Archaeological Post-Excavation Practice in Contracting Archaeology in England and Wales

This historical review and detailed analysis of the evolution of post-excavation policy and practice within British professional archaeology employs Grounded Theory methodology for the collection and analysis of qualitative data from interviews with individual archaeologists who had completed post-excavation projects and written archaeological reports and archaeological publications over the last fifty years in an attempt to gain a new perspective upon the interpretation of data from archaeological excavations. The researcher's analysis demonstrates significant changes in both the process of archaeological interpretation and the quality of the archaeological reports and the archaeological publications produced over the last fifty years, particularly since the emergence of commercial archaeology in the late 1980's and significantly since 1990. The thesis proposes that published and unpublished reports must be subject to a more critical approach, a form of 'source criticism', to re-evaluate the quality of data and interpretation and ensure that conclusions drawn from their findings are based on valid assumptions. It argues that there has been a shift from a 'bottom up' approach, grounded in evidence based interpretation of site records, to a 'top down' approach which imposes an archaeological interpretation upon site records, what the author describes as 'preservation by interpretation'. In a larger view the researcher proposes that the quality and reliability of archaeological interpretation and reporting is a product, at a macro-level, of heritage policy and market economics and, at a micro-level, of distinctive local institutional and personal variation in methodology and preference. A future framework is proposed for integrating archaeological archiving and area base interpretation of excavation data, designed principally to respond to the complexity of urban archaeology

Prostate Cancer in Primary Care

This is the final version of the article. Available from Springer Verlag via the DOI in this record.Prostate cancer is a common malignancy seen worldwide. The incidence has risen in recent decades, mainly fuelled by more widespread use of prostate-specific antigen (PSA) testing, although prostate cancer mortality rates have remained relatively static over that time period. A man's risk of prostate cancer is affected by his age and family history of the disease. Men with prostate cancer generally present symptomatically in primary care settings, although some diagnoses are made in asymptomatic men undergoing opportunistic PSA screening. Symptoms traditionally thought to correlate with prostate cancer include lower urinary tract symptoms (LUTS), such as nocturia and poor urinary stream, erectile dysfunction and visible haematuria. However, there is significant crossover in symptoms between prostate cancer and benign conditions affecting the prostate such as benign prostatic hypertrophy (BPH) and prostatitis, making it very challenging to distinguish between them on the basis of symptoms. The evidence for the performance of PSA in asymptomatic and symptomatic men for the diagnosis of prostate cancer is equivocal. PSA is subject to false positive and false negative results, affecting its clinical utility as a standalone test. Clinicians need to counsel men about the risks and benefits of PSA testing to inform their decision-making. Digital rectal examination (DRE) by primary care clinicians has some evidence to show discrimination between benign and malignant conditions affecting the prostate. Patients referred to secondary care for diagnostic testing for prostate cancer will typically undergo a transrectal or transperineal biopsy, where a number of samples are taken and sent for histological examination. These biopsies are invasive procedures with side effects and a risk of infection and sepsis, and alternative tests such as multiparametric magnetic resonance imaging (mpMRI) are currently being trialled for their accuracy and safety in diagnosing clinically significant prostate cancer

PENDAHULUAN KIMIA FISIK POLIMER

PEMBAHASAN KFPOL MELIPUTI SEJARAH POLIMER, KLASIFIKASI POLIMER, METODE SINTESIS POLIMER, MODIFIKASI POLIME

Active surveillance for prostate cancer: an update

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record. An increasing number of men diagnosed with localised prostate cancer has been accompanied by more men being considered for active surveillance as a management option. Here the author provides an update on recent developments in active surveillance and changes to NICE guidance

PyShoreVolume 1.0.0: A Python based Shoreline Change and beach Volumetric Change Analysis tool

Shoreline Change Analysis (SCA) and Volumetric Change Analysis (VCA) are of growing importance to coastal managers throughout the world. The volume, resolution and accuracy of shoreline configurations are gradually improving, which demands tools for efficient processing and analysis. The limited number of systems that combine the two analysis types have lengthy workflows or require commercial software licences, with no current tool that automates VCA from a time series of Digital Elevation Models (DEM’s). We present a new, dedicated and open-source package for automating SCA and VCA in the Python environment. It is designed with a user-friendly interface and workflow, delivers efficient processing speeds, automatically generates map based graphical outputs and computes a full range of positional statistics. We verify the package delivers equivalent outputs to existing tools (AMBUR, DSAS) and demonstrate strong performance by reconstructing erosion and accretion over the last twenty years along the beaches of the Taw and Torridge Estuary, North Devon, UK, a region known to have a complex sediment and morphometric dynamics

Systemic anticancer therapies and the role of primary care

This is the author accepted manuscript. The final version is available from Wiley via the link in this recordCancer therapeutics are complex, constantly evolving, and aim to prolong the life of a patient with cancer by cure, inducing remission, or by slowing disease progression. Cancer treatments can be delivered locally directly against the tumour (i.e. surgery or radiotherapy) or systemically (i.e. chemotherapy, hormone therapy). Systemic therapies have traditionally been administered intravenously in a hospital or day unit setting; however many of the more recently discovered systemic cancer therapies are taken as an oral medication. They also pose significant potential risks to a patient’s health through side effects, immunosuppression, and later development of secondary cancers. This article focusses on systemic cancer therapies from a primary care perspective. Recent developments and classifications of systemic therapies are briefly presented. Key considerations around monitoring, potential treatment harms, and patient support are discussed to inform the delivery of primary care for cancer patients receiving systemic therapies

