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Imaging for prostate cancer defines the extent of disease. Guidelines recommend against imaging low-risk prostate cancer patients with a computed tomography (CT) scan or bone scan due to the low probability of metastasis. We reviewed imaging performed for men diagnosed with low-risk prostate cancer across the Pennsylvania Urologic Regional Collaborative (PURC), a physician-led data sharing and quality improvement collaborative. The data of 10 practices were queried regarding the imaging performed in men diagnosed with prostate cancer from 2015 to 2022. The cohort included 13,122 patients with 3502 (27%) low-risk, 2364 (18%) favorable intermediate-risk, 3585 (27%) unfavorable intermediate-risk, and 3671 (28%) high-risk prostate cancer, based on the AUA guidelines. Amongst the low-risk patients, imaging utilization included pelvic MRI (59.7%), bone scan (17.8%), CT (16.0%), and PET-based imaging (0.5%). Redundant imaging occurred in 1022 patients (29.2%). There was variability among the PURC sites for imaging used in the low-risk patients, and iterative education reduced the need for CT and bone scans. Approximately 15% of low-risk patients had staging imaging performed using either a CT or bone scan, and redundant imaging occurred in almost one-third of men. Such data underscore the need for continued guideline-based education to optimize the stewardship of resources and reduce unnecessary costs to the healthcare system.

Abstract The design and preparation of efficient catalysts for ammonia production under mild conditions is a desirable but highly challenging target. Here, we report a series of single-atom catalysts [M-SACs, M = Mn(II), Fe(III), Co(II), Ni(II), Cu(II), Zn(II), Mo(II)] derived from UiO-66 containing structural defects and their application to electrochemical reduction of nitrate (NO3 -) to ammonia (NH3). Cu-SAC and Fe-SAC exhibit remarkable yield rates for NH3 production of 30.0 and 29.0 mg h−1 cm−2, respectively, with a high Faradaic efficiency (FENH3) of over 96% at −1.0 V versus the reversible hydrogen electrode. Importantly, their catalytic performance can be retained in various simulated wastewaters. Complementary experiments confirmed the nature of single-atom sites within these catalysts and the binding domains of NO3 - in UiO-66-Cu. In situ spectroscopic techniques, coupled with density functional theory calculations confirm the strong binding of NO3 - and the formation of reaction intermediates, thus facilitating the catalytic conversion to NH3.

Abstract A significant number of wind bracings in existing railway transom top bridges are numerically assessed deficient against the assessment nosing load recommended by the AS5100, where in almost all cases, there is no observed evidence of wind bracings being overloaded. This paper estimates the nosing load applied by various trains to a couple of random spans of an existing railway transom top bridge. Firstly, field testing of this bridge is conducted and the measured stresses at the mid-center of girders and wind bracings are collected during various normal train operations to validate the developed Finite Element (FE) models of this bridge. Then, the nosing loads due to different trains are estimated using the validated FE model through a two-staged validation approach, including automatic FE stress intensity optimization and rigorous manual FE model sensitivity analysis while transoms in various conditions are also incorporated in the FE model. Results demonstrate that the nosing load is significantly less than the required load in the AS5100 with magnitudes ranging between 8.6% to 9.4% of the maximum vertical axle load of the passed trains; suggesting that the AS5100 assessment nosing load should be revised to avoid unnecessary expensive upgrades of numerically assessed deficient wind bracings.

OBJECTIVES: Overall, this comprehensive analysis aims to evaluate the expression profile of CCDC86 in Head and Neck Squamous Cell Carcinoma, providing insights into its potential as a diagnostic biomarker. METHODS: Initially, we conducted transcriptomic integration analysis to examine CCDC86 expression in HNSCC using various datasets (RNA-seq) obtained from the gene expression profiling interactive analysis database. We also established the diagnostic significance of CCDC86 and coregulated genes in HNSCC through the Kaplan–Meier Plotter. RESULTS: Initially, we detected elevated levels of CCDC86 in HNSCC, which correlated with lower survival rates (p=

