185 research outputs found

    Second primary cancers after radiation for prostate cancer: A systematic review of the clinical data and impact of treatment technique

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    The development of a radiation induced second primary cancer (SPC) is one the most serious long term consequences of successful cancer treatment. This review aims to evaluate SPC in prostate cancer (PCa) patients treated with radiotherapy, and assess whether radiation technique influences SPC. A systematic review of the literature was performed to identify studies examining SPC in irradiated PCa patients. This identified 19 registry publications, 21 institutional series and 7 other studies. There is marked heterogeneity in published studies. An increased risk of radiation-induced SPC has been identified in several studies, particularly those with longer durations of follow-up. The risk of radiation-induced SPC appears small, in the range of 1 in 220 to 1 in 290 over all durations of follow-up, and may increase to 1 in 70 for patients followed up for more than 10 years, based on studies which include patients treated with older radiation techniques (i.e. non-conformal, large field). To date there are insufficient clinical data to draw firm conclusions about the impact of more modern techniques such as IMRT and brachytherapy on SPC risk, although limited evidence is encouraging. In conclusion, despite heterogeneity between studies, an increased risk of SPC following radiation for PCa has been identified in several studies, and this risk appears to increase over time. This must be borne in mind when considering which patients to irradiate and which techniques to employ

    Simultaneous segmentation and grading of anatomical structures for patient's classification: application to Alzheimer's Disease

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    Data used in the preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (www.loni.ucla.edu/ADNI).In this paper, we propose an innovative approach to robustly and accurately detect Alzheimer's disease (AD) based on the distinction of specific atrophic patterns of anatomical structures such as hippocampus (HC) and entorhinal cortex (EC). The proposed method simultaneously performs segmentation and grading of structures to efficiently capture the anatomical alterations caused by AD. Known as SNIPE (Scoring by Non-local Image Patch Estimator), the novel proposed grading measure is based on a nonlocal patch-based frame-work and estimates the similarity of the patch surrounding the voxel under study with all the patches present in different training populations. In this study, the training library was composed of two populations: 50 cognitively normal subjects (CN) and 50 patients with AD, randomly selected from the ADNI database. During our experiments, the classification accuracy of patients (CN vs. AD) using several biomarkers was compared: HC and EC volumes, the grade of these structures and finally the combination of their volume and their grade. Tests were completed in a leave-one-out framework using discriminant analysis. First, we showed that biomarkers based on HC provide better classification accuracy than biomarkers based on EC. Second, we demonstrated that structure grading is a more powerful measure than structure volume to distinguish both populations with a classification accuracy of 90%. Finally, by adding the ages of subjects in order to better separate age-related structural changes from disease-related anatomical alterations, SNIPE obtained a classification accuracy of 93%Data collection and sharing for this project were funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904). ADNI is funded by the National Insti- tute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: Abbott, AstraZeneca AB, Bayer Schering Pharma AG, Bristol-Myers Squibb, Eisai Global Clinical Development, Elan Corporation, Genentech, GE Healthcare, GlaxoSmithKline, Innogenetics, Johnson and Johnson, Eli Lilly and Co., Medpace, Inc., Merck and Co., Inc., Novartis AG, Pfizer Inc, F. Hoffman-La Roche, Schering-Plough, Synarc, Inc., as well as non-profit partners the Alzheimer's Association and Alzheimer's Drug Discovery Foundation, with participation from the U.S. Food and Drug Administration. Private sector contributions to ADNI are facilitated by the Foundation for the National Institutes of Health (www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Disease Cooperative Study at the University of California, San Diego. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of California, Los Angeles. This research was also supported by NIH grants P30AG010129, K01 AG030514, and the Dana Foundation.Coupé, P.; Eskildsen, SF.; Manjón Herrera, JV.; Fonov, VS.; Collins, DL.; Alzheimer's Dis Neuroimaging (2012). Simultaneous segmentation and grading of anatomical structures for patient's classification: application to Alzheimer's Disease. NeuroImage. 59(4):3736-3747. https://doi.org/10.1016/j.neuroimage.2011.10.080S3736374759

    Standardised Outcomes in Nephrology-Polycystic Kidney Disease (SONG-PKD): study protocol for establishing a core outcome set in polycystic kidney disease

