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Sample records for psa screening rates

  1. The influence of stress, depression, and anxiety on PSA screening rates in a nationally representative sample.

    Science.gov (United States)

    Kotwal, Ashwin A; Schumm, Phil; Mohile, Supriya G; Dale, William

    2012-12-01

    Prostate-specific antigen (PSA) testing for prostate cancer is controversial, with concerning rates of both overscreening and underscreening. The reasons for the observed rates of screening are unknown, and few studies have examined the relationship of psychological health to PSA screening rates. Understanding this relationship can help guide interventions to improve informed decision-making for screening. A nationally representative sample of men 57-85 years old without prostate cancer (N = 1169) from the National Social life, Health and Aging Project was analyzed. The independent relationship of validated psychological health scales measuring stress, anxiety, and depression to PSA testing rates was assessed using multivariable logistic regression analyses. PSA screening rates were significantly lower for men with higher perceived stress [odds ratio (OR) = 0.76, P = 0.006], but not for higher depressive symptoms (OR = 0.89, P = 0.22) when accounting for stress. Anxiety influences PSA screening through an interaction with number of doctor visits (P = 0.02). Among the men who visited the doctor once those with higher anxiety were less likely to be screened (OR = 0.65, P = 0.04). Conversely, those who visited the doctor 10+ times with higher anxiety were more likely to be screened (OR = 1.71, P = 0.04). Perceived stress significantly lowers PSA screening likelihood, and it seems to partly mediate the negative relationship of depression with screening likelihood. Anxiety affects PSA screening rates differently for men with different numbers of doctor visits. Interventions to influence PSA screening rates should recognize the role of the patients' psychological state to improve their likelihood of making informed decisions and improve screening appropriateness.

  2. Impact of Prostate-specific Antigen (PSA) Screening Trials and Revised PSA Screening Guidelines on Rates of Prostate Biopsy and Postbiopsy Complications.

    Science.gov (United States)

    Gershman, Boris; Van Houten, Holly K; Herrin, Jeph; Moreira, Daniel M; Kim, Simon P; Shah, Nilay D; Karnes, R Jeffrey

    2017-01-01

    Prostate biopsy and postbiopsy complications represent important risks of prostate-specific antigen (PSA) screening. Although landmark randomized trials and updated guidelines have challenged routine PSA screening, it is unclear whether these publications have affected rates of biopsy or postbiopsy complications. To evaluate whether publication of the 2008 and 2012 US Preventive Services Task Force (USPSTF) recommendations, the 2009 European Randomized Study of Screening for Prostate Cancer and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or the 2013 American Urological Association (AUA) guidelines was associated with changes in rates of biopsy or postbiopsy complications, and to identify predictors of postbiopsy complications. This quasiexperimental study used administrative claims of 5279315 commercially insured US men aged ≥40 yr from 2005 to 2014, of whom 104584 underwent biopsy. Publications on PSA screening. Interrupted time-series analysis was used to evaluate the association of publications with rates of biopsy and 30-d complications. Logistic regression was performed to identify predictors of complications. From 2005 to 2014, biopsy rates fell 33% from 64.1 to 42.8 per 100000 person-months, with immediate reductions following the 2008 USPSTF recommendations (-10.1; 95% confidence interval [CI], -17.1 to -3.0; pprostate-specific antigen screening; however, the relative morbidity of biopsy continues to increase. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  3. Cost implications of PSA screening differ by age.

    Science.gov (United States)

    Rao, Karthik; Liang, Stella; Cardamone, Michael; Joshu, Corinne E; Marmen, Kyle; Bhavsar, Nrupen; Nelson, William G; Ballentine Carter, H; Albert, Michael C; Platz, Elizabeth A; Pollack, Craig E

    2018-05-09

    Multiple guidelines seek to alter rates of prostate-specific antigen (PSA)-based prostate cancer screening. The costs borne by payers associated with PSA-based screening for men of different age groups-including the costs of screening and subsequent diagnosis, treatment, and adverse events-remain uncertain. We sought to develop a model of PSA costs that could be used by payers and health care systems to inform cost considerations under a range of different scenarios. We determined the prevalence of PSA screening among men aged 50 and higher using 2013-2014 data from a large, multispecialty group, obtained reimbursed costs associated with screening, diagnosis, and treatment from a commercial health plan, and identified transition probabilities for biopsy, diagnosis, treatment, and complications from the literature to generate a cost model. We estimated annual total costs for groups of men ages 50-54, 55-69, and 70+ years, and varied annual prostate cancer screening prevalence in each group from 5 to 50% and tested hypothetical examples of different test characteristics (e.g., true/false positive rate). Under the baseline screening patterns, costs of the PSA screening represented 10.1% of the total costs; costs of biopsies and associated complications were 23.3% of total costs; and, although only 0.3% of all screen eligible patients were treated, they accounted for 66.7% of total costs. For each 5-percentage point decrease in PSA screening among men aged 70 and older for a single calendar year, total costs associated with prostate cancer screening decreased by 13.8%. For each 5-percentage point decrease in PSA screening among men 50-54 and 55-69 years old, costs were 2.3% and 7.3% lower respectively. With constrained financial resources and with national pressure to decrease use of clinically unnecessary PSA-based prostate cancer screening, there is an opportunity for cost savings, especially by focusing on the downstream costs disproportionately associated with

  4. Screen for Life: Meryl Streep PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2013-05-16

    In this 30 second PSA, Academy Award®-winning actress Meryl Streep urges viewers to get screened for colorectal cancer.  Created: 5/16/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/16/2013.

  5. Screen for Life: Meryl Streep PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-05-16

    In this 60 second PSA, Academy Award®-winning actress Meryl Streep urges viewers to get screened for colorectal cancer.  Created: 5/16/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/16/2013.

  6. PSA-based evaluation and rating of operational events

    International Nuclear Information System (INIS)

    Gomez Cobo, A.

    1997-01-01

    The presentation discusses the PSA-based evaluation and rating of operational events, including the following: historical background, procedures for event evaluation using PSA, use of PSA for event rating, current activities

  7. Probability of an Abnormal Screening PSA Result Based on Age, Race, and PSA Threshold

    Science.gov (United States)

    Espaldon, Roxanne; Kirby, Katharine A.; Fung, Kathy Z.; Hoffman, Richard M.; Powell, Adam A.; Freedland, Stephen J.; Walter, Louise C.

    2014-01-01

    Objective To determine the distribution of screening PSA values in older men and how different PSA thresholds affect the proportion of white, black, and Latino men who would have an abnormal screening result across advancing age groups. Methods We used linked national VA and Medicare data to determine the value of the first screening PSA test (ng/mL) of 327,284 men age 65+ who underwent PSA screening in the VA healthcare system in 2003. We calculated the proportion of men with an abnormal PSA result based on age, race, and common PSA thresholds. Results Among men age 65+, 8.4% had a PSA >4.0ng/mL. The percentage of men with a PSA >4.0ng/mL increased with age and was highest in black men (13.8%) versus white (8.0%) or Latino men (10.0%) (PPSA >4.0ng/mL ranged from 5.1% of Latino men age 65–69 to 27.4% of black men age 85+. Raising the PSA threshold from >4.0ng/mL to >10.0ng/mL, reclassified the greatest percentage of black men age 85+ (18.3% absolute change) and the lowest percentage of Latino men age 65–69 (4.8% absolute change) as being under the biopsy threshold (PPSA threshold together affect the pre-test probability of an abnormal screening PSA result. Based on screening PSA distributions, stopping screening among men whose PSA 10ng/ml has the greatest effect on reducing the number of older black men who will face biopsy decisions after screening. PMID:24439009

  8. Doctors' perspectives on PSA testing illuminate established differences in prostate cancer screening rates between Australia and the UK: a qualitative study

    Science.gov (United States)

    Pickles, Kristen; Carter, Stacy M; Rychetnik, Lucie; Entwistle, Vikki A

    2016-01-01

    Objectives To examine how general practitioners (GPs) in the UK and GPs in Australia explain their prostate-specific antigen (PSA) testing practices and to illuminate how these explanations are similar and how they are different. Design A grounded theory study. Setting Primary care practices in Australia and the UK. Participants 69 GPs in Australia (n=40) and the UK (n=29). We included GPs of varying ages, sex, clinical experience and patient populations. All GPs interested in participating in the study were included. Results GPs' accounts revealed fundamental differences in whether and how prostate cancer screening occurred in their practice and in the broader context within which they operate. The history of prostate screening policy, organisational structures and funding models appeared to drive more prostate screening in Australia and less in the UK. In Australia, screening processes and decisions were mostly at the discretion of individual clinicians, and varied considerably, whereas the accounts of UK GPs clearly reflected a consistent, organisationally embedded approach based on local evidence-based recommendations to discourage screening. Conclusions The GP accounts suggested that healthcare systems, including historical and current organisational and funding structures and rules, collectively contribute to how and why clinicians use the PSA test and play a significant role in creating the mindlines that GPs employ in their clinic. Australia's recently released consensus guidelines may support more streamlined and consistent care. However, if GP mindlines and thus routine practice in Australia are to shift, to ultimately reduce unnecessary or harmful prostate screening, it is likely that other important drivers at all levels of the screening process will need to be addressed. PMID:27920082

  9. Metastatic prostate cancer in the modern era of PSA screening

    Directory of Open Access Journals (Sweden)

    Philip A. Fontenot Jr

    Full Text Available ABSTRACT Introduction To characterize initial presentation and PSA screening status in a contemporary cohort of men treated for metastatic prostate cancer at our institution. Materials and methods We reviewed records of 160 men treated for metastatic prostate cancer between 2008-2014 and assessed initial presentation, categorizing patients into four groups. Groups 1 and 2 presented with localized disease and received treatment. These men suffered biochemical recurrence late (>1 year or earlier (<1 year, respectively, and developed metastases. Groups 3 and 4 had asymptomatic and symptomatic metastases at the outset of their diagnosis. Patients with a first PSA at age 55 or younger were considered to have guideline-directed screening. Results Complete records were available on 157 men for initial presentation and 155 men for PSA screening. Groups 1, 2, 3 and 4 included 27 (17%, 7 (5%, 69 (44% and 54 (34% patients, respectively. Twenty (13% patients received guideline-directed PSA screening, 5/155 (3% patients presented with metastases prior to age 55 with their first PSA, and 130/155 (84% had their first PSA after age 55, of which 122/130 (94% had metastasis at the time of diagnosis. Conclusion Despite widespread screening, most men treated for metastatic prostate cancer at our institution presented with metastases rather than progressed after definitive treatment. Furthermore, 25 (16% patients received guideline-directed PSA screening at or before age 55. These data highlight that, despite mass screening efforts, patients treated for incurable disease at our institution may not have been a result of a failed screening test, but a failure to be screened.

  10. Metastatic prostate cancer in the modern era of PSA screening

    Science.gov (United States)

    Fontenot, Philip A.; Nehra, Avinash; Parker, William; Wyre, Hadley; Mirza, Moben; Duchene, David A.; Holzbeierlein, Jeffrey; Thrasher, James Brantley; Veldhuizen, Peter Van; Lee, Eugene K.

    2017-01-01

    ABSTRACT Introduction To characterize initial presentation and PSA screening status in a contemporary cohort of men treated for metastatic prostate cancer at our institution. Materials and methods We reviewed records of 160 men treated for metastatic prostate cancer between 2008-2014 and assessed initial presentation, categorizing patients into four groups. Groups 1 and 2 presented with localized disease and received treatment. These men suffered biochemical recurrence late (>1 year) or earlier (<1 year), respectively, and developed metastases. Groups 3 and 4 had asymptomatic and symptomatic metastases at the outset of their diagnosis. Patients with a first PSA at age 55 or younger were considered to have guideline-directed screening. Results Complete records were available on 157 men for initial presentation and 155 men for PSA screening. Groups 1, 2, 3 and 4 included 27 (17%), 7 (5%), 69 (44%) and 54 (34%) patients, respectively. Twenty (13%) patients received guideline-directed PSA screening, 5/155 (3%) patients presented with metastases prior to age 55 with their first PSA, and 130/155 (84%) had their first PSA after age 55, of which 122/130 (94%) had metastasis at the time of diagnosis. Conclusion Despite widespread screening, most men treated for metastatic prostate cancer at our institution presented with metastases rather than progressed after definitive treatment. Furthermore, 25 (16%) patients received guideline-directed PSA screening at or before age 55. These data highlight that, despite mass screening efforts, patients treated for incurable disease at our institution may not have been a result of a failed screening test, but a failure to be screened. PMID:28338310

  11. Long-term longitudinal changes in baseline PSA distribution and estimated prevalence of prostate cancer in male Japanese participants of population-based PSA screening.

    Science.gov (United States)

    Oki, Ryo; Ito, Kazuto; Suzuki, Rie; Fujizuka, Yuji; Arai, Seiji; Miyazawa, Yoshiyuki; Sekine, Yoshitaka; Koike, Hidekazu; Matsui, Hiroshi; Shibata, Yasuhiro; Suzuki, Kazuhiro

    2018-04-26

    Japan has experienced a drastic increase in the incidence of prostate cancer (PC). To assess changes in the risk for PC, we investigated baseline prostate specific antigen (PSA) levels in first-time screened men, across a 25-year period. In total, 72,654 men, aged 50-79, underwent first-time PSA screening in Gunma prefecture between 1992 and 2016. Changes in the distribution of PSA levels were investigated, including the percentage of men with a PSA above cut-off values and linear regression analyses comparing log 10 PSA with age. The 'ultimate incidence' of PC and clinically significant PC (CSPC) were estimated using the PC risk calculator. Changes in the age-standardized incidence rate (AIR) during this period were analyzed. The calculated coefficients of linear regression for age versus log 10 PSA fluctuated during the 25-year period, but no trend was observed. In addition, the percentage of men with a PSA above cut-off values varied in each 5-year period, with no specific trend. The 'risk calculator (RC)-based AIR' of PC and CSPC were stable between 1992 and 2016. Therefore, the baseline risk for developing PC has remained unchanged in the past 25 years, in Japan. The drastic increase in the incidence of PC, beginning around 2000, may be primarily due to increased PSA screening in the country. © 2018 UICC.

  12. Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer

    NARCIS (Netherlands)

    Rybalov, Maxim; Breeuwsma, Anthonius J.; Leliveld, Anna M.; Pruim, Jan; Dierckx, Rudi A.; de Jong, Igle J.

    PURPOSE: To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of (11)C-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT). METHODS: We included 185 patients with BCR after RP (PSA >0.2 ng/ml)

  13. [Rates of total and free PSA prescriptions in France (2012-2014)].

    Science.gov (United States)

    Tuppin, Philippe; Leboucher, Claire; Peyre-Lanquar, Gabrielle; Lamy, Pierre-Jean; Gabach, Pierre; Rébillard, Xavier

    2017-10-01

    In 2010, the French Haute Autorité de santé (National Health Authority) confirmed the limited value of prostate cancer (PCa) screening by total prostate-specific antigen (PSA) assay. This study was designed to determine the modalities of ordering total PSA or free PSA assays (in the absence of PCa) according to various parameters and the corresponding sums reimbursed. Men aged 40 years and older covered by the national health insurance general scheme (73% of the French population) between 2012 and 2014 were selected. Data were derived from the Système national d'information inter-régimes de l'assurance maladie (Sniiram) (National health insurance information system) database. In 2014, 27% of the 11.6 million men 40 years and older underwent at least one total PSA assay and 5.6% underwent at least one free PSA assay, with marked variations according to the presence or absence of treated lower urinary tract symptoms (LUTS) (53% and 15% vs 24% and 5%) and from one administrative department to another. The peak total PSA assay rate was observed between the ages of 65 and 74 years: 64% of men with LUTS, 46% without LUTS. Between 2012 and 2014, men in whom at least one PSA assay had been performed underwent a mean of 1.8 total PSA assays and 1.7 free PSA assays, with means of 2.3 and 2, respectively, in the presence of LUTS. General practice specialists ordered 91% of the PSA tests reimbursed in 2014 (92% for total PSA and 87% for free PSA) and urologists ordered 4% of reimbursed tests. The total sum reimbursed was €28.5 million, comprising €8.7 million for free PSA. An average of 10 laboratory tests was performed at the same time as the PSA assay in the absence of treated LUTS. Total PSA and free PSA assays are performed in a large number of men, although the value of these tests as first-line test before biopsy remains controversial. These PSA assays are associated with many other laboratory tests looking for possible abnormalities, especially in younger

  14. PROSTATE CANCER SCREENING: PSA TEST AWARENESS AMONG ADULT MALES.

    Science.gov (United States)

    Obana, Michael; O'Lawrence, Henry

    2015-01-01

    The overall purpose of this study was to determine whether visits to the doctor in the last 12 months, education level, and annual household income for adult males increased the awareness of prostate-specific antigen (PSA) tests. The effect of these factors for the knowledge of PSA exams was performed using statistical analysis. A retrospective secondary database was utilized for this study using the questionnaire in the California Health Interview Survey from 2009. Based on this survey, annual visits to the doctor, higher educational levels attained, and greater take-home pay were statistically significant and the results of the study were equivalent to those hypothesized. This also reflects the consideration of marketing PSA blood test screenings to those adult males who are poor, uneducated, and do not see the doctor on a consistent basis.

  15. Alcohol Screening and Counseling PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement is based on the January 2014 CDC Vital Signs report. Millions of Americans drink too much, a dangerous behavior that can lead to serious health problems. Alcohol screening and counseling can help.

  16. Alcohol Screening and Counseling PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-01-07

    This 60 second public service announcement is based on the January 2014 CDC Vital Signs report. Millions of Americans drink too much, a dangerous behavior that can lead to serious health problems. Alcohol screening and counseling can help.  Created: 1/7/2014 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/7/2014.

  17. PSA and Prostate Health Index based prostate cancer screening in a hereditary migration complicated population: implications in precision diagnosis.

    Science.gov (United States)

    Akizhanova, Mariyam; Iskakova, Elzira E; Kim, Valdemir; Wang, Xiao; Kogay, Roman; Turebayeva, Aiym; Sun, Qinglei; Zheng, Ting; Wu, Shenghui; Miao, Lixia; Xie, Yingqiu

    2017-01-01

    Precision diagnosis requires specific markers for differential ethnic populations. Prostate-Specific Antigen (PSA) level (threshold of 4ng/ml) has been widely used to screen prostate cancer and as reference of pro-biopsy but false diagnosis frequently occurs. Prostate health Index (PHI) is a new diagnosis marker which combines PSA, free PSA and p2PSA4. Overall the PCa screening database is lacking in Kazakhstani patients. We analyzed the PSA levels and Gleason scores of 222 biopsies collected in 2015 in Almaty area, Kazakhstan approved by institutional ethics board. We found using PSA of 4ng/ml as threshold, only 25.68% of patients have cancer with Gleason score ranged 6-8 and 65.77% of patients have no character of cancer. Moreover, there is no significant correlation between PSA and cancerous (P=0.266) or Gleason grade (P=0.3046) based on pathological biopsy. In addition, PHI is not correlated to prostate cancer (P=0.4301). Our data suggest that false-positive rate is much higher than the correct-positive diagnosis when using PSA as the first screening. Thus in this cohort study, most patients can not get benefit from the PSA screening for precision PCa diagnosis. As Kazakhstani family trees are unique and complicated because of history and migration, the high rate of over diagnosis might be due to the hyperexpression of PSA via heterosis in Eurasian men. Therefore we should be cautious when using pro-biopsy in precision diagnosis for Eurasian prostate cancer patients.

  18. Comparison of clinical and survival characteristics between prostate cancer patients of PSA-based screening and clinical diagnosis in China.

    Science.gov (United States)

    Xu, Libo; Wang, Jinguo; Guo, Baofeng; Zhang, Haixia; Wang, Kaichen; Wang, Ding; Dai, Chang; Zhang, Ling; Zhao, Xuejian

    2018-01-02

    Prostate-specific antigen (PSA)-based mass screening remains the most controversial topic in prostate cancer. PSA-based mass screening has not been widely used in China yet. The aim of our study was to evaluate the effect of the PSA-based screening in China. The cohort consisted of 1,012 prostate cancer patients. Data were retrospectively collected and clinical characteristics of the cohorts were investigated. Survival was analyzed for prostatic carcinoma of both PSA screened and clinically diagnosed patients according to clinical characteristics and the National Comprehensive Cancer Network (NCCN) risk classification. Cox Proportional Hazards Model analysis was done for risk predictor identification. The median age was 71 years old. Five-year overall and prostate-cancer-specific survival in prostatic adenocarcinoma patients were 77.52% and 79.65%; 10-year survivals were 62.57% and 68.60%, respectively. Survival was significantly poorer in patients with metastases and non-curative management. T staging and Gleason score by NCCN classification effectively stratified prostatic adenocarcinoma patients into different risk groups. T staging was a significant predictor of survival by COX Proportional Hazard Model. PSA screened patients had a significantly higher percentage diagnosed in early stage. PSA screened prostatic adenocarcinoma patients had a better prognosis in both overall and prostate cancer-specific survivals. This Chinese cohort had a lower overall and prostate cancer survival rate than it is reported in western countries. The incidence of early-stage prostate cancer found in PSA-based mass screening was high and there were significant differences in both overall and prostate cancer-specific survival between the PSA-screened and clinically diagnosed patients.

  19. [Prostate cancer screening at Tatebayashi City in Gunma prefecture--results of screening with PSA alone between 2003 and 2005].

    Science.gov (United States)

    Nakamura, Toshiyuki; Etsunaga, Toru; Sasaki, Yasushi; Nitta, Takashi; Okugi, Yasunobu; Okazaki, Hiroshi; Katou, Nobuo; Yamamoto, Takumi; Suzuki, Kazuhiro

    2007-05-01

    Since 2003, a basic health checkup has involved prostate cancer screening with prostate specific antigen (PSA) alone. We investigated the results between 2003 and 2005. Among males aged over 50 years who underwent a basic health checkup, the subjects were those who desired prostate cancer screening. Cancer screening with PSA alone was performed; mass screening or individual screening in hospitals in the city. We employed PSA with respect to age stratification. On the primary screening, written informed consent regarding the analysis of the screening results was obtained. In 2003, there were 15,303 males aged over 50 years in Tatebayashi City. In 2003, 2004, and 2005, 11.8%, 12.2%, and 12.7% of the males underwent PSA screening, respectively. The rate of elevated PSA levels between 2003 and 2005 was 20.6%. Furthermore, 208, 165, and 179 males required secondary screening, and 80.3%, 61.2%, and 55.3% of the males underwent secondary screening, respectively. Of the males who underwent secondary screening, prostate biopsy was performed in 123 (73.2%), 54 (53.5%), and 38 (38.4%). Prostate cancer was detected in 60, 28, and 16 males, respectively. These values corresponded to 3.4%, 1.5%, and 0.8% of the males who underwent primary screening. The incidence of prostate cancer was 1.85% during the 3 years, and 3.2% in males who underwent the initial health checkup. Of 101 males in whom the stage was evaluated, the clinical stage was evaluated as B in 86 (85.1%), C in 9 (8.9%), and D in 6 (5.9%). Of the 101 males, endocrine therapy was performed in 46 (45.5%), surgery in 31 (30.7%), external irradiation in 5 (5.0%), and followup without treatment in 6 (5.9%). In addition, 7 (6.3%) desired treatment in another hospital, and 6 (5.9%) refused treatment. Prostate cancer was detected in 1.85% of males who underwent primary screening between 2003 and 2005. Of 101 males in whom the stage was evaluated, the clinical stage was evaluated as B in 86 (85.1%), and the early treatment of

  20. Estimation of Internal Flooding Frequency for Screening Analysis of Flooding PSA

    International Nuclear Information System (INIS)

    Choi, Sun Yeong; Yang, Jun Eon

    2005-01-01

    The purpose of this paper is to estimate the internal frequency for the quantitative screening analysis of the flooding PSA (Probabilistic Safety Assessment) with the appropriate data and estimation method. In the case of the existing flood PSA for domestic NPPs (Nuclear Power Plant), the screening analysis was performed firstly and then detailed analysis was performed for the area not screened out. For the quantitative screening analysis, the plant area based flood frequency by MLE (Maximum Likelihood Estimation) method was used, while the component based flood frequency is used for the detailed analysis. The existing quantitative screening analysis for domestic NPPs have used data from all LWRs (Light Water Reactor), namely PWR (Pressurized Water Reactor) and BWR (Boiling Water Reactor) for the internal flood frequency of the auxiliary building and turbine building. However, in the case of the primary auxiliary building, the applicability of the data from all LWRs needs to be examined carefully because of the significant difference in equipments between the PWR and BWR structure. NUREG/CR-5750 suggested the Bayesian update method with Jeffrey's noninformative prior to estimate the initiating event frequency for the flood. It, however, did not describe any procedure of the flood PSA. Recently, Fleming and Lydell suggested the internal flooding frequency in the unit of the plant operation year-pipe length (in meter) by pipe size of each specific system which is susceptible to the flooding such as the service water system and the circulating water system. They used the failure rate, the rupture conditional probability given the failure to estimate the internal flooding frequency, and the Bayesian update to reduce uncertainties. To perform the quantitative screening analysis with the method, it requires pipe length by each pipe size of the specific system per each divided area to change the concept of the component based frequency to the concept of the plant area

  1. PSA-Based Screening Outcomes, Dietary Heterocyclic Amine Exposure, and Prostate Cancer Risk in African-Americans

    National Research Council Canada - National Science Library

    Bogen, Kenneth

    2006-01-01

    ... as more abnormal results from screening tests that correlate with current or eventual PC. A 3-year prospective clinic-based study is studying the performance of current (PSA and DRE) vs. (% free PSA...

  2. Mass screening for prostate cancer at Ikeda City in Osaka Prefecture. Results of screening with PSA alone between 2003 and 2007

    International Nuclear Information System (INIS)

    Inoue, Hitoshi; Kinouchi, Toshiro; Kinoshita, Tatsuya

    2010-01-01

    Since 2003, screening with prostate specific antigen (PSA) has been conducted to detect prostate cancer. We investigated the results between 2003 and 2007. Screening with PSA alone was performed for males aged over 50 years who desired prostate cancer screening. We used a PSA cutoff value of 4.00 ng per milliliter. In 2003, there were 18,161 males aged over 50 years in Ikeda City. 3,738, 3,905, 4,129, 4,410, and 4,515 of the males underwent PSA screening in 2003, 2004, 2005, 2006, and 2007. The rate of elevated PSA levels was 7.9%-9.8% (median 9.1%). 161, 81, 70, 75 and 60 of the males visited us for secondary screening, and prostate biopsy was performed in 130 (80.7%), 57 (70.4%), 45 (64.3%), 38 (50.7%), and 42 (70.0%). Prostate cancer was detected in 91, 33, 29, 20 and 25 males, respectively. These values corresponded to 2.43%, 0.85%, 0.70%, 0.45% and 0.55% of the males who underwent primary screening. The incidence of prostate cancer was 0.96% during the 5 years. Clinical stage was B in 137 (69.2%), C in 52 (26.3%), D in 7 (3.5%), and unknown in 2. Surgery was performed in 87 (43.9%), endocrine therapy in 61 (30.8%), irradiation in 37 (18.7%), and follow up without treatment in 7 (3.5%). Treatment for 6 (3.0%) is unknown because they desired treatment at another hospital. 198 males were diagnosed with prostate cancer between 2003 and 2007. The clinical stage B was present in 137 (69.2%), and the early treatment was achieved. This may lead to a future decrease in the mortality rate. (author)

  3. Effect of a Low-Intensity PSA-Based Screening Intervention on Prostate Cancer Mortality: The CAP Randomized Clinical Trial.