In recent months, Artificial Intelligence (AI) has had, and will continue to have, a dramatic impact on Higher Education (HE). A study conducted by researchers at a leading university in Australia surveyed 30 of their teaching staff, drawn predominantly from their teaching academy, and interviewed eight of them regarding the impact of AI on HE. Data were analyzed using the procedures of Inductive Thematic Analysis and revealed a lack of any homogenous sentiment around AI in HE and much ambiguity regarding best practice regarding recent technological developments. The results indicate concerns exist around concepts relating to academic integrity, however, these concerns may be exaggerated. Almost half of the participants indicated they were using AI within their teaching roles with the most common design change being modifications to assessments. Less than a quarter of staff agreed the university has adequately equipped them for AI, and more than three quarters indicated they would like support. They unanimously assumed the technology will improve. Keeping in mind universities’ obligation to serve students by preparing them for industry, it is vitally important that the HE sector stays informed of developments in AI and commit to ongoing research and discussions regarding best practice in response to AI. However, anything regarding AI and future developments will be extremely difficult to predict.

BackgroundEstimating the size of key populations, including female sex workers (FSW) and men who have sex with men (MSM), can inform planning and resource allocation for HIV programs at local and national levels. In geographic areas where direct population size estimates (PSEs) for key populations have not been collected, small area estimation (SAE) can help fill in gaps using supplemental data sources known as auxiliary data. However, routinely collected program data have not historically been used as auxiliary data to generate subnational estimates for key populations, including in Namibia. ObjectiveTo systematically generate regional size estimates for FSW and MSM in Namibia, we used a consensus-informed estimation approach with local stakeholders that included the integration of routinely collected HIV program data provided by key populations’ HIV service providers. MethodsWe used quarterly program data reported by key population implementing partners, including counts of the number of individuals accessing HIV services over time, to weight existing PSEs collected through bio-behavioral surveys using a Bayesian triangulation approach. SAEs were generated through simple imputation, stratified imputation, and multivariable Poisson regression models. We selected final estimates using an iterative qualitative ranking process with local key population implementing partners. ResultsExtrapolated national estimates for FSW ranged from 4777 to 13,148 across Namibia, comprising 1.5% to 3.6% of female individuals aged between 15 and 49 years. For MSM, estimates ranged from 4611 to 10,171, comprising 0.7% to 1.5% of male individuals aged between 15 and 49 years. After the inclusion of program data as priors, the estimated proportion of FSW derived from simple imputation increased from 1.9% to 2.8%, and the proportion of MSM decreased from 1.5% to 0.75%. When stratified imputation was implemented using HIV prevalence to inform strata, the inclusion of program data increased the proportion of FSW from 2.6% to 4.0% in regions with high prevalence and decreased the proportion from 1.4% to 1.2% in regions with low prevalence. When population density was used to inform strata, the inclusion of program data also increased the proportion of FSW in high-density regions (from 1.1% to 3.4%) and decreased the proportion of MSM in all regions. ConclusionsUsing SAE approaches, we combined epidemiologic and program data to generate subnational size estimates for key populations in Namibia. Overall, estimates were highly sensitive to the inclusion of program data. Program data represent a supplemental source of information that can be used to align PSEs with real-world HIV programs, particularly in regions where population-based data collection methods are challenging to implement. Future work is needed to determine how best to include and validate program data in target settings and in key population size estimation studies, ultimately bridging research with practice to support a more comprehensive HIV response.

