Inverse Stage Research Articles

Temperature- and internal structural size-dependent strength of nanotwinned face-centered cubic metals

The Nanotwin structure exhibits great potential as a strengthening medium, with its effectiveness influenced by both internal structural size and temperature. In this work, we developed a strength model that incorporates the dependence on temperature and internal structural size. This model can predict the strength of nanotwinned (NT) FCC metals with intracrystalline or intercrystalline twin boundaries featuring different internal structural sizes at varying temperatures at the inverse Hall-Petch stage. The proposed prediction model has significant importance for enhancing our understanding of the mechanical behavior exhibited by NT metals and facilitating the design of super-strong materials that can withstand extreme conditions.

Непружність та демпфуюча здатність магнію і сплавів Mg—Al в умовах циклічного високоамплітудного навантаження

For Mg—Al alloys with magnesium content from 0 to 9%, measurements of anelastic deformation, damping capacity, and twinning start stresses were carried out. The method of cyclic loading under tension for a wide range of oscillations amplitudes with precision fixation of displacement was used. A method for determination of the start twinning deformation point σ0,002tw under conditions of cyclic loading is proposed, This stress characterizes the beginning of the inverse twinning stage, when the anelastic strain is 2∙10-5. Characteristics of σ0,002tw for technical magnesium and its alloys with aluminum in a wide range of plastic deformation are determined. An insignificant linear increase of σ0,002tw with increasing deformation was established for all Mg—Al alloys. The start twinning deformation point increases with increasing aluminum concentration. For low-alloy alloys with a solid-solution strengthening mechanism, the stress at the beginning of twinning increases insignificantly. For highly alloyed alloys, a significant increase of σ0,002tw stress is observed. It is established that repeated loading within the hysteresis loop to stresses. which is less than the maximum and is not accompanied by additional plastic deformation. If the level of applied stresses during repeated loading reaches the maximum value, the amount of plastic deformation after unloading increases. The addition in εpl gradually decreases with the rise of cycles number. The dependences of inelastic deformation and dissipated energy on the previous deformation degree for all investigated magnesium alloys demonstrate an extreme character. The growth of these characteristics is observed only in the initial part of the load to the residual deformation of 1—2%. With a further increase in deformation, the tendency to anelasticity and the damping capacity decrease. For the dependences dissipatson energy vs amplitude of loob stress, the maximum of dissipation energy is observed under the condition when the stress reaches a critical value, which corresponds to the beginning of prismatic or pyramidal sliding. Keywords: Mg—Al alloys, quasi-static cyclic loading, hysteresis loops, dissipation energy, damping capacity, elasticity, anelasticity, twinning start point.

Forward modeling and inverse estimation for nonlinear filtering

AbstractThe highly accurate state estimation of nonlinear systems is needed in many different application fields. In many existing nonlinear filters, the uncompensated nonlinear approximation error and widely used numerical sampling methods both seriously affect the estimation accuracy and numerical stability. In this paper, based on the variational Bayesian framework, a novel iterative nonlinear filter consisting of forward modeling and inverse estimation is proposed. In the forward modeling stage, a linear Gaussian regression process with distributed variational parameters (VPs) is designed to fit the whole nonlinear measurement likelihood. The distributed VPs consider both first and second moments information, so as to compensate for approximation error from the whole likelihood perspective, instead of only the nonlinear function approximation, which can further improve the accuracy of Bayesian posterior update. In the linear Gaussian regression process, the original nonlinear measurement function (NMF) is just viewed as a prior and no longer directly participates in the modeling of the measurement likelihood. Hence, in the inverse estimation stage, when maximizing the evidence lower bound to update the posteriors of the state and VPs, we can obtain closed‐form solutions without numerical sampling methods to approximate the integral of NMF required in many existing methods, which can guarantee numerical stability. Moreover, to avoid the random setting of hyperparameters and to block the propagation of the accumulated error, we propose two rules, estimation and lower bound consistencies, to conduct the hyperparameters' initialization at the beginning of iteration at each sampling time and also derive an optimization method to update hyperparameters during iteration. Finally, the performance of our proposed method is demonstrated in the nonlinear orbital estimation problems.

