Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial.

Based on previous findings, we hypothesised that radiotherapy to the prostate would improve overall survival in men with metastatic prostate cancer, and that the benefit would be greatest in patients with a low metastatic burden. We aimed to compare standard of care for metastatic prostate cancer, with and without radiotherapy.This article is freely available via Open Access

Temporal/Spatial Trends and Concentrations of Microplastics in Streams Throughout the Central Illinois Watersheds

Daily activities, like washing clothes, using soap, industrial cleaning use, etc., introduce potenially dangerous [OC1] microplastics into our freshwater systems. These plastic particles are defined by their size, which is \u3c5mm in diameter. Throughout cities across the United States, local municipalities have to treat their household and industrial sewage water at WWTP\u27s (Waste Water Treatment Plants) in order for it to be released back into the environment. In many instances, WWTP effluent has been recorded to contain microplastics. WWTP\u27s can be seen as a mechanism where high concentrations of microplastics can be focused into our water sources. There are currently no policies or regulations requiring treatment plants to treat for microplastics. Microplastic particles have been known to carry bacteria assemblages that cause gastrointestinal infections as well as leaching PCB (polychlorinated biphenyl) which has been known to cause health risks like cancer and infertility in humans . Due to the relatively unstudied side effects that these particles can have on humans, it is important to identify the sources of microplastics and to reduce them into our environment. Within the central Illinois watersheds there are a multitude of WWTP\u27s. By studying effluent from WWTP\u27s, we can begin to understand how microplastics are derived in the treatment process. Current microplastic studies have been focused on very large urban populations like Chicago and large bodies of water like the Great Lakes. Little attention has been focused on small scale watersheds and streams within central Illinois as well as watersheds throughout the United States. By examining water samples upstream and downstream from WWTP\u27s, I can determine if microplastics are being produced by WWTP\u27s. This study is not limited to the central Illinois watershed or to WWTP\u27s, the methods used in my study can be applied to any watershed where flowing surface water is present. Do higher populated urban areas within the central Illinois watershed have a larger concentration of microplastics than less populated areas? The cities of Bloomington-Normal, Clinton, Champaign-Urbana have a population of 130,000, 7,200, and 120,000 respectively and all use WWTP\u27s to treat household and industrial sewage. I conclude that Bloomington-Normal will have the highest concentration of microplastics based on its higher population. This is expected since there are more people and more household sewage would have to be treated at WWTP\u27s

The Effects of Sand, Cloth, and No Tertiary Filtration on Microplastic Particles

Microplastics are ubiquitous contaminants that reside in all environments worldwide. From Artic ice down to small-scale river systems, these are just a few of the environments that are affected by these inherently small particles. Three WWTP’s within central Illinois were studied to see how their filtration methods reduced microplastics in wastewater. Two types of tertiary filtration (Sand and cloth) were studied to determine their ability at microplastic reduction. Microplastic reduction ranged from 42%-50% for cloth, and 25%-52% for sand. Our 3rd plant did not have tertiary filtration and reduced microplastics at a higher rate than WWTP’s that had tertiary filtration. Although the reduction of microplastics was low, the effluent from WWTP’s was diluting stream environments downstream from their discharge outlet. Factors like populations sized served by our WWTP’s was seen as a factor in influencing microplastic concentrations and abundances in WWTP Effluent. Although our WWTP’s are diluting stream microplastic concentrations, WWTP’s are still discharging up to 250,000 microplastics a day. The large volumes discharged over the course of a day by WWTP result in these high numbers of particles discharged. WWTP’s across the country are adequately reducing microplastics in wastewater, but they can be a concentrated discharge outlet of microplastics to our environment

Karst Susceptibility to Anthropogenic Influences in the Driftless Area of Northwest Illinois

