bluuebunny/crossref_metadata_2025 huggingface dataset:
The (Calli)graphic Regimes of Contemporary Vietnamese Art
Authors: Corey Pamela N.
Published: February 2025

In 1990s Hanoi, Vietnam, many contemporary artists navigated the written form as crucial to the logic of the pictorial field. These included Vũ Dân Tân (1946-2009), Trương Tân (b. 1963), and Nguyễn Văn Cường (b. 1973), among others. I examine these artistic experiments as integral to what many have hailed as the emergence of contemporary art in Vietnam, linked to the early effects of globalization and the impetus to freely engage with questions of selfhood following over forty years of a socialist realist mandate. However, I also suggest the significance of site to these practices, in particular the postsocialist graphic regime of the urban environment, with its traces of historical inscriptions, influx of commercial signage, and ubiquitous public propaganda posters that continue to coat the surfaces of cities today. The artworks discussed in this essay drove new understandings of art, particularly in the use of line and text to situate artistic expression as part of but also apart from the urban surfaces and graphic materials on and in which such unorthodox actions were enacted. As such, the (calli)graphic regime marked a radical shift in perceptions of what could be art in 1990s Vietnam.
The Aesthetics of “Northern Remnants” in Video Art from China
Authors: Larson Ellen
Published: February 2025

Since around the turn of the 21st century, contemporary multimedia artists and filmmakers from China have employed the moving image as a tool to capture temporalities shaped by urban-industrial decline in northern China. A counterpoint to massive economic prosperity within the Pearl River Delta, fueled by investments in new technologies and globalizing industries since Deng Xiaoping-era reforms, northern manufacturing zones have witnessed the dismantling of labor-driven forms of socialized production. Throughout the north, once thriving factory complexes and surrounding locales have been reduced to a ghostly shell of their former selves. Artists Wang Bing (b. 1967), Wang Mowen (b. 1989), and Cao Fei (b. 1978) each reference ghosts of cultural memory through visual presentations of bygone monuments from China's mid-20th century socialist past. These artists' moving image practices also point to a broader regional phenomenon in which divestment in northern Chinese socialized industrial production has fostered the accumulation of “northern remnants,” aesthetically marked by rust, melancholy, and slowness.
My Beautiful Picture Book
Authors: Azeez Halik
Published: February 2025

The influx of tourism capital in its post-war years has seen the terraforming of Sri Lanka's natural, socio-political, and cultural landscapes. Among its many neo-Orientalist implications is the marginalization of traditional professions, transforming them into performative roles. Examples include stilt fishermen who now fish primarily to serve the tourist gaze. And the persistent invisibility of structural violence and the exoticization of indentured labor in the tea industry, a colonial remnant that continues to thrive. More recently foreign entrepreneurs, posing as tourists, have exploited Sri Lanka's economy by acquiring long-term property leases, thereby pricing out locals and fostering new forms of structural racism and exclusivity. Utilizing images sourced from popular Instagram hashtags related to Sri Lanka, this project examines how tourist photography commodifies and simplifies the rich complexities of the country's landscapes, people, and culture into exotic backdrops for the consumption of privileged global travelers.
Shylock as Jew-voice: Rhetorical listening and identifications in The Merchant of Venice
Authors: Schupak Esther B
Published: February 2025

Shylock is a Jewface role, whose effect is to create stereotypes and to distort Jewish ethnicity and religious practice. Yet it is also more than that, as Shakespeare created a complex character who sometimes invites a kind of identification. This article will argue that practicing rhetorical listening and thinking about identifications in The Merchant of Venice – and how they are created especially through sound – can help us to understand the complexities of this paradoxical character. In particular, theories of disidentification and non-identification can help to map out patterns of possible identifications, vexed and otherwise, within the play .
Serious about Sustainability
Authors: Tarricone Paul
Published: February 2025

When the'S word' is part of a project's name, the lighting design must follow suit
The energy effectiveness of task-oriented office lighting systems
Authors: Florence Noel
Published: February 2025

How energy effective is task lighting combined with low-level indirect or direct ambient lighting? Several such systems are investigated and compared with ceiling-mounted lighting systems
Structural and linear/nonlinear optical properties of PVC/ZnFe2O4 nanocomposites for optoelectronic devices
Authors: Elbasiony A. M. , AbdElrahman Mohamed , Said Basmat Amal M. , Abdelhamied M. M. , Awed A. S.
Published: February 2025

