Value of systematic sampling in an mp-MRI targeted prostate biopsy strategy

The clinical utility of systematic prostate biopsy in addition to multi-parametric magnetic resonance imagining (mp-MRI) targeted biopsy pathways remains unclear. Despite radiological advancements in mp-MRI and utilisation of international standardised reporting systems (i.e., PI-RADS, LIKERT), undetected clinically significant prostate cancer (csPCa) on imaging persists. This has prevented the widespread adoption of an exclusively targeted biopsy approach. The current evidence on csPCa cancer detection rates in mp-MRI targeted alone and combined with a non-targeted systematic sampling is presented. Arguments for and against routine limited systematic sampling as an adjunct to an mp-MRI targeted biopsy are discussed. Our review will report the clinical utility of a combined sampling strategy on csPCa detection rate. The available evidence suggests that we are yet to reach a stage where non-targeted systematic prostate biopsy can be routinely omitted in mp-MRI targeted prostate biopsy pathways. Research should focus on improving the accuracy of mp-MRI, prostate biopsy techniques, and in identifying those men that will most benefit from a combined prostate biopsy. Such strategies may help future urologists reduce the burden of non-targeted cores in modern mp-MRI prostate biopsy pathways

An Intercultural Study in Health Literacy and Adherence among Patients with Diabetes

poster abstractHealth Literacy is believed to play an essential role in the ability of individuals to effectively manage their own health care. A report by the Institute of Medicine acknowledges that 90 million Americans with low literacy probably also have low health literacy, and that even individuals with adequate health literacy face challenges in the complex demands of health care contexts. This poster presents results of a 3-year study of an interdisciplinary project on health literacy and adherence at the Indiana Center for Intercultural Communication (ICIC) funded by the Eli Lilly & Co. Foundation. The purpose was to examine multiple dimensions of health literacy, based on patients’ perspectives (van Dulmen et al., 2008), with the goal of creating a new conceptualization and way of assessing health literacy in its broader sense that includes processing and acting on information in order to integrate those findings into interventions to improve health regimen adherence. Taking critical studies into account, we developed a model to identify the most important variables of adherence (Nutbeam, D., 2000; Levin-Zamir, D. and Peterburg, Y., 2001; Von Wagner, C., Steptoe, A., Wolf, M., and Wardle, J., 2008). The data consisted of video-taped interviews with 43 English-speakers and 21 Spanish-speakers, all of whom have diabetes. The interviews involved open-ended questions that elicited information about living with diabetes as well as questions on health beliefs, medication adherence, information sources and uses, literacy level and basic demographic information. These narratives were analyzed using grounded theory methodology of the patients’ own words. The quantitative data were analyzed using a multivariate analysis as well as an ordered probit analysis (Connor, U., et al., 2008, 2009, 2010; Lauten, K., et al., 2009, 2010; Lopez-Yunez, A., et al., 2009; Matthias, M.S. & Goering, E., 2008; Rozycki, W. & Connor, U., 2008; Wolf, M.S., et al, 2007). The model that ICIC has built provides practical interventions for patient-centered care. This poster presents examples of linguistic cues and phrases from the interviews, the results of the intercultural comparisons between which information sources were used in the English-speaking and Spanish-speaking subgroups, and the resultant model. Implications are discussed in terms of enhancing the patient-centered tailoring of health information and communication.

Assessing L2 Argumentation in the UAE Context

In this rapidly changing world, argumentation and critical thinking skills are undeniably crucial for new generations of Emirati students. These skills lay the groundwork for a competitive economy, which is a priority for the UAE in its Vision 2021. Specifically, today’s modern workplaces require workers to evaluate different propositions and develop their own after weighing up these various ideas, and thus the ability to defend arguments in English has become increasingly important for UAE university students in English-medium universities as well as their future professional contexts. Despite this importance, research regarding argumentation and the related critical thinking skills is sorely lacking in the UAE. This chapter delineates how written argumentation was assessed in a timed essay in a mandatory argumentative writing course taken by university freshmen in a government university in the UAE, and how the feedback gleaned from this common assessment was mapped to the teaching curriculum to shed light on the teaching effectiveness and to provide directions for future teaching

The effect of pulmonary rehabilitation on mortality, balance, and risk of fall in stable patients with chronic obstructive pulmonary disease: a systematic review

