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Several previous studies on YouTubeTMinformation on medical topics have already been published. The current study aimed to evaluate the quality information of YouTubeTMvideos on Phosphodiesterase 5 inhibitors (PDE5-is). A systematic search on YouTube™ was conducted using 30 keyword combinations. For each keyword’s combination, the first 50 videos were recorded. The quality of videos on YouTube™ was assessed with Patient Education Materials Assessment Tool for audio‐visual content (PEMAT A/V), DISCERN score and a specified created Misinformation tool. According to the selection criteria, 229 YouTube™ videos were suitable for the analyses. Videos were stratified according to the five main identified topics: sildenafil [n= 98; 42.79%] vs tadalafil [n= 50; 21.83%] vs vardenafil [n= 44;19.21%] vs avanafil [n= 17; 7.42%] vs PDE5-is in general [n= 20; 8.73%]. The median overall PEMAT A/V Understandability score and Actionability score were 55% (interquartile range [IQR]: 42–75) and 0% (IQR = 0–67), respectively. Specifically, according to our stratification, YouTube Videos on avanafil reached higher values of both Understandability and Actionability (72.7% and 66.7, respectively) in contrast to other categories. According to DISCERN tool, the total overall median score was 29.5 (IQR = 18–41). According to Misinformation scale, the item 1 (‘sexual stimulation’) harboured an overall median score of 2 (IQR = 1–2); the item 2 (‘side effects’) an overall median score of 2 (IQR = 1–3); the item 3 (‘treatment choices’) an overall median score of 1 (IQR = 1–2); the item 4 (‘contraindications’) an overall median score of 2 (IQR = 1–2). YouTube™ is a fast and open-access source for mass information. The overall quality of the PDE5-is contents provided is sadly unsatisfactory. Nowadays, YouTube™ cannot be recommended as a reliable source of information on PDE5-is.

Introduction: It is unknown whether race/ethnicity affects access and/or survival after neoadjuvant (NAC) or adjuvant chemotherapy (ADJ) at radical cystectomy (RC). We addressed these knowledge gaps. Material and Methods: Within the Surveillance, Epidemiology, and End Results database (2007–2020), we identified NAC candidates (T2-T4N0M0) and ADJ candidates (T3-T4 and/or N1-3). We focused on the four most prevalent race/ethnicities: Caucasians, Hispanics, African American (AA), and Asian/Pacific Islanders (API). Multivariable logistic regression models (MLR) tested access to NAC and ADJ. Subsequently, within NAC-exposed patients, survival analyses consisting of Kaplan–Meier plots and multivariable Cox regression models addressed CSM according to race/ethnicity were fitted. We repeated the same methodology in ADJ-exposed patients. Results: In 6418 NAC candidates, NAC was administered in 1011 (19.0%) Caucasians, 88 (21.0%) Hispanics, 65 (17.0%) AA, and 53 (18.0%) API. In MLR, AA exhibited lower access rates to NAC (OR 0.83, p= 0.04). In NAC-exposed patients, AA independently predicted higher CSM (HR 1.3, p< 0.001) and API independently predicted lower CSM (HR 0.83, p= 0.03). Similarly, in 5195 ADJ candidates, ADJ was administered to 1387 (33.0%) Caucasians, 100 (28.0%) Hispanics, 105 (29.0%) AA, and 90 (37.0%) API. In MLR, AA (OR 68, p= 0.003) and Hispanics (OR 0.69, p= 0.004) exhibited lower access rates to ADJ. In ADJ-exposed patients, AA independently predicted lower CSM (HR 1.32, p< 0.001), while API showed better CSM (HR 0.82, p= 0.01). Conclusion: Relative to Caucasians, AA are less likely to receive either NAC or ADJ. Moreover, relative to Caucasians, AA exhibit higher CSM even when treated with either NAC or ADJ.

