Pilot Study of [18F] Fluorodeoxyglucose Positron Emission Tomography (FDG-PET)/Magnetic Resonance Imaging (MRI) for Staging of Muscle-invasive Bladder Cancer (MIBC)

Introduction: Computed tomography (CT) has limited diagnostic accuracy for staging of muscle-invasive bladder cancer (MIBC). [18F] Fluorodeoxyglucose positron emission tomography (FDG-PET)/magnetic resonance imaging (MRI) is a novel imaging modality incorporating functional imaging with improved soft tissue characterization. This pilot study evaluated the use of preoperative FDG-PET/MRI for staging of MIBC. Patients and Methods: Twenty-one patients with MIBC with planned radical cystectomy were enrolled. Two teams of radiologists reviewed FDG-PET/MRI scans to determine: (1) presence of primary bladder tumor; and (2) lymph node involvement and distant metastases. FDG-PET/MRI was compared with cystectomy pathology and computed tomography (CT). Results: Eighteen patients were included in the final analysis, most (72.2%) of whom received neoadjuvant chemotherapy. Final pathology revealed 10 (56%) patients with muscle invasion and only 3 (17%) patients with lymph node involvement. Clustered analysis of FDG-PET/MRI radiology team reads revealed a sensitivity of 0.80 and a specificity of 0.56 for detection of the primary tumor with a sensitivity of 0 and a specificity of 1.00 for detection of lymph node involvement when compared with cystectomy pathology. CT imaging demonstrated similar rates in evaluation of the primary tumor (sensitivity, 0.91; specificity, 0.43) and lymph node involvement (sensitivity, 0; specificity, 0.93) when compared with pathology. Conclusions: This pilot single-institution experience of FDG-PET/MRI for preoperative staging of MIBC performed similar to CT for the detection of the primary tumor; however, the determination of lymph node status was limited by few patients with true pathologic lymph node involvement. Further studies are needed to evaluate the potential role for FDG-PET/MRI in the staging of MIBC. © 2020 Elsevier Inc.In this pilot study, preoperative staging with [18F] fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging in muscle-invasive bladder cancer detected the primary bladder tumor; however, the determination of lymph node status was limited by few patients with pathologic lymph node involvement. Additional studies are needed to evaluate the potential role for [18F] fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging in the staging of bladder cancer

The meaning and method of systematic theology in Amandus Polanus

SIGLEAvailable from British Library Document Supply Centre- DSC:D32037/80 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Content Validity and Inter-rater Reliability of the Assessment of Occupational Functioning- Collaborative Version

Abstract Purpose: This psychometric study examined the content validity and inter-rater reliability of the Assessment of Occupational Functioning-Collaborative Version (AOF-CV) through content validity index and percent agreement, to determine clinical usefulness and alignment with the current version of the Model of Human Occupation (MOHO). Method: Data was gathered in two phases over four months. The first phase gathered inter-rater reliability through administering the AOF-CV virtually to college students. Percent agreement was determined using AOF-CV ratings completed by two teams of two raters per team. The second phase gathered content validity data from a MOHO content expert using a content validity index form and interview. Results: Nine participants completed the AOF-CV and follow-up interview. The overall interrater reliability was 84.35%, based on nine completed AOF-CV by four raters. Data analysis from participants, raters, and content expert focused on content validity and identified two themes: AOF-CV Administration aspects and AOF-CV Yield of Occupational Profile. Content expert rated AOF-CV items as representative of MOHO constructs (93%), with 90% of items demonstrating clarity. Conclusion: The results strengthen the existing evidence on inter-rater reliability and identified alignment with majority of current MOHO constructs. The AOF-CV can measure occupational functioning of young adults and effectively contribute to developing an occupational profile. Future research should address recommendations for revisions, use with other populations and continued psychometric research to support increased use of the AOF-CV in practice. Keywords: occupational functioning; measurement; inter-rater reliability; content validity; Model of Human Occupation, assessment psychometrics

No barrier to emergence of bathyal king crabs on the Antarctic shelf

Cold-water conditions have excluded durophagous (skeleton-breaking) predators from the Antarctic seafloor for millions of years. Rapidly warming seas off the western Antarctic Peninsula (WAP) could now facilitate their return to the continental shelf, with profound consequences for the endemic fauna. Among the likely first arrivals are king crabs (Lithodidae), which were discovered recently on the adjacent continental slope. During the austral summer of 2010-2011, we used underwater imagery to survey a slope-dwelling population of the lithodid Paralomis birsteini off Marguerite Bay, WAP for environmental or trophic impediments to shoreward expansion. The average density was ~4.5 ind·1000m-2 within a depth-range of 1100-1500 m (overall observed depth-range 841–2266 m). Evidence of juveniles, molting, and precopulatory behavior suggested a reproductively viable population on the slope. At the time of the survey, there was no thermal barrier to prevent the lithodids from expanding upward and emerging on the outer shelf (400–500 m depth); however, near-surface temperatures remained too cold for them to survive in shallow, coastal environments (<200 m). Ambient salinity, composition of the substrate, and the depth-distribution of potential predators likewise indicated no barriers to expansion onto the outer shelf. Primary food resources for lithodids—echinoderms and mollusks—were abundant on the upper slope (500–800 m) and outer shelf. At present rates of warming, lithodids should emerge in outer-shelf environments within several decades. As sea temperatures continue to rise, they will likely play an increasingly important trophic role in subtidal communities closer to shore