A Rare Location of Metastasis from Prostate Cancer: Hydronephrosis Associated with Ureteral Metastasis

Prostate carcinoma is a very rare origin of metastatic disease in the ureter. We report a case of a 74-year-old man who presented in November 2008 initially with flank pain and lower urinary tract symptoms. Diagnostic investigation revealed a skeletal metastasizing prostate carcinoma, and the cause for the flank pain was a hydronephrosis due to ureteral metastasis diagnosed by biopsy. Antihormonal treatment led to disappearance of the hydronephrosis; however, further progress finally ended in acute liver failure with patient's death in July 2010

Enhancing adjustment to parental cancer: counselling interventions for families with a parent with cancer

The challenges of a parental cancer diagnosis not only affect the patients themselves, but the entire family. Moreover, there is evidence that family members are at increased risk of developing psychosocial problems. Therefore, the aim of the research projects presented within this cumulative dissertation was to obtain a better insight of the impact of parental cancer on the family and to develop, implement and evaluate interventions to support families in this exceptional situation. The first two publications cover results of the feasibility of and the lessons learned from a web-based intervention program during the first months of treatment. Furthermore, it reports on psychological adjustment in children of a parent with cancer, family satisfaction and communication, and on the effect of minimal contact interventions on the couple. Due to the low enrolment rate, feasibility of the web-based program was limited. Baseline data of the 28 participating children showed a good adjustment to the parental cancer diagnosis and high family communication levels. Couples showed signs of anxiety and decreased optimism scores at baseline, which slightly improved in patients. Feedback from participating families exhibit that the program was helpful for families with a newly diagnosed parent who are in need of specific information on cancer and family. The third publication discusses the feasibility and acceptability of a face-to-face short-term counselling intervention. Data showed a limited feasibility but good acceptability of the counselling. It was considered recommendable and helpful by nearly all participating families. The enrolment rate was low due to different reasons, such as having no need, lack of time, or local distance. Our research projects suggest that a parental cancer diagnosis may represent a burden, may trigger anxiety and may decrease optimism. Low-threshold interventions represent a helpful option to use at a time when needed

Proof-Pattern Recognition and Lemma Discovery in ACL2

We present a novel technique for combining statistical machine learning for proof-pattern recognition with symbolic methods for lemma discovery. The resulting tool, ACL2(ml), gathers proof statistics and uses statistical pattern-recognition to pre-processes data from libraries, and then suggests auxiliary lemmas in new proofs by analogy with already seen examples. This paper presents the implementation of ACL2(ml) alongside theoretical descriptions of the proof-pattern recognition and lemma discovery methods involved in it

Deep Learning-based Anonymization of Chest Radiographs: A Utility-preserving Measure for Patient Privacy

Robust and reliable anonymization of chest radiographs constitutes an essential step before publishing large datasets of such for research purposes. The conventional anonymization process is carried out by obscuring personal information in the images with black boxes and removing or replacing meta-information. However, such simple measures retain biometric information in the chest radiographs, allowing patients to be re-identified by a linkage attack. Therefore, there is an urgent need to obfuscate the biometric information appearing in the images. We propose the first deep learning-based approach (PriCheXy-Net) to targetedly anonymize chest radiographs while maintaining data utility for diagnostic and machine learning purposes. Our model architecture is a composition of three independent neural networks that, when collectively used, allow for learning a deformation field that is able to impede patient re-identification. Quantitative results on the ChestX-ray14 dataset show a reduction of patient re-identification from 81.8% to 57.7% (AUC) after re-training with little impact on the abnormality classification performance. This indicates the ability to preserve underlying abnormality patterns while increasing patient privacy. Lastly, we compare our proposed anonymization approach with two other obfuscation-based methods (Privacy-Net, DP-Pix) and demonstrate the superiority of our method towards resolving the privacy-utility trade-off for chest radiographs.Comment: Accepted at MICCAI 202

How greater mouse-eared bats deal with ambiguous echoic scenes

Echolocating bats have to assign the received echoes to the correct call that generated them. Failing to do so will result in the perception of virtual targets that are positioned where there is no actual target. The assignment of echoes to the emitted calls can be ambiguous especially if the pulse intervals between calls are short and kept constant. Here, we present first evidence that greater mouse-eared bats deal with ambiguity by changing the pulse interval more often, in particular by reducing the number of calls in the terminal group before landing. This strategy separates virtual targets from real ones according to their change in position. Real targets will always remain in a constant position, and virtual targets will jitter back and forth according to the change in the time interval

Biased Ligands Differentially Shape the Conformation of the Extracellular Loop Region in 5-HT2B Receptors

G protein-coupled receptors are linked to various intracellular transducers, each pathway associated with different physiological effects. Biased ligands, capable of activating one pathway over another, are gaining attention for their therapeutic potential, as they could selectively activate beneficial pathways whilst avoiding those responsible for adverse effects. We performed molecular dynamics simulations with known β-arrestin-biased ligands like lysergic acid diethylamide and ergotamine in complex with the 5-HT2B receptor and discovered that the extent of ligand bias is directly connected with the degree of closure of the extracellular loop region. Given a loose allosteric coupling of extracellular and intracellular receptor regions, we delineate a concept for biased signaling at serotonin receptors, by which conformational interference with binding pocket closure restricts the signaling repertoire of the receptor. Molecular docking studies of biased ligands gathered from the BiasDB demonstrate that larger ligands only show plausible docking poses in the ergotamine-bound structure, highlighting the conformational constraints associated with bias. This emphasizes the importance of selecting the appropriate receptor conformation on which to base virtual screening workflows in structure-based drug design of biased ligands. As this mechanism of ligand bias has also been observed for muscarinic receptors, our studies provide a general mechanism of signaling bias transferable between aminergic receptors

Predictive Value of Positive Surgical Margins after Radical Prostatectomy for Lymph Node Metastasis in Locally Advanced Prostate Carcinoma

Introduction. Suspected locally advanced prostate carcinoma shows lymph node involvement in a high percentage of cases. For a long time, such patients were not radically prostatectomised. In recent years, however, this viewpoint has changed. Material and Methods. We analysed a single-centre series of 34 patients with suspected locally advanced prostate cancer to establish predictive parameters for lymph node metastasis. All patients underwent radical prostatectomy between 2007 and 2010. Results. Of the 34 patients, 26% showed pathological stage T3a, 59% pT3b, and 15% pT4. Median preoperative PSA level was 25 ng/mL, and five patients had had neoadjuvant antihormonal treatment. Positive margins were found in 76% of patients. Patients without neoadjuvant treatment showed it in 79%, and after preoperative antihormonal treatment the rate was 60%. Positive margins were associated with lymph node involvement in 85% of cases, complete resection was associated only in 50% of cases. Conclusions. Positive surgical margins play an important predictive role when estimating lymph node involvement in patients with locally advanced prostate carcinoma. Neoadjuvant antihormonal therapy is associated with a relevant reduction in the rate of positive margins but not with the rate of lymph node metastasis. As such, a combination of antihormonal and surgical treatment should be considered