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Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.

Background The purpose of this study is to assess the body composition changes in men with recently diagnosed oligometastatic prostate cancer following neoadjuvant chemohormonal therapy. Further, we evaluated whether CT‐based body composition parameters are associated with biochemical recurrence or imaging progression. Material and methods Recently diagnosed castration‐naïve oligometastatic prostate cancer patients who received neoadjuvant docetaxel chemotherapy and androgen deprivation treatment (ADT) before prostatectomy and consolidation of local and oligometastatic disease (total eradication therapy), as part of a phase‐II prospective clinical trial were included. Body composition parameters including cross‐sectional areas of the psoas muscle, total, visceral, and subcutaneous adipose tissue were measured on serial CT scans obtained before and following completion of neoadjuvant treatment. Results A total of 22 prostate cancer patients were included (median age 58 years, median Gleason score 8). The median time intervals between commencement of neoadjuvant chemohormonal therapy and first and second follow‐up CTs were 3 and 12 months, respectively. Compared to the baseline scan, there were significant declines in psoas muscle cross‐sectional areas with estimated percentage declines of −13.9% (IQR: 7.6%–16.5%, p

Background The use of scores for the assessment of endoscopic activity in inflammatory bowel disease (IBD) patients is crucial for accurate and reproducible evaluation of mucosal healing, which is a relevant marker of prognosis. Frequency and patterns of their use in a real-life setting are not known. We aimed to describe the prevalence of adequate use of endoscopic scores in IBD patients who underwent colonoscopy in a real-life setting. Methods A multicenter observational study comprising six community hospitals in Argentina was undertaken. Patients with a diagnosis of Crohn’s disease or ulcerative colitis who underwent colonoscopy for endoscopic activity assessment between July 2018 and July 2022 were included. Colonoscopy reports of included subjects were manually reviewed to determine the proportion of colonoscopies that included an endoscopic score report. We compared the endoscopic findings to determine if there were differences in the score reported and the inflammatory activity described. Finally, we determined the proportion of colonoscopy reports that included all of the IBD colonoscopy report quality elements proposed by BRIDGe group. Endoscopist’s specialty, years of experience as well as expertise in IBD were assessed. Chi square test was used for the comparison of categorical variables; Student t test for the comparison of numerical variables. A multivariate analysis was performed using a logistic regression model. A p value of less than 0.05 was considered to be statistically significant. Results A total of 1206 patients were included for analysis (32.25% patients with Crohn’s disease). Mean age was 45.48±15.6. Endoscopic score reporting was found in only 34.45% of Crohn’s disease colonoscopies and in 52.87% of ulcerative colitis colonoscopies. Most frequently used scores were Mayo endoscopic score (90.56%) and SES-CD (56.03%). We found discrepancies between the score reported and the findings described in colonoscopies in 10.92% of cases; only 26% of reports included all recommendations proposed by BRIDGe group. On multivariate analysis, surgeons as operators [OR 0.08 (0.03-0.18)], >15 years of endoscopist experience [OR 0.24 (0.07-0.37)], IBD expertise [OR 2.86 (1.86-4.41)] and compliance of quality elements of reporting [OR 2.48 (1.24-3.76)] were significantly associated with endoscopic score reporting. Conclusion We identified a low prevalence of endoscopic activity score reporting in IBD patients’ colonoscopies. This finding is associated with operator-dependent characteristics. Educational interventions can be introduced to increase adequate score reporting.

Human Activity Recognition (HAR) plays an important role in behavior analysis, video surveillance, gestures recognition, gait analysis, and posture recognition. Given the recent progress of Artificial Intelligence (AI) applied to HAR, the inputs that are the data from wearable sensors can be treated as time-series from which movement events can be classified with high accuracy. In this study, a dataset of raw sensor data served as input to four different deep learning networks (DNN, CNN, LSTM, and CNN-LSTM). Differences in accuracy and learning time were then compared and evaluated for each model. An analysis of HAR was made based on an attempt to classify three activities: walking, sit-to-stand, and squatting. We also compared the performance of two different sensor data types: 3-axis linear acceleration measured from two inertial measurement units (IMUs) versus 3D acceleration of two retro-reflective markers from the high-end optoelectronic motion capture system (MOCAP). The dataset created from observations of ten subjects was preprocessed with labelling and sliding windows and then used as input to the four frameworks. The results indicate that, for HAR prediction, linear accelerations estimated using IMUs are as reliable as those measured using the MOCAP system. Also, the use of the hybrid CNN-LSTM framework for both methods resulted in higher accuracy (99%).