MP53-13 TRANSITION OF PROSTATE CANCER PRIMARY DIAGNOSTICS: TAKEOVER OF MRI-GUIDED TARGETED- VERSUS SYSTEMATIC BIOPSY

You have accessJournal of UrologyCME1 May 2022MP53-13 TRANSITION OF PROSTATE CANCER PRIMARY DIAGNOSTICS: TAKEOVER OF MRI-GUIDED TARGETED- VERSUS SYSTEMATIC BIOPSY Mykyta Kachanov, Sami-Ramzi Leyh-Bannurah, Christoph Würnschimmel, Dirk Beyersdorff, Fabian Falkenbach, Tobias Maurer, Hendrik Isbarn, Thomas Steuber, Markus Graefen, and Lars Budäus Mykyta KachanovMykyta Kachanov More articles by this author , Sami-Ramzi Leyh-BannurahSami-Ramzi Leyh-Bannurah More articles by this author , Christoph WürnschimmelChristoph Würnschimmel More articles by this author , Dirk BeyersdorffDirk Beyersdorff More articles by this author , Fabian FalkenbachFabian Falkenbach More articles by this author , Tobias MaurerTobias Maurer More articles by this author , Hendrik IsbarnHendrik Isbarn More articles by this author , Thomas SteuberThomas Steuber More articles by this author , Markus GraefenMarkus Graefen More articles by this author , and Lars BudäusLars Budäus More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002628.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To explore stage migration patterns of primary diagnostic tools of prostate cancer, namely systematic biopsy (SBx) and the dawn of MRI-targeted biopsy (TBx) combined with SBx. METHODS: Within our institutional database, we identified 7,470 SBx and 1,717 TBx+SBx patients, who received respective primary diagnostics between 2005-2020 and 2016-2020. The estimated annual percentage changes (EAPC) for Gleason Grade Groups (GGG) and for proportion strata of PCa yield, within overall biopsy tissue was calculated by a log linear regression methodology. For TBx+SBx, adjustment according to PIRADS strata 3,4 and 5 was performed. RESULTS: At SBx, the incidence of GGG 1 (EAPC -3.45) and GGG 3 (EAPC -3.51) significantly decreased, accompanied by an increase of GGG 5 (EAPC +10; p=0.003). Similarly, proportion of biopsy tissue PCa yield >20% also significantly increased (EAPC: +3.71; p=0.002). After TBx+SBx was introduced at our institution 2016, the percentage of TBx+SBx for purpose of primary PCa diagnostics (as opposed to repeat Bx) increased from 12% to 52% until 2020. There were no significant EAPCs of TBx+SBx GGGs within this period. During the period 2016-2020, clinically significant GGG ≥2 was detected at a significantly higher rate of 58% at TBx+SBx compared to 46% at SBx, respectively. CONCLUSIONS: Increased high-risk GGG 5 proportions at SBx strongly suggest that previously observed inverse stage migration pattern of unfavorable PCa characteristics at first diagnosis are still present in contemporary PCa patients. However, the greater comparable yield of clinically significant PCa at TBx+SBX also indicates that the inverse stage migration of SBx might systematically underestimate truly aggressive PCa burden due to poorer diagnostic performance. This must be taken into account when considering a primary biopsy examination, supporting the existing recommendations regarding primary MRI and TBx based diagnostics. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e900 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mykyta Kachanov More articles by this author Sami-Ramzi Leyh-Bannurah More articles by this author Christoph Würnschimmel More articles by this author Dirk Beyersdorff More articles by this author Fabian Falkenbach More articles by this author Tobias Maurer More articles by this author Hendrik Isbarn More articles by this author Thomas Steuber More articles by this author Markus Graefen More articles by this author Lars Budäus More articles by this author Expand All Advertisement PDF DownloadLoading ...