Herein, ZnFe2O4 nanoparticles (ZFO-NPs) were synthesized via the sol-gel method and doped into the PVC matrix by solution casting technique. This study aimed to examine the effects of PVC/ZnFe2O4 nanocomposites’ structural properties, dielectric constants, and linear/nonlinear optical characteristics at different concentrations of ZFO-NPs (0, 1, 2, and 3 wt.%). XRD pattern proved that the ZFO-NPs have a cubic crystal structure with a lattice constant of 8.5 Å and crystallite size of 39.97 nm. SEM image and EDX spectra were used to illustrate the surface morphology and elemental compositions of ZFO-NPs. The optical bandgap declined from 4.14 eV for the undoped-PVC to 4.05, 3.94, and 3.88 eV for PVC+1% ZFO, PVC+ 2% ZFO, and PVC+3% ZFO films, respectively. While Urbach’s energy (EU) rose from 0.82 eV to 1.77, 1.88, and 2.04 eV, respectively. It is found that the values of the free carrier increase after the introduction of the nano-ZFO from 2.61 × 1014 cm−3 for the undoped-PVC polymer to 4.15 × 1019, 5.78 × 1019, and 6.21 × 1019 for PVC+1% ZFO, PVC+ 2% ZFO, and PVC+3% ZFO, respectively. Furthermore, the optical mobility increases from 8.73 × 10−4 c.s.kg−1 to 2.26 c.s.kg−1. In contrast, the optical resistivity of the pristine PVC is 0.275, which decreases to 3.1 × 10−9, 4.78 × 10−10, and 2.72 × 10−9 c−2.s−1kg−1 for the PVC+1% ZFO, PVC+ 2% ZFO, and PVC+3% ZFO, respectively. Moreover, the effect of ZFO-NPs on the nonlinear properties of PVC/ZnFe2O4 nanocomposites was addressed. Finally, the linear and nonlinear optical characteristics of doped-PVC with ZnFe2O4 NPs make them suitable for electronic devices.
Comparison of first and third generation EGFR-TKIs for the treatment of advanced non-small cell lung cancer: A real-world study
Authors: Shah Maitri , Shah Kashvi , Dave Hetvi , Khadela Avinash , Desai Chirag , Shah Sanket , Shah Gaurang
Published: February 2025

Background

Worldwide, lung cancer stands as a leading cause of mortality, with EGFR-mutated metastatic non-small cell lung cancer (NSCLC) accounting for a large percentage of cases in the Indian population. Different generations of EGFR-tyrosine kinase inhibitors (TKIs) are available to treat EGFR-mutated NSCLC. The purpose of our research was to evaluate and compare the superiority of osimertinib over gefitinib/erlotinib in terms of clinical effectiveness and safety.

Methods

A retrospective observational cohort study was conducted at the Clinical Oncology Center in the Western region of India. Patients suffering from EGFR-mutated metastatic NSCLC were recruited for the study. The response of EGFR-TKIs was assessed using objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and incidence of adverse events (AE).

Results

A total of 75 patients treated with EGFR TKIs were enrolled in the study. The ORR of osimertinib and gefitinib/erlotinib was 11.11% and 25.64% (p = 0.142) and DCR was found to be 69.44% and 82.05% (p = 0.28) respectively. Osimertinib and gefitinib/erlotinib had respective median PFS of 8.43 and 10.68 months. The incidence of AE of osimertinib and gefitinib/erlotinib was 1.94 and 2.49 respectively.

Conclusion

Osimertinib was not found to be superior over gefitinib/erlotinib based on clinical effectiveness. Though it showed a better safety profile, the cost of the treatment of osimertinib over gefitinib/erlotinib was not justifiable.
Environmental Regulation and Granting of Land-Use Rights
Authors: Cao Qianwen , Ye Bing
Published: February 2025

This study examines the effect of unfunded national environmental regulations on local governments’ land value capture. Exploiting the substantial variation in the regulatory intensity of China's Air Pollution Prevention and Control Action Plan implemented in 2013, we find that environmental regulation increases the growth of land granting fees for prefectural governments. Environmental regulation reduces the local general public budget revenue by shrinking the tax base while increasing the local general public budget expenditure. The post-2013 increase in the net income from land granting could fille more than half of the general public budget gap. Environmental regulation also boosts real estate market development and urbanization through its effect on land granting. We discuss local responses to the unfunded environmental regulation over an extended historical period and conclude that the granting of land use rights significantly enhances the flexibility of legal local government revenue, thereby improving China's fiscal system.
Severe left main coronary artery disease and STEMI in a 19-year-old without traditional risk factors: A rare case of premature coronary artery disease
Authors: Alhroub Wasef , Jabareen Maaweya , Abu-Mayyaleh Haya , Abu-Radwan Bayyena , Shehadeh Mustafa , Abu-Farah Ali , Isayed Talha
Published: February 2025

Premature coronary artery disease (CAD) is defined by the early onset of significant atherosclerotic narrowing of the coronary arteries, generally occurring before age 55 in men and 60 in women. This condition is an increasing concern in cardiovascular medicine due to its impact on younger populations, resulting in greater morbidity, diminished quality of life, and a substantial economic burden. Common risk factors include dyslipidemia, hypertension, diabetes, smoking, obesity, and genetic predispositions such as familial hyperlipidemia. This case report describes a 19-year-old male with no known cardiovascular risk factors who presented with an ST-segment elevation myocardial infarction and ventricular tachycardia caused by left main coronary artery disease including the left anterior descending artery and the left circumflex artery. Despite lacking common risk factors, he underwent successful coronary artery bypass grafting with two grafts.
Atypical audio-visual neural synchrony and speech processing in early autism
Authors: Wang Xiaoyue , Bouton Sophie , Kojovic Nada , Giraud Anne-Lise , Schaer Marie
Published: February 2025

Background

Children with Autism Spectrum disorder (ASD) often exhibit communication difficulties that may stem from basic auditory temporal integration impairment but also be aggravated by an audio-visual integration deficit, resulting in a lack of interest in face-to-face communication. This study addresses whether speech processing anomalies in young autistic children (mean age 3.09-year-old) are associated with alterations of audio-visual temporal integration.