Multimodal therapies were combined to eradicate the primary site, metastatic, and micrometastatic disease in men with newly diagnosed, synchronous, oligometastatic prostate cancer. The investigation included companion, phase II studies: total eradication therapy-1 (TET-1) for those treatment-naïve and total eradication therapy-2 (TET-2) for those post-prostatectomy. The treatment-naive protocol included androgen deprivation and docetaxel (with concurrent abiraterone added in a protocol amendment), followed by a prostatectomy, adjuvant radiation (if positive margins, T3/4, or detectable PSA), and metastasis-directed therapy. The post-prostatectomy protocol assigned the same therapies (omitting the prostatectomy). The primary endpoint was an undetectable PSA with recovered testosterone. The safety boundaries were ≤ 50% for grade 3/4 neutropenic and ≤ 20% for grade 3/4 surgical- and radiation-related toxicities. Enrollment was planned for 60 patients per protocol, to detect a PSA progression-free survival ≥ 32%, as compared to 15% in a historic control. Enrollment closed early. An interim analysis was conducted once 50% of patients were evaluable for the primary endpoint. The primary endpoint duration was assessed by median progression-free survival. 52 patients were enrolled (n = 26 per protocol). Medium follow-up was 30.3 months. 80% (24/30) of evaluable patients achieved the primary endpoint; the duration was not reached. Of those not evaluable, 77% (17/22) had not reached the endpoint and 23% (5/22) had exited. There were 8% (4/52) grade 3/4 neutropenic and 2% (1/48) grade 3/4 surgical or radiation-induced toxicities. Interim findings suggest the trials' endpoints were met, advancing the concept of total eradication therapy in men with oligometastatic prostate cancer.

The rising need for wholesome, fresh, safe and "minimally-processed" foods has led to pioneering research activities in the emerging non-thermal technology of food processing

Bone metastases in prostate cancer (PCa) have important prognostic significance, and imaging modalities used for PCa staging should have high sensitivity for detecting such lesions. Prostate-specific membrane antigen (PSMA)-targeted PET radiotracers are promising new agents for imaging PCa. We undertook a head-to-head comparison of PSMA-targeted 2-(3-{1-carboxy-5-[(6-18F-fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) PET to Na18F PET to determine which modality was more sensitive for the detection of lesions suggestive of bone metastases in a group of patients with metastatic PCa. Methods: Patients with progressive, metastatic PCa were prospectively imaged with both 18F-DCFPyL and Na18F PET/CT, with both scans occurring within 24 h of each other. A consensus 2-reader central review was performed to identify all bone lesions suggestive of sites of PCa involvement on both scans, and maximized SUVs corrected for body weight (SUVmax) and lean body mass (SULmax) were recorded. Soft-tissue lesions were also noted on both scans, and SUVmax, SULmax, and PSMA reporting and data system (RADS) version 1.0 scores were recorded. Data from the 2 scans were compared using a generalized estimating equation. Results: In total, 16 patients meeting all inclusion criteria were enrolled in this study, and 15 of the 16 (93.8%) were imaged with both PET radiotracers. In total, 405 bone lesions suggestive of sites of PCa were identified on at least 1 scan. On 18F-DCFPyL PET/CT, 391 (96.5%) were definitively positive, 4 (1.0%) were equivocally positive, and 10 (2.5%) were negative. On Na18F PET/CT, the corresponding values were 388 (95.8%), 4 (1.0%), and 13 (3.2%). Of the definitively negative lesions on 18F-DCFPyL PET, 8 of 10 (80.0%) were sclerotic and 2 of 10 (20.0%) were infiltrative or marrow-based. Additionally, 12 of 13 (92.3%) of the definitively negative lesions on Na18F PET were infiltrative or marrow-based and 1 of 13 (7.7%) was lytic. Also identified were 78 PSMA-RADS-4, 17 PSMA-RADS-5, and 1 PSMA-RADS-3C soft-tissue lesions. Conclusion: PET/CT imaging using 18F-DCFPyL and Na18F PET had nearly identical sensitivities for the detection of bone lesions in patients with metastatic PCa. As would be expected, PSMA-targeted PET provides more information on soft-tissue disease. There may be little additional value to imaging PCa patients with Na18F after a PSMA-targeted PET scan has already been performed.