    Science.gov (United States)

    Martin, Richard M; Donovan, Jenny L; Turner, Emma L; Metcalfe, Chris; Young, Grace J; Walsh, Eleanor I; Lane, J Athene; Noble, Sian; Oliver, Steven E; Evans, Simon; Sterne, Jonathan A C; Holding, Peter; Ben-Shlomo, Yoav; Brindle, Peter; Williams, Naomi J; Hill, Elizabeth M; Ng, Siaw Yein; Toole, Jessica; Tazewell, Marta K; Hughes, Laura J; Davies, Charlotte F; Thorn, Joanna C; Down, Elizabeth; Davey Smith, George; Neal, David E; Hamdy, Freddie C

    2018-03-06

    Prostate cancer screening remains controversial because potential mortality or quality-of-life benefits may be outweighed by harms from overdetection and overtreatment. To evaluate the effect of a single prostate-specific antigen (PSA) screening intervention and standardized diagnostic pathway on prostate cancer-specific mortality. The Cluster Randomized Trial of PSA Testing for Prostate Cancer (CAP) included 419 582 men aged 50 to 69 years and was conducted at 573 primary care practices across the United Kingdom. Randomization and recruitment of the practices occurred between 2001 and 2009; patient follow-up ended on March 31, 2016. An invitation to attend a PSA testing clinic and receive a single PSA test vs standard (unscreened) practice. Primary outcome: prostate cancer-specific mortality at a median follow-up of 10 years. Prespecified secondary outcomes: diagnostic cancer stage and Gleason grade (range, 2-10; higher scores indicate a poorer prognosis) of prostate cancers identified, all-cause mortality, and an instrumental variable analysis estimating the causal effect of attending the PSA screening clinic. Among 415 357 randomized men (mean [SD] age, 59.0 [5.6] years), 189 386 in the intervention group and 219 439 in the control group were included in the analysis (n = 408 825; 98%). In the intervention group, 75 707 (40%) attended the PSA testing clinic and 67 313 (36%) underwent PSA testing. Of 64 436 with a valid PSA test result, 6857 (11%) had a PSA level between 3 ng/mL and 19.9 ng/mL, of whom 5850 (85%) had a prostate biopsy. After a median follow-up of 10 years, 549 (0.30 per 1000 person-years) died of prostate cancer in the intervention group vs 647 (0.31 per 1000 person-years) in the control group (rate difference, -0.013 per 1000 person-years [95% CI, -0.047 to 0.022]; rate ratio [RR], 0.96 [95% CI, 0.85 to 1.08]; P = .50). The number diagnosed with prostate cancer was higher in the intervention group (n = 8054; 4

  4. Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA) screening.

    Science.gov (United States)

    Wheeler, David C; Szymanski, Konrad M; Black, Amanda; Nelson, David E

    2011-04-21

    Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA) screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM) or shared decision making (SDM) approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP) to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA screening decision-making. Our proposal to augment IDM

  5. Rate of PSA rise predicts metastatic versus local recurrence after definitive radiotherapy

    International Nuclear Information System (INIS)

    Sartor, C.I.; Strawderman, M.H.; Lin, X.; Kish, K.E.; McLaughlin, P.W.; Lichter, A.S.; Sandler, H.S.

    1995-01-01

    Objective: A rising PSA following treatment for adenocarcinoma of the prostate indicates eventual clinical failure, but the rate of rise can be quite different from patient to patient, as can the pattern of clinical failure. We sought to determine whether the rate of PSA rise could differentiate future local vs. metastatic failure. Materials and Methods: PSA values from our series of 671 patients treated between 1987 and 1994 with 3-D conformal radiotherapy for localized adenocarcinoma were analyzed. Patients who had a pre-treatment PSA and >4 post-treatment PSA values available, had received no hormonal therapy, and had information detailing clinical outcome were used in this analysis. First site of failure was determined by abnormal DRE or biopsy, abnormal bone scan or radiographic evidence of metastasis as directed by clinical symptoms or follow-up clinical exam. Each patient's PSA pattern was defined by the function PSA(t)=C 1 e - a 1 (t) + C 2 e a 2 (t) where -a 1 relates to the rate of decline and a 2 to the rate of rise, if any. Univariate analysis was used to determine the correlation between initial PSA or rising PSA and clinical failure. Adjacent category logistic regression analysis was used to analyze the rate of rise and pattern of clinical failure. Results: 671 patients were reviewed; 401 patients met the requirements and 2667 PSA values were analyzed. We confirmed the finding of others that pre-treatment PSA is a prognostic indicator: patients presenting with PSA 3-20ng/ml had a relative risk of 9 (p=0.03) and PSA>20ng/ml had a RR of 26 (p=0.002) for clinical failure when compared to presenting PSA 2 >1.5/year predicted metastatic as opposed to local failure when compared to PSA rise with a 2 between 0.5-1.5/yr or 1.5 log(ng/ml)/year vs. 0.5-1.5 log(ng/ml)/yr or <0.5 log(ng/ml)/yr. Conclusions: The rate of rise of PSA following definitive radiotherapy can predict clinical failure patterns, with a rapidly rising PSA indicating metastatic as opposed to

  6. Can PSA Reflex Algorithm be a valid alternative to other PSA-based prostate cancer screening strategies?

    Science.gov (United States)

    Caldarelli, G; Troiano, G; Rosadini, D; Nante, N

    2017-01-01

    The available laboratory tests for the differential diagnosis of prostate cancer, are represented by the total PSA, the free PSA, and the free/total PSA ratio. In Italy most of doctors tend to request both total and free PSA for their patients even in cases where the total PSA doesn't justify the further request of free PSA, with a consequent growth of the costs for the National Health System. The aim of our study was to predict the saving in Euro (due to reagents) and reduction in free PSA tests, applying the "PSA Reflex" algorithm. We calculated the number of total PSA and free PSA exams performed in 2014 in the Hospital of Grosseto and, simulating the application of the "PSA Reflex" algorithm in the same year, we calculated the decrease in the number of free PSA requests and we tried to predict the Euro savings in reagents, obtained from this reduction. In 2014 in the Hospital of Grosseto 25,955 total PSA tests have been performed: 3,631 (14%) resulted greater than 10 ng / ml; 7,686 (29.6%) between 2 and 10 ng / ml; 14,638 (56.4%) lower than 2 ng / ml. The performed free PSA tests were 16904. Simulating the use of "PSA Reflex" algorithm, the free PSA tests would be performed only in cases with total PSA values between 2 and 10 ng / mL with a saving of 54.5% of free PSA exams and of 8,971 euros, only for reagents. Our study showed that the "PSA Reflex" algorithm is a valid alternative leading to a reduction of the costs. The estimated intralaboratory savings, due to the reagents, seem to be modest, however, they are followed by the additional savings due to the other diagnostic processes for prostate cancers.

  7. Influence of PSA, PSA velocity and PSA doubling time on contrast-enhanced 18F-choline PET/CT detection rate in patients with rising PSA after radical prostatectomy

    International Nuclear Information System (INIS)

    Schillaci, Orazio; Calabria, Ferdinando; Tavolozza, Mario; Caracciolo, Cristiana Ragano; Orlacchio, Antonio; Danieli, Roberta; Simonetti, Giovanni; Agro, Enrico Finazzi; Miano, Roberto

    2012-01-01

    To evaluate the accuracy of contrast-enhanced 18 F-choline PET/CT in restaging patients with prostate cancer after radical prostatectomy in relation to PSA, PSA velocity (PSAve) and PSA doubling time (PSAdt). PET/CT was performed in 49 patients (age range 58-87 years) with rising PSA (mean 4.13 ng/ml) who were divided in four groups according to PSA level: ≤1 ng/ml, 1 to ≤2 ng/ml, 2 to ≤4 ng/ml, and >4 ng/ml. PSAve and PSAdt were measured. PET and CT scans were interpreted separately and then together. PET/CT diagnosed relapse in 33 of the 49 patients (67%). The detection rates were 20%, 55%, 80% and 87% in the PSA groups ≤1, 1 to ≤2, 2 to ≤4 and >4 ng/ml, respectively. PET/CT was positive in 7 of 18 patients (38.9%) with a PSA ≤2 ng/ml, and in 26 of 31 (83.9%) with a PSA >2 ng/ml. PET/CT was positive in 7 of 25 patients (84%) with PSAdt ≤6 months, and in 12 of 24 patients (50%) with PSAdt >6 months, and was positive in 26 of 30 patients (86%) with a PSAve >2 ng/ml per year, and in 7 of 19 patients (36.8%) with PSAve ≤2 ng/ml per year. PET alone was positive in 31 of 49 patients (63.3%), and of these 31 patients, CT was negative in 14 but diagnosed bone lesions in 2 patients in whom PET alone was negative. CT with the administration of intravenous contrast medium did not provide any further information. Detection rate of 18 F-choline imaging is closely related to PSA and PSA kinetics. In particular, 18 F-choline PET/CT is recommended in patients with PSA >2 ng/ml, PSAdt ≤6 months and PSAve >2 ng/ml per year. CT is useful for detecting bone metastases that are not 18 F-choline-avid. The use of intravenous contrast agent seems unnecessary. (orig.)

  8. Influence of PSA, PSA velocity and PSA doubling time on contrast-enhanced {sup 18}F-choline PET/CT detection rate in patients with rising PSA after radical prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Schillaci, Orazio [University ' ' Tor Vergata' ' , Department of Biopathology and Diagnostic Imaging, Interventional, Rome (Italy); IRCCS Neuromed, Department of Nuclear Medicine and Molecular Imaging, Pozzilli (Italy); Calabria, Ferdinando [IRCCS Neuromed, Department of Nuclear Medicine and Molecular Imaging, Pozzilli (Italy); Tavolozza, Mario; Caracciolo, Cristiana Ragano; Orlacchio, Antonio; Danieli, Roberta; Simonetti, Giovanni [University ' ' Tor Vergata' ' , Department of Biopathology and Diagnostic Imaging, Interventional, Rome (Italy); Agro, Enrico Finazzi; Miano, Roberto [University Hospital ' ' Tor Vergata' ' , Department of Urology, Rome (Italy)

    2012-04-15

    To evaluate the accuracy of contrast-enhanced {sup 18}F-choline PET/CT in restaging patients with prostate cancer after radical prostatectomy in relation to PSA, PSA velocity (PSAve) and PSA doubling time (PSAdt). PET/CT was performed in 49 patients (age range 58-87 years) with rising PSA (mean 4.13 ng/ml) who were divided in four groups according to PSA level: {<=}1 ng/ml, 1 to {<=}2 ng/ml, 2 to {<=}4 ng/ml, and >4 ng/ml. PSAve and PSAdt were measured. PET and CT scans were interpreted separately and then together. PET/CT diagnosed relapse in 33 of the 49 patients (67%). The detection rates were 20%, 55%, 80% and 87% in the PSA groups {<=}1, 1 to {<=}2, 2 to {<=}4 and >4 ng/ml, respectively. PET/CT was positive in 7 of 18 patients (38.9%) with a PSA {<=}2 ng/ml, and in 26 of 31 (83.9%) with a PSA >2 ng/ml. PET/CT was positive in 7 of 25 patients (84%) with PSAdt {<=}6 months, and in 12 of 24 patients (50%) with PSAdt >6 months, and was positive in 26 of 30 patients (86%) with a PSAve >2 ng/ml per year, and in 7 of 19 patients (36.8%) with PSAve {<=}2 ng/ml per year. PET alone was positive in 31 of 49 patients (63.3%), and of these 31 patients, CT was negative in 14 but diagnosed bone lesions in 2 patients in whom PET alone was negative. CT with the administration of intravenous contrast medium did not provide any further information. Detection rate of {sup 18}F-choline imaging is closely related to PSA and PSA kinetics. In particular, {sup 18}F-choline PET/CT is recommended in patients with PSA >2 ng/ml, PSAdt {<=}6 months and PSAve >2 ng/ml per year. CT is useful for detecting bone metastases that are not {sup 18}F-choline-avid. The use of intravenous contrast agent seems unnecessary. (orig.)

  9. Deciding on PSA-screening - Quality of current consumer information on the Internet.

    Science.gov (United States)

    Korfage, Ida J; van den Bergh, Roderick C N; Essink-Bot, Marie-Louise

    2010-11-01

    Given that screening for prostate cancer has the potential to reduce prostate cancer mortality at the expense of considerable overdiagnosis and overtreatment, the availability of core consumer information - correct, balanced and supportive of autonomous decision-making - is a must. We assessed the quality of consumer information available through the Internet per November 2009 and its possible contribution to informed decision-making by potential screenees. Consumer information on PSA-screening was sought through the Internet in November 2009. Materials had to be targeted at potential consumers, offered by not-for-profit organisations, released in 2005 or after, in English or Dutch. Per material 2 of the authors assessed independently from each other whether standardised pre-defined topics were addressed, whether the content was correct and which approach was taken towards the decision-making process about uptake. Twenty-three materials were included, of which 11 were released (shortly) after the results of 2 large randomized-controlled trials (RCTs) that evaluated the effectiveness of screening for prostate cancer had been published in March 2009. That a PSA-test result can be abnormal because of non-cancerous conditions (false positive) and that it may miss prostate cancer (false negative) was not addressed in 2/23 and 8/23 materials, respectively. The risk of overdiagnosis and overtreatment was not mentioned in 6 out of 23. PSA-screening was presented as a usual thing to do in some materials, whereas other materials emphasised the voluntary nature of PSA-screening ('it is your decision'). The content of 19/23 materials was considered sufficiently informative according to the pre-defined criteria, 12/23 materials were considered supportive of informed decision-making by men. Most materials of not-for-profit organizations supplied adequate information about PSA-screening, whilst the degree of persuasion towards uptake reflected variations in opinions on men

  10. Prostate-Specific Antigen (PSA) Screening and New Biomarkers for Prostate Cancer (PCa).

    Science.gov (United States)

    Stephan, Carsten; Rittenhouse, Harry; Hu, Xinhai; Cammann, Henning; Jung, Klaus

    2014-04-01

    PSA screening reduces PCa-mortality but the disadvantages overdiagnosis and overtreatment require multivariable risk-prediction tools to select appropriate treatment or active surveillance. This review explains the differences between the two largest screening trials and discusses the drawbacks of screening and its meta-analysisxs. The current American and European screening strategies are described. Nonetheless, PSA is one of the most widely used tumor markers and strongly correlates with the risk of harboring PCa. However, while PSA has limitations for PCa detection with its low specificity there are several potential biomarkers presented in this review with utility for PCa currently being studied. There is an urgent need for new biomarkers especially to detect clinically significant and aggressive PCa. From all PSA-based markers, the FDA-approved prostate health index (phi) shows improved specificity over percent free and total PSA. Another kallikrein panel, 4K, which includes KLK2 has recently shown promise in clinical research studies but has not yet undergone formal validation studies. In urine, prostate cancer gene 3 (PCA3) has also been validated and approved by the FDA for its utility to detect PCa. The potential correlation of PCA3 with cancer aggressiveness requires more clinical studies. The detection of the fusion of androgen-regulated genes with genes of the regulatory transcription factors in tissue of (~)50% of all PCa-patients is a milestone in PCa research. A combination of the urinary assays for TMPRSS2:ERG gene fusion and PCA3 shows an improved accuracy for PCa detection. Overall, the field of PCa biomarker discovery is very exciting and prospective.

  11. Prostate-Specific Antigen (PSA) Screening and New Biomarkers for Prostate Cancer (PCa)

    Science.gov (United States)

    Rittenhouse, Harry; Hu, Xinhai; Cammann, Henning; Jung, Klaus

    2014-01-01

    Abstract PSA screening reduces PCa-mortality but the disadvantages overdiagnosis and overtreatment require multivariable risk-prediction tools to select appropriate treatment or active surveillance. This review explains the differences between the two largest screening trials and discusses the drawbacks of screening and its meta-analysisxs. The current American and European screening strategies are described. Nonetheless, PSA is one of the most widely used tumor markers and strongly correlates with the risk of harboring PCa. However, while PSA has limitations for PCa detection with its low specificity there are several potential biomarkers presented in this review with utility for PCa currently being studied. There is an urgent need for new biomarkers especially to detect clinically significant and aggressive PCa. From all PSA-based markers, the FDA-approved prostate health index (phi) shows improved specificity over percent free and total PSA. Another kallikrein panel, 4K, which includes KLK2 has recently shown promise in clinical research studies but has not yet undergone formal validation studies. In urine, prostate cancer gene 3 (PCA3) has also been validated and approved by the FDA for its utility to detect PCa. The potential correlation of PCA3 with cancer aggressiveness requires more clinical studies. The detection of the fusion of androgen-regulated genes with genes of the regulatory transcription factors in tissue of ~50% of all PCa-patients is a milestone in PCa research. A combination of the urinary assays for TMPRSS2:ERG gene fusion and PCA3 shows an improved accuracy for PCa detection. Overall, the field of PCa biomarker discovery is very exciting and prospective. PMID:27683457

  12. Message from Terrence Howard: Screening for Colorectal Cancer PSA (:20)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message from the actor/musician Terrence Howard about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  13. Message from Terrence Howard: Screening for Colorectal Cancer PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message from the actor/musician Terrence Howard about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  14. Predictive simulations and optimization of nanowire field-effect PSA sensors including screening

    KAUST Repository

    Baumgartner, Stefan; Heitzinger, Clemens; Vacic, Aleksandar; Reed, Mark A

    2013-01-01

    We apply our self-consistent PDE model for the electrical response of field-effect sensors to the 3D simulation of nanowire PSA (prostate-specific antigen) sensors. The charge concentration in the biofunctionalized boundary layer at the semiconductor-electrolyte interface is calculated using the propka algorithm, and the screening of the biomolecules by the free ions in the liquid is modeled by a sensitivity factor. This comprehensive approach yields excellent agreement with experimental current-voltage characteristics without any fitting parameters. Having verified the numerical model in this manner, we study the sensitivity of nanowire PSA sensors by changing device parameters, making it possible to optimize the devices and revealing the attributes of the optimal field-effect sensor. © 2013 IOP Publishing Ltd.

  15. Predictive simulations and optimization of nanowire field-effect PSA sensors including screening

    KAUST Repository

    Baumgartner, Stefan

    2013-05-03

    We apply our self-consistent PDE model for the electrical response of field-effect sensors to the 3D simulation of nanowire PSA (prostate-specific antigen) sensors. The charge concentration in the biofunctionalized boundary layer at the semiconductor-electrolyte interface is calculated using the propka algorithm, and the screening of the biomolecules by the free ions in the liquid is modeled by a sensitivity factor. This comprehensive approach yields excellent agreement with experimental current-voltage characteristics without any fitting parameters. Having verified the numerical model in this manner, we study the sensitivity of nanowire PSA sensors by changing device parameters, making it possible to optimize the devices and revealing the attributes of the optimal field-effect sensor. © 2013 IOP Publishing Ltd.

  16. Clinical performance of serum [-2]proPSA derivatives, %p2PSA and PHI, in the detection and management of prostate cancer

    OpenAIRE

    Huang, Ya-Qiang; Sun, Tong; Zhong, Wei-De; Wu, Chin-Lee

    2014-01-01

    Prostate-specific antigen (PSA) has been widely used as a serum marker for prostate cancer (PCa) screening or progression monitoring, which dramatically increased rate of early detection while significantly reduced PCa-specific mortality. However, a number of limitations of PSA have been noticed. Low specificity of PSA may lead to overtreatment in men who presenting with a total PSA (tPSA) level of < 10 ng/mL. As a type of free PSA (fPSA), [-2]proPSA is differentially expressed in peripheral ...

  17. Clinical performance of serum [-2]proPSA derivatives, %p2PSA and PHI, in the detection and management of prostate cancer.

    Science.gov (United States)

    Huang, Ya-Qiang; Sun, Tong; Zhong, Wei-De; Wu, Chin-Lee

    2014-01-01

    Prostate-specific antigen (PSA) has been widely used as a serum marker for prostate cancer (PCa) screening or progression monitoring, which dramatically increased rate of early detection while significantly reduced PCa-specific mortality. However, a number of limitations of PSA have been noticed. Low specificity of PSA may lead to overtreatment in men who presenting with a total PSA (tPSA) level of PHI) and %p2PSA, which were defined as [(p2PSA/fPSA) × √ tPSA] and [(p2PSA/fPSA) × 100] respectively, have been suggested to be increased in PCa and can better distinguish PCa from benign prostatic diseases than tPSA or fPSA. We performed a systematic review of the available scientific evidences to evaluate the potentials of %p2PSA and PHI in clinical application. Mounting evidences suggested that both %p2PSA and PHI possess higher area under the ROC curve (AUC) and better specificity at a high sensitivity for PCa detection when compare with tPSA and %fPSA. It indicated that measurements of %p2PSA and PHI significantly improved the accuracy of PCa detection and diminished unnecessary biopsies. Furthermore, elevations of %p2PSA and PHI are related to more aggressive diseases. %p2PSA and PHI might be helpful in reducing overtreatment on indolent cases or assessing the progression of PCa in men who undergo active surveillance. Further studies are needed before being applied in routine clinical practice.

  18. In-vitro radioimmunoassay of prostate specific antigen (PSA) for the screening and management of prostate cancer in Lebanon

    International Nuclear Information System (INIS)

    El Ezzi, Asmahan; El Ahmadiyeh, Nabil

    2004-01-01

    Full text: Immunoassays for prostate-specific antigen (PSA) are used to detect early-stage prostate cancer, monitor disease progress, and evaluate therapeutic response. At least two forms of PSA, free PSA (F-PSA) and PSA complexed to alpha-1 anti-chymotrypsin (PSA-ACT) are detected by commercial PSA assays. The fraction of F-PSA is shown to be smaller in patients with untreated prostate cancer than in patients with benign prostate hyperplasia (BPH). Thus, combined measurements of both total and free PSA are used for a better discrimination between BPH and prostate cancer. Detection of PSA for screening of prostate cancer has been a subject of debate for many years. The reason of this debate is mainly because screening for prostate cancer is not cost-effective, as was shown by studies undertaken in Europe and United States. In Lebanon, no previous programs of screening for prostate cancer were done and so the incidence of this cancer is not known. Recently, the cancer registry in Lebanon found that lung and prostate are the highest cancers in the Lebanese men. The Lebanese association of urologists noted that 80% of men suffering from prostate cancer consult their urologists when the cancer is spread outside the prostate capsule. There is a socio-economic barrier behind this delay. We decided to undertake this study for the screening of prostate cancer in Lebanon, taking into consideration the above-mentioned facts and the experience of other countries. Volunteer men aged 45 and above, who were not visitors of a urology clinic, were selected randomly. A blood sample was withdrawn from each man, then a rectal examination was done and a questionnaire was filled. The blood serum separated was assayed for total PSA first and where abnormal or borderline, was assayed for free PSA. The percentage of free to total PSA was calculated. Men having borderline or abnormal results did undergo more investigations for the definitive diagnosis of their samples. IRMA

  19. Prostate cancer screening by prostate-specific antigen (PSA); a relevant approach for the small population of the Cayman Islands.

    Science.gov (United States)

    Jyoti, Shravana Kumar; Blacke, Camille; Patil, Pallavi; Amblihalli, Vibha P; Nicholson, Amanda

    2018-01-01

    The common tool for diagnosing prostate cancer is prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing are the problems in clinical practice. There are no proper guidelines to investigate the suspected prostate cancer in the Cayman Islands. We correlated PSA levels with the incidence of prostate cancers by tissue diagnosis and proposed logical protocol for prostate screening by using PSA test in this small population. A total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. The patients were divided into subgroups by baseline PSA levels as follows: 100 ng/mL and were correlated to the age and presence of cancer. Benign lesions had lower PSA levels compared to cancer which generally had higher values. Only three cases that had less than 4 ng/mg were turned out to be malignant. When PSA value was more than 100 ng/mL, all the cases were malignant. Between PSA values of 4-100 ng/mL, the probability of cancer diagnosis was 56.71% (76 cancers out of 134 in this range). Limitation of PSA testing has the risk of over diagnosis and the resultant negative biopsies owing to poor specificity. Whereas the cutoff limit for cancer diagnosis still remains 4 ng/mL from our study, most of the patients can be assured of benign lesion below this level and thus morbidity associated with the biopsy can be prevented. When the PSA value is greater than 100 ng, biopsy procedure was mandatory as there were 100% cancers above this level. On the background of vast literature linking PSA to prostate cancer and its difficulty in implementing in clinical practice, we studied literature of this conflicting and complex topic and tried to bring relevant protocols to the small population of Cayman Islands for the screening of prostate cancer. In this study, a total of 165 Afro Caribbean individuals who had prostate biopsy done after the

  20. PSA, PSA derivatives, proPSA and prostate health index in the diagnosis of prostate cancer

    OpenAIRE

    Ayyıldız, Sema Nur; Ayyıldız, Ali

    2014-01-01

    Currently, prostate- specific antigen (PSA) is the most common oncological marker used for prostate cancer screening. However, high levels of PSA in benign prostatic hyperplasia and prostatitis decrease the specificity of PSA as a cancer marker. To increase the specificity of PSA, PSA derivatives and PSA kinetics have been used. However, these new techniques were not able to increase the diagnostic specificity for prostate cancer. Therefore, the search for new molecules and derivatives of PSA...

  1. Prostate-Specific Antigen (PSA)–Based Population Screening for Prostate Cancer: An Evidence-Based Analysis

    Science.gov (United States)

    Pron, G

    2015-01-01

    Background Prostate cancer (PC) is the most commonly diagnosed non-cutaneous cancer in men and their second or third leading cause of cancer death. Prostate-specific antigen (PSA) testing for PC has been in common practice for more than 20 years. Objectives A systematic review of the scientific literature was conducted to determine the effectiveness of PSA-based population screening programs for PC to inform policy decisions in a publicly funded health care system. Data Sources A systematic review of bibliographic databases was performed for systematic reviews or randomized controlled trials (RCT) of PSA-based population screening programs for PC. Review Methods A broad search strategy was employed to identify studies reporting on key outcomes of PC mortality and all-cause mortality. Results The search identified 5 systematic reviews and 6 RCTs. None of the systematic reviews found a statistically significant reduction in relative risk (RR) of PC mortality or overall mortality with PSA-based screening. PC mortality reductions were found to vary by country, by screening program, and by age of men at study entry. The European Randomized Study of Screening for Prostate Cancer found a statistically significant reduction in RR in PC mortality at 11-year follow-up (0.79; 95% CI, 0.67–0.92), although the absolute risk reduction was small (1.0/10,000 person-years). However, the primary treatment for PCs differed significantly between countries and between trial arms. The American Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) found a statistically non-significant increase in RR for PC mortality with 13-year follow-up (1.09; 95% CI, 0.87–1.36). The degree of opportunistic screening in the control arm of the PLCO trial, however, was high. None of the RCTs found a reduction in all-cause mortality and all found a statistically significant increase in the detection of mainly low-risk, organ-confined PCs in the screening arm. Conclusions There was no

  2. Estimation of component failure rates for PSA on nuclear power plants 1982-1997

    International Nuclear Information System (INIS)

    Kirimoto, Yukihiro; Matsuzaki, Akihiro; Sasaki, Atsushi

    2001-01-01

    Probabilistic safety assessment (PSA) on nuclear power plants has been studied for many years by the Japanese industry. The PSA methodology has been improved so that PSAs for all commercial LWRs were performed and used to examine for accident management.On the other hand, most data of component failure rates in these PSAs were acquired from U.S. databases. Nuclear Information Center (NIC) of Central Research Institute of Electric Power Industry (CRIEPI) serves utilities by providing safety- , and reliability-related information on operation and maintenance of the nuclear power plants, and by evaluating the plant performance and incident trends. So, NIC started a research study on estimating the major component failure rates at the request of the utilities in 1988. As a result, we estimated the hourly-failure rates of 47 component types and the demand-failure rates of 15 component types. The set of domestic component reliability data from 1982 to 1991 for 34 LWRs has been evaluated by a group of PSA experts in Japan at the Nuclear Safety Research Association (NSRA) in 1995 and 1996, and the evaluation report was issued in March 1997. This document describes the revised component failure rate calculated by our re-estimation on 49 Japanese LWRs from 1982 to 1997. (author)

  3. A comparative Study of Aptasensor Vs Immunosensor for Label-Free PSA Cancer Detection on GQDs-AuNRs Modified Screen-Printed Electrodes.

    Science.gov (United States)

    Srivastava, Monika; Nirala, Narsingh R; Srivastava, S K; Prakash, Rajiv

    2018-01-31

    Label-free and sensitive detection of PSA (Prostate Specific Antigen) is still a big challenge in the arena of prostate cancer diagnosis in males. We present a comparative study for label-free PSA aptasensor and PSA immunosensor for the PSA-specific monoclonal antibody, based on graphene quantum dots-gold nanorods (GQDs-AuNRs) modified screen-printed electrodes. GQDs-AuNRs composite has been synthesized and used as an electro-active material, which shows fast electron transfer and catalytic property. Aptamer or anti-PSA has immobilized onto the surface of modified screen printed electrodes. Three techniques are used simultaneously, viz. cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedence spectroscopy (EIS) to investigate the analytical performance of both PSA aptasensor and PSA immunosensor with its corresponding PSA antigen. Under optimum conditions, both sensors show comparable results with an almost same limit of detection (LOD) of 0.14 ng mL -1 . The results developed with aptasensor and anti-PSA is also checked through the detection of PSA in real samples with acceptable results. Our study suggests some advantages of aptasensor in terms of better stability, simplicity and cost effectiveness. Further our present work shows enormous potential of our developed sensors for real application using voltammetric and EIS techniques simultaneous to get reliable detection of the disease.

  4. The impact of sociodemographic factors and PSA screening among low-income Black and White men: data from the Southern Community Cohort Study.

