BACKGROUND: Existing models for predicting that biochemical recurrence (BCR) will occur in patients after radical prostatectomy (RP) vary in their predictive results from magnetic resonance imaging (MRI). This study aimed to assess the predictive value of preoperative prostate-specific antigen (PSA) levels combined with MRI features in determining BCR following radical prostatectomy.
METHODS: A retrospective analysis was conducted on a cohort comprising 102 patients who underwent radical prostatectomy at our hospital between January 2019 and December 2019. On the basis of the outcomes observed during a 4-year follow-up after surgery, the patients were categorised into BCR group (n = 52) and non-BCR group (n = 50). Differences in preoperative PSA levels and MRI characteristics between the two groups were compared, and factors influencing postoperative BCR were analysed. The receiver operating characteristic curve was drawn, and the sensitivity, specificity, area under the curve (AUC) and Youden index were calculated to observe the predictive value of the combination of preoperative PSA level and MRI features for BCR following radical prostatectomy.
RESULTS: Logistic regression analysis showed that preoperative PSA level, postoperative Gleason score, data system (Prostate Imaging-Reporting and Data System (PI-RADS)) score and clinical T stage were independent risk factors for BCR in patients following radical prostatectomy, with odds ratio (OR) greater than 1. The AUC value of preoperative PSA level combined with PI-RADS score was 0.921, surpassing the AUC values of 0.783, 0.822, 0.617 and 0.608 predicted by preoperative PSA level, postoperative Gleason score, PI-RADS score and clinical T stage alone, respectively.
CONCLUSIONS: Postoperative BCR in patients with prostate cancer undergoing radical prostatectomy is associated with preoperative PSA level, postoperative Gleason score, PI-RADS score and clinical T stage. The combination of preoperative PSA level and MRI features can improve the predictive efficiency for postoperative BCR.

Asciminib is a first-in-class BCR::ABL1 inhibitor that Specifically Targets the ABL1 Myristoyl Pocket (STAMP). It is approved worldwide and in Japan for chronic myeloid leukemia in chronic phase (CML-CP) with resistance or intolerance to previous tyrosine kinase inhibitor (TKI) therapy. In the Phase 3 ASCEMBL study, patients with CML-CP who received ≥ 2 prior ATP-competitive TKIs were randomized (2:1) to asciminib 40 mg twice-daily or bosutinib 500 mg once-daily. Here, we report the 96-week results of the subgroup analysis of Japanese patients (asciminib, n = 13; bosutinib, n = 3) in the ASCEMBL study. The MMR rate at Week 96 was 46.2% in asciminib-treated patients, increasing from Weeks 24 and 48. Patients who achieved MMR at Week 24 remained in MMR up to the Week 96 cutoff. While a high proportion of patients treated with asciminib remained on treatment at cutoff, none randomized to bosutinib were on treatment at Week 96. Despite the longer duration of exposure to asciminib, its safety and tolerability continued to be favorable with no new or worsening safety findings. Overall, the efficacy and safety outcomes in the Japanese subgroup were comparable with the ASCEMBL global study population, which supports the use of asciminib in Japanese patients with previously treated CML-CP.

This study is on the outskirts of the rapidly growing city of Jaipur, located in the semiarid region of India and gateway to the \'Great Indian Thar\' desert, and focused on potentially toxic elements (PTE) pollution in the farmlands around the city. Concentrations of PTE, along with associated soil parameters such as pH, available nitrogen, organic carbon, phosphorus, and potassium, were estimated in agricultural soil samples near an industrial region on the outskirts of the capital city of the largest state of India. The PTE concentrations in the soil were in the following order: Mn > Pb > Ni > Cr > Cu > Cd. Soil pollution indices, such as the geochemical accumulation index (Igeo), contamination factor (CF), and ecological risk index (ERI), indicated that the soil was moderately to highly polluted. The result of BCR extraction techniques showed Cd is found mainly in the exchangeable and residual fractions, Pb, Mn were found in the reducible as well as residual fractions, while other PTE were mostly bound to residual fraction. All other PTEs are primarily found in the residual fraction, tightly linked with the silicate lattice of soil minerals. Multivariate analysis and the Pearson correlation matrix indicate a common source apportionment for Pb and Cd. Cd, and Pb concentrations in agricultural soil indicate ecological harm that warrants immediate attention and policy-level intervention.