Objective: to analyze treatment outcomes in patients with stage IIA–IIIB cervical cancer.Materials and methods. The study included 278 women with stage IIA–IIIB cervical cancer. Study participants were divided into 2 groups. Group 1 comprised 165 patients who received chemoradiotherapy + surgery (radical hysterectomy). Patients in group 2 received standard radiotherapy.Results. Patients receiving combination therapy demonstrated better overall and relapse-free survival compared to those receiving standard treatment.Conclusion. Both publications of other authors and our own results suggest high efficacy and safety of combination therapy for stage IIA–IIIB cervical cancer.

The aim of the study was to evaluate the feasibility of utilizing peripheral androgen blockade in men with biochemical recurrent castrate-sensitive prostate cancer. A registration study to track outcomes of men with biochemical recurrent castrate-sensitive prostate cancer treated with peripheral androgen blockade utilizing concomitant administration of finasteride and bicalutamide. Men were on intermittent peripheral blockade for a median 20.2 months, continuous peripheral blockade for a median 6.8 months, intermittent triple dose peripheral androgen blockade for a median 10.7 months, and continuous triple dose peripheral androgen blockade for 4.4 months before failing therapy. Six men (21%) had additional therapies during treatment that included metastasis-directed therapy (5/37, 14%), systemic Lu-177 (2/37, 5%), and salvage RT (1/37, 3%). The median time to progression, which includes time from initiation through all therapies to the initiation of ADT, was 37.6 months (IQR 20-74.7). From the start of PAB, median time to castrate resistance was 49.8 months (IQR 40.9-NR). After starting ADT, median time to castrate resistance was 8.8 months (IQR 4.6-17.7). Our data support the exploration of PAB as a treatment option in carefully selected patients who present with biochemical recurrence after failure of definitive local therapy for prostate cancer.

Background PhilHealth, the social health insurance (SHI) agency of the Philippines, still does not sufficiently cover the informal sector workers (ISWs) - or the “missing middle”. Previous approaches had limited success. The impetus for finding solutions to protect the missing middle still remains. Methods A multi-component action research was done to address the complex social problem. Literature review and interviews were conducted to understand the nature of ISWs. National survey data was analyzed for factors affecting the ISWs' membership and retention in SHI. Findings were triangulated to construct evidence-based and context-rich marketing personas to understand PhilHealth's target clients. Using Human-Centered Design Thinking (HCDT), solutions that aim to address the low retention of ISWs in health insurance (HI) were proposed. Results The exact nature of ISWs is still unknown. Costly insurance premiums, poor knowledge of SHI, low perceived value of SHI, and inconvenient payment mechanisms contribute to low participation in SHI. Every additional 1000 PHP (∼20 USD) income increases odds of being an active member by 4%. Those who access private facilities are 2.8 times more likely to be active members. Those who perceive themselves to be sickly were 52% more likely to drop-out of the insurance. The results were fed into the HCDT process producing four prototypes: 1) solutions that explore partnership of PhilHealth with other organizations, 2) use of mobile application platforms for payment and member status updates, 3) automated algorithm to identify and calculate fair premiums, and 4) integration of money-saving strategies. Conclusions The government needs to step-up current efforts to extend health financial risk protection for the ISWs. PhilHealth can take advantage of the research results by testing the prototypes produced, and by adopting the HCDT process to improve their service and coverage for the informal sector. Key messages This government-funded project integrated principles of public health, epidemiology, health financing, participatory governance, and implementation research to address a complex social problem. The results provide a better understanding of the informal sector workers’ nature and needs with regards health insurance and can help PhilHealth improve coverage of informal sector workers.