Twenty-year trends in prostate cancer stage and grade migration in a large contemporary german radical prostatectomy cohort.

A trend towards inverse stage migration in prostate cancer (PCa) was reported. However, previous analyses did not take into account potential differences in sampling strategies (number of biopsy cores), which might have confounded these reports. Within our single-institutional database we identified PCa patients treated with radical prostatectomy (RP) between 2000 and 2020 (n = 21,646). We calculated the estimated annual percentage change (EAPC) for D'Amico risk groups, biopsy Gleason Grade Group (GGG), PSA and cT stage as well as postoperative RP GGG and pT stage relying on log linear regression methodology. Subsequently, we repeated the analyses after adjustment for number of cores obtained at biopsy. Absolute rates of D'Amico low risk decreased (-30.1%), while intermediate and high risk increased (+21.2% and +9.0%, respectively). Rates of GGG I decreased (-50.0%), while GGG II-V increased, with the largest increase in GGG II (+22.5%). This trend, albeit less pronounced, was also recorded after adjusted EAPC analyses (p < .05). Specifically, EAPC values for D'Amico low vs intermediate vs high risk were -1.07%, +0.37%, +0.45%, respectively, and EAPC values for GGG ranged between -0.71% (GGG I) and +0.80% (GGG IV). Finally, an increase in ≥cT2 (EAPC: +3.16%) was displayed (all p < .001). These trends were confirmed in EAPC calculations in RP GGG and pT stages (p < .001). Our findings confirm the trend towards less frequent treatment of low risk PCa and more frequent treatment of high risk PCa, also after adjustment for number of biopsy cores.

Changing trends in robot-assisted radical prostatectomy: Inverse stage migration-A retrospective analysis.

BackgroundWith increasing availability of data on outcomes of surgery for prostate cancer, the profile of patients undergoing robot-assisted radical prostatectomy (RARP) has changed over the past decade. This impacts the decision-making process for surgeons and patients, particularly in low-incidence regions of Asia. Our institution was among the first in Asia to acquire a da Vinci surgical robot in 2005. We evaluated the changes in the clinical and pathology profile of patients undergoing RARP at our institution over the past 15 years (2005-2019).MethodsA retrospective analysis of patients undergoing RARP between April 2005 and December 2019 was conducted from the hospital database. The patients were divided into two groups; patients undergoing RARP from April 2005 to December 2012 (Group I, first 8 years) and January 2013 to December 2019 (Group II, next 7 years). The perioperative characteristics were compared between these two groups to assess changes in their profile and outcome.ResultsFour hundred forty-seven patients were included in this study; 244 (54.6%) in Group I and 203 (45.4%) in Group II. The median prostate specific antigen in Group II was significantly higher than that in Group I (14.5 vs. 11.7 ng/ml, P = 0.016). Unfavorable pathological characteristics, i.e., Gleason Grade ≥3, perineural invasion, and the margin positivity rate increased substantially from 18.5% to 37.5%, 20.5% to 36.9%, and 15.2% to 26.6%, respectively, in Group II compared with Group I. More patients in Group II received adjuvant therapy than in Group I (P < 0.001).ConclusionThere has been a change in profile of patients undergoing RARP and patients with more unfavorable disease characteristics such as higher prostate specific antigen and tumor grade are undergoing surgery. In line with international trends, the number of patients with low-grade disease undergoing surgery has substantially decreased. Multimodal treatment with adjuvant therapy is increasingly used, particularly in high-risk disease.

Inverse Stage Migration in Radical Prostatectomy-A Sustaining Phenomenon.