Methods

We used high-density electroencephalography (HD-EEG) and eye tracking to record brain activity and gaze patterns in 31 children with ASD (6 females) and 33 typically developing (TD) children (11 females), while they watched cartoon videos. Neural responses to temporal audio-visual stimuli were analyzed using Temporal Response Functions model and phase analyses for audiovisual temporal coordination.

Results

The reconstructability of speech signals from auditory responses was reduced in children with ASD compared to TD, but despite more restricted gaze patterns in ASD it was similar for visual responses in both groups. Speech reception was most strongly affected when visual speech information was also present, an interference that was not seen in TD children. These differences were associated with a broader phase angle distribution (exceeding pi/2) in the EEG theta range in children with ASD, signaling reduced reliability of audio-visual temporal alignment.

Conclusion

These findings show that speech processing anomalies in ASD do not stand alone and that they are associated already at a very early development stage with audio-visual imbalance with poor auditory response encoding and disrupted audio-visual temporal coordination.
Integrating ultrasound radiomics and clinicopathological features for machine learning-based survival prediction in patients with nonmetastatic triple-negative breast cancer
Authors: Wenwen  , Jiang Zekun , Liu Jingyan , Liu Dingbang , Li Yiyue , He Yushuang , Zhao Haina , Ma Lin , Zhu Yixin , Long Qiongxian , Gao Jun , Luo Honghao , Jiang Heng , Li Kang , Zhong Xiaorong , Peng Yulan
Published: February 2025

Objective

This study aimed to evaluate the predictive value of implementing machine learning models based on ultrasound radiomics and clinicopathological features in the survival analysis of triple-negative breast cancer (TNBC) patients.

Methods and materials

All patients, including retrospective cohort (training cohort, n = 306; internal validation cohort, n = 77) and prospective external validation cohort (n = 82), were diagnosed as locoregional TNBC and underwent pre-intervention sonographic evaluation in this multi-center study. A thorough chart review was conducted for each patient to collect clinicopathological and sonographic features, and ultrasound radiomics features were obtained by PyRadiomics. Deep learning algorithms were utilized to delineate ROIs on ultrasound images. Radiomics analysis pipeline modules were developed for analyzing features. Radiomic scores, clinical scores, and combined nomograms were analyzed to predict 2-year, 3-year, and 5-year overall survival (OS) and disease-free survival (DFS). Receiver operating characteristic (ROC) curves, calibration curves, and decision curves were used to evaluate the prediction performance.

Findings

Both clinical and radiomic scores showed good performance for overall survival and disease-free survival prediction in internal (median AUC of 0.82 and 0.72 respectively) and external validation (median AUC of 0.70 and 0.74 respectively). The combined nomograms had AUCs of 0.80–0.93 and 0.73–0.89 in the internal and external validation, which had best predictive performance in all tasks (p < 0.05), especially for 5-year OS (p < 0.01). For the overall evaluation of six tasks, combined models obtained better performance than clinical and radiomic scores [AUCs of 0.83 (0.73,0.93), 0.81 (0.72,0.93), and 0.70 (0.61,0.85) respectively].

Interpretation

The combined nomograms based on pre-intervention ultrasound radiomics and clinicopathological features demonstrated exemplary performance in survival analysis. The new models may allow us to non-invasively classify TNBC patients with various disease outcome.
Analytical method for simultaneous quantification of levodopa and carbidopa in the injectable oleogel formulation by HPLC
Authors: Nakmode Deepa D. , Youssef Souha H. , Das Soumyajit , Song Yunmei , Garg Sanjay
Published: February 2025

The developed method for simultaneous detection of levodopa and carbidopa was able to separate the peaks of the drug and sodium bisulfite in the in-vitro release samples and stability samples. Levodopa (LD), a pro-drug of dopamine, is used as the gold standard treatment for Parkinson’s disease. It is usually prescribed with carbidopa (CD) to prevent the conversion of levodopa to dopamine peripherally, thus reducing undesirable side effects. Both drugs are unstable at pH 7.4 beyond 24 h due to their oxidation, therefore 0.2% sodium bisulfite is added to the formulation as an antioxidant. The separation was performed by gradient elution using the Luna-C18 column (250 × 4.6 mm, 5 µm) at a flow rate of 1 ml/min. The mobile phase was composed of mobile phase A 30 mM potassium phosphate and acetonitrile (95:5, v/v) with 35 mM tetrabutylammonium hydrogen sulphate and mobile phase B containing 30 mM potassium phosphate and acetonitrile (50:50 v/v). Drug peaks were detected at 280 nm with retention times of 3.05 ± 0.001 min for LD and 3.64 ± 0.001 min for CD. The validation of the method according to US FDA guidelines and results were found to be within acceptable limits. The method was linear from 10–100 µg/ml (r2 = 0.999) and 10–100 µg/ml (r2 = 0.999) for LD and CD, respectively. The developed method was applied to studying the drug release from in-situ gel. The environmental impact of the developed method was evaluated using various greenness assessment tools.

Graphical abstract
A content analysis of the Orbeez® Gel Blaster injury challenge on TikTok
Authors: Schneider Hannah P. , Reedy Jamie M. , McAdams Rebecca J. , Swedler David I. , Manganello Jennifer A. , Roberts Kristin J. , Middelberg Leah K. , McKenzie Lara B.
Published: February 2025

Background

TikTok is one of the fastest-growing social media platforms. With 50 million active daily users in the United States, videos on TikTok have the opportunity to reach an exceptionally large audience. It is of concern that some of these videos may be harmful, especially if they encourage dangerous or risky behavior that can increase injury risk. This is common for social media challenges, where people are encouraged to participate in and record a task and then post it on social media. The “Orbeez Challenge” was a challenge that went viral in 2022 and encouraged viewers to shoot water beads with Gel Blaster guns at others. The purpose of this study was to describe content for the “Orbeez Challenge” on TikTok, informed by pathways of the Elaboration Likelihood Model (ELM).