In karst, the water chemistry of spring waters reveals the interactions between surface water and groundwater. Concerns about anthropogenic influences on the waters in northwest Illinois prompted an investigation examining the water chemistry of local springs and streams. For a year, six streams and six springs were sampled monthly for concentrations of major ions, pH, temperature, specific conductance, dissolved oxygen, biological oxygen demand, turbidity, and total coliform. Qualitative and quantitative analyses, including principal component analysis (PCA), were conducted to assess the influences of surface conditions on the karst waters. When plotted on a Piper Diagram, both waters displayed similar hydrochemical facies: Ca-Mg HCO3. PCA confirmed the importance of water-rock interaction on the water chemistry, but highlighted differences among the parameters controlling the anthropogenic chemical signatures of the waters. These anthropogenic impacts observed in both waters include NO3-N and total coliform. NO3-N concentrations ranged from 2.9 to 14.6 mg/L for the streams and from 0.3 to 30.1 mg/L for the springs; reported background concentrations are 2.5 mg/L. Total coliform was detected in both waters, with more frequent and higher counts in the stream water. The pH (6.5±0.15:mean±standard deviation) and the calcite saturation index values (-0.60±0.21) of the spring waters imply short residence times within the karst system, limiting any remedial mechanism in the subsurface. Overall, the chemical fingerprints of the stream and spring waters display differences; however, both streams and springs are susceptible to anthropogenic practices

Differentiation of Surface Water and Groundwater in a Karst System Using Anthropogenic Signatures

Surface water–groundwater interaction within a karstic system enhances contaminant transport, making karst aquifers susceptible to anthropogenic practices. Contaminated waters related to agricultural and animal husbandry in northwestern Illinois (USA) prompted this investigation. Six streams and five springs were sampled for 16 parameters to assess anthropogenic influences. Statistical analyses revealed differences in 13 of 16 parameters between the stream and spring waters. Rock–water interaction was identified as the dominant mechanism defining the chemistry for both waters, which were classified as Ca-Mg HCO3. Elevated nitrate as nitrogen (NO3-N), chloride (Cl−), sodium, and potassium concentrations indicate that human activities have influenced the quality of both water types. All streams and springs had NO3-N concentration exceeding background levels, with concentrations ranging from 2.9 to 14.5 mg/L and 2.9 to 30.1 mg/L, respectively. NO3-N/Cl relationships at individual locations showed elevated concentrations of NO3-N due to fertilizers, while the spring waters were influenced by manure, septic effluent, or mixed sources. The presence of coliform supports the likelihood of animal or human waste influences on waters. Dissimilarities within their chemical fingerprints can be traced to aid in differentiating sources within the waters

Salvage Stereotactic Radiosurgery for Recurrent WHO Grade 2 and 3 Meningiomas: A Multicenter Study (STORM)

The role of stereotactic radiosurgery (SRS) in the management of grade 2 and 3 meningiomas is not well elucidated. Unfortunately, local recurrence rates are high, and guidelines for management of recurrent disease are lacking. To address this knowledge gap, we conducted STORM, a multicenter retrospective cohort study of patients treated with primary SRS for recurrent grade 2 and 3 meningiomas. Data on patients with recurrent grade 2 and 3 meningioma treated with SRS at first recurrence were retrospectively collected from eight academic centers in the United States. Patients with multiple lesions at the time of initial diagnosis or more than two lesions at the time of first recurrence were excluded from this analysis. Patient demographics and treatment parameters were extracted at time of diagnosis, first recurrence, and second recurrence. Oncologic outcomes including progression-free survival (PFS) and overall survival (OS) as well as toxicity outcomes were reported at the patient level. From 2000-2022, 108 patients were identified (94% grade 2, 6.0% grade 3). 106 patients (98%) had upfront surgical resection (60% gross-total resection) with 18% receiving adjuvant radiotherapy (RT). Median time to first progression was 2.5 years (IQR 1.34-4.30). At first recurrence, patients were treated with single or fractionated SRS to a median marginal dose of 16 Gy to a maximum of two lesions (87% received single fraction SRS). Median follow-up time after SRS was 2.6 years. 1-, 2-, and 3-year PFS was 90%, 75%, and 57%, respectively after treatment with SRS. 1-, 2-, and 3-year OS was 97%, 94%, and 92%, respectively. On multivariable analysis, grade 3 disease (HR 6.80; 95% CI 1.61-28.6), male sex (HR 3.48; 95% CI 1.47-8.26), and receipt of prior RT (HR 2.69; 95% CI 1.23-5.86) were associated with worse PFS. SRS dose and tumor volume were not correlated with progression. Treatment was well-tolerated, with a 3.0% incidence of grade 2+ radiation necrosis. This is the largest multi-center study to evaluate salvage SRS in recurrent grade 2 and 3 meningiomas. In this select cohort of patients with primarily grade 2 meningioma with potentially more favorable natural history of delayed, localized first recurrence amenable to salvage SRS, local control rates and toxicity profiles were favorable, warranting further prospective validation