Distant Nodes Research Articles

Observation of non-local impedance response in a passive electrical circuit

In media with only short-ranged couplings and interactions, it is natural to assume that physical responses must be local. Yet, we discover that this is not necessarily true, even in a system as commonplace as an electric circuit array. This work reports the experimental observation of non-local impedance response in a designed circuit network consisting exclusively of passive elements such as resistors, inductors and capacitors (RLC). Measurements reveal that the removal of boundary connections dramatically affects the two-point impedance between certain distant nodes, even in the absence of any amplification mechanism for the voltage signal. This non-local impedance response is distinct from the reciprocal non-Hermitian skin effect, affecting only selected pairs of nodes even as the circuit Laplacian exhibits universally broken spectral bulk-boundary correspondence. Surprisingly, not only are component parasitic resistances unable to erode the non-local response, but they in fact give rise to novel loss-induced topological modes at sufficiently large system sizes, constituting a new manifestation of the critical non-Hermitian skin effect. Our findings chart a new route towards attaining non-local responses in photonic or electrical metamaterials without involving non-linear, non-local, active or amplificative elements.

S6K1 deficiency in tumor stroma impairs lung metastasis of melanoma in mice

Accumulating data suggest that ribosomal protein S6 kinase 1 (S6K1), an effector in the mammalian target of rapamycin (mTOR) pathway, plays pleiotropic roles in tumor progression. However, to date, while the tumorigenic function of S6K1 in tumor cells has been well elucidated, its role in the tumor stroma remains poorly understood. We recently showed that S6K1 mediates vascular endothelial growth factor A (VEGF-A) production in macrophages, thereby supporting tumor angiogenesis and growth. As macrophage-derived VEGF-A is crucial for both tumor cell intravasation and extravasation across the vascular endothelium, our previous findings suggest that stromal S6K1 signaling is required for tumor metastatic spread. Therefore, we aimed to determine the impact of host S6K1 depletion on tumor metastasis using a murine model of pulmonary metastasis (S6k1−/− mice implanted with B16F10 melanoma). The ablation of S6K1 in the host microenvironment significantly reduced the metastasized B16F10 melanoma cells on the lung surface in both spontaneous and intravenous lung metastasis mouse models without affecting the incidence of metastasis to distant lymph nodes. In addition, stromal S6K1 loss decreased the number of tumor cells circulating in the peripheral blood of mice bearing B16F10 xenografts without affecting the vascular leakage induced by VEGF-A in vivo. These observations demonstrate that S6K1 signaling in host cells other than endothelial cells is required to modulate the host microenvironment to facilitate the metastatic spread of tumors via blood circulation, thus revealing its novel role in the tumor stroma during tumor progression.

Distance-Distributed Energy Efficient Clustering (D-DEEC) Routing Protocol for Wireless Sensor Network

A wireless sensor network (WSN) composed of many tiny devices that rely on energy efficient routing protocols for extension of their lifetime. Many cluster-based routing protocols have been proposed based on heterogeneity in recent times. Indeed, these protocols are aiming at achieving energy efficiency, throughputs and better lifetime of the networks. However, two important factors that could have helped some of these protocols to achieve the above-mentioned aims are really missing. Factors such as the distance and average distance between nodes and the Base Station (BS) in selecting a cluster head needed to be considered. These were the major challenges that were identified in the Distributed Energy Efficient Clustering (DEEC) protocol after careful study. As a result, the throughputs and the lifetime of the scheme were affected. In this paper, a reviewed hierarchy-based heterogeneous routing protocol called Distance-DEEC (D-DEEC) is proposed to enhance the DEEC protocol. The new algorithm took into account the residual energy, distance of the individual nodes and average distance of all the nodes from the BS in selecting the Cluster Heads (CHs). This has allowed the protocol to select a cluster head that has high residual energy, is closer to the BS and at the same time not too far from its neighbours. The scheme also employed the sleep and awake approach to reduce energy dissipation. The technique allows the Base BS to calculate the maximum energy of distant nodes and determines when such nodes can transmit their report based on a given threshold energy, Eth . The performance of the proposed algorithm was evaluated using MatLab R2018a and the outcomes showed that, D-DEEC protocol outperformed TDEEC in terms of energy consumption, throughputs and the network lifetime.

