Genome-wide association study of prostate cancer-specific survival

BACKGROUND: Unnecessary intervention and overtreatment of indolent disease are common challenges in clinical management of prostate cancer. Improved tools to distinguish lethal from indolent disease are critical. METHODS: We performed a genome-wide survival analysis of cause-specific death in 24,023 prostate cancer patients (3,513 disease-specific deaths) from the PRACTICAL and BPC3 consortia. Top findings were assessed for replication in a Norwegian cohort (CONOR). RESULTS: We observed no significant association between genetic variants and prostate cancer survival. CONCLUSIONS: Common genetic variants with large impact on prostate cancer survival were not observed in this study. IMPACT: Future studies should be designed for identification of rare variants with large effect sizes or common variants with small effect sizes.

Prediction of individual genetic risk to prostate cancer using a polygenic score

BACKGROUND Polygenic risk scores comprising established susceptibility variants have shown to be informative classifiers for several complex diseases including prostate cancer. For prostate cancer it is unknown if inclusion of genetic markers that have so far not been associated with prostate cancer risk at a genome-wide significant level will improve disease prediction. METHODS We built polygenic risk scores in a large training set comprising over 25,000 individuals. Initially 65 established prostate cancer susceptibility variants were selected. After LD pruning additional variants were prioritized based on their association with prostate cancer. Six-fold cross validation was performed to assess genetic risk scores and optimize the number of additional variants to be included. The final model was evaluated in an independent study population including 1,370 cases and 1,239 controls. RESULTS The polygenic risk score with 65 established susceptibility variants provided an area under the curve (AUC) of 0.67. Adding an additional 68 novel variants significantly increased the AUC to 0.68 (P = 0.0012) and the net reclassification index with 0.21 (P = 8.5E-08). All novel variants were located in genomic regions established as associated with prostate cancer risk. CONCLUSIONS Inclusion of additional genetic variants from established prostate cancer susceptibility regions improves disease prediction. Prostate 75:1467–1474, 2015. © 2015 Wiley Periodicals, Inc.

Absolute quantification of human tear lactoferrin using multiple reaction monitoring technique with stable-isotopic labeling

The mass spectrometry technique of multiple reaction monitoring (MRM) was used to quantify and compare the expression level of lactoferrin in tear films among control, prostate cancer (CaP), and benign prostate hyperplasia (BPH) groups. Tear samples from 14 men with CaP, 15 men with BPH, and 14 controls were analyzed in the study. Collected tears (2 μl) of each sample were digested with trypsin overnight at 37 °C without any pretreatment, and tear lactoferrin was quantified using a lactoferrin-specific peptide, VPSHAVVAR, both using natural/light and isotopic-labeled/heavy peptides with MRM. The average tear lactoferrin concentration was 1.01 ± 0.07 μg/μl in control samples, 0.96 ± 0.07 μg/μl in the BPH group, and 0.98 ± 0.07 μg/μl in the CaP group. Our study is the first to quantify tear proteins using a total of 43 individual (non-pooled) tear samples and showed that direct digestion of tear samples is suitable for MRM studies. The calculated average lactoferrin concentration in the control group matched that in the published range of human tear lactoferrin concentration measured by enzyme-linked immunosorbent assay (ELISA). Moreover, the lactoferrin was stably expressed across all of the samples, with no significant differences being observed among the control, BPH, and CaP groups.

Evidence-based practice

This chapter traces the history of evidence-based practice (EBP) from its roots in evidence-based medicine to contemporary thinking about its usefulness to public health practice. It defines EBP and differentiates it from ‘evidence-based medicine’, ‘evidence-based policy’ and ‘evidence-based healthcare’. As it is important to understand the subjective nature of knowledge and the research process, this chapter describes the nature and production of knowledge. This chapter considers the necessary skills for EBP, and the processes of attaining the necessary evidence. We examine the barriers and facilitators to identifying and implementing ‘best practice’, and when EBP is appropriate to use. There is a discussion about the limitations of EBP and the use of other information sources to guide practice, and concluding information about the application of evidence to guide policy and practice.