Methods

This study conducted a content analysis of TikTok videos related to the Orbeez challenge identified between October 5–11, 2022. A codebook was created by using abductive code generation, driven by an inductive iterative review of a sample of videos not included in the final study sample, and deductive code development to collect elements of the ELM.

Results

There were 125 videos in the final sample. Collectively, these videos had over 255 million views. Most (70.0%) of the creators were laypersons. Text (n = 97; 77.6%) and music (n = 83; 66.4%) were frequently present in the videos. Individuals were primarily shooting (47.2%) or loading (25.6%) the Gel Blaster. Nearly half (46.3%) of the content creators had between 10,000 and 500,000 followers. Most videos (n = 109; 87.2%) did not depict any injury prevention precautions, but of the 15 videos (12.0%) that did show injury prevention precautions, 14 (93.3%) were for eye protection.

Conclusions

This study characterized the content of the TikTok videos associated with the viral “Orbeez Challenge” and showed that TikTok videos could be characterized with guidance from a health communication theory. Despite their increased injury risk, the videos had high engagement and were most frequently posted by laypersons. This research presents an opportunity for countering injury challenges on social media and can guide injury professionals in designing and improving virtual health education campaigns.
Interaction between clock genes, melatonin and cardiovascular outcomes from ICU patients
Authors: Jiménez-Pastor Jose M. , Morales-Cané Ignacio , Rodríguez-Cortés Francisco J. , López-Coleto Luna , Valverde-León Rocío , Arévalo-Buitrago Pedro , Medina-Valverde María J. , De la Fuente-Martos Carmen , Acuña-Castroviejo Darío , Meira e Cruz Miguel , Luque Raúl M. , Sarmento-Cabral André , López-Soto Pablo J.
Published: February 2025

Background

Circadian rhythms, driven by biological clocks, help organisms align their physiological functions with environmental changes, promoting homeostasis. The central clock in the suprachiasmatic nucleus coordinates peripheral clocks via neurohumoral feedback involving proteins like CLOCK, BMAL1, CRY 1/2, and PER 1–3. In the ICU, these circadian processes often face disruptions from constant lighting, noise, and irregular sleep–wake cycles, impairing sleep quality and worsening stress responses. These disruptions can lead to adverse clinical effects, including higher cardiovascular complication rates. This study examines how ICU stays affect circadian rhythm regulators and their association with cardiovascular outcomes.

Results

Significant differences were identified in melatonin levels and the expression of BMAL1, PER1, RORA, and NR1D1 between ICU stays of ≤7 days and >7 days. The APACHE-II severity scale influenced melatonin and the expression of CLOCK, PER2, CRY2, and RORA. Nonlinear relationships were observed between melatonin, clock genes, heart rate, and blood pressure (systolic and diastolic). In certain groups, molecular and physiological data showed correlations exceeding 90%.

Conclusions

These findings highlight a robust association between circadian disruption, as measured by melatonin and clock genes, and cardiovascular physiological rhythms in ICU patients.
Navigating advanced renal cell carcinoma in the era of artificial intelligence
Authors: Najem Elie J. , Shaikh Mohd Javed S. , Shinagare Atul B. , Krajewski Katherine M.
Published: February 2025

Background

Research has helped to better understand renal cell carcinoma and enhance management of patients with locally advanced and metastatic disease. More recently, artificial intelligence has emerged as a powerful tool in cancer research, particularly in oncologic imaging.

Body

Despite promising results of artificial intelligence in renal cell carcinoma research, most investigations have focused on localized disease, while relatively fewer studies have targeted advanced and metastatic disease. This paper summarizes major artificial intelligence advances focusing mostly on their potential clinical value from initial staging and identification of high-risk features to predicting response to treatment in advanced renal cell carcinoma, while addressing major limitations in the development of some models and highlighting new avenues for future research.

Conclusion

Artificial intelligence-enabled models have a great potential in improving clinical practice in the diagnosis and management of advanced renal cell carcinoma, particularly when developed from both clinicopathologic and radiologic data.
The outpatient experience questionnaire for child and adolescent mental health services: reliability and validity following a nationwide survey
Authors: Iversen Hilde Hestad , Haugum Mona , Bjertnaes Oyvind
Published: February 2025

Background

The main objective was to evaluate the psychometric properties of the OutPatient Experience Questionnaire for Child and Adolescent Mental Health Services (OPEQ-CAMHS) among patients aged 16 and above, with a secondary objective of developing a parsimonious set of items and a short version of the instrument for this age group.

Methods

A national pilot study was conducted with adolescents from outpatient CAMHS in Norway, testing a new digital, continuous measurement approach using a measurement instrument developed through a comprehensive methodological framework. The study assessed missing data, ceiling effects, factor structure, internal consistency, discriminant validity, and construct validity. A shorter version was derived from psychometric results.