Mining and validation of prognosis of various visceral metastasis in renal cell carcinoma: a study based on SEER database.

Our study was aimed to analyze a substantial of renal cell carcinoma (RCC) patients, research the high-risk factors and prognostic factors of metastasis, and thoroughly examine the effects of primary site surgery, lymph node dissection (LND), and chemotherapy on the prognosis of different visceral metastases. The baseline characteristics were characterized, and logistic regression was used to predict the risk factors for metastasis. Prognostic factors of metastatic RCC were assessed using batch univariate and multivariate Cox regression, with adjustments made through PSM. Next, the Kaplan-Meier method was employed to assess OS and create the survival curve. Logistic regression identified risk factors for metastasis: male gender [OR, 1.223; P < 0.001], Hist clear (OR, 9.37; P < 0.001), Hist papillary (OR, 2.49; P < 0.001), and TTX (OR, 23.33; P < 0.001). We found several independent prognostic variables: among which chemotherapy (HR, 0.64), local LND (HR, 0.67), and primary site surgery (HR, 0.97) were associated with better OS. Further study results demonstrated that all kinds of visceral metastasis except for liver metastasis in the operation group had substantially better prognoses than those in the non-operation group (P < 0.05). Regional LND had no discernible impact on survival. Patients with liver, lung, and distant lymph node (LN) metastasis benefited from chemotherapy (P < 0.05), but the bone and brain metastasis did not significantly benefit from treatment (P > 0.05). We recommend primary surgery for different types of visceral metastases except liver metastasis. Routine regional LND is not recommended. Chemotherapy should be considered for patients with lung, distant LN, and liver metastases, but not for those with bone and brain metastases.

Linking EMT Status of Circulating Tumor Cells to Clinical Outcomes in Lung Cancer.

Lung cancer (LC) remains a leading cause of cancer-related mortality worldwide, with its prognosis influenced by complex biological factors. This study delves into the clinical relevance of circulating tumor cells (CTCs) and their Epithelial-Mesenchymal Transition (EMT) status in LC patients. We enrolled 30 newly diagnosed LC patients and utilized the CanPatrol technique for the separation and categorization of CTCs from peripheral blood samples. Immunofluorescent staining identified epithelial (CK8/18/19, EpCAM), mesenchymal (Vimentin, Twist), and leukocyte (CD45) markers in these cells. Fluorescence microscopy analyzed the slides, and RECIST 1.1 criteria assessed treatment response. Spearman's method was used to correlate CTCs' EMT states with their count and clinical characteristics. Our findings reveal three distinct CTC groups: epithelial (E-CTCs), hybrid epithelial/mesenchymal (E/M-CTCs), and mesenchymal (M-CTCs). Significant statistical differences were observed in stages III-IV vs I-II, tumor sizes T3-T4 vs T1-T2, and in the presence or absence of distant metastasis and lymph node involvement. Notably, the count of E/M-CTCs was positively correlated with TNM staging, tumor size, lymph node, and distant metastasis. Changes in M-CTC count pre- and post-treatment closely mirrored disease progression and control, showing considerable consistency with RECIST criteria. In conclusion, the EMT status of CTCs, especially E/M-CTCs, holds predictive value for LC staging, tumor size, and metastasis. Dynamic monitoring of M-CTCs can accurately reflect disease progression.

68Ga-labeled fibroblast activation protein inhibitor (FAPI) PET/CT for locally advanced or recurrent pancreatic cancer staging and restaging after chemoradiotherapy.