    Science.gov (United States)

    Moses, K A; Zhao, Z; Bi, Y; Acquaye, J; Holmes, A; Blot, W J; Fowke, J H

    2017-12-01

    Variation in PSA screening is a potential source of disparity in prostate cancer survival, particularly among underserved populations. We sought to examine the impact of race and socioeconomic status (SES) on receipt of PSA testing among low-income men. Black (n=22 167) and White (n=9588) men aged ⩾40 years completed a baseline questionnaire from 2002 to 2009 as part of the Southern Community Cohort Study. Men reported whether they had ever received PSA testing and had testing within the prior 12 months. To evaluate the associations between SES, race and receipt of PSA testing, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from the multivariable logistic models where age, household income, insurance status, marital status, body mass index and educational level were adjusted. Black men were younger, had a lower income, less attained education and were more likely to be unmarried and uninsured (all PPSA testing rose from 50 more likely than Blacks to have received testing. Lower SES was significantly associated with less receipt of PSA testing in both groups. After adjustment for SES, White men had significantly lower odds of PSA testing (OR 0.81; 95% CI: 0.76-0.87). Greater PSA testing among White than Black men over the age of 50 years in this low-income population appears to be mainly a consequence of SES. Strategies for PSA screening may benefit from tailoring to the social circumstances of the men being screened.

  5. Two-year survival rates of anti-TNF-α therapy in psoriatic arthritis (PsA) patients with either polyarticular or oligoarticular PsA.

    Science.gov (United States)

    Iannone, F; Lopriore, S; Bucci, R; Scioscia, C; Anelli, M G; Notarnicola, A; Lapadula, G

    2015-05-01

    To evaluate the 2-year drug survival rates of the tumour necrosis factor (TNF)-α blockers adalimumab, etanercept, and infliximab in psoriatic arthritis (PsA) patients with either oligoarticular (oligo-PsA) or polyarticular PsA (poly-PsA). We studied a prospective cohort of 328 PsA patients with peripheral arthritis (213 with poly-PsA and 115 with oligo-PsA), beginning their first ever anti-TNF-α treatment with adalimumab, etanercept, or infliximab. The aim of the study was to evaluate the drug survival rates and possible baseline predictors at 2 years. After 24 months, persistence in therapy with the first anti-TNF-α blocker was not statistically different in the oligo-PsA (70.4%) and poly-PsA (65.7%) subsets. Predictors of drug discontinuation were female sex [hazard ratio (HR) 1.63, 95% confidence interval (CI) 1.00-2.68, p = 0.04] and starting the therapy in years 2003-8 (HR 0.51, 95% CI 0.33-0.80, p = 0.003). In poly-PsA, the persistence of etanercept (68.3%) was significantly higher than that of adalimumab (51.9%, p = 0.01), whereas in oligo-PsA no significant difference was detected. In poly-PsA, the period 2003-8 was a negative predictor (HR 0.36, 95% CI 0.21-0.62, p = 0.0001) whereas in oligo-PsA female gender was a positive predictor of drug discontinuation (HR 2.08, 95% CI 1.02-4.24, p = 0.04). With regard to clinical outcomes, the best responses in terms of European League Against Rheumatism (EULAR) 'good' response or Disease Activity Score (DAS28) remission, crude or adjusted according to the LUND Efficacy indeX (LUNDEX), were seen in patients on etanercept or infliximab. Our study provides some evidence that anti-TNF-α drugs may perform differently in PsA, and that the analysis of clinical disease subsets may improve our knowledge and promote better management of PsA.

  6. Prostate-Specific Antigen (PSA) Test

    Science.gov (United States)

    ... Cancer Prostate Cancer Screening Research Prostate-Specific Antigen (PSA) Test On This Page What is the PSA ... parts of the body before being detected. The PSA test may give false-positive or false-negative ...

  7. Quality PSA for PSA applications

    International Nuclear Information System (INIS)

    Carska, K.; Rybar, J.

    2012-03-01

    The safety guideline defines with more precision Nuclear Regulatory Authority of the Slovak Republic requirements of the quality of probabilistic safety assessment (PSA) for PSA application. Term of quality of PSA is explained in detail. Procedure for determining the quality of PSA is provided. The categorization of PSA study according the quality of PSA is suggested. A comprehensive list of PSA applications for nuclear facilities is provided. What technical features of a PSA should be satisfied to support the PSA applications of interest is stated. (authors)

  8. The diagnostic utility of the PSA screening test in a Ghanaian population

    International Nuclear Information System (INIS)

    Gyamfi, O.K.; Aryeetey, D.G.; Achel, D.G.; Gyasi, R. K.

    2004-01-01

    An immunoradiometric (IRMA) protocol was used in the PSA test to measure PSA levels in the sera of 240 men presenting with various complaints bordering on their prostate condition. These men were also made to undergo a fine-needle biopsy. Using the universal cut-off of 4.0ng/ml and the histopathological findings from the biopsies as a 'gold standard' statistical performance criteria (such as Sensitivity, Specificity, False Positive Ratio (FP), False Negative Ratio (FN), Likelihood Ratio (L), Positive Predictive Value (PPV), Negative Predictive Value (NPV), Prior Odds Ratio (Ω and Prevalence) were determined and compared with available literature values. This was to determine the diagnostic efficiency and utility of the PSA test for our Ghanaian population of 240 men. The test returned a Sensitivity and Specificity of 92.9% and 18.6% respectively. The FP and FN ratios were 81.4% and 7.1% respectively. The PPV and NPV were 38.1% and 82.9% respectively while the Prior Odds and Prevalence were 7:13 and 35% respectively. High sensitivities ranging from 79-90% and as low as 34 % have been reported. On the other hand specificities ranging from 59% to 70% have also been reported. The PPV compares favourably with the available literature values to us: within range 28-40%. The PPV and NPV values together with an application of Baye's theorem indicates that in our setting the PSA test is more efficient in ruling out disease than in detecting it. (au)

  9. Relationship between PSA kinetics and [{sup 18}F]fluorocholine PET/CT detection rates of recurrence in patients with prostate cancer after total prostatectomy

    Energy Technology Data Exchange (ETDEWEB)

    Graute, Vera; Jansen, Nathalie; Uebleis, Christopher; Cumming, Paul; Klanke, Katharina; Tiling, Reinhold; Bartenstein, Peter; Hacker, Marcus [University of Munich, Department of Nuclear Medicine, Munich (Germany); Seitz, Michael [University of Munich, Department of Urology, Munich (Germany); Hartenbach, Markus [Bundeswehrkrankenhaus Ulm, Department of Nuclear Medicine, Ulm (Germany); Scherr, Michael Karl; Thieme, Sven [University of Munich, Institute of Clinical Radiology, Munich (Germany)

    2012-02-15

    The aim of the present study was to identify prostate-specific antigen (PSA) threshold levels, as well as PSA velocity, progression rate and doubling time in relation to the detectability and localization of recurrent lesions with [{sup 18}F]fluorocholine (FC) PET/CT in patients after radical prostatectomy. The study group comprised 82 consecutive patients with biochemical relapse after radical prostatectomy. PSA levels measured at the time of imaging were correlated with the FC PET/CT detection rates in the entire group with PSA velocity (in 48 patients), with PSA doubling time (in 47 patients) and with PSA progression (in 29 patients). FC PET/CT detected recurrent lesions in 51 of the 82 patients (62%). The median PSA value was significantly higher in PET-positive than in PET-negative patients (4.3 ng/ml vs. 1.0 ng/ml; p < 0.01). The optimal PSA threshold from ROC analysis for the detection of recurrent prostate cancer lesions was 1.74 ng/ml (AUC 0.818, 82% sensitivity, 74% specificity). Significant differences between PET-positive and PET-negative patients were found for median PSA velocity (6.4 vs. 1.1 ng/ml per year; p < 0.01) and PSA progression (5.0 vs. 0.3 ng/ml per year, p < 0.01) with corresponding optimal thresholds of 1.27 ng/ml per year and 1.28 ng/ml per year, respectively. The PSA doubling time suggested a threshold of 3.2 months, but this just failed to reach statistical significance (p = 0.071). In a study cohort of patients with biochemical recurrence of prostate cancer after radical prostatectomy there emerged clear PSA thresholds for the presence of FC PET/CT-detectable lesions. (orig.)

  10. Impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC) on prostate-specific antigen (PSA) testing by Dutch general practitioners

    NARCIS (Netherlands)

    Van der Meer, Saskia; Kollen, Boudewijn J.; Hirdes, Willem H.; Steffens, Martijn G.; Hoekstra-Weebers, Josette E. H. M.; Nijman, Rien M.; Blanker, Marco H.

    Objective To determine the impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC) publication in 2009 on prostate-specific antigen (PSA) level testing by Dutch general practitioners (GPs) in men aged 40 years. Materials and Methods Retrospective study with a Dutch insurance

  11. Living PSA

    International Nuclear Information System (INIS)

    Evans, M.G.K.

    1997-01-01

    The aim of this presentation is to gain an understanding of the requirements for a PSA to be considered a Living PSA. The presentation is divided into the following topics: Definition; Planning/Documentation; Task Performance; Maintenance; Management. 4 figs

  12. Determining if pretreatment PSA doubling time predicts PSA trajectories after radiation therapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Soto, Daniel E.; Andridge, Rebecca R.; Pan, Charlie C.; Williams, Scott G.; Taylor, Jeremy M.G.; Sandler, Howard M.

    2009-01-01

    Introduction: To determine if pretreatment PSA doubling time (PSA-DT) can predict post-radiation therapy (RT) PSA trajectories for localized prostate cancer. Materials and methods: Three hundred and seventy-five prostate cancer patients treated with external beam RT without androgen deprivation therapy (ADT) were identified with an adequate number of PSA values. We utilized a linear mixed model (LMM) analysis to model longitudinal PSA data sets after definitive treatment. Post-treatment PSA trajectories were allowed to depend on the pre-RT PSA-DT, pre-RT PSA (iPSA), Gleason score (GS), and T-stage. Results: Pre-RT PSA-DT had a borderline impact on predicting the rate of PSA rise after nadir (p = 0.08). For a typical low risk patient (T1, GS ≤ 6, iPSA 10), the predicted PSA-DT post-nadir was 21% shorter for pre-RT PSA-DT 24 month (19 month vs. 24 month). Additional significant predictors of post-RT PSA rate of rise included GS (p < 0.0001), iPSA (p < 0.0001), and T-stage (p = 0.02). Conclusions: We observed a trend between rapidly rising pre-RT PSA and the post-RT post-nadir PSA rise. This effect appeared to be independent of iPSA, GS, or T-stage. The results presented suggest that pretreatment PSA-DT may help predict post-RT PSA trajectories

  13. Deciding on PSA-screening - Quality of current consumer information on the Internet

    NARCIS (Netherlands)

    Korfage, Ida J.; van den Bergh, Roderick C. N.; Essink-Bot, Marie-Louise

    2010-01-01

    Purpose of the study: Given that screening for prostate cancer has the potential to reduce prostate cancer mortality at the expense of considerable overdiagnosis and overtreatment, the availability of core consumer information - correct, balanced and supportive of autonomous decision-making - is a

  14. PSA velocity does not aid the detection of prostate cancer in men with a prior negative biopsy: data from the European Randomized Study of Prostate Cancer Screening in Göteborg, Sweden and Rotterdam, Netherlands

    Science.gov (United States)

    Vickers, Andrew J.; Wolters, Tineke; Savage, Caroline J.; Cronin, Angel M.; O’Brien, M. Frank; Roobol, Monique J.; Aus, Gunnar; Scardino, Peter T.; Hugosson, Jonas; Schröder, Fritz H.; Lilja, Hans

    2012-01-01

    Purpose Prostate specific antigen (PSA) velocity has been proposed as a marker to aid detection of prostate cancer. We sought to determine whether PSA velocity could predict the results of repeat biopsy in men with persistently elevated PSA after initial negative biopsy. Materials and Methods We identified 1,837 men who participated in the Göteborg or Rotterdam section of the European Randomized Screening study of Prostate Cancer (ERSPC), and who had one or more subsequent prostate biopsies after an initial negative finding. We evaluated whether PSA velocity improved predictive accuracy beyond that of PSA alone. Results There were a total of 2579 repeat biopsies, of which 363 (14%) were positive for prostate cancer, and 44 (1.7%) were high grade (Gleason score ≥7). Although PSA velocity was statistically associated with cancer risk (p<0.001), it had very low predictive accuracy (area-under-the-curve [AUC] of 0.55). There was some evidence that PSA velocity improved AUC compared to PSA for high grade cancer. However, the small increase in risk associated with high PSA velocity – from 1.7 % to 2.8% as velocity increased from 0 to 1 ng / ml / year - is of questionable clinical relevance. Conclusions Men with a prior negative biopsy have a lower risk for prostate cancer at subsequent biopsies, with high grade disease particularly rare. We found little evidence to support the use of PSA velocity to aid decisions about repeat biopsy for prostate cancer. PMID:20643434

  15. Failure cause and failure rate evaluation on pumps of BWR plants in PSA. Hypothesis testing for typical or plant specific failure rate of pumps

    International Nuclear Information System (INIS)

    Sanada, Takahiro; Nakamura, Makoto

    2009-01-01

    In support of domestic nuclear industry effort to gather and analyze failure data of components concerning nuclear power plants, Nuclear Information Archives (NUCIA) are published for useful information to help PSA. This report focuses on NUCIA pertaining to pumps in domestic nuclear power plants, and provides the reliable estimation on failure rate of pumps resulting from failure cause analysis and hypothesis testing of classified and plant specific failure rate of pumps for improving quality in PSA. The classified and plant specific failure rate of pumps are estimated by analyzing individual domestic nuclear power plant's data of 26 Boiling Water Reactors (BWRs) concerning functionally structurally classified pump failures reported from beginning of commercial operation to March 31, 2007. (author)

  16. Can delayed time to referral to a tertiary level urologist with an abnormal PSA level affect subsequent Gleason grade in the opportunistically screened population?

    LENUS (Irish Health Repository)

    O'Kelly, Fardod

    2013-09-01

    There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low-risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened-PSA levels have on subsequent Gleason grade.

  17. The detection rate of [11C]Choline-PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

    International Nuclear Information System (INIS)

    Krause, B.J.; Souvatzoglou, M.; Tuncel, M.; Herrmann, K.; Buck, A.K.; Praus, C.; Schwaiger, M.; Schuster, T.; Geinitz, H.; Treiber, U.

    2008-01-01

    An increase of the serum PSA-level is a sensitive in vitro marker for recurrent prostate cancer. However, it remains difficult to differentiate between local, regional or distant recurrent disease. The aim of this study was to assess the relationship between the detection rate of [ 11 C]Choline-PET/CT and the serum PSA-level in patients with a biochemical recurrence of prostate cancer with the view towards localisation of recurrent disease. Sixty-three patients (mean age, 68.8 ± 6.9; range, 45-83 years) with biochemical recurrence after primary therapy for prostate cancer were included in the analysis. Mean PSA-levels were 5.9 ± 9.7 ng/ml (range, 0.2-39 ng/ml; median, 2.15). Of the 63 patients, 17 were under anti-androgen therapy at the time of [ 11 C]Choline PET/CT. Patients underwent a [ 11 C]Choline-PET/CT study after injection of 656 ± 119 MBq [ 11 C]Choline on a Sensation 16 Biograph PET/CT scanner. Of the 63 patients, 35 (56%) showed a pathological [ 11 C]Choline uptake. The detection rate of [ 11 C]Choline-PET/CT showed a relationship with the serum PSA-level: The detection rate was 36% for a PSA-value 11 C]Choline-PET/CT (p = 0.374). As an important result our study shows that even for PSA-values 11 C]Choline-PET/CT is 36%. Furthermore, the detection rate of [ 11 C]Choline-PET/CT shows a positive relationship with serum PSA-levels in patients with biochemical recurrence of prostate cancer after primary therapy. Therefore, in these patients, [ 11 C]Choline PET/CT allows not only to diagnose but also to localise recurrent disease with implications on disease management (localised vs systemic therapy). (orig.)

  18. PSA kinetics after prostate brachytherapy: PSA bounce phenomenon and its implications for PSA doubling time

    International Nuclear Information System (INIS)

    Ciezki, Jay P.; Reddy, Chandana A.; Garcia, Jorge; Angermeier, Kenneth; Ulchaker, James; Mahadevan, Arul; Chehade, Nabil; Altman, Andrew; Klein, Eric A.

    2006-01-01

    Purpose: To analyze prostate-specific antigen (PSA) kinetics in patients treated with prostate brachytherapy (PI) with a minimum of 5 years of PSA follow-up. Methods and Materials: The records of 162 patients treated with PI for localized prostate cancer with a minimum of 5 years of PSA follow-up were reviewed. A variety of pretreatment and posttreatment variables were examined. Patients were coded as having a PSA bounce if their PSA achieved a nadir, elevated at least 0.2 ng/mL greater than that nadir, and decreased to, or below, the initial nadir. Two definitions of biochemical failure (bF) or biochemical relapse-free survival (bRFS) were used: the classic American Society for Therapeutic Radiology and Oncology consensus definition of three consecutive rises (bF3) and the nadir plus 2 ng/mL definition (bFn+2). Associations between a PSA bounce and the various pre- and posttreatment factors were assessed with logistic regression analysis, and the association between a PSA bounce and bF was examined with the log-rank test. The Mann-Whitney U test was applied to test for differences in the PSA doubling time (PSADT) and the time to a PSA rise between the PSA bounce patients and the bF patients. PSADT was calculated from the nadir to the time of the first PSA rise, because this point is known first in the clinical setting. Results: The 5-year overall bRFS rate was 87% for the bF3 definition and 96% for the bFn+2 definition. A PSA bounce was experienced by 75 patients (46.3%). Patients who experienced a PSA bounce were less likely to have a bF, regardless of the bRFS definition used (bF3: p = 0.0015; bFn+2: p = 0.0040). Among the pre- and posttreatment factors, only younger age predicted for a PSA bounce on multivariate analysis (p = 0.0018). The use of androgen deprivation had no effect on PSA bounce. No difference was found in the PSADT between patients who had a PSA bounce and those with bF. The median PSADT for those with a PSA bounce was 8.3 months vs. 10.3 months

  19. PSA methodology

    Energy Technology Data Exchange (ETDEWEB)

    Magne, L

    1997-12-31

    The purpose of this text is first to ask a certain number of questions on the methods related to PSAs. Notably we will explore the positioning of the French methodological approach - as applied in the EPS 1300{sup 1} and EPS 900{sup 2} PSAs - compared to other approaches (Part One). This reflection leads to more general reflection: what contents, for what PSA? This is why, in Part Two, we will try to offer a framework for definition of the criteria a PSA should satisfy to meet the clearly identified needs. Finally, Part Three will quickly summarize the questions approached in the first two parts, as an introduction to the debate. 15 refs.

  20. PSA methodology

    International Nuclear Information System (INIS)

    Magne, L.

    1996-01-01

    The purpose of this text is first to ask a certain number of questions on the methods related to PSAs. Notably we will explore the positioning of the French methodological approach - as applied in the EPS 1300 1 and EPS 900 2 PSAs - compared to other approaches (Part One). This reflection leads to more general reflection: what contents, for what PSA? This is why, in Part Two, we will try to offer a framework for definition of the criteria a PSA should satisfy to meet the clearly identified needs. Finally, Part Three will quickly summarize the questions approached in the first two parts, as an introduction to the debate. 15 refs

  1. Early detection of prostate cancer in Syria using T.PSA and F.PSA

    International Nuclear Information System (INIS)

    Adel, M.; Abu Daher, D.

    2009-12-01

    The aim of the current study is performing an initial prostate cancer screening test using PSA and F PSA tumour markers. A total of 3000 men in 40-75 years of age were participated in this study. Demographic and clinical data for subjects were collected by the programme staff. Total PSA and free PSA assays were determined using the ImunoTech total and free PSA assay kits, based on IRMA technique (kindly provided by the International Atomic Energy Agency). Criteria for participating in this study included : 1) men of age 50-75 (men of age as low as 40 were included in case of positive family history). 2) No previous history of prostate cancer. The following parameters were followed to refer the suspicious cases to a specialized hospital specific tests: 1)PSA>3 ng/ml . 2)High PSA value according to the participant age group. 3) Low F/TPSA ratio. In the hospital the following tests were performed:1) Complete clinical exam including DRE.2)TRUS in some cases.3) Biopsy for highly suspicious cases. 4)The low suspicious cases were retested in six months. Out of 338 cases referred to a specialized hospital, 264 cases were shown prostatic benign prostatic hyperplasia (BPH),while 36 cases proved to be prostatic cancer. However, the contact was lost in 36 cases because of changing the phone number or travelling outside the country . The detection rate of prostate cancer among all participating cases in this study was 1.2%, while this ratio was 10.7% among the referred cases. F/TPSA ratio has shown a good ability to discriminate between prostate cancer and benign prostatic hyperplasia. (author)

  2. Seismic Level 2 PSA

    International Nuclear Information System (INIS)

    Dirksen, Gerben; Pellissetti, Manuel; Duncan-Whiteman, Paul

    2014-01-01

    For most external events, the calculation of the core damage frequency (CDF) in Level 1 PSA is sufficient to be able to show that the contribution of the event to the plant risk is negligible. However, it is not sufficient to compare the CDF due to the external event to the total plant CDF; instead the Level 1 PSA result for the event should be compared to the large early release frequency (LERF), or alternatively arguments should be given why the CDF from the external event will not contribute mostly to LERF. For seismic events in particular, it can often not be easily excluded that sequences leading to core damage would not also result in LERF. Since the confinement function is one of the most essential functions for Level 2 PSA, special care must be taken of the containment penetrations. For example systems with containment penetrations that are normally closed during operation or are designed to withstand more than the maximum containment pressure are normally screened out in the Level 2 PSA for the containment isolation function, however the possibility of LOCA in such systems due to an earthquake may nevertheless lead to containment bypass. Additionally, the functionality of passive features may be compromised in case of a beyond design earthquake. In the present paper, we present crucial ingredients of a methodology for a Level 2 seismic PSA. This methodology consists of the following steps: Extension of the seismic equipment list (SEL) to include Level 2 PSA relevant systems (e.g. containment isolation system, features for core melt stabilization, hydrogen mitigation systems), Determination of the systems within the existing SEL with increased demands in case of severe accidents, Determination of essential components for which a dedicated fragility analysis needs to be performed. (author)

  3. Comparison of biochemical failure rates between permanent prostate brachytherapy and radical retropubic prostatectomy as a function of posttherapy PSA nadir plus ‘X’

    International Nuclear Information System (INIS)

    Ahmed, Kamran A; Davis, Brian J; Mynderse, Lance A; Slezak, Jeffrey M; Bergstralh, Eric J; Wilson, Torrence M; Choo, C Richard

    2014-01-01

    Prostate-specific antigen (PSA) nadir + 2 ng/mL, also known as the Phoenix definition, is the definition most commonly used to establish biochemical failure (BF) after external beam radiotherapy for prostate cancer management. The purpose of this study is to compare BF rates between permanent prostate brachytherapy (PPB) and radical retropubic prostatectomy (RRP) as a function of PSA nadir plus varying values of X and examine the associated implications. We retrospectively searched for patients who underwent PPB or RRP at our institution between 1998 and 2004. Only primary patients not receiving androgen-deprivation therapy were included in the study. Three RRP patients were matched to each PPB patient on the basis of prognostic factors. BF rates were estimated for PSA nadirs + different values of X. A total of 1,164 patients were used for analysis: 873 in the RRP group and 291 in the PPB group. Patients were equally matched by clinical stage, biopsy Gleason sum, primary Gleason grade, and pretherapy PSA value. Median follow-up was 3.1 years for RRP patients and 3.6 years in the PPB group (P = .01). Using PSA nadir + 0.1 ng/mL for the definition of BF, the 5-year BF rate was 16.3% for PPB patients and 13.5% for RRP patients (P = .007), whereas at nadir + 2 ng/mL or greater, the BF rates were less than 3% and were indistinguishable between PPB and RRP patients. In a cohort of well-matched patients who had prostatectomy or brachytherapy, we examined BF as a function of nadir + X, where X was treated as a continuous variable. As X increases from 0.1 to 2.0 ng/mL, the BF curves converge, and above 2.0 ng/mL they are essentially indistinguishable. The data presented are of interest as BF definitions continue to evolve

  4. A method for estimating failure rates for low probability events arising in PSA

    International Nuclear Information System (INIS)

    Thorne, M.C.; Williams, M.M.R.

    1995-01-01

    The authors develop a method for predicting failure rates and failure probabilities per event when, over a given test period or number of demands, no failures have occurred. A Bayesian approach is adopted to calculate a posterior probability distribution for the failure rate or failure probability per event subsequent to the test period. This posterior is then used to estimate effective failure rates or probabilities over a subsequent period of time or number of demands. In special circumstances, the authors results reduce to the well-known rules of thumb, viz: 1/N and 1/T, where N is the number of demands during the test period for no failures and T is the test period for no failures. However, the authors are able to give strict conditions on the validity of these rules of thumb and to improve on them when necessary

  5. PSA applications

    Energy Technology Data Exchange (ETDEWEB)

    Dubreuil Chambardel, A

    1997-12-31

    The IAEA now defines three types of PSA applications: Validation of design and of operation procedures; optimization of plant operation; and regulatory applications. The applications of PSA are manifold: only a few are dealt with here (precursor analysis is dealt with in session 3, topic 4). For each of them, we will do the utmost to demonstrate the main difficulties encountered, EDF`s viewpoint on the matter, and the points remaining to be solved. In what follows, unless explicitly stated otherwise, we have made every effort to represent the different applications as they are practiced by all concerned in the international community, and to describe the inherent difficulties the international community has encountered with these applications with all objectivity. It goes without saying that the comments below are simply those of the ESF department, and are submitted here for discussion by the experts. 13 refs.

  6. PSA applications

    International Nuclear Information System (INIS)

    Dubreuil Chambardel, A.

    1996-01-01

    The IAEA now defines three types of PSA applications: Validation of design and of operation procedures; optimization of plant operation; and regulatory applications. The applications of PSA are manifold: only a few are dealt with here (precursor analysis is dealt with in session 3, topic 4). For each of them, we will do the utmost to demonstrate the main difficulties encountered, EDF's viewpoint on the matter, and the points remaining to be solved. In what follows, unless explicitly stated otherwise, we have made every effort to represent the different applications as they are practiced by all concerned in the international community, and to describe the inherent difficulties the international community has encountered with these applications with all objectivity. It goes without saying that the comments below are simply those of the ESF department, and are submitted here for discussion by the experts. 13 refs

  7. [Use of prostatic specific antigen in primary care (PSA)].

    Science.gov (United States)

    Panach-Navarrete, J; Gironés-Montagud, A; Sánchez-Cano, E; Doménech-Pérez, C; Martínez-Jabaloyas, J M

    2017-04-01

    In the literature it is shown that the use of PSA is occasionally wrong, by requesting this marker in very young or very old men, and repeated measurements in short periods of time. The main objective of this study was to describe the use of PSA in daily practice by primary care physicians in our area, dealing with aspects such as the importance of patient age, the value in the screening for prostate cancer, or the subjective beliefs about its usefulness. A secondary objective was the comparison of use, and beliefs among doctors who claim to know PSA well, and those who do not. A descriptive and comparative study was conducted using questionnaires that were handed to primary care doctors in all health centres in our area. A descriptive analysis was performed and response rates among doctors who thought they had enough information about PSA, and those who did not, were compared using the Chi-squared test. A total of 103 questionnaires were received from the physicians, with 83.5% claiming to have sufficient knowledge about the PSA. The professionals in this latter group request PSA at an earlier age (P=.029), with a higher frequency (P=.011) and have more doubts about its usefulness (P=.009) than those with less knowledge. Almost half (49.5%) said they request less than 50 determinations per year, and 33% between 50 and 100. More than half (53.4%) of doctors would not request the first PSA on a patient until their 50s, and up to 49% request it up to 80 years. The true value of PSA has been established many times by 64.1% of requesters, and 29.1% believe it is unhelpful in the diagnosis of cancer. In our study, 64% of primary care physicians have considered the true value of the PSA several times, and 29% believe it to be of little use in the diagnosis of prostate cancer. In addition, some data suggest it has limited use due to the fact that 50% made less than 50 PSA requests per years, and 28% of the professionals would never request it on a male without urinary

  8. Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer.

    Science.gov (United States)

    Ecke, Thorsten H; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

    2016-11-10

    High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D'Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis ( p = 0.009), PSA on date of first HDR-BT ( p = 0.033), and PSA on date of first follow-up after one year ( p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  9. Minimal percentage of dose received by 90% of the urethra (%UD90) is the most significant predictor of PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer.

