Prostate Cancer Liver Metastasis: An Ominous Metastatic Site in Need of Distinct Management Strategies.

Prostate cancer liver metastasis (PCLM), seen in upwards of 25% of metastatic castration-resistant PC (mCRPC) patients, is the most lethal site of mCRPC with a median overall survival of 10-14 months. Despite its ominous prognosis and anticipated rise in incidence due to longer survival with contemporary therapy, PCLM is understudied. This review aims to summarize the existing literature regarding the risk factors associated with the development of PCLM, and to identify areas warranting further research.

Predicting Patterns of Distant Metastasis in Breast Cancer Patients following Local Regional Therapy Using Machine Learning.

Up to 30% of breast cancer (BC) patients will develop distant metastases (DM), for which there is no cure. Here, statistical and machine learning (ML) models were developed to estimate the risk of site-specific DM following local-regional therapy. This retrospective study cohort included 175 patients diagnosed with invasive BC who later developed DM.

Drivers of Emergency Department Use Among Oncology Patients in the Era of Novel Cancer Therapeutics: A Systematic Review.

Background: Patients diagnosed with cancer are frequent users of the emergency department (ED). While many visits are unavoidable, a significant portion may be potentially preventable ED visits (PPEDs). Cancer treatments have greatly advanced, whereby patients may present with unique toxicities from targeted therapies and are often living longer with advanced disease.

Quantitative digital histopathology and machine learning to predict pathological complete response to chemotherapy in breast cancer patients using pre-treatment tumor biopsies.

Complete pathological response (pCR) to neoadjuvant chemotherapy (NAC) is a prognostic factor for breast cancer (BC) patients and is correlated with improved survival. However, pCR rates are variable to standard NAC, depending on BC subtype. This study investigates quantitative digital histopathology coupled with machine learning (ML) to predict NAC response a priori.

Assessment of Digital Pathology Imaging Biomarkers Associated with Breast Cancer Histologic Grade.

Background: Evaluating histologic grade for breast cancer diagnosis is standard and associated with prognostic outcomes. Current challenges include the time required for manual microscopic evaluation and interobserver variability. This study proposes a computer-aided diagnostic (CAD) pipeline for grading tumors using artificial intelligence.

The "unknown territory" of goal-setting: Negotiating a novel interactional activity within primary care doctor-patient consultations for patients with multiple chronic conditions.

Goal-setting is widely recommended for supporting patients with multiple long-term conditions. It involves a proactive approach to a clinical consultation, requiring doctors and patients to work together to identify patient's priorities, values and desired outcomes as a basis for setting goals for the patient to work towards. Importantly it comprises a set of activities that, for many doctors and patients, represents a distinct departure from a conventional consultation, including goal elicitation, goal-setting and action planning.

Learning or leaving? An international qualitative study of factors affecting the resilience of female family doctors.

​BACKGROUND: Many countries have insufficient numbers of family doctors, and more females than males leave the workforce at a younger age or have difficulty sustaining careers. Understanding the differing attitudes, pressures, and perceptions between genders toward their medical occupation is important to minimise workforce attrition. ​AIM: To explore factors influencing the resilience of female family doctors during lifecycle transitions.

Can goal-setting for patients with multimorbidity improve outcomes in primary care? Cluster randomised feasibility trial.

Introduction: Goal-setting is recommended for patients with multimorbidity, but there is little evidence to support its use in general practice.

Objective: To assess the feasibility of goal-setting for patients with multimorbidity, before undertaking a definitive trial.

Design And Setting: Cluster-randomised controlled feasibility trial of goal-setting compared with control in six general practices.

Setting goals with patients living with multimorbidity: qualitative analysis of general practice consultations.

Background: Establishing patient goals is widely recommended as a way to deliver care that matters to the individual patient with multimorbidity, who may not be well served by single-disease guidelines. Though multimorbidity is now normal in general practice, little is known about how doctors and patients should set goals together.