Disease control and management

Globally, the main contributors to morbidity and mortality are chronic conditions, including cardiovascular disease and diabetes. Chronic disease is costly and partially avoidable, with around 60% of deaths and nearly 50% of the global disease burden attributable to these conditions. By 2020, chronic illnesses will likely be the leading cause of disability worldwide. Existing healthcare systems that focus on acute episodic health conditions, both national and international, cannot address the worldwide transition to chronic illness; nor are they appropriate for the ongoing care and management of those already dealing with chronic diseases. As such, chronic disease management requires integrated approaches that incorporate interventions targeted at both individuals and populations, and emphasise the shared risk factors of different conditions. International and Australian strategic planning documents articulate similar elements to manage chronic disease, including the need for aligning sectoral policies for health, forming partnerships, and engaging communities in decision-making. Infectious diseases are also a common and significant contributor to ill health throughout the world. In many countries, this impact has been minimised by the combined efforts of preventative health measures and improved treatment methods. However, in low-income countries, infectious diseases remain the dominant cause of death and disability. The World Health Organization (WHO) estimates that infectious diseases (including respiratory infections) still account for around 23% (or around 14 million) of all deaths each year, and result in over 4.6 billion episodes of diarrhoeal disease and 243 million cases of malaria each year (Lozano et al. 2012, WHO 2009). In addition to the high level of mortality, infectious diseases disable many hundreds of millions of people each year, mainly in developing countries, with the global burden of disease from infectious diseases estimated to be around 300 million DALYs (disability-adjusted life years) (WHO 2012). The aim of this chapter is to outline the impact that infectious diseases and chronic diseases have on the health of the community, describe the public health strategies used to reduce the burden of those diseases, and discuss the historic and emerging disease risks to public health. This chapter examines the comprehensive approaches implemented to prevent both chronic and infectious diseases, and to manage and care for communities with these conditions.

Characterisation of head-hardened rail steel in terms of cyclic plasticity response and microstructure for improved material modelling

Stress- and strain-controlled tests of heat treated high-strength rail steel (Australian Standard AS1085.1) have been performed in order to improve the characterisation of the said material׳s ratcheting and fatigue wear behaviour. The hardness of the rail head material has also been studied and it has been found that hardness reduces considerably below four-millimetres from the rail top surface. Historically, researchers have used test coupons with circular cross-sections to conduct cyclic load tests. Such test coupons, typically five-millimetres in gauge diameter and ten‐millimetres in grip diameter, are usually taken from the rail head sample. When there is considerable variation of material properties over the cross-section it becomes likely that localised properties of the rail material will be missed. In another case from the literature, disks 47 mm in diameter for a twin-disk rolling contact test machine were obtained directly from the rail sample and used to validate ratcheting and rolling contact fatigue wear models. The question arises: How accurate are such tests, especially when large material property gradients exist? In this research paper, the effects of rail sampling location on the ratcheting behaviour of AS1085.1 rail steel were investigated using rectangular-shaped specimens obtained at four different depths to observe their respective cyclic plasticity behaviour. The microstructural features of the test coupons were also analysed, especially the pearlite inter-lamellar spacing which showed strong correlation with both hardness and cyclic plasticity behaviour of the material. This work ultimately provides new data and testing methodology to aid the selection of valid parameters for material constitutive models to better understand rail surface ratcheting and wear.

Nickel(II) meso-hydroxyporphyrin complexes revisited: Palladium-catalysed synthesis, electronic structures of derived oxy radicals, and oxidative coupling to a dioxoporphodimethene dyad

We report the synthesis and characterisation of new examples of meso-hydroxynickel(II) porphyrins with 5,15-diphenyl and 10-phenyl-5,15-diphenyl/diaryl substitu- tion. The OH group was introduced by using carbonate or hydroxide as nucleophile by using palladium/phosphine cat- alysis. The NiPor OHs exist in solution in equilibrium with the corresponding oxy radicals NiPor OC. The 15-phenyl group stabilises the radicals, so that the 1H NMR spectra of {NiPor OH} are extremely broad due to chemical exchange with the paramagnetic species. The radical concentration for the diphenylporphyrin analogue is only 1%, and its NMR line-broadening was able to be studied by variable-tempera- ture NMR spectroscopy. The EPR signals of NiPor OC are con- sistent with somewhat delocalised porphyrinyloxy radicals, and the spin distributions calculated by using density func- tional theory match the EPR and NMR spectroscopic obser- vations. Nickel(II) meso-hydroxy-10,20-diphenylporphyrin was oxidatively coupled to a dioxo-terminated porphodimethene dyad, the strongly red-shifted electronic spectrum of which was successfully modelled by using time-dependent DFT calculations.