    Science.gov (United States)

    Tanaka, Nobumichi; Asakawa, Isao; Fujimoto, Kiyohide; Anai, Satoshi; Hirayama, Akihide; Hasegawa, Masatoshi; Konishi, Noboru; Hirao, Yoshihiko

    2012-09-14

    To clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer. We studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng/mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormone-naïve patients who underwent LDR-brachytherapy alone. Fifty patients (25%) showed PSA bounce and 10 patients (5%) showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng/mL, and 7.0 months, respectively. In 103 hormone-naïve patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce. Minimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naïve patients treated with LDR-brachytherapy alone.

  10. App Improves Colorectal Cancer Screening Rates

    Science.gov (United States)

    Colorectal cancer screening reduces deaths from the disease, yet about one-third of Americans aren’t up to date with screening. In this Cancer Currents blog post, learn what happened when people waiting for routine checkups could order their own screening test using a computer app.

  11. SERIAL PERCENT-FREE PSA IN COMBINATION WITH PSA FOR POPULATION-BASED EARLY DETECTION OF PROSTATE CANCER

    Science.gov (United States)

    Ankerst, Donna Pauler; Gelfond, Jonathan; Goros, Martin; Herrera, Jesus; Strobl, Andreas; Thompson, Ian M.; Hernandez, Javier; Leach, Robin J.

    2016-01-01

    PURPOSE To characterize the diagnostic properties of serial percent-free prostate-specific antigen (PSA) in relation to PSA in a multi-ethnic, multi-racial cohort of healthy men. MATERIALS AND METHODS 6,982 percent-free PSA and PSA measures were obtained from participants in a 12 year+ Texas screening study comprising 1625 men who never underwent biopsy, 497 who underwent one or more biopsies negative for prostate cancer, and 61 diagnosed with prostate cancer. Area underneath the receiver-operating-characteristic-curve (AUC) for percent-free PSA, and the proportion of patients with fluctuating values across multiple visits were determined according to two thresholds (under 15% versus 25%) were evaluated. The proportion of cancer cases where percent-free PSA indicated a positive test before PSA > 4 ng/mL did and the number of negative biopsies that would have been spared by percent-free PSA testing negative were computed. RESULTS Percent-free PSA fluctuated around its threshold of PSA tested positive earlier than PSA in 71.4% (34.2%) of cancer cases, and among men with multiple negative biopsies and a PSA > 4 ng/mL, percent-free PSA would have tested negative in 31.6% (65.8%) instances. CONCLUSIONS Percent-free PSA should accompany PSA testing in order to potentially spare unnecessary biopsies or detect cancer earlier. When near the threshold, both tests should be repeated due to commonly observed fluctuation. PMID:26979652

  12. Factors prompting PSA-testing of asymptomatic men in a country with no guidelines: a national survey of general practitioners.

    LENUS (Irish Health Repository)

    Drummond, Frances J

    2009-01-01

    BACKGROUND: Increased use of prostate specific antigen (PSA) has been associated with increased prostate cancer incidence. Ireland is estimated to have one of the highest prostate cancer incidences in Europe and has no national guidelines for prostate cancer screening. GPs have a pivotal role in influencing PSA testing, therefore, our aim was to describe GP testing practices and to identify factors influencing these. METHODS: A postal survey, including questions on clinical practice and experience, knowledge and demographics was distributed to all GPs (n = 3,683). The main outcomes were (i) PSA testing asymptomatic men and (ii) "inappropriate" PSA testing, defined as testing asymptomatic men aged < 50 or > 75 years. Factors associated with these outcomes were identified using logistic regression. RESULTS: 1,625 GPs responded (response rate corrected for eligibility = 53%). Most respondents (79%) would PSA test asymptomatic men. Of these, 34% and 51% would test asymptomatic men < 50 and > 75 years, respectively. In multivariate analyses, GPs were more likely to test asymptomatic men if they were >or= 50 years, in practice >or= 10 years, female or less knowledgeable about PSA efficacy. Male GPs who would have a PSA test themselves were > 8-times more likely to PSA test asymptomatic men than GPs who would not have a test. GPs who had an asymptomatic patient diagnosed with prostate cancer following PSA testing, were > 3-times more likely to test asymptomatic men. Practice-related factors positively associated with testing included: running \\'well man\\' clinics, performing occupational health checks and performing other tests routinely with PSA. Factors positively associated with \\'inappropriate\\' testing included; being male and willing to have a PSA test, having worked\\/trained in the UK and supporting annual PSA testing. 91% of respondents supported the development of national PSA testing guidelines. CONCLUSION: Our findings suggest that widespread PSA testing

  13. Methodology - PSA Regulatory handbook. Comparisons to a modern PSA study

    International Nuclear Information System (INIS)

    Bostroem, Urban; Jung, Gunnar; Flodin, Yngve

    2003-03-01

    fault tree model correspond. The main focus of the review has been on the plant model. The comments and conclusions are dominated by issues concerning modelling. As of part 1.5, the criteria for the review as presented in the PSA Handbook are not to be seen as strict requirements. The layout of the Handbook does not follow the traditional PSA with its subdivision of into internal and external events, level 1 and level 2 PSA, or power operation and shut-down. The reason for this is that this has given the regulatory handbook a more logical structure, and that this approach underlines the integrated character of PSA when it comes to creating the plan risk profile. When the Handbook is used as the reference for a review of a PSA this has to be taken into consideration. One partial analysis of a PSA program can not be expected to meet all requirements of the PSA Handbook. On a general level, the PSA in question in many ways seem to be on a satisfactory level with modern PSA standard. As expected though, in relation to the level of ambition as described in the Handbook, some areas could be improved. The main conclusions can be summarised as: The PSA Handbook (PSAHB) is not intended to be used for detailed review of analyses, but for an overall judgement of a complete PSA program - The PSAHB pictures an 'ideal' version of a complete PSA. During a comparative review, as the one described in this report, considerable discrepancies show up concerning level of ambition etc. - The PSAHB, and in particular its chapters on presentation and analysis of results are well written and worth considering for any PSA analyst. - The specific PSA analysis studied shows a high level of ambition, but as - A thorough analysis of the results is missing. - Some of the analyses are overly conservative. - The CCI-analysis is presented only in a 'first screening' status. - No uncertainty analysis is presented. - The criteria for the sensitivity analysis are not shown. - The models used for internal

  14. PRESSING MORTALITY RATE THROUGH SCREENING oral cancer

    Directory of Open Access Journals (Sweden)

    L. K. Widnyani Wulan Laksmi

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Based on World Health Organization (WHO data, oral cancer is one of malignancy with the highest mortality. In USA, there are more than 30.000 new cases every year. We can find many risk factors of oral cancer in our daily living. Moreover, it’s easy to find the main risk factors in our society, they are smoking, alcohol consumption, tobacco consumtion, viral infection, and bad oral hygiene. For the early stadium, Five-years survival rate is about 82% and 61% for all stadium. But, more than 50% of oral cancer has been distributed (metastatic regionally and also into the other organ far away from the oral itself when it’s detected. It will decrease 5-years survival rate to be less than 50%. So that, it’s really important to detect the oral cancer at the earlier stadium. Screening is the way to find the earlier stadium. Screening is done by some methods, start from the anamnesis, physical examination, toluidine blue staining, endoscopy, cytology, telomerase examination, and also PET-scan if it’s possible (because of the financial reasons. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  15. Putting PSA to work

    International Nuclear Information System (INIS)

    Gubler, R.; Gomez-Cobo, A.

    1998-01-01

    The IAEA has, during the last three years, been working intensively on PSA applications. The draft TECDOC prepared during these activities, ''PSA Applications'' is summarized in this paper. Actual events at nuclear facilities provide an important basis to compare PSAs with reality. PSA based operational event analysis therefore can be used to evaluate the importance of operational events from a risk perspective but also can contribute to validating and enhancing PSAs and to continuously check whether or not the PSA models are adequate, appropriate and complete. The work of the IAEA in this area is therefore summarized as well. In a companion paper, titled ''Towards a credible PSA fit for applications'', two specific aspects regarding the quality of the PSA to be used are discussed in detail, namely the Living PSA concept, which ensures that the PSA reflects actual design and operational features and Quality Assurance for PSA. (author)

  16. PSA Review Handbook

    International Nuclear Information System (INIS)

    Hallman, Anders; Nyman, Ralph; Knochenhauer, Michael

    2004-05-01

    The Swedish Nuclear Power Inspectorate (SKI) expresses requirements on the performance of PSAs as well as on PSA activities in general in the the regulatory document 'Regulations Concerning Safety in Certain Nuclear Facilities', SKlFS 1998:1. The follow-up of these activities is part of the inspection tasks of the SKI. In view or this, there is a need for documented guidelines on now to perform these inspections and reviews. The SKI PSA Review Handbook is intended to be a support in the SKI inspection and control of the PSA activities or the licensees. These PSA activities include both the organisation and working procedures of the licensee, the layout and contents of the PSA, and its areas of application. Using the regulation SKIFS 1998:1 as a starting point, the review handbook presents important aspects to be considered when judging whether a licensee fulfils the requirements on PSA activities, including the performance of PSA:s or PSA applications. The handbook shall also be a guidance for the review of PSA:s. However, the intention of the PSA Review Handbook is not to be a handbook for how a PSA is performed. The PSA Review Handbook is applicable to all types or initiating events and all operating conditions, and has been structured in a way, which stresses the integrated characteristics of PSA in the creation of the risk picture of a plant. The PSA Review Handbook has been based on the requirements for PSA of nuclear power plants, as this is the most extensive application. However, the relevant parts of it are also applicable when analysing other nuclear installations. The PSA Review Handbook is published as a research report as its contents are judged to be of general interest, and the SKI welcomes comments to the handbook. An update or the PSA Review Handbook may be required as experience with the use of the handbook is acquired and if general PSA requirements change

  17. Improving PSA quality of KSNP PSA model

    International Nuclear Information System (INIS)

    Yang, Joon Eon; Ha, Jae Joo

    2004-01-01

    In the RIR (Risk-informed Regulation), PSA (Probabilistic Safety Assessment) plays a major role because it provides overall risk insights for the regulatory body and utility. Therefore, the scope, the level of details and the technical adequacy of PSA, i.e. the quality of PSA is to be ensured for the successful RIR. To improve the quality of Korean PSA, we evaluate the quality of the KSNP (Korean Standard Nuclear Power Plant) internal full-power PSA model based on the 'ASME PRA Standard' and the 'NEI PRA Peer Review Process Guidance.' As a working group, PSA experts of the regulatory body and industry also participated in the evaluation process. It is finally judged that the overall quality of the KSNP PSA is between the ASME Standard Capability Category I and II. We also derive some items to be improved for upgrading the quality of the PSA up to the ASME Standard Capability Category II. In this paper, we show the result of quality evaluation, and the activities to improve the quality of the KSNP PSA model

  18. PSA-stratified detection rates for [68Ga]THP-PSMA, a novel probe for rapid kit-based 68Ga-labeling and PET imaging, in patients with biochemical recurrence after primary therapy for prostate cancer.

    Science.gov (United States)

    Derlin, Thorsten; Schmuck, Sebastian; Juhl, Cathleen; Zörgiebel, Johanna; Schneefeld, Sophie M; Walte, Almut C A; Hueper, Katja; von Klot, Christoph A; Henkenberens, Christoph; Christiansen, Hans; Thackeray, James T; Ross, Tobias L; Bengel, Frank M

    2018-06-01

    [ 68 Ga]Tris(hydroxypyridinone)(THP)-PSMA is a novel radiopharmaceutical for one-step kit-based radiolabelling, based on direct chelation of 68 Ga 3+ at low concentration, room temperature and over a wide pH range, using direct elution from a 68 Ge/ 68 Ga-generator. We evaluated the clinical detection rates of [ 68 Ga]THP-PSMA PET/CT in patients with biochemically recurrent prostate cancer after prostatectomy. Consecutive patients (n=99) referred for evaluation of biochemical relapse of prostate cancer by [ 68 Ga]THP-PSMA PET/CT were analyzed retrospectively. Patients underwent a standard whole-body PET/CT (1 h p.i.), followed by delayed (3 h p.i.) imaging of the abdomen. PSA-stratified cohorts of positive PET/CT results, standardized uptake values (SUVs) and target-to-background ratios (TBRs) were analyzed, and compared between standard and delayed imaging. At least one lesion suggestive of recurrent or metastatic prostate cancer was identified on PET images in 52 patients (52.5%). Detection rates of [ 68 Ga]THP-PSMA PET/CT increased with increasing PSA level: 94.1% for a PSA value of ≥10 ng/mL, 77.3% for a PSA value of 2 to PSA value of 1 to PSA value of 0.5 to PSA value of >0.2 to PSA value of 0.01 to 0.2 ng/mL. [ 68 Ga]THP-PSMA uptake (SUVs) in metastases decreased over time, whereas TBRs improved. Delayed imaging at 3 h p.i. exclusively identified pathologic findings in 2% of [ 68 Ga]THP-PSMA PET/CT scans. Detection rate was higher in patients with a Gleason score ≥8 (P=0.02) and in patients receiving androgen deprivation therapy (P=0.003). In this study, [ 68 Ga]THP-PSMA PET/CT showed suitable detection rates in patients with biochemical recurrence of prostate cancer and PSA levels ≥ 2 ng /mL. Detections rates were lower than in previous studies evaluating other PSMA ligands, though prospective direct radiotracer comparison studies are mandatory particularly in patients with low PSA levels to evaluate the relative performance of different PSMA ligands.

  19. Clinical significance of combined determination of serum levels of free prostate specific antigen (fPSA) and insulin-like growth factor-1 (IGF-1) in patients with prostatic cancer

    International Nuclear Information System (INIS)

    Wang Xiaolong; Chen Baixun; Chen Yue

    2004-01-01

    Objective: To explore the clinical significance of combined determination of serum levels of fPSA and IGF-1 in patients with prostatic cancer. Methods: Serum levels of fPSA (with chemiluminescence) and IGF-1 (with IRMA) were measured in 48 patients with prostatic cancer, 63 patients with benign prostate hyperplasia and 38 controls. Results: Serum levels of fPSA and IGF-1 in the 111 patients were significantly higher than those in controls (P<0.05). The positive rate for prostatic cancer detection with fPSA, IGF-1 and fPSA combined with IGF-1 was 83.3%, 79.2% and 95.8% respectively. Conclusion: Combined measurement of fPSA and IGF-1 was most preferable for screening prostatic cancer

  20. Rapid elimination kinetics of free PSA or human kallikrein-related peptidase 2 after initiation of gonadotropin-releasing hormone-antagonist treatment of prostate cancer

    DEFF Research Database (Denmark)

    Ulmert, David; Vickers, Andrew J; Scher, Howard I

    2012-01-01

    The utility of conventional prostate-specific antigen (PSA) measurements in blood for monitoring rapid responses to treatment for prostate cancer is limited because of its slow elimination rate. Prior studies have shown that free PSA (fPSA), intact PSA (iPSA) and human kallikrein-related peptidase...... of tPSA, fPSA, iPSA and hK2 after rapid induction of castration with degarelix (Firmagon(®)), a novel GnRH antagonist....

  1. Comparative evaluation of PSA-Density, percent free PSA and total PSA

    OpenAIRE

    Ströbel, Greta

    2010-01-01

    BACKGROUND The objective of this study was to evaluate the prostate specific antigen (PSA) density (PSAD) (the quotient of PSA and prostate volume) compared with the percent free PSA (%fPSA) and total PSA (tPSA) in different total PSA (tPSA) ranges from 2 ng/mL to 20 ng/mL. Possible cut-off levels depending on the tPSA should be established. METHODS In total, 1809 men with no pretreatment of the prostate were enrolled between 1996 and 2004. Total and free PSA were measured with t...

  2. Molecular Form Differences Between Prostate-Specific Antigen (PSA) Standards Create Quantitative Discordances in PSA ELISA Measurements

    Science.gov (United States)

    McJimpsey, Erica L.

    2016-01-01

    The prostate-specific antigen (PSA) assays currently employed for the detection of prostate cancer (PCa) lack the specificity needed to differentiate PCa from benign prostatic hyperplasia and have high false positive rates. The PSA calibrants used to create calibration curves in these assays are typically purified from seminal plasma and contain many molecular forms (intact PSA and cleaved subforms). The purpose of this study was to determine if the composition of the PSA molecular forms found in these PSA standards contribute to the lack of PSA test reliability. To this end, seminal plasma purified PSA standards from different commercial sources were investigated by western blot (WB) and in multiple research grade PSA ELISAs. The WB results revealed that all of the PSA standards contained different mass concentrations of intact and cleaved molecular forms. Increased mass concentrations of intact PSA yielded higher immunoassay absorbance values, even between lots from the same manufacturer. Standardization of seminal plasma derived PSA calibrant molecular form mass concentrations and purification methods will assist in closing the gaps in PCa testing measurements that require the use of PSA values, such as the % free PSA and Prostate Health Index by increasing the accuracy of the calibration curves. PMID:26911983

  3. Molecular Form Differences Between Prostate-Specific Antigen (PSA) Standards Create Quantitative Discordances in PSA ELISA Measurements

    Science.gov (United States)

    McJimpsey, Erica L.

    2016-02-01

    The prostate-specific antigen (PSA) assays currently employed for the detection of prostate cancer (PCa) lack the specificity needed to differentiate PCa from benign prostatic hyperplasia and have high false positive rates. The PSA calibrants used to create calibration curves in these assays are typically purified from seminal plasma and contain many molecular forms (intact PSA and cleaved subforms). The purpose of this study was to determine if the composition of the PSA molecular forms found in these PSA standards contribute to the lack of PSA test reliability. To this end, seminal plasma purified PSA standards from different commercial sources were investigated by western blot (WB) and in multiple research grade PSA ELISAs. The WB results revealed that all of the PSA standards contained different mass concentrations of intact and cleaved molecular forms. Increased mass concentrations of intact PSA yielded higher immunoassay absorbance values, even between lots from the same manufacturer. Standardization of seminal plasma derived PSA calibrant molecular form mass concentrations and purification methods will assist in closing the gaps in PCa testing measurements that require the use of PSA values, such as the % free PSA and Prostate Health Index by increasing the accuracy of the calibration curves.

  4. An approach to develop a PSA workstation in KAERI

    International Nuclear Information System (INIS)

    Kim, T. W.; Han, S. H.; Park, C. K.

    1995-01-01

    This paper describes three kinds of efforts for the development of PSA workstation in KAERI; Development of a PSA tool, KIRAP, Reliability Database Development, Living PSA tool development. Korea has 9 nuclear power plants (NPPs) in operation and 9 NPPs under design or construction. For the NPPs recently constructed or designed, the probabilistic safety assessments (PSAs) have been performed by the Government requirements. For these PSAs, the MSDOS version of KIRAP has been used. For the consistent data management and the easiness of information handling needed in PSA, APSA workstation, KIRAP-Win is under development under Windows environment. For the reliability database on component failure rate, human error rate, and common cause failure rate, data used in international PSA or reliability data handbook are collected and processed to use in Korean new plants' PSAs. Finally, an effort for the development of a living PSA tool in KAERI based on dynamic PSA concept is described

  5. Failure to Achieve a PSA Level ≤1 ng/mL After Neoadjuvant LHRHA Therapy Predicts for Lower Biochemical Control Rate and Overall Survival in Localized Prostate Cancer Treated With Radiotherapy

    International Nuclear Information System (INIS)

    Mitchell, Darren M.; McAleese, Jonathan; Park, Richard M.; Stewart, David P.; Stranex, Stephen; Eakin, Ruth L.; Houston, Russell F.; O'Sullivan, Joe M.

    2007-01-01

    Purpose: To investigate whether failure to suppress the prostate-specific antigen (PSA) level to ≤1 ng/mL after ≥2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy in patients scheduled to undergo external beam radiotherapy for localized prostate carcinoma is associated with reduced biochemical failure-free survival. Methods and Materials: A retrospective case note review of consecutive patients with intermediate- or high-risk localized prostate cancer treated between January 2001 and December 2002 with neoadjuvant hormonal deprivation therapy, followed by concurrent hormonal therapy and radiotherapy was performed. Patient data were divided for analysis according to whether the PSA level in Week 1 of radiotherapy was ≤1.0 ng/mL. Biochemical failure was determined using the American Society for Therapeutic Radiology and Oncology (Phoenix) definition. Results: A total of 119 patients were identified. The PSA level after neoadjuvant hormonal deprivation therapy was ≤1 ng/mL in 67 patients and >1 ng/mL in 52. At a median follow-up of 49 months, the 4-year actuarial biochemical failure-free survival rate was 84% vs. 60% (p = 0.0016) in favor of the patients with a PSA level after neoadjuvant hormonal deprivation therapy of ≤1 ng/mL. The overall survival rate was 94% vs. 77.5% (p = 0.0045), and the disease-specific survival rate at 4 years was 98.5% vs. 82.5%. Conclusions: The results of our study have shown that patients with a PSA level >1 ng/mL at the beginning of external beam radiotherapy after ≥2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of ≤1 ng/mL. Patients without adequate PSA suppression should be considered a higher risk group and considered for dose escalation or the use of novel treatments

  6. Effects of ion and electron screening on thermonuclear reaction rates

    International Nuclear Information System (INIS)

    Brady, L.R. Jr.

    1977-01-01

    The effects of screening by ions and electrons on thermonuclear reaction rates in stellar plasmas are considered. The enhancement of the reaction rate ranges from negligible to extremely large (on the order of 10 26 or greater). In order to calculate these effects, the potential about a given reacting nucleus is determined. First, Boltzmann-Vlasov and Poisson-Boltzmann equations are solved to yield a Yukawa potential. A suitable approximation to this potential is integrated in the action integral to give the barrier penetration. The screened reaction rate is then found by the saddle-point method. In developing a general formalism to calculate the screened reaction rate and the screening factor, effects due to the finite size of the nucleus are considered and found to be negligible. An expression for the screening factor for resonant reaction rates is also derived. A different and relatively simple approach, based on work of Stewart and Pyatt (1966), is used to find the barrier penetration from the action integral in two approximations: a modified Coulomb potential and a constant-shift potential. Screening factors are calculated for carbon burning at T 6 = 100 and T 6 = 400 for a wide range of densities and also for several examples in late stellar evolution. These screening factors are, for the most part, greater than those given by most others by a few percent at low density to 4 or more orders of magnitude at T 6 = 100 and rho = 10 10 g/cm 3 . Near the edge of the crystalline lattice region, however, they are significantly lower than those of some others. The increase in reaction rates for carbon burning indicates that carbon ignition may occur at lower densities than previously thought and may affect the density at which a supernova shock may occur

  7. Comparison of PSA value at last follow-up of patients who underwent low-dose rate brachytherapy and intensity-modulated radiation therapy for prostate cancer.

    Science.gov (United States)

    Tanaka, Nobumichi; Asakawa, Isao; Nakai, Yasushi; Miyake, Makito; Anai, Satoshi; Fujii, Tomomi; Hasegawa, Masatoshi; Konishi, Noboru; Fujimoto, Kiyohide

    2017-08-25

    To compare the PSA value at the last follow-up of patients who underwent prostate low-dose rate brachytherapy (LDR-BT) with that of patients who underwent intensity-modulated radiation therapy (IMRT). A total of 610 prostate cancer patients (cT1c-3bN0M0) were enrolled, and 445 of them underwent LDR-BT, while 165 received IMRT (74-76 Gy). The median follow-up period of these two groups was 75 months (LDR-BT) and 78 months (IMRT), respectively. We also evaluated the biochemical recurrence (BCR)-free rate using two definitions (Phoenix definition and PSA ≥ 0.2 ng/mL). The percentage of patients who achieved PSA LDR-BT group and 49.7% in the IMRT group (p LDR-BT group and 32.1% in the IMRT group (p LDR-BT groups was 89.5 and 95.0% (p LDR-BT groups, respectively (p LDR-BT was significantly lower than that of IMRT, and this result was particularly marked in patients with a normal testosterone level at the last follow-up.

  8. Text Messaging Interventions on Cancer Screening Rates: A Systematic Review.

    Science.gov (United States)

    Uy, Catherine; Lopez, Jennifer; Trinh-Shevrin, Chau; Kwon, Simona C; Sherman, Scott E; Liang, Peter S

    2017-08-24

    Despite high-quality evidence demonstrating that screening reduces mortality from breast, cervical, colorectal, and lung cancers, a substantial portion of the population remains inadequately screened. There is a critical need to identify interventions that increase the uptake and adoption of evidence-based screening guidelines for preventable cancers at the community practice level. Text messaging (short message service, SMS) has been effective in promoting behavioral change in various clinical settings, but the overall impact and reach of text messaging interventions on cancer screening are unknown. The objective of this systematic review was to assess the effect of text messaging interventions on screening for breast, cervical, colorectal, and lung cancers. We searched multiple databases for studies published between the years 2000 and 2017, including PubMed, EMBASE, and the Cochrane Library, to identify controlled trials that measured the effect of text messaging on screening for breast, cervical, colorectal, or lung cancers. Study quality was evaluated using the Cochrane risk of bias tool. Our search yielded 2238 citations, of which 31 underwent full review and 9 met inclusion criteria. Five studies examined screening for breast cancer, one for cervical cancer, and three for colorectal cancer. No studies were found for lung cancer screening. Absolute screening rates for individuals who received text message interventions were 0.6% to 15.0% higher than for controls. Unadjusted relative screening rates for text message recipients were 4% to 63% higher compared with controls. Text messaging interventions appear to moderately increase screening rates for breast and cervical cancer and may have a small effect on colorectal cancer screening. Benefit was observed in various countries, including resource-poor and non-English-speaking populations. Given the paucity of data, additional research is needed to better quantify the effectiveness of this promising intervention

  9. Issues reporting PSA in prostate cancer

    International Nuclear Information System (INIS)

    Lange, Paul H.

    1996-01-01

    The National Cancer Institute Prostate; Lung; Colon; Ovarian Cancer Screening (PLCO) project is a multi-center trial developed to investigate the effectiveness of DRE and PSA testing in the early detection and outcome of patients with prostate cancer. Accordingly, the Prostate Cancer Intervention versus Observation Trial (PIVOT) has been launched and is a randomized trial comparing radical prostatectomy versus expectant management for ALCaP. PSA: Initially PSA was thought to be of little value for diagnosis because 20% of men undergoing radical prostatectomy have 'normal' PSA and patients with apparently only symptomatic BPH have 'elevated' levels as follows: 4-10 ng/ml (Tandem-R) - 20%, >10 ng/ml -3%. Yet, PSA has looked attractive as a diagnostic tool in many studies; for example, when PSA was used in a screening approach as the first test which then drove further evaluation (Catalona, Brawer). It was shown that the positive predictive value for PSA's between 4 and 10 is approximately 20% and > 10 approximately 55%. The value of serial PSA's (velocity) is unknown but is under intense study: one major issue is determination of what represents a significant rise (details to be presented). Studies have also revealed that a DRE and PSA are important for optimal results. About 18% of clinically detectable cancers are only DRE positive while about 25 - 30% are only PSA positive. When both a DRE and PSA are used together, very few clinically apparent cancers are missed (3-5%). Recent ROC curves suggest that 4 ng/ml is reasonable. Recently, PSA values for men without apparent cancer were stratified by age, and taking the 2SD, age specific reference values were generated as follows: age 40-49 (0-2.5 ng/ml), 50-59 (0-3.5), 60-69 (0-4.5), 70-70 (0-6.5). Finally, there is the issue about different PSA assays regarding the compatabilities/reliability of the upper limit of normal and serial values. Much of the confusion is because there is no international PSA standard and

  10. Experiences of Uncertainty in Men With an Elevated PSA.

    Science.gov (United States)

    Biddle, Caitlin; Brasel, Alicia; Underwood, Willie; Orom, Heather

    2015-05-15

    A significant proportion of men, ages 50 to 70 years, have, and continue to receive prostate specific antigen (PSA) tests to screen for prostate cancer (PCa). Approximately 70% of men with an elevated PSA level will not subsequently be diagnosed with PCa. Semistructured interviews were conducted with 13 men with an elevated PSA level who had not been diagnosed with PCa. Uncertainty was prominent in men's reactions to the PSA results, stemming from unanswered questions about the PSA test, PCa risk, and confusion about their management plan. Uncertainty was exacerbated or reduced depending on whether health care providers communicated in lay and empathetic ways, and provided opportunities for question asking. To manage uncertainty, men engaged in information and health care seeking, self-monitoring, and defensive cognition. Results inform strategies for meeting informational needs of men with an elevated PSA and confirm the primary importance of physician communication behavior for open information exchange and uncertainty reduction. © The Author(s) 2015.

  11. A PSA study for the SMART basic design

    International Nuclear Information System (INIS)

    Han, Sang Hoon; Kim, H. C.; Yang, S. H.; Lee, D. J.

