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Background: In 2017, the European Commission launched 24 European Reference Networks (ERNs). ERN eUROGEN is the network for urorectogenital diseases and complex conditions, and started with 29 full member healthcare providers (HCPs) in 11 countries. It then covered 19 different disease areas distributed over three work -streams (WSs). Objective: To provide an overview and identify challenges in data collection at European level of the ERN eUROGEN patient population treated by HCPs in the network. Design, setting, and participants: A retrospective cohort study was conducted of the 29 HCPs who were full members between 2013 and 2019. Outcome measurements and statistical analysis: Data were extracted from the original HCP applications and the ERN continuous monitoring system. Patient volumes, new patient numbers, and procedures were compared between different WSs, countries, and HCPs. Discrepancies between monitoring and application data were identified. Results and limitations: Between 2013 and 2019, 122 040 patients required long-term care within the 29 HCPs. The volume of patients treated and procedures undertaken per year increased over time. Large discrepancies were found between patient numbers contained in the application forms and those reported in the continuous monitoring system (0-1357% deviation). Conclusions: Patient numbers and procedures increased across ERN eUROGEN HCPs. Reliable data extraction appeared challenging, illustrated by the patient volume dis-crepancies between application forms and the continuous monitoring data. Improved disease definitions, re-evaluation of affiliated HCPs, and valid data extraction are needed for future improvements. Patient summary: We analysed the patient population with rare urorectogenital dis-eases or complex conditions within the ERN eUROGEN network between 2013 and 2019. Clinical activity was found to increase, but differences in patient numbers were evident between healthcare providers. In order to acquire valid patient numbers, both improved definitions of diagnostic codes and greater insight into the data-gathering process are required. (c) 2021 The Authors. Published by Elsevier B.V. on behalf of European Association of Urology. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/).

PURPOSE: Burnout is defined as a three-dimensional syndrome—emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA)—caused by chronic occupational stress. The aim of the current study was to investigate the prevalence of burnout among oncologists in Eastern Europe and to identify the contributing factors. METHODS: The study was conducted as an online survey between October 2017 and March 2018. Oncologists (including medical, radiation, clinical, and surgical oncologists) from 19 countries were invited to participate. The survey consisted of 30 questions, including the standardized burnout instrument, Maslach Burnout Inventory, and eight demographic questions. Burnout risk was scored according to the scoring manual for health care workers. RESULTS: The study included 637 oncologists. Overall, 28% were at low or intermediate risk and 72% were at high risk for burnout. Forty-four percent of participants were at high risk for EE, 28.7% for DP, and 47.3% for PA. EE risk was associated with female sex. DP risk was highest among clinical and radiation oncologists, whereas PA risk was positively correlated with years of service, percentage of cancer deaths, and availability of the number of oncologists. In multivariate logistic regression analysis, burnout was significantly associated with standardized cancer mortality and fewer years of practice. CONCLUSION: Burnout among oncologists in Eastern Europe is high, and younger oncologists are the most vulnerable group. Preventive measures should be taken to address this issue, which negatively affects optimal care delivery and poses a threat to oncologists’ health and well-being.

Prva vakcina za rak koja je odobrena za rutinsko liječenje bio je sipuleucel-T za liječenje bolesnika s metastatskim kastracijski rezistentnim rakom prostate. Međutim, drugi imunoterapijski lijekovi koji su bili istraživani u bolesnika s rakom prostate, posebno inhibitori imunološke kontrolne točke, nisu pokazali terapijski učinak. Nekoliko je mogućih objašnjenja za nedostatak terapijskog odgovora na ove lijekove kod raka prostate. Ta objašnjenja koja su vezana uz specifična genetička (npr. nisko mutacijsko opterećenje) i imunološka (npr. imunosupresivni tumorski imunološki mikrookoliš) obilježja raka prostate opisana su u ovom preglednom radu. Također, prikazane su nove terapijske strategije s ciljem prevladavanja otpornosti raka prostate na imunoterapiju i za odabir podskupina bolesnika u kojih se može očekivati korist od imunoterapije.

