A seven-year follow-up of men following a benign prostate biopsy

Objectives: To determine the incidence and clinical relevance of newly diagnosed cases of prostate cancer in a group of men who had an elevated PSA and benign prostate biopsy 7 years previously. Patients and Method: Patients under the age of 80 years with an elevated PSA who had had a benign prostate biopsy in the 12 months between March 1, 1994 and February 28, 1995 were studied. One hundred and sixty four patients with a mean age of 66.8 years (range 47-79 years) were identified. The mean PSA for this group was 10.3 ng/ml (range 4.1-81 ng/ml). One hundred and fifty nine of the 164 (97%) hospital records were available for review and all but 21 (12.8%) of the General Practitioners were contacted. Results: Eighteen (11%) of the original 164 patients were subsequently diagnosed with prostate cancer, 2 died from their disease. Conclusions: In a population where the follow-up of patients with a benign biopsy was arranged on clinical grounds alone, 11% of the study group were diagnosed with prostate cancer during a seven-year follow-up. Although some of these cancers appear to be slow growing, most of those diagnosed in the initial follow-up period were deemed to be clinically significant and a small proportion progressed rapidly to metastases. All patients who have an elevated PSA, but benign biopsy, should undergo a period of PSA monitoring until it is clear that their PSA is not rising. We propose an initial intensive monitoring period to avoid missing those with clinically aggressive disease. (C) 2003 Elsevier Science B.V. All rights reserved.

Can drug-bearing liposomes penetrate intact skin?

Using liposomes to deliver drugs to and through human skin is controversial, as their function varies with type and composition. Thus they may act as drug carriers controlling release of the medicinal agent. Alternatively, they may provide a localized depot in the skin so minimizing systemic effects or can be used for targeting delivery to skin appendages (hair follicles and sweat glands). Liposomes may also enhance transdermal drug delivery, increasing systemic drug concentrations. With such a multiplicity of functions, it is not surprising that mechanisms of liposomal delivery of therapeutic agents to and through the skin are unclear. Accordingly, this article provides an overview of the modes and mechanisms of action of different vesicles as drug delivery vectors in human skin. Our conclusion is that vesicles, depending on the composition and method of preparation, can vary with respect to size, lamellarity, charge, membrane fluidity or elasticity and drug entrapment. This variability allows for multiple functions ranging from local to transdermal effects. Application to dissimilar skins (animal or human) via diverse protocols may reveal different mechanisms of action with possible vesicle skin penetration reaching different depths, from surface assimilation to (rarely) the viable tissue and subsequent systemic absorption.

Real option pricing in mixed-use development projects

The application of real options theory to commercial real estate has developed rapidly during the last 15 Years. In particular, several pricing models have been applied to value real options embedded in development projects. In this study we use a case study of a mixed use development scheme and identify the major implied and explicit real options available to the developer. We offer the perspective of a real market application by exploring different binomial models and the associated methods of estimating the crucial parameter of volatility. We include simple binomial lattices, quadranomial lattices and demonstrate the sensitivity of the results to the choice of inputs and method.

A new floating model level scheme for the assimilation of boundary layer top inversions: the univariate assimilation of temperature.

The assimilation of observations with a forecast is often heavily influenced by the description of the error covariances associated with the forecast. When a temperature inversion is present at the top of the boundary layer (BL), a significant part of the forecast error may be described as a vertical positional error (as opposed to amplitude error normally dealt with in data assimilation). In these cases, failing to account for positional error explicitly is shown t o r esult in an analysis for which the inversion structure is erroneously weakened and degraded. In this article, a new assimilation scheme is proposed to explicitly include the positional error associated with an inversion. This is done through the introduction of an extra control variable to allow position errors in the a priori to be treated simultaneously with the usual amplitude errors. This new scheme, referred to as the ‘floating BL scheme’, is applied to the one-dimensional (vertical) variational assimilation of temperature. The floating BL scheme is tested with a series of idealised experiments a nd with real data from radiosondes. For each idealised experiment, the floating BL scheme gives an analysis which has the inversion structure and position in agreement with the truth, and outperforms the a ssimilation which accounts only for forecast a mplitude error. When the floating BL scheme is used to assimilate a l arge sample of radiosonde data, its ability to give an analysis with an inversion height in better agreement with that observed is confirmed. However, it is found that the use of Gaussian statistics is an inappropriate description o f t he error statistics o f t he extra c ontrol variable. This problem is alleviated by incorporating a non-Gaussian description of the new control variable in the new scheme. Anticipated challenges in implementing the scheme operationally are discussed towards the end of the article.