    2002-03-01

    SMART (System-Integrated Modular Advanced Reactor) is under development that is an advanced integral type small and medium category nuclear power reactor with the rated thermal power of 330 MW. A Probabilistic Safety Analysis (PSA) for the SMART basic design has been performed to evaluate the safety and optimize the design. Currently, the basic design is done and the detailed design is not available for the SMART, we made several assumptions about the system design before performing the PSA. The scope of the PSA was limited to the Level-1 internal full power PSA. The level-2 and 3 PSA, the external PSA, and the low power/shutdown PSA will be performed in the final design stage

  12. Whooping Cough PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    This 30 second PSA encourages pregnant women to get the whooping cough vaccine, called Tdap, during the third trimester of each pregnancy in order to pass antibodies to their babies so they are born with protection against this serious disease.

  13. What implementation interventions increase cancer screening rates? a systematic review

    Directory of Open Access Journals (Sweden)

    Lent Barbara

    2011-09-01

    Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic

  14. Human behaviour in PSA

    International Nuclear Information System (INIS)

    Schott, H.

    1999-01-01

    Based on the current international state of the art of methodology for evaluation of human errors for PSA, many research projects have been initiated by the competent departments of the BMU and the BfS (Federal Min. of the Environment and Reactor Safety, Federal Radiation Protection Office). Three major areas of the research activities are discussed: Database: - Specific investigations into the applicability of generic data (THERP) to other than the original cases, possibly elaboration of approaches for application-specific modification, further evaluation of operating results; - general enhancement of insight into human performance and errors, e.g. with respect to causes of error and application areas (influence of organisation, cognitive performance); interviews with experts as a supplementary approach for data verification and database enhancement. Sensitivity analysis: - Identification of information describing human errors essentially contributing to frequency of occurrence of incidents and system non-availability; - establishment of relevance rating system, methodology for uncertainty analysis. Further development of methodology: - Modelling of repair activities and knowledge-based behaviour. (orig./CB) [de

  15. Low percentage of free prostate-specific antigen (PSA) is a strong predictor of later detection of prostate cancer among Japanese men with serum levels of total PSA of 4.0 ng/mL or less.

    Science.gov (United States)

    Sasaki, Mitsuharu; Ishidoya, Shigeto; Ito, Akihiro; Saito, Hideo; Yamada, Shigeyuki; Mitsuzuka, Koji; Kaiho, Yasuhiro; Shibuya, Daisuke; Yamaguchi, Takuhiro; Arai, Yoichi

    2014-11-01

    To investigate the effect of the percentage of free prostate-specific antigen (%fPSA) on future prostate cancer risk. We examined serum total PSA (tPSA) and %fPSA annually in a prostate cancer-screening cohort between July 2001 and June 2011. Men with tPSA >4.0 ng/mL or tPSA of 2.0-4.0 ng/mL with %fPSA ≤12% were screened as positive and were recommended to undergo a biopsy. The study population consisted of 6368 men, aged 40-79 years, who had tPSA ≤4.0 ng/mL at initial screening and who subsequently underwent 1 or more screenings. We calculated the cumulative risk and hazard ratio of prostate cancer stratified by the initial %fPSA groups as quartiles of prostate cancer patients. During a median follow-up of 36 months, 119 men were diagnosed with prostate cancer. The lowest quartile of %fPSA (22.2%). For the subset with an initial tPSA ≤1.0 ng/mL, all men diagnosed with cancer had an initial %fPSA ≤33.3% (median). For the subset with tPSA >1.0 ng/mL, men with %fPSA ≤23.0% (median) had significantly higher risk for cancer than those with %fPSA >23.0% (P men with prostate cancer in whom pathologic findings were available, 79 (69.3%) had a Gleason score ≥3 + 4 = 7. A low %fPSA is a strong predictor of a subsequent diagnosis of prostate cancer among men with tPSA levels ≤4.0 ng/mL. Measurement of %fPSA might enhance the detection of high-grade cancer that warrants aggressive treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. External Events PSA for the Paks NPP

    International Nuclear Information System (INIS)

    Bareith, Attila; Karsa, Zoltan; Siklossy, Tamas; Vida, Zoltan

    2014-01-01

    Initially, probabilistic safety assessment of external events was limited to the analysis of earthquakes for the Paks Nuclear Power Plant in Hungary. The level 1 seismic PSA was completed in 2002 showing a significant contribution of seismic failures to core damage risk. Although other external events of natural origin had previously been screened out from detailed plant PSA mostly on the basis of event frequencies, a review of recent experience on extreme weather phenomena made during the periodic safety review of the plant led to the initiation of PSA for external events other than earthquakes in 2009. In the meantime, the accident of the Fukushima Dai-ichi Nuclear Power Plant confirmed further the importance of such an analysis. The external event PSA for the Paks plant followed the commonly known steps: selection and screening of external hazards, hazard assessment for screened-in external events, analysis of plant response and fragility, PSA model development, and risk quantification and interpretation of results. As a result of event selection and screening the following weather related external hazards were subject to detailed analysis: extreme wind, extreme rainfall (precipitation), extreme snow, extremely high and extremely low temperatures, lightning, frost and ice formation. The analysis proved to be a significant challenge due to scarcity of data, lack of knowledge, as well as limitations of existing PSA methodologies. This paper presents an overview of the external events PSA performed for the Paks NPP. Important methodological aspects are summarised. Key analysis findings and unresolved issues that need further elaboration are highlighted. Development of external events PSA for the Paks NPP was completed by the end of 2012. The analysis followed the commonly known steps: selection and screening of external hazards, hazard assessment for screened-in external events, analysis of plant response and fragility, PSA model development, and risk

  17. Time to PSA rise differentiates the PSA bounce after HDR and LDR brachytherapy of prostate cancer.

    Science.gov (United States)

    Burchardt, Wojciech; Skowronek, Janusz

    2018-02-01

    To investigate the differences in prostate-specific antigen (PSA) bounce (PB) after high-dose-rate (HDR-BT) or low-dose-rate (LDR-BT) brachytherapy alone in prostate cancer patients. Ninety-four patients with localized prostate cancer (T1-T2cN0), age ranged 50-81 years, were treated with brachytherapy alone between 2008 and 2010. Patients were diagnosed with adenocarcinoma, Gleason score ≤ 7. The LDR-BT total dose was 144-145 Gy, in HDR-BT - 3 fractions of 10.5 or 15 Gy. The initial PSA level (iPSA) was assessed before treatment, then PSA was rated every 3 months over the first 2 years, and every 6 months during the next 3 years. Median follow-up was 3.0 years. Mean iPSA was 7.8 ng/ml. In 58 cases, PSA decreased gradually without PB or biochemical failure (BF). In 24% of patients, PB was observed. In 23 cases (24%), PB was observed using 0.2 ng/ml definition; in 10 cases (11%), BF was diagnosed using nadir + 2 ng/ml definition. The HDR-BT and LDR-BT techniques were not associated with higher level of PB (26 vs. 22%, p = 0.497). Time to the first PSA rise finished with PB was significantly shorter after HDR-BT then after LDR-BT (median, 10.5 vs. 18.0 months) during follow-up. Predictors for PB were observed only after HDR-BT. Androgen deprivation therapy (ADT) and higher Gleason score decreased the risk of PB (HR = 0.11, p = 0.03; HR = 0.51, p = 0.01). The higher PSA nadir and longer time to PSA nadir increased the risk of PB (HR 3.46, p = 0.02; HR 1.04, p = 0.04). There was no predictors for PB after LDR-BT. HDR-BT and LDR-BT for low and intermediate risk prostate cancer had similar PB rate. The PB occurred earlier after HDR-BT than after LDR-BT. ADT and higher Gleason score decreased, and higher PSA nadir and longer time to PSA nadir increased the risk of PB after HDR-BT.

  18. UV/EB curable psa's

    International Nuclear Information System (INIS)

    Glotfelter, C.A.

    1995-01-01

    The author describe both water-based and 100% solids UV/EB curable PSA's (Pressure Sensitive Adhesives) and their properties. A new acrylate monomer, ethoxylated nonyl phenol acrylate, has great utility in the formulation of water-based PSA's

  19. Association of PSA, free-PSA and testosteron levels in serum of patients with benign prostate hyperplasia (BPH) and prostate cancer

    International Nuclear Information System (INIS)

    Wiwin Mailana; Kristina Dwi P; Sri Insani WW; Puji Widayati

    2015-01-01

    Prostate cancer screening can be done by measuring the concentration levels of PSA, free-PSA and testosterone in serum that examined with radioimmunoassay (RIA). A total of 30 patients of 45-81 years old had enrolled in this study and were taken their venous blood. The aim of research is to know the relationship between PSA and testosterone free-PSA with BPH and prostate cancer. Results showed that there was no correlation between age with BPH and prostate cancer (p = 0.06), but there is a relationship between PSA with BPH and prostate cancer (p = 0.002), the relationship between free-PSA with BPH and prostate cancer (p = 0.001). No correlation was found between PSA ratio with BPH and prostate cancer as well as the absence of a relationship between testosterone with BPH and prostate cancer (p = 0.924). (author)

  20. A new self-rating questionnaire for dementia screening

    Directory of Open Access Journals (Sweden)

    Jin WANG

    2015-07-01

    Full Text Available Background The AD8 plays an important role in the early diagnosis of dementia. However, because of cultural and language difference, it is difficult for Chinese subjects to understand and answer questions in AD8. This paper aims to make a new dementia self-rating questionnaire for Chinese people based on the AD8, and to determine its value for dementia screening.  Methods According to early symptoms of dementia and life style of old Chinese people, a dementia self-rating questionnaire was made based on the AD8. The new questionnaire includes 10 questions, and can be finished in 3 min. The reliability and validity was validated by a questionnaire survey in senior citizens older than 50 years in urban Xi'an. All patients were screened by Mini-Mental State Examination (MMSE and dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders Forth Edition (DSM-Ⅳ criteria.  Results A total of 620 patients finished the new questionnaire, and among them 17 patients (2.74% were diagnosed as dementia. The score of each question in the questionnaire was positively correlated with the total score (rs = 0.300-0.709; P = 0.000, for all. The Cronbach α was 0.795, indicating that the questionnaire got good internal consistency reliability. Two principal components were extracted, and the cumulative variance contribution ratio was 49.771%. Factor loading of each subitem was > 0.500, indicating a good construct validity. According to receiver operating characteristic (ROC curve, the critical value was 2, with the sensitivity 94.10% and specificity 82.10%. Youden index was 0.762.  Conclusions The new dementia self-rating questionnaire can detect dementia patients sensitively and correctly, and is very useful for early screening of dementia. DOI: 10.3969/j.issn.1672-6731.2015.07.009

  1. Prostate MR imaging for patients with elevated serum PSA levels. The clinical value of diffusion-weighted and dynamic MR imaging in cancer screening

    International Nuclear Information System (INIS)

    Tanimoto, Akihiro; Shinmoto, Hiroshi; Kuribayasi, Sachio; Nakashima, Jun; Kohno, Hidaka; Murai, Masaru

    2006-01-01

    The purpose of this study was to evaluate the clinical value of diffusion-weighted imaging (DWI) and dynamic magnetic resonance imaging (MRI) in combination with T 2 -weighted imaging (T 2 W) for the detection of prostate cancer. Eighty-three patients with elevated serum levels of prostate-specific antigen (PSA) (>4.0 ng/mL) were evaluated by T 2 W, DWI, and dynamic MRI at 1.5T prior to needle biopsy. The data from the results of the T 2 W alone (protocol A), combination of T 2 W and DWI (protocol B), and combination of T 2 W+DWI and dynamic MRI (protocol C) were entered into a receiver operating characteristic (ROC) analysis. Prostate cancer was detected by pathology in 44 of 83 patients. The sensitivity, respective specificity, accuracy, and Az (the area under the ROC curve) for the detection of prostate cancer were 73%, 54%, 64%, and 0.71 in protocol A; 84%, 85%, 84%, and 0.90 in protocol B; and 95%, 74%, 86%, and 0.97 in protocol C. The sensitivity, specificity, and accuracy were significantly different among the 3 protocols (p 2 W, DWI, and dynamic MRI may be valuable for detecting prostate cancer and avoiding unnecessary biopsy. (author)

  2. Tools for PSA reviews

    International Nuclear Information System (INIS)

    Linden, J. von

    1998-01-01

    It is desirable to have a uniform and competent procedure for the review of PSAs which are performed within the framework of the Periodic Safety Review of German Nuclear Power Plants. Guidelines for the review process should therefore be evaluated within task A. 1 of project SR 2096. The basis for this work is the experience and knowledge within GRS derived from PSA-related work and from several review projects as well as the German PSA Guide with its appendices. Furthermore, the review processes in the USA, Switzerland and Sweden and the Guidelines for the International Peer Review Service (IPERS Guidelines) were utilized. As a result, recommendations are given for the review process, with individual recommendations concerning the organization of the review, task allocation between the reviewers, interface problems, assessment criteria, the scope and depth of the review as well as the supporting documents. An additional result are checklists for the technical elements of the PSA, which are listed to facilicate the review work. It is not the intention of this report to work out complete review guidelines. Its aims is rather more to give recommondations and support for the review in addition to what can be derived from the existing documents that should be used for the review. The recommendations reflect the view of GRS and go beyond the statements given in the German PSA Guide (Leitfaden Probabilistische Sicherheitsanalyse /PSUe97/) in some points. (orig.) [de

  3. Binge Drinking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This PSA is based on the October, 2010 CDC Vital Signs report which indicates that drinking too much, including binge drinking, causes more than 79,000 deaths in the U.S. each year and is the third leading preventable cause of death.

  4. Introduction to PSA applications

    International Nuclear Information System (INIS)

    Evans, M.G.K.

    1997-01-01

    The aim of this presentation is to show how the PSA can be used to determine the risk impact of the various deterministic processes for plant design or operational changes, and the evaluation of off normal events that occurred at the plant. The presentation is divided into the following topics: Identification of issues; Tasks/element identification; Modelling changes; Data changes. 6 figs

  5. Guideline level-3 PSA

    International Nuclear Information System (INIS)

    Roelofsen, P.M.; Van der Steen, J.

    1993-09-01

    For several applications of radioactive materials calculations must be executed to determine the radiation risk for the population. A guideline for the risk calculation method of two main sources: nuclear power plants, and other intended and unintended activities with radioactive materials, is given. The standards, recommendations and regulations in this report concern mainly the analysis of the radiological (external) consequences of nuclear power plant accidents, classified as level-3 PSA (Probabilistic Safety Analysis). Level-3 PSA falls within the scales 5-7 of the International Nuclear Event Scale (INES). The standards, etc., focus on the risks for groups of people and the so-called maximum individual risk. In chapter two the standards and regulations are formulated for each part of level-3 PSA: the source term spectrum, atmospheric distribution and deposition, exposure to radiation doses and calculation of radiation doses, dose-response relationships, measures to reduce the effect of radiation doses, design basis accidents, and finally uncertainty analysis. In chapter four, modelled descriptions are given of the standards and regulations, which could or should be used in a calculation program in case of level-3 PSA. In chapter three the practical execution of a probabilistic consequences analysis, the collection of input data and the presentation of the results are dealt with. 2 figs., 14 tabs., 64 refs

  6. Babesiosis PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This 60 second PSA describes babesiosis, a preventable and treatable tickborne disease, including the signs and symptoms of infection and ways to prevent it.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/26/2012.

  7. Long-term prediction of prostate cancer diagnosis and death using PSA and obesity related anthropometrics at early middle age: data from the malmö preventive project.

    Science.gov (United States)

    Assel, Melissa J; Gerdtsson, Axel; Thorek, Daniel L J; Carlsson, Sigrid V; Malm, Johan; Scardino, Peter T; Vickers, Andrew; Lilja, Hans; Ulmert, David

    2018-01-19

    To evaluate whether anthropometric parameters add to PSA measurements in middle-aged men for risk assessment of prostate cancer (PCa) diagnosis and death. After adjusting for PSA, both BMI and weight were significantly associated with an increased risk of PCa death with the odds of a death corresponding to a 10 kg/m2 or 10 kg increase being 1.58 (95% CI 1.10, 2.28; p = 0.013) and 1.14 (95% CI 1.02, 1.26; p = 0.016) times greater, respectively. AUCs did not meaningfully increase with the addition of weight or BMI to prediction models including PSA. In 1974 to 1986, 22,444 Swedish men aged 44 to 50 enrolled in Malmö Preventive Project, Sweden, and provided blood samples and anthropometric data. Rates of PSA screening in the cohort were very low. Documentation of PCa diagnosis and disease-specific death up to 2014 was retrieved through national registries. Among men with anthropometric measurements available at baseline, a total of 1692 men diagnosed with PCa were matched to 4190 controls, and 464 men who died of disease were matched to 1390 controls. Multivariable conditional logistic regression was used to determine whether diagnosis or death from PCa were associated with weight and body mass index (BMI) at adulthood after adjusting for PSA. Men with higher BMI and weight at early middle age have an increased risk of PCa diagnosis and death after adjusting for PSA. However, in a multi-variable numerical statistical model, BMI and weight do not importantly improve the predictive accuracy of PSA. Risk-stratification of screening should be based on PSA without reference to anthropometrics.

  8. PSA in America

    International Nuclear Information System (INIS)

    Linn, M.A.; Cunningham, M.A.; Johnson, D.H.

    1996-01-01

    Although the concept of acceptable risk has always been the foundation of the nuclear industry design, the use of formal PSA (or PRA-probabilistic risk assessment) in the U.S. nuclear power industry has followed an unusual path in arriving at its current level of notability. Prior to 1975, probabilistic evaluations were limited to a few specific applications such as the evaluation of man-made (i.e., airplane crashes) and natural (i.e., earthquakes) hazards. In 1975, the industry was introduced to comprehensive PSA by the Reactor Safety Study (WASH-1400). However, the study languished in relative obscurity until the accident at Three Mile Island 2 (TMI-2) in 1979. This event significantly altered the industry's view of severe accidents in the U.S. and worldwide. Investigative committees of TMI-2 recommended that PSA techniques be more widely used to augment the traditional deterministic methods of determining nuclear plant safety. This initiated an unprecedented effort by nuclear regulators and licensees worldwide to significantly improve the state of knowledge of severe accidents at nuclear power plants. In the U.S., use of PSA began to increase as evidenced by its application in the anticipated transient without scram and station blackout rulemakings, generic issue prioritization and resolution, risk-based inspection guidelines, backfit policy, and technical specification improvements. However, broad application of probabilistic techniques to the industry as a whole was initiated in 1986 with the publication of Safety Goals for the Operation of Nuclear Power Plant; Policy Statement. This put PSA front and center in the U.S. regulatory arena by open-quotes establish[ing] goals that broadly define an acceptable level of radiological risk that might be imposed on the public as a result of nuclear power plant operation.close quotes Both qualitative safety goals and quantitative objectives were articulated in this policy statement

  9. PSA in operator training

    International Nuclear Information System (INIS)

    Nos, V.; Faig, J.; Plesa, P.; Delgado, J. L.

    2000-01-01

    The systematic approach to training is internationally accepted as the best method to achieve and maintain the qualification and competence of power plant personnel and to guarantee the quality of their training. Following the recommendations and guidelines of international organisations competent in the field, TECNATOM SA has developed projects based on the systematic approach to training for all Spanish nuclear power plants. One of the latest projects was the systematic approach to training developed for the operation personnel of ASCO Nuclear Power Plant. In this case, certain results of the Probabilistic Safety Analysis (PSA) which complement the systematic safety and reliability criteria of the systematic approach to training process have been incorporated in the traditional processes of work and task analysis and training plan design. This incorporation provides the training manager with additional criteria based not only on safety aspects obtained through the statistical treatment of considerations of skilled technical personnel (operators, operation chief supervisors, etc), but also on the independent criterion of the PSA. The inclusion of this approach basically affects all systematics in two of its stages: During the selection process of operating practices in SMR or SGI, the possible scenarios have been associated with all those situations where human actions which lead to an initiating event or human actions to mitigate an initiating event, may take place, as defined in the PSA. During the scenario development process, the instruments involved in the performance of human actions which originate or mitigate an event taking place have been identified. This pakes it possible to reconcile the scenario event sequence with the sequence considered in the PSA study, as the most likely to provoke a more serious accident. The incorporation of these PSA results contributes to the strengthening of safety aspects in training in an objective way, and confirms that

  10. Effect of adding screening ultrasonography to screening mammography on patient recall and cancer detection rates: A retrospective study in Japan

    International Nuclear Information System (INIS)

    Tohno, Eriko; Umemoto, Takeshi; Sasaki, Kyoko; Morishima, Isamu; Ueno, Ei

    2013-01-01

    Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening

  11. NPP Krsko Living PSA Concept

    International Nuclear Information System (INIS)

    Vrbanic, I.; Spiler, J.

    2000-01-01

    NPP Krsko developed PSA model of internal and external initiators within the frame of the Individual Plant Examination (IPE) project. Within this project PSA model was used to examine the existing plant design features. In order to continue with use of this PSA model upon the completion of IPE in various risk-informed applications in support of plant operation and evaluations of design changes, an appropriate living PSA concept needed to be defined. The Living PSA concept is in NPP Krsko considered as being a set of activities pursued in order to update existing PSA model in a manner that it appropriately represents the plant design, operation practice and history. Only a PSA model which is being updated in this manner can serve as a platform for plant-specific risk informed applications. The NPP Krsko living PSA concept is based on the following major ponts. First, the baseline PSA model is defined, which is to be maintained and updated and which is to be reference point for any risk-informed application. Second, issues having a potential for impact on baseline PSA model are identified and procedure and responsibilities for their permanent monitoring and evaluation are established. Third, manner is defined in which consequential changes to baseline PSA model are implemented and controlled, together with associated responsibilities. Finally, the process is defined by which the existing version of baseline PSA model is superseded by a new one. Each time a new version of baseline PSA model is released, it would be re-quantified and the results evaluated and interpreted. By documenting these re-quantifications and evaluations of results in a sequence, the track is being kept of changes in long-term averaged risk perspective, represented by long-term averaged frequencies of core damage and pre-defined release categories. These major topics of NPP Krsko living PSA concept are presented and discussed in the paper. (author)

  12. Time from first detectable PSA following radical prostatectomy to biochemical recurrence: A competing risk analysis

    Science.gov (United States)

    de Boo, Leonora; Pintilie, Melania; Yip, Paul; Baniel, Jack; Fleshner, Neil; Margel, David

    2015-01-01

    Introduction: In this study, we estimated the time from first detectable prostate-specific antigen (PSA) following radical prostatectomy (RP) to commonly used definitions of biochemical recurrence (BCR). We also identified the predictors of time to BCR. Methods: We identified subjects who underwent a RP and had an undetectable PSA after surgery followed by at least 1 detectable PSA between 2000 and 2011. The primary outcome was time to BCR (PSA ≥0.2 and successive PSA ≥0.2) and prediction of the rate of PSA rise. Outcomes were calculated using a competing risk analysis, with univariable and multivariable Fine and Grey models. We employed a mixed effect model to test clinical predictors that are associated with the rate of PSA rise. Results: The cohort included 376 patients. The median follow-up from surgery was 60.5 months (interquartile range [IQR] 40.8–91.5) and from detectable PSA was 18 months (IQR 11–32). Only 45.74% (n = 172) had PSA values ≥0.2 ng/mL, while 15.16% (n = 57) reached the PSA level of ≥0.4 ng/mL and rising. On multivariable analysis, the values of the first detectable PSA and pathologic Gleason grade 8 or higher were consistently independent predictors of time to BCR. In the mixed effect model rate, the PSA rise was associated with time from surgery to first detectable PSA, Gleason score, and prostate volume. The main limitation of this study is the large proportion of patients that received treatment without reaching BCR. It is plausible that shorter estimated median times would occur at a centre that does not use salvage therapy at such an early state. Conclusion: The time from first detectable PSA to BCR may be lengthy. Our analyses of the predictors of the rate of PSA rise can help determine a personalized approach for patients with a detectable PSA after surgery. PMID:25624961

  13. Whooping Cough PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2015-01-22

    This 30 second PSA encourages pregnant women to get the whooping cough vaccine, called Tdap, during the third trimester of each pregnancy in order to pass antibodies to their babies so they are born with protection against this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  14. Binge Drinking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-10-05

    This PSA is based on the October, 2010 CDC Vital Signs report which indicates that drinking too much, including binge drinking, causes more than 79,000 deaths in the U.S. each year and is the third leading preventable cause of death.  Created: 10/5/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/5/2010.

  15. Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer.

    Science.gov (United States)

    Nordström, Tobias; Akre, Olof; Aly, Markus; Grönberg, Henrik; Eklund, Martin

    2018-04-01

    Screening for prostate cancer using prostate-specific antigen (PSA) alone leads to un-necessary biopsying and overdiagnosis. PSA density is easily accessible, but early evidence on its use for biopsy decisions was conflicting and use of PSA density is not commonly recommended in guidelines. We analyzed biopsy outcomes in 5291 men in the population-based STHLM3 study with PSA ≥ 3 ng/ml and ultrasound-guided prostate volume measurements by using percentages and regression models. PSA density was calculated as total PSA (ng/ml) divided by prostate volume (ml). Main endpoint was clinically significant cancer (csPCa) defined as Gleason Score ≥ 7. The median PSA-density was 0.10 ng/ml 2 (IQR 0.075-0.14). PSA-density was associated with the risk of finding csPCa both with and without adjusting for the additional clinical information age, family history, previous biopsies, total PSA and free/total PSA (OR 1.06; 95% CI:1.05-1.07 and OR 1.07, 95% CI 1.06-1.08). Discrimination for csPCa was better when PSA density was added to a model with additional clinical information (AUC 0.75 vs. 0.73, P PSA-density. Omitting prostate biopsy for men with PSA-density ≤0.07 ng/ml 2 would save 19.7% of biopsy procedures, while missing 6.9% of csPCa. PSA-density cutoffs of 0.10 ng/ml 2 and 0.15 ng/ml 2 resulted in detection of 77% (729/947) and 49% (461/947) of Gleason Score ≥7 tumors. PSA-density might inform biopsy decisions, and spare some men from the morbidity associated with a prostate biopsy and diagnosis of low-grade prostate cancer.

  16. PSA results and trends for Spain's NPPs

    International Nuclear Information System (INIS)

    Carretero, J.A.

    1993-01-01

    The Spain regulatory authority CSN demanded performance of PSA for all Spain nuclear power plants. The specific data analysis carried out as a part of the PSA has contributed to the realistic view on the results which could be achieved by the PSA. The main characteristics of the PSA in Spain and PSA trends in the development are presented in the paper

  17. Implementation guidelines for seismic PSA

    International Nuclear Information System (INIS)

    Coman, Ovidiu; Samaddar, Sujit; Hibino, Kenta; )

    2014-01-01

    The presentation was devoted to development of guidelines for implementation of a seismic PSA. If successful, these guidelines can close an important gap. ASME/ANS PRA standards and the related IAEA Safety Guide (IAEA NS-G-2.13) describe capability requirements for seismic PSA in order to support risk-informed applications. However, practical guidance on how to meet these requirements is limited. Such guidelines could significantly contribute to improving risk-informed safety demonstration, safety management and decision making. Extensions of this effort to further PSA areas, particularly to PSA for other external hazards, can enhance risk-informed applications

  18. PSA Update Procedures, an Ultimate Need for Living PSA

    International Nuclear Information System (INIS)

    Hegedus, D.

    1998-01-01

    Nuclear facilities by their complex nature, change with time. These changes can be both physical (plant modification, etc.), operational (enhanced procedures, etc.) and organizational. In addition, there are also changes in our understanding of the plant, due to operational experience, data collection, technology enhancements, etc. Therefore, it is imperative that PSA model must be frequently up-dated or modified to reflect these changes. Over the last ten years. these has been a remarkable growth of the use of Probabilistic Safety Assessments (PSAs). The most rapidly growing area of the PSA Applications is their use to support operational decision-making. Many of these applications are characterized by the potential for not only improving the safety level but also for providing guidance on the optimal use of resources and reducing regulatory burden. To enable a wider use of the PSA model as a tool for safety activities it is essential to maintain the model in a controlled state. Moreover, to fulfill requirements for L iving PSA , the PSA model has to be constantly updated and/or monitored to reflect the current plant configuration. It should be noted that the PSA model should not only represent the plant design but should also represent the operational and emergency procedures. To keep the PSA model up-to-date several issues should be clearly defined including: - Responsibility should be divided among the PSA group, - Procedures for implementing changes should be established, and - QA requirements/program should be established to assure documentation and reporting. (author)

  19. Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

    Directory of Open Access Journals (Sweden)

    Boris V Schmid

    Full Text Available BACKGROUND: A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future. METHODS AND FINDINGS: We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run. CONCLUSIONS: Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level

  20. Colorectal Cancer - What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second Public Service Announcement (PSA) is based on the July, 2011 CDC Vital Signs report. Colorectal cancer kills about 50,000 men and women every year. Screening can save lives! Screening can find abnormal growths so they can be removed before turning into cancer, and can find the cancer early, when it's easiest to treat. If you're over 50, talk to your doctor about getting screened for colorectal cancer.