Uuden median murros Alma Mediassa, Sanoma Oy:ssä ja Yleisradiossa 1994-2004

This is a qualitative and multimethodological comparative study, which consists of two main parts: examining the development of new media and analysing and comparing the new media strategies of the three companies studied (Alma Media, Sanoma and the Finnish Broadcasting Company Yleisradio). The study includes the first large-scale review in Finnish of the development of new media, paying attention to the birth of the Internet as well as to mobile media, web TV and any other element of new media. It also concentrates on the function of electronic distribution channels before the age of the Internet, e.g. cable text and videotext. Answers about how the three traditional Finnish media houses began spreading their content to the Internet and wireless applications in 1994–2004 are also given. In researching the new media strategies the study pays special attention to the attitudes that the three media companies adopted towards the Internet and other forms of new media in their strategies during the years in question. By analysing and comparing, e.g., the companies’ strategies and their investments, the study ascertains whether the companies had a joint functional model in adopting new media or acted totally on their own without taking too much notice of the media field overall. The study makes extensive use of previously published material. The researcher has also interviewed almost twenty people who were involved in getting the companies’ new media functions under way. The methods for the interviews were dialogue and snowball sampling. The researcher has created a classification in which he divides the business strategies into four different categories: active strategy, careful strategy, permissive strategy, and passive strategy. In comparing and analysing the companies the researcher has used the classification devised by Allan Afuah & Christopher L. Tucci. The seven element classification consists of dominant managerial logic, competency trap, fear of cannibalisation and loss of revenue, channel conflict, political power, co-opetitor power and emotional attachment. In analysing the company strategies the researcher has also noted the classifications of convergence made by Everette E. Dennis and Graham Murdock as well as the aspects formulated by Sylvia Chan-Olmsted and Louisa Ha concerning the success of the companies in adopting the Internet into their functions. Based on all these classifications and by further developing them the researcher analyses and compares the success of the new media strategies of the three Finnish companies. The outcome of the study is a conclusion as to what kind of strategies the companies have carried out their new media functions and how they have succeeded in it.

Expected Performance of the ATLAS Experiment - Detector, Trigger and Physics

A detailed study is presented of the expected performance of the ATLAS detector. The reconstruction of tracks, leptons, photons, missing energy and jets is investigated, together with the performance of b-tagging and the trigger. The physics potential for a variety of interesting physics processes, within the Standard Model and beyond, is examined. The study comprises a series of notes based on simulations of the detector and physics processes, with particular emphasis given to the data expected from the first years of operation of the LHC at CERN.

Pärjätäkseen pitää olla sosiaalinen, aktiivinen ja menestyvä ihminen. Kaikkea hyvää vaan heille, mutta entäs me muut? Vertaistuki Yksinäisyys-nettiryhmässä avunsaajan ja avunantajan näkökulmista.