Purpose: 68Ga-labeled fibroblast activation protein inhibitor (FAPI) is a novel PET tracer with great potential for staging pancreatic cancer. Data on locally advanced or recurrent disease is sparse, especially on tracer uptake before and after high dose chemoradiotherapy (CRT). The aim of this study was to evaluate [68Ga]Ga-FAPI-46 PET/CT staging in this setting. Methods: Twenty-seven patients with locally recurrent or locally advanced pancreatic adenocarcinoma (LRPAC n = 15, LAPAC n = 12) in stable disease or partial remission after chemotherapy underwent FAPI PET/CT and received consolidation CRT in stage M0 with follow-up FAPI PET/CT every three months until systemic progression. Quantitative PET parameters SUVmax, SUVmean, FAPI-derived tumor volume and total lesion FAPI-uptake were measured in baseline and follow-up PET/CT scans. Contrast-enhanced CT (ceCT) and PET/CT data were evaluated blinded and staged according to TNM classification. Results: FAPI PET/CT modified staging compared to ceCT alone in 23 of 27 patients in baseline, resulting in major treatment alterations in 52% of all patients (30%: target volume adjustment due to N downstaging, 15%: switch to palliative systemic chemotherapy only due to diffuse metastases, 7%: abortion of radiotherapy due to other reasons). Regarding follow-up scans, major treatment alterations after performing FAPI PET/CT were noted in eleven of 24 follow-up scans (46%) with switch to systemic chemotherapy or best supportive care due to M upstaging and ablative radiotherapy of distant lymph node and oligometastasis. Unexpectedly, in more than 90 % of the follow-up scans, radiotherapy did not induce local fibrosis related FAPI uptake. During the first follow-up, all quantitative PET metrics decreased, and irradiated lesions showed significantly lower FAPI uptake in locally controlled disease (SUVmax p = 0.047, SUVmean p = 0.0092) compared to local failure. Conclusion: Compared to ceCT, FAPI PET/CT led to major therapeutic alterations in patients with LRPAC and LAPAC prior to and after radiotherapy, which might help identify patients benefiting from adjustments in every treatment stage. FAPI PET/CT should be considered a useful diagnostic tool in LRPAC or LAPAC before and after CRT.

Prognostic value and distribution pattern of tumor infiltrating lymphocytes and their subsets in distant metastases of advanced breast cancer

BackgroundThere are significant correlations between the levels of tumor infiltrating lymphocytes (TILs) and the prognosis of primary breast cancer. While little is known about immunological mechanisms in the distant metastasis of advanced breast cancer. Patients and MethodsA total of 106 patients with advanced metastatic breast cancer were enrolled in this study between 2016 and 2022. Hematoxylin and eosin staining and immunohistochemistry were used to assess the densities of stromal TILs (sTILs), intratumoral TILs (iTILs) and invasive marginal TILs (imTILs) and CD4+, CD8+, CD20+, FOXP3+ TILs in the primary tumor and metastasis (bone, lung, liver, and distant lymph node) of advanced breast cancer. ResultsHigher levels of sTILs at metastatic sites were associated with better progression-free survival (PFS), postmetastasis survival (PMS) and overall survival (OS) (p = .026, .001 and .005, respectively). The levels of iTILs were significantly lower than those of sTILs and imTILs in both primary tumor (p< .001, both) and metastasis (p< .001, both). The level of CD4+ T cells was higher than those of CD8+ T cells and CD20+ B cells in both primary tumor (p < .001) and metastasis (p < .001). The levels of sTILs (p=0. 001) and imTILs (p< .001) in the primary tumor were generally higher than those in the metastasis. ConclusionThe levels of TILs and their subsets can predict the survival and prognosis of patients with advanced breast cancer. The distributions of TILs and their subsets are similar between the primary tumor and metastasis. The metastases have a lower degree of lymphocytes infiltration than its corresponding primary tumor.

Self-adjuvant Astragalus polysaccharide-based nanovaccines for enhanced tumor immunotherapy: a novel delivery system candidate for tumor vaccines.