Objective: To investigate temporal trends in prostate cancer (PCa) radical prostatectomy (RP) candidates.Materials and Methods: Patients who underwent RP for PCa between January 2014 and December 2019 were identified form our institutional database. Trend analysis and logistic regression models assessed RP trends after stratification of PCa patients according to D'Amico classification and Gleason score. Patients with neoadjuvant androgen deprivation or radiotherapy prior to RP were excluded from the analysis.Results: Overall, 528 PCa patients that underwent RP were identified. Temporal trend analysis revealed a significant decrease in low-risk PCa patients from 17 to 9% (EAPC: −14.6%, p < 0.05) and GS6 PCa patients from 30 to 14% (EAPC: −17.6%, p < 0.01). This remained significant even after multivariable adjustment [low-risk PCa: (OR): 0.85, p < 0.05 and GS6 PCa: (OR): 0.79, p < 0.001]. Furthermore, a trend toward a higher proportion of intermediate-risk PCa undergoing RP was recorded.Conclusion: Our results confirm that inverse stage migration represents an ongoing phenomenon in a contemporary RP cohort in a European tertiary care PCa center. Our results demonstrate a significant decrease in the proportion of low-risk and GS6 PCa undergoing RP and a trend toward a higher proportion of intermediate-risk PCa patients undergoing RP. This indicates a more precise patient selection when it comes to selecting suitable candidates for definite surgical treatment with RP.

VITAMIN CONTENT OF MARINE RED ALGA CHAMPIA PARVULA

Objective: The current investigation focuses on determining the vitamin content of marine red alga Champia parvula.&#x0D; Methods: Vitamins were divided and analyzed using Milichrom A-02 LC and multiwavelength ultraviolet visible as a detector. A 2 mm (ID)×250 mm (l) column was used to filter comprising C18 in the inverse stage used for separation.&#x0D; Results: The results suggest that the seaweed, C. parvula, contains 0.583±0.01, 3.43±0.01, 4.95±0.01, 1.95±0.01, 6.33±0.00, 174.74±0.01, and 15.75±0.01 μg of Vitamin A, B1, B5, folic acid, B12, C, and E, respectively, per gram of dry weight of the seaweed.&#x0D; Conclusion: The findings indicate that the seaweed, C. parvula, has a higher nutritional value and could be used as great dietary supplements for vitamins.

A novel inverse procedure for load identification based on improved artificial tree algorithm

This paper presents an accurate and effective method, namely, the improved artificial tree algorithm based on the Green’s kernel function method (IAT-GKFM), to identify the load in time domain. The forward problem of load identification is constructed by using the Green’s kernel function method. The forward problem is discretized using the time domain Galerkin method, where a matrix form for load identification is formed. The IAT algorithm is proposed to solve the inverse multi-dimensions problem in the inverse stage, which aims to minimize the measuring dispersion between the calculated response and the actual response. Several numerical examples are conducted. It is demonstrated that the IAT with high performance can provide more optimum results than those of other compared algorithms. Using this optimized strategy, the loads acting on a simple plate and a vehicle roof are reconstructed successfully. The superiority of IAT-GKFM may motivate the improvement of the other inverse problems.

P200 - Which patients with low-risk prostate cancer are still receiving radical prostatectomy? Impact of patient selection on inverse stage migration at two european, tertiary referral centers

P200 - Which patients with low-risk prostate cancer are still receiving radical prostatectomy? Impact of patient selection on inverse stage migration at two european, tertiary referral centers

Inverse stage migration patterns in North American patients undergoing local prostate cancer treatment: a contemporary population-based update in light of the 2012 USPSTF recommendations.