Yksinäisyyden merkitys hyvinvointia uhkaavana tekijänä on viimeaikoina noussut esiin yhä enenevissä määrin. Yksinäiset korkeakouluopiskelijat ovat erityisen haavoittuvassa elämäntilanteessa, sillä nuoren aikuisen elämään liittyvät erityiset kehitykselliset haasteet. Tärkeää on, että opiskelijat saavat tukea tilanteeseensa, jotta yksinäisyyden kauaskantoisilta vaikutuksilta vältyttäisiin. Vertaistuki voi monen kohdalla olla tärkeää, ja Internet mahdollistaa matalan kynnyksen paikan avun hakemiseen. Tutkielmassani perehdyn Nyyti ry:n ylläpitämään, korkeakouluopiskelijoille tarkoitettuun Yksinäisyys-nettiryhmään, ja siinä esiintyvään vertaistukeen. Erityisen tutkimusasetelmastani tekee vertaistuen tarkastelu sen kaksijakoisuuden kautta: millaisia avunsaajana olemisen ja avunantajana toimimisen tapoja kirjoituksista on löydettävissä, ja miten ne suhteutuvat toisiinsa. Näin voidaan ymmärtää paremmin keskustelijoiden tarpeita ja odotuksia, ja sitä, miten ryhmä pystyy niihin vastaamaan. Aineistoa on tutkittu sisällönanalyysin menetelmin. Näyttäisi siltä, että ryhmään kohdistetaan enemmän odotuksia ja tarpeita kuin mihin se pystyy vastaamaan. Avunsaajana olemisen luokkia oli yhteensä 15, jotka kuvasivat viittä eri ulottuvuutta. Ulottuvuudet olivat kokemuksellisuus, kontrolliodotus, vaikeusaste, suhde tietoon ja odotuksellisuus. Avunantajana toimimisen kohdalla luokkia muodostui kahdeksan, jotka kuvasivat neljää ulottuvuutta. Näitä olivat empatia, eteenpäin suuntaavuus, opastus ja kyseenalaistus. Avunsaajana oleminen hallitsi nettiryhmän keskusteluja, ja sitä kuvastavat tekstit olivat paitsi määrällisesti pidempiä, myös sisällöllisesti rikkaampia. Suhteutettaessa avunsaajan ja avunantajan tapoja toisiinsa havaitaan, että ryhmässä osoitettu tuki pystyy hyvin vastaamaan moniin odotuksiin, mutta toisaalta jokin tuenmuoto saattaa olla päinvastainenkin joidenkin luokkien tarpeille. Voikin olla, että vertaistuesta on keskustelijoille hyötyä tiettyyn tasoon asti, mutta suuri määrä erilaisia tarpeita ja odotuksia tekee mahdottomaksi niihin kaikkiin vastaamisen. Hyvä jatkotutkimuksen aihe olisi haastatteluin selvittää kirjoittajien omia näkemyksiä siitä, mistä kokevat ryhmään kirjoittaessaan hyötyvänsä. Tutkielman keskeisimpiä lähteitä ovat olleet: Weiss, R.S. (1973). Loneliness: the experience of emotional and social isolation, Kraut, R. ym (1998). Internet paradox. A social technology that reduces social involvement and psychological well-being?, Jung, J. (1987) Toward a social psychology of social support., Dennis, C-L. (2003). Peer support within a health care context: a concept analysis.

The Commercial Structure of Pedestrian Streets and Shopping Districts - Three Cases from Finland