Investigation of Multiple Recognitions Used for EFL Writing in Authentic Contexts

Recognition technologies had been prevailing and widely used for EFL learning. We investigated the different recognitions used for EFL writing based on image-to-text, translated speech-to-text, and location-to-text recognitions – ITR, TSTR, and LTR. A quasi-experiment was implemented for 12 weeks in a vocational high school with experimental and control groups in two stages. Pre-test, posttests 1 and 2, questionnaires, and interviews were conducted and analyzed. Experimental learners, who wrote writing based on ITR and TSTR, outperformed control learners who wrote that based on TSTR only. Also, the experimental learners, who wore writing based on ITR, TSTR, and LTR, outperformed the control learners who wrote that based on ITR and TSTR. Particularly, LTR was beneficial for identifying controlling ideas and addressing the writing topics. ITR was beneficial for brainstorming and generating more ideas. TSTR was beneficial for yielding and transferring writing contents into words. The multiple recognitions were beneficial for most EFL writers, especially for low-ability language writers. Most writers were interested in describing based on authentic context learning. However, they complained about the low accuracy of LTR and TSTR and the difficulty of ITR texts when writing. Accordingly, the LTR database with various categories of places, the generation of ITR based on the language abilities of learners, and the higher accuracy of TSTR should be strictly considered when applying multiple recognitions for EFL writing

Exploring the causes of death among patients with metastatic prostate cancer - A changing landscape

This is the final version. Available on open access from the American Medical Association via the DOI in this recordCancer Research U

Systematic review and meta-analysis of the diagnostic accuracy of prostate-specific antigen (PSA) for the detection of prostate cancer in symptomatic patients.

BACKGROUND: Prostate-specific antigen (PSA) is a commonly used test to detect prostate cancer. Attention has mostly focused on the use of PSA in screening asymptomatic patients, but the diagnostic accuracy of PSA for prostate cancer in patients with symptoms is less well understood. METHODS: A systematic database search was conducted of Medline, EMBASE, Web of Science, and the Cochrane library. Studies reporting the diagnostic accuracy of PSA for prostate cancer in patients with symptoms were included. Two investigators independently assessed the titles and abstracts of all database search hits and full texts of potentially relevant studies against the inclusion criteria, and data extracted into a proforma. Study quality was assessed using the QUADAS-2 tool by two investigators independently. Summary estimates of diagnostic accuracy were calculated with meta-analysis using bivariate mixed effects regression. RESULTS: Five hundred sixty-three search hits were assessed by title and abstract after de-duplication, with 75 full text papers reviewed. Nineteen studies met the inclusion criteria, 18 of which were conducted in secondary care settings with one from a screening study cohort. All studies used histology obtained by transrectal ultrasound-guided biopsy (TRUS) as a reference test; usually only for patients with elevated PSA or abnormal prostate examination. Pooled data from 14,489 patients found estimated sensitivity of PSA for prostate cancer was 0.93 (95% CI 0.88, 0.96) and specificity was 0.20 (95% CI 0.12, 0.33). The area under the hierarchical summary receiver operator characteristic curve was 0.72 (95% CI 0.68, 0.76). All studies were assessed as having a high risk of bias in at least one QUADAS-2 domain. CONCLUSIONS: Currently available evidence suggests PSA is highly sensitive but poorly specific for prostate cancer detection in symptomatic patients. However, significant limitations in study design and reference test reduces the certainty of this estimate. There is very limited evidence for the performance of PSA in primary care, the healthcare setting where most PSA testing is performed

Routes to diagnosis of symptomatic cancer in sub-Saharan Africa: Systematic review

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordData availability statement: Data sharing is not applicable as no datasets are generated and/or analysed for this study. No data are available. No additional data available.Background Most cancers in sub-Saharan Africa (SSA) are diagnosed at advanced stages, with limited treatment options and poor outcomes. Part of this may be linked to various events occurring in patients' journey to diagnosis. Using the model of pathways to treatment, we examined the evidence regarding the routes to cancer diagnosis in SSA. Design and settings A systematic review of available literature was performed. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Between 30 September and 30 November 2019, seven electronic databases were searched using terms relating to SSA countries, cancer and routes to diagnosis comprising the population, exposure and outcomes, respectively. Citation lists of included studies were manually searched to identify relevant studies. Furthermore, ProQuest Dissertations Theses Global was searched to identify appropriate grey literature on the subject. Results 18 of 5083 references identified met the inclusion criteria: Eight focused on breast cancer; three focused on cervical cancer; two each focused on lymphoma, Kaposi's sarcoma and childhood cancers; and one focused on colorectal cancer. With the exception of Kaposi's sarcoma, definitive diagnoses were made in tertiary healthcare centres, including teaching and regional hospitals. The majority of participants initially consulted within primary care, although a considerable proportion first used complementary medicine before seeking conventional medical help. The quality of included studies was a major concern, but their findings provided important insight into the pathways to cancer diagnosis in the region. Conclusion The proportion of patients who initially use complementary medicine in their cancer journey may explain a fraction of advanced-stage diagnosis and poor survival of cancer in SSA. However, further research would be necessary to fully understand the exact role (or activities) of primary care and alternative care providers in patient cancer journeys.Cancer Research UK (CRUK)Can Test Collaborativ