Introduction Multidisciplinary teams (MDTs) are integral to oncology management, involving specialised healthcare professionals who collaborate to develop individualised treatment plans for patients. However, as cancer care grows more complex, MDTs must continually adapt to better address patient needs. This scoping review will explore barriers and challenges MDTs have encountered in the past decade; and propose strategies for optimising their utilisation to overcome these obstacles and improve patient care.Methods and analysis The scoping review will follow Arksey and O’Malley’s framework and begin with a literature search using keywords in electronic databases such as PubMed/MEDLINE, Scopus and PsychINFO, covering the period from January 2013 to December 2022 and limited to English language publications. Four independent reviewers will screen titles and abstracts based on predefined inclusion criteria, followed by full-text review of selected titles. Relevant references cited in the publications will also be examined. A Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram will be utilised to illustrate the methodology. Data from selected publications will be extracted, analysed, and categorised for further analysis.Ethics and dissemination The results of the scoping review will provide a comprehensive overview of the barriers and challenges encountered by oncology MDTs over the past decade. These findings will contribute to the existing literature and provide insights into areas that require improvement in the functioning of MDTs in oncology management. The results will be disseminated through publication in a scientific journal, which will help to share the findings with the wider healthcare community and facilitate further research and discussion in this field.Trial registration details The protocol for this scoping review is registered with Open Science Framework, available at DOI 10.17605/OSF.IO/R3Y8U.

Improving equity in undergraduate STEM is a national imperative. Although there is a rapidly growing body of research in this area, there is still a need to generate empirical evidence for equitable teaching techniques. We ground our work in Complex Instruction, an extensively researched pedagogical approach based on sociological theories and the malleability of status. This approach has been applied primarily in K-12 classrooms. In this manuscript, we explore the application of one strategy from Complex Instruction-assigning competence-to undergraduate STEM classrooms. We provide an analysis of three instructors' implementation of assigning competence and track the impact on student participation. This work makes a unique contribution to the field, as the first study that directly documents changes in student participation resulting from assigning competence in undergraduate STEM.

Although research has demonstrated that transport infrastructure development can have positive and negative health-related impacts, most of this research has not considered mental health and wellbeing separately from physical health. There is also limited understanding of whether and how any effects might be experienced differently across population groups, whether this differs according to the stage of development (e.g. planning, construction), and how changes to planned infrastructure may affect mental health and wellbeing. This paper presents a protocol for the Wellbeing Impact Study of HS2 (WISH2), which seeks to address these questions using a high-speed rail development in the UK as an applied example. WISH2 is a 10-year, integrated, longitudinal, mixed-methods project using general practices (primary medical care providers in the UK) as an avenue for participant recruitment and for providing a geographically defined population for which aggregated data on mental health indicators are available. The research comprises: (i) a combined longitudinal and repeated cross-sectional cohort study involving multiple waves of survey data collection and data from medical records; (ii) longitudinal, semi-structured interviews and focus groups with residents and community stakeholders from exposed areas; (iii) analysis of administrative data aggregated at the general practice population level; and (iv) health economic analysis of mental health and wellbeing impacts. The study findings will support the development of strategies to reduce negative impacts and/or enhance positive mental health and wellbeing impacts of high-speed rail developments and other large-scale infrastructure projects.

Background. This retrospective review reports on patients who underwent glaucoma drainage implant (GDI) surgery and had baseline intraocular pressure (IOP) of ≤18 mmHg with at least one year of follow-up. Methods. Clinical data of 67 eyes of 67 patients were collected from patients’ charts, and the outcomes of GDI were evaluated until 7 years. GDI failure was defined as IOP reduction of less than 20% from the baseline at two consecutive visits three months after surgery, decline to no light perception, or if additional glaucoma surgery was performed. Results. The average age was 65.9 ± 13.2 years. Most cases were male (52.2%), White (53.7%), and had primary open-angle glaucoma (62.7%). Forty-four eyes had prior glaucoma surgery (68.6%) and 46 (68.6%) had severe glaucoma. Though postoperative (postop) IOP changes were insignificant, the average postop number of medications dropped from 2.4 ± 1.4 to 1.9 ± 1.2 medications two years after surgery (p=0.0451). Postop complications (23.9%) included GDI exposure (7.5%), inflammation (4.5%), shallow anterior chamber (4.5%), and strabismus (1.5%). Hypotony was observed in 4 eyes (5.9%), none of which developed hypotony maculopathy. The cumulative one-year failure rate was 56.7%, most of which were due to failure to lower IOP. Conclusion. In patients with baseline IOP ≤18 mmHg who had GDI surgery, though the change in IOP was not statistically significant, the number of medications dropped and visual field progression slowed in a subset of patients with adequate perimetric data. Due to a relatively high rate of complications and limited effectiveness in lowering IOP, GDI should be cautiously used in these eyes.

