Ablative therapy for people with localised prostate cancer : a systematic review and economic evaluation

The research reported in this issue of the journal was funded by the HTA programme as project number 10/136/01. The contractual start date was in April 2012. The draft report began editorial review in October 2013 and was accepted for publication in April 2014. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report. Acknowledgements We thank l the people recruited from the local UCAN for providing valuable consumer insight and advice through their participation as members of the project focus group: - Mark Emberton (Professor of Interventional Oncology), Damian Greene (consultant urologist), Axel Heidenreich (Professor and Director of Department of Urology), Christoph von Klot (specialist in brachytherapy), Roger Kockelbergh (BAUS chairman and Clinical Director of Urology) and Axel Merserburger (Deputy Clinical Director of Urology and Urologic Oncology) for providing their clinical expertise as members of the project advisory group - Edgar Paez (consultant urologist) and Gill Lawrence (Head of Radiotherapy Physics) for providing a list of staff time by grade and specialty involved in EBRT - Debbie Bennett (Radiotherapy Service Manager) for providing estimates for the expected number of uses for EBRT - Ian Pedley (clinical director/clinical oncologist) and Gill Lawrence for providing a list of all resource inputs relevant to brachytherapy - Steve Locks (Consultant Clinical Scientist in Radiotherapy) for providing a list of reusable equipment and consumables used during brachytherapy, along with their unit costs - Sue Asterling (urology research nurse) and Mark Kelly (Acting Divisional General Manager – Theatres) for providing a list of all resource inputs relevant to cryotherapy - Lara Kemp for providing secretarial support. The Health Services Research Unit is core funded by the Chief Scientist Office of the Scottish Government Health Directorates.Peer reviewedPublisher PD

Isolated gestational proteinuria preceding the diagnosis of preeclampsia : an observational study

Introduction. Some pregnant women develop significant proteinuria in the absence of hypertension. However, clinical significance of isolated gestational proteinuria (IGP) is not well understood. This study aimed to determine the prevalence of IGP in singleton pregnancies and the proportion of women with IGP who subsequently developed preeclampsia (IGP-PE) among all PE cases. Material and methods. This was an observational study of 6819 women with singleton pregnancies at 12 centers, including 938 women with at least once determination of protein-to-creatinine ratio (P/Cr). Significant proteinuria in pregnancy (SPIP) was defined as P/Cr (mg/mg) level >0.27. IGP was defined as SPIP in the absence of hypertension. Gestational hypertension (GH) preceding preeclampsia (GH-PE) was defined as preeclampsia (PE) in which GH preceded SPIP. Simultaneous PE (S-PE) was defined as PE in which both SPIP and hypertension occurred simultaneously. Results. IGP and PE were diagnosed in 130 (1.9%) and 158 (2.3%) of 6819 women, respectively. Of 130 women with IGP, 32 (25%) progressed to PE and accounted for 20% of all women with PE. Hence, women with IGP had a relative risk of 13.1 (95% CI; 9.2-18.5) for developing PE compared with those without IGP [25% (32/130) vs. 1.9% (126/6689)]. At diagnosis of SPIP, P/Cr levels already exceeded 1.0 more often in women with S-PE than in those with IGP-PE [67% (33/49) vs. 44% (14/32), respectively, p = 0.031]. Conclusions. IGP is a risk factor for PE, and IGP-PE accounts for a considerable proportion (20%) of all PE

Health and medical research funding agencies' promotion of public engagement within research: a qualitative interview study exploring the UK context

Background: Public engagement (PE) has become a common feature of many liberal governmental agendas worldwide. Since the turn of this century there has been a succession of United Kingdom policy initiatives to encourage research funding agencies, universities and researchers to reconsider how they engage with citizens and communities. Although most funding agencies now explicitly promote PE within research, little empirical work has been carried out in this area. In this study, we explored why and how health and medical research funding agencies in the United Kingdom have interpreted and implemented their role to promote PE within research. Methods: Semi-structured interviews were carried out with 30 key informants from 10 agencies that fund health or medical research. Data were also gathered from agencies’ websites and documentation. The analysis was based on the constant comparative method. Results: Across agencies, we found that PE was being interpreted and operationalised in various different ways. The terminology used within funding agencies to describe PE seems to be flexibly applied. Disciplinary differences were evident both in the terminology used to describe PE and the drivers for PE highlighted by participants – with applied health science funders more aligned with participatory models of PE. Within the grant funding process PE was rarely systematically treated as a key component of research. In particular, PE was not routinely incorporated into the planning of funding calls. PE was more likely to be considered in the application and assessment phases, where it was largely appraised as a tool for enhancing science. Concerns were expressed regarding how to monitor and evaluate PE within research. Conclusions: This study suggests funding agencies working within specific areas of health and medicine can promote particular definitions of PE and aligned practices which determine the boundaries in which researchers working in these areas understand and practice PE. Our study also highlights how the research grant process works to privilege particular conceptions of PE and its purpose. Tensions are evident between some funders’ core concepts of traditional science and PE, and they face challenges as they try to embed PE into long-standing systems that prioritise particular conceptions of ‘scientific excellence’ in research

Are physical education policies working? A snapshot from San Francisco, 2011.