The floodplain soils are often heavily enriched in metal(loid)s released from the industrial areas. A related environmental risk depends on their total concentrations and the forms and conditions conducive to mobilization. This study was aimed to examine the concentrations of metal(loid)s in the Odra floodplain soils and to assess the risk associated with their possible contamination. In this study, topsoil and deeper soil layer samples were collected from the inter- and out-of-embankment zones. Total concentrations of Pb, Zn, Cu, As, Mn and Fe, and their extractable fractions were determined in 1 M NH4NO3 (actual solubility) and by BCR sequential extraction. The environmental risk was assessed based on total concentrations, according to legal regulations, geochemical enrichment indices and extractability of elements, with considering soil morphological features. Some topsoil samples from the inter-embankment zone turned out considerably enriched in Pb, Zn, Cu, and As, as confirmed by geochemical indices. Zn and As concentrations in some samples exceeded the permissible values defined by Polish law. Zn and Mn showed a high actual solubility, but a simple experiment proved that it can be efficiently reduced by liming. BCR fractionation showed that all the elements occurred mainly in reducible forms. Therefore, the risk of their release from the layers that do not indicate redoximorphic features was assessed as negligible. The study showed that such a complementary approach is needed to assess the real environmental risk in the case of soils considerably enriched in potentially toxic elements.

OBJECTIVE: The aim of this study was to compare a bicruciate-retaining (BCR) total knee arthroplasty (TKA) with a posterior cruciate-retaining (CR) TKA design in terms of kinematics, measured using fluoroscopy and stability as micromotion using radiostereometric analysis (RSA).
METHODS: A total of 40 patients with end-stage osteoarthritis were included in this randomized controlled trial. All patients performed a step-up and lunge task in front of a monoplane fluoroscope one year postoperatively. Femorotibial contact point (CP) locations were determined at every flexion angle and compared between the groups. RSA images were taken at baseline, six weeks, three, six, 12, and 24 months postoperatively. Clinical and functional outcomes were compared postoperatively for two years.
RESULTS: The BCR-TKA demonstrated a kinematic pattern comparable to the natural knee\'s screw-home mechanism in the step-up task. In the lunge task, the medial CP of the BCR-TKA was more anterior in the early flexion phase, while laterally the CP was more posterior during the entire movement cycle. The BCR-TKA group showed higher tibial migration. No differences were found for the clinical and functional outcomes.
CONCLUSIONS: The BCR-TKA shows a different kinematic pattern in early flexion/late extension compared to the CR-TKA. The difference between both implants is mostly visible in the flexion phase in which the anterior cruciate ligament is effective; however, both designs fail to fully replicate the motion of a natural knee. The higher migration of the BCR-TKA was concerning and highlights the importance of longer follow-up.Cite this article: Bone Joint J 2023;105-B(1):35-46.