The study of tumor nanovaccines (NVs) has gained interest because they specifically recognize and eliminate tumor cells. However, the poor recognition and internalization by dendritic cells (DCs) and insufficient immunogenicity restricted the vaccine efficacy. Herein, we extracted two molecular-weight Astragalus polysaccharides (APS, 12.19 kD; APSHMw, 135.67 kD) from Radix Astragali and made them self-assemble with OVA257-264 directly forming OVA/APS integrated nanocomplexes through the microfluidic method. The nanocomplexes were wrapped with a sheddable calcium phosphate layer to improve stability. APS in the formed nanocomplexes served as drug carriers and immune adjuvants for potent tumor immunotherapy. The optimal APS-NVs were approximately 160 nm with uniform size distribution and could remain stable in physiological saline solution. The FITC-OVA in APS-NVs could be effectively taken up by DCs, and APS-NVs could stimulate the maturation of DCs, improving the antigen cross-presentation efficiency in vitro. The possible mechanism was that APS can induce DC activation via multiple receptors such as dectin-1 and Toll-like receptors 2 and 4. Enhanced accumulation of APS-NVs both in draining and distal lymph nodes were observed following s.c. injection. Smaller APS-NVs could easily access the lymph nodes. Furthermore, APS-NVs could markedly promote antigen delivery efficiency to DCs and activate cytotoxic T cells. In addition, APS-NVs achieve a better antitumor effect in established B16-OVA melanoma tumors compared with the OVA+Alum treatment group. The antitumor mechanism correlated with the increase in cytotoxic T cells in the tumor region. Subsequently, the poor tumor inhibitory effect of APS-NVs on the nude mouse model of melanoma also confirmed the participation of antitumor adaptive immune response induced by NVs. Therefore, this study developed a promising APS-based tumor NV that is an efficient tumor immunotherapy without systemic side effects.

Assessing the Dormant Bud Fruitfulness in Grapevines Spur for Yield Estimation

Bud dissection is generally done to determine potential bud fruitfulness (average number of potential inflorescence primordia), can be used to predict the next season’s crop yield and make decision on pruning by analyzing fruitfulness of bud with respect to its position on cane/spur in order to achieve desired crop load. Comparison of potential inflorescence primordia with actual bunches with respect to each node give reliability on data from bud-dissection. The objective of this study was to detect potential inflorescence primordia and correlate it with observed bunches in vine. Bud dissection was carried out in a spur (having 4 buds from basal node towards apex) per vine of var. Himrod and var. Steuben from a vineyard of Warm Temperate Horticulture Centre, Kirtipur, Kathmandu, Nepal with the help of micro-dissection tools under stereo-microscope. It was revealed that cultivars ‘Himrod’ and ‘Steuben’ were both more prolific toward the buds located on distal nodes in comparison to buds situated on basal nodes; as a result, it was found that bud dissection can be used as a decisive tool for the detection of bud fruitfulness, thus for yield prediction and to develop appropriate management practice.

Selective adjuvant radiation therapy for distant lymph node metastasis in patients with stage 4B epithelial ovarian cancer: a case series

Although the efficacy of surgery followed by taxane- and platinum-based systemic chemotherapy has been clearly demonstrated in the standard first-line treatment of epithelial ovarian cancer, the role of radiation therapy for distant lymph node metastasis in patients with epithelial ovarian cancer is not well-established due to a lack of reported studies. We identified four patients who underwent selective adjuvant radiation therapy for neck and para-aortic lymph node lesions after primary debulking surgery between 2020 and 2022, followed by platinum-based chemotherapy for stage 4B high-grade serous ovarian cancer. Through a retrospective review of medical records, we analyzed patient clinicopathologic features, treatment course, and imaging findings. The median age was 49.25 years (range, 46–54 years). All patients had the International Federation of Gynecology and Obstetrics stage 4B disease. Following primary debulking surgery, all patients received weekly paclitaxel-carboplatin chemotherapy and maintenance treatment with poly(ADP-ribose) polymerase (PARP) inhibitors. All patients received selective adjuvant radiation therapy for neck and para-aortic lymph node metastasis before PARP inhibitor maintenance. The median follow-up time was 36.75 months (range, 19–45 months). All patients achieved a complete response. None of the patients experienced disease recurrence or died during the follow-up period. The management of distant lymph node metastasis in patients with epithelial ovarian cancer remains a matter of debate. Selective adjuvant radiation therapy in first-line treatment for ovarian cancer appears to be a feasible approach with maintenance therapy for stage 4B epithelial ovarian cancer.