IntroductionSchool physical education (PE) has been identified as a critical public health tool to increase physical activity among youths. We sought to objectively assess compliance with PE quantity mandates and quality recommendations in a large urban California school district.MethodsWe collected PE schedules and systematically observed PE lessons (n=154) in 20 elementary, 4 middle, and 4 high schools from February through May 2011.ResultsOn the basis of schools' master schedules, 83% of elementary schools met the California state mandate of 100 PE minutes per week. Teachers' actual schedules indicated that 20% of schools met the mandate, and observation showed that only 5% were in compliance. All middle and high schools met the mandated 200 minutes per week. On average, classes at all school levels met the recommended 50% of PE lesson time in moderate-to-vigorous physical activity. No teacher- or school-level factors significantly predicted PE quantity, but credentialed elementary PE teachers spent more time building students' motor skills.ConclusionsOur results suggest that current national estimates of PE, which are based on schools' self-report, overestimate the amount of PE provided in elementary schools. Although more than half of PE class time was spent in moderate-to-vigorous physical activity, total physical activity in elementary schools from PE is minimal and may do little to contribute to students' overall health

Time evolution of the classical and quantum mechanical versions of diffusive anharmonic oscillator: an example of Lie algebraic techniques

We present the general solutions for the classical and quantum dynamics of the anharmonic oscillator coupled to a purely diffusive environment. In both cases, these solutions are obtained by the application of the Baker-Campbell-Hausdorff (BCH) formulas to expand the evolution operator in an ordered product of exponentials. Moreover, we obtain an expression for the Wigner function in the quantum version of the problem. We observe that the role played by diffusion is to reduce or to attenuate the the characteristic quantum effects yielded by the nonlinearity, as the appearance of coherent superpositions of quantum states (Schr\"{o}dinger cat states) and revivals.Comment: 21 pages, 6 figures, 2 table

How Peclet number affects microstructure and transient cluster aggregation in sedimenting colloidal suspensions

We study how varying the P \'eclet number (Pe) affects the steady state sedimentation of colloidal particles that interact through short-ranged attractions. By employing a hybrid molecular dynamics simulation method we demonstrate that the average sedimentation velocity changes from a non- monotonic dependence on packing fraction {\phi} at low Pe numbers, to a monotonic decrease with {\phi} at higher Pe numbers. At low Pe number the pair correlation functions are close to their equilibrium values, but as the Pe number increases, important deviations from equilibrium forms are observed. Although the attractive forces we employ are not strong enough to form permanent clusters, they do induce transient clusters whose behaviour is also affected by Pe number. In particular, clusters are more likely to fragment and less likely to aggregate at larger Pe numbers, and the probability of finding larger clusters decreases with increasing Pe number. Interestingly, the life-time of the clusters is more or less independent of Pe number in the range we study. Instead, the change in cluster distribution occurs because larger clusters are less likely to form with increasing Pe number. These results illustrate some of the subtleties that occur in the crossover from equilibrium like to purely non-equilibrium behaviour as the balance between convective and thermal forces changes.Comment: 8 page

Complexation of a polyelectrolyte with oppositely charged spherical macroions: Giant inversion of charge

Complexation of a long flexible polyelectrolyte (PE) molecule with oppositely charged spherical particles such as colloids, micelles, or globular proteins in a salty water solution is studied. PE binds spheres winding around them, while spheres repel each other and form almost periodic necklace. If the total charge of PE is larger than the total charge of spheres, repulsive correlations of PE turns on a sphere lead to inversion of the net charge of each sphere. In the opposite case, we predict another correlation effect: under-screened by PE spheres bind to PE in such a great number that they invert charge of PE. The inverted charge by absolute value can be larger than the bare charge of PE even when screening by monovalent salt is weak. At larger concentrations of monovalent salt, the inverted charge can reach giant proportions. Our theory is in qualitative agreement with recent experiments on micelles-PE systems.Comment: Various additions and corrections to the text, Figures and references. Accepted for publication in J. Chem. Phys. 200

KADAR TNF-aIL-6 DAN APOPTOSIS TROFOBLAST PLASENTA Pada Preeklampsia-Eklampsia dan non Preklampsia-Eklampsia

Objectives: The aim of this study is to investigate the relation among TNF-a -6 concentration/expression with placental tissue infarction and apoptosis between PE-E and non PE-E. Material and method: Research subjects were 35 subjects, composed of 17 non PE-E and 18 PE-E parturient that delivery or hospitalized on Department of OBGYN Dr. Kariadi General Hospital Semarang. The concentration/expression of TNF- -6 were measured from vein blood sample and placental tissue by ELISA and immunohystochemistry (IHC) method. Apoptosis area was measured by IHC with Acridine orange staining. Results: The average of infarction on normal subjects was 12.5%, however, on PE-E was 35.3% (p=0.001). The average of apoptosis on normal subjects was 32.3 %, however, on PE-E subjects were 71.0% (p=0.001). The average of placenta TNFpg/ mL, on PE-E was 2.0 pg/mL (p<0.001). The average of serum TNFnormal subjects was 2.3 pg/mL, on PE-E was 2.8 pg/mL (p<0.001). The average of placenta IL- 6 concentration of normal subjects was 0.6 pg/mL, on PE-E was 1.3 pg/mL (p<0.001). The average of serum IL-6 concentration of normal subjects was 1.4 pg/mL, on PE-E was 2.0 pg/mL (p<0.001). There were a significant correlation among TNF-a -6 serum and placenta with apoptosis of placenta. Conclusion: Proinflammatory cytokines concentration on serum and placenta extract of subjects with PE-E were significantly higher than non PE-E. There was a significant correlation between proinflammatory cytokines concentration on serum or placenta with apoptosis of placental tissue. Keywords: TNF-a , IL-6, infarct, apoptosis, placenta, preeclampsia, eclampsia