  1. Prostate-specific antigen (PSA) testing of men in UK general practice: a 10-year longitudinal cohort study.

    Science.gov (United States)

    Young, Grace J; Harrison, Sean; Turner, Emma L; Walsh, Eleanor I; Oliver, Steven E; Ben-Shlomo, Yoav; Evans, Simon; Lane, J Athene; Neal, David E; Hamdy, Freddie C; Donovan, Jenny L; Martin, Richard M; Metcalfe, Chris

    2017-10-30

    Cross-sectional studies suggest that around 6% of men undergo prostate-specific antigen (PSA) testing each year in UK general practice (GP). This longitudinal study aims to determine the cumulative testing pattern of men over a 10-year period and whether this testing can be considered equivalent to screening for prostate cancer (PCa). Patient-level data on PSA tests, biopsies and PCa diagnoses were obtained from the UK Clinical Practice Research Datalink (CPRD) for the years 2002 to 2011. The cumulative risks of PSA testing and of being diagnosed with PCa were estimated for the 10-year study period. Associations of a man's age, region and index of multiple deprivation with the cumulative risk of PSA testing and PCa diagnosis were investigated. Rates of biopsy and diagnosis, following a high test result, were compared with those from the programme of PSA testing in the Prostate Testing for Cancer and Treatment (ProtecT) study. The 10-year risk of exposure to at least one PSA test in men aged 45 to 69 years in UK GP was 39.2% (95% CI 39.0 to 39.4%). The age-specific risks ranged from 25.2% for men aged 45-49 years to 53.0% for men aged 65-69 years (p for trend PSA level ≥3, a test in UK GP was less likely to result in a biopsy (6%) and/or diagnosis of PCa (15%) compared with ProtecT study participants (85% and 34%, respectively). A high proportion of men aged 45-69 years undergo PSA tests in UK GP: 39% over a 10-year period. A high proportion of these tests appear to be for the investigation of lower urinary tract symptoms and not screening for PCa. ISRCTN20141297,NCT02044172. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Development of PSA workstation KIRAP

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Un; Han, Sang Hoon; Kim, Kil You; Yang, Jun Eon; Jeong, Won Dae; Chang, Seung Cheol; Sung, Tae Yong; Kang, Dae Il; Park, Jin Hee; Lee, Yoon Hwan; Hwang, Mi Jeong

    1997-01-01

    Advanced Research Group of Korea Atomic Energy Research Institute has been developing the Probabilistic Safety Assessment(PSA) workstation KIRAP from 1992. This report describes the recent development activities of PSA workstation KIRAP. The first is to develop and improve the methodologies for PSA quantification, that are the incorporation of fault tree modularization technique, the improvement of cut set generation method, the development of rule-based recovery, the development of methodology to solve a fault tree which has the logical loops and to handle a fault tree which has several initiators. These methodologies are incorporated in the PSA quantification software KIRAP-CUT. The second is to convert PSA modeling softwares for Windows, which have been used on the DOS environment since 1987. The developed softwares are the fault tree editor KWTREE, the event tree editor CONPAS, and Data manager KWDBMAN for event data and common cause failure (CCF) data. With the development of PSA workstation, it makes PSA modeling and PSA quantification and automation easier and faster. (author). 8 refs.

  3. Development of PSA workstation KIRAP

    International Nuclear Information System (INIS)

    Kim, Tae Un; Han, Sang Hoon; Kim, Kil You; Yang, Jun Eon; Jeong, Won Dae; Chang, Seung Cheol; Sung, Tae Yong; Kang, Dae Il; Park, Jin Hee; Lee, Yoon Hwan; Hwang, Mi Jeong.

    1997-01-01

    Advanced Research Group of Korea Atomic Energy Research Institute has been developing the Probabilistic Safety Assessment(PSA) workstation KIRAP from 1992. This report describes the recent development activities of PSA workstation KIRAP. The first is to develop and improve the methodologies for PSA quantification, that are the incorporation of fault tree modularization technique, the improvement of cut set generation method, the development of rule-based recovery, the development of methodology to solve a fault tree which has the logical loops and to handle a fault tree which has several initiators. These methodologies are incorporated in the PSA quantification software KIRAP-CUT. The second is to convert PSA modeling softwares for Windows, which have been used on the DOS environment since 1987. The developed softwares are the fault tree editor KWTREE, the event tree editor CONPAS, and Data manager KWDBMAN for event data and common cause failure (CCF) data. With the development of PSA workstation, it makes PSA modeling and PSA quantification and automation easier and faster. (author). 8 refs

  4. Detection of prostate cancer with complexed PSA and complexed/total PSA ratio - is there any advantage?

    OpenAIRE

    Strittmatter, F; Stieber, P; Nagel, D; Füllhase, C; Walther, S; Stief, CG; Waidelich, R

    2011-01-01

    Abstract Objective To evaluate the performance of total PSA (tPSA), the free/total PSA ratio (f/tPSA), complexed PSA (cPSA) and the complexed/total PSA ratio (c/tPSA) in prostate cancer detection. Methods Frozen sera of 442 patients have been analysed for tPSA, free PSA (fPSA) and cPSA. 131 patients had prostate cancer and 311 patients benign prostatic hyperplasia. Results Differences in the distribution of the biomarkers were seen as follows: tPSA, cPSA and c/tPSA were significantly higher i...

  5. Primary care practice and facility quality orientation: influence on breast and cervical cancer screening rates.

    Science.gov (United States)

    Goldzweig, Caroline Lubick; Parkerton, Patricia H; Washington, Donna L; Lanto, Andrew B; Yano, Elizabeth M

    2004-04-01

    Despite the importance of early cancer detection, variation in screening rates among physicians is high. Insights into factors influencing variation can guide efforts to decrease variation and increase screening rates. To explore the association of primary care practice features and a facility's quality orientation with breast and cervical cancer screening rates. Cross-sectional study of screening rates among 144 Department of Veterans Affairs (VA) medical centers and for a national sample of women. We linked practice structure and quality improvement characteristics of individual VA medical centers from 2 national surveys (1 to primary care directors and 1 to a stratified random sample of employees) to breast and cervical cancer screening rates determined from a review of random medical records. We conducted bivariate analyses and multivariate logistic regression of primary care practice and facility features on cancer screening rates, above and below the median. While the national screening rates were high for breast (87%) and cervical cancer (90%), higher screening rates were more likely when primary care providers were consistently notified of specialty visits and when staff perceived a greater organizational commitment to quality and anticipated rewards and recognition for better performance. Organization and quality orientation of the primary care practice and its facility can enhance breast and cervical cancer screening rates. Internal recognition of quality performance and an overall commitment to quality improvement may foster improved prevention performance, with impact varying by clinical service.

  6. The correlation of PSA nadir and biochemical freedom from cancer after external beam treatment: effects of stage, grade and pretreatment PSA groupings

    International Nuclear Information System (INIS)

    Pinover, W.H.; Hanlon, A.L.; Lee, W.R.; Hanks, G.E.

    1996-01-01

    Purpose: This study demonstrates the correlation of various post-irradiation PSA nadirs with long term biochemical freedom from disease (bNED) survival in patients treated mainly with conformal external beam radiation therapy. It also shows the effects of various groupings of pretreatment (prerx) PSA level, stage, and Gleason score on the rate of achieving a favorable PSA nadir. Materials and Methods: Three hundred forty patients with known pretreatment PSA, >2 years followup treated with radiation alone (278 conformal, 62 conventional) are reported. The median followup is 41 months (range 24 to 96 mos.). Patient grouping by pretreatment PSA levels are <10 ng/ml (143 patients), 10-19.9 ng/ml (108 patients), ≥20 ng/ml (89 patients); by palpation stage are T1C,2AB (240 patients) and T2C,3,4 (100 patients); and by differentiation are Gleason 2-4 (108 patients), Gleason 5-7 (221 patients), Gleason 8-10 (11 patients). The PSA nadir response is given for all patients, and for each of the above prerx groupings. The 5 year actuarial bNED survival is determined for all patients by PSA nadir. Biochemical failure is a PSA ≥1.5 ng/ml and rising on two consecutive measures. Multivariate analysis (MVA) is performed to determine factors predictive of favorable PSA nadir response and predictive of bNED survival. Results: The PSA nadir responses and 5 year bNED survival rates are shown in the table for all patients according to PSA nadir. 66% of patients achieved a favorable nadir (<1.0 ng/ml) which was associated with a 75%-87% 5 year bNED rate, while 34% achieved an unfavorable nadir associated with an 18-32% bNED survival rate at 5 years. The figure illustrates the dramatic separation in outcome associated with the nadir response. The table also illustrates the fraction of patients that achieve various nadir levels subdivided by prerx PSA level, palpation stage and Gleason score. A favorable PSA nadir is obtained in 90%, 63%, and 31% of patients with a prerx PSA <10, 10

  7. Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening.

    Science.gov (United States)

    Strech, Daniel

    2014-03-01

    Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Guidance for Decision Making based on Extended PSA. Volume 1 - Summary report

    International Nuclear Information System (INIS)

    Loeffler, H.; Kumar, M.; Raimond, E.

    2016-01-01

    This report of ASAMPSA-E project is a summary report of the WP30 activities which were intended to develop guidance on decision-making process based on extended PSA results, when the PSA scope has been extended to all sources of radioactivity, all internal and relevant external events. It summarizes the ASAMPSA-E recommendations on: - the lessons of Fukushima Dai-ichi accident for PSA, - the risk metrics, - the method for identifying Initiating Events and Hazards for an Extended PSA (screening), - the link between extended PSA and the defense-in-depth concept. The report then provides some general considerations on application of extended PSA results, criteria that can be applied and also some difficulties inherent to the status of extended PSAs. (authors)

  9. Clinical diagnostic value of combined determination of serum tPSA, cPSA and IGF-I levels in patients with prostatic disorders

    International Nuclear Information System (INIS)

    Zhang Bashan; Zhang Zigang; Lai Fudi

    2008-01-01

    Objective: To investigate the diagnostic value of combined determination of serum total prostatic specific antigen (tPSA), complex prostatic specific antigen (cPSA) and IGF-I levels in patients with prostatic disorders. Methods: Serum tPSA, cPSA (with CLIA) and IGF-I (with IRMA) levels were determined in 41 patients with prostatic carcinoma, 60 patients with benign prosta- tic hypertrophy (BPH) and 55 controls. Results: The serum tPSA, cPSA and IGF-I levels in patients with prostatic cancer were significantly higher than those in patients with BPH and controls (P<0.01). Taking the cut-off values of 4ng/ml, 3.6ng/ml and 150 for tPSA, cPSA and IGF-I respectively, the combined determination of these three items would yield a sensitivity of 88.6%, specificity of 84.9%, positive predicative value of 83% and negative predicative value of 90.0% for diagnosis of prostatic cancer. Conclusion: Combined determination of tPSA, cPSA and IGF-I would yield better sensitive and accurate diagnostic rate in patients with prostatic cancer, especially in those with laboratory values within the 'grey zone'. (authors)

  10. Impact of a Metabolic Screening Bundle on Rates of Screening for Metabolic Syndrome in a Psychiatry Resident Outpatient Clinic

    Science.gov (United States)

    Wiechers, Ilse R.; Viron, Mark; Stoklosa, Joseph; Freudenreich, Oliver; Henderson, David C.; Weiss, Anthony

    2012-01-01

    Objective: Although it is widely acknowledged that second-generation antipsychotics are associated with cardiometabolic side effects, rates of metabolic screening have remained low. The authors created a quality-improvement (QI) intervention in an academic medical center outpatient psychiatry resident clinic with the aim of improving rates of…

  11. Cell viability and PSA secretion assays in LNCaP cells: a tiered in vitro approach to screen chemicals with a prostate-mediated effect on male reproduction within the ReProTect project.

    Science.gov (United States)

    Lorenzetti, Stefano; Marcoccia, Daniele; Narciso, Laura; Mantovani, Alberto

    2010-08-01

    Prostate function is critical for male fertility; nevertheless, prostate was so far overlooked in reproductive toxicity assays. Within the EU project ReProTect, the human prostate cell line LNCaP was utilized to identify molecules targeting prostate function by the integrated assessment of cell viability (MTS assay) and prostate-specific antigen (PSA) secretion as specific marker; a training set - five (anti)androgenic chemicals - and a ReProTect feasibility set - ten chemicals - were used. Several compounds reduced PSA only at cytotoxic concentrations. Androgens (DHT, MT) markedly increased PSA as did the herbicide glufosinate ammonium, not known as androgen agonist. Anti-androgens (2OH-flutamide, linuron, vinclozolin, di-n-butyl phthalate) also increased PSA, but the effect of magnitude was much lower than for androgens. The ER-binder bisphenol A reduced PSA, while increasing cell viability. At this stage, the approach can identify chemicals able to interfere with prostate function: further refinements may allow to include prostate effects in reproductive toxicity in vitro testing. Copyright 2010 Elsevier Inc. All rights reserved.

  12. Geographic variation and effect of area-level poverty rate on colorectal cancer screening

    Directory of Open Access Journals (Sweden)

    Schootman Mario

    2008-10-01

    Full Text Available Abstract Background With a secular trend of increasing colorectal cancer (CRC screening, concerns about disparities in CRC screening also have been rising. It is unclear if CRC screening varies geographically, if area-level poverty rate affects CRC screening, and if individual-level characteristics mediate the area-level effects on CRC screening. Methods Using 2006 Missouri Behavioral Risk Factor Surveillance System (BRFSS data, a multilevel study was conducted to examine geographic variation and the effect of area-level poverty rate on CRC screening use among persons age 50 or older. Individuals were nested within ZIP codes (ZIP5 areas, which in turn, were nested within aggregations of ZIP codes (ZIP3 areas. Six groups of individual-level covariates were considered as potential mediators. Results An estimated 51.8% of Missourians aged 50 or older adhered to CRC screening recommendations. Nearly 15% of the total variation in CRC screening lay between ZIP5 areas. Persons residing in ZIP5 areas with ≥ 10% of poverty rate had lower odds of CRC screening use than those residing in ZIP5 areas with Conclusion Large geographic variation of CRC screening exists in Missouri. Area-level poverty rate, independent of individual-level characteristics, is a significant predictor of CRC screening, but it only explains a small portion of the geographic heterogeneity of CRC screening. Individual-level factors we examined do not mediate the effect of the area-level poverty rate on CRC screening. Future studies should identify other area- and individual-level characteristics associated with CRC screening in Missouri.

  13. Geographic variation and effect of area-level poverty rate on colorectal cancer screening.

    Science.gov (United States)

    Lian, Min; Schootman, Mario; Yun, Shumei

    2008-10-16

    With a secular trend of increasing colorectal cancer (CRC) screening, concerns about disparities in CRC screening also have been rising. It is unclear if CRC screening varies geographically, if area-level poverty rate affects CRC screening, and if individual-level characteristics mediate the area-level effects on CRC screening. Using 2006 Missouri Behavioral Risk Factor Surveillance System (BRFSS) data, a multilevel study was conducted to examine geographic variation and the effect of area-level poverty rate on CRC screening use among persons age 50 or older. Individuals were nested within ZIP codes (ZIP5 areas), which in turn, were nested within aggregations of ZIP codes (ZIP3 areas). Six groups of individual-level covariates were considered as potential mediators. An estimated 51.8% of Missourians aged 50 or older adhered to CRC screening recommendations. Nearly 15% of the total variation in CRC screening lay between ZIP5 areas. Persons residing in ZIP5 areas with > or = 10% of poverty rate had lower odds of CRC screening use than those residing in ZIP5 areas with poverty rate (unadjusted odds ratio [OR], 0.69; 95% confidence interval [95% CI], 0.58-0.81; adjusted OR, 0.81; 95% CI, 0.67-0.98). Persons who resided in ZIP3 areas with > or = 20% poverty rate also had lower odds of following CRC screening guidelines than those residing in ZIP3 areas with poverty rate (unadjusted OR, 0.66; 95% CI, 0.52-0.83; adjusted OR, 0.64; 95% CI, 0.50-0.83). Obesity, history of depression/anxiety and access to care were associated with CRC screening, but did not mediate the effect of area-level poverty on CRC screening. Large geographic variation of CRC screening exists in Missouri. Area-level poverty rate, independent of individual-level characteristics, is a significant predictor of CRC screening, but it only explains a small portion of the geographic heterogeneity of CRC screening. Individual-level factors we examined do not mediate the effect of the area-level poverty rate on

  14. Blackpool: More evidence on PSA

    International Nuclear Information System (INIS)

    Cullingford, M.

    1985-01-01

    PSA is spreading widely throughout the world, with 30 IAEA Member States having active programmes in this area. The main reason for its popularity is that it offers insights critical in the safety decision-making process available from no other method. It allows power plant designers, regulators, and operators to discriminate between issues important to safety and those which are trivial. Although it is beneficial to perform a PSA to utilize the potential products available from such a study, it is especially important to realize that the PSA process itself is a valuable experience. The main points such as potential users of PSA, safety evaluations, treatment of uncertainties as well as future trends are briefly discussed in this paper

  15. Development of a PSA information database system

    International Nuclear Information System (INIS)

    Kim, Seung Hwan

    2005-01-01

    The need to develop the PSA information database for performing a PSA has been growing rapidly. For example, performing a PSA requires a lot of data to analyze, to evaluate the risk, to trace the process of results and to verify the results. PSA information database is a system that stores all PSA related information into the database and file system with cross links to jump to the physical documents whenever they are needed. Korea Atomic Energy Research Institute is developing a PSA information database system, AIMS (Advanced Information Management System for PSA). The objective is to integrate and computerize all the distributed information of a PSA into a system and to enhance the accessibility to PSA information for all PSA related activities. This paper describes how we implemented such a database centered application in the view of two areas, database design and data (document) service

  16. Evaluation of PSA-age volume score in predicting prostate cancer in Chinese populationArticle Subject.

    Science.gov (United States)

    Wu, Yi-Shuo; Wu, Xiao-Bo; Zhang, Ning; Jiang, Guang-Liang; Yu, Yang; Tong, Shi-Jun; Jiang, Hao-Wen; Mao, Shan-Hua; Na, Rong; Ding, Qiang

    2018-02-06

    This study was performed to evaluate prostate-specific antigen-age volume (PSA-AV) scores in predicting prostate cancer (PCa) in a Chinese biopsy population. A total of 2355 men who underwent initial prostate biopsy from January 2006 to November 2015 in Huashan Hospital were recruited in the current study. The PSA-AV scores were calculated and assessed together with PSA and PSA density (PSAD) retrospectively. Among 2133 patients included in the analysis, 947 (44.4%) were diagnosed with PCa. The mean age, PSA, and positive rates of digital rectal examination result and transrectal ultrasound result were statistically higher in men diagnosed with PCa (all P PSA-AV were 0.864 and 0.851, respectively, in predicting PCa in the entire population, both performed better than PSA (AUC = 0.805; P PSA-AV was more obvious in subgroup with PSA ranging from 2.0 ng ml-1 to 20.0 ng ml-1. A PSA-AV score of 400 had a sensitivity and specificity of 93.7% and 40.0%, respectively. In conclusion, the PSA-AV score performed equally with PSAD and was better than PSA in predicting PCa. This indicated that PSA-AV score could be a useful tool for predicting PCa in Chinese population.

  17. Hepatitis A and B screening and vaccination rates among patients with chronic liver disease.

    Science.gov (United States)

    Ramirez, Jonathan C; Ackerman, Kimberly; Strain, Sasha C; Ahmed, Syed T; de Los Santos, Mario J; Sears, Dawn

    2016-01-01

    Vaccinations against hepatitis A virus (HAV) and hepatitis B virus (HBV) are recommended for patients with chronic liver disease (CLD), yet implementation of these recommendations is lacking. This study reviewed HAV and HBV antibody testing and vaccination status of patients with CLD. In 2008, we began using pre-printed liver order sets, which included vaccination options. We compared Scott & White liver clinic CLD patient records from 2005 (238) with patient records from 2008 (792). Screening rates for immunity and vaccination rates of those lacking immunity were calculated. In 2005, 66% of CLD patients were screened for HAV immunity. In 2008, 56% of CLD patients were screened. The HAV vaccination completion rate was 37% in 2005, while in 2008, the rate was 46%. In 2005, 66% of CLD patients were screened for HBV immunity; in 2008, 56 % CLD patients were screened. The HBV vaccination completion rate was 26% in 2005 compared with 36% in 2008. Although there was a lower percentage of screening in 2008, the overall number of patients tripled between 2005 and 2008. There was a significant increase in the total number of patients screened and vaccinated in 2008. Some physicians may have vaccinated their patients without checking for immunity. In January 2008, we implemented pre-printed order sets with checkboxes to help remind providers to order labs to screen for immunity against HAV and HBV and to order vaccinations for those who lacked immunity. The use of these sets may have aided in the increase of vaccination completion rates.

  18. Predictors of participation in prostate cancer screening at worksites.

    Science.gov (United States)

    Weinrich, S P; Greiner, E; Reis-Starr, C; Yoon, S; Weinrich, M

    1998-01-01

    Unfortunately, African American men have a higher incidence of and a higher mortality rate for prostate cancer than White men but are less likely to participate in prostate cancer screening. This correlational survey research identifies predictors for participation in a free prostate cancer screening in 179 men, 64% of whom are African American. Each man was invited to see his personal physician for a free prostate cancer screening following a prostate cancer educational program given at his worksite. Forty-seven percent of the African American men went to their personal physician following the educational program and received a digital rectal examination (DRE) and a prostate specific antigen (PSA) screening. In the original cohort of educational program attendees, only 16% of the African Americans had obtained a DRE in the previous 12 months. However, 44% subsequently did participate in free DRE screening. Similarly, only 6% of the African American men had received a PSA screening in the previous 12 months, yet 42% obtained a PSA screening after the educational program, a sevenfold increase. Implications for allocating limited resources for education and screening to the high-risk group of African American men are discussed. This study's model of a prostate cancer educational program at worksites followed by attendees visiting their personal physician for screening could be replicated throughout the United States to increase African American men's participation in prostate cancer screening.

  19. Survey of Dynamic PSA Methodologies

    International Nuclear Information System (INIS)

    Lee, Hansul; Kim, Hyeonmin; Heo, Gyunyoung; Kim, Taewan

    2015-01-01

    Event Tree(ET)/Fault Tree(FT) are significant methodology in Probabilistic Safety Assessment(PSA) for Nuclear Power Plants(NPPs). ET/FT methodology has the advantage for users to be able to easily learn and model. It enables better communication between engineers engaged in the same field. However, conventional methodologies are difficult to cope with the dynamic behavior (e.g. operation mode changes or sequence-dependent failure) and integrated situation of mechanical failure and human errors. Meanwhile, new possibilities are coming for the improved PSA by virtue of the dramatic development on digital hardware, software, information technology, and data analysis.. More specifically, the computing environment has been greatly improved with being compared to the past, so we are able to conduct risk analysis with the large amount of data actually available. One method which can take the technological advantages aforementioned should be the dynamic PSA such that conventional ET/FT can have time- and condition-dependent behaviors in accident scenarios. In this paper, we investigated the various enabling techniques for the dynamic PSA. Even though its history and academic achievement was great, it seems less interesting from industrial and regulatory viewpoint. Authors expect this can contribute to better understanding of dynamic PSA in terms of algorithm, practice, and applicability. In paper, the overview for the dynamic PSA was conducted. Most of methodologies share similar concepts. Among them, DDET seems a backbone for most of methodologies since it can be applied to large problems. The common characteristics sharing the concept of DDET are as follows: • Both deterministic and stochastic approaches • Improves the identification of PSA success criteria • Helps to limit detrimental effects of sequence binning (normally adopted in PSA) • Helps to avoid defining non-optimal success criteria that may distort the risk • Framework for comprehensively considering

  20. Survey of Dynamic PSA Methodologies

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hansul; Kim, Hyeonmin; Heo, Gyunyoung [Kyung Hee University, Yongin (Korea, Republic of); Kim, Taewan [KEPCO International Nuclear Graduate School, Ulsan (Korea, Republic of)

    2015-05-15

    Event Tree(ET)/Fault Tree(FT) are significant methodology in Probabilistic Safety Assessment(PSA) for Nuclear Power Plants(NPPs). ET/FT methodology has the advantage for users to be able to easily learn and model. It enables better communication between engineers engaged in the same field. However, conventional methodologies are difficult to cope with the dynamic behavior (e.g. operation mode changes or sequence-dependent failure) and integrated situation of mechanical failure and human errors. Meanwhile, new possibilities are coming for the improved PSA by virtue of the dramatic development on digital hardware, software, information technology, and data analysis.. More specifically, the computing environment has been greatly improved with being compared to the past, so we are able to conduct risk analysis with the large amount of data actually available. One method which can take the technological advantages aforementioned should be the dynamic PSA such that conventional ET/FT can have time- and condition-dependent behaviors in accident scenarios. In this paper, we investigated the various enabling techniques for the dynamic PSA. Even though its history and academic achievement was great, it seems less interesting from industrial and regulatory viewpoint. Authors expect this can contribute to better understanding of dynamic PSA in terms of algorithm, practice, and applicability. In paper, the overview for the dynamic PSA was conducted. Most of methodologies share similar concepts. Among them, DDET seems a backbone for most of methodologies since it can be applied to large problems. The common characteristics sharing the concept of DDET are as follows: • Both deterministic and stochastic approaches • Improves the identification of PSA success criteria • Helps to limit detrimental effects of sequence binning (normally adopted in PSA) • Helps to avoid defining non-optimal success criteria that may distort the risk • Framework for comprehensively considering

  1. PSA kinetics following primary focal cryotherapy (hemiablation) in organ-confined prostate cancer patients.

    Science.gov (United States)

    Kongnyuy, Michael; Islam, Shahidul; Mbah, Alfred K; Halpern, Daniel M; Werneburg, Glenn T; Kosinski, Kaitlin E; Chen, Connie; Habibian, David J; Schiff, Jeffrey T; Corcoran, Anthony T; Katz, Aaron E

    2018-02-01

    We aim to evaluate prostate-specific antigen (PSA) trends in post-primary focal cryotherapy (PFC) patients. This was an institutional review board-approved retrospective study of PFC patients from 2010 to 2015. Patients with at least one post-PFC PSA were included in the study. Biochemical recurrence (BCR) was determined using the Phoenix criteria. PSA bounce was also assessed. We analyzed rates of change of PSA over time of post-PFC between BCR and no BCR groups. PSA-derived variables were analyzed as potential predictors of BCR. A total of 104 PFC patients were included in our analysis. Median (range) age and follow-up time were 66 (48-82) years and 19 (6.3-38.6) months, respectively. Four (3.8%) patients experienced PSA bounce. The median percent drop in first post-PFC PSA of 80.0% was not associated with BCR (p = 0.256) and may indicate elimination of the index lesion. The rate of increase of PSA in BCR patients was significantly higher compared to patients who did not recur (median PSA velocity (PSAV): 0.15 vs 0.04 ng/ml/month, p = 0.001). Similar to PSAV (HR 9.570, 95% CI 3.725-24.592, p PSA nadir ≥ 2 ng/ml [HR (hazard ratio) 1.251, 95% CI 1.100-1.422, p = 0.001] was independently associated with BCR. A significant drop in post-PFC PSA may indicate elimination of the index lesion. Patients who are likely to recur biochemically have a significantly higher PSAV compared to those who do not recur. Nadir PSA of less than 2 ng/ml may be considered the new normal PSA in focal cryotherapy (hemiablation) follow-up.

  2. Accessibility and screening uptake rates for gestational diabetes mellitus in Ireland.

    LENUS (Irish Health Repository)

    Cullinan, John

    2012-03-01

    Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with a range of maternal and neonatal complications and conditions. Given increasing levels of prevalence worldwide, there are growing calls for the implementation of screening practices to identify and treat positive GDM cases. This paper uses a unique dataset to investigate the role of healthcare centre accessibility on the decision to attend for screening, employing geographic information systems, econometric and simulation techniques. We focus on the extent to which \\'travel distance to screening hospital site\\' impacts upon the individual\\'s screen uptake decision, whether significant geographic inequalities exist in relation to accessibility to screening, and the likely impact on uptake rates of providing screening services at a local level via primary care. Our findings have important implications for the provision of GDM screening services.