To evaluate the outcomes of total eradication therapy (TET), designed to eradicate all sites of visible cancer and micrometastases, in men with newly diagnosed oligometastatic prostate cancer (OMPCa). Men with ≤ 5 sites of metastases were enrolled in a prospective registry study, underwent neoadjuvant chemohormonal therapy, followed by radical prostatectomy, adjuvant radiation (RT) to prostate bed/pelvis, stereotactic body radiation therapy (SBRT) to oligometastases, and adjuvant hormonal therapy (HT). When possible, the prostate-specific membrane antigen targeted 18F-DCFPyL PET/CT (18F-DCFPyL) scan was obtained, and abiraterone was added to neoadjuvant HT. Twelve men, median 55 years, ECOG 0, median PSA 14.7 ng/dL, clinical stages M0—1/12 (8%), M1a—3/12 (25%) and M1b—8/12 (67%), were treated. 18F-DCFPyL scan was utilized in 58% of cases. Therapies included prostatectomy 12/12 (100%), neoadjuvant [docetaxel 11/12 (92%), LHRH agonist 12/12 (100%), abiraterone + prednisone 6/12 (50%)], adjuvant radiation [RT 2/12 (17%), RT + SBRT 4/12 (33%), SBRT 6/12 (50%)], and LHRH agonist 12/12 (100%)]. 2/5 (40%) initial patients developed neutropenic fever (NF), while 0/6 (0%) subsequent patients given modified docetaxel dosing developed NF. Otherwise, TET resulted in no additive toxicities. Median follow-up was 48.8 months. Overall survival was 12/12 (100%). 1-, 2-, and 3-year undetectable PSA’s were 12/12 (100%), 10/12 (83%) and 8/12 (67%), respectively. Median time to biochemical recurrence was not reached. The outcomes suggest TET in men with newly diagnosed OMPCa is safe, does not appear to cause additive toxicities, and may result in an extended interval of undetectable PSA.

Objective To investigate the circulating tumour cells (CTCs) capture abilities of two technologies that are not dependent on cell-surface marker expression: a selection-free platform [AccuCyte® -CyteFinder® system (Rarecyte)] and a size-based platform [fluid-assisted separation technology (FAST)]. In addition, the combination of the two systems to more completely assess CTCs was investigated. Patients and methods In all, 28 patients with metastatic prostate cancer were included. Two 6 mL peripheral blood samples were taken from each patient at the same time-point. The samples were then subjected to the two different technology platforms in parallel. An additional group of samples was acquired by applying the waste chamber material from the FAST-group tests (flow-through that goes through the FAST filter membrane) to the Rarecyte system for the detection any CTCs that were not captured by FAST. Results The three groups had significantly different putative CTC-positive tests, with positive rates of 29% for Rarecyte, 57% for FAST, and 79% for the combination. We also assessed CTC phenotype: 56.6% of the CTCs were cytokeratin (CK)+/epithelial cell adhesion molecule (EpCAM)-, 3.1% were CK-/EpCAM+, and 40.3% were CK+/EPCAM+. The captured CTCs diameter ranged from 5.2 to 16.9 µm. The mean CTC size from the FAST waste chamber was significantly smaller. The diameters for each of the phenotypic groups were significantly different. Conclusions These data highlight disparities in the positive rates and enumerated CTC numbers detected by the two techniques. Notably, the combination of the two technologies resulted in the highest CTC-capture rates. Smaller CTCs were more likely to be missed by the FAST as they passed through the filter system. Sizes of CTCs varied with different cell surface marker phenotypes.

Local ablative treatment to oligometastatic patients can result in long-term disease-free survival in some cancer patients. The importance of this treatment paradigm in prostate cancer is a rapidly evolving field. Herein, we report on the safety and preliminary clinical outcomes of a modern cohort of oligometastatic prostate cancer (OPC) patients treated with consolidative stereotactic ablative radiation (SABR). Records of men with OPC who underwent consolidative SABR at our institution were reviewed. SABR was delivered in 1–5 fractions of 5–18 Gray. Kaplan–Meier estimates of local progression-free survival (LPFS), biochemical progression-free survival (bPFS; PSA nadir + 2), distant progression-free survival (DPFS), and time-to-next intervention (TTNI) were calculated. In total, 66 OPC patients were identified with consolidative SABR delivered to 134 metastases: 89 bone, 40 nodal, and 5 viscera. The majority of men (49/66) had hormone-sensitive prostate cancer (HSPC). Crude grade 1 and 2 acute toxicities were 36% and 11%, respectively, with no ≥ grade 3 toxicity. At 1 year, LPFS was 92% and bPFS and DPFS were 69%. Of the 18 men with HSPC who had deferred hormone therapy , 11 (56%) remain disease free following SABR (1-year ADT-FS was 78%). In 17 castration-resistant men, 11 had > 50% prostate-specific antigen (PSA) declines with 1-year TTNI of 30%. Consolidative SABR in OPC is feasible and well tolerated. The heterogeneity and small size of our series limit extrapolation of clinically meaningful outcomes following consolidative SABR in OPC, but our preliminary data suggest that this approach warrants continued prospective study.