A good enough approach to setting planning obligations

In this paper we propose an alternative model of, what is often called, land value capture in the planning system. Based on development viability models, negotiations and policy formation regarding the level of planning obligations have taken place at the local level with little clear guidance on technique, approach and method. It is argued that current approaches are regressive and fail to reflect how the ability of sites to generate planning gain can vary over time and between sites. The alternative approach suggested here attempts to rationalise rather than replace the existing practice of development viability appraisal. It is based upon the assumption that schemes with similar development values should produce similar levels of return to the landowner, developer and other stakeholders in the development as well as similar levels of planning obligations in all parts of the country. Given the high level of input uncertainty in viability modelling, a simple viability model is ‘good enough’ to quantify the maximum level of planning obligations for a given level of development value. We have argued that such an approach can deliver a more durable, equitable, simpler, consistent and cheaper method for policy formation regarding planning obligations.

Predictability of large interannual Arctic sea-ice anomalies

In projections of twenty-first century climate, Arctic sea ice declines and at the same time exhibits strong interannual anomalies. Here, we investigate the potential to predict these strong sea-ice anomalies under a perfect-model assumption, using the Max-Planck-Institute Earth System Model in the same setup as in the Coupled Model Intercomparison Project Phase 5 (CMIP5). We study two cases of strong negative sea-ice anomalies: a 5-year-long anomaly for present-day conditions, and a 10-year-long anomaly for conditions projected for the middle of the twenty-first century. We treat these anomalies in the CMIP5 projections as the truth, and use exactly the same model configuration for predictions of this synthetic truth. We start ensemble predictions at different times during the anomalies, considering lagged-perfect and sea-ice-assimilated initial conditions. We find that the onset and amplitude of the interannual anomalies are not predictable. However, the further deepening of the anomaly can be predicted for typically 1 year lead time if predictions start after the onset but before the maximal amplitude of the anomaly. The magnitude of an extremely low summer sea-ice minimum is hard to predict: the skill of the prediction ensemble is not better than a damped-persistence forecast for lead times of more than a few months, and is not better than a climatology forecast for lead times of two or more years. Predictions of the present-day anomaly are more skillful than predictions of the mid-century anomaly. Predictions using sea-ice-assimilated initial conditions are competitive with those using lagged-perfect initial conditions for lead times of a year or less, but yield degraded skill for longer lead times. The results presented here suggest that there is limited prospect of predicting the large interannual sea-ice anomalies expected to occur throughout the twenty-first century.

Capillary assay device with internal hydrophilic coating

The present invention provides assay devices having a unitary body with an exterior surface, the unitary body being substantially transparent to visible light and formed from a material having a refractive index in the range 1.26 to 1.40, the refractive index being measured at 20 °C with light of wavelength 589 nm, and wherein the unitary body is formed from a hydrophobic material, and at least two capillary bores extending internally along the unitary body, wherein at least a portion of the surface of each capillary bore includes a hydrophilic layer for retaining an assay reagent, and wherein the hydrophilic layer is also substantially transparent to visible light to allow optical interrogation of the capillary bores through the capillary wall. The present invention also provides assay systems including such assay devices, methods of performing an assay using such assay devices and method of method for manufacturing such assay devices.

Memorias enfrentadas : las reacciones a los informes Nunca Más de Argentina y Chile

This paper analyzes the most immediate responses of human rights institutions, the Armed Forces, political parties, and society following the publication of the Report of the National Commission on the Disappeared (Conadep) in Argentina and the Report of the National Commission for Truth and Reconciliation (CNVR) in Chile. The publication of these reports had a great national significance because, only one year after the reestablishment of democracy, they officially recognized the human rights violations committed during the preceding dictatorships. Each of the four sectors mentioned in this article responded to the reports in its own way, according to its demands and political ideology.

The effectiveness of proactive telephone support provided to breastfeeding mothers of preterm infants : study protocol for a randomized controlled trial

Background: Although breast milk has numerous benefits for infants' development, with greater effects in those born preterm (at < 37 gestational weeks), mothers of preterm infants have shorter breastfeeding duration than mothers of term infants. One of the explanations proposed is the difficulties in the transition from a Neonatal Intensive Care Unit (NICU) to the home environment. A person-centred proactive telephone support intervention after discharge from NICU is expected to promote mothers' sense of trust in their own capacity and thereby facilitate breastfeeding. Methods/design: A multicentre randomized controlled trial has been designed to evaluate the effectiveness and cost-effectiveness of person-centred proactive telephone support on breastfeeding outcomes for mothers of preterm infants. Participating mothers will be randomized to either an intervention group or control group. In the intervention group person-centred proactive telephone support will be provided, in which the support team phones the mother daily for up to 14 days after hospital discharge. In the control group, mothers are offered a person-centred reactive support where mothers can phone the breastfeeding support team up to day 14 after hospital discharge. The intervention group will also be offered the same reactive telephone support as the control group. A stratified block randomization will be used; group allocation will be by high or low socioeconomic status and by NICU. Recruitment will be performed continuously until 1116 mothers (I: 558 C: 558) have been included. Primary outcome: proportion of mothers exclusively breastfeeding at eight weeks after discharge. Secondary outcomes: proportion of breastfeeding (exclusive, partial, none and method of feeding), mothers satisfaction with breastfeeding, attachment, stress and quality of life in mothers/partners at eight weeks after hospital discharge and at six months postnatal age. Data will be collected by researchers blind to group allocation for the primary outcome. A qualitative evaluation of experiences of receiving/providing the intervention will also be undertaken with mothers and staff. Discussion: This paper presents the rationale, study design and protocol for a RCT providing person-centred proactive telephone support to mothers of preterm infants. Furthermore, with a health economic evaluation, the cost-effectiveness of the intervention will be assessed. Trial registration: NCT01806480

