Determinants of active surveillance uptake in a diverse population-based cohort of men with low-risk prostate cancer: The Treatment Options in Prostate Cancer Study (TOPCS).

BACKGROUND: Active surveillance (AS) is the preferred strategy for low-risk prostate cancer (LRPC); however, limited data on determinants of AS adoption exist, particularly among Black men. METHODS: Black and White newly diagnosed (from January 2014 through June 2017) patients with LRPC ≤75 years of age were identified through metro-Detroit and Georgia population-based cancer registries and completed a survey evaluating factors influencing AS uptake. RESULTS: Among 1688 study participants, 57% chose AS (51% of Black participants, 61% of White) over definitive treatment. In the unadjusted analysis, patient factors associated with initial AS uptake included older age, White race, and higher education. However, after adjusting for covariates, none of these factors was significant predictors of AS uptake. The strongest determinant of AS uptake was the AS recommendation by a urologist (adjusted prevalence ratio, 6.59, 95% CI, 4.84-8.97). Other factors associated with the decision to undergo AS included a shared patient-physician treatment decision, greater prostate cancer knowledge, and residence in metro-Detroit compared with Georgia. Conversely, men whose decision was strongly influenced by the desire to achieve "cure" or "live longer" with treatment and those who perceived their LRPC diagnosis as more serious were less likely to choose AS. CONCLUSIONS: In this contemporary sample, the majority of patients with newly diagnosed LRPC chose AS. Although the input from their urologists was highly influential, several patient decisional and psychological factors were independently associated with AS uptake. These data shed new light on potentially modifiable factors that can help further increase AS uptake among patients with LRPC.

The Efficiency of Evaluating Candidates for Living Kidney Donation: A Scoping Review.

INTRODUCTION: The process of evaluating candidates for living kidney donation can be inefficient. A structured review of existing information on this topic can provide a necessary foundation for quality improvement. METHODS: We conducted a scoping review to map the published literature to different themes related to an efficient donor candidate evaluation. We reviewed the websites of living donor programs to describe information provided to candidates about the nature and length of the evaluation process. RESULTS: We reviewed of 273 published articles and 296 websites. Surveys of living donor programs show variability in donor evaluation protocols. Computed tomography (a routinely done test for all successful candidates) may be used to assess split renal volume instead of nuclear renography when the 2 kidneys differ in size. Depending on the candidate's estimated glomerular filtration rate, a nuclear medicine scan for measured glomerular filtration rate may not be needed. When reported, the time to complete the evaluation varied from 3 months to over a year. The potential for undesirable outcomes was reported in 23 studies, including missed opportunities for living donation and/or preemptive transplants. According to living donor websites, programs generally evaluate 1 candidate at a time when multiple come forward for assessment, and few programs describe completing most of the evaluation in a single in-person visit. CONCLUSIONS: Data on the efficiency of the living donor evaluation are limited. Future efforts can better define, collect, and report indicators of an efficient living donor evaluation to promote quality improvement and better patient outcomes.

A novel tungsten trioxide (WO3)/ITO porous nanocomposite for enhanced photo-catalytic water splitting.

Hybrid nanocomposite films of ITO-coated, self-assembled porous nanostructures of tungsten trioxide (WO(3)) were fabricated using electrochemical anodization and sputtering. The morphology and chemical nature of the porous nanostructures were studied by Scanning Electron Microscopy (SEM) and X-ray Photoelectron Spectroscopy (XPS), respectively. The photoelectrochemical (PEC) properties of WO(3) porous nanostructures were studied in various alkaline electrolytes and compared with those of titania nanotubes. A new type of alkaline electrolyte containing a mixture of NaOH and KOH was proposed for the first time to the best of our knowledge and shown to improve the photocurrent response of the photoanodes. Here, we show that both the WO(3) nanostructures and titania nanotubes (used for comparison) exhibit superior photocurrent response in the mixture of NaOH and KOH than in other alkaline electrolytes. The WO(3) porous nanostructures suffered from surface corrosion resulting in a huge reduction in the photocurrent density as a function of time in the alkaline electrolytes. However, with a protective coating of ITO (100 nm), the surface corrosion of WO(3) porous nanostructures reduced drastically. A tremendous increase in the photocurrent density of as much as 340% was observed after the ITO was applied to the WO(3) porous nanostructures. The results suggest that the hybrid ITO/WO(3) nanocomposites could be potentially coupled with titania nanotubes in a multi-junction PEC cell to expand the light absorption capability in the solar spectrum for water splitting to generate hydrogen.

Controlled growth of self-organized hexagonal arrays of metallic nanorods using template-assisted glancing angle deposition for superhydrophobic applications.

The fabrication of controlled, self-organized, highly ordered tungsten and aluminum nanorods was accomplished via the aluminum lattice template-assisted glancing angle sputtering technique. The typical growth mechanism of traditional glancing angle deposition technique was biased by self-organized aluminum lattice seeds resulting in superior quality nanorods in terms of size control, distribution, and long range order. The morphology, size, and distribution of the nanorods were highly controlled by the characteristics of the template seeds indicating the ability to obtain metallic nanorods with tunable distributions and morphologies that can be grown to suit a particular application. Water wettability of hexagonally arranged tungsten and aluminum nanorods was studied after modifying their surface with 5 nm of Teflon AF 2400, as an example, to exhibit the significance of such a controlled growth of metallic nanorods. This facile and scalable approach to generate nano seeds to guide GLAD, with nano seeds fabricated by anodic oxidization of aluminum followed by chemical etching, for the growth of highly ordered nanorods could have significant impact in a wide range of applications such as anti-icing coating, sensors, super capacitors, and solar cells.

Design and fabrication of teflon-coated tungsten nanorods for tunable hydrophobicity.

The nature of water interaction with tungsten nanorods (WNRs) fabricated by the glancing-angle deposition technique (GLAD)-using RF magnetron sputtering under various Ar pressures and substrate tilting angles and then subsequent coating with Teflon-has been studied and reported. Such nanostructured surfaces have shown strong water repellency properties with apparent water contact angles (AWCA) of as high as 160°, which were found to depend strongly upon the fabrication conditions. Variations in Ar pressure and the substrate tilting angle resulted in the generation of WNRs with different surface roughness and porosity properties. A theoretical model has been proposed to predict the observed high AWCAs measured at the nanostructure interfaces. The unique pyramidal tip geometry of WNRs generated at low Ar pressure with a high oblique angle reduced the solid fraction at the water interface, explaining the high AWCA measured on such surfaces. It was also found that the top geometrical morphologies controlling the total solid fraction of the WNRs are dependent upon and controlled by both the Ar pressure and substrate tilting angle. The water repellency of the tungsten nanorods with contact angles as high as 160° suggests that these coatings have enormous potential for robust superhydrophobic and anti-icing applications in harsh environments.