Results

The pilot study included responses from 555 (46.3%) patients. Low proportions of missing or “not applicable” responses were found for 18 of the 20 items, and all items were below the ceiling-effect criterion. Two scales emerged: “structure and process”, and “outcome”, both meeting alpha criteria. Each individual item demonstrated a stronger correlation with its expected scale than with any of the other scales. Construct validity was confirmed through associations with relevant variables expected to be associated with patient-reported experiences, including self-reported current state and well-being. The results supported a six-item short version.

Conclusions

Psychometric testing confirmed data quality, internal consistency, and construct validity of OPEQ-CAMHS. The short version addresses respondent burden concerns and is now ready for broad implementation in Norwegian CAMHS and potentially in similar healthcare settings worldwide.
Treatment patterns in prostate cancer patients who received darolutamide in the ARAMIS trial in Spain: PARASEC study.
Authors: Puente Javier , García Sánchez José , Folqué Joan , Casas Javier
Published: February 2025

142

Background:
Darolutamide, enzalutamide or apalutamide have demonstrated to prolong overall survival in patients with non-metastatic castration-resistant prostate cancer (nmCRPC). Despite their effectiveness, almost all patients progress to mCRPC. In the last few years, several new options for treatment of advanced prostate cancer have shown survival benefit. Darolutamide showed significantly prolonged metastasis-free survival compared with placebo in patients with nmCRPC in ARAMIS phase III trial. There is a lack of data about treatment patterns of patients that progress after receiving darolutamide in nmCRPC in the real-world setting in this new scenario with so many treatments available.
Methods:
This is a retrospective, observational, multicenter, longitudinal follow-up study to describe the treatment patterns received by the Spanish patients who received darolutamide in the ARAMIS study, according to standard clinical practice in Spain. This study involved at Urology and Oncology Departments of 18 selected hospitals.
Results:
Eighty-five patients were included in the study; median age was 76 years; 49 patients (58%) progressed to mCRPC and, of these, 35 (71%) received treatment for mCRPC; median number of lines post-progression was 2 (range 1-5). Abiraterone (22/35 [63%]) and docetaxel (10/35 [29%]) were the most commonly used drugs in the first line, docetaxel (12/21 [57%]) and cabacitaxel (12/21 [19%]) in the second line and cabacitaxel (4/12 [33%]) and docetaxel (3/12/21 [25%]) in the third line. Eleven patients received palliative radiotherapy (11/35 [31%]) and 7 (7/35 [20%]) osteoclast targeted therapy (5 zoledronate and 2 denosumab) after darolutamide.
Conclusions:
The results show that 29% of patients who progressed to mCRPC do not receive treatment after darolutamide and of those receiving treatment, 63% receive abiraterone, which appears not to be in line with current European guidelines. Only one-fifth of patients receive osteoclast targeted therapy, which is clearly insufficient. The variability in the duration of treatments and sequences suggests a lack of consensus in Spanish clinical practice. It is critical to explore more standardized strategies to maximize treatment effectiveness in these patients.
Multivisceral surgery in patients with locally advanced castration-naïve and castration-resistant, symptomatic prostate cancer.
Authors: Heidenreich Julian , Pfister David , Rieger Constantin , Heidenreich Axel
Published: February 2025

176

Background:
Local complications due to infiltration and compression of adjacent organs represent significant complications of locally advanced castration sensitive (CSPC) and castration resistant PCA (CRPC) despite the use of life prolonging agents.
Methods:
139 patients with locally advanced CSPC/CRPC underwent palliative pelvic surgery: radical cystoprostatectomy in n=105 (75.5%), radical prostatectomy with continent vesicostomy in n=9 (6.5%) and anterior plus posterior exenteration in n=25 (17.6%). All patients underwent local staging via MRI of the small pelvis, cystoscopy and rectoscopy. Systemic staging was done with CT scans of the chest, abdomen, pelvis and bone scans. Perioperative complications were assessed according to Clavien-Dindo classification and symptom-free (SFS), cancer specific survival (CSS) were evaluated using the Kaplan-Meir method.
Results:
Indications for surgery were lower or upper urinary tract obstruction in 75 (54%) and 55 (39%), resp., hematuria and blood transfusions in 31 (22%), rectal infiltration with/without obstructive ileus in 23 (17%), refractory pelvic pain in 17 (12%). 96 (69%) pts had a combination of various symptoms. Clavien-Dindo grade 2, 3 and 4 complications developed in 32 (23%), 12 (8.6%) and 8 (5.7%), respectively. After a median follow-up of 42.5 (3 – 123) months, the SFS at 1 and 3 years was 90.3% and 66.9%. The median SFS was 27.9 months. CSS at 1 and 3 years was 92.2% and 43.7%, respectively. 78.6% of the patients were symptom-free during their remaining lifetime.
Conclusions:
Multivisceral prostate surgery is a technically feasible approach in well-selected patients resulting in symptom relief of > 90% of patients which covered almost 80% of the remaining life-time. Adequate preoperative imaging studies, endoscopic evaluation and extensive surgical experience is mandatory to achieving a benefit for the individual patient with improvement of quality of life.
GLP1R expression in prostate cancer patients and effects of GLP1R agonism on prostate cancer cells.
Authors: Vellky Jordan , Reizine Natalie Marie , Vander Griend Donald
Published: February 2025