ESRP1-driven alternative splicing of CLSTN1 inhibits the metastasis of gastric cancer

Tumor metastasis severely limits the prognosis of gastric cancer patients. RNA-binding proteins (RBPs) are crucial in tumor metastasis, yet there is limited research into their involvement in gastric cancer. Here, we found that ESRP1, a RBP specific in epithelial cells, is important in regulating the metastasis of gastric cancer cells. ESRP1 is negatively correlated with distant metastasis and lymph node metastasis in gastric cancer patients. And we demonstrated that ESRP1 inhibit migration and invasion of gastric cancer in vitro and in vivo. Mechanistically, ESRP1 promotes exon 11 alternative splicing of CLSTN1 pre-mRNA. The post-splicing short CLSTN1 stabilizes the Ecadherin/β-catenin binding structure, and promotes β-catenin protein ubiquitination and degradation, thereby inhibiting the migration and invasion of gastric cancer cells. Our study highlights the role of ESRP1 in regulating metastasis of gastric cancer and extends its mechanism. These results provide a possibility for ESRP1 and CLSTN1 to become therapeutic targets for metastasis of gastric cancer.

High SNHG expression may predict a poor lung cancer prognosis based on a meta-analysis

BackgroundAn increasing number of small nucleolar RNA host genes (SNHGs) have been revealed to be dysregulated in lung cancer tissues, and abnormal expression of SNHGs is significantly correlated with the prognosis of lung cancer. The purpose of this study was to conduct a meta-analysis to explore the correlation between the expression level of SNHGs and the prognosis of lung cancer.MethodsA comprehensive search of six related databases was conducted to obtain relevant literature. Relevant information, such as overall survival (OS), progression-free survival (PFS), TNM stage, lymph node metastasis (LNM), and tumor size, was extracted. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled to evaluate the relationship between SNHG expression and the survival outcome of lung cancers. Sensitivity and publication bias analyses were performed to explore the stability and reliability of the overall results.ResultsForty publications involving 2205 lung cancer patients were included in this meta-analysis. The pooled HR and 95% CI values indicated a significant positive association between high SNHG expression and poor OS (HR: 1.890, 95% CI: 1.595–2.185), disease-free survival (DFS) (HR: 2.31, 95% CI: 1.57–3.39) and progression-free survival (PFS) (HR: 2.01, 95% CI: 0.66–6.07). The pooled odds ratio (OR) and 95% CI values indicated that increased SNHG expression may be correlated with advanced TNM stage (OR: 1.509, 95% CI: 1.267–1.799), increase risk of distant lymph node metastasis (OR: 1.540, 95% CI: 1.298–1.828), and large tumor size (OR: 1.509, 95% CI: 1.245–1.829). Sensitivity analysis and publication bias results showed that each result had strong reliability and robustness, and there was no significant publication bias or other bias.ConclusionMost SNHGs are upregulated in lung cancer tissues, and high expression of SNHGs predicts poor survival outcomes in lung cancer. SNHGs may be potential prognostic markers and promising therapeutic targets.

Identification of the six-hormone secretion-related gene signature as a prognostic biomarker for colon adenocarcinoma.

