An electronic registry to improve adherence to active surveillance monitoring among men with prostate cancer at a safety-net hospital: protocol for a pilot study.

BackgroundThe evidence-based practice of active surveillance to monitor men with favorable-risk prostate cancer in lieu of initial definitive treatment is becoming more common. However, there are barriers to effective implementation, particularly in low-resource settings. Our goal is to assess the efficacy and feasibility of a health information technology registry for men on active surveillance at a safety-net hospital to ensure patients receive guideline-recommended care.MethodsWe developed an electronic registry for urology clinic staff to monitor men on active surveillance. The health information technology tool was developed using the Systems Engineering Initiative for Patient Safety model and iteratively tailored to the needs of the clinic by engaging providers in a co-design process. We will enroll all men at Zuckerberg San Francisco General Hospital and Trauma Center who choose active surveillance as a treatment strategy. The primary outcomes to be assessed during this non-randomized, pragmatic evaluation are number of days delayed beyond recommended date of follow-up testing, the proportion of men who are lost to follow-up, the cancer stage at active treatment, and the feasibility and acceptability of the clinic-wide intervention with clinic staff. Secondary outcomes include appointment adherence within 30 days of the scheduled date.DiscussionUse of a customized electronic approach for monitoring men on active surveillance could improve patient outcomes. It may help reduce the number of men lost to follow-up and improve adherence to timely follow-up testing. Evaluating the adoption and efficacy of a customized registry in a safety-net setting may also demonstrate feasibility for implementation in diverse clinical contexts.Trial registrationClinicalTrials.gov identifier NCT03553732, An Electronic Registry to Improve Adherence to Active Surveillance Monitoring at a Safety-net Hospital. Registered 11 June 2018

The Applicant's Perspective on Urology Residency Interviews: A Qualitative Analysis

ObjectiveTo better understand what urology applicants look for on interview day and what they care about in selecting a residency program through an analysis of anonymous online posts about the urology interview process.MethodsWe collected 3 years (2016-2018) of comments and posts from the Interview Impressions tab of the Urology Match Google Sheet for 133 urology residencies. Qualitative data analysis was performed using grounded theory methodology.ResultsWe identified 6 categories of themes on (1) interview day structure, (2) diverse faculty, (3) program culture, (4) surgical training, (5) research, and (6) program benefits. These themes appeared in comments for 77%-86% of the residency programs except for research which was present for 44% of the programs. The efficiency and structure of interview day are very important. Applicants also care about young and diverse fellowship-trained faculty across a wide breadth of subspecialties. They believe they are able to discern the program culture and collegiality between residents and faculty. Applicants want a balance of surgical and clinical training with a focus on robotics and surgical autonomy. Not all applicants are interested in research but those that are appreciate a strong support system. Finally, additional program benefits and the positives and negatives of the program's location are frequently discussed.ConclusionAnalysis of anonymous social media posts can help improve the interview process for applicants and programs alike. Programs can also identify areas of improvement for residency training. Our findings provide additional insight towards the ultimate goal of improving the match process

Fluorescence-Based Functional Assay for Wnt/-Catenin Signaling Activity

Aberrant activation of beta-catenin signaling has been implicated in the development of human cancers. As a Wnt signal transducer, beta-catenin forms a complex with the lymphocyte enhancer-binding factor/T cell factor transcription factor and activates downstream targets that promote cell proliferation. Here we developed a Wnt-dependent beta-catenin-mediated heterologous transactivation system, which consisted of a chimeric transcription factor constructed by fusing the GAL4 DNA-binding domain with the full-length beta-catenin, and a GAL4-responsive reporter expressing GFP. The chimeric transcription factor was highly unstable and exerted no detectable transactivating effect on the GAL4-responsive reporter. However, lithium and Wnt1 significantly stabilized this chimeric transactivator, indicating that this transactivation system is regulated by beta-catenin in a Wnt-responsive fashion. Thus, this transactivation system could be used as a functional reporter to identify potential upstream factors that deregulate beta-catenin signaling during tumorigenesis, as well as to screen for potential anti-cancer agents that specifically inhibit beta-catenin signaling in human tumors

Simulation of integrate-and-fire neuron circuits using HfO₂-based ferroelectric field effect transistors

Inspired by neurobiological systems, Spiking Neural Networks (SNNs) are gaining an increasing interest in the field of bio-inspired machine learning. Neurons, as central processing and short-term memory units of biological neural systems, are thus at the forefront of cutting-edge research approaches. The realization of CMOS circuits replicating neuronal features, namely the integration of action potentials and firing according to the all-or-nothing law, imposes various challenges like large area and power consumption. The non-volatile storage of polarization states and accumulative switching behavior of nanoscale HfO₂ - based Ferroelectric Field-Effect Transistors (FeFETs), promise to circumvent these issues. In this paper, we propose two FeFET-based neuronal circuits emulating the Integrate-and-Fire (I&F) behavior of biological neurons on the basis of SPICE simulations. Additionally, modulating the depolarization of the FeFETs enables the replication of a biology-based concept known as membrane leakage. The presented capacitor-free implementation is crucial for the development of neuromorphic systems that allow more complex features at a given area and power constraint

Influence of Castor canadensis on northern lower Michigan forest succession

General EcologyForests undergo a natural progression, called ecological succession, in which they experience a gradual change in community species composition (Luken 1990). As the tree community cycles through each stage of succession, the surrounding habitat cycles and transforms with it (Barnes and Wagner 2004). Our study focuses on how Castor canadensis (North American beaver) affects the direction of forest succession in northern lower Michigan. We counted, identified, and measured the diameter of standing and felled trees at four known beaver sites in the vicinity of Pellston, MI. In addition, we counted and identified 50 randomly selected juvenile trees at each site. Our results showed that C. Canadensis have a preference for Populus tremuloides (trembling aspen) (chi-square: p=0.008) and early successional tree species (chi-square: p=0.000) and show no foraging preference based on tree diameter (Mann-Whitney U: p=0.109). By comparing adult tree species to juvenile tree species, we also found that the species composition prior to and during beaver interference differs significantly from future forest species composition (chi-square: p=0.016). Given these results, we conclude that the foraging preferences of C. canadensis caused a premature progression of forest succession.http://deepblue.lib.umich.edu/bitstream/2027.42/78379/1/Breyer_Ruddy_Silver_2010.pd