Contextual and Mediating Factors in Body Image Dissatisfaction

The purpose of this study was to examine the specific nature of the interaction and contribution of variables related to body image in a nonclinical population using a path analysis. This paper discusses various theoretical models and variables in the development and maintenance of body image dissatisfaction and eating concerns. Several variables and personality traits have been suggested as etiological factors in the development of body image dissatisfaction. These variables stem from different theoretical models. The five theoretical models discussed are: (1) Developmental, (2) Social-comparison, (3), Self-discrepancy, (4) Self-objectification, and (5) Feminist theory. From these broad theoretical models, many variables are viewed as risk factors for developing and maintaining eating and body image concerns. Six of the more prominent variables are explored, including sociocultural influence, family environment, perfectionism, gender-role orientation, stress, and guilt/shame. My hypothesized path model consists of two contextual (exogenous) variables and five mediating (endogenous) variables. The two variables of family and media influences are hypothesized to be the strongest path variables to body image dissatisfaction. Therefore, the exogenous variables are hypothesized to have an effect on the mediating variables, but are not affected by the other variables

Adjuvant vs. salvage radiation therapy in men with high-risk features after radical prostatectomy: Survey of North American genitourinary expert radiation oncologists

INTRODUCTION: The management of patients with high-risk features after radical prostatectomy (RP) is controversial. Level 1 evidence demonstrates that adjuvant radiation therapy (RT) improves survival compared to no treatment; however, it may overtreat up to 30% of patients, as randomized clinical trials (RCTs) using salvage RT on observation arms failed to reveal a survival advantage of adjuvant RT. We, therefore, sought to determine the current view of adjuvant vs. salvage RT among North American genitourinary (GU) radiation oncology experts. METHODS: A survey was distributed to 88 practicing North American GU physicians serving on decision-making committees of cooperative group research organizations. Questions pertained to opinions regarding adjuvant vs. salvage RT for this patient population. Treatment recommendations were correlated with practice patterns using Fisher's exact test. RESULTS: Forty-two of 88 radiation oncologists completed the survey; 23 (54.8%) recommended adjuvant RT and 19 (45.2%) recommended salvage RT. Recommendation of active surveillance for Gleason 3+4 disease was a significant predictor of salvage RT recommendation (p=0.034), and monthly patient volume approached significance for recommendation of adjuvant over salvage RT; those seeing <15 patients/month trended towards recommending adjuvant over salvage RT (p=0.062). No other demographic factors approached significance. CONCLUSIONS: There is dramatic polarization among North American GU experts regarding optimal management of patients with high-risk features after RP. Ongoing RCTs will determine whether adjuvant RT improves survival over salvage RT. Until then, the almost 50/50 division seen from this analysis should encourage practicing clinicians to discuss the ambiguity with their patients

Is moderate hypofractionation accepted as a new standard of care in north america for prostate cancer patients treated with external beam radiotherapy? Survey of genitourinary expert radiation oncologists

INTRODUCTION: Several recent randomized clinical trials have evaluated hypofractionated regimens against conventionally fractionated EBRT and shown similar effectiveness with conflicting toxicity results. The current view regarding hypofractionation compared to conventional EBRT among North American genitourinary experts for management of prostate cancer has not been investigated. MATERIALS AND METHODS: A survey was distributed to 88 practicing North American GU physicians serving on decision - making committees of cooperative group research organizations. Questions pertained to opinions regarding the default EBRT dose and fractionation for a hypothetical example of a favorable intermediate - risk prostate cancer (Gleason 3 + 4). Treatment recommendations were correlated with practice patterns using Fisher's exact test. RESULTS: Forty - two respondents (48%) completed the survey. We excluded from analysis two respondents who selected radical hypofractionation with 5 - 12 fractions as a preferred treatment modality. Among the 40 analyzed respondents, 23 (57.5%) recommend conventional fractionation and 17 (42.5%) recommended moderate hypofractionation. No demographic factors were found to be associated with preference for a fractionation regimen. Support for brachytherapy as a first choice treatment modality for low - risk prostate cancer was borderline significantly associated with support for moderate hypofractionated EBRT treatment modality (p = 0.089). CONCLUSIONS: There is an almost equal split among North American GU expert radiation oncologists regarding the appropriateness to consider moderately hypofractionated EBRT as a new standard of care in management of patients with prostate cancer. Physicians who embrace brachytherapy may be more inclined to support moderate hypofractionated regimen for EBRT. It is unclear whether reports with longer followups will impact this balance, or whether national care and reimbursement policies will drive the clinical decisions. In the day and age of patient - centered care delivery, patients should receive an objective recommendation based on available clinical evidence. The stark division among GU experts may influence the design of future clinical trials utilizing EBRT for patients with prostate cancer

Estimation of the Family and Community Unobserved Heterogeneity Effects on the Risk of Under-Five Mortality in Nigeria using Frailty Model

The Under-five mortality (U5M) rate is an important determinant of societal and national advancement- a key marker of wellbeing, value, and access. In spite of efforts to identify the predictors of U5M to reduce its high level in Nigeria, the problem remains a major cause for concern. This study estimated the potential role of unmeasured/unobserved factors at both family and community levels, using shared frailty models on the 2013 Nigeria Demographic and Health Survey (2013 NDHS) data. The Log-rank test was used to identify variables associated with U5M- hazard ratio estimates with P&lt;0.05 were considered as statistically significant. Our findings suggested region, marital status, place of residence and place of delivery were significant determinants of U5M in both frailty models. We also found evidence of frailty effect on the risk, particularly at the community level- heterogeneity due to unmeasured/unobserved factors, which are generally ignored when we assess the risk using only observed variables. We, therefore, suggest that to achieve the sustainable development goals relating to child health in Nigeria, more significant efforts should be directed at identifying more determinants, such as to reduce the influence of unobserved factors and facilitate an extension of interventions to these factors