Colon adenocarcinoma (COAD) is a globally prevalent cancer, with hormone secretion playing a crucial role in its progression. Despite this, there is limited understanding of the impact of hormone secretion on COAD prognosis. This study aimed to establish a prognostic signature based on hormone secretion-related genes and to elucidate the potential functional mechanisms of these genes in COAD. Using data from The Cancer Genome Atlas COAD cohort (TCGA-COAD), six hormone secretion-related genes were identified (CYP19A1, FOXD1, GRP, INHBB, SPP1, and UCN). These genes were used to develop a Hormone secretion score (HSS), which was then evaluated using the Kaplan-Meier curve and multivariable Cox analysis. The HSS model was further validated with external GEO cohorts (GSE41258, GSE39582, and GSE87211). Functional enrichment analyses were performed, and the CIBERSORT and TIDE algorithms were used to assess tumor infiltration. The study developed a prognostic signature, dividing patients into HSS-high and HSS-low groups. The HSS-high group showed a notably worse prognosis within the TCGA-COAD dataset and in three independent datasets: GSE41258, GSE39582, and GSE87211. Moreover, the HSS-high group predicted a shorter overall survival rate in patients maintaining microsatellite stability (MSS). The functional analysis associated HSS-high with the hypoxic, epithelial-mesenchymal transition (EMT), and TGF-β signaling pathways and correlated with distant and lymph node metastases. The tumor immune microenvironment analysis revealed an elevated CIBERSORT score in the HSS-high group, suggesting an association with tumor metastasis. Further, the HSS-high group showed a higher TIDE score, indicating that patients with high HSS scores are less likely to benefit from Immune Checkpoint Inhibitor (ICI) therapy. This study demonstrated the prognostic significance of a HSS signature based on six hormone secretion-related genes in COAD. The findings suggest that this gene signature may serve as a reliable biomarker for predicting survival outcomes in COAD patients.

Unveiling the potential of long-range dependence with mask-guided structure learning for hypergraph

Hypergraph neural networks have recently drawn widespread attention and have succeeded in many fields. However, existing hypergraph-based neural network approaches are limited to learning local neighborhoods and ignore the representation of long-range dependence. Since the lack of necessary long-range interactions tends to lose critical signals from distant nodes, this paper proposes a new mask-guided hypergraph structure learning (MHSL) method. Specifically, MHSL is comprised of two learning components, i.e., the structure learning component and the initial hypergraph learning component. We design a flexible hypergraph structure learning module in the structure learning component to generate a hypergraph representing the global structure by node stream and hyperedge stream. The initial hypergraph learning component contains the hypergraph convolution that retains the local topological information. Additionally, we design a bidirectional node and hyperedge contrastive learning to learn the consistency between local and global structures. The node classification experiments on the hypergraph datasets demonstrate that the proposed MHSL method achieves competitive performance.

Clinical significance of baseline Epstein-Barr virus DNAfor recurrent or metastatic primary pulmonary lymphoepithelioma-like carcinoma.

Background: This study aimed to evaluate the clinical significance of baseline Epstein-Barr virus (EBV) DNA in recurrent or metastatic primary pulmonary lymphoepithelioma-like carcinoma (PLELC). Methods: 75patients with baseline EBV DNA were included. The relationships between baseline EBV DNA and clinical characteristics, survivaland objective response rate were analyzed. Results: The baseline EBV DNA levels were related to the liver, chest wall, distant lymph node(s)or multiple sites of distant metastasis. The high baseline EBV DNA group (≥41,900copies/ml) was related to shorter progression-freeand overall survival in univariate analysis and remained significant for progression-free survival in multivariate analysis. Conclusion: The baseline EBV DNA is a valuable biomarker for predicting prognosis and reflecting tumor burden in recurrent or metastatic PLELC.

