The interaction of marine fouling organisms with topography of varied scale and geometry: a review

Many studies have examined the effects of surface topography on the settlement behaviour of marine organisms and this article reviews these investigations with more emphasis on the effects of topography scale. It has been observed that macro topographies (1-100 mm) are generally favoured by marine fouling taxa and are unsuitable for antifouling applications. This is because macro topographies are usually large enough to fit fouling organisms and provide refuge from dangers in the marine environment. Micro topographies had only limited success at reducing fouling from a wide range of marine taxa. The antifouling performance of micro topographies (1 to ≤1000 μm) is dependent on the properties of topography features in terms of symmetry, isotropy, width, length, height/depth, separation distance and average roughness. In terms of the antifouling performance of micro topography, topography geometry may only be of secondary importance in comparison to the size of features itself. It is also noted that hydrodynamic stresses also contribute to the settlement trends of foulers on textured surfaces. Future studies on antifouling topographies should be directed to hierarchical topographies because the mixed topography scales might potentially reduce fouling by both micro and macro organisms. Patterned nano-topographies (1- ≤1000 nm) should also be explored because the antifouling mechanisms of these topographies are not yet clear

Empirical estimates of prostate cancer overdiagnosis by age and prostate-specific antigen

Background: Prostate cancer screening depends on a careful balance of benefits, in terms of reduced prostate cancer mortality, and harms, in terms of overdiagnosis and overtreatment. We aimed to estimate the effect on overdiagnosis of restricting prostate specific antigen (PSA) testing by age and baseline PSA.Methods: Estimates of the effects of age on overdiagnosis were based on population based incidence data from the US Surveillance, Epidemiology and End Results database. To investigate the relationship between PSA and overdiagnosis, we used two separate cohorts subject to PSA testing in clinical trials (n = 1,577 and n = 1,197) and a population-based cohort of Swedish men not subject to PSA-screening followed for 25 years (n = 1,162).Results: If PSA testing had been restricted to younger men, the number of excess cases associated with the introduction of PSA in the US would have been reduced by 85%, 68% and 42% for age cut-offs of 60, 65 and 70, respectively. The risk that a man with screen-detected cancer at age 60 would not subsequently lead to prostate cancer morbidity or mortality decreased exponentially as PSA approached conventional biopsy thresholds. For PSAs below 1 ng/ml, the risk of a positive biopsy is 65 (95% CI 18.2, 72.9) times greater than subsequent prostate cancer mortality.Conclusions: Prostate cancer overdiagnosis has a strong relationship to age and PSA level. Restricting screening in men over 60 to those with PSA above median (>1 ng/ml) and screening men over 70 only in selected circumstances would importantly reduce overdiagnosis and change the ratio of benefits to harms of PSA-screening

Feasibility study of a clinically-integrated randomized trial of modifications to radical prostatectomy

<p>Abstract</p> <p>Background</p> <p>Numerous technical modifications to radical prostatectomy have been proposed. Such modifications are likely to lead to only slight improvements in outcomes. Although small differences would be worthwhile, an appropriately powered randomized trial would need to be very large, and thus of doubtful feasibility given the expense, complexity and regulatory burden of contemporary clinical trials. We have proposed a novel methodology, the clinically-integrated randomized trial, which dramatically streamlines trial procedures in order to reduce the marginal cost of an additional patient towards zero. We aimed to determine the feasibility of implementing such a trial for radical prostatectomy.</p> <p>Methods</p> <p>Patients undergoing radical prostatectomy as initial treatment for prostate cancer were randomized in a factorial design to involvement of the fascia during placement of the anastomotic sutures, urethral irrigation, both or neither. Endpoint data were obtained from routine clinical documentation. Accrual and compliance rates were monitored to determine the feasibility of the trial.</p> <p>Results</p> <p>From a total of 260 eligible patients, 154 (59%) consented; 56 patients declined to participate, 20 were not approached on recommendation of the treating surgeon, and 30 were not approached for logistical reasons. Although recording by surgeons of the procedure used was incomplete (~80%), compliance with randomization was excellent when it was recorded, with only 6% of procedures inconsistent with allocation. Outcomes data was received from 71% of patients at one year. This improved to 83% as the trial progressed.</p> <p>Conclusions</p> <p>A clinically-integrated randomized trial was conducted at low cost, with excellent accrual, and acceptable compliance with treatment allocation and outcomes reporting. This demonstrates the feasibility of the methodology. Improved methods to ensure documentation of surgical procedures would be required before wider implementation.</p> <p>Trial registration</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT00928850">NCT00928850</a></p