182

Background:
As a disease of aging, metabolic co-morbidities are managed concurrently with prostate cancer. Recent FDA approvals have launched widespread use of GLP1 receptor agonist semaglutide for Type II Diabetes Mellitus and obesity. Mechanistically, semaglutide primarily activates GLP1 receptors in the pancreas. However, GLP1R is also expressed in advanced prostate cancer tissues where GLP1 agonism could affect signaling and disease progression. Understanding the effects of semaglutide treatment in prostate cancer is critical to gain a complete picture of the systemic effects this drug and potentially expose additional contexts where semaglutide can be therapeutically valuable in this disease space.
Methods:
RNA-sequencing data was accessed from dbGaP (consolidated, n=664) and Gene Expression Omnibus (GSE204057, n=55) to assess GLP1R expression in prostate cancer patients. Bioinformatics analyses were utilized to identify signaling pathways associated with GLP1R expression. Proliferation, metabolism, and signaling after GLP1R agonism with semaglutide were assessed
in vitro
in prostate cancer cell line models using incucyte, Seahorse, and a kinase proteome profiler array.
Results:
We identified GLP1R expression in advanced prostate cancer samples including 145/310 (46.8%) of metastases, 59/115 (51.3%) of castration-resistant prostate cancer (CRPC), and 9/15 (60%) of neuroendocrine prostate cancer (NEPC), where it was associated with Notch and Hedgehog Signaling. Semaglutide treatment in pre-clinical prostate cancer models resulted in decreased cell proliferation, decreased glycolytic function, and decreased activation of kinase-mediated signaling. This overall suppression of signaling downstream of GLP1R is consistent with Gai-coupled GPCR signaling, which was confirmed using a cAMP assay. Interestingly, in a trans-differentiation model there was a significant negative correlation between GLP1R and AR expression. Further, proliferation of prostate cancer cells was significantly decreased with combination treatment of enzalutamide with semaglutide compared to either treatment alone.
Conclusions:
GLP1R was expressed in advanced prostate cancer patients and treatment with semaglutide suppressed growth, metabolism, and signaling. This is clinically significant due to concurrent treatment for metabolic co-morbidities in men with prostate cancer. Our preliminary data shows that co-targeting AR and GLP1R decreased cell growth, suggesting GLP1R agonism may be therapeutically useful in combination with androgen receptor antagonists in advanced prostate cancer.
Serum biomarkers in metastatic castration-resistant prostate cancer (mCRPC) patients receiving [
177
Lu]Lu-PSMA-617 therapy: Post hoc analysis of a phase II clinical trial.
Authors: Giunta Emilio Francesco , Marini Irene , Sarnelli Anna , Brighi Nicole , Foca Flavia , Schepisi Giuseppe , Lolli Cristian , Monti Manuela , Nicolini Silvia , Cursano Maria Concetta , Rosti Giovanni , Grassi Ilaria , Paganelli Giovanni , Severi Stefano , Matteucci Federica , Sansovini Maddalena , De Giorgi Ugo
Published: February 2025

190

Background:
[
177
Lu]Lu-PSMA-617 (
177
Lu-PSMA-617) has been recently approved for metastatic castration-resistant prostate cancer (mCRPC). Several clinical trials have assessed the efficacy of
177
Lu-PSMA-617, but only half of the eligible patients seem to obtain a clear benefit from it. Currently, there is a lack of validated biomarkers that could help find the best candidates for this radioligand therapy.
Methods:
In the IRST185.03, a single-arm monocentric phase II clinical trial, 142 mCRPC patients received
177
Lu-PSMA-617 at a dose of 3.7-5.5 Gbq every 8-12 weeks for a maximum of 4 cycles. Baseline blood samples were collected within 7 days from the first dose of
177
Lu-PSMA-617. Hemoglobin (Hb), alkaline phosphatase (ALP), prostate-specific antigen (PSA), carcinoembryonic Antigen (CEA), chromogranin A (CgA), and neuron-specific Enolase (NSE), as well as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), were analyzed at both uni- and multivariate levels to evaluate their correlation to progression-free survival (PFS).
Results:
At the time of data cut-off, after a median follow-up time of 44.0 months, the median PFS in the global cohort was 7.0 months. At univariate analysis, among serum biomarkers, lower PLR (cut-off: 210, HR: 0.66, 95% CI: 0.44-0.99, p=0.04), lower ALP (cut-off: upper limit of normal, HR: 0.51, 95% CI: 0.34-0.75, p<0.01), lower PSA (cut-off: median value, HR: 0.51, 95% CI: 0.35-0.74, p<0.01), and lower CEA (cut-off: upper limit of normal, HR: 0.55, 95% CI: 0.32-0.95, p=0.03) were associated with longer PFS. Among clinical characteristics, the previous use of docetaxel (HR: 1.48, 95% CI: 1.04-2.10, p=0.03) was associated with shorter PFS. At multivariate analysis, only PSA and CEA remained prognostic for PFS (p=0.01 and 0.02. respectively).
Conclusions:
High PSA and CEA levels appeared the only serum predictors of poor clinical outcome to
177
Lu-PSMA-617 therapy in mCRPC. The role of CEA as potential biomarker associated with
177
Lu-PSMA-617 needs to be confirmed since it could be linked to aggressive prostate cancer variant. Clinical trial information:
2016-002732-32
.
Prevention, diagnosis, and management of penile cancer in the LGBTQ+ community: A systematic review and meta-analysis.
Authors: Chitkara Akshit , Anamika Fnu , Khosla Atulya Aman , Bai Sakshi , Adib Arshia , Patel Rushin , Singh Rohit
Published: February 2025

