Practice patterns and outcomes of equivocal bone scans for patients with castration-resistant prostate cancer: Results from SEARCH.

ObjectiveTo review follow-up imaging after equivocal bone scans in men with castration resistant prostate cancer (CRPC) and examine the characteristics of equivocal bone scans that are associated with positive follow-up imaging.MethodsWe identified 639 men from five Veterans Affairs Hospitals with a technetium-99m bone scan after CRPC diagnosis, of whom 99 (15%) had equivocal scans. Men with equivocal scans were segregated into "high-risk" and "low-risk" subcategories based upon wording in the bone scan report. All follow-up imaging (bone scans, computed tomography [CT], magnetic resonance imaging [MRI], and X-rays) in the 3 months after the equivocal scan were reviewed. Variables were compared between patients with a positive vs. negative follow-up imaging after an equivocal bone scan.ResultsOf 99 men with an equivocal bone scan, 43 (43%) received at least one follow-up imaging test, including 32/82 (39%) with low-risk scans and 11/17 (65%) with high-risk scans (p = 0.052). Of follow-up tests, 67% were negative, 14% were equivocal, and 19% were positive. Among those who underwent follow-up imaging, 3/32 (9%) low-risk men had metastases vs. 5/11 (45%) high-risk men (p = 0.015).ConclusionWhile 19% of all men who received follow-up imaging had positive follow-up imaging, only 9% of those with a low-risk equivocal bone scan had metastases versus 45% of those with high-risk. These preliminary findings, if confirmed in larger studies, suggest follow-up imaging tests for low-risk equivocal scans can be delayed while high-risk equivocal scans should receive follow-up imaging

HABITAT-RELATED DIFFERENCES IN NECROPH- ILOUS SPECIES COMPOSITION: IMPLICATIONS FOR RESOURCE COMPETITION

Competition for resources is one of the most important selective factors influencing the expression of life history traits in both plants and animals (Darwin 1859). In grasslands, competition for resources such as nutrients, water, and space often is constrained by stochastic processes (Axelrod 1985). Disturbance factors such as fire, grazing by large herbivores, and fluctuating climatic conditions tend to alter the structure and magnitude of competition for limited resources among grassland communities more frequently than in other ecosystems (Snaydon 1987, van der Maarel 1993). Vertebrate carrion is one important resource used by both plants and animals in grasslands, providing a rich but ephemeral point source of nutrients (Towne 2000, Barton et al. 2013). A complex ecological network of vertebrate and invertebrate necrophilous animal species compete intensely for these carrion resources, often aided by specialized sensory and motility adaptations that aid resource discovery and sequestration (Putman 1978, Scott et al. 1979, DeVault et al. 2003)

Assessment of Adverse Events From the Patient Perspective in a Phase 3 Metastatic Castration-Resistant Prostate Cancer Clinical Trial

IMPORTANCE Standard adverse event (AE) reporting in oncology clinical trials has historically relied on clinician grading, which prior research has shown can lead to underestimation of rates of symptomatic AEs. Industry sponsors are beginning to implement in trials the National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), which was developed to allow patients to self-report symptomatic AEs and improve the quality of symptomatic AE detection. OBJECTIVES To evaluate the feasibility of implementing PRO-CTCAE in a prespecified correlative analysis of the phase 3 COMET-2 trial and enumerate statistically significant between-group differences in symptomatic AEs using PRO-CTCAE and the CTCAE. DESIGN, SETTING, AND PARTICIPANTS This correlative study of 119 men in the randomized, double-blind, placebo-controlled phase 3 COMET-2 trial with metastatic castration-resistant prostate cancer who had undergone at least 2 prior lines of systemic treatment was conducted from March 2012 to July 2014. Participants completed PRO-CTCAE items using an automated telephone system from home prior to treatment and every 3 weeks during treatment. Statistical analysis was performed from May 2018 to June 2019. MAIN OUTCOMES AND MEASURES The proportion of patients who completed expected PRO-CTCAE self-reports was computed as a measure of feasibility. RESULTS Among the 119 men in the study (median age, 65 years [range, 44-80 years]), 534 of 587 (91.0%) expected PRO-CTCAE self-reports were completed, with consistently high rates of completion throughout participation. Rates of self-report adherence were similar between groups (cabozantinib s-maleate, 286 of 317 [90.2%]; and mitoxantrone hydrochloride-prednisone, 248 of 270 [91.9%]). Of 12 measured, patient-reported PRO-CTCAE symptomatic AEs, 4 reached statistical significance when comparing the proportion of patients with at least 1 postbaseline score greater than 0 between groups (differences ranged from 20.1% to 34.1% with higher proportions in the cabozantinib group; all P < .05), and use of a method for accounting for preexisting symptoms at baseline yielded 7 AEs with statistically significant differences between groups (differences ranged from 20.5%to 41.2%with higher proportions in the cabozantinib group; all P < .05). In the same analysis using investigator-reported CTCAE data, no statistically significant differences were found between groups for any symptomatic AEs. CONCLUSIONS AND RELEVANCE PRO-CTCAE data collection was feasible and improved the accuracy of symptomatic AE detection in a phase 3 cancer trial. This analysis adds to mounting evidence of the feasibility and value of patient-reported AEs in oncology, which should be considered for inclusion in cancer trials that incorporate AE evaluation

