Sex differences in treatment patterns for non-advanced muscle-invasive bladder cancer: a descriptive analysis of 3484 patients of the Netherlands Cancer Registry.

PURPOSE Bladder cancer (BC) is a common malignancy with well-established differences in incidence, clinical manifestation and outcomes between men and women. It is unknown to what extent disparities in outcomes are influenced by differences in treatment approaches. This paper describes treatment patterns among men and women with muscle-invasive BC focusing on curative treatment (radical cystectomy or trimodal therapy). METHODS A retrospective population-based cohort study was performed with data from the Netherlands Cancer Registry. All patients newly diagnosed with muscle-invasive, non-advanced BC (MIBC, cT2-4a, N0/X, M0/X) in the years 2018, 2019 and 2020 were identified. Patient and tumor characteristics and initial treatment were compared between men and women with descriptive statistics and multivariable logistic regression analyses. RESULTS A total of 3484 patients were diagnosed with non-advanced MIBC in 2018-2020 in the Netherlands, of whom 28% were women. Women had higher T-stage and more often non-urothelial histology. Among all strata of clinical T-stage, women less often received treatment with curative intent (radical cystectomy [RC] or trimodality treatment). Among RC-treated patients, women more often received neoadjuvant treatment (except for cT4a disease). After adjustment for pre-treatment factors, odds ratios were indicative of women having lower probability of receiving curative treatment and RC specifically, and higher probability to receive NAC when treated with RC then men, although not statistically significant. CONCLUSIONS Considerable differences in treatment patterns between men and women with MIBC exist. A more considerate role of the patient's sex in treatment decisions could help decrease these differences and might mitigate disparities in outcomes

Rome wasn't built in a day: the accessibility of social protection for informal workers: a mapping of 5 West African countries

ASC – Publicaties niet-programma gebonde

Real-time automatic integrated monitoring of barn environment and dairy cattle behaviour: Technical implementation and evaluation on three commercial farms

Due to increasing herd sizes and automation on dairy farms there is an important need for automated monitoring of cow production, health, and welfare. Despite much progress in automatic monitoring techniques, there is still a need to integrate data from multiple sources to create a comprehensive overview and accurate diagnosis of a cow’s state. To aid the technological development of data integration, a prototype of an open and customizable automatic system that integrates data from multiple sensors relating to barn environment and cow behaviour was developed. The system integrates data from sensors that measure barn climate (e.g., temperature, humidity, wind speed), air quality (e.g., CO2 concentration), water use and temperature, the moisture and temperature of the litter and cow behaviour (e.g., lying, eating, ruminating). An external weather system and video recording system are also included. The system’s architecture consists of four main elements: sensors, nodes, gateways, and backend. The data are recorded by sensors, then locally processed on custom-developed sensor nodes, and then transmitted via radio channels to local gateways that combine the data from multiple nodes and transmit them to distributed digital storage (“the cloud”) via a 3G/4G cellular network. On the cloud, the data are further processed and stored in a database. The data are then presented to the user continuously and in real time on a dashboard that can be accessed via the internet. In the design of the local wireless network, care was taken to avoid data packet collision and thus to minimize data loss. To test the system’s performance, the system was installed and operated on three commercial dairy cattle farms for one year. The system provided high data stability with minimal loss and outliers, showing that the system is reliable and suitable for long term application on commercial dairy farms. The system’s architecture, communication network, and data processing and visualization applications form an open framework for research and development purposes, allowing it to be customized and fine-tuned before being deployed as a management assistant on commercial dairy farms. Missing elements that should be added in the future are the integration of the data from the milking parlour and cow identification. Algorithms to integrate information from multiple sensors can be added to provide a comprehensive system that monitors all aspects related to cow welfare, health, and production automatically, remotely and in real time, thereby supporting farmers in important management decision-making

Golden standard for radical cystectomy:open or robot assisted?

De open radicale cystectomie wordt beschouwd als de standaardbehandeling van het spierinvasief blaascarcinoom en bij recidiverend hoogrisico niet-spierinvasief blaascarcinoom. Sinds 2000 wordt de cystectomie steeds meer laparoscopisch en met assistentie van de robot uitgevoerd, al dan niet met een intracorporeel aangelegde urinedeviatie. De resultaten uit de literatuur komen vooral uit retrospectieve studies, waarin de resultaten worden vergeleken met historische open cystectomieseries. In combinatie met de resultaten van enkele kleinere prospectieve series is er aanzienlijk bewijs dat de robotgeassisteerde radicale cystectomie (RARC) een veilige techniek is waarbij minder bloedverlies en bloedtransfusiebehoefte optreedt en patiënten minder lang opgenomen zijn ten opzichte van de open radicale cystectomie (ORC). Ten aanzien van de functionele en oncologische resultaten lijkt de RARC niet onder te doen voor de ORC. Daarbij heeft de RARC een groot ergonomisch voordeel. Een nadeel is dat de aanschaf en het gebruik van een daVinci™-systeem gepaard gaan met hogere kosten. Zowel internationaal als nationaal wordt momenteel gewerkt aan prospectieve multicentrische vergelijkende studies om het mogelijke verschil aan te tonen ten opzichte van de ORC op het oncologische en/of functionele vlak, maar daarnaast meer duidelijkheid te verkrijgen ten aanzien van de kosteneffectiviteit van de RARC