Background: To assess cancer-specific mortality (CSM) and other-cause mortality (OCM) rates in patients with rare histological prostate cancer subtypes. Methods: Using the Surveillance, Epidemiology, and End Results database (2004–2020), we applied smoothed cumulative incidence plots and competing risks regression (CRR) models. Results: Of 827,549 patients, 1510 (0.18%) harbored ductal, 952 (0.12%) neuroendocrine, 462 (0.06%) mucinous, and 95 (0.01%) signet ring cell carcinoma. In the localized stage, five-year CSM vs. OCM rates ranged from 2 vs. 10% in acinar and 3 vs. 8% in mucinous, to 55 vs. 19% in neuroendocrine carcinoma patients. In the locally advanced stage, five-year CSM vs. OCM rates ranged from 5 vs. 6% in acinar, to 14 vs. 16% in ductal, and to 71 vs. 15% in neuroendocrine carcinoma patients. In the metastatic stage, five-year CSM vs. OCM rates ranged from 49 vs. 15% in signet ring cell and 56 vs. 16% in mucinous, to 63 vs. 9% in ductal and 85 vs. 12% in neuroendocrine carcinoma. In multivariable CRR, localized neuroendocrine (HR 3.09), locally advanced neuroendocrine (HR 9.66), locally advanced ductal (HR 2.26), and finally metastatic neuroendocrine carcinoma patients (HR 3.57; all p< 0.001) exhibited higher CSM rates relative to acinar adenocarcinoma patients. Conclusions: Compared to acinar adenocarcinoma, patients with neuroendocrine carcinoma of all stages and locally advanced ductal carcinoma exhibit higher CSM rates. Conversely, CSM rates of mucinous and signet ring cell adenocarcinoma do not differ from those of acinar adenocarcinoma.

Introduction: Trimodal therapy (TMT) is the most validated bladder-sparing treatment for organ-confined urothelial carcinoma of the urinary bladder (OC UCUB, namely cT2N0M0). However, it is unknown if barriers to the use of TMT or cancer-specific mortality (CSM) differences exist according to race/ethnicity. We addressed this knowledge gap. Material and methods: Within the Surveillance, Epidemiology, and End Results database (2004–2020), we identified OC UCUB patients aged from 18 to 85 treated with radical cystectomy (RC) or TMT. Temporal trends described TMT versus RC use over time. Subsequently, in the subgroup of TMT-treated patients, survival analyses consisting of Kaplan–Meier plots and multivariable Cox regression (MCR) models addressed CSM according to race/ethnicity. Results: Among 19,501 assessable patients, 15,336 (79%) underwent RC versus 4165 TMT (21%). Overall, of all races/ethnicities, 16,245 (83.3%) were White Americans, 1215 (6.3%) Hispanics, 1160 (5.9%) African Americans, and 881 (4.5%) Asian/Pacific Islanders. Among TMT-treated patients, 3460 (83.1%) were White Americans, 298 (7.1%) African Americans, 218 (5.3%) Hispanics, and 189 (4.5%) Asian/Pacific Islanders. The lowest rate of TMT use relative to RC and TMT patients was recorded in Hispanics (17.9%). Over time, TMT use increased in White Americans (EAPC: + 4.5%, p= 0.001) and Asians/Pacific Islanders (EAPC: + 5.2%, p= 0.003), but not in others. Kaplan–Meier analyses showed median CSM of 49 months, 41 months, and 34 months and not reached in White Americans, Hispanics, African Americans, and Asian/Pacific Islanders, respectively (p= 0.02). In MCR models, two race/ethnicity subgroups independently predicted either worse (African Americans, HR: 1.20, p= 0.02) or better CSM (Asian/Pacific Islanders, HR: 0.75, p= 0.02). Conclusion: Race/ethnicity affects both access to TMT (lower access in Hispanics) as well as survival after TMT (better in Asians/Pacific Islanders and worse in African Americans).