Cervical cancer patients with locally advanced disease are treated with combined external beam radiotherapy EBRT and high dose rate brachytherapy HDRBT. In treatment reports, doses to HRCTV (high risk clinical target volume) and doses for organs at risk, bladder and rectum, are usually reported. Dose constraints for vagina as organ at risk and methods for reporting vaginal dose points are not yet introduced in clinical practice. This study aims to analyze and report vaginal dose points in the lower and upper part of vagina.

Scores of avalanche injuries and fatalities occur annually. This research presents an avalanche search and rescue (SAR) proof-of-concept option that utilizes a small unmanned aerial vehicle (UAV) helicopter with a payload capable of detecting and locating a buried victim's cell phone. Cell phones involved in this research were modern-day fourth generation (4G) Long Term Evolution (LTE) devices with an application specifically designed for potential SAR detection. This study focused primarily on radio frequency (RF) propagation modeling through snow and air. The analysis and associated field trials demonstrate that it is feasible to detect these cell phone devices through avalanche debris up to 7 feet deep. Alpine UAS inclement flight demonstrations were also conducted. Although many studies have been published on detecting the position of mobile cellular devices, this is the first of its kind to quantify the detection of a cell phone that is buried under the snow.

Short-course radiotherapy for locallly advanced rectal cancer: an IAEA randomized trial

o optimize palliation in incurable locally advanced non-small cell lung cancer (NSCLC), the International Atomic Energy Agency conducted a prospective randomized study (NCT00864331) comparing protracted palliative radiotherapy (RT) course with chemotherapy (CHT) followed by short-course palliative RT. Treatment-naive patients with histologically confirmed NSCLC, stage IIIA/IIIB, received either 39 Gy in 13 fractions as RT alone (arm A, n = 31) or 2–3 platinum-based CHT cycles followed by 10 Gy in a single fraction or 16 Gy in 2 fractions separated by one week (arm B, n = 34). Primary outcome was overall survival. Treatment groups were balanced with respect to various variables. Median survival for all 65 patients was 8 months, while median survival was 7.1 and 8.1 months for the two arms, respectively (log-rank p = 0.4 by study arm, and p = 0.6 by Cox regression and stratified by country and sub-stage). One and three year survival rates for the two arms were 29%, and 9% and 41%, and 6%, respectively. There were no differences in any of the following endpoints: any failure, local failure, regional failure, contralateral thoracic failure, and distant failure between the two arms. High-grade (⩾3) toxicity was similar between the two arms. Symptoms, adverse events of any kind, KPS and body-mass index, were not different during treatment and during follow-up. There was no grade 5 toxicity. This incomplete and underpowered trial only hinted similar outcome between the treatment arms. Therefore, combined CHT-RT can perhaps be considered, in limited resource setting, where access to RT remains inadequate.

Differences in surgical resection rates , RO pathological margins and overall survival were not statistically significant, while relative safety was demonstrated for short-course RT. With a mean follow-up of 1, 5 years , the preliminary results of this trial do not show a significant difference between randomization arms. An operability rate of 60% is important fo a group of patients deemed inoperable / borderline at diagnosis in this group of developing countries.

The aberrant overexpression of alpha satellite DNA is characteristic of many human cancers including prostate cancer; however, it is not known whether the change in the alpha satellite RNA amount occurs in the peripheral tissues of cancer patients, such as blood. Here, we analyse the level of intracellular alpha satellite RNA in the whole blood of cancer prostate patients at different stages of disease and compare it with the levels found in healthy controls. Our results reveal a significantly increased level of intracellular alpha satellite RNA in the blood of metastatic cancers patients, particularly those with metastatic castration-resistant prostate cancer relative to controls. In the blood of patients with localised tumour, no significant change relative to the controls was detected. Our results show a link between prostate cancer pathogenesis and blood intracellular alpha satellite RNA levels. We discuss the possible mechanism which could lead to the increased level of blood intracellular alpha satellite RNA at a specific metastatic stage of prostate cancer. Additionally, we analyse the clinically accepted prostate cancer biomarker PSA in all samples and discuss the possibility that alpha satellite RNA can serve as a novel prostate cancer diagnostic blood biomarker.