The trends in prostate specific antigen usage amongst United Kingdom urologists – a questionnaire based study

<p>Abstract</p> <p>Background</p> <p>Worldwide, the use of prostate specific antigen (PSA) testing as a screen for prostate cancer is contentious. Whilst there is no National UK Screening programme, many men undergo opportunistic screening. This study investigates UK urologist's usage of PSA and the awareness surrounding the Department of Health (DoH) PSA guidelines.</p> <p>Methods</p> <p>Urologists were sent a questionnaire regarding PSA cut-off values.</p> <p>Results</p> <p>Of the 733 urologists eligible to participate in this study 346 returned completed questionnaires giving a response rate of 47%. The most commonly generally used age-related PSA cut-off values (36% of respondents) are – 3.5 ng/ml for 50 – 59 year olds, 4.5 ng/ml for 60 – 69 year olds and 6.5 ng/ml for over 70 year olds. Two-thirds (58%, 200/346) of respondents were aware of the DoH PSA guidelines but only 20% (n = 69/346) follow these guidelines. The majority of respondents (68%, n = 234/346) used higher PSA cut-offs than recommended by the DoH. The level of compliance showed marked regional variation with a range from 7% to 44% (median 19%). In addition, it was apparent that lower PSA cut-off values were used in private practice as opposed to the National Health Service.</p> <p>Conclusion</p> <p>A nationwide lack of agreement on PSA cut-off values may generate a variable standard of care both regionally and in NHS versus private practice. Generally, higher PSA cut-off values are being used than recommended by the DoH guidance.</p

Loss of AP-2delta reduces retinal ganglion cell numbers and axonal projections to the superior colliculus

Background: AP-2 delta is the most divergent member of the Activating Protein-2 (TFAP2) family of transcription factors. AP-2 delta is restricted to specific regions of the CNS, including a subset of ganglion cells in the retina. Retinal ganglion cells (RGCs), the only output neurons of the retina, are responsible for transmitting the visual signal to the brain. Results: AP-2 delta knockout results in loss of Brn3c (Pou4f3) expression in AP-2 delta -positive RGCs. While AP-2 delta-/- mice have morphologically normal retinas at birth, there is a significant reduction in retinal ganglion cell numbers by P21, after eye opening. Chromatin immunoprecipitation indicates that Brn3c is a target of AP-2 delta in the retina. Using fluorochrome-conjugated cholera toxin subunit B to trace ganglion cell axons from the eye to the major visual pathways in the brain, we found 87 % and 32 % decreases in ipsilateral and contralateral projections, respectively, to the superior colliculus in AP-2 delta-/- mice. In agreement with anatomical data, visually evoked responses recorded from the brain confirmed that retinal outputs to the brain are compromised. Conclusions: AP-2 delta is important for the maintenance of ganglion cell numbers in the retina. Loss of AP-2 delta alters retinal axonal projections to visual centers of the brain, with ipsilaterial projections to the superior colliculus being the most dramatically affected. Our results have important implications for integration of the visual signal at the superior colliculus

Development of Best Practices for Right-of-Way Valuations and Negotiations in Transportation Projects

The valuations of properties and the negotiations with property owners are two major tasks in the right-of-way acquisition process for transportation projects. If improved, those tasks can increase the overall project delivery efficiency. The Texas Department of Transportation (TxDOT) funded a research project that aimed to recommend some best practices for successful valuations and negotiations in Texas. The authors reviewed the different strategies and procedures followed in TxDOT by conducting interviews and surveys with right-of-way personnel. Guidelines supported by recommended practices were identified for both valuation and negotiation and then reviewed and validated by experts. Lastly, implementation guides were developed

The Circumcision Issue

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68100/2/10.1177_000992289903800407.pd

Increased expression of integrin-linked kinase is associated with shorter survival in non-small cell lung cancer

BACKGROUND: Integrin-linked kinase (ILK) promotes tumor growth and invasion. Increased ILK expression is correlated with progression of several tumor types, but the expression of ILK has not been investigated in patients with non-small cell lung cancers (NSCLCs). METHODS: We investigated ILK expression in patients with NSCLC by means of immunohistochemistry. RESULTS: ILK expression was significantly associated with tumor grade, T status, lymph node metastasis and stage. (p = 0.0169 for tumor grade; p = 0.0006 for T status; p = 0.0002 for lymph node metastasis; p < 0.0001 for stage). The 5-year survival rates for patients with strong and weak or no ILK expression levels were 20% and 59%, respectively: the difference was statistically significant (p < 0.0001). A multivariate analysis of survival revealed that ILK expression, T status, N status and vascular invasion were statistically significant prognostic factors (p = 0.0218 for ILK; p = 0.0046 for T status; p < 0.0001 for N status; p < 0.0001 for vascular invasion). CONCLUSIONS: Our study demonstrates that increased expression of ILK is a poor prognostic factor in patients with NSCLC

P3‐473: Service need among individuals with mild cognitive impairment and Alzheimer’s disease

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/152600/1/alzjjalz2008052044.pd