Doctors\u27 perspectives on PSA testing illuminate established differences in prostate cancer screening rates between Australia and the UK: A qualitative study

Objectives: To examine how general practitioners (GPs) in the UK and GPs in Australia explain their prostate-specific antigen (PSA) testing practices and to illuminate how these explanations are similar and how they are different. Design: A grounded theory study. Setting: Primary care practices in Australia and the UK. Participants: 69 GPs in Australia (n=40) and the UK (n=29). We included GPs of varying ages, sex, clinical experience and patient populations. All GPs interested in participating in the study were included. Results: GPs’ accounts revealed fundamental differences in whether and how prostate cancer screening occurred in their practice and in the broader context within which they operate. The history of prostate screening policy, organisational structures and funding models appeared to drive more prostate screening in Australia and less in the UK. In Australia, screening processes and decisions were mostly at the discretion of individual clinicians, and varied considerably, whereas the accounts of UK GPs clearly reflected a consistent, organisationally embedded approach based on local evidence-based recommendations to discourage screening. Conclusions: The GP accounts suggested that healthcare systems, including historical and current organisational and funding structures and rules, collectively contribute to how and why clinicians use the PSA test and play a significant role in creating the mindlines that GPs employ in their clinic. Australia’s recently released consensus guidelines may support more streamlined and consistent care. However, if GP mindlines and thus routine practice in Australia are to shift, to ultimately reduce unnecessary or harmful prostate screening, it is likely that other important drivers at all levels of the screening process will need to be addressed

Evolutionary history and identification of conservation units in the giant otter, Pteronura brasiliensis.

The giant otter, Pteronura brasiliensis, occupies a range including the major drainage basins of South America, yet the degree of structure that exists within and among populations inhabiting these drainages is unknown. We sequenced portions of the mitochondrial DNA (mtDNA) cytochrome b (612 bp) and control region (383 bp) genes in order to determine patterns of genetic variation within the species. We found high levels of mtDNA haplotype diversity (h = 0.93 overall) and support for subdivision into four distinct groups of populations, representing important centers of genetic diversity and useful units for prioritizing conservation within the giant otter. We tested these results against the predictions of three hypotheses of Amazonian diversification (Pleistocene Refugia, Paleogeography, and Hydrogeology). While the phylogeographic pattern conformed to the predictions of the Refugia Hypothesis, molecular dating using a relaxed clock revealed the phylogroups diverged from one another between 1.69 and 0.84 Ma, ruling out the influence of Late Pleistocene glacial refugia. However, the role of Plio-Pleistocene climate change could not be rejected. While the molecular dating also makes the influence of geological arches according to the Paleogeography Hypothesis extremely unlikely, the recent Pliocene formation of the Fitzcarrald Arch and its effect of subsequently altering drainage pattern could not be rejected. The data presented here support the interactions of both climatic and hydrological changes resulting from geological activity in the Plio-Pleistocene, in shaping the phylogeographic structure of the giant otter

On the orbital period of the magnetic Cataclysmic Variable HS 0922+1333

Context: The object HS 0922+1333 was visited briefly in 2002 in a mini survey of low accretion rate polars (LARPs) in order to test if they undergo high luminosity states similar to ordinary polars. On the basis of that short observation the suspicion arose that the object might be an asynchronous polar (Tovmassian et al. 2004). The disparity between the presumed orbital and spin period appeared to be quite unusual. Aims: We performed follow-up observations of the object to resolve the problem. Methods: New simultaneous spectroscopic and photometric observations spanning several years allowed measurements of radial velocities of emission and absorption lines from the secondary star and brightness variations due to synchrotron emission from the primary. Results: New observations show that the object is actually synchronous and its orbital and spin period are equal to 4.04 hours. Conclusions: We identify the source of confusion of previous observations to be a high velocity component of emission line arousing from the stream of matter leaving L1 point.Comment: 5 pages, 5 figures, accepted for publication in Astronomy & Astrophysic

Associations between maternal prenatal cortisol and fetal growth are specific to infant sex: findings from the Wirral Child Health and Development Study