Swapping-Based Entanglement Routing Design for Congestion Mitigation in Quantum Networks

The quantum network is designed to connect numerous quantum nodes and support various ground-breaking quantum applications. Most of these applications require communicating parties to share entangled pairs. Therefore, entanglement routing, a technology distributing entangled pairs between distant quantum nodes, plays a vital role in realizing quantum networks’ capability. However, due to the limitation of quantum memory size and quantum decoherence, the entangled pairs shared by adjacent quantum nodes can hardly satisfy concurrent entanglement routing requests, thus leading to severe network congestion. In this paper, we propose a novel congestion mitigation (CM) scheme to tackle such bottleneck problems. The basic idea of CM is to “recycle” idle link-level entanglement resources from well-resourced links to bottleneck links utilizing a unique enabling technology of quantum networks, called entanglement swapping. CM can increase the capacity of each bottleneck link, thus overcoming resource limitations to improve resource utilization and network throughput. To complete our work, we also propose a swapping-based entanglement routing design, including path selection and resource allocation algorithms. Extensive simulations show that our design can significantly alleviate network congestion and improve the request service rate of quantum networks compared to the traditional entanglement routing designs.

Recurrent prostate cancer: combined role for MRI and PSMA-PET in 68Ga-PSMA-11 PET/MRI

ObjectivesTo investigate the specific strengths of MRI and PET components in 68Ga-PSMA-11 PET/MRI for staging of patients with biochemically recurrent prostate cancer (PCa).MethodsPatients with biochemical recurrence of PCa and contrast-enhanced whole-body 68Ga-PSMA-11 PET/MRI including a dedicated pelvic multiparametric MRI were included in this retrospective study. Imaging datasets of MRI and PET were evaluated separately regarding local PCa recurrence (Tr), pelvic lymph node metastases (N1), distant lymph node metastases (M1a), bone metastases (M1b), and soft tissue metastases (M1c) according to PROMISE version 1. Data evaluation was performed patient- and region-/lesion-based. Cox regression revealed a PSA of 1.69 ng/mL as a cut-off for subgroup analysis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were evaluated for each image component. Differences in staging accuracy were assessed using the Wilcoxon and McNemar test.ResultsAltogether 102 patients (mean aged 68 ± 8 years, median PSA 1.33 ng/mL) were included. PCa was found in 70/102 (68%) patients. Accuracy of MRI in the detection of Tr, N1, M + , M1a, and M1b was 100%, 79%, 90%, 97%, and 95% for PSA < 1.69 ng/mL and 100%, 87%, 87%, 91%, and 96% for PSA > 1.69 ng/mL. Accuracy of 68Ga-PSMA-11 PET was 93%, 97%, 93%, 98%, and 100% for PSA < 1.69 ng/mL and 87%, 91%, 96%, 100%, and 96% for PSA > 1.69 ng/mL.ConclusionsCombined assessment of 68Ga-PSMA-11 PET/MRI improves tumor localization in men with biochemical recurrence. The MRI detected local recurrence of PCa more often whereas 68 Ga-PSMA-11 PET detected lymph node metastases more often, especially for PSA < 1.69 ng/mL.Clinical relevance statementThis study gives a scientific baseline to improve the understanding and reading of 68Ga-PSMA-11 PET/MRI imaging in patients with biochemically recurrent PCa by showing the specific strength of each imaging component.Key Points• Combining the individual modality strengths of 68Ga-PSMA-11 PET/MRI improves tumor localization in men with biochemical recurrence of prostate cancer.• MRI component of 68 Ga-PSMA-11 PET/MRI shows its strength in detecting local recurrence of prostate cancer, especially at PSA < 1.69 ng/mL.• 68 Ga-PSMA-11 PET component shows its strength in detecting local and distant lymph node metastases, especially at PSA < 1.69 ng/mL.

Biphoton routing in few-emitter chiral waveguide quantum electrodynamics ladders

We study the problem of two-photon routing in waveguide QED ladders where a few two-level quantum emitters (QEs) are simultaneously coupled with two chiral waveguides. We analyze the routing probability in two regimes, namely, under a purely plane wave approximation (scattering case) and in the presence of photon-photon bound state formation. Within the scattering case, we examine the two-photon routing in the presence of up to five QEs, considering two possibilities separately: ideal-symmetric coupling and the critical coupling scenario. We examine the photon routing up to the two QEs for the bound state situation and compare the photon redirection efficiency with the corresponding scattering case. Our findings show the potential of utilizing chiral light-matter interactions in multi-photon and multi-emitter-based quantum networking protocols where interlinking among spatially distant nodes is required.