Validation study of a web-based assessment of functional recovery after radical prostatectomy

<p>Abstract</p> <p>Background</p> <p>Good clinical care of prostate cancer patients after radical prostatectomy depends on careful assessment of post-operative morbidities, yet physicians do not always judge patient symptoms accurately. Logistical problems associated with using paper questionnaire limit their use in the clinic. We have implemented a web-interface ("STAR") for patient-reported outcomes after radical prostatectomy.</p> <p>Methods</p> <p>We analyzed data on the first 9 months of clinical implementation to evaluate the validity of the STAR questionnaire to assess functional outcomes following radical prostatectomy. We assessed response rate, internal consistency within domains, and the association between survey responses and known predictors of sexual and urinary function, including age, time from surgery, nerve sparing status and co-morbidities.</p> <p>Results</p> <p>Of 1581 men sent an invitation to complete the instrument online, 1235 responded for a response rate of 78%. Cronbach's alpha was 0.84, 0.86 and 0.97 for bowel, urinary and sexual function respectively. All known predictors of sexual and urinary function were significantly associated with survey responses in the hypothesized direction.</p> <p>Conclusions</p> <p>We have found that web-based assessment of functional recovery after radical prostatectomy is practical and feasible. The instrument demonstrated excellent psychometric properties, suggested that validity is maintained when questions are transferred from paper to electronic format and when patients give responses that they know will be seen by their doctor and added to their clinic record. As such, our system allows ready implementation of patient-reported outcomes into routine clinical practice.</p

Master's Recitals

Recital presented at the UNT College of Music Kenton Hall in partial fulfillment of the Master of Music (MM) degree

Inhibition of invertebrate larval settlement by biofilm ciliates

Protozoa, a ubiquitous component of microbial biofilms, are able to rapidly colonise new substrata and reach high abundances, yet their potential to influence invertebrate settlement on these biofilms remains largely unknown. We conducted still-water, no-choice settlement assays to determine the individual effects of 4 different species of marine biofilm-dwelling ciliates on settlement of the polychaete worm, Galeolaria caespitosa. The ciliates included vagile and planktonic species common to natural assemblages. Each ciliate species significantly inhibited the settlement of G. caespitosa, with the exception of Litonotus sp. The extent of inhibition differed significantly among ciliate species. Settlement was significantly reduced in the presence of Amphisiella sp. (37.5%), Euplotes minuta (43.7%) and Uronema marinum (39.6%) over 72 hours compared to the control. Settlement rates in the presence of filtrate from ciliate cultures were at no point significantly different from a control, ruling out a dissolved chemical cue; settlement was only inhibited in the physical presence of ciliates. Video analysis showed that the ciliate Euplotes minuta elicits more erratic movement and substrate avoidance in surface exploration by G. caespitosa larvae. In addition, the distribution of bacteria in the ciliate treatments was significantly more clustered than in controls, indicating a potential indirect mechanism by which ciliates impacted larval settlement. This is the first report of a behavioural response of invertebrate larvae following direct contact with ciliates which, together with possible indirect interactions involving bacteria, may constrain invertebrate recruitment in nature

Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition.

PURPOSE: Prostate-specific antigen (PSA) defined biochemical recurrence (BCR) of prostate cancer is widely used for reporting the outcome of radical prostatectomy (RP). A standardized BCR definition is lacking, and overall progression-free probability and risk of subsequent metastatic disease progression may vary greatly depending on the PSA criterion used. Ten definitions of BCR were evaluated to identify the one that best explains metastatic progression. METHODS: Of 3,125 patients who underwent RP at our institution since 1985, 75 developed distant metastasis during a median follow-up of 49 months. To predict metastasis progression, we modeled the clinical information using multivariable Cox regression analysis. BCR was included in the model as a time-dependent covariate, and separate models were developed for each definition. A goodness-of-fit (R2) statistic was used to determine the Cox model (and thereby the BCR definition) that best explained metastatic progression. RESULTS: The 10-year progression-free probability ranged from 63% to 79%, depending on the BCR definition. The model containing BCR defined as a PSA of at least 0.4 ng/mL followed by another increase best explained metastatic progression (R2 = 0.21). This definition was also associated with a high probability of subsequent secondary therapy, continued PSA progression, and rapid PSA doubling time. CONCLUSION: BCR defined as a PSA value of at least 0.4 ng/mL followed by another increase best explains the development of distant metastasis among 10 candidate definitions, after controlling for clinical variables and the use of secondary therapy. On the basis of this evidence, we propose that this definition be adopted as the standard for reporting the outcome of RP