Recent studies demonstrated ongoing inverse stage migration in prostate cancer (PCa) patients towards more advanced and unfavorable tumors. The USPSTF grade D recommendation may impact this trend in North American patients. We assessed contemporary stage migration and treatment trends in a large North American cohort diagnosed with PCa 2009-2014. Time-trend analyses were performed in patients within the Surveillance, Epidemiology, and End Results database, with complete data of clinical tumor stage, biopsy Gleason score, and validated PSA values, resulting in 211,645 assessable patients. Patients were stratified according to their different treatment methods [radical prostatectomy (RP), radiotherapy (RT), and no local treatment (NLT)] and according to clinical and pathological risk stratification (D'Amico and CAPRA-S score). Over time, proportions of D'Amico low-risk (LR) decreased, with an increase in intermediate-to-high-risk (IR/HR) patients. These trends were more distinct in men ≥ 70years. NLT proportions increased, most notably in D'Amico LR and/or older patients. Conversely, RP proportions remained stable in younger HR and increased in older HR patients. Similar patterns were demonstrated in the RP-treated subgroup: D'Amico HR, pT3, and/or lymph-node invasion or CAPRA-S HR proportions increased from 23.5 to 30.8, 24.3 to 32.9, and 10.7 to 16.3% (each p ≤ 0.015). Inverse stage migration with increase of unfavorable PCa continues in most contemporary North American patients. However, a paradigm shift to treat LR patients with less invasive methods (NLT) was demonstrated. Contrary, HR patients increasingly undergo LT. Future studies with long-term follow-up might answer if inverse stage migration vs. treatment trends translate into different PCa metastases/mortality rates vs. proposed NLT benefits, particularly related to USPSTF-recommended reduced PSA screening.

Increasing rate of lymph node invasion in patients with prostate cancer treated with radical prostatectomy and lymph node dissection

ObjectivesTo investigate lymph node invasion (LNI) rates in prostate cancer (PCa) patients. Recent studies demonstrated an inverse stage migration in PCa patients toward more advanced and unfavorable diseases. We hypothesized that this trend is also evident in LNI rates, in PCa patients treated with radical prostatectomy (RP) and pelvic lymph node dissection (PLND). Patients and methodsWithin the Surveillance, Epidemiology, and End Results database (2004–2014), we identified patients who underwent RP and PLND. Annual trends of LNI rates and PLND extent were plotted. Univariable and multivariable logistic regression models tested the hypothesis that LNI rates are increasing annually, even after adjustment for clinical or pathological characteristics. ResultsOf 96,874 patients treated with RP and PLND, 4.1% (n = 4,002) exhibited LNI. The rate of LNI (2.5%–6.6%.), the mean (6.5–8.4) and median (5–6) number of removed lymph nodes increased during the study period. In multivariable logistic regression models, more contemporary year of diagnosis was associated with higher LNI rate, when year of diagnosis was modeled as a continuous, categorized or cubic spline variable, with adjustment for either clinical (prostate specific antigen, clinical tumor stage, and biopsy Gleason group) or pathological characteristics (pathologic tumor stage and Gleason group), as well as PLND extent (number of removed lymph nodes). ConclusionWe confirmed the hypothesis about increasing LNI rate over time in RP patients. This observation implies an increasing rate of unfavorable PCa defined as LNI. This finding is novel for contemporary epidemiological North American or European databases.

MP82-06 INVERSE STAGE MIGRATION PATTERNS IN NORTH AMERICAN PATIENTS UNDERGOING LOCAL PROSTATE CANCER TREATMENT: A CONTEMPORARY POPULATION-BASED UPDATE IN LIGHT OF THE 2012 USPSTF RECOMMENDATIONS

