Denosumab for bone health in prostate and breast cancer patients receiving endocrine therapy? A systematic review and a meta-analysis of randomized trials

Hormonal therapies for receptor positive-breast and prostate cancer patients have shown clinical efficacy but also several side effects including osteoporosis, loss of bone mass and increased fracture risk. Denosumab represents an anti RANKL (receptor activator of nuclear factor-kB ligand) monoclonal anti-body acting as inhibitor of osteoclasts formation, function, and survival, then increasing bone mass. Herein, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the role of Denosumab in saving bone health in prostate and breast cancer patients receiving respectively androgen deprivation therapy and adjuvant endocrine therapy. Moreover, selected patients have to be treated with Denosumab at the dose of 60 mg every six month or placebo. Outcomes studied included the bone mass density (BMD) increase at 24 and 36 months, BMD loss, reduction of fractures risk (in particular vertebral) at 24 and 36 months and safety (overall, serious adverse events - SAEs and discontinuation rate). Our results showed a reduction of the BMD loss up to 36 months both at the lumbar and femoral level and a BMD increase both at 24 and 36 months. It was also found a reduction in the number of new vertebral and femoral fractures at 24 and 36 months. Finally, our pooled analysis showed that Denosumab did not affect both the SAEs and therapy discontinuation risk. In conclusion, Denosumab administration can be considered effective and safe in the prevention and management of the above mentioned adverse events related to hormonal therapies designed for breast and prostate tumors

An optimization model for charging and discharging battery-exchange buses: Consider carbon emission quota and peak-shaving auxiliary service market

The mode of battery replacement will become the main means of urban public transport energy supply, which will have a significant impact on the energy cost of public transport companies and the stability of the power system. Therefore, this paper proposes a charging and discharging optimization model for electric buses to participate in the carbon trading market and the peak shaving auxiliary service market. The upper model aims to minimize the total daily energy cost of the bus company, and the lower model is optimized based on the upper optimization results to minimize grid load fluctuations. Then, the scheme proposed in this paper is compared with disordered charging and orderly charging based on time of use price. Finally, a bus company in Beijing is taken as an example of simulation. The results show that compared with the disordered charging and the orderly charging based on time of use price, the charging and discharging schemes proposed in this paper can reduce the daily energy cost of 6052.68 yuan and 617.42 yuan respectively, reduce the fluctuation of power grid load by 92.14 % and 13.85 %, and reduce the carbon emission of the bus power combined system by 3930 kg and 2080 kg