We present the case of a man with oligometastatic prostate cancer who underwent a PSMA-targeted 18F-DCFPyL PET/CT scan in order to illustrate how the PSMA-RADS grading sytem can be successfully used to support clinical decision-making and treatment planning. Notably, the presented patient was found to have an equivocal bone lesion (PSMA-RADS-3B) which was further worked up with a tumor protocol MRI and found to be definitively benign (PSMA-RADS-1B) and thus removed from the oligometastatic treatment plan. Remaining avid lesions were incorporated into the treatment plan or deferred for later work-up or monitoring, as indicated within the PSMA-RADS framework. Keywords: PSMA, DCFPyL, Prostate cancer, Oligometastatic

The Latin American Giant Observatory (LAGO) is an international network of water-Cherenkov detectors (WCD) set in different sites across Latin America. On top of the Sierra Negra volcano in Mexico at an altitude of 4530 m, LAGO has completed its first out of three instrumented detector. It consists of a cylindrical water tank with a diameter of 7.3 m and a height of 1 m and a total detection area of 40 m2 that is sectioned in four equal slices. In this work we present the full calibration procedure of this detector and the initial measurements of stability in rate. We also derive the effective area to gamma-ray bursts for the complete array using the LAGO simulation chain, based on CORSIKA and GEANT4.

Microgrids with renewable distributed generation appears to be a good alternative to provide electricity for rural areas and isolated zones. However, these microgrids presents relatively low robustness due to their distributed generation topology with lack of dominant nodes to absorb and compensate instabilities, and intermittent energy availability. This work presents a novel strategy to model microgrids in an extended graph model, generating additional model embedded information, essential for optimization processes in the quest of robustness and economy, among other objectives. The traditional impedance model of microgrid is complemented by an extended graph integrating additional information of grids elements such as saturation, current and voltage limits or energy resource availability. This paper presents the extended graph developed model, which yields to a concise representation of an entire microgrid system, as well as a set of graph metrics usable for electrical grid evaluation. The presented model and metrics show to be useful to store, in a single and simple model, valuable information for design, evaluation and operation of microgrid systems.

INTRODUCTION AND OBJECTIVES:Although men with newly-diagnosed oligometastatic prostate cancer have historically been treated with androgen deprivation therapy (ADT), emerging evidence suggests loca...

Bone metastases in prostate cancer (PCa) have important prognostic significance, and imaging modalities used for PCa staging should have high sensitivity for detecting such lesions. Prostate-specific membrane antigen (PSMA)-targeted PET radiotracers are promising new agents for imaging PCa. We undertook a head-to-head comparison of PSMA-targeted 2-(3-{1-carboxy-5-[(6

Purpose: Radioembolization with yttrium-90 microspheres may be optimized with patient-specific pretherapy treatment planning. Dose verification and validation of treatment planning methods require quantitative imaging of the post-therapy distribution of yttrium-90 (Y-90). Methods for quantitative imaging of Y-90 using both bremsstrahlung SPECT and PET have previously been described. The purpose of this study was to compare the two modalities quantitatively in humans. Methods: Calibration correction factors for both quantitative Y-90 bremsstrahlung SPECT and a non-time-of-flight PET system without compensation for prompt coincidences were developed by imaging three phantoms. The consistency of these calibration correction factors for the different phantoms was evaluated. Post-therapy images from both modalities were obtained from 15 patients with hepatocellular carcinoma who underwent hepatic radioembolization using Y-90 glass microspheres. Quantitative SPECT and PET images were rigidly registered and the total liver activities and activity distributions estimated for each modality were compared. The activity distributions were compared using profiles, voxel-by-voxel correlation and Bland–Altman analyses, and activity-volume histograms. Results: The mean ± standard deviation of difference in the total activity in the liver between the two modalities was 0% ± 9% (range −21%–18%). Voxel-by-voxel comparisons showed a good agreement in regions corresponding roughly to treated tumor and treated normal liver; the agreement was poorer in regions with low or no expected activity, where PET appeared to overestimate the activity. The correlation coefficients between intrahepatic voxel pairs for the two modalities ranged from 0.86 to 0.94. Cumulative activity volume histograms were in good agreement. Conclusions: These data indicate that, with appropriate reconstruction methods and measured calibration correction factors, either Y-90 SPECT/CT or Y-90 PET/CT can be used for quantitative post-therapy monitoring of Y-90 activity distribution following hepatic radioembolization.