Kävelykadut ovat tunnustettu tapa elävöittää keskusta-alueiden kauppaa. Aluksi moni kauppias epäilee kävelykadun tuomia muutoksia, mutta kokemus osoittaa, että kävelykadut ovat olleet menestyksekkäitä ja nostavat siellä olevien yritysten myyntiä. Jotkut yritykset eivät kuitenkin hyödy kävelykaduista, kun taas toiset hyötyvät paljon kun katu muuttuu kävelykaduksi. Tämä pro gradu -tutkielma tutkii kävelykatujen kaupallista rakennetta, jotta saataisiin selville minkätyyppiset yritykset löytyvät kävelykadulta. Tuloksia verrataan sen kaupallisen keskusvyöhykkeen kaupalliseen rakenteeseen missä kävelykatu sijaitsee. Näin saadaan selville erot kaupallisessa rakenteessa. Pro gradu tutkii myös miten tavallisia ketjuyritykset ovat kävelykaduilla ja kaupallisissa keskusvyöhykkeissä. Tutkimusaineisto koottiin kaupallisen inventoinnin avulla, joka suoritettiin kolmessa suomalaisessa kaupungissa: Tammisaaressa, Keravalla ja Porissa. Saatu aineisto luokiteltiin ja tulokset piirrettiin kartalle. Perustilastollisia menetelmiä käytettiin tulosten analysoimisessa. Tulokset eriteltiin kävelykadun, kauppakeskusten ja muiden paikkojen osalta ja luokiteltiin yleisluokkiin vähittäiskauppa, ravintola ja muu palvelu. Tulokset näyttävät, että on olemassa selkeitä eroja kun vertaa kävelykatuja ja kaupallisia keskusvyöhykkeitä. Kävelykaduilla on paljon enemmän vähittäiskauppoja, etenkin muotikauppoja, kuin muilla kaduilla. Kauppakeskuksilla on samantapainen kaupallinen rakenne kuin kävelykaduilla kun taas muilla kaduilla esiintyy vähemmän vähittäiskauppoja ja enemmän palveluyrityksiä. Ravintolat ovat melkein yhtä tavallisia koko kaupallisessa keskusvyöhykkeessä. Ketjuyritysten osalta tulokset ovat epäselviä. On olemassa osviittaa siitä, että ne ovat tavallisempia kävelykaduilla, etenkin suurissa kaupungeissa. Saatua tulosta ei ole kuitenkin tarpeeksi, jotta varmaa tietoa olisi saatu. Viimeisten 10–15 vuoden ajan Suomen kävelykadut ovat muuttuneet enemmän ravintolavaltaisiksi muiden palveluiden kustannuksella. Vähittäiskauppojen määrä on pysynyt vakaana. Suomalaiset kävelykadut eroavat kaupalliselta rakenteeltaan pohjoismaisista kävelykaduista, joilla on enemmän vähittäiskauppoja ja vähemmän palveluyrityksiä. Tapauskohtaisissa tuloksissa esiintyy paljon eroavaisuuksia. Paikalliset tekijät ovat usein voimakkaampia kuin yleiset teoriat kauppojen sijainnista kävelykaduilla. Yleisesti ottaen tulokset tukevat teoreettista viitekehystä. Tulokset antavat tarkempaa tietoa kävelykatujen ja kaupallisten keskusvyöhykkeiden kaupallisesta rakenteesta ja siitä, mitkä tekijät tähän vaikuttaa.

Averting biodiversity collapse in tropical forest protected areas

The rapid disruption of tropical forests probably imperils global biodiversity more than any other contemporary phenomenon(1-3). With deforestation advancing quickly, protected areas are increasingly becoming final refuges for threatened species and natural ecosystem processes. However, many protected areas in the tropics are themselves vulnerable to human encroachment and other environmental stresses(4-9). As pressures mount, it is vital to know whether existing reserves can sustain their biodiversity. A critical constraint in addressing this question has been that data describing a broad array of biodiversity groups have been unavailable for a sufficiently large and representative sample of reserves. Here we present a uniquely comprehensive data set on changes over the past 20 to 30 years in 31 functional groups of species and 21 potential drivers of environmental change, for 60 protected areas stratified across the world's major tropical regions. Our analysis reveals great variation in reserve `health': about half of all reserves have been effective or performed passably, but the rest are experiencing an erosion of biodiversity that is often alarmingly widespread taxonomically and functionally. Habitat disruption, hunting and forest-product exploitation were the strongest predictors of declining reserve health. Crucially, environmental changes immediately outside reserves seemed nearly as important as those inside in determining their ecological fate, with changes inside reserves strongly mirroring those occurring around them. These findings suggest that tropical protected areas are often intimately linked ecologically to their surrounding habitats, and that a failure to stem broad-scale loss and degradation of such habitats could sharply increase the likelihood of serious biodiversity declines.

RRI-GBT MULTI-BAND RECEIVER: MOTIVATION, DESIGN, AND DEVELOPMENT

We report the design and development of a self-contained multi-band receiver (MBR) system, intended for use with a single large aperture to facilitate sensitive and high time-resolution observations simultaneously in 10 discrete frequency bands sampling a wide spectral span (100-1500 MHz) in a nearly log-periodic fashion. The development of this system was primarily motivated by need for tomographic studies of pulsar polar emission regions. Although the system design is optimized for the primary goal, it is also suited for several other interesting astronomical investigations. The system consists of a dual-polarization multi-band feed (with discrete responses corresponding to the 10 bands pre-selected as relatively radio frequency interference free), a common wide-band radio frequency front-end, and independent back-end receiver chains for the 10 individual sub-bands. The raw voltage time sequences corresponding to 16 MHz bandwidth each for the two linear polarization channels and the 10 bands are recorded at the Nyquist rate simultaneously. We present the preliminary results from the tests and pulsar observations carried out with the Robert C. Byrd Green Bank Telescope using this receiver. The system performance implied by these results and possible improvements are also briefly discussed.

