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Racially and ethnically minoritized populations have been historically excluded and underrepresented in research. This paper will describe best practices in multicultural and multilingual awareness-raising strategies used by the Recruitment Innovation Center to increase minoritized enrollment into clinical trials. The Passive Immunity Trial for Our Nation will be used as a primary example to highlight real-world application of these methods to raise awareness, engage community partners, and recruit diverse study participants.
Introduction
Urologists and pathologists have focused more and more on the anatomic structures of the human prostate gland and their relationship to prostate carcinoma development and prognosis since the resurgence of radical prostatectomy in the late 1980s. The accessibility of whole-mount slide preparation in the study of the prostate has greatly simplified this analysis.
This chapter concentrates on the anatomy of the prostate gland and analyzes how anatomic structures relate to the origin, development, and evolution of prostate carcinoma. The concept of zonal anatomy and its role in prostate carcinoma will also be described.
Anatomy and histology of the normal prostate gland
Embryology and development of the prostate gland
During the third month of gestation, the prostate gland develops from epithelial invaginations from the posterior urogenital sinus under the influence of the underlying mesenchyme [1]. The normal formation of the prostate gland requires the presence of 5α-dihydrotestosterone, which is synthesized from fetal testosterone by the action of 5α-reductase [2]. This enzyme is localized in the urogenital sinus and external genitalia of humans [3]. Consequently, deficiencies of 5α-reductase will cause a rudimentary or undetectable prostate in addition to severe abnormalities of the external genitalia, although the epididymides, vasa deferentia, and seminal vesicles remain normal [4].
During the prepubertal period, the constitution of the human prostate remains more or less identical but begins to undergo morphologic changes into the adult phenotype with the beginning of puberty.
In August–September 2004, a cryptosporidiosis outbreak affected >250 persons who visited a California waterpark. Employees and patrons of the waterpark were affected, and three employees and 16 patrons admitted to going into recreational water while ill with diarrhoea. The median illness onset date for waterpark employees was 8 days earlier than that for patrons. A case-control study determined that getting water in one's mouth on the waterpark's waterslides was associated with illness (adjusted odds ratio 7·4, 95% confidence interval 1·7–32·2). Laboratory studies identified Cryptosporidium oocysts in sand and backwash from the waterslides' filter, and environmental investigations uncovered inadequate water-quality record keeping and a design flaw in one of the filtration systems. Occurring more than a decade after the first reported outbreaks of cryptosporidiosis in swimming pools, this outbreak demonstrates that messages about healthy swimming practices have not been adopted by pool operators and the public.
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