Aim: To determine the key components of the goal-setting process in general practice.

Demonstration of an 8-dimensional modulation format with reduced inter-channel nonlinearities in a polarization multiplexed coherent system.

We demonstrate a polarization-managed 8-dimensional modulation format that is time domain coded to reduce inter-channel nonlinearity. Simulation results show a 2.3 dB improvement in maximum net system margin (NSM) relative to polarization multiplexed (PM)-BPSK, and a 1.

Examining the practice of generalist expertise: a qualitative study identifying constraints and solutions.

Objectives: Provision of person-centred generalist care is a core component of quality primary care systems. The World Health Organisation believes that a lack of generalist primary care is contributing to inefficiency, ineffectiveness and inequity in healthcare. In UK primary care, General Practitioners (GPs) are the largest group of practising generalists.

Professional learning during the transition from trainee to newly qualified general practitioner.

Background: The transition from training to qualified practice is inherently challenging. Structured support following training was once available, but this no longer exists and the current climate of primary care places increasing demands on GPs. Professional learning, and the transition to independent practice, may thus be problematic.

CEP stable 1.6 cycle laser pulses at 1.8 μm.

By using the novel approach for pulse compression that combines spectral broadening in hollow-core fiber (HCF) with linear propagation in fused silica (FS), we generate 1.6 cycle 0.24 mJ laser pulses at 1.

Age-related differential diagnosis of vaginal bleeding in postmenopausal women: a series of 3047 symptomatic postmenopausal women.

Objective: The aim of this study is to identify the causes of vaginal bleeding in different age groups of postmenopausal women. Also, we attempt to estimate the incidence of postmenopausal vaginal bleeding and endometrial cancer in a defined geographical area.

Study Design: The study was conducted at a gynaecological oncology centre in the United Kingdom, between February 2006 and May 2009.

Predicting the risk of endometrial cancer in postmenopausal women presenting with vaginal bleeding: the Norwich DEFAB risk assessment tool.

Background: This study aimed to show the longitudinal use of routinely collected clinical data from history and ultrasound evaluation of the endometrium in developing an algorithm to predict the risk of endometrial carcinoma for postmenopausal women presenting with vaginal bleeding.

Methods: This prospective study collected data from 3047 women presenting with postmenopausal bleeding. Data regarding the presence of risk factors for endometrial cancer was collected and univariate and multivariate analyses were performed.

Wavelength scaling of high harmonic generation efficiency.

Using longer wavelength laser drivers for high harmonic generation is desirable because the highest extreme ultraviolet frequency scales as the square of the wavelength. Recent numerical studies predict that high harmonic efficiency falls dramatically with increasing wavelength, with a very unfavorable lambda(-(5-6)) scaling. We performed an experimental study of the high harmonic yield over a wavelength range of 800-1850 nm.

Laser tunnel ionization from multiple orbitals in HCl.

Tunneling, one of the most striking manifestations of quantum mechanics, influences the electronic structure of many molecules and solids and is responsible for radioactive decay. Much of the interaction of intense light pulses with matter commences with electrons tunneling from atoms or molecules to the continuum. Until recently, this starting point was assumed to be the highest occupied orbital of a given system.

Pulse compression of submillijoule few-optical-cycle infrared laser pulses using chirped mirrors.

We report generation of 400 microJ, 13.1 fs, 1425 nm optical parametric amplifier laser pulses. Spectral broadening of a 100 Hz optical parametric amplifier laser source is achieved by self-phase modulation in an argon-filled hollow-core fiber, and dispersion compensation is performed using chirped mirrors.

Severe metabolic acidosis as a consequence of acute starvation in pregnancy.

Ketoacidosis is most often due to uncontrolled diabetes mellitus. Similar metabolic changes can occur with poor dietary intake of carbohydrates or prolonged fasting. Metabolic acidosis due to prolonged fasting is rarely described in the literature.