This bicentric, retrospective analysis investigated the efficacy of PET/CT with a novel theranostic prostate-specific membrane antigen (PSMA)--targeting ligand, 18F-rhPSMA-7, in patients with biochemical recurrence (BCR) of prostate cancer after curative-intent primary radiotherapy. Methods: Datasets from patients with BCR of prostate cancer after external-beam radiation therapy or brachytherapy who underwent 18F-rhPSMA-7 PET/CT at either Technical University Munich or Ludwig-Maximilians-University Munich were retrospectively reviewed by experienced nuclear medicine physicians and radiologists at both centers. The median injected activity was 299 MBq (range, 204-420 MBq), and the median uptake time was 77 min (range, 46-120 min). All lesions suggestive of recurrent prostate cancer were noted. Detection rates were correlated with patients\' prostate-specific antigen (PSA) level, primary Gleason score, and prior use of androgen-deprivation therapy (ADT). Results: Ninety-seven patients were included (65 at Technical University Munich and 32 at Ludwig-Maximilians-University Munich). The median prescan PSA was 4.19 ng/mL (range, 0.1-159 ng/mL). The primary Gleason score was ≤6 in 19 patients, 7 in 25, ≥8 in 33, and unknown in 20. Thirty patients received ADT in the 6 mo preceding PET/CT. 18F-rhPSMA-7 identified lesions in 91 of 97 (94%) patients. Detection rates stratified by PSA were 88% (22/25), 97% (30/31), 90% (19/21), and 100% (20/20) for a PSA of <2, 2-<5, 5-<10, and ≥10 ng/mL, respectively. Detection rates in the subgroup of patients not meeting the Phoenix criteria for BCR were 80% (4/5), 90% (9/10), 100% (4/4), and 83% (5/6) for a PSA of <0.5, 0.5-<1, 1-<1.5, and 1.5-2 ng/mL, respectively. There were no significant differences in detection rates between patients with and without prior ADT (100% vs. 91%, P = 0.173) or patients with a Gleason score of ≤7 and a Gleason score of ≥8 (98% vs. 91%, P = 0.316).18F-rhPSMA-7 revealed local recurrence in 80% (78/97); pelvic lymph node metastases in 38% (37/97); retroperitoneal and supradiaphragmatic lymph node metastases in 9% (9/97) and 4% (4/97), respectively; bone metastases in 27% (26/97); and visceral metastases in 3% (3/97). In the subgroup of patients with a PSA of <2 ng/mL above nadir, local recurrence occurred in 76% (19/25) and pelvic lymph node metastases in 36% (9/25). Conclusion:18F-rhPSMA-7 PET/CT demonstrates high detection rates in prostate cancer patients with BCR after primary radiation therapy, even at low PSA values. Its diagnostic efficacy is comparable to published data for other PSMA ligands.

BACKGROUND: Bicruciate retaining (BCR) total knee arthroplasty (TKA) was designed to simulate natural knee kinematics and improve proprioception by retaining both the ACL and PCL. While the prospect of the design appears favorable to patients, previous designs have demonstrated modest survivorship rates compared to traditional designs. This study aims to report the early functional outcomes and implant survivorship of a novel BCR design.
METHODS: A multi-center, retrospective study was conducted identifying BCR TKA patients from 2016 to 2017. Patient demographics, quality outcomes, and post-operative complications were collected. A Kaplan-Meier analysis was used to evaluate revision-free survival.
RESULTS: One-hundred thirty-three patients with a mean follow-up time of 2.35 ± 0.25 years (range: 2.00-2.87 years) were identified. Patients receiving BCR TKA were, on average, 61.46 ± 9.27 years-old, obese (BMI = 31.80 ± 6.01 kg/m2), predominantly white (71.4%), and female (69.9%). The device was most often implanted using standard instruments (85.7%) compared to computer-assisted navigation (13.5%). Average length-of-stay was 1.77 ± 0.97 days. Six patients had a reoperation; three (2.5%) full revisions occurred for: infection (n = 1), arthrofibrosis (n = 1), and ACL rupture (n = 1); one (0.8%) tibial revision occurred for: arthrofibrosis; two (1.5%) liner exchanges occurred for: infection (n = 1) and arthrofibrosis (n = 1). Kaplan-Meier survivorship analysis of cumulative failure at 2-year showed a survival rate of 96.2% (95% confidence interval, 91.2-98.4%) for all-cause reoperation, 97.3% (91.6-99.1%) for aseptic revision, and 100% for mechanical failure.
CONCLUSIONS: Survivorship was 96.2% for all-cause reoperation, 97.3% for aseptic revision, and 100% for mechanical implant failure at 2-years. This novel BCR TKA demonstrated no implant-related complications and excellent survivorship outcomes over 2 years with comparable revision rates to those previously reported in the literature.