Novel Low-Temperature Poss-Containing Siloxane Elastomers

One route to increased aircraft performance is through the use of flexible, shape-changeable aerodynamics effectors. However, state of the art materials are not flexible or durable enough over the required broad temperature range. Mixed siloxanes were crosslinked by polyhedral oligomeric silsesquioxanes (POSS) producing novel materials that remained flexible and elastic from -55 to 94 C. POSS molecules were chemically modified to generate homogeneous distributions within the siloxane matrix. High resolution scanning electron microscope (HRSEM) images indicated homogenous POSS distribution up to 0.8 wt %. Above the solubility limit, POSS aggregates could be seen both macroscopically and via SEM (approx.60-120 nm). Tensile tests were performed to determine Young s modulus, tensile strength, and elongation at break over the range of temperatures associated with transonic aircraft use (-55 to 94 C; -65 to 200 F). The siloxane materials developed here maintained flexibility at -55 C, where previous candidate materials failed. At room temperature, films could be elongated up to 250 % before rupturing. At -55 and 94 C, however, films could be elongated up to 400 % and 125 %, respectively

Multiple-Beam Detection of Fast Transient Radio Sources

A method has been designed for using multiple independent stations to discriminate fast transient radio sources from local anomalies, such as antenna noise or radio frequency interference (RFI). This can improve the sensitivity of incoherent detection for geographically separated stations such as the very long baseline array (VLBA), the future square kilometer array (SKA), or any other coincident observations by multiple separated receivers. The transients are short, broadband pulses of radio energy, often just a few milliseconds long, emitted by a variety of exotic astronomical phenomena. They generally represent rare, high-energy events making them of great scientific value. For RFI-robust adaptive detection of transients, using multiple stations, a family of algorithms has been developed. The technique exploits the fact that the separated stations constitute statistically independent samples of the target. This can be used to adaptively ignore RFI events for superior sensitivity. If the antenna signals are independent and identically distributed (IID), then RFI events are simply outlier data points that can be removed through robust estimation such as a trimmed or Winsorized estimator. The alternative "trimmed" estimator is considered, which excises the strongest n signals from the list of short-beamed intensities. Because local RFI is independent at each antenna, this interference is unlikely to occur at many antennas on the same step. Trimming the strongest signals provides robustness to RFI that can theoretically outperform even the detection performance of the same number of antennas at a single site. This algorithm requires sorting the signals at each time step and dispersion measure, an operation that is computationally tractable for existing array sizes. An alternative uses the various stations to form an ensemble estimate of the conditional density function (CDF) evaluated at each time step. Both methods outperform standard detection strategies on a test sequence of VLBA data, and both are efficient enough for deployment in real-time, online transient detection applications

Injecting Artificial Memory Errors Into a Running Computer Program

Single-event upsets (SEUs) or bitflips are computer memory errors caused by radiation. BITFLIPS (Basic Instrumentation Tool for Fault Localized Injection of Probabilistic SEUs) is a computer program that deliberately injects SEUs into another computer program, while the latter is running, for the purpose of evaluating the fault tolerance of that program. BITFLIPS was written as a plug-in extension of the open-source Valgrind debugging and profiling software. BITFLIPS can inject SEUs into any program that can be run on the Linux operating system, without needing to modify the program s source code. Further, if access to the original program source code is available, BITFLIPS offers fine-grained control over exactly when and which areas of memory (as specified via program variables) will be subjected to SEUs. The rate of injection of SEUs is controlled by specifying either a fault probability or a fault rate based on memory size and radiation exposure time, in units of SEUs per byte per second. BITFLIPS can also log each SEU that it injects and, if program source code is available, report the magnitude of effect of the SEU on a floating-point value or other program variable

Dramatic polarization in genitourinary expert opinions regarding the clinical utility of positron emission tomography (PET) imaging in prostate cance

OBJECTIVES: To ascertain the opinions of North American genitourinary (GU) experts regarding inclusion of technologies such as prostate - specific membrane antigen (PSMA) and C - 11 choline positron emission tomography (PET) into routine practice. MATERIALS AND METHODS: A survey was distributed to North American GU experts. Questions pertained to the role of PSMA and C - 11 PET in PCa management. Participants were categorized as "supporters" or "opponents" of incorporation of novel imaging techniques. Opinions were correlated with practice patterns. RESULTS: Response rate was 54% and we analyzed 42 radiation oncologist respondents. 17 participants (40%) have been in practice for > 20 years and 38 (90%) practice at an academic center. 24 (57%) were supporters of PSMA and 29 (69%) were supporters of C - 11. Supporters were more likely to treat pelvic nodes (88% vs. 56%, p < 01) and trended to be more likely to treat patients with moderate or extreme hypofractionation (58% vs. 28%, p = 065). Supporters trended to be more likely to offer brachytherapy boost (55% vs. 23%, p = 09), favor initial observation and early salvage over adjuvant radiation (77% vs. 55%, p = 09), and to consider themselves expert brachytherapists (69% vs. 39%, p = 09). CONCLUSIONS: There is a polarization among GU radiation oncology experts regarding novel imaging techniques. A correlation emerged between support of novel imaging and adoption of treatment approaches that are clinically superior or less expensive. Pre - existing biases among GU experts on national treatment - decision panels and leaders of cooperative group studies may affect the design of future studies and influence the adoption of these technologies in clinical practice