Extramammary Paget's disease with ureteral metastasis: A case report

AbstractExtramammary Paget's disease (EMPD) is a skin cancer that can metastasize to distant lymph nodes and organs. However, there are no reports showing histological evidence of metastasis to the ureter. Here we report a case of EMPD that metastasized to the ureter in an 80‐year‐old man. The primary EMPD was resected and the right inguinal lymph node metastasis was dissected. Radiation therapy was administered around the right inguinal lymph nodes postoperatively. Four years later, a thickening of the wall of the right ureter was found, and a total right nephroureterectomy was performed due to suspicion of primary ureteral cancer. Histological examination showed nests of atypical cells in the renal adventitia and the surrounding lymphatic vessels, muscular layer and mucosal layer, but not in the ureteral epithelium. Immunohistochemical staining of tumour cells was positive for carcinoembryonic antigen, cytokeratin 7 and gross cystic disease fluid protein‐15 and was negative for cytokeratin 20. These results are consistent with a primary skin lesion. Although EMPD is not a frequent source of ureteral metastasis, EMPD can metastasize to the ureter. This case implies the feasibility of an accurate preoperative diagnosis through immunostaining, offering the potential to circumvent nephroureterectomy and instead facilitate appropriate management using a ureteral stent.

Safety and potential effectiveness of platelet-rich plasma and extracorporeal shock wave therapy in the treatment of erectile dysfunction after nerve-sparing radical prostatectomy in patients: pilot study

Background. Prostate cancer is the most common type of cancer in men. Radical prostatectomy (RPE), including nerve-sparing, often leads to erectile dysfunction and a significant decrease in the quality of life. The available treatments are limited in effectiveness and/or are not suitable for patients.Aim. The aim of the study was to evaluate the safety and effectiveness of platelet-rich plasma (PRP) and extracorporeal shock wave therapy (ESWT) in the treatment of erectile dysfunction in patients after nerve-sparing RPE.Materials and methods. 14 men were included in the study after unilateral or bilateral nerve-sparing RPE more than 3 months ago. The total prostate-specific antigen in all patients was less than 0.2 ng/ml 3 months or more after surgery. Age – 57.8 ± 6.2 (49–72) years, duration of erectile dysfunction – 7.6 ± 3.9 (3–16) months. Two visits per week were out for 6 weeks: in visit 1, the ESWT (Dornier Aries) was performed on penis and injections of PRP into the penis, the muscles involved in the erection were activated at the end of the session by ESWT, in visit 2, ESWT on penis. The examinations were performed on the 0 and 60 days of the study: International Index of Erectile Function (IIEF-5), Sexual Encounter Profile (SEP), Erection Hardness Score (EHS), Global Assessment Questionnaire (GAQ), International Prostate Symptom Score (IPSS), Quality of Life (QoL), total blood testosterone, to penile duplex Doppler ultrasonography (PDDU) with prostaglandin E1 analog. Inclusion criteria were absence of metastases to distant organs and lymph nodes; stage no more than T3b; IIEF-5 less than 21 points after RPE; PSV less than 30 cm/s and/or RI less than 0.8 according to the PDDU after RPE; the presence of erections before RPE.Results. Treatment was tolerated satisfactorily for all patients. Significant improvement of erectile function was noted according to IIEF-5 (p &lt;0.05), SEP (p = 0.002), EHS (p = 0.002). According to GAQ, 11 patients (78.5 %) noted a positive effect of treatment. PSV and RI in both cavernous arteries increased significantly (p &lt;0.05) according PDDU. All patients noted a dysuria decrease based on IPSS (p = 0.007) and QoL (p = 0.58). The concentration of total testosterone in the blood without significant dynamics (p = 0.192).Conclusion. There are positive effects in relation to a significant improvement in erectile function in all patients according to validated questionnaires and PDDU. The proposed treatment is a promising method of restoring patient data. The study continues on a larger sample of patients.