You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2018MP82-06 INVERSE STAGE MIGRATION PATTERNS IN NORTH AMERICAN PATIENTS UNDERGOING LOCAL PROSTATE CANCER TREATMENT: A CONTEMPORARY POPULATION-BASED UPDATE IN LIGHT OF THE 2012 USPSTF RECOMMENDATIONS Sami-Ramzi Leyh-Bannurah, Pierre Karakiewicz, Raisa Pompe, Felix Preisser, Emmanuelle Zaffuto, Paolo Dell'Oglio, Alberto Briganti, Omar Nafez, Margit Fisch, Thomas Steuber, Markus Graefen, and Lars Budäus Sami-Ramzi Leyh-BannurahSami-Ramzi Leyh-Bannurah More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Raisa PompeRaisa Pompe More articles by this author , Felix PreisserFelix Preisser More articles by this author , Emmanuelle ZaffutoEmmanuelle Zaffuto More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Omar NafezOmar Nafez More articles by this author , Margit FischMargit Fisch More articles by this author , Thomas SteuberThomas Steuber More articles by this author , Markus GraefenMarkus Graefen More articles by this author , and Lars BudäusLars Budäus More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2734AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent studies demonstrated ongoing inverse stage migration in prostate cancer (PCa) patients towards more advanced and unfavourable tumors. The USPSTF grade D recommendation may impact this trend in North American patients. To assess contemporary stage migration- and treatment-trends in a large North American cohort diagnosed with PCa 2009-2014. METHODS Time-trend-analyses were performed in patients within the Surveillance, Epidemiology and End Results database, with complete data of clinical tumor stage, biopsy Gleason score and validated PSA values, resulting in 211,645 assessable patients. Patients were stratified according to their different treatment methods (radical prostatectomy[RP], radiotherapy[RT], no local treatment[NLT])and according to clinical and pathological risk stratification (D′Amico and CAPRA-S score). RESULTS Proportions of D′Amico low-(LR), intermediate(IR)- and high-risk(HR) PCa patients changed from 35.0-29.6%, 38.0-39.7% and 27.1-30.7% (p>0.05), respectively. These trends were more distinct and statistically significant in men ≥70 years (D′Amico LR 27.5-19.3%, p<0.001 vs. HR 35.9-42.8%, p=0.013). NLT proportions increased, most notably in D′Amico LR ≥70 years (35.5-51.2%, p<0.001). Conversely, RP proportions remained stable in younger HR patients (52.4-51.6% p=0.3) and increased in older HR patients (12.1-15.6%, p=0.003). Similar patterns were demonstrated in the RP-treated subgroup: Unfavourable D′Amico HR, pT3 and/or lymph-node invasion or CAPRA-S HR proportions increased from 23.5-30.8%, 24.3-32.9% and 10.7-16.3% (each p≤0.015). CONCLUSIONS Inverse stage migration with increase of unfavourable PCa continues in most contemporary North American patients. However, a paradigm-shift to treat LR patients with less invasive methods (NLT) was demonstrated. Contrary, HR patients increasingly undergo LT. Future studies with long-term follow-up might answer if inverse stage migration- vs. treatment-trends translate into different PCa metastases/mortality rates vs. proposed NLT benefits, particularly related to USPSTF-recommended reduced PSA screening. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1107-e1108 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Sami-Ramzi Leyh-Bannurah More articles by this author Pierre Karakiewicz More articles by this author Raisa Pompe More articles by this author Felix Preisser More articles by this author Emmanuelle Zaffuto More articles by this author Paolo Dell'Oglio More articles by this author Alberto Briganti More articles by this author Omar Nafez More articles by this author Margit Fisch More articles by this author Thomas Steuber More articles by this author Markus Graefen More articles by this author Lars Budäus More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

1071 - Inverse stage migration patterns in North American patients undergoing local prostate cancer treatment: A contemporary population-based update in light of the 2012 USPSTF recommendations

1071 - Inverse stage migration patterns in North American patients undergoing local prostate cancer treatment: A contemporary population-based update in light of the 2012 USPSTF recommendations

675 - Which patients with low-risk prostate cancer are still receiving radical prostatectomy? Impact of patient selection on inverse stage migration at two European, tertiary referral centers

675 - Which patients with low-risk prostate cancer are still receiving radical prostatectomy? Impact of patient selection on inverse stage migration at two European, tertiary referral centers

Are the Results of the Prostate Testing for Cancer and Treatment Trial Applicable to Contemporary Prostate Cancer Patients Treated with Radical Prostatectomy? Results from Two High-volume European Institutions

