Urinary and sexual outcomes in long-term (5+ years) prostate cancer disease free survivors after radical prostatectomy

<p>Abstract</p> <p>Background</p> <p>After long term disease free follow up (FUp) patients reconsider quality of life (QOL) outcomes. Aim of this study is assess QoL in prostate cancer patients who are disease-free at least 5 years after radical prostatectomy (RP).</p> <p>Methods</p> <p>367 patients treated with RP for clinically localized pCa, without biochemical failure (PSA ≤ 0.2 ng/mL) at the follow up ≥ 5 years were recruited.</p> <p>Urinary (UF) and Sexual Function (SF), Urinary (UB) and Sexual Bother (SB) were assessed by using UCLA-PCI questionnaire. UF, UB, SF and SB were analyzed according to: treatment timing <it>(age at time of RP, FUp duration, age at time of FUp)</it>, tumor characteristics <it>(preoperative PSA, TNM stage, pathological Gleason score)</it>, nerve sparing (NS) procedure, and hormonal treatment (HT).</p> <p>We calculated the differences between 93 NS-RP without HT (group A) and 274 non-NS-RP or NS-RP with HT (group B). We evaluated the correlation between function and bother in group A according to follow-up duration.</p> <p>Results</p> <p>Time since prostatectomy had a negative effect on SF and a positive effect SB (both p < 0.001). Elderly men at follow up experienced worse UF and SF (p = 0.02 and p < 0.001) and better SB (p < 0.001).</p> <p>Higher stage PCa negatively affected UB, SF, and SB (all: p ≤ 0.05). NS was associated with better UB, SF and SB (all: p ≤ 0.05); conversely, HT was associated with worse UF, SF and SB (all: p ≤ 0.05).</p> <p>More than 8 years after prostatectomy SF of group A and B were similar. Group A subjects (NS-RP without HT) demonstrated worsening SF, but improved SB, suggesting dissociation of the correlation between SF and SB over time.</p> <p>Conclusion</p> <p>Older age at follow up and higher pathological stage were associated with worse QoL outcomes after RP. The direct correlation between UF and age at follow up, with no correlation between UF and age at time of RP suggests that other issues (i.e: vascular or neurogenic disorders), subsequent to RP, are determinant on urinary incontinence. After NS-RP without HT the correlation between SF and SB is maintained for 7 years, after which function and bother appear to have divergent trajectories.</p

Descemet membrane air-bubble separation in donor corneas

We describe a technique to obtain Descemet-endothelium disks from donors. To detach Descemet membrane, an air bubble was introduced in the deep stroma of human donor corneas mounted on an artificial chamber. In Group A (n = 5), the bubble was left inflated. In Group B (n = 4), the bubble was deflated immediately after the membrane was detached. In Group C (n = 7), the Descemet-endothelium disk was trephined and separated from the stroma after the bubble was deflated. All tissues were stored at 4\ub0C. Descemet detachment was achieved in 89% of the tissues. After 48 hours, the mean endothelial loss was 83% \ub1 10% (SD), 15% \ub1 11%, and 3% \ub1 3% in the 3 groups, respectively. With this technique, Descemet-endothelium disks were obtained without significant alterations in the endothelial layer

Data-Driven Resource Shaping for Compute Clusters

Nowadays, data-centers are largely under-utilized because resource allocation is based on reservation mechanisms which ignore actual resource utilization. Indeed, it is common to reserve resources for peak demand, which may occur only for a small portion of the application life time. As a consequence, cluster resources often go under-utilized. In this work, we propose a mechanism that improves cluster utilization, thus decreasing the average turnaround time, while preventing application failures due to contention in accessing finite resources such as RAM. Our approach monitors resource utilization and employs a data-driven approach to resource demand forecasting, featuring quantification of uncertainty in the predictions. Using demand forecast and its confidence, our mechanism modulates cluster resources assigned to running applications, and reduces the turnaround time by more than one order of magnitude while keeping application failures under control. Thus, tenants enjoy a responsive system and providers benefit from an efficient cluster utilization