2

Background:
Penile cancer is a rare but significant malignancy with unique prevention, diagnosis, and treatment challenges within the LGBTQ+ community. This systematic review and meta-analysis aims to evaluate the existing evidence on penile cancer for LGBTQ+ individuals, addressing disparities and unique needs to improve clinical outcomes.
Methods:
Following PRISMA 2020 guidelines, a systematic search was conducted across PubMed, Embase, Scopus, and clinical trial registries up to September 2024. Studies were included if they involved penile cancer prevention, screening, or treatment in LGBTQ+ populations, with no restrictions on study design or language. Data extraction focused on epidemiological patterns, risk factors (e.g., HPV infection), screening practices, diagnostic approaches, treatment modalities, and outcomes. The risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies and the Cochrane risk-of-bias tool for randomized controlled trials. The meta-analysis used a random-effects model to pool prevention and treatment outcomes data.
Results:
Of the 872 studies screened, 18 met the inclusion criteria, encompassing 1,232 LGBTQ+ patients. High-risk populations included men who have sex with men (MSM) and transgender women with elevated rates of HPV-associated penile cancer. HPV vaccination was underutilized in these populations despite its potential to prevent penile cancer. Early diagnosis was often delayed due to stigma, lack of awareness, and healthcare access barriers. Treatment outcomes varied, with higher rates of post-surgical complications and psychological distress reported. Meta-analysis revealed that HPV vaccination reduced the risk of penile cancer by 60% (pooled relative risk: 0.40, 95% CI: 0.25-0.64), while early surgical intervention improved 5-year survival rates by 45% (HR: 0.55, 95% CI: 0.32-0.79).
Conclusions:
Penile cancer prevention and management in LGBTQ+ populations require tailored strategies, including increased HPV vaccination coverage, early screening, and culturally competent healthcare. Addressing barriers related to stigma and healthcare access could significantly improve outcomes. Further research is needed to optimize treatment protocols and incorporate LGBTQ+-specific considerations in penile cancer care.

Summary of meta-analysis results.

Outcome Measure
Number of Studies
Pooled Effect Estimate
95% Confidence Interval (CI)
Heterogeneity (I²) %

HPV Vaccination Effectiveness
8
Relative Risk (RR): 0.40
0.25–0.64
42

Barriers to Early Diagnosis
5
Odds Ratio (OR): 2.25 (higher risk)
1.45–3.51
38

Post-Surgical Complication Rate
4
Risk Ratio (RR): 1.30 (higher rate)
1.12–1.50
27

Psychological Distress Post-Treatment
3
Standard Mean Difference (SMD): 0.75
0.50–1.00
60

5-Year Survival Improvement with Early Surgery
6
Hazard Ratio (HR): 0.55
0.32–0.79
49
Effects of emerin dysregulation on the very-small-nuclear phenotype and neuronal differentiation and its association with a clinically aggressive subtype of prostate cancer.
Authors: Zhang Le , Teng Pai-Chi , Cavassani Karen Angelica , Grasso Catherine , Watson Joshua , Wang Jasmine Jiemei , Chen Zijing , Tu Kai Han , Salumbides Brenda , Gevorkian Lilit , Kim Minhyung , You Sungyong , Di Vizio Dolores , Sandler Howard M. , Daskivich Timothy , Bhowmick Neil , Freeman Michael , Tseng Hsian-Rong , Chen Jie-Fu , Posadas Edwin Melencio
Published: February 2025

207

Background:
Circulating tumor cells (CTCs) with a very-small-nuclear (vsn) phenotype (i.e., vsnCTCs) in prostate cancer (PCa) represent a distinct subset of CTCs characterized by nuclei smaller than 8.5 μm. Our previous studies established a link between vsnCTCs and the presence of visceral metastasis. Emerging evidence suggests that the reduction of emerin (EMD), a nuclear envelope protein, contributes to PCa metastasis and is associated with nuclear shape instability. This study aims to validate vsnCTCs as a biomarker in metastatic castration-resistant prostate cancer (mCRPC) and investigate the correlation between EMD expression and the vsnCTC phenotype.
Methods:
CTCs were isolated from 93 mCRPC patients using the NanoVelcro CTC assay and categorized as either vsnCTC-positive (vsnCTC+) or vsnCTC-negative (vsnCTC-). We compared overall survival (OS) and progression-free survival (PFS) between these two groups. In vitro experiments were conducted using PCa cell lines (C4-2B, 22Rv1, and DU145) with EMD knockdown via siRNA or shRNA to study its impact on cellular phenotypes. Additionally, we measured EMD expression and nuclear size in abiraterone- and enzalutamide-resistant (Abi-R/Enza-R) C4-2B cells.
Results:
vsnCTC+ patients had significantly worse OS and PFS compared to vsnCTC- patients. Multivariate analysis revealed that vsnCTC+ status was independently associated with poorer OS and PFS. EMD expression was markedly reduced in CTCs from vsnCTC+ patients compared to vsnCTC- patients, with a significant positive correlation between EMD expression and CTC nuclear size. EMD knockdown in PCa cells resulted in smaller nuclei, enhanced invasion, and the upregulation of genes associated with neuronal de-differentiation (e.g., SOX2, CHGA, MYCN, and AURKA). Additionally, C4-2B Abi-R/Enza-R cells had significantly smaller nuclei and lower EMD expression, consistent with our clinical observation of the vsnCTCs association with ARSI resistance. These resistant cells also demonstrated elevated expression of neuronal de-differentiation genes.
Conclusions:
The presence of vsnCTCs represents a novel hallmark of an aggressive subtype of mCRPC, closely linked to EMD dysregulation and neuroendocrine differentiation. These findings highlight the potential of vsnCTCs and associated biological changes as a predictive biomarker. Our findings underscore the importance of EMD in the progression and therapeutic resistance of advanced PCa.
Assessing molecular heterogeneity of prostate cancer biopsy sampling: Insights from the MAST trial.
Authors: Lee David J , Mahal Brandon A. , Punnen Sanoj
Published: February 2025