Introduction and objective: The presence of circulating tumor cells (CTC) is associated with poor prognosis in metastatic prostate cancer (mPCa) patients. The aim of this study is to evaluate the feasibility of using diagnostic leukapheresis (LP) followed by gene profiling using the NanoString low RNA input nCounter assay to achieve reliable CTC gene profiling. Methods: Blood samples were collected from 4 mPCa patients and 3 healthy donors. In the LP procedure, different blood elements were separated based on density. The mononuclear cell layer (presumed to contain any CTCs) was collected. The Alere™ CTC AdnaTest (AdnaGen, Langenhagen, Germany), an EpCAM positive selection method for isolation of EpCAM+ CTCs, followed by RT-qPCR for PSA, PSMA, and HOXB13 was used to detect CTCs from LP. The Ct value thresholds for positive CTC signal by RT-qPCR were set based on healthy donor LP subjected to AdnaTest as a negative control (PSA 36.3, PSMA 36.82, HOXB13 40). The cDNA of cells captured by EpCAM+ selection (including putative CTCs) and of the EpCAM+ depleted white blood cells (WBC) were assayed by the nCounter PanCancer Progression Panel to determine expression of 770 selected mRNAs. The NanoString nCounter Low RNA Input Kit with the multiplex 770-gene primer pool was used for the pre-amplification of cDNA and overnight hybridization with the PanCancer Progression panel. To validate the assay, healthy donor LPs were spiked with known numbers of PCa cell line LN95 cells. Results: For mPCa patients, the LP procedure took 136.2±10.6 min, with a screening volume of 10L of peripheral blood. The mean volume of mPCa LP product was 123.64±12.23 ml. The WBC concentration was 69.75±28.2×109/L. All samples were subjected to AdnaTest in triplicate and CTCs were identified in 3 out of 4 patients. The positive Ct values of PSA were 33.86±0.81, 32.14±0.31 and 33.09±0.34; PSMA were 35.55±1.02, 33.55±0.83 and 35.30±0.65; HOXB13 were 36.25±0.34, 37.15±0.22 and 37.09±0.33. To assess profiling of CTCs isolated from LP using the nCounter platform, 100, 500, and 1000 LN95 cells were spiked in healthy LPs and were analyzed with the AdnaTest. Within each spiking group, pre-spiking WBC, captured CTC, post-capture WBC, and LN95 cells in PBS alone were subjected to the Nanostring assay. Eisen Cluster analysis separated pre- and post- WBCs, captured CTCs, LN95 cells into three groups. The gene expression of captured CTCs correlated with those of LN95 cells, and the correlation increased with the spiking cancer cell number (R2=0.45, 0.57, and 0.70, respectively). The gene expression of pre-spiked WBCs were highly correlated with those of post-capture WBCs regardless of spiking cancer cell number (R2=0.83, 0.84 and 0.85). Conclusions: Analyzing CTCs in LP samples by AdnaTest is feasible and offers a promising method for liquid biopsy of mPCa patients. The NanoString low RNA input nCounter assay can provide reliable gene expression profiling of CTC. Citation Format: Liang Dong, Chung-Ying Huang, Changxue Lu, Diane Reyes, Sarah R. Amend, Jun Luo, Kenneth Pienta. Profiling circulating tumor cell RNA from a large blood screening volume: A pilot study using diagnostic leukapheresis followed by the NanoString low RNA input nCounter assay [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5365.

