Is the digital rectal exam any good as a prostate cancer screening test?

© The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/There is no shortage of references in popular culture to the prostate examination, with many a laugh built on the punchline of the finger up the bum. Interestingly, while cervical, breast, or bowel screening share barriers to uptake around the intimacy of the examination, ‘ick-factor’, or cultural taboos, they have never become comedy tropes — reflecting the uniquely emasculating perception of the rectal examination.Peer reviewe

Why test study protocol: a UK-wide audit using the primary care academic collaborative to explore the reasons for primary care testing

This is the author accepted manuscript. The final version is available on open access from the Royal College of General Practitioners via the DOI in this recordBackground The number of blood tests done in primary care has been increasing over the last 20 years. Some estimates suggest that up to a quarter of these tests may not have been needed. This could lead to a cascade effect of further investigations, appointments, or referrals, as well as anxiety for patients, increased workload and costs to the health service. To better understand the impact and sequelae of blood tests on patients, we need to know why blood tests are requested and what is done with the results. Aims To explore who orders blood tests and why, and how test results are actioned in primary care. Design & Setting Retrospective audit of electronic health records in general practices across the UK. Method The Primary care Academic CollaboraTive (PACT), a UK-wide network of primary care health professionals, will be utilised to collect data from individual practices. PACT members will be asked to review the electronic health records of 50 patients who had recent blood tests in their practice, and manually extract anonymised data on who requested the test, the indication, the result, and subsequent actions. Data will also be collected from PACT members to assess the feasibility of the collaborative model. Conclusion PACT offers a unique opportunity to extract clinical data which cannot otherwise be obtained. Understanding the indications for tests will help identify priority areas for research to optimise testing and patient safety in primary care.Bristol, North Somerset and South Gloucestershire Clinical Commissioning Grou

Planetary gear innovation : A study of how redesigning planetary gears leads to more efficient manufacturing

Syftet med examensarbetet är att undersöka om det är möjligt att genom omkonstruktion av innerkuggade ytterringar till planetväxlar effektivisera tillverkningen av dessa, där omkonstruktionen syftade till användandet av lösa kuggar. En given konceptidé som undersöktes var att använda cylindrar från rullager som placeras i en ring med urtagningar för cylindrarna. Detta tillämpas idag i industrirobotar. Även ett koncept baserat på lösa evolventkuggar framtogs, där huvudtanken var att undvika omkonstruktion av sol- och planethjul. Genom att modellera en planetväxel som agerade referens erhölls erforderliga data för beräkningarna. De framtagna koncepten analyserades med avseende på spänningar och yttryck med FEM och analytiska beräkningar. Analysen av dessa beräkningar visade att koncepten fungerar tillfredsställande med avseende på yttryck och spänningar för de aktuella lastfall och dimensioner som simulerades. Dock kräver koncepten vidare arbete för att säkerställa dimensionsintervall inom vilka lösa kuggar kan tillämpas samt för att fastslå den exakta geometrin på kuggarna.The purpose of this study is to investigate the possibility of making the manufacturing process for outer rings of planetary gears more efficient by redesign, where the use of loose cogs was the idea of the redesign. One idea was to use the cylinders of roller bearings placed in a ring with holes. This is today used in industrial robots. Another concept was to use loose cogs with the profile-shape of involutes, where the main idea was to maintain the shape of the sun gear and the planet gear. By modeling a “reference” planetary gear the necessary data for calculations was obtained. The concepts were analyzed in terms of stress and pressure with FEM and analytical methods. The analysis of the results confirmed that the concepts met the requirements for the used load and dimensions. However, the concepts require further work to ensure the size range within which loose cogs are applicable, and also to determine the exact geometry of the profile of the cog