Active surveillance should be considered for select men with Grade Group 2 prostate cancer

Abstract Background Treatment decisions for localized prostate cancer must balance patient preferences, oncologic risk, and preservation of sexual, urinary and bowel function. While Active Surveillance (AS) is the recommended option for men with Grade Group 1 (Gleason Score 3 + 3 = 6) prostate cancer without other intermediate-risk features, men with Grade Group 2 (Gleason Score 3 + 4 = 7) are typically recommended active treatment. For select patients, AS can be a possible initial management strategy for men with Grade Group 2. Herein, we review current urology guidelines and the urologic literature regarding recommendations and evidence for AS for this patient group. Main body AS benefits men with prostate cancer by maintaining their current quality of life and avoiding treatment side effects. AS protocols with close follow up always allow for an option to change course and pursue curative treatment. All the major guideline organizations now include Grade Group 2 disease with slightly differing definitions of eligibility based on risk using prostate-specific antigen (PSA) level, Gleason score, clinical stage, and other factors. Selected men with Grade Group 2 on AS have similar rates of deferred treatment and metastasis to men with Grade Group 1 on AS. There is a growing body of evidence from randomized controlled trials, large observational (prospective and retrospective) cohorts that confirm the oncologic safety of AS for these men. While some men will inevitably conclude AS at some point due to clinical reclassification with biopsy or imaging, some men may be able to stay on AS until transition to watchful waiting (WW). Magnetic resonance imaging is an important tool to confirm AS eligibility, to monitor progression and guide prostate biopsy. Conclusion AS is a viable initial management option for well-informed and select men with Grade Group 2 prostate cancer, low volume of pattern 4, and no other adverse clinicopathologic findings following a well-defined monitoring protocol. In the modern era of AS, urologists have tools at their disposal to better stage patients at initial diagnosis, risk stratify patients, and gain information on the biologic potential of a patient’s prostate cancer

Ultrasonic Characterization of Fatigue Behavior in Metal-Matrix Composites

In the past decades, the incorporation of ceramic reinforcement in metal-matrix composites (MMC’s) brought about considerable improvements in elastic modulus, strength, wear resistance, structural efficiency, reliability and control of physical properties (e.g. density and coefficient of thermal expansion) thereby providing for improved mechanical performance in comparison to the unreinforced matrix [1–4]. S-N curves for materials such as steels are available elsewhere [5–6] whereas are limited for MMC’s. Studies on the elastic constants behavior for MMC’s as a function of temperature, volume fractions of reinforcement and applied stresses had already been conducted [7–8]. However, the fatigue behavior of elastic constants in MMC’s is not well understood. Further, the trend now is aimed at nondestructive evaluation (NDE) of materials which in the past years gained significant attention over the conventional destructive tests since the former is capable of determining the usefulness, serviceability or quality of a part or material without limiting its usefulness, which is not possible in the latter’s case [9–10]. In view of the above discussion, a result of the study on the fatigue behavior and ultrasonic characterization of monolithic aluminum and aluminum MMC’s will be discussed here

Conservation status of freshwater mussels in Europe: state of the art and future challenges

Freshwater mussels of the Order Unionida provide important ecosystem functions and services, yet many of their populations are in decline. We comprehensively review the status of the 16 currently recognized species in Europe, collating for the first time their life-history traits, distribution, conservation status, habitat preferences, and main threats in order to suggest future management actions. In northern, central, and eastern Europe, a relatively homogeneous species composition is found in most basins. In southern Europe, despite the lower species richness, spatially restricted species make these basins a high conservation priority. Information on freshwater mussels in Europe is unevenly distributed with considerable differences in data quality and quantity among countries and species. To make conservation more effective in the future, we suggest greater international cooperation using standardized protocols and methods to monitor and manage European freshwater mussel diversity. Such an approach will not only help conserve this vulnerable group but also, through the protection of these important organisms, will offer wider benefits to freshwater ecosystems. © 2016 Cambridge Philosophical Societ