• Book : ()
• Pub. Date : 2025
• Page : pp.101652-101652
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ABSTRACTBackgroundProstate cancer is an example of the undervaluation of clinical examinations in care of patients. After external radiotherapy, cancer recurrence is primarily determined biologically by measuring prostate‐specific antigen concentration. Consequently, there is no systematic requirement for the digital rectal examination (DRE). Nevertheless, research has shown that patients attach both practical and symbolic significance to being examined by their physicians. This study aimed to assess how patients perceive DRE omission after prostate cancer radiation therapy.Materials and MethodsWe conducted a survey of 107 men in remission after radiotherapy for prostate cancer in the Radiotherapy Oncology Department of Bordeaux University Hospital, France. The aim of the survey was to assess the significance that patients place on undergoing a DRE as part of their follow‐up care, both from a practical perspective (medical relevance) and a symbolic perspective (influence on the perception of the treating radiation oncologist).ResultsDespite receiving information on the lack of relevance of DRE during follow‐up, 40 of the 100 respondents still perceived a practical benefit of undergoing DRE (pragmatic dimension). On a symbolic level, many patients associated the performance of DRE by their radiotherapy oncologist with impressions of competence, concern for their health and concern for them personally (61%, 63% and 64%, respectively). Although the correlations between the pragmatic and symbolic dimensions were significant, more than one‐third of patients who understood the lack of clinical relevance of DRE still attributed symbolic value to it.ConclusionsA positive perception of DRE persists among patients, mainly at the symbolic level, including a proportion of patients who understand the low clinical utility of DRE. Importantly, the persistence of these perceptions regarding DRE should not be misconstrued as justification for performing pelvic examinations without clear clinical reasons.

• Book : 14(1)
• Pub. Date : 2025
• Page :
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• Book : ()
• Pub. Date : 2025
• Page :
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AbstractWomen now comprise over 50% of medical school graduates and over one‐third of practicing physicians in the United States. Despite this progress, significant barriers to career advancement and leadership persist, particularly in male‐dominated fields like urology and oncology. Women physicians are linked to improved patient outcomes and are critical to addressing the projected physician shortage, which is expected to be exaggerated in oncology specialties. This review highlights progress, challenges, and future directions for gender equity in urology, urologic oncology, and oncology subspecialties. Urology and urologic oncology have seen growth in female representation, whereas radiation oncology remains stagnant, and medical oncology has reached near gender parity among trainees. However, leadership roles across all these fields continue to reflect gender inequities. Key barriers include the gender pay gap, insufficient maternal leave policies, workplace harassment, and lack of mentorship and sponsorship for women physicians. Moving forward, efforts to advance gender equity must include transparent pay structures, supportive maternal leave, and robust antiharassment policies. Promoting women in leadership and fostering mentorship are also essential to retaining and advancing women in these fields. By addressing these issues, the health care community can progress toward gender equity, strengthen the physician workforce, and improve patient outcomes. Institutional and national advocacy is crucial for creating an equitable and effective medical community.

• Book : 131(1)
• Pub. Date : 2025
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Abstract Terrestrial exoplanets around M- and K-type stars are important targets for atmospheric characterization. Such planets are likely tidally locked with the order of spin–orbit resonances (SORs) depending on eccentricity. We explore the impact of SORs on 3D atmospheric dynamics and chemistry, employing a 3D coupled climate-chemistry model to simulate Proxima Centauri b in 1:1 and 3:2 SORs. For a 1:1 SOR, Proxima Centauri b is in the Rhines rotator circulation regime with dominant zonal gradients (global mean surface temperature 229 K). An eccentric 3:2 SOR warms Proxima Centauri b to 262 K with gradients in the meridional direction. We show how a complex interplay between stellar radiation, orbit, atmospheric circulation, and (photo)chemistry determines the 3D ozone distribution. Spatial variations in ozone column densities align with the temperature distribution and are driven by stratospheric circulation mechanisms. Proxima Centauri b in a 3:2 SOR demonstrates additional atmospheric variability, including daytime–nighttime cycles in water vapor of +55% to −34% and ozone (±5.2%) column densities and periastron–apastron water vapor cycles of +17% to −10%. Synthetic emission spectra for the spectral range of the Large Interferometer For Exoplanets fluctuate by up to 36 ppm with the orbital phase angle for a 1:1 SOR due to 3D spatial and temporal asymmetries. The homogeneous atmosphere for the 3:2 SOR results in relatively constant emission spectra and provides an observational discriminant from the 1:1 SOR. Our work emphasizes the importance of understanding the 3D nature of exoplanet atmospheres and associated spectral variations to determine habitability and interpret atmospheric spectra.