Objectives: To evaluate the impact of pulmonary rehabilitation on survival and fall (including balance) in patients with chronic obstructive pulmonary disease (COPD) at stability. Design: Systematic Review. Methods: OVID, MEDLINE, EMBASE, and Cochrane Collaboration Library were searched for literature dating from January 1980 up to November 2014 as well as an update in October 2015. Two reviewers screened titles, abstracts and full text records, extracted data and assessed studies for risk of bias; any disagreements were resolved by a third member of the team, and consensus was always sought. Results: Initial searches yielded 3216 records but after review, only 7 studies were included and no studies focused solely on falls. Two cohort studies found some positive benefits of pulmonary rehabilitation on balance but the results were inconsistent across the studies. Regarding survival, two randomised controlled trials were conducted; one study showed significant survival benefit at 1 year while the other one showed non-significant survival benefit at 3 years. Neither were adequately powered and in both, survival was a secondary outcome. Conclusions: There was only limited inconclusive evidence to show that pulmonary rehabilitation has a significant beneficial effect on balance or survival

Molecular Genetic Approaches to Disease of Neural Development

This study utilized novel genetic techniques in order to find causative gene mutations that underlie diseases of neural development. Our laboratory has collected 175 cases of malformations of cortical development (MCD) from the United States and Europe. Four of these cases are the focus of this manuscript: two familial cases of infantile neuroaxonal dystrophy (INAD), a familial case of hereditary spastic paraparesis (HSP), and a sporadic case of Greig cephalopolysyndactyly (GCPS) and cerebral cavernous malformations (CCMs). The techniques utilized to study the affected patients include microarray-based single nucleotide polymorphism (SNP) genotyping and copy number variation (CNV) analysis, both of which are powerful tools in the hunt for disease-causing gene mutations. In the familial cases of INAD, we report two novel mutations in the PLA2G6 gene, previously shown to cause INAD when mutated. In the familial case of HSP, we demonstrate linkage to the SPG11 locus on chromosome 15q. Finally, in the sporadic case of GCPS and CCM, we published the first report on this novel syndrome along with a genetic analysis that demonstrates a microdeletion on chromosome 7p, resulting in heterozygous loss of both the GLI3 and CCM2 genes. The three studies presented in this manuscript demonstrate the utility of SNP genotyping and CNV analysis in revealing the genetic mutations that underlie diseases of neural development

Measurement and physical interpretation of the mean motion of turbulent density patterns detected by the BES system on MAST

The mean motion of turbulent patterns detected by a two-dimensional (2D) beam emission spectroscopy (BES) diagnostic on the Mega Amp Spherical Tokamak (MAST) is determined using a cross-correlation time delay (CCTD) method. Statistical reliability of the method is studied by means of synthetic data analysis. The experimental measurements on MAST indicate that the apparent mean poloidal motion of the turbulent density patterns in the lab frame arises because the longest correlation direction of the patterns (parallel to the local background magnetic fields) is not parallel to the direction of the fastest mean plasma flows (usually toroidal when strong neutral beam injection is present). The experimental measurements are consistent with the mean motion of plasma being toroidal. The sum of all other contributions (mean poloidal plasma flow, phase velocity of the density patterns in the plasma frame, non-linear effects, etc.) to the apparent mean poloidal velocity of the density patterns is found to be negligible. These results hold in all investigated L-mode, H-mode and internal transport barrier (ITB) discharges. The one exception is a high-poloidal-beta (the ratio of the plasma pressure to the poloidal magnetic field energy density) discharge, where a large magnetic island exists. In this case BES detects very little motion. This effect is currently theoretically unexplained.Comment: 28 pages, 15 figures, submitted to PPC

Using keystroke logging to understand writers’ processes on a reading-into-writing test

Background Integrated reading-into-writing tasks are increasingly used in large-scale language proficiency tests. Such tasks are said to possess higher authenticity as they reflect real-life writing conditions better than independent, writing-only tasks. However, to effectively define the reading-into-writing construct, more empirical evidence regarding how writers compose from sources both in real-life and under test conditions is urgently needed. Most previous process studies used think aloud or questionnaire to collect evidence. These methods rely on participants’ perceptions of their processes, as well as their ability to report them. Findings This paper reports on a small-scale experimental study to explore writers’ processes on a reading-into-writing test by employing keystroke logging. Two L2 postgraduates completed an argumentative essay on computer. Their text production processes were captured by a keystroke logging programme. Students were also interviewed to provide additional information. Keystroke logging like most computing tools provides a range of measures. The study examined the students’ reading-into-writing processes by analysing a selection of the keystroke logging measures in conjunction with students’ final texts and interview protocols. Conclusions The results suggest that the nature of the writers’ reading-into-writing processes might have a major influence on the writer’s final performance. Recommendations for future process studies are provided