The Prostate Testing for Cancer and Treatment (ProtecT) trial reported excellent outcomes for patients with localized prostate cancer (PCa) managed with radical prostatectomy (RP), radiotherapy, or active monitoring. We aimed at assessing the generalizability of the ProtecT trial to contemporary patients undergoing RP at two high-volume institutions. Overall, 29147 PCa patients treated with RP between 1999 and 2016 were included. We evaluated changes in disease characteristics over time. Competing-risk analyses estimated the 10-yr cancer-specific mortality (CSM) and other-cause mortality (OCM) rates. Overall, 20598 (71%) patients were eligible for the ProtecT trial, ranging from 76% in 1999–2005 to 67% in 2014–2016. The proportion of prostate-specific antigen (PSA) ≥20ng/ml, biopsy grade group 4–5, and high-risk disease increased over time (all p<0.001). Among men potentially eligible for the ProtecT trial included in our study, median PSA and grade group 4–5 were higher as compared with the ProtecT trial (6.5 vs 4.7ng/ml and 9% vs 2%), especially in individuals treated in more recent years (7.1ng/ml and 16% for 2014–2016). Median follow-up was 50 mo. When considering patients eligible for the ProtecT trial, the 10-yr OCM rate exceeded the CSM rate (7% vs 2%). Conversely, when focusing on patients not eligible due to disease aggressiveness, the risk of CSM exceeded that of OCM (10% vs 7%). Clinicians should carefully consider the inverse stage migration toward more aggressive disease among surgical candidates in more recent years. Individuals not eligible for the ProtecT trial are more likely to die from PCa than from OCM, thus being the optimal candidates for testing the role of primary treatments. Patient summaryContemporary prostate cancer surgery candidates harbor more aggressive disease features at presentation as compared with men included in the Prostate Testing for Cancer and Treatment (ProtecT) trial and are, in turn, at an increased risk of progression and mortality. Clinicians should take this into consideration when generalizing the results of the ProtecT trial with a particular emphasis on the oncologic safety of active monitoring in contemporary patients not included in structured prostate-specific antigen-based screening programs.

Radical prostatectomy in locally advanced prostate cancer

Due to an inverse stage migration, the proportion of patients with more aggressive and locally advanced prostate cancer (PCa) has increased over the last few years. The natural history in these patients shows ahigher risk of local complications and worse oncologic outcome. To analyze the impact of radical prostatectomy (RP) in patients with locally advanced PCa. A review of the literature was performed using PubMed and MEDLINE databases focusing on articles addressing locally advanced PCa. Current guidelines recommend local therapy in patients with locally advanced PCa among other treatment options. Thereby no strong evidence favoring radiotherapy or RP is present. Compared to patients without local treatment, RP may improve oncologic outcome and decrease the risk of local complications. Due to more difficult surgery and an increased need of multimodal therapy, higher perioperative morbidity and worse functional outcomes compared to patients with localized PCa are reported. No reliable prospective data indicating awidespread use of neoadjuvant treatment exists. Indication for further adjuvant or salvage therapies depends on pathologic results and postoperative course. RP is one of the treatment options with good long-term results which can be offered to patients with locally advanced PCa. Nevertheless, patients need to be counselled especially about the worse postoperative functional outcome compared to patients with localized PCa.

Current trends in patient enrollment for robotic‐assisted laparoscopic prostatectomy in Belgium

During the last decade, an inverse stage migration has been observed in radical prostatectomy series at tertiary centers. However, it remains unclear whether similar trends can also be observed in solely robotic practices, including nonreferral centers. The aim of this study was to investigate the clinical and pathological trends in robotic-assisted laparoscopic prostatectomy (RALP) enrollment in Belgium over a period of 6 years through an analysis of a prospective registry. A prospective, multicenter database was constructed: consecutive patients undergoing RALP in Belgium from 2010 to 2015 were enrolled, and 7366 men were analyzed. Variations in clinical and pathological variables were explored as a function of the enrollment year with proportional odds for categorical variables and with linear regressions for continuous variables. Net increases were observed in the prostate-specific antigen levels, cT stage, and biopsy Gleason scores across the study years (P < .001). The rate of low-risk prostate cancer (PCa) decreased from 36% in 2010 to 21% in 2015, whereas the rate of intermediate-risk PCa rose from 47% to 58%, and the rate of high-risk PCa rose from 17% to 21%. In parallel, the pT2 stage rate decreased from 76% to 64%, and the rate of Gleason 6 (3 + 3) cases was reduced from 45% to 23% (P < .001). Conversely, the pT3a stage rate rose from 16% to 24%, the pT3b stage rate rose from 7% to 11%, and the rate of Gleason 7 (4 + 3) cases rose from 7% to 21% (P < .0001). Finally, more patients underwent node dissection, and positive lymph nodes were increasingly diagnosed (from 3% in 2010 to 7% in 2015). During the last 6 years of RALP implementation in Belgium, there was a significant increase in the enrollment of intermediate- and high-risk PCa patients. This yielded a significant increase in adverse pathological characteristics. These results suggest a paradigm shift in PCa treatment, with radical robotic surgery increasing for intermediate- and high-risk patients. Cancer 2017;123:4139-4146. © 2017 American Cancer Society.