Recent work in eschatology has sought to retrieve the doctrine of the beatific vision, one that has served as one of the predominant views of the eschatological life throughout church history. Yet the doctrine has been criticized for its reported marginalization of the human body. This essay seeks to provide a modest contribution and response to this objection through the retrieval of 17th‐century theologian Petrus van Mastricht. I argue that humanity's telos can be conceived of as complex involving a particular mode of life with God that the visio Dei makes possible, one which requires the resurrection and glorification of the body. [ABSTRACT FROM AUTHOR]

Background: Accurate delineations of regions of interest (ROIs) on multi‐parametric magnetic resonance imaging (mpMRI) are crucial for development of automated, machine learning‐based prostate cancer (PCa) detection and segmentation models. However, manual ROI delineations are labor‐intensive and susceptible to inter‐reader variability. Histopathology images from radical prostatectomy (RP) represent the "gold standard" in terms of the delineation of disease extents, for example, PCa, prostatitis, and benign prostatic hyperplasia (BPH). Co‐registering digitized histopathology images onto pre‐operative mpMRI enables automated mapping of the ground truth disease extents onto mpMRI, thus enabling the development of machine learning tools for PCa detection and risk stratification. Still, MRI‐histopathology co‐registration is challenging due to various artifacts and large deformation between in vivo MRI and ex vivo whole‐mount histopathology images (WMHs). Furthermore, the artifacts on WMHs, such as tissue loss, may introduce unrealistic deformation during co‐registration. Purpose: This study presents a new registration pipeline, MSERgSDM, a multi‐scale feature‐based registration (MSERg) with a statistical deformation (SDM) constraint, which aims to improve accuracy of MRI‐histopathology co‐registration. Methods: In this study, we collected 85 pairs of MRI and WMHs from 48 patients across three cohorts. Cohort 1 (D1), comprised of a unique set of 3D printed mold data from six patients, facilitated the generation of ground truth deformations between ex vivo WMHs and in vivo MRI. The other two clinically acquired cohorts (D2 and D3) included 42 patients. Affine and nonrigid registrations were employed to minimize the deformation between ex vivo WMH and ex vivo T2‐weighted MRI (T2WI) in D1. Subsequently, ground truth deformation between in vivo T2WI and ex vivo WMH was approximated as the deformation between in vivo T2WI and ex vivo T2WI. In D2 and D3, the prostate anatomical annotations, for example, tumor and urethra, were made by a pathologist and a radiologist in collaboration. These annotations included ROI boundary contours and landmark points. Before applying the registration, manual corrections were made for flipping and rotation of WMHs. MSERgSDM comprises two main components: (1) multi‐scale representation construction, and (2) SDM construction. For the SDM construction, we collected N = 200 reasonable deformation fields generated using MSERg, verified through visual inspection. Three additional methods, including intensity‐based registration, ProsRegNet, and MSERg, were also employed for comparison against MSERgSDM. Results: Our results suggest that MSERgSDM performed comparably to the ground truth (p > 0.05). Additionally, MSERgSDM (ROI Dice ratio = 0.61, landmark distance = 3.26 mm) exhibited significant improvement over MSERg (ROI Dice ratio = 0.59, landmark distance = 3.69 mm) and ProsRegNet (ROI Dice ratio = 0.56, landmark distance = 4.00 mm) in local alignment. Conclusions: This study presents a novel registration method, MSERgSDM, for mapping ex vivo WMH onto in vivo prostate MRI. Our preliminary results demonstrate that MSERgSDM can serve as a valuable tool to map ground truth disease annotations from histopathology images onto MRI, thereby assisting in the development of machine learning models for PCa detection on MRI. [ABSTRACT FROM AUTHOR]