• Book : 6(1)
• Pub. Date : 2025
• Page : pp.5-5
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• Book : ()
• Pub. Date : 2025
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There is an argument that the Comprehensive Safeguards Agreement (CSA) should be applied to the milling process, which is the first stage of nuclear fuel cycle, to reduce the possibility of nuclear proliferation. Therefore, this study aims to propose new and conceptual safeguards applicable to milling facilities and design Nuclear Material Accountancy for its application. Mill tailings reach a secular equilibrium state. While approaching this equilibrium state, the ratio of each isotope changes. First, the Bateman equation was used to analyze this phenomenon and evaluate the feasibility of utilizing the specific isotope ratio to track undeclared nuclear activities.Second, the gamma spectrum analysis of mill tailings was conducted using the Monte Carlo N-Particle Code to validate undeclared nuclear activities. This study shows that the ratio of U-235/Th-234 and U-235/Pa-234m can estimate the production time within a year. Furthermore, gamma spectrum analysis of mill tailings revealed visible differences in the low-energy region due to the decay of Th-234. Finally, a conceptual Material Balance Area, Key Measurement Points, and Material Balance Period for milling facilities were designed to apply CSA. It is anticipated that applying CSA to milling facilities could enhance not only the nuclear fuel cycles but also nuclear non-proliferation system

• Book : 57(1)
• Pub. Date : 2025
• Page : pp.1-8
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• Book : ()
• Pub. Date : 2025
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AbstractObjectiveThis study investigates the impact of Titin (TTN) gene mutations on radiotherapy sensitivity in rectum adenocarcinoma (READ) by examining changes in the tumour immune microenvironment.MethodsData on gene expression and mutations in READ were obtained from The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) databases. Bioinformatics analysis explored the correlation between TTN mutations and immune cell infiltration. In vitro, lentiviral vectors were used to assess TTN mutations' effects on ANKRD1 expression in two READ cell lines. ANKRD1 was overexpressed, and clonogenic assays evaluated radiotherapy sensitivity. Flow cytometry, immunofluorescence, and comet assays examined mutations' impact on cell cycle, apoptosis, and DNA damage response (DDR). An in vivo mouse model and formalin‐fixed paraffin‐embedded samples from locally advanced rectal cancer (LARC) patients before and after radiotherapy were analyzed, followed by prognostic evaluation.ResultsBioinformatics revealed that TTN mutations increase radiation sensitivity in LARC by slowing cell proliferation, promoting apoptosis, and reducing DDR. TTN mutations also inhibit ANKRD1 expression via JUN disruption and enhance CD4/CD8 T‐cell infiltration, improving anti‐tumour immunity and outcomes. Observations from the clinical study showed a substantial decline in ANKRD1 expression levels alongside a notable surge in the counts of CD4+ and CD8+ T cells after undergoing radiotherapy. Patients with TTN mutations, low ANKRD1 expression, and high densities of CD4+ and CD8+ T cells had longer 3‐year disease‐free survival in READ.ConclusionOur findings reveal that TTN mutations can serve as biomarkers for enhanced radiotherapy sensitivity in READ. By altering the tumour's immune microenvironment, these mutations may provide a novel target for personalized radiotherapy strategies, potentially improving therapeutic outcomes in patients with READ.Highlights The association between TTN mutations and tumour mutation burden, as well as immune cell infiltration in READ, is examined. TTN mutations enhance the radiation sensitivity of READ cells and weaken DNA damage repair in response to radiation. TTN mutations increase the radiation sensitivity of READ cells by inhibiting ANKRD1. The infiltration of CD8+ and CD4+ T cells induced by TTN mutations is essential for anti‐tumour immunity. TTN mutations serve as a biomarker for the pathological response to preoperative radiotherapy in READ.

• Book : 15(1)
• Pub. Date : 2025
• Page :
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• Book : 51()
• Pub. Date : 2025
• Page : pp.100912-100912
• Keyword :