  3. Rates of Cervical Cancer Screening Among Women With Severe Mental Illness in the Public Health System.

    Science.gov (United States)

    James, Monique; Thomas, Melanie; Frolov, Latoya; Riano, Nicholas S; Vittinghoff, Eric; Schillinger, Dean; Newcomer, John W; Mangurian, Christina

    2017-08-01

    This study aimed to determine cervical cancer screening rates among women with severe mental illness. California Medicaid administrative records (2010-2011) for 31,308 women with severe mental illness were examined. Participants received specialty mental health services and were not dually eligible for Medicare. Poisson models assessed association between selected predictors and cervical cancer screening. Overall, 20.2% of women with severe mental illness received cervical cancer screening during the one-year period. Compared with white women, Asian women (adjusted risk ratio [ARR]=1.23), black women (ARR=1.10), and Hispanic women (ARR=1.11) (pWomen ages 28-37 were more likely than those ages 18-27 to have been screened (ARR=1.31, phealth care use was the strongest predictor of screening (ARR=3.07, pwomen in the sample were not regularly screened for cervical cancer. Cervical cancer screening for this high-risk population should be prioritized.

  4. NRC regulatory uses of PSA

    International Nuclear Information System (INIS)

    Murley, T.E.

    1991-01-01

    The publication in 1975 of WASH-1400, with its new probabilistic safety assessment (PSA) methodology, had the effect of presenting a pair of eyeglasses to a man with poor eyesight. Suddenly, it gave us a view of nuclear safety with a new clarity, and it allowed us to sort out the important safety issues from the unimportant. In the intervening years, PSA insights have permeated the fabric of nearly all our safety judgments. This acceptance can be seen from the following list of broad areas where the Nuclear Regulatory Commission (NRC) staff uses PSA insights and methodology: evaluating the safety significance of operating events and recommending safety improvements where warranted; requesting licensees to systematically look for design vulnerabilities in each operating reactor; evaluating the safety significance of design weaknesses or non-compliances when judging the time frame for necessary improvements; conducting sensitivity analyses to judge where safety improvements are most effective; assessing the relative safety benefits of design features for future reactors. In judging where PSA methodology can be improved to give better safety insights, it is believed that the following areas need more attention: better modeling of cognitive errors; more comprehensive modeling of accident sequences initiated from conditions other than full power; more comprehensive modeling of inter-system loss of coolant accident (ISLOCA) sequences. Although PSA is widely used in the staff's regulatory activities, the NRC deliberately chooses not to include probabilistic prescriptions in regulations or guidance documents. The staff finds the bottom line risk estimates to be one of the least reliable products of a PSA. The reason for this view is that PSA cannot adequately address cognitive errors nor assess the effects of a pervasive poor safety attitude

  5. Independent screening for single-index hazard rate models with ultrahigh dimensional features

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Scheike, Thomas

    2013-01-01

    can be viewed as the natural survival equivalent of correlation screening. We state conditions under which the method admits the sure screening property within a class of single-index hazard rate models with ultrahigh dimensional features and describe the generally detrimental effect of censoring...

  6. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jonah Musa

    Full Text Available Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally.The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS rates compared to control conditions in eligible women population at risk of cervical cancer.We used the PICO (Problem or Population, Interventions, Comparison and Outcome framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO. The protocol registration number is CRD42016045605 available at: http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA. We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I2 was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot.Out of 3072 study reports screened, 28 articles were found to

  7. Introducing Bayesian thinking to high-throughput screening for false-negative rate estimation.

    Science.gov (United States)

    Wei, Xin; Gao, Lin; Zhang, Xiaolei; Qian, Hong; Rowan, Karen; Mark, David; Peng, Zhengwei; Huang, Kuo-Sen

    2013-10-01

    High-throughput screening (HTS) has been widely used to identify active compounds (hits) that bind to biological targets. Because of cost concerns, the comprehensive screening of millions of compounds is typically conducted without replication. Real hits that fail to exhibit measurable activity in the primary screen due to random experimental errors will be lost as false-negatives. Conceivably, the projected false-negative rate is a parameter that reflects screening quality. Furthermore, it can be used to guide the selection of optimal numbers of compounds for hit confirmation. Therefore, a method that predicts false-negative rates from the primary screening data is extremely valuable. In this article, we describe the implementation of a pilot screen on a representative fraction (1%) of the screening library in order to obtain information about assay variability as well as a preliminary hit activity distribution profile. Using this training data set, we then developed an algorithm based on Bayesian logic and Monte Carlo simulation to estimate the number of true active compounds and potential missed hits from the full library screen. We have applied this strategy to five screening projects. The results demonstrate that this method produces useful predictions on the numbers of false negatives.

  8. Prostate Cancer Screening Efficacy in African-Americans Using Case-Control Methodology

    National Research Council Canada - National Science Library

    Godley, Paul

    1999-01-01

    ...-control study of PSA screening for prostate cancer in African Americans. The lack of symptoms documented in the patient's medical record was to be used as evidence that PSA was intended as a screening examination...

  9. Opportunistic mammography screening provides effective detection rates in a limited resource healthcare system.

    Science.gov (United States)

    Teh, Yew-Ching; Tan, Gie-Hooi; Taib, Nur Aishah; Rahmat, Kartini; Westerhout, Caroline Judy; Fadzli, Farhana; See, Mee-Hoong; Jamaris, Suniza; Yip, Cheng-Har

    2015-05-15

    Breast cancer is the leading cause of cancer deaths in women world-wide. In low and middle income countries, where there are no population-based mammographic screening programmes, late presentation is common, and because of inadequate access to optimal treatment, survival rates are poor. Mammographic screening is well-studied in high-income countries in western populations, and because it has been shown to reduce breast cancer mortality, it has become part of the healthcare systems in such countries. However the performance of mammographic screening in a developing country is largely unknown. This study aims to evaluate the performance of mammographic screening in Malaysia, a middle income country, and to compare the stage and surgical treatment of screen-detected and symptomatic breast cancer. A retrospective review of 2510 mammograms performed from Jan to Dec 2010 in a tertiary medical centre is carried out. The three groups identified are the routine (opportunistic) screening group, the targeted (high risk) screening group and the diagnostic group. The performance indicators of each group is calculated, and stage at presentation and treatment between the screening and diagnostic group is analyzed. The cancer detection rate in the opportunistic screening group, targeted screening group, and the symptomatic group is 0.5 %, 1.25 % and 26 % respectively. The proportion of ductal carcinoma in situ is 23.1 % in the two screening groups compared to only 2.5 % in the diagnostic group. Among the opportunistic screening group, the cancer detection rate was 0.2 % in women below 50 years old compared to 0.65 % in women 50 years and above. The performance indicators are within international standards. Early-staged breast cancer (Stage 0-2) were 84.6 % in the screening groups compared to 61.1 % in the diagnostic group. From the results, in a setting with resource constraints, targeted screening of high risk individuals will give a higher yield, and if more resources are

  10. Cost Effectiveness of Screening Colonoscopy Depends on Adequate Bowel Preparation Rates - A Modeling Study.

    Directory of Open Access Journals (Sweden)

    James Kingsley

    Full Text Available Inadequate bowel preparation during screening colonoscopy necessitates repeating colonoscopy. Studies suggest inadequate bowel preparation rates of 20-60%. This increases the cost of colonoscopy for our society.The aim of this study is to determine the impact of inadequate bowel preparation rate on the cost effectiveness of colonoscopy compared to other screening strategies for colorectal cancer (CRC.A microsimulation model of CRC screening strategies for the general population at average risk for CRC. The strategies include fecal immunochemistry test (FIT every year, colonoscopy every ten years, sigmoidoscopy every five years, or stool DNA test every 3 years. The screening could be performed at private practice offices, outpatient hospitals, and ambulatory surgical centers.At the current assumed inadequate bowel preparation rate of 25%, the cost of colonoscopy as a screening strategy is above society's willingness to pay (<$50,000/QALY. Threshold analysis demonstrated that an inadequate bowel preparation rate of 13% or less is necessary before colonoscopy is considered more cost effective than FIT. At inadequate bowel preparation rates of 25%, colonoscopy is still more cost effective compared to sigmoidoscopy and stool DNA test. Sensitivity analysis of all inputs adjusted by ±10% showed incremental cost effectiveness ratio values were influenced most by the specificity, adherence, and sensitivity of FIT and colonoscopy.Screening colonoscopy is not a cost effective strategy when compared with fecal immunochemical test, as long as the inadequate bowel preparation rate is greater than 13%.

  11. What do PSA changes after radiotherapy with or without prior androgen deprivation mean?

    International Nuclear Information System (INIS)

    Denham, J.W.; Woodhead, D.; Lamb, D.S.; Duchesne, G.

    2003-01-01

    The TROG 96.01 randomised patients with Stage B2 and C prostate cancer to radiotherapy alone to 66 Gy (RT), 3 months maximal androgen deprivation (MAD) with goserelin and flutamide prior to and during RT, and 6 months MAD prior to and during RT. Minimum follow up time is now 3 years. Prior to preliminary analysis of one of the trial's main endpoints biochemical relapse free survival (bRFS), the prostate-specific antigen (PSA) time course for every patient was evaluated to assess the performance of the ASTRO definition of biochemical failure (BF). Following MAD and RT PSA levels immediately rise in the majority of cases (PSA 'rebound'). In over 50% of cases, PSA levels then plateau at <1 ng/ml for 2 - 3 years prior to clear evidence of failure. Premature diagnosis of BF is possible in some of these cases. Fluctuations in PSA level ('bouncing') are more frequent after MAD and RT. As a result there can be difficulty in interpreting the ASTRO definition of BF in cases where overall PSA trend is upwards shortly after completion of therapy. In patients experiencing BF, the rate of PSA rise often corresponds to the site of failure. PSA doubling times (DT) under 7 months are usually associated with development of bony metastases, while DTs greater than that are usually associated with local failure. Decline in PSA levels following RT alone is frequently not mono-exponential and patients with those patterns experience lower PSA nadir levels and are subject to lower risks of all forms of relapse. These patients also survive longer. In cases where PSA descent patterns are discernable after MAD and RT, opposite trends are seen. Caution is necessary in diagnosing BF after MAD plus RT. Variations in the natural history of prostate cancer are reflected by variations in the rate of PSA changes following therapy. The importance of monitoring this marker and evaluating its time course is emphasised. Prospective studies are needed

  12. Detection rate of prostate cancer using prostate specific antigen in patients presenting with lower urinary tract symptoms: A retrospective study

    Directory of Open Access Journals (Sweden)

    Chavan P

    2009-01-01

    Full Text Available Background: Need for undertaking prostate biopsies for detection of prostate cancer is often decided on the basis of serum levels of prostate specific antigen (PSA. Aim: To evaluate the case detection rate of prostate cancer among patients presenting with lower urinary tract symptoms (LUTS on the basis of PSA levels and to assess the scope of prostate biopsy in these patients. Setting and Design: A retrospective study from a tertiary care center. Materials and Methods: The clinical and histopathological data of 922 patients presenting with LUTS in the last five years was obtained from the medical record section. They had been screened for prostate cancer using PSA and /or digital rectal examination examination followed by confirmation with prostate biopsy. Statistical Analysis Used: Detection rate and receiver operating characteristic curve were performed using SPSS 16 and Medcalc softwares. Results: The detection rate of prostate cancer according to the PSA levels was 0.6%, 2.3%, 2.5%, 34.1% and 54.9% in the PSA range of 0-4, 4-10, 10-20, 20-50 and> 50 ng/ml, respectively. Maximum prostate cancer cases were detected beyond a PSA value of 20 ng/ml whereas no significant difference in the detection rate was observed in the PSA range of 0-4, 4-10 and 10-20 ng/ml. Conclusion: A low detection rate of prostate cancer observed in the PSA range of 4-20 ng/ml in LUTS patients indicates the need for use of higher cutoff values of PSA in such cases. Therefore we recommend a cutoff of 20 ng/ml of PSA for evaluation of detection rate of prostate cancer among patients presenting with LUTS.

  13. Celebrity endorsements of cancer screening.

    Science.gov (United States)

    Larson, Robin J; Woloshin, Steven; Schwartz, Lisa M; Welch, H Gilbert

    2005-05-04

    Celebrities often promote cancer screening by relating personal anecdotes about their own diagnosis or that of a loved one. We used data obtained from a random-digit dialing survey conducted in the United States from December 2001 through July 2002 to examine the extent to which adults of screening age without a history of cancer had seen or heard or been influenced by celebrity endorsements of screening mammography, prostate-specific antigen (PSA) testing, or sigmoidoscopy or colonoscopy. The survey response rate was 72% among those known to be eligible and 51% among potentially eligible people accounting for those who could not be contacted. A total of 360 women aged 40 years or older and 140 men aged 50 years or older participated in the survey. Most respondents reported they "had seen or heard a celebrity talk about" mammography (73% of women aged 40 years or older), PSA testing (63% of men aged 50 years or older), or sigmoidoscopy or colonoscopy (52% of adults aged 50 years or older). At least one-fourth of respondents who had seen or heard a celebrity endorsement said that the endorsement made them more likely to undergo mammography (25%), PSA testing (31%), or sigmoidoscopy or colonoscopy (37%).

  14. Contribution of screening and survival differences to racial disparities in colorectal cancer rates

    Science.gov (United States)

    Lansdorp-Vogelaar, Iris; Kuntz, Karen M.; Knudsen, Amy B.; van Ballegooijen, Marjolein; Zauber, Ann G.; Jemal, Ahmedin

    2012-01-01

    Background Considerable disparities exist in colorectal cancer (CRC) incidence and mortality rates between blacks and whites in the US. We estimated how much of these disparities could be explained by differences in CRC screening and stage-specific relative CRC survival. Methods We used the MISCAN-Colon microsimulation model to estimate CRC incidence and mortality rates in blacks aged 50 years and older from 1975 to 2007 assuming they had: 1) the same trends in screening rates as whites instead of observed screening rates (incidence and mortality); and 2) the same trends in stage-specific relative CRC survival rates as whites instead of observed (mortality only); and 3) a combination of both. The racial disparities in CRC incidence and mortality rates attributable to differences in screening and/or stage-specific relative CRC survival were then calculated by comparing rates from these scenarios to the observed black rates. Results Differences in screening account for 42% of disparity in CRC incidence and 19% of disparity in CRC mortality between blacks and whites. 36% of the disparity in CRC mortality could be attributed to differences in stage-specific relative CRC survival. Together screening and survival explained a little over 50% of the disparity in CRC mortality between blacks and whites. Conclusion Differences in screening and relative CRC survival are responsible for a considerable proportion of the observed disparities in CRC incidence and mortality rates between blacks and whites. Impact Enabling blacks to achieve equal access to care as whites could substantially reduce the racial disparities in CRC burden. PMID:22514249

  15. The role of PSA in safety management

    International Nuclear Information System (INIS)

    Szikszai, T.

    1997-01-01

    The presentation discusses the following issues: defence in depth principle (the role of the barriers, how does PSA represents the barriers?); the safety management and nuclear power plants; the probabilistic and deterministic approaches; the PSA applications and safety management

  16. A trial for improving the rate of participation in breast cancer screening

    International Nuclear Information System (INIS)

    Aki, Fuminori; Ito, Sueyoshi; Kaneko, Akira; Yamakawa, Takashi; Sugimoto, Takeki

    2007-01-01

    In order to search for a good method of increasing the rate of participation in breast cancer screening, we reviewed our previous records of breast cancer screening carried out by inspection and palpation during the preceding 32-year period. Screening by mammography was started in 2004, and in the following year became employed in all districts of Kochi Prefecture. When mammography screening began, we hoped that the participation rate would be at least 20%, which was the level when breast cancer screening was performed by inspection and palpation. In fact, the participation rate was as high as 27.6% in the period 2004-2005, and the breast cancer detection rate was 0.38%. We think that this high participation rate was achieved through complete transition from screening by inspection and palpation to that by mammography, offering guidance to district health nurses and local government administrative staff, education of the public about the importance of breast self-palpation, and other informative activities. (author)

  17. Does screening for vaginal infection have an impact on pregnancy rates in intracytoplasmic sperm injection cycles?

    Directory of Open Access Journals (Sweden)

    Özlem Eldivan

    2016-03-01

    Full Text Available Objective: Assisted reproduction techniques have become widespread worldwide. Considering their costs, physicians endeavor to improve pregnancy rates. Infections are one of the disrupting problems in this arena. We aimed to investigate the effects of screening for vaginal infection on pregnancy rates in intracytoplasmic sperm injection cycles. Materials and Methods: One hundred twenty patients randomized into two groups for this study. Patients were screened for vaginal infections in group 1, and no screening was performed in group 2. The assisted reproduction outcomes were investigated and compared between the two groups. Results: There was no significant difference between ages, or durations and causes of infertility of patients who conceived and of those who did conceive. Forty-five patients in group 1, and 40 patients in group 2 reached the embryo transfer stage. The rates of conception were 23.5% (n=4 in culture-positive patients (n=17, and 42.9% (n=12 in culture-negative patients (n=28 in group 1. There was no significant difference among patients who were not screened, screen-positive, and screen-negative, in terms of pregnancy rates. None of the patients had Neisseria gonorrhoeae or Trichomonas vaginalis. Bacterial vaginosis was detected in 13 patients, and both bacterial vaginosis and Chlamydia trachomatis were detected in 4 patients. Three of 4 patients who conceived screen-positive and 8 of 12 patients who conceived screen-negative delivered healthily at term. Conclusion: No significant difference was found between patients who were sampled for culture and patients who were not sampled in terms of pregnancy rates. Also, no difference was found between the patients who were culture-negative and patients who were treated with antimicrobials after a culture positive result. Further larger studies are warranted to clarify this issue. PRECIS: No significant difference was found between patients who were sampled for culture and those who

  18. Development of a PSA information management system

    International Nuclear Information System (INIS)

    Ho, Seok; Dong Kyu, Kim; Sun Koo, Kang

    2007-01-01

    In general, Probabilistic Safety Agreement (PSA) is a very complicated work that uses and generates a lot of resources such as reports, procedures, drawings, assumptions, calculation sheets, PSA model, and so on. In many PSAs, however, the data, materials and knowledge considered and generated during performing PSA are scattered in many documents so that overall structure of PSA and information relationship between documents and models cannot easily be understood. To organize and manage all documents related to PSA, to capture knowledge of analysts, and finally to improve the quality of PSA, a PSA information management system (PIMS) was developed. The PIMS can manage all the documents of a PSA in a database and connect the causal relation between one information to another in the scattered documents via link. The PIMS can manage all the assumptions and technical basis used in PSA, and it can keep the record of the design changes the revision of PSA model. It can also control the review results of PSA models. The link of the PIMS can explicitly describe and reveal the expertise of the PSA analysts, and it enables the users to capture the knowledge and to understand the structure and contents of a PSA with ease. We are planning to apply the PIMS to the PSA of Shin Kori Units 1 and 2 as feasibility study and then to all the PSAs of the nuclear power plants in Korea. The PIMS is expected to contribute to enhancing the quality and confidence of PSA and reducing the efforts and costs of maintenance and update of PSA. (authors)

  19. PSA - a tool for the nuclear safety

    International Nuclear Information System (INIS)

    Himanen, R.

    1992-01-01

    The PSA-model for BWR-type reactors of Finnish power company, Teollisuuden Voima Oy (TVO) was finished in year 1989. This basic PSA model included all safety systems, normal operating systems and auxiliary systems. Today TVO is working to enlarge the PSA to level 2 (environmental effects, for the fires, for the floodings and the outages). The TVO's experiences has been showed the PSA an useful tool for the developing the safety of BWR's (orig.)

  20. Development of a PSA information management system

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Seok; Dong Kyu, Kim; Sun Koo, Kang [Korea Power Engineering Company, Inc (Korea, Republic of)

    2007-07-01

    In general, Probabilistic Safety Agreement (PSA) is a very complicated work that uses and generates a lot of resources such as reports, procedures, drawings, assumptions, calculation sheets, PSA model, and so on. In many PSAs, however, the data, materials and knowledge considered and generated during performing PSA are scattered in many documents so that overall structure of PSA and information relationship between documents and models cannot easily be understood. To organize and manage all documents related to PSA, to capture knowledge of analysts, and finally to improve the quality of PSA, a PSA information management system (PIMS) was developed. The PIMS can manage all the documents of a PSA in a database and connect the causal relation between one information to another in the scattered documents via link. The PIMS can manage all the assumptions and technical basis used in PSA, and it can keep the record of the design changes the revision of PSA model. It can also control the review results of PSA models. The link of the PIMS can explicitly describe and reveal the expertise of the PSA analysts, and it enables the users to capture the knowledge and to understand the structure and contents of a PSA with ease. We are planning to apply the PIMS to the PSA of Shin Kori Units 1 and 2 as feasibility study and then to all the PSAs of the nuclear power plants in Korea. The PIMS is expected to contribute to enhancing the quality and confidence of PSA and reducing the efforts and costs of maintenance and update of PSA. (authors)

  1. Colorectal Cancer - What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-07-05

    This 60 second Public Service Announcement (PSA) is based on the July, 2011 CDC Vital Signs report. Colorectal cancer kills about 50,000 men and women every year. Screening can save lives! Screening can find abnormal growths so they can be removed before turning into cancer, and can find the cancer early, when it's easiest to treat. If you're over 50, talk to your doctor about getting screened for colorectal cancer.  Created: 7/5/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/5/2011.

  2. Hepatitis Awareness Month PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2011-05-11

    May is National Hepatitis Awareness Month. This 30 second PSA discusses hepatitis and encourages listners to talk to their health care professional about getting tested.  Created: 5/11/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.   Date Released: 5/11/2011.

  3. World AIDS Day PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2011-11-16

    December 1 is World AIDS Day. In this PSA, communities are encouraged to get tested for HIV.  Created: 11/16/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 11/16/2011.

  4. Raccoon Roundworm Infection PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-08-27

    This 60 second PSA describes the signs and symptoms of and ways to prevent Baylisascaris infection, a parasitic roundworm infection that is spread through raccoon feces.  Created: 8/27/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/28/2012.

  5. Methods and use of PSA

    International Nuclear Information System (INIS)

    Vaurio, J.

    2005-01-01

    The objective is to introduce possible methods and methodological issues for application of PSA for decision making at nuclear power plants based on risk and cost, to present a number of application examples, and to describe recommendations and regulatory guides for risk-informed applications. (orig.)

  6. PSA bounce after 125I-brachytherapy for prostate cancer as a favorable prognosticator

    International Nuclear Information System (INIS)

    Engeler, Daniel S.; Schwab, Christoph; Schmid, Hans-Peter; Thoeni, Armin F.; Hochreiter, Werner; Prikler, Ladislav; Suter, Stefan; Stucki, Patrick; Schiefer, Johann; Plasswilm, Ludwig; Putora, Paul Martin

    2015-01-01

    Permanent low-dose-rate brachytherapy (BT) with iodine 125 is an established curative treatment for localized prostate cancer. After treatment, prostate-specific antigen (PSA) kinetics may show a transient rise (PSA bounce). Our aim was to investigate the association of PSA bounce with biochemical control. Patients treated with BT in Switzerland were registered in a prospective database. Only patients with a follow-up of at least 2 years were included in our analysis. Clinical follow-up and PSA measurements were assessed after 1.5, 3, 6, and 12 months, and annually thereafter. If PSA increased, additional follow-up visits were scheduled. Cases of PSA bounce were defined as a rise of at least 0.2 ng/ml above the initial PSA nadir with a subsequent decline to or below the initial nadir without treatment. Biochemical failure was defined as a rise to nadir + 2 ng/ml. Between March 2001 and November 2010, 713 patients with prostate cancer undergoing BT with at least 2 years of follow-up were registered. Median follow-up time was 41 months. Biochemical failure occurred in 28 patients (3.9 %). PSA bounce occurred in 173 (24.3 %) patients; only three (1.7 %) patients with PSA bounce developed biochemical failure, in contrast to 25 (4.6 %) patients without previous bounce (p < 0.05). The median time to bounce was 12 months, the median time to biochemical failure was 30 months. The median bounce increase was 0.78 ng/ml. Twenty-eight patients with bounce (16.5 %) had a transient PSA rise of + 2 ng/ml above the nadir. In most cases, an early increase in PSA after BT indicates PSA bounce and is associated with a lower risk of biochemical failure. (orig.) [de

  7. The human error rate assessment and optimizing system HEROS - a new procedure for evaluating and optimizing the man-machine interface in PSA

    International Nuclear Information System (INIS)

    Richei, A.; Hauptmanns, U.; Unger, H.

    2001-01-01

    A new procedure allowing the probabilistic evaluation and optimization of the man-machine system is presented. This procedure and the resulting expert system HEROS, which is an acronym for Human Error Rate Assessment and Optimizing System, is based on the fuzzy set theory. Most of the well-known procedures employed for the probabilistic evaluation of human factors involve the use of vague linguistic statements on performance shaping factors to select and to modify basic human error probabilities from the associated databases. This implies a large portion of subjectivity. Vague statements are expressed here in terms of fuzzy numbers or intervals which allow mathematical operations to be performed on them. A model of the man-machine system is the basis of the procedure. A fuzzy rule-based expert system was derived from ergonomic and psychological studies. Hence, it does not rely on a database, whose transferability to situations different from its origin is questionable. In this way, subjective elements are eliminated to a large extent. HEROS facilitates the importance analysis for the evaluation of human factors, which is necessary for optimizing the man-machine system. HEROS is applied to the analysis of a simple diagnosis of task of the operating personnel in a nuclear power plant

  8. Cancer of the prostate - role of PSA

    International Nuclear Information System (INIS)

    Shittu, O.B.

    1999-02-01

    Since 1979 when prostate specific antigen (PSA), found in the cytoplasm of benign and malignant prostatic cells, was first purified, it has attained world wide popularity in prostate cancer detection. It is also a sensitive test for skeletal meta states from carcinoma of the prostate. Prostate cancer has become the number one cancer in men and constitutes 11% of all cancers. Approximately 50% of men over 50 years have symptoms referable to the lower urinary tract. 50% or more of patients at Ibadan present an advanced stage of the disease and are therefore not curable. Thus, lacking the skill to manage advanced manifestations, early detection and screening programs are the best means to reduce mortality due to prostate cancer

  9. Prostate Cancer Screening

    Science.gov (United States)

    ... treat. There is no standard screening test for prostate cancer. Researchers are studying different tests to find those ... PSA level may be high if you have prostate cancer. It can also be high if you have ...

  10. Understanding recall rates in screening mammography: A conceptual framework review of the literature

    International Nuclear Information System (INIS)

    Mohd Norsuddin, N.; Reed, W.; Mello-Thoms, C.; Lewis, S.J.

    2015-01-01

    Recall rates are one of the performance measures used to evaluate the effectiveness of mammography screening programs. There is conflicting evidence regarding the link between recall rates and cancer detection rates and a variety of differing recall rates exist between countries and readers. This variability in recall rates may have important clinical and economic implications such as unnecessary follow-up procedures, additional costs to the health care system and psychological effects for the women themselves associated with false-positive mammograms results. In order to reduce the impact of false positive recall rates in screening mammography, it is essential for all multidisciplinary health care providers, especially those in medical imaging, to fully understand the factors that may contribute and affect recall rates. The multifactorial nature of recall rates is explored in this paper through the construction of a conceptual map based on a review of the current literature. - Highlights: • Recall rates vary across countries and readers and for initial and subsequent screens. • Falsely recalling women has important clinical, cost and psycho-social implications. • Imaging technology, readers' expertise and patient presentation affect recall rates. • Higher recall rates do not translate into improved sensitivity at higher thresholds. • Multidisciplinary approaches to reduce recall rates may improve women experiences.

  11. Early Dysphagia Screening by Trained Nurses Reduces Pneumonia Rate in Stroke Patients: A Clinical Intervention Study.

    Science.gov (United States)

    Palli, Christoph; Fandler, Simon; Doppelhofer, Kathrin; Niederkorn, Kurt; Enzinger, Christian; Vetta, Christian; Trampusch, Esther; Schmidt, Reinhold; Fazekas, Franz; Gattringer, Thomas

    2017-09-01

    Dysphagia is a common stroke symptom and leads to serious complications such as aspiration and pneumonia. Early dysphagia screening can reduce these complications. In many hospitals, dysphagia screening is performed by speech-language therapists who are often not available on weekends/holidays, which results in delayed dysphagia assessment. We trained the nurses of our neurological department to perform formal dysphagia screening in every acute stroke patient by using the Gugging Swallowing Screen. The impact of a 24/7 dysphagia screening (intervention) over swallowing assessment by speech-language therapists during regular working hours only was compared in two 5-month periods with time to dysphagia screening, pneumonia rate, and length of hospitalization as outcome variables. Overall, 384 patients (mean age, 72.3±13.7 years; median National Institutes of Health Stroke Scale score of 3) were included in the study. Both groups (pre-intervention, n=198 versus post-intervention, n=186) were comparable regarding age, sex, and stroke severity. Time to dysphagia screening was significantly reduced in the intervention group (median, 7 hours; range, 1-69 hours) compared with the control group (median, 20 hours; range, 1-183; P =0.001). Patients in the intervention group had a lower rate of pneumonia (3.8% versus 11.6%; P =0.004) and also a reduced length of hospital stay (median, 8 days; range, 2-40 versus median, 9 days; range, 1-61 days; P =0.033). 24/7 dysphagia screening can be effectively performed by nurses and leads to reduced pneumonia rates. Therefore, empowering nurses to do a formal bedside screening for swallowing dysfunction in stroke patients timely after admission is warranted whenever speech-language therapists are not available. © 2017 American Heart Association, Inc.

