Defining a standard set of patient-centered outcomes for men with localized prostate cancer

Background Value-based health care has been proposed as a unifying force to drive improved outcomes and cost containment. Objective To develop a standard set of multidimensional patient-centered health outcomes for tracking, comparing, and improving localized prostate cancer (PCa) treatment value. Design, setting, and participants We convened an international working group of patients, registry experts, urologists, and radiation oncologists to review existing data and practices. Outcome measurements and statistical analysis The group defined a recommended standard set representing who should be tracked, what should be measured and at what time points, and what data are necessary to make meaningful comparisons. Using a modified Delphi method over a series of teleconferences, the group reached consensus for the Standard Set. Results and limitations We recommend that the Standard Set apply to men with newly diagnosed localized PCa treated with active surveillance, surgery, radiation, or other methods. The Standard Set includes acute toxicities occurring within 6 mo of treatment as well as patient-reported outcomes tracked regularly out to 10 yr. Patient-reported domains of urinary incontinence and irritation, bowel symptoms, sexual symptoms, and hormonal symptoms are included, and the recommended measurement tool is the Expanded Prostate Cancer Index Composite Short Form. Disease control outcomes include overall, cause-specific, metastasis-free, and biochemical relapse-free survival. Baseline clinical, pathologic, and comorbidity information is included to improve the interpretability of comparisons. Conclusions We have defined a simple, easily implemented set of outcomes that we believe should be measured in all men with localized PCa as a crucial first step in improving the value of care. Patient summary Measuring, reporting, and comparing identical outcomes across treatments and treatment centers will provide patients and providers with information to make informed treatment decisions. We defined a set of outcomes that we recommend being tracked for every man being treated for localized prostate cancer

Effects of alpha particle radiation on gene expression in human pulmonary epithelial cells

The general public receives approximately half of its exposure to natural radiation through alpha (α)-particles from radon ( 222Rn) gas and its decay progeny. Epidemiological studies have found a positive correlation between exposure to 222Rn and lung carcinogenesis. An understanding of the transcriptional responses involved in these effects remains limited. In this study, genomic technology was employed to mine for subtle changes in gene expression that may be representative of an altered physiological state. Human lung epithelial cells were exposed to 0, 0.03, 0.3 and 0.9Gy of α-particle radiation. Microarray analysis was employed to determine transcript expression levels 4h and 24h after exposure. A total of 590 genes were shown to be differentially expressed in the α-particle radiated samples (false discovery rate (FDR)≤0.05). Sub-set of these transcripts were time-responsive, dose-responsive an

Foreign language competence and cultural affinity: a study of UK executives in foreign markets

Reports exploratory research which examines the relationship between the extent to which executives have a positive attitude towards a foreign culture and the level of competence they have achieved in that language. Suggests that this was a weak correlation but a much stronger one existed between these two factors within the Spanish market. Cites that cultural liking may be a positive factor in foreign language acquisition but only in some circumstances or cultures and ecnourages further research in this area

Possibility for reverse zoonotic transmission of sars-cov-2 to free-ranging wildlife: A case study of bats

10.1371/journal.ppat.1008758PLoS Pathogens169e100875