Multi-phase-field simulation of cyclic phase transformation in Fe-C-Mn and Fe-C-Mn-Si alloys

The stagnant and inverse transformation stages during cyclic phase transformation in the two-phase region “ferrite+austenite” (intercritical region) of Fe-C-Mn and Fe-C-Mn-Si alloys were investigated using the non-equilibrium multi-phase-field (NEMPF) model, i.e. an MPF model with finite interface dissipation. We showed that if we used large interfacial permeability parameters that characterize the partitioning rate of solute atoms in the ferrite/austenite interface, the NEMPF model predicted the same transformation behavior as that simulated using the MPF model based on the assumption of the parallel tangent law. The simulation demonstrated that the inverse transformation stage, in which ferrite-to-austenite transformation proceeds despite decreasing temperature, could be naturally described by the NEMPF model coupled with the CALPHAD-based thermodynamic database. This study also elucidated a switching of the polarities of Mn and Si spike formed at the ferrite/austenite interface governed the driving force of the austenite-to-ferrite transformation and caused the stagnant stage where the phase transformation was suppressed. Furthermore, the impact of the amount of Mn and Si atoms on the stagnant stage length was examined using the NEMPF model. The simulations revealed that increasing the concentration of Mn and Si extended the stagnant stage, with a more pronounced effect with Mn rather than Si atoms.

IR studies of the oxygen and carbon precipitation processes in electron irradiated tin-doped silicon

Oxygen (O) and carbon (C) are key impurities in silicon (Si) and the control of their properties and behavior is an important issue for the microelectronic industry. A number of these properties can be manipulated by isovalent doping. Here we employ Fourier transform infrared (FTIR) spectroscopy to study the evolution of O and C concentration as well as the evolution of the oxygen precipitate bands in electron- irradiated tin (Sn) doped Si, subjected to isochronal anneals up to 950 °C. Special attention was given in connecting infrared absorption bands with certain precipitation morphologies. In this study, bands at 1040, 1060, 1080 and 1170 cm−1 generally attributed to precipitate morphologies were detected. Using arguments from classical theoretical mechanics we have attributed the 1040 cm−1 band to a structure more close to a spherical morphology, although the 1060 and 1080 cm−1 bands were attributed to structures more close to octahedral and polyhedral morphologies, respectively. Additionally the band at 1170 cm−1 was attributed to platelet precipitates. The effect of C and (C, Sn) co-doping Si in the morphologies of the precipitates bands was investigated in detail. It was found that in the irradiated material C suppresses the formation of spheroidal precipitates although it enhances the platelet precipitates, whereas in Si containing C and Sn the opposite behavior was detected. The presence of the two impurities modifies the number of the O precipitates and affects the relative density among the formed morphologies in Si, determining whether the spheroidal or platelet precipitates will prevail. The phenomenon was discussed taking into consideration the effect of the density of the nucleation sites on the interfacial energy of the precipitates. Furthermore, an inverse annealing stage in the evolution curve of C, namely an increase of C concentration prior to its complete disappearance was studied. This recovery stage was determined to be enhanced in (C, Sn) co-doping Si with relatively low Sn content although in Si with high Sn content the increase of C is substantially lower. An explanation was suggested based on the ability of the Sn to temporarily trap vacancies, thus affecting the restoration of the C substitutional atoms in the Si lattice.