The Effects of Music on Maximal Anaerobic Performance

Undergraduate Applie

Ten-year mortality, disease progression, and treatment-related side effects in men with localised prostate cancer from the ProtecT randomised controlled trial according to treatment received

Background The ProtecT trial reported intention-to-treat analysis of men with localised prostate cancer randomly allocated to active monitoring (AM), radical prostatectomy, and external beam radiotherapy. Objective To report outcomes according to treatment received in men in randomised and treatment choice cohorts. Design, setting, and participants This study focuses on secondary care. Men with clinically localised prostate cancer at one of nine UK centres were invited to participate in the treatment trial comparing AM, radical prostatectomy, and radiotherapy. Intervention Two cohorts included 1643 men who agreed to be randomised and 997 who declined randomisation and chose treatment. Outcome measurements and statistical analysis Analysis was carried out to assess mortality, metastasis and progression and health-related quality of life impacts on urinary, bowel, and sexual function using patient-reported outcome measures. Analysis was based on comparisons between groups defined by treatment received for both randomised and treatment choice cohorts in turn, with pooled estimates of intervention effect obtained using meta-analysis. Differences were estimated with adjustment for known prognostic factors using propensity scores. Results and limitations According to treatment received, more men receiving AM died of PCa (AM 1.85%, surgery 0.67%, radiotherapy 0.73%), whilst this difference remained consistent with chance in the randomised cohort (p = 0.08); stronger evidence was found in the exploratory analyses (randomised plus choice cohort) when AM was compared with the combined radical treatment group (p = 0.003). There was also strong evidence that metastasis (AM 5.6%, surgery 2.4%, radiotherapy 2.7%) and disease progression (AM 20.35%, surgery 5.87%, radiotherapy 6.62%) were more common in the AM group. Compared with AM, there were higher risks of sexual dysfunction (95% at 6 mo) and urinary incontinence (55% at 6 mo) after surgery, and of sexual dysfunction (88% at 6 mo) and bowel dysfunction (5% at 6 mo) after radiotherapy. The key limitations are the potential for bias when comparing groups defined by treatment received and changes in the protocol for AM during the lengthy follow-up required in trials of screen-detected PCa. Conclusions Analyses according to treatment received showed increased rates of disease-related events and lower rates of patient-reported harms in men managed by AM compared with men managed by radical treatment, and stronger evidence of greater PCa mortality in the AM group. Patient summary More than 95 out of every 100 men with low or intermediate risk localised prostate cancer do not die of prostate cancer within 10 yr, irrespective of whether treatment is by means of monitoring, surgery, or radiotherapy. Side effects on sexual and bladder function are better after active monitoring, but the risks of spreading of prostate cancer are more common

Functional and quality of life outcomes of localised prostate cancer treatments (prostate testing for cancer and treatment [ProtecT] study)

Objective To investigate the functional and quality of life (QoL) outcomes of treatments for localised prostate cancer and inform treatment decision-making. Patients and Methods Men aged 50–69 years diagnosed with localised prostate cancer by prostate-specific antigen testing and biopsies at nine UK centres in the Prostate Testing for Cancer and Treatment (ProtecT) trial were randomised to, or chose one of, three treatments. Of 2565 participants, 1135 men received active monitoring (AM), 750 a radical prostatectomy (RP), 603 external-beam radiotherapy (EBRT) with concurrent androgen-deprivation therapy (ADT) and 77 low-dose-rate brachytherapy (BT, not a randomised treatment). Patient-reported outcome measures (PROMs) completed annually for 6 years were analysed by initial treatment and censored for subsequent treatments. Mixed effects models were adjusted for baseline characteristics using propensity scores. Results Treatment-received analyses revealed different impacts of treatments over 6 years. Men remaining on AM experienced gradual declines in sexual and urinary function with age (e.g., increases in erectile dysfunction from 35% of men at baseline to 53% at 6 years and nocturia similarly from 20% to 38%). Radical treatment impacts were immediate and continued over 6 years. After RP, 95% of men reported erectile dysfunction persisting for 85% at 6 years, and after EBRT this was reported by 69% and 74%, respectively (P < 0.001 compared with AM). After RP, 36% of men reported urinary leakage requiring at least 1 pad/day, persisting for 20% at 6 years, compared with no change in men receiving EBRT or AM (P < 0.001). Worse bowel function and bother (e.g., bloody stools 6% at 6 years and faecal incontinence 10%) was experienced by men after EBRT than after RP or AM (P < 0.001) with lesser effects after BT. No treatment affected mental or physical QoL. Conclusion Treatment decision-making for localised prostate cancer can be informed by these 6-year functional and QoL outcomes

Shadows of the Cantor Set (II)

In this paper we investigate a special projection of n-dimensional Cantor sets which produces shadows . This projection can be analogized as follows: consider an n-dimensional Cantor set C. Let n-dimensional lines of light, or light rays , pass through the Cantor set onto an (n − 1)-dimensional space. Light which does not hit the Cantor set shines onto the space, whereas light which hits the Cantor set produces a dark spot on the space. The set of dark spots created by the shining of light rays through a Cantor set constitutes the shadow of the Cantor set. What is the motivation for investigating these shadows? Cantor shadows provide greater insight into the nature of the Cantor set. In particular, Cantor shadows are often interesting fractals themselves, we can calculate various metrics for them, such as dimension and measure. This paper serves as an exploratory analysis of various Cantor sets, light rays, and their corresponding shadows. The conclusion of this paper is a proposed general method to calculate the dimension of Cantor shadows. We find that shadows can have integer, rational, and even irrational dimensions. In particular, shadows of the standard two-dimensional Cantor set have dimension 1 and positive measure. On the other hand, other two- and three-dimensional Cantor sets can take on a wide range of dimensions and have measure 0. We find that Cantor shadows provide tremendous insight into the space-filling capacity of Cantor sets in different dimensions

Impacts from Control Operations on a Recreationally Hunted Feral Swine Population at a Large Military Installation in Florida

Feral swine were targeted for control at Avon Park Air Force Range in south-central Florida to avert damage to sensitive wetland habitats on the 40,000-ha base.We conducted a 5-year study to assess impacts from control to this population that had been recreationally hunted formany years. Control was initiated in early 2009. The feral swine population was monitored from 2008 to 2012 using a passive tracking index (PTI) during the dry and wet seasons and using recreational hunter take rates from the dry season. All three indices showed substantial feral swine declines after implementing control, with indices leveling for the final two study years. Military missions and recreational hunting seasons impacted temporal and spatial consistency of control application, thereby limiting further impacts of control efforts on the feral swine population. The PTI was also able to monitor coyotes, another invasive species on the base, and detect Florida black bear and Florida panther, species of particular concern