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    BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common potentially life threatening inherited kidney disease and is responsible for 5-10% of cases of end-stage kidney disease (ESKD). Cystic kidneys may enlarge up to 20 times the weight of a normal kidney due to the growth of renal cysts, and patients with ADPKD have an increased risk of morbidity, premature mortality, and other life-time complications including renal and hepatic cyst and urinary tract infection, intracranial aneurysm, diverticulosis, and kidney pain which impair quality of life. Despite some therapeutic advances and the growing number of clinical trials in ADPKD, the outcomes that are relevant to patients and clinicians, such as symptoms and quality of life, are infrequently and inconsistently reported. This potentially limits the contribution of trials to inform evidence-based decision-making. The Standardised Outcomes in Nephrology-Polycystic Kidney Disease (SONG-PKD) project aims to establish a consensus-based set of core outcomes for trials in PKD (with an initial focus on ADPKD but inclusive of all stages) that patients and health professionals identify as critically important. METHODS: The five phases of SONG-PKD are: a systematic review to identify outcomes that have been reported in existing PKD trials; focus groups with nominal group technique with patients and caregivers to identify, rank, and describe reasons for their choices; qualitative stakeholder interviews with health professionals to elicit individual values and perspectives on outcomes for trials involving patients with PKD; an international three-round Delphi survey with all stakeholder groups (including patients, caregivers, healthcare providers, policy makers, researchers, and industry) to gain consensus on critically important core outcome domains; and a consensus workshop to review and establish a set of core outcome domains and measures for trials in PKD. DISCUSSION: The SONG-PKD core outcome set is aimed at improving the consistency and completeness of outcome reporting across ADPKD trials, leading to improvements in the reliability and relevance of trial-based evidence to inform decisions about treatment and ultimately improve the care and outcomes for people with ADPKD

    Group communication and the transformation of judgments: an impossibility result

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    While a large social-choice-theoretic literature discusses the aggregation of individual judgments into collective ones, there is much less formal work on the transformation of judgments in group communication. I develop a model of judgment transformation and prove a baseline impossibility theorem: Any judgment transformation function satisfying some initially plausible conditions is the identity function, under which no opinion change occurs. I identify escape routes from this impossibility and argue that the kind of group communication envisaged by deliberative democrats must be 'holistic': It must focus on webs of connected propositions, not on one proposition at a time, which echoes the Duhem-Quine 'holism thesis' on scientific theory testing. My approach provides a map of the logical space in which different possible group communication processes are located

    The impact of a selective entry examination on children's feelings as they approach the transition to secondary school

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    In the current study we examined how different experiences of a secondary school selective entry examination influenced children’s feelings about themselves, school, and intelligence as they approached transition. Children were recruited from three English schools that use a selective entry examination to stream students into secondary schools based on ability (98 children aged around 10) and were assessed at two time points. At Time 1 children had recently decided whether to take the exam, and at Time 2 children had received their exam results. At each time children completed measures of theory of intelligence, locus of control, self-esteem, and feelings about the school system. At Time 1, children who intended to take the exam showed more positive outcomes than those who did not. However, they were also more likely to hold a fixed view of intelligence, which has been associated with longer-term negative outcomes. Similarly at Time 2 children who had passed the exam showed more positive outcomes than those who had failed or had not taken the exam, but again they were more likely to hold a potentially maladaptive fixed view of intelligence. Those who failed the exam were indistinguishable from those who had not taken the exam. These results suggest that passing the selective exam can lead to positive outcomes for children, except in terms of their view of intelligence. However, failing and not being given the opportunity to sit the exam leads to consistently negative outcomes. The potential implications of these results are discussed

    The genetic architecture of the human cerebral cortex

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    The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

    Neighborhoods and health

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    Features of neighborhoods or residential environments may affect health and contribute to social and race/ethnic inequalities in health. The study of neighborhood health effects has grown exponentially over the past 15 years. This chapter summarizes key work in this area with a particular focus on chronic disease outcomes (specifically obesity and related risk factors) and mental health (specifically depression and depressive symptoms). Empirical work is classified into two main eras: studies that use census proxies and studies that directly measure neighborhood attributes using a variety of approaches. Key conceptual and methodological challenges in studying neighborhood health effects are reviewed. Existing gaps in knowledge and promising new directions in the field are highlighted.http://deepblue.lib.umich.edu/bitstream/2027.42/78378/1/DiezRouxMair2010_AnnNYAcadSci.pd

    The relationship between racial attitudes and social-cognitive development in children: An Australian study

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    Positive and negative racial attitudes of 122 Euro-Australian children (60 girls and 62 boys) toward Euro-, Asian, and Aboriginal Australians were examined across the 5–6-, 7–9-, and 10–12-year age groups. Children were more positive toward Euro- and Asian Australians than toward Aborigines. The middle group were less negative toward Aborigines than were the older and younger groups. Greater maturity in the ability to reconcile different racial perspectives and to perceive between-race similarity was moderately related to greater racial tolerance. Although the results support the role of cognition in age-related changes in prejudice between ages 5 to 9, found by A. B. Doyle and F. E. Aboud (see record 1995-28726-001) in Canadian children, the differences in attitudes to the 2 other groups and the finding that older children's negativity did not differ from that of the youngest group suggest the influence of environmental in addition to cognitive factors in the development of prejudice
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