Metabolites of PPI-2458, a selective, irreversible inhibitor of methionine aminopeptidase-2: structure determination and In vivo activity

The natural product fumagillin exhibits potent antiproliferative and antiangiogenic properties. The semisynthetic analog PPI-2458, (3R,4S,5S,6R)-5-methoxy-4-(2R,3R)-2-methyl-3-(3-methylbut-2-enyl) oxiran-2-yl]-1-oxaspiro2.5]octan-6-yl] N-(2R)-1-amino-3-methyl-1-oxobutan-2-yl]carbamate, demonstrates rapid inactivation of its molecular target, methionine aminopeptidase-2 (MetAP2), and good efficacy in several rodent models of cancer and inflammation with oral dosing despite low apparent oral bioavailability. To probe the basis of its in vivo efficacy, the metabolism of PPI-2458 was studied in detail. Reaction phenotyping identified CYP3A4/5 as the major source of metabolism in humans. Six metabolites were isolated from liver microsomes and characterized by mass spectrometry and nuclear resonance spectroscopy, and their structures were confirmed by chemical synthesis. The synthetic metabolites showed correlated inhibition of MetAP2 enzymatic activity and vascular endothelial cell growth. In an ex vivo experiment, MetAP2 inhibition in white blood cells, thymus, and lymph nodes in rats after single dosing with PPI-2458 and the isolated metabolites was found to correlate with the in vitro activity of the individual species. In a phase 1 clinical study, PPI-2458 was administered to patients with non-Hodgkin lymphoma. At 15 mg administered orally every other day, MetAP2 in whole blood was 80% inactivated for up to 48 hours, although the exposure of the parent compound was only similar to 10% that of the summed cytochrome P450 metabolites. Taken together, the data confirm the participation of active metabolites in the in vivo efficacy of PPI-2458. The structures define a metabolic pathway for PPI-2458 that is distinct from that of TNP-470 ((3R, 4S, 5S, 6R)-5-methoxy-4-(2R, 3R)-2-methyl-3-(3-methylbut-2-enyl)oxiran-2-yl]-1-oxaspiro2.5]octan-6 -yl] N-(2-chloroacetyl)carbamate). The high level of MetAP2 inhibition achieved in vivo supports the value of fumagillin-derived therapeutics for angiogenic diseases.

Toward Real-Time Availability of 3D Temperature Maps Created with Temporally Constrained Reconstruction

PurposeTo extend the previously developed temporally constrained reconstruction (TCR) algorithm to allow for real-time availability of three-dimensional (3D) temperature maps capable of monitoring MR-guided high intensity focused ultrasound applications. MethodsA real-time TCR (RT-TCR) algorithm is developed that only uses current and previously acquired undersampled k-space data from a 3D segmented EPI pulse sequence, with the image reconstruction done in a graphics processing unit implementation to overcome computation burden. Simulated and experimental data sets of HIFU heating are used to evaluate the performance of the RT-TCR algorithm. ResultsThe simulation studies demonstrate that the RT-TCR algorithm has subsecond reconstruction time and can accurately measure HIFU-induced temperature rises of 20 degrees C in 15 s for 3D volumes of 16 slices (RMSE = 0.1 degrees C), 24 slices (RMSE = 0.2 degrees C), and 32 slices (RMSE = 0.3 degrees C). Experimental results in ex vivo porcine muscle demonstrate that the RT-TCR approach can reconstruct temperature maps with 192 x 162 x 66 mm 3D volume coverage, 1.5 x 1.5 x 3.0 mm resolution, and 1.2-s scan time with an accuracy of 0.5 degrees C. ConclusionThe RT-TCR algorithm offers an approach to obtaining large coverage 3D temperature maps in real-time for monitoring MR-guided high intensity focused ultrasound treatments. Magn Reson Med 71:1394-1404, 2014. (c) 2013 Wiley Periodicals, Inc.