To determine the efficacy of combined continuous sorafenib therapy and drug-eluting bead (DEB) transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC).This study was conducted in accordance with the principles of the Declaration of Helsinki, and all patients provided written informed consent prior to enrollment. Inclusion criteria included unresectable HCC, a treatment naïve status, an Eastern Cooperative Oncology Group score of 0-1, and a Child-Pugh score of A-B7. Continuous sorafenib therapy (400 mg twice daily) was started 1 week before the first round of DEB TACE, which was performed in 6-week cycles. Up to four rounds of DEB TACE therapy were allowed on demand within 6 months. The primary end point was safety. Secondary end points were time to progression (TTP), response rate, and overall survival (OS) and were stratified by the Barcelona Clinic Liver Cancer (BCLC) stage and the duration of sorafenib therapy. OS was assessed with Kaplan-Meier estimates, and the Mantel-Cox log-rank test was used to determine differences in survival. A two-sided P value of less than .05 was considered to indicate a significant difference. The study was approved by the Johns Hopkins institutional review board and remained open from March 2009 to January 2012.Fifty patients--of whom 76% were male, 92% had a Child-Pugh score of A, and 62% had BCLC stage C disease--underwent a median of three cycles of therapy. The 6-month disease control rate (defined as complete response plus partial response plus stable disease) was 94% according to the response evaluation criteria in solid tumors. Median TTP and OS were 13.9 and 20.4 months, respectively, and 81% of toxicities were grades 1-2. There was one death that was possibly treatment related.Combined continuous sorafenib therapy and on-demand DEB TACE provided excellent local disease control and did not lead to multiplicative toxicities. Long-term administration of sorafenib therapy in combination with DEB TACE may have a survival benefit in patients with advanced HCC.

This case of oligometastatic prostate cancer to the foot highlights the importance of: 1) metastasis remaining high in the differential for unexplained malady, in the setting of a primary cancer, despite an atypical presentation, and 2) comparing sequential imaging studies to baseline images, especially when remote, because subtle findings can declare themselves over time.

Clinical reports of limited and treatable cancer metastases, a disease state that exists in a transitional zone between localized and widespread systemic disease, were noted on occasion historically and are now termed oligometastasis. The ramification of a diagnosis of oligometastasis is a change in treatment paradigm, i.e. if the primary cancer site (if still present) is controlled, or resected, and the metastatic sites are ablated (surgically or with radiation), a prolonged disease-free interval, and perhaps even cure, may be achieved. Contemporary molecular diagnostics are edging closer to being able to determine where an individual metastatic deposit is within the continuum of malignancy. Preclinical models are on the outset of laying the groundwork for understanding the oligometastatic state. Meanwhile, in the clinic, patients are increasingly being designated as having oligometastatic disease and being treated owing to improved diagnostic imaging, novel treatment options with the potential to provide either direct or bridging therapy, and progressively broad definitions of oligometastasis.

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and is the fifth most common cancer worldwide.1,2 It is the third leading cause of cancer-related deaths worldwide and globally accounts for as many as 500,000 deaths annually.1 Although hepatic resection and transplantation offer a potential for curative therapy, most patients with HCC (70%–80%) are not candidates for curative resection or transplantation because of either advanced stage at the time of initial presentation or because of underlying advanced cirrhosis.3,4 Transarterial chemoembolization (TACE) is the most widely used first-line treatment in the Western World and Asia for patients with unresectable HCC. Transarterial chemoembolization is considered the standard of care especially in Barcelona-Clinic Liver Cancer (BCLC) B patients, based on 2 meta-analyses that demonstrated 2-year overall survival benefit.5,6 In addition, TACE alone or in combination with laser induced thermotherapy resulted in improved patient survival in patients with unresectable noncolorectal and nonbreast cancer origin.7 There is increased interest in determining response of hepatic malignancies to therapy using the entire tumor burden rather than a single index lesion.8 In developing RECIST 1.1, the response evaluation criteria in solid tumors (RECIST) working group considered moving from anatomic unidimensional assessment of tumor burden to either volumetric anatomical assessment or to functional assessment. However, this was deemed inappropriate owing to insufficient standardization of the acquisition or image analysis techniques.8 Measuring volumetric tumor burden remains critical because patients with extensive hepatic involvement at baseline may have less functioning liver parenchyma and therefore less likelihood for survival after intra-arterial therapy (IAT) compared with those with low tumor burden.9 Moreover, in patients with colorectal metastases, the number and size of metastases are significant prognostic factors for long-term survival in patients treated with laser-induced interstitial therapy.10 Functional imaging techniques are increasingly being used to monitor response to therapy, often predicting the success of therapy before conventional measurements using size change.11-14 The European Association for the Study of the Liver guidelines recommend measuring the enhancing part of the tumor in the axial plane for assessing treatment response; however, enhancement in a single axial plane may not reflect global changes in the entire tumor volume.15 Dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) can quantify tumor vascularity and thus can delineate zones of viable enhancing tumor and zones of tumor necrosis with poor/absent contrast enhancement.16 Several previous studies reported significant changes in contrast enhancement as well as apparent diffusion coefficient (ADC) after loco-regional therapy.13,17,18 Diffusion weighted imaging (DWI) and the generated ADC values can differentiate viable from dead tumor cells by assessing differences in membrane permeability. Successful treatment is reflected by increase in tumor water diffusion values, which manifests as increase in ADC values.11 With advances in image processing techniques, several recent studies have demonstrated changes in both of these functional techniques (ADC and DCE-MRI) in the index tumor volume rather than in a single axial plane.19-21 However, to date, there is sparse evidence of the value of assessing response in all targeted tumors using these functional techniques. Therefore, the objective of this study was to evaluate response in the entire targeted tumor burden using functional MRI response and its impact on overall survival in patients with HCC treated by IAT.

