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Objective: To investigate the clinical efficacy of cytoreductive surgery in oligometastatic hormone-sensitive prostate cancer (omHSPC). Methods: The basic characteristics, treatment strategies and long-term follow-up of 181 patients with omHSPC were retrospectively analyzed. All patients were divided into cytoreductive surgery group and no local therapy group according to the administration of cytoreductive surgery before progression to metastatic castration-resistant prostate cancer (mCRPC). Subsequently, our study explored the effect of cytoreductive surgery on CRPC-free survival in omHSPC patients. Results: A total of 181 patients were enrolled in the study, including 48 patients who received cytoreductive surgery and 133 patients who did not receive local therapy. No significant differences were detected between the two groups regarding prostate-specific antigen (PSA) at the initial diagnosis (P = 0.194), the International Society of Urological Pathology (ISUP) grade group (P = 0.158), the treatment options during omHSPC (P = 0.090), common comorbidities (P = 0.649) and the number of metastases (P = 0.291). The proportions of patients with Tx stage (P = 0.027) and Nx stage (P = 0.027) in the no local therapy group were significantly higher than that in the cytoreductive group. After propensity score matching (PSM), it was found that cytoreductive surgery could significantly improve the CRPC-free survival of omHSPC patients (hazard ratio (HR) = 0.537, 95% confidence interval (CI) = 0.317–0.909, P = 0.016). Conclusion: Cytoreductive surgery can significantly improve the CRPC-free survival of omHSPC patients. Additionally, large sample-size, prospective and randomized controlled studies are needed to validate the results of our study in the future. [ABSTRACT FROM AUTHOR]

Rock mass discontinuities are an excellent information set for reflecting the geometric, spatial, and physical properties of the rock mass. Using clustering algorithms to analyze them is a significant way to select advantageous orientations of structural surfaces and provide a scientific theoretical basis for other rock mass engineering research. Traditional clustering algorithms often suffer from sensitivity to initialization and lack practical applicability, as discontinuity data are typically rough, low-precision, and unlabeled. Confronting these challenges, II-LA-KM, a learning-augmented clustering algorithm with improved initialization for rock discontinuity grouping, is proposed. Our method begins with heuristically selecting initial centers to ensure they are well-separated. Then, optimal transport is used to adjust these centers, minimizing the transport cost between them and other points. To enhance fault tolerance, a learning-augmented algorithm is integrated that iteratively reduces clustering costs, refining the initial results toward optimal clustering. Extensive experiments on a simulated artificial dataset and a real dataset from Woxi, Hunan, China, featuring both orientational and non-orientational attributes, demonstrate the effectiveness of II-LA-KM. The algorithm achieves a 97.5% accuracy on the artificial dataset and successfully differentiates between overlapping groups. Its performance is even more pronounced on the real dataset, underscoring its robustness for handling complex and noisy data. These strengths make our approach highly beneficial for practical rock discontinuity grouping applications. [ABSTRACT FROM AUTHOR]

The issue of uncertain roll angle and large angle of attack during the initial stage of launch has a significant impact on the initial attitude and control of canard‐controlled missiles. In this study, canard‐controlled missiles are employed to study the influence of multivortex structure present in the head under different roll angles at high angles of attack. The turbulence model was verified and used for simulation. The evolution of the multivortex structures behind the canard and their impact on the flow field and lateral force was investigated. The results show that the multivortex structure at the head forms a flow field structure dominated by two main vortices through vortices merging. When the geometry is symmetric, the symmetric vortices maintain a long symmetry region on the flow field, and the "X" shape shows higher flow field stability than the "+" shape. The asymmetric geometric structure produces two asymmetric main vortices, causing alternating steady separation and shedding of downstream vortices. This leads to alternating pressure fluctuations on the surface of the body, which are reflected in the lateral force through the integration of the pressure along the lateral direction. In contrast to the alternating shedding of separation vortices observed in a wingless configuration due to natural asymmetry, the asymmetrical main vortices induced by the asymmetry of canard cause alternant vortex shedding to occur earlier. With the increase of the angle of attack, the pressure difference of the head gradually dominated the lateral force, resulting in a drastic decrease in the lateral force coefficient. [ABSTRACT FROM AUTHOR]