What is new?•In metastatic urothelial carcinoma of the urinary bladder, unmarried status invariably predicts lower rates of guideline-recommended systemic therapy in unmarried males and females.•From a clinical perspective, this observation suggests that unmarried individuals with muscle-invasive urothelial carcinoma of the urinary bladder may face barriers to accessing guideline-recommended therapy.•These findings emphasize the importance of considering social factors such as married status and the need for tailored approaches to treatment access and in both male and female patients with metastatic urothelial carcinoma of the urinary bladder.

Administration of chemotherapy before radical cystectomy (RC) in neoadjuvant setting (NAC) or after RC in adjuvant setting (ADJ) are both associated with a survival benefit relative to RC alone. However, no study directly compared the magnitude of such benefit associated with NAC versus ADJ in locally-advanced UCUB patients (T3-T4N0M0). We addressed this knowledge gap.

Unmarried status has been associated with higher proportions of locally advanced stage and lower treatment dose intensification rates in several urological and non-urological malignancies. However, no previous investigators focused on the association between unmarried status and advanced stage (T3-4N0-2) at presentation and lower nephroureterectomy (RNU) and systemic therapy (ST) rates in non-metastatic upper tract urothelial carcinoma (UTUC) patients.

Trimodal therapy (TMT) is guideline-recommended for the management of organ confined urothelial carcinoma of urinary bladder (UCUB). However, temporal trends in TMT use and cancer-specific mortality free-survival (CSM-FS) between historical TMT vs. contemporary TMT have not been assessed. We addressed this knowledge gap.

To test the association between number as well as locations of organ-specific metastatic sites and overall survival (OS) in systhemic-therapy exposed metastatic urothelial carcinoma of urinary bladder (mUCUB) patients.

AbstractLow temperature is considered the main limiting factor for plant growth and nutrient supply at high elevations. It has been repeatedly reported that an increase in foliar nutrient contents occurs with elevation which is interpreted as the plants’ inability to use the absorbed resources for growth. However, although large data sets from various mountainous regions are available, data from elevations exceeding 5000 m elevation are rare, leaving uncertainties on the relevance of these patterns under extreme alpine conditions. To fill this gap, we examined foliar macronutrients (N, P, K, Ca, Mg) content in Poa attenuataand Waldheimia tridactylitesalong an elevation gradient of 1600 m in Ladakh, northwestern Himalaya. Species showed rather similar response: N, Ca, and Mg concentration decreased with elevation. However, P concentration decreased with elevation in Poabut slightly increased in Waldheimia; K concentration was related to elevation in Poaonly (positively). The surprising decreases of N, and/or N/P and N/K ratios towards higher elevation suggest that nitrogen uptake decreased with elevation and it may limit plant growth. Our results suggest that plants growing at very high elevations tend to be limited by a combination of lower nutrient uptake, possibly because of poorly developed soils, and scarcity of water.

The problem of estimating the thermal state of an induction cooking system is analyzed. The first step is to model the thermal system composed by the cooktop, the pot, and the pot content. Then, by relying on the formulated model, the aim is to design a suitable state observer, so that an estimation of the temperature of the cooking vessel content can be made online. Two kinds of observers are proposed. An Extended Kalman Filter (EKF) and a Sliding Mode Observer (SMO). A comparison of the performances which can be obtained with these two solutions is then made by relying on experimental results obtained on a real induction cooktop heating a pot containing a certain quantity of water.

Multidimensional efficiency maps are commonly used in high-energy physics experiments to mitigate the limitations in the generation of large samples of simulated events. Binned efficiency maps are however strongly limited by statistics. We propose a neural network approach to learn ratios of local densities to estimate in an optimal fashion efficiencies as a function of a set of parameters. Graph neural network techniques are used to account for the high dimensional correlations between different physics objects in the event. We show in a specific toy model how this method is applicable to produce accurate multidimensional efficiency maps for heavy-flavor tagging classifiers in HEP experiments, including for processes on which it was not trained.