Background Chronic diseases have become a main cause of morbidity and mortality provoking function loss in organs. Quality of life is poor and expensive with replacement therapy. Transplantation offers a higher survival rate and a better life; however, the donation rate in Mexico is low, making it important to know the opinion of the population. Methods Six hundred forty-two people in Guanajuato, Mexico, (>15 years old) were enrolled. Demographic characteristics, education, religion, organ donation, and transplantation attitudes were evaluated. Results Donation attitudes in life or death were: very willing to donation (82.8% vs 61.5%), refuse to donate (12.7% vs 29.4%), and undecided (4.5% vs 9.1%). Reasons for donation were: altruism (63%), being useful to someone (28.6%), and empathy (7.1%). Negative causes were: personal beliefs (35.6%), fear (23.7%), and ignorance or “I don't know the recipient” (18.5%). Finally, 94.5% of the population is willing to receive a transplant if they need it. Conclusions Guanajuato has a high tendency to donate their own organs, but less to donate from a family member. Refusal to donate has originated from lack/misinformation that people received from health professionals. Although most people are willing to donate, this is not reflected in donation rates. To be able to make this intention reality, we must create educational models for health care personnel that will allow them to transmit proper information to the population.

This paper presents a methodology to represent, process and visualize large bird audio recordings. The proposed methodology is based on audio signal processing, image processing, and machine learning techniques. We evaluated the methodology in a collection of 6,856 audio recordings belonging to 560 Colombian bird species. Results show that it is possible to build a tool that help ornithologists to process and analyze large collections of bird species in and effective and efficient way.

To prospectively assess treatment response using volumetric functional magnetic resonance imaging (MRI) metrics in patients with hepatocellular carcinoma (HCC) treated with the combination of doxorubicin-eluting bead-transarterial chemoembolization (DEB TACE) and sorafenib.A single center study enrolled 41 patients treated with systemic sorafenib, 400 mg twice a day, combined with DEB TACE. All patients had a pre-treatment and 3-4 week post-treatment MRI. Anatomic response criteria (RECIST, mRECIST and EASL) and volumetric functional response (ADC, enhancement) were assessed. Statistical analyses included paired Student's t-test, Kaplan-Meier curves, Cohen's Kappa, and multivariate cox proportional hazard model.Median tumour size by RECIST remained unchanged post-treatment (8.3 ± 4.1 cm vs. 8.1 ± 4.3 cm, p = 0.44). There was no significant survival difference for early response by RECIST (p = 0.93). EASL and mRECIST could not be analyzed in 12 patients. Volumetric ADC increased significantly (1.32 × 10(-3) mm(2)/sec to 1.60 × 10(-3) mm(2)/sec, p 0.001), and volumetric enhancement decreased significantly in HAP (38.2% to 17.6%, p 0.001) and PVP (76.6% to 41.2%, p 0.005). Patients who demonstrated ≥ 65% decrease PVP enhancement had significantly improved overall survival compared to non-responders (p 0.005).Volumetric PVP enhancement was demonstrated to be significantly correlated with survival in the combination of DEB TACE and sorafenib for patients with HCC, enabling precise stratification of responders and non-responders.• PVP enhancement is significantly correlated with survival in responders (p 0.005). • There was no significant survival difference for early response using RECIST (p = 0.93). • mRECIST or EASL could not assess tumour response in 29% of patients.