Biparametric versus multiparametric MRI in the diagnosis of prostate cancer

BACKGROUND: Since multiparametric magnetic resonance imaging (mp-MRI) of the prostate exceeds 30 min, minimizing the evaluation time of significant (Gleason scores > 6) prostate cancer (PCa) would be beneficial. A reduced protocol might be sufficient for the diagnosis. PURPOSE: To study whether a short unenhanced biparametric MRI (bp-MRI) matches mp-MRI in detecting significant PCa. MATERIAL AND METHODS: A total of 204 men (median age, 65 years; mean ± SD, 64.1; range 45–75 years; median serum PSA level, 14 ng/mL; range, 2.2–120 ng/mL; median prostate volume, 60 mL; range, 23–263 mL) fulfilled the criteria for being enrolled. They underwent mp-MRI and prostate biopsy from January through June 2014. Of the included patients, 9.3% underwent prostatectomy, 90.7% had TRUS-bx, and 10.8 had MRI-targeted TRUS-bx. Two radiologists separately assessed the mp-MRI examination (T2-weighted [T2W] imaging, diffusion-weighted imaging [DWI], apparent diffusion coefficient map [ADC-map] and dynamic contrast-enhanced imaging [DCE]). Two months later, the bp-MRI version (T2W imaging, DWI, and ADC-map) was evaluated. RESULTS: Reader 1: Assessing mp-MRI: 0 false negatives, sensitivity of 1, and specificity 0.04. Assessing bp-MRI: four false negatives, sensitivity of 0.94, and specificity 0.15. Reader 2: Assessing mp-MRI: five false negatives, sensitivity of 0.93, and specificity 0.16. Assessing bp-MRI: three false negatives, sensitivity of 0.96, and specificity 0.15. Intra-reader agreement Cohen’s Kappa (κ) was 0.87 for reader 1 (95% confidence interval [CI], 0.83–0.92) and 0.84 for reader 2 (95% CI 0.78–0.89). CONCLUSION: Bp-MRI is as good as mp-MRI at detecting PCa. A large prospective study seems to be strongly warranted

MyHospitalVoice – a digital tool co-created with children and adolescents that captures patient-reported experience measures: a study protocol

Abstract Background Children and adolescents have the right to participate in decisions concerning their health and express their views, also regarding hospital experiences. Patient-reported experience measures (PREMs) are valuable tools for systematically incorporating patient voices into healthcare systems. New developments have focused on PREMs for children and adolescents, though they are more commonly used in adults. A recent systematic review mapping their use for children and adolescents indicates a growing interest in this area. However, most PREMs are completed by proxy, in this case parents, so they do not necessarily reflect children’s experiences or align with their rights. Innovation is required to support and engage children and adolescents in responding to these types of questionnaires. Methods Collaborating with children and adolescents (4–17 years), the primary aim of this study is to develop and validate the tool MyHospitalVoice containing digital and developmentally appropriate PREMs. The secondary aim is to document and evaluate the approaches used to involve children and adolescents and to assess the impact of their involvement. Based on the European Organisation for Research and Treatment of Cancer framework, we will divide its development and validation into four phases. First, we will discuss PREM items with children and adolescents, who will select and prioritise what they perceive as most important. Second, we will create items targeting different age groups (4–7, 8–12, and 13–17 years) and design a responsive digital interface with child and youth friendly ways of responding to the questionnaires. Third, we will explore how children and adolescents perceive MyHospitalVoice using cognitive interviewing techniques and other age-appropriate methods. Last, we will pilot test MyHospitalVoice to explore patient experiences and response rates. In each phase, children and adolescents will play an active role. We will involve young adults as peer researchers in the project group to ensure that their perspectives are part of the decision-making process. Discussion This project will contribute to research on co-creating with children and adolescents and enhance our understanding of their patient experiences. A validated tool like MyHospitalVoice can help improve quality of care by translating the needs and preferences of children and adolescents into clinical practice

Making Sense or Non-Sense? Communicating COVID-19 Guidelines to Young Adults at Danish Folk High Schools

Little is known about young people’s behaviors and responses under outbreaks of infectious diseases such as the COVID-19 pandemic, especially in institutional settings. This research investigated the reactions of young adults residing at Danish folk high schools (FHSs) towards COVID-19 guidelines and the communicative styles used to enforce COVID-19 guidelines. The qualitative data consists of focus group discussions (FGDs) with students, interviews with staff, and participant observations, as well as survey data from 1800 students. This study showed that young adults reacted negatively when first faced with the new reality of COVID-19 restrictions. They expressed distress over the loss of meaning (non-sense), loss of sense of community, as well as uncertainty. Hygiene guidelines, however, made immediate sense and were socially well accepted. Most FHSs actively involved students in risk communication and creative examples of community-building communication were identified. This study demonstrates that successful risk communication at educational institutions must take into consideration how young adults make sense of and cope with the uncertainties of life during crisis situations including epidemics