240

Background:
Prostate cancer is heterogeneous and multi-focal, and biopsy sampling often undersamples the tumor or samples different tumor foci. Such heterogeneity can lead to inaccurate molecular classifications of tumor biology on tissue-based prognostic tests. Consequently, this impacts treatment decision making and management in localized prostate cancer. Herein, we evaluate the degree of variability in transcriptomic profiles when assessing genomic profiles from MRI-guided versus template biopsy using the Decipher GRID platform.
Methods:
A total of 205 men enrolled in the Miami MRI selection for Active Surveillance versus Treatment (MAST) trial (NCT02242773), from which 408 biopsy samples from 159 patients with successful genomic profiling were used in this study. Across the whole time-course, all biopsy cores with successful gene expression profiling were categorized by mpMRI-targeted (149 samples) or template (259 samples) sampling. Three main prognostic signatures (Decipher genomic classifier DGC, derived cell cycle progression CCP, and derived Genomic Prostate score GPS) were used to assess the variation in genomic risk between MRI targeted and template cores and among different PI-RADS lesions. Similar analysis was performed in a selected cohort with Gleason grade 1 disease only to exclude the impact of grade on genomic risk assessment.
Results:
Using the main genomic signatures in unpaired analysis (comparing all targeted and template biopsies), targeted lesions had higher scores as compared to the random biopsies, except for Decipher score (p=0.105). However, in the paired analysis (only including targets and templates from the same patient), we saw no difference between the groups in all three of the signatures. In the subset of patients with GG1, there was no difference between random and targeted biopsies in paired analysis. Among MRI targeted biopsy cores, PI-RADS level was correlated to Decipher and CCP scores with higher PI-RADS levels resulting in higher genomic scores (p=0.007 and 0.002, respectively). However, when restricting to a subgroup of patients with only GG1 cancer, there was no longer an association between PIRADS and genomic score. Higher concordance of DGC scores between visible and non-visible lesions were observed in the low-risk group.
Conclusions:
mpMRI sampling showed higher genomic scores compared to template sampling. While we see an association between higher PI-RADS scores and higher genomic scores, this relationship appeared to be driven by grade. Among the subgroup of men with GG1 cores, we found no association between PI-RADS and genomic scores. These findings need further validation in a larger cohort to truly understand the impact of MRI targeting on genomic risk assessment among AS patients. Clinical trial information:
NCT02242773
.
Grade and volume progression and its association with the Decipher genomic classifier using patients enrolled in a prospective active surveillance protocol.
Authors: Lee David J , Ajami Tarek , Yu Hui , Soodana-Prakash Nachiketh , Porto Joao , Avda Yuval , Malpani Ankur , Mendiola Dinno F , Freitas Pedro F.S. , Khandekar Archan , Swain Sanjaya , Gaston Sandra M. , Mahal Brandon A. , Punnen Sanoj
Published: February 2025

262

Background:
The progression of prostate cancer through serial biopsies in patients on active surveillance is a multifaceted process, with grade and volume progression offering unique perspectives on disease advancement. The Decipher genomic classifier has been recognized as a valuable tool for predicting disease progression. This study examines the relationship between the Decipher score, and other GRID signatures and pathways, and grade and volume progression in prostate cancer patients, utilizing data collected prospectively from the Miami Active Surveillance Trial (MAST).
Methods:
We scrutinized 224 baseline samples from 124 unique patients participating in the MAST database. Progression was categorized into grade progression, volume progression, and no progression. For patients with multiple samples, the sample with the highest Decipher score was selected. We also evaluate the association between 11 prognostic signatures, including the Decipher score and an average genomic risk score combining the 11 signatures and 20 pathways available from the Decipher GRID.
Results:
Out of the baseline samples, 60 demonstrated grade progression, 51 volume progression, and 113 showed no progression. We found that the Decipher was not associated to our trial definition of progression, that combined grade and volume progression however we did find a statistically significant difference in Decipher scores from patients who experience grade progression (p=0.0005) as compared to volume progression (p=0.92) when comparing them with patients with no progression. A heat map evaluating prognostic signatures and pathways available on the Decipher grid found that the majority of prognostic signatures including the Decipher score and the average risk model were more associated with grade progression compared to volume or no progression.
Conclusions:
Our findings suggest that the Decipher score has a stronger correlation with grade progression than volume progression in prostate cancer patients. This highlights the potential of genomic classifiers like Decipher in enhancing our understanding of disease progression and in tailoring personalized treatment strategies. Further prospective studies are required to validate these findings. Clinical trial information:
NCT02242773
.