Corrections to the universal behavior of the Coulomb-blockade peak splitting for quantum dots separated by a finite barrier

Building upon earlier work on the relation between the dimensionless interdot channel conductance g and the fractional Coulomb-blockade peak splitting f for two electrostatically equivalent dots, we calculate the leading correction that results from an interdot tunneling barrier that is not a delta-function but, rather, has a finite height V and a nonzero width xi and can be approximated as parabolic near its peak. We develop a new treatment of the problem for g much less than 1 that starts from the single-particle eigenstates for the full coupled-dot system. The finiteness of the barrier leads to a small upward shift of the f-versus-g curve at small values of g. The shift is a consequence of the fact that the tunneling matrix elements vary exponentially with the energies of the states connected. Therefore, when g is small, it can pay to tunnel to intermediate states with single-particle energies above the barrier height V. The correction to the zero-width behavior does not affect agreement with recent experimental results but may be important in future experiments.Comment: Title changed from ``Non-universal...'' to ``Corrections to the universal...'' No other changes. 10 pages, 1 RevTeX file with 2 postscript figures included using eps

Influence of typical environments on quantum processes

We present the results of studying the influence of different environmental states on the coherence of quantum processes. We choose to discuss a simple model which describe two electronic reservoirs connected through tunneling via a resonant state. The model could, e.g., serve as an idealization of inelastic resonant tunneling through a double barrier structure. We develop Schwinger's closed time path formulation of non-equilibrium quantum statistical mechanics, and show that the influence of the environment on a coherent quantum process can be described by the value of a generating functional at a specific force value, thereby allowing for a unified discussion of destruction of phase coherence by various environmental states: thermal state, classical noise, time dependent classical field, and a coherent state. The model allows an extensive discussion of the influence of dissipation on the coherent quantum process, and expressions for the transmission coefficient are obtained in the possible limits.Comment: 46 pages, 11 post script figures. Accepted for publication in Physical Review

Hybrid-Vlasov simulation of soft X-ray emissions at the Earth’s dayside magnetospheric boundaries

Solar wind charge exchange produces emissions in the soft X-ray energy range which can enable the study of near-Earth space regions such as the magnetopause, the magnetosheath and the polar cusps by remote sensing techniques. The Solar wind Magnetosphere Ionosphere Link Explorer (SMILE) and Lunar Environment heliospheric X-ray Imager (LEXI) missions aim to obtain soft X-ray images of near-Earth space thanks to their Soft X-ray Imager (SXI) instruments. While earlier modeling works have already simulated soft X-ray images as might be obtained by SMILE SXI during its mission, the numerical models used so far are all based on the magnetohydrodynamics description of the space plasma. To investigate the possible signatures of ion-kinetic-scale processes in soft X-ray images, we use for the first time a global hybrid-Vlasov simulation of the geospace from the Vlasiator model. The simulation is driven by fast and tenuous solar wind conditions and purely southward interplanetary magnetic field. We first produce global X-ray images of the dayside near-Earth space by placing a virtual imaging satellite at two different locations, providing meridional and equatorial views. We then analyze regional features present in the images and show that they correspond to signatures in soft X-ray emissions of mirror-mode wave structures in the magnetosheath and flux transfer events (FTEs) at the magnetopause. Our results suggest that, although the time scales associated with the motion of those transient phenomena will likely be significantly smaller than the integration time of the SMILE and LEXI imagers, mirror-mode structures and FTEs can cumulatively produce detectable signatures in the soft X-ray images. For instance, a local increase by 30% in the proton density at the dayside magnetopause resulting from the transit of multiple FTEs leads to a 12% enhancement in the line-of-sight- and time-integrated soft X-ray emissivity originating from this region. Likewise, a proton density increase by 14% in the magnetosheath associated with mirror-mode structures can result in an enhancement in the soft X-ray signal by 4%. These are likely conservative estimates, given that the solar wind conditions used in the Vlasiator run can be expected to generate weaker soft X-ray emissions than the more common denser solar wind. These results will contribute to the preparatory work for the SMILE and LEXI missions by providing the community with quantitative estimates of the effects of small-scale, transient phenomena occurring on the dayside