Recent findings highlight that there are prenatal risks for affective disorders that are mediated by glucocorticoid mechanisms, and may be specific to females. There is also evidence of sex differences in prenatal programming mechanisms and developmental psychopathology, whereby effects are in opposite directions in males and females. As birth weight is a risk for affective disorders, we sought to investigate whether maternal prenatal cortisol may have sex-specific effects on fetal growth. Participants were 241 mothers selected from the Wirral Child Health and Development Study (WCHADS) cohort (n=1233) using a psychosocial risk stratifier, so that responses could be weighted back to the general population. Mothers provided saliva samples, which were assayed for cortisol, at home over 2 days at 32 weeks gestation (on waking, 30-min post-waking and during the evening). Measures of infant birth weight (corrected for gestational age) were taken from hospital records. General population estimates of associations between variables were obtained using inverse probability weights. Maternal log of the area under the curve cortisol predicted infant birth weight in a sex-dependent manner (interaction term P=0.029). There was a positive and statistically significant association between prenatal cortisol in males, and a negative association in females that was not statistically significant. A sex interaction in the same direction was evident when using the waking (P=0.015), and 30-min post-waking (P=0.013) cortisol, but not the evening measure. There was no interaction between prenatal cortisol and sex to predict gestational age. Our findings add to an emerging literature that suggests that there may be sex-specific mechanisms that underpin fetal programming

On the secondary star of the cataclysmic variable 1RXS J094432.1+035738

We present V and Rc band photometry and optical near-infrared spectroscopy of the cataclysmic variable 1RXS J094432.1+035738. We detected features of a cool secondary star, which can be modeled with a red dwarf of spectral type M2 (+0.5 -1.0) V at a distance of 433 +- 100 pc.Comment: Accepted for publication in Astronomy and Astrophysic

On the master equation approach to diffusive grain-surface chemistry: the H, O, CO system

We have used the master equation approach to study a moderately complex network of diffusive reactions occurring on the surfaces of interstellar dust particles. This network is meant to apply to dense clouds in which a large portion of the gas-phase carbon has already been converted to carbon monoxide. Hydrogen atoms, oxygen atoms, and CO molecules are allowed to accrete onto dust particles and their chemistry is followed. The stable molecules produced are oxygen, hydrogen, water, carbon dioxide (CO2), formaldehyde (H2CO), and methanol (CH3OH). The surface abundances calculated via the master equation approach are in good agreement with those obtained via a Monte Carlo method but can differ considerably from those obtained with standard rate equations.Comment: 13 pages, 5 figure

A novel onset detection technique for brain?computer interfaces using sound-production related cognitive tasks in simulated-online system

Objective. Self-paced EEG-based BCIs (SP-BCIs) have traditionally been avoided due to two sources of uncertainty: (1) precisely when an intentional command is sent by the brain, i.e., the command onset detection problem, and (2) how different the intentional command is when compared to non-specific (or idle) states. Performance evaluation is also a problem and there are no suitable standard metrics available. In this paper we attempted to tackle these issues. Approach. Self-paced covert sound-production cognitive tasks (i.e., high pitch and siren-like sounds) were used to distinguish between intentional commands (IC) and idle states. The IC states were chosen for their ease of execution and negligible overlap with common cognitive states. Band power and a digital wavelet transform were used for feature extraction, and the Davies?Bouldin index was used for feature selection. Classification was performed using linear discriminant analysis. Main results. Performance was evaluated under offline and simulated-online conditions. For the latter, a performance score called true-false-positive (TFP) rate, ranging from 0 (poor) to 100 (perfect), was created to take into account both classification performance and onset timing errors. Averaging the results from the best performing IC task for all seven participants, an 77.7% true-positive (TP) rate was achieved in offline testing. For simulated-online analysis the best IC average TFP score was 76.67% (87.61% TP rate, 4.05% false-positive rate). Significance. Results were promising when compared to previous IC onset detection studies using motor imagery, in which best TP rates were reported as 72.0% and 79.7%, and which, crucially, did not take timing errors into account. Moreover, based on our literature review, there is no previous covert sound-production onset detection system for spBCIs. Results showed that the proposed onset detection technique and TFP performance metric have good potential for use in SP-BCIs