Oxidation of Methane/<i>n</i>‑Heptane Mixtures in a High-Pressure Flow Reactor

To evaluate the use of diesel as a pilot fuel in natural gas combustion in two-stroke maritime engines, research on high-pressure oxidation of methane/n-heptane mixtures is of interest. In this study, laminar flow reactor experiments were conducted at pressures of 21 and 100 bar, temperatures in the range 450–900 K, and under stoichiometric and fuel-lean conditions. For all conditions, the n-heptane conversion starts below 600 K. A pronounced negative temperature coefficient region was observed at 21 bar. The n-heptane was depleted at all conditions before reaching 900 K. Methane oxidation was initiated once n-heptane was consumed. Compared to the oxidation of pure n-heptane and NH3/n-heptane mixtures, the presence of methane promoted n-heptane oxidation in the full temperature range. The model from Zhang et al. provided overall a good agreement with the experimental data. However, the low-temperature conversion of n-heptane at 21 bar and stoichiometric conditions is underpredicted, possibly because some chemical coupling between n-heptane and methane is missing in the model

Oxidation of Methane/<i>n</i>‑Heptane Mixtures in a High-Pressure Flow Reactor

To evaluate the use of diesel as a pilot fuel in natural gas combustion in two-stroke maritime engines, research on high-pressure oxidation of methane/n-heptane mixtures is of interest. In this study, laminar flow reactor experiments were conducted at pressures of 21 and 100 bar, temperatures in the range 450–900 K, and under stoichiometric and fuel-lean conditions. For all conditions, the n-heptane conversion starts below 600 K. A pronounced negative temperature coefficient region was observed at 21 bar. The n-heptane was depleted at all conditions before reaching 900 K. Methane oxidation was initiated once n-heptane was consumed. Compared to the oxidation of pure n-heptane and NH3/n-heptane mixtures, the presence of methane promoted n-heptane oxidation in the full temperature range. The model from Zhang et al. provided overall a good agreement with the experimental data. However, the low-temperature conversion of n-heptane at 21 bar and stoichiometric conditions is underpredicted, possibly because some chemical coupling between n-heptane and methane is missing in the model

Establishing consensus on principles and competencies for the use of play in clinical practice in hospitals: An international Delphi study.

Acknowledgements: We thank Nancy Aaen, copy editor and translator, for revising the manuscript.Funder: LEGO Foundation; doi: http://dx.doi.org/10.13039/100018325Funder: National HospitalAlthough play has existed in paediatric hospitals for decades, a shared understanding of why and how healthcare professionals use play in clinical practice is lacking. This study aims to reach consensus on a common set of principles and competencies for play interventions and practices in hospitals. We conducted a three-round Delphi study that included healthcare professionals selected by hospital management. The first round comprised open-ended questions on the use of play in clinical practice. Principles and competencies, including learning objectives, were established using content analysis through an iterative process. Participants rated the importance of each principle and learning objective in the second and third rounds. Among the 66 participants, 45 (68%) responded in round 1 and 41 (62%) in rounds 2 and 3. The participants represented ten countries and nine different health professions. After the three rounds, we identified 33 principles and six overall competencies: building trusting relationships; delivering information and increasing understanding; promoting cooperation and participation; reducing procedure-related anxiety and pain; supporting coping and development; and ensuring a professional approach to play, which comprised 20 learning objectives.  Conclusion: According to healthcare professionals, play in clinical practice can be used to communicate and build relationships with paediatric patients and thus potentially help provide patient-centred care. Our findings may help guide and prioritize future research initiatives and operationalize play interventions and practices in hospitals. What is Known: • Evidence suggests that using play in clinical practice can help paediatric patients during hospitals stays. • Despite the evidence supporting the use of play, a shared understanding of why and how paediatric healthcare professionals use play is needed. What is New: • This international Delphi study contributes to a shared interprofessional understanding of the principles, competencies and learning objectives for the use of play in clinical practice. • The findings have the potential to aid initiatives in developing training programmes for healthcare professionals in using play to provide care with a patient-centred approach

Establishing consensus on principles for the use of play in clinical practice in hospitals: an international Delphi study protocol

Protocol for International Delphi study about establishing consensus on principles for the use of play in clinical practice in hospital