PhaseQuant: A tool for quantifying tomographic data sets of geological specimens

a b s t r a c t Micro-CT is becoming an increasingly important tool for non-destructive analysis of rock specimens. One of the major challenges with micro-CT is to extract quantitative information as opposed to qualitative information from the datasets. In this paper, PhaseQuant -a new software tool for processing a micro-CT image stack -is introduced. PhaseQuant is an open source freeware distributed as an ImageJ plugin. PhaseQuant is a simple and easy-to-use software tool that comprises phase segmentation, phase measurement, validation and density calibration modules which together enable the user to follow a repeatable experimentation protocol for quantifying phases and components from a micro-CT image stack of rock specimens. The techniques used in the software tool are outlined in this paper along with some illustrative examples of application of the software to meteorites and rock cores. Detailed instructions on how to use the code are available on the Internet

Number of Unfavorable Intermediate‐Risk Factors Predicts Pathologic Upstaging and Prostate Cancer‐Specific Mortality Following Radical Prostatectomy: Results From the SEARCH Database

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135480/1/pros23255.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/135480/2/pros23255_am.pd

Modified risk stratification grouping using standard clinical and biopsy information for patients undergoing radical prostatectomy: Results from SEARCH

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139104/1/pros23436_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139104/2/pros23436.pd

Giant Outer Transiting Exoplanet Mass (GOT 'EM) Survey. I. Confirmation of an Eccentric, Cool Jupiter With an Interior Earth-sized Planet Orbiting Kepler-1514*

Despite the severe bias of the transit method of exoplanet discovery toward short orbital periods, a modest sample of transiting exoplanets with orbital periods greater than 100 days is known. Long-term radial velocity (RV) surveys are pivotal to confirming these signals and generating a set of planetary masses and densities for planets receiving moderate to low irradiation from their host stars. Here, we conduct RV observations of Kepler-1514 from the Keck I telescope using the High Resolution Echelle Spectrometer. From these data, we measure the mass of the statistically validated giant ($1.108\pm0.023$ $R_{\rm J}$) exoplanet Kepler-1514 b with a 218 day orbital period as $5.28\pm0.22$ $M_{\rm J}$. The bulk density of this cool ($\sim$390 K) giant planet is $4.82^{+0.26}_{-0.25}$ g cm$^{-3}$, consistent with a core supported by electron degeneracy pressure. We also infer an orbital eccentricity of $0.401^{+0.013}_{-0.014}$ from the RV and transit observations, which is consistent with planet-planet scattering and disk cavity migration models. The Kepler-1514 system contains an Earth-size, Kepler Object of Interest on a 10.5 day orbit that we statistically validate against false positive scenarios, including those involving a neighboring star. The combination of the brightness ($V$=11.8) of the host star and the long period, low irradiation, and high density of Kepler-1514 b places this system among a rare group of known exoplanetary systems and one that is amenable to continued study.Comment: 18 pages, 9 figures, accepted for publication in the Astronomical Journa