Skolkuratorns roll i arbetet mot mobbning : En kvalitativ studie

Syftet med studien var att undersöka hur skolkuratorerna upplever sitt arbete mot mobbning och hur de praktiskt arbetar mot mobbning. Metoden var kvalitativ och intervjuer genomfördes med sju skolkuratorer på olika skolor i två mindre kommuner. Studien visade att skolkuratorerna vill arbeta mer med det förebyggande arbetet mot mobbningen än det finns tid till. Deras arbete handlar mycket om att gå in och hjälpa där behovet och mobbningsproblematiken redan finns. I de metoder och program som finns att tillgå i arbetet mot mobbningen är det inget som rekommenderas utan det är upp till skolkuratorerna att själva utforma en metod som ska passa den individuella eleven. Det finns ett behov av att utveckla ett program- och metodkoncept som motsvarar dagens problematik.

O pragmatismo em economia: bases filosóficas para uma interpretação do discurso econômico

O trabalho tem por objetivo trazer elementos da corrente filosófica do pragmatismo para a discussão metodológica em economia, particularmente no que diz respeito a teoria da verdade e suas implicações para o debate epistemológico. Após apresentar as contribuições dos pioneiros do pragmatismo William James, John Dewey e Charles S. Peirce e discutir aspectos da obra de W. Quine e Richard Rorty, procuramos identificar influências dessa corrente filosófica em importantes economistas tais como J. M. Keynes, M. Friedman e T. Veblen. Por fim concluímos com algumas reflexões possivelmente úteis para a prática da ciência econômica.

Programa PNAD: uma construção científica

Estudo sobre o processo de revisão dos parâmetros conceituais e metodológicos norteadores da Pesquisa Nacional por Amostra de Domicilios - PNAD, da Fundação Instituto Brasileiro de Geografia e Estatistica IBGE, abrangendo o periodo de 1989 a 1992. Objetiva-se mostrar o processo de produção estatistica, bem como compreender as relações entre objeto, teoria e método em investigações voltadas para a mensuração do real. A luz de reflexões sobre a construção do conhecimento cientifico e o papel do método no processo de pesquisa, discute-se a especificidade do método estatistico. Os resultados indicam que o processo de construção da PNAD se afirma como um fazer cientifico.

Verdade e subjetividade: um ensaio sobre a epistemologia genética

Ao fim do século XX, o discurso da pós-modernidade assinala a desconstrução de conceitos caros ao pensamento ocidental, dentre eles o de verdade e subjetividade. A ciência se defronta com o desafio de, em rompendo com o determinismo laplaciano, encontrar uma nova racionalidade capaz de expressar conceitos como incomensurabilidade,incerteza, acaso, desordem e imprevisibilidade. A Epistemologia Genética, nestes tempos que anunciam a pluralidade, a descontinuidade, a polimorfia e o ecletismo, e um projeto eivado de modernidade, o que faz de seu idealizador Jean Piaget, neste século, o grande narrador da razão analítica ocidental. Tornar a Epistemologia científica foi a tentativa máxima do "antigo futuro ex-filósofo" de nome Jean Piaget, no reencantamento da episteme grega, mantida ainda sua supremacia em relação a doxa. Ambição possível, somente, para quem fez do conhecimento científico sinônimo de verdade e da ciência, a sua própria vida.

Strategic manipulation of empirical tests

Theories can be produced by individuals seeking a good reputation of knowledge. Hence, a significant question is how to test theories anticipating that they might have been produced by (potentially uninformed) experts who prefer their theories not to be rejected. If a theory that predicts exactly like the data generating process is not rejected with high probability then the test is said to not reject the truth. On the other hand, if a false expert, with no knowledge over the data generating process, can strategically select theories that will not be rejected then the test can be ignorantly passed. These tests have limited use because they cannot feasibly dismiss completely uninformed experts. Many tests proposed in the literature (e.g., calibration tests) can be ignorantly passed. Dekel and Feinberg (2006) introduced a class of tests that seemingly have some power of dismissing uninformed experts. We show that some tests from their class can also be ignorantly passed. One of those tests, however, does not reject the truth and cannot be ignorantly passed. Thus, this empirical test can dismiss false experts.We also show that a false reputation of knowledge can be strategically sustained for an arbitrary, but given, number of periods, no matted which test is used (provided that it does not reject the truth). However, false experts can be discredited, even with bounded data sets, if the domain of permissible theories is mildly restricted.