The optimization and validation of a methodology for determining and extracting inorganic ionic Te(VI) and Te(IV) forms in easily-leached fractions of soil by Ion Chromatography-Inductively Coupled Plasma-Mass Spectrometry (IC-ICP-MS) were studied. In this paper, the total concentration of Te, pH, and red-ox potential were determined. Ions were successfully separated in 4 min on a Hamilton PRPX100 column with 0.002 mg/kg and 0.004 mg/kg limits of detection for Te(VI) and Te(IV), respectively. Soil samples were collected from areas subjected to the influence of an electrowaste processing and sorting plant. Sequential chemical extraction of soils showed that tellurium was bound mainly with sulphides, organic matter, and silicates. Optimization of soil extraction allowed 20% average extraction efficiency to be obtained, using 100 mM citric acid as the extractant. In the tested soil samples, both tellurium species were present. In most cases, the soils contained a reduced Te form, or the concentrations of both species were similar.

Prostate-specific membrane antigen (PSMA) ligand PET induces management changes in patients with prostate cancer. We aim to better characterize the impact of 68Ga-PSMA-11 PET (68Ga-PSMA PET) on management of recurrent prostate cancer in a large prospective cohort. Methods: We report management changes after 68Ga-PSMA PET, a secondary endpoint of a prospective multicenter trial in men with biochemical recurrence of prostate cancer. Pre-PET (Q1), post-PET (Q2), and posttreatment (Q3) questionnaires were sent to referring physicians recording site of recurrence and intended (Q1 to Q2 change) and implemented (Q3) therapeutic and diagnostic management. Results: Q1 and Q2 response was collected for 382 of 635 patients (60%, intended cohort), and Q1, Q2, and Q3 response was collected for 206 patients (32%, implemented cohort). An intended management change occurred in 260 of 382 (68%) patients. The intended change was considered major in 176 of 382 (46%) patients. Major changes occurred most often for patients with prostate-specific antigen of 0.5 to less than 2.0 ng/mL (81/147, 55%). By analysis of stage groups, management change was consistent with PET disease location, that is, a majority of major changes toward active surveillance (47%) for unknown disease site (103/382, 27%), toward local or focal therapy (56%) for locoregional disease (126/382, 33%), and toward systemic therapy (69% M1a; 43% M1b/c) for metastatic disease (153/382, 40%). According to Q3 responses, the intended management was implemented in 160 of 206 (78%) patients. In total, 150 intended diagnostic tests, mostly CT (n = 43, 29%) and bone scans or 18F-NaF PET (n = 52, 35%), were prevented by 68Ga-PSMA PET; 73 tests, mostly biopsies (n = 44, 60%) as requested by the study protocol, were triggered. Conclusion: According to referring physicians, sites of recurrence were clarified by 68Ga-PSMA PET, and disease localization translated into management changes in more than half of patients with biochemical recurrence of prostate cancer.

The optimization of new methodology for simultaneous determination of arsenic [As(III), As(V)] and antimony [Sb(III), Sb(V), SbMe3] species using high-performance liquid chromatography (HPLC) coupled with inductively coupled plasma mass spectrometry (ICP-MS) in water and bottom sediment samples collected from the dam Kozłowa Góra Reservoir (Poland) was studied. Samples were collected monthly from May to September 2018 in four-point (water) and fifth-point (sediment) transects. The contents of Mn, Co, Ni, Cu, Zn, As, Cr, Rb, Sr, Cd, Sb, Ba, Tl, Pb, and Sb were studied in water and bottom sediments using ICP-MS techniques. Additionally, arsenic and antimony fractions were determined in sediments with the BCR method. Pollution Load Index (PLI), Geoaccumulation Index (Igeo), LAWA classification, and Sb/As ratio indicated the presence of extreme sediment pollution for Zn, Cd, Pb, and Cr from anthropogenic sources. Research has shown that the easy-leached bottom sediment fraction contained in most cases more As(V) and Sb(V). But often Sb(V) concentration was equal as Sb(III), which can be released into the pelagic zone under favorable conditions. Even though As(V) and Sb(V) prevail in the reservoir bottom sediments, they can be transformed into As(III) and Sb(III) as a result of drastic changes in pH or redox potential. The Kozłowa Góra sediments are heavily polluted with Pb, Zn, Cd, and As, Cu, and Ni. The highest concentrations of the heavy metals were recorded in the middle of the tank and there was a small spatial variability. The migration of metals along the reservoir transect was closely related to its morphometry.