years-to-prevalence ratio, mortality-to-incidence ratio, and Years of Life Lost-to-Years Lived with Disability ratio. We used principal component analysis to allocate 0–100 QCI scores based on region, age groups, year, and gender.
Results
Global burden of BCa is on the rise with 524,305 (95% UI 475,952–569,434) new BCa cases and 228,735 (95% UI 210743–243193) deaths in 2019, but age-standardized incidence and mortality rates did not increase. Global age-standardized QCI improved from 75.7% in 1990 to 80.9% in 2019. The European and African regions had the highest and lowest age-standardized QCI of 89.7% and 37.6%, respectively. Higher Socio-demographic index (SDI) quintiles had better QCI scores, ranging from 90.1% in high SDI to 30.2% in low SDI countries in 2019; however, 5-year QCI improvements from 2014 to 2019 were 0.0 for high and 4.7 for low SDI countries.
Conclusion
The global QCI increased in the last 30 years, but the gender disparities remained relatively unchanged despite substantial improvements in several regions. Higher SDI quintiles had superior QOC and less gender- and age-based inequalities compared to lower SDI countries. We encourage countries to implement the learned lessons and improve their QOC shortcomings.
IntroductionBladder cancer (BCa) is the second most common genitourinary cancer and among the leading causes of cancer-related deaths. We aimed to assess BCa quality of care (QOC) utilizing a novel ...multi-variable quality of care index (QCI).Materials and methodsData were retrieved from the Global Burden of Disease 1990-2019 database. QCI scores were calculated using four indices of prevalence-to-incidence ratio, Disability-Adjusted Life Years-to-prevalence ratio, mortality-to-incidence ratio, and Years of Life Lost-to-Years Lived with Disability ratio. We used principal component analysis to allocate 0-100 QCI scores based on region, age groups, year, and gender.ResultsGlobal burden of BCa is on the rise with 524,305 (95% UI 475,952-569,434) new BCa cases and 228,735 (95% UI 210743-243193) deaths in 2019, but age-standardized incidence and mortality rates did not increase. Global age-standardized QCI improved from 75.7% in 1990 to 80.9% in 2019. The European and African regions had the highest and lowest age-standardized QCI of 89.7% and 37.6%, respectively. Higher Socio-demographic index (SDI) quintiles had better QCI scores, ranging from 90.1% in high SDI to 30.2% in low SDI countries in 2019; however, 5-year QCI improvements from 2014 to 2019 were 0.0 for high and 4.7 for low SDI countries.ConclusionThe global QCI increased in the last 30 years, but the gender disparities remained relatively unchanged despite substantial improvements in several regions. Higher SDI quintiles had superior QOC and less gender- and age-based inequalities compared to lower SDI countries. We encourage countries to implement the learned lessons and improve their QOC shortcomings.
We report a case of isolated renal mucormycosis 2 weeks following transurethral resection of prostate. The patient also mentioned history of admission for COVID-19, two months earlier. Symptoms ...progressed and patient underwent urgent nephrectomy. CT scan resembled imaging features of emphysematous pyelonephritis and therefore, patient did not receive timely treatment with amphotericin B in addition to nephrectomy and succumbed to the disease.
Skeletal muscle metastasis of prostate cancer is a very rare phenomenon that has only been described in limited case reports. In this study, we present a case of neuroendocrine prostate cancer with ...muscle metastasis, a histological subtype associated with a grim prognosis. This case illustrates the potential efficacy of urgent surgical resection of the metastatic muscle mass, followed by adjuvant radiation therapy, as a suitable management strategy for this condition. However, a comprehensive understanding of the biological characteristics of neuroendocrine prostate cancer is imperative in our fight against this lethal form of the disease and in the prevention of metastatic spread.
•Proposing an effective optimizer to maximize the power absorption of an OSWEC.•Developing a technical feasibility landscape analysis utilizing the WEC-Sim model.•Insights for selecting optimal ...offshore sites with maximizing WEC power output.•Achieving a significant increase in power output (up to 58%) compared other methods.•Gaining valuable knowledge for deploying OSWECs in the South Caspian Sea.
Ocean wave energy stands as a crucial component in the quest for sustainable and renewable energy sources, essential in the global effort to mitigate climate change. However, a significant challenge in this field is optimizing the efficiency of Wave Energy Converters (WECs) on a regional scale, particularly Oscillating Surge Wave Energy Converters (OSWECs). This challenge stems from the complex, nonlinear interactions between ocean waves and these devices, necessitating precise tuning of Power Take-Off (PTO) system settings and optimal placement for the highest possible performance and stability. To address this challenge, our study introduces the Hill Climb - Explorative Grey Wolf Optimizer (HC-EGWO), a novel algorithm combining local search and swarm-based global optimization strategies. This hybrid approach effectively balances exploration and exploitation in the solution space, leading to more optimal PTO settings for OSWECs. Alongside this algorithmic development, we conduct a thorough feasibility analysis based on the constraints of the flap’s maximum angular motion. This ensures the optimized OSWEC operates within safe and efficient limits. In a comparative analysis with the Genetic Algorithm (GA), the Particle Swarm Optimization (PSO), the artificial Gorilla Troops Optimizer (GTO), and different implementations of the GWO, our results show an improvement in power output, with the HC-EGWO method achieving up to a 3.31% increase over other variations of the GWO and 45% increase compared to all the methods. The findings of this study not only demonstrate the effectiveness of the HC-EGWO method but also provide strategic insights for the deployment of OSWECs in areas like the South Caspian Sea, where unique environmental factors imply careful consideration in the site selection process.
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