  12. 1988 failure rate screening data for fusion reliability and risk analysis

    International Nuclear Information System (INIS)

    Cadwallader, L.C.; Piet, S.J.

    1988-01-01

    This document contains failure rate screening data for application to fusion components. The screening values are generally fission or aerospace industry failure rate estimates that can be extrapolated for use by fusion system designers, reliability engineers and risk analysts. Failure rate estimates for tritium-bearing systems, liquid metal-cooled systems, gas-cooled systems, water-cooled systems and containment systems are given. Preliminary system availability estimates and selected initiating event frequency estimates are presented. This first edition document is valuable to design and safety analysis for the Compact Ignition Tokamak and the International Thermonuclear Experimental Reactor. 20 refs., 28 tabs

  13. State of living PSA and further development

    International Nuclear Information System (INIS)

    1999-01-01

    In October 1985 OECD-Principal Working Group (PWG 5) - Risk Assessment has initiated the Task Force 7 'Use of PSA in Nuclear Power Plant Management' to explore and report on the principles, characteristics, requirements and status of PSA oriented safety management. During this study, it became apparent that the utilisation of PSA techniques in nuclear plant safety management requires the development of supporting programmes to ensure that PSA models are being updated to reflect plant changes, and to direct their use towards the evaluation and determination of plant changes. These requirements also influence the software and hardware characteristics necessary to support the programme. This overall process is known as Living PSA. In this context OECD-PWG 5 has arranged international workshops on Living PSA application to support this development, to facilitate exchange of international experience and to summarise the state-of-the-art of L-PSA methodology. These activities were accompanied by following Task Groups of OECD-PWG 5 and the work results were published in state-of-the-art reports. According to the increasing development of Living PSA in the international field and its capacity to support plant safety management in a broad sense, OECD PWG 5 continues its work in setting up the Task Group 96-1 'State of Living PSA and Further Development' to clarify specific aspects of Living PSA. This report summarises the state of Living PSA in the international field based on the four Living PSA Workshops from 1988 to 1994 (Chapter 2) and the state of Reliability Data Collection based on the results of Task Group 12 'Reliability Data Collection and Analysis to Support PSA' and the two Data-Workshops from 1995 and 1998 (Chapter 3). The specific items of further development of Living PSA application as mentioned above are treated in Chapter 4. Chapter 5 gives a summary of the current state of Living PSA as well as outlook and recommendations of further development

  14. Applicability of living PSA in NPP modernization

    International Nuclear Information System (INIS)

    Himanen, R.

    1999-01-01

    Recently the utility Teollisuuden Voima Oy (TVO) has modernized the Olkiluoto 1 and 2 nuclear units and increased the net electric power by 18 per cent. Level 2 PSA was performed during the modernization project and the living level 1 PSA was used to support the design of the plant modifications. The plant specific living PSA model was a powerful tool when evaluating modernization alternatives. Successive support of safety management with the PSA model requires, that both the utility and the Regulatory Body understand capability and limitations of the model in details. TVO has prepared an internal procedure that presents in detail the practices and responsibilities concerning living PSA. The procedure is based on general guidelines and requirements on probabilistic safety analysis of nuclear power plants in Finland, released by the Regulatory Body. Living PSA requires that also the procedure for the use of living PSA is living. The recently published USNRC Regulatory Guides on PSA will be taken into account in the next version of the TVO PSA procedure. The PSA Peer Review Certification Process is one way to evaluate the quality of PSA in general, but also to detect the weaknesses of the PSA. However, the Certification Process cover only limited scope of PSA omitting e.g. all other external events except internal floods. This paper gives an overview on the scope of living PSA for Olkiluoto 1 and 2, and presents some examples on the real use of PSA concerning the modernization of the plant. Definition of quantitative dependability requirements for renovated systems is possible, but on the other hand, proving of these targets is in some cases extremely difficult, because of lacking dependability data. The problems are mainly concerned in systems with of programmable logic control. (au)

  15. Role of Magnetic Resonance Imaging in Prostate Cancer Screening: A Pilot Study Within the Göteborg Randomised Screening Trial

    Science.gov (United States)

    Bergdahl, Anna Grenabo; Wilderäng, Ulrica; Aus, Gunnar; Carlsson, Sigrid; Damber, Jan-Erik; Frånlund, Maria; Geterud, Kjell; Khatami, Ali; Socratous, Andreas; Stranne, Johan; Hellström, Mikael; Hugosson, Jonas

    2016-01-01

    Background Magnetic resonance imaging (MRI) and targeted biopsies (TB) have shown potential to more accurately detect significant prostate cancer (PC) compared to prostate-specific antigen (PSA) and systematic biopsies (SB). Objective To compare sequential screening (PSA + MRI) with conventional PSA screening. Design, Setting and Participants Of 384 attendees in the 10th screening round of the Göteborg randomised screening trial, 124 men, median age 69.5, had a PSA of ≥1.8 ng/ml and underwent a prebiopsy MRI. Men with suspicious lesions on MRI and/or PSA ≥3.0 ng/ml were referred for biopsy. SB was performed blinded to MRI results and TB was performed in men with tumour-suspicious findings on MRI. Three screening strategies were compared (PSA≥3.0+SB; PSA≥3.0+MRI+TB and PSA≥1.8+MRI+TB). Outcome Measurements and Statistical Analysis Cancer detection rates, sensitivity and specificity were calculated per screening strategy and compared using McNemar´s test. Results and Limitations In total, 28 PC were detected, of which 20 were diagnosed in biopsy-naïve men. Both PSA≥3.0+MRI and PSA≥1.8+MRI significantly increased specificity compared with PSA≥3.0+SB (0.92 and 0.79 vs. 0.52; p=3.0+MRI (0.73 vs. 0.46, p=0.008). The detection rate of significant cancer was higher with PSA≥1.8+MRI compared to PSA≥3.0+SB (5.9 vs. 4.0%), while the detection rate of insignificant cancer was lowered by PSA≥3.0+MRI (0.3 vs. 1.2%). The primary limitation of this study is the small sample of men. Conclusion A screening strategy with a lowered PSA cut-off followed by TB in MRI-positive men seems to increase the detection of significant cancers while improving specificity. If replicated, these results may contribute to a paradigm shift in future screening. Patient Summary Major concerns in prostate-specific antigen screening are overdiagnosis and underdiagnosis. We evaluated whether prostate magnetic resonance imaging could improve the balance of benefits to harm in

  16. Risk Metrics and Measures for an Extended PSA

    International Nuclear Information System (INIS)

    Wielenberg, A.; Loeffler, H.; Hasnaoui, C.; Burgazzi, L.; Cazzoli, E.; Jan, P.; La Rovere, S.; Siklossy, T.; Vitazkova, J.; Raimond, E.

    2016-01-01

    This report provides a review of the main used risk measures for Level 1 and Level 2 PSA. It depicts their advantages, limitations and disadvantages and develops some more precise risk measures relevant for extended PSAs and helpful for decision-making. This report does not recommend or suggest any quantitative value for the risk measures. It does not discuss in details decision-making based on PSA results neither. The choice of one appropriate risk measure or a set of risk measures depends on the decision making approach as well as on the issue to be decided. The general approach for decision making aims at a multi-attribute approach. This can include the use of several risk measures as appropriate. Section 5 provides some recommendations on the main risk metrics to be used for an extended PSA. For Level 1 PSA, Fuel Damage Frequency and Radionuclide Mobilization Frequency are recommended. For Level 2 PSA, the characterization of loss of containment function and a total risk measure based on the aggregated activity releases of all sequences rated by their frequencies is proposed. (authors)

  17. PSA testing for men at average risk of prostate cancer

    Directory of Open Access Journals (Sweden)

    Bruce K Armstrong

    2017-07-01

    Full Text Available Prostate-specific antigen (PSA testing of men at normal risk of prostate cancer is one of the most contested issues in cancer screening. There is no formal screening program, but testing is common – arguably a practice that ran ahead of the evidence. Public and professional communication about PSA screening has been highly varied and potentially confusing for practitioners and patients alike. There has been much research and policy activity relating to PSA testing in recent years. Landmark randomised controlled trials have been reported; authorities – including the 2013 Prostate Cancer World Congress, the Prostate Cancer Foundation of Australia, Cancer Council Australia, and the National Health and Medical Research Council – have made or endorsed public statements and/or issued clinical practice guidelines; and the US Preventive Services Task Force is revising its recommendations. But disagreement continues. The contention is partly over what the new evidence means. It is also a result of different valuing and prioritisation of outcomes that are hard to compare: prostate cancer deaths prevented (a small and disputed number; prevention of metastatic disease (somewhat more common; and side-effects of treatment such as incontinence, impotence and bowel trouble (more common again. A sizeable proportion of men diagnosed through PSA testing (somewhere between 20% and 50% would never have had prostate cancer symptoms sufficient to prompt investigation; many of these men are older, with competing comorbidities. It is a complex picture. Below are four viewpoints from expert participants in the evolving debate, commissioned for this cancer screening themed issue of Public Health Research & Practice. We asked the authors to respond to the challenge of PSA testing of asymptomatic, normal-risk men. They raise important considerations: uncertainty, harms, the trustworthiness and interpretation of the evidence, cost (e.g. of using multiparametric

  18. Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia

    Science.gov (United States)

    Pashayan, N; Powles, J; Brown, C; Duffy, S W

    2006-01-01

    This study aimed to estimate the extent of ‘overdiagnosis' of prostate cancer attributable to prostate-specific antigen (PSA) testing in the Cambridge area between 1996 and 2002. Overdiagnosis was defined conceptually as detection of prostate cancer through PSA testing that otherwise would not have been diagnosed within the patient's lifetime. Records of PSA tests in Addenbrookes Hospital were linked to prostate cancer registrations by NHS number. Differences in prostate cancer registration rates between those receiving and not receiving prediagnosis PSA tests were calculated. The proportion of men aged 40 years or over with a prediagnosis PSA test increased from 1.4 to 5.2% from 1996 to 2002. The rate of diagnosis of prostate cancer was 45% higher (rate ratios (RR)=1.45, 95% confidence intervals (CI) 1.02–2.07) in men with a history of prediagnosis PSA testing. Assuming average lead times of 5 to 10 years, 40–64% of the PSA-detected cases were estimated to be overdiagnosed. In East Anglia, from 1996 to 2000, a 1.6% excess of cases was associated with PSA testing (around a quarter of the 5.3% excess incidence cases observed in East Anglia from 1996 to 2000). Further quantification of the overdiagnosis will result from continued surveillance and from linkage of incidence to testing in other hospitals. PMID:16832417

  19. Prevalence and causes of abnormal PSA recovery.

    Science.gov (United States)

    Lautenbach, Noémie; Müntener, Michael; Zanoni, Paolo; Saleh, Lanja; Saba, Karim; Umbehr, Martin; Velagapudi, Srividya; Hof, Danielle; Sulser, Tullio; Wild, Peter J; von Eckardstein, Arnold; Poyet, Cédric

    2018-01-26

    Prostate-specific antigen (PSA) test is of paramount importance as a diagnostic tool for the detection and monitoring of patients with prostate cancer. In the presence of interfering factors such as heterophilic antibodies or anti-PSA antibodies the PSA test can yield significantly falsified results. The prevalence of these factors is unknown. We determined the recovery of PSA concentrations diluting patient samples with a standard serum of known PSA concentration. Based on the frequency distribution of recoveries in a pre-study on 268 samples, samples with recoveries 120% were defined as suspect, re-tested and further characterized to identify the cause of interference. A total of 1158 consecutive serum samples were analyzed. Four samples (0.3%) showed reproducibly disturbed recoveries of 10%, 68%, 166% and 4441%. In three samples heterophilic antibodies were identified as the probable cause, in the fourth anti-PSA-autoantibodies. The very low recovery caused by the latter interference was confirmed in serum, as well as heparin- and EDTA plasma of blood samples obtained 6 months later. Analysis by eight different immunoassays showed recoveries ranging between PSA which however did not show any disturbed PSA recovery. About 0.3% of PSA determinations by the electrochemiluminescence assay (ECLIA) of Roche diagnostics are disturbed by heterophilic or anti-PSA autoantibodies. Although they are rare, these interferences can cause relevant misinterpretations of a PSA test result.

  20. PSA applications. Good practices and documentation

    International Nuclear Information System (INIS)

    Dewailly, J.; Magne, L.

    1997-10-01

    In this paper, it is shown what the condensed documentation of the main strategic choices and technical assumptions related to a PSA could contain: how to select the internal and external initiating events, how the detail the plant configuration and the general organization of the plant and operating staff, how to highlight the assumptions related to physical models, etc. The proposals in this documentation are based on the R and D D's experience with PSA (construction of PSA models, use of PSA models for operation or maintenance, PSA tools). This document also presents different types of rules or recommendations related to PSA modelling for various applications involved in nuclear power plant operating. Finally, the paper stresses the main difficulties encountered (appropriate use of uncertainties, communication of PSA results to non-specialist users) and it also outlines some prospects for the future. (author)

  1. Methodology for seismic PSA of NPPs

    International Nuclear Information System (INIS)

    Jirsa, P.

    1999-09-01

    A general methodology is outlined for seismic PSA (probabilistic safety assessment). The main objectives of seismic PSA include: description of the course of an event; understanding the most probable failure sequences; gaining insight into the overall probability of reactor core damage; identification of the main seismic risk contributors; identification of the range of peak ground accelerations contributing significantly to the plant risk; and comparison of the seismic risk with risks from other events. The results of seismic PSA are typically compared with those of internal PSA and of PSA of other external events. If the results of internal and external PSA are available, sensitivity studies and cost benefit analyses are performed prior to any decision regarding corrective actions. If the seismic PSA involves analysis of the containment, useful information can be gained regarding potential seismic damage of the containment. (P.A.)

  2. Testing the variability of PSA expression by different human prostate cancer cell lines by means of a new potentiometric device employing molecularly antibody assembled on graphene surface

    International Nuclear Information System (INIS)

    Rebelo, Tânia S.C.R.; Noronha, João P.; Galésio, Marco; Santos, Hugo; Diniz, Mário; Sales, M. Goreti F.; Fernandes, Maria H.; Costa-Rodrigues, João

    2016-01-01

    Prostate Specific Antigen (PSA) is widely used as a biomarker for prostate cancer. Recently, an electrochemical biosensor for PSA detection by means of molecularly imprinted polymers (MIPs) was developed. This work evaluated the performance and the effectiveness of that PSA biosensor in screening the biomarker PSA in biological media with complex composition, collected from different human prostate cell line cultures. For that, the prostate cancer LNCaP and PC3 cells, and the non-cancerous prostate cell line PNT2 were cultured for 2, 7 and 14 days in either α-MEM or RPMI in the presence of 10% or 30% fetal bovine serum. Human gingival fibroblasts were used as a non-cancerous non-prostatic control. The different culture conditions modulated cellular proliferation and the expression of several prostate markers, including PSA. The electrochemical biosensor was able to specifically detect PSA in the culture media and values obtained were similar to those achieved by a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit, the most commonly used method for PSA quantification in prostate cancer diagnosis. Thus, the tested biosensor may represent a useful alternative as a diagnostic tool for PSA determination in biological samples. - Highlights: • PSA quantification was performed in prostate cancer cell culture media. • Culture media composition and culture period significantly affect PSA production. • The PSA biosensor detected a wide range of PSA levels in complex media. • A high data correlation was observed between the biosensor and the ELISA analysis.

  3. Testing the variability of PSA expression by different human prostate cancer cell lines by means of a new potentiometric device employing molecularly antibody assembled on graphene surface

    Energy Technology Data Exchange (ETDEWEB)

    Rebelo, Tânia S.C.R. [BioMark-CINTESIS/ISEP, Instituto Superior de Engenharia do Instituto Politécnico do Porto (Portugal); LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica (Portugal); Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, Universidade do Porto, Porto (Portugal); Noronha, João P.; Galésio, Marco; Santos, Hugo; Diniz, Mário [LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica (Portugal); Sales, M. Goreti F. [BioMark-CINTESIS/ISEP, Instituto Superior de Engenharia do Instituto Politécnico do Porto (Portugal); Fernandes, Maria H. [Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, Universidade do Porto, Porto (Portugal); Costa-Rodrigues, João, E-mail: jrodrigues@fmd.up.pt [Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, Universidade do Porto, Porto (Portugal); ESTSP — Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto (Portugal)

    2016-02-01

    Prostate Specific Antigen (PSA) is widely used as a biomarker for prostate cancer. Recently, an electrochemical biosensor for PSA detection by means of molecularly imprinted polymers (MIPs) was developed. This work evaluated the performance and the effectiveness of that PSA biosensor in screening the biomarker PSA in biological media with complex composition, collected from different human prostate cell line cultures. For that, the prostate cancer LNCaP and PC3 cells, and the non-cancerous prostate cell line PNT2 were cultured for 2, 7 and 14 days in either α-MEM or RPMI in the presence of 10% or 30% fetal bovine serum. Human gingival fibroblasts were used as a non-cancerous non-prostatic control. The different culture conditions modulated cellular proliferation and the expression of several prostate markers, including PSA. The electrochemical biosensor was able to specifically detect PSA in the culture media and values obtained were similar to those achieved by a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit, the most commonly used method for PSA quantification in prostate cancer diagnosis. Thus, the tested biosensor may represent a useful alternative as a diagnostic tool for PSA determination in biological samples. - Highlights: • PSA quantification was performed in prostate cancer cell culture media. • Culture media composition and culture period significantly affect PSA production. • The PSA biosensor detected a wide range of PSA levels in complex media. • A high data correlation was observed between the biosensor and the ELISA analysis.

  4. Re-examining Prostate-specific Antigen (PSA) Density: Defining the Optimal PSA Range and Patients for Using PSA Density to Predict Prostate Cancer Using Extended Template Biopsy.

    Science.gov (United States)

    Jue, Joshua S; Barboza, Marcelo Panizzutti; Prakash, Nachiketh S; Venkatramani, Vivek; Sinha, Varsha R; Pavan, Nicola; Nahar, Bruno; Kanabur, Pratik; Ahdoot, Michael; Dong, Yan; Satyanarayana, Ramgopal; Parekh, Dipen J; Punnen, Sanoj

    2017-07-01

    To compare the predictive accuracy of prostate-specific antigen (PSA) density vs PSA across different PSA ranges and by prior biopsy status in a prospective cohort undergoing prostate biopsy. Men from a prospective trial underwent an extended template biopsy to evaluate for prostate cancer at 26 sites throughout the United States. The area under the receiver operating curve assessed the predictive accuracy of PSA density vs PSA across 3 PSA ranges (10 ng/mL). We also investigated the effect of varying the PSA density cutoffs on the detection of cancer and assessed the performance of PSA density vs PSA in men with or without a prior negative biopsy. Among 1290 patients, 585 (45%) and 284 (22%) men had prostate cancer and significant prostate cancer, respectively. PSA density performed better than PSA in detecting any prostate cancer within a PSA of 4-10 ng/mL (area under the receiver operating characteristic curve [AUC]: 0.70 vs 0.53, P PSA >10 mg/mL (AUC: 0.84 vs 0.65, P PSA density was significantly more predictive than PSA in detecting any prostate cancer in men without (AUC: 0.73 vs 0.67, P PSA increases, PSA density becomes a better marker for predicting prostate cancer compared with PSA alone. Additionally, PSA density performed better than PSA in men with a prior negative biopsy. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. The effect of changing from one to two views at incident (subsequent) screens in the NHS breast screening programme in England: impact on cancer detection and recall rates

    International Nuclear Information System (INIS)

    Blanks, R.G.; Bennett, R.L.; Patnick, J.; Cush, S.; Davison, C.; Moss, S.M.

    2005-01-01

    AIM: To assess the effect on cancer detection and recall rates of changing from one to two views for incident (subsequent) screens. METHODS: Controlled, comparative, observational study of programmes in NHS breast screening programme in England. Subjects: women aged 50-64 years were screened by the NHSBSP between 1 April 2001 and 31 March 2003. RESULTS: The effect of changing to two-view mammography was a 20% increase in overall incident screen cancer detection rate, with the biggest effect seen for small (<15 mm) invasive cancers. This increased detection rate was achieved with an 11% drop-in recall rate. CONCLUSION: The introduction of two-view mammography for incident screens has resulted in considerable improvements in overall NHS breast screening performance

  6. Screens

    OpenAIRE

    2016-01-01

    This Sixth volume in the series The Key Debates. Mutations and Appropriations in European Film Studies investigates the question of screens in the context both of the dematerialization due to digitalization and the multiplication of media screens. Scholars offer various infomations and theories of topics such as the archeology of screen, film and media theories, contemporary art, pragmatics of new ways of screening (from home video to street screening).

  7. Concurrent Driving Method with Fast Scan Rate for Large Mutual Capacitance Touch Screens

    Directory of Open Access Journals (Sweden)

    Mohamed Gamal Ahmed Mohamed

    2015-01-01

    Full Text Available A novel touch screen control technique is introduced, which scans each frame in two steps of concurrent multichannel driving and differential sensing. The proposed technique substantially increases the scan rate and reduces the ambient noise effectively. It is also extended to a multichip architecture to support excessively large touch screens with great scan rate improvement. The proposed method has been implemented using 0.18 μm CMOS TowerJazz process and tested with FPGA and AFE board connecting a 23-inch touch screen. Experimental results show a scan rate improvement of up to 23.8 times and an SNR improvement of 24.6 dB over the conventional method.

  8. Childhood Obesity PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement is based on the August 2013 CDC Vital Signs report. The rate of obesity among low-income preschoolers has declined, but one in eight is still obese. This program briefly discusses what can be done.

  9. Measurement of serum isoform [-2]proPSA derivatives shows superior accuracy to magnetic resonance imaging in the diagnosis of prostate cancer in patients with a total prostate-specific antigen level of 2-10 ng/ml.

    Science.gov (United States)

    Furuya, Kazuhiro; Kawahara, Takashi; Narahara, Masaki; Tokita, Takashi; Fukui, Sachi; Imano, Masashi; Mitome, Taku; Ito, Yusuke; Izumi, Koji; Osaka, Kimito; Yokomizo, Yumiko; Hayashi, Narihiko; Hasumi, Hisashi; Nawata, Shintaro; Kawano, Tsuyoshi; Yao, Masahiro; Uemura, Hiroji

    2017-08-01

    More accurate diagnostic procedures for prostate cancer are needed to avoid unnecessary biopsy due to the low specificity of prostate-specific antigen (PSA). Recent studies showed that the percentage of serum isoform [-2]proPSA (p2PSA) to free PSA (%p2PSA), the Prostate Health Index (PHI) and magnetic resonance imaging (MRI) were more accurate than PSA. The aim of this study was to test the accuracy of %p2PSA, PHI and MRI in discriminating patients with and without prostate cancer. The subjects were 50 consecutive men with a PSA level of 2.0-10.0 ng/ml, who underwent prostate biopsy from October 2012 to July 2014. These patients underwent multiparametric MRI before biopsy, and their serum samples were measured for PSA, free PSA and p2PSA. The sensitivity, specificity and accuracy of PHI, %p2PSA and MRI were compared with PSA in the diagnosis of biopsy-confirmed prostate cancer. In a univariate analysis, %p2PSA [area under the curve (AUC): 0.811] and PHI (AUC 0.795) were more accurate than MRI (AUC: 0.583) and PSA (AUC: 0.554) for prostate cancer detection. At 60% sensitivity, the specificity of PHI (76.5%) was higher than that of MRI (52.9%). For significant cancer detection, %p2PSA (AUC: 0.745), PHI (AUC: 0.791) and MRI (AUC: 0.739) were marginally more accurate than PSA (AUC: 0.696). At 85% sensitivity, the specificity of MRI (62.1%) was higher than that of PHI (34.5%). PHI and %p2PSA can be used for screening the general population and MRI can be used for detection of significant cancer in patients suspected, from screening tests, of having prostate cancer.

  10. Childhood Obesity PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-08-06

    This 60 second public service announcement is based on the August 2013 CDC Vital Signs report. The rate of obesity among low-income preschoolers has declined, but one in eight is still obese. This program briefly discusses what can be done.  Created: 8/6/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/6/2013.

  11. [Attendance rate in the Polish Cervical Cancer Screening Program in the years 2007-2009].

    Science.gov (United States)

    Spaczyński, Marek; Karowicz-Bilinska, Agata; Rokita, Wojciech; Molińska-Glura, Marta; Januszek-Michalecka, Lucyna; Seroczyński, Przemysław; Uchlik, Joanna; Nowak-Markwitz, Ewa

    2010-09-01

    In Poland in 2007, according to the National Cancer Registry 3431 women were diagnosed with cervical cancer and 1907 died. To change the unfavorable epidemiologic situation, in 2005 the Ministry of Health (MH), the National Health Fund (NHF) and the Polish Gynecological Society following WHO/IARC guidelines developed a National Population-Based Cervical Cancer Screening Program. Its implementation and roll-out started in 2006. The target population are women aged 25 to 59 insured in the National Health Fund. A Pap test is done with a three-year interval, free of charge. The system is based on personal invitations sent by regular post. Invitation to screening is supported by a social educational campaign "Choose Life" run under one slogan and logo across the whole country The NHF data base enables identification of women to screen. Pap smears are collected by gynecologists and since 2008 also by midwives trained and certified by the Program National Coordinating Center Pap test results are reported in the Bethesda 2001 system. The Screening Program has its system of quality assurance and control and is supported by a specially designed computer data base called SIMP (System of Information Monitoring in Prophylaxis) with online access to all records. In addition to organized, population-based screening there is also opportunistic screening in Poland practiced either by private gynecological practices or by some units that cooperate with the National Health Fund, but do Pap tests as an element of comprehensive gynecological examination. Those smears are not registered in the SIMP. Our aim was analysis of attendance rate in the Cervical Cancer Screening Program in the years 2007-2009. We also investigated correlation between screening coverage and invitation sending schedule, as well as between coverage and screening accessibility determined by the number of gynaecological practices where Pap smears are collected. Attendance rate in the Screening Program was evaluated

  12. Too Much Sodium PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second PSA is based on the February 2012 CDC Vital Signs report. Ninety percent of Americans age two and older eat too much sodium which can increase your risk for high blood pressure and often leads to heart disease and stroke, two leading causes of death in the US. Learn several small steps you can take to reduce the amount of sodium in your diet.

  13. Obesity and Cancer Screening according to Race and Gender

    Directory of Open Access Journals (Sweden)

    Heather Bittner Fagan

    2011-01-01

    Full Text Available The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC screening, the relationship between weight and screening in men is inconsistent, while there is a trend towards lower CRC screening in higher weight women.

  14. Programmable automation systems in PSA

    International Nuclear Information System (INIS)

    Pulkkinen, U.

    1997-06-01

    The Finnish safety authority (STUK) requires plant specific PSAs, and quantitative safety goals are set on different levels. The reliability analysis is more problematic when critical safety functions are realized by applying programmable automation systems. Conventional modeling techniques do not necessarily apply to the analysis of these systems, and the quantification seems to be impossible. However, it is important to analyze contribution of programmable automation systems to the plant safety and PSA is the only method with system analytical view over the safety. This report discusses the applicability of PSA methodology (fault tree analyses, failure modes and effects analyses) in the analysis of programmable automation systems. The problem of how to decompose programmable automation systems for reliability modeling purposes is discussed. In addition to the qualitative analysis and structural reliability modeling issues, the possibility to evaluate failure probabilities of programmable automation systems is considered. One solution to the quantification issue is the use of expert judgements, and the principles to apply expert judgements is discussed in the paper. A framework to apply expert judgements is outlined. Further, the impacts of subjective estimates on the interpretation of PSA results are discussed. (orig.) (13 refs.)

  15. Status of the PSA use in the Czech regulatory process

    International Nuclear Information System (INIS)

    Dusek, J.

    1994-01-01

    A review of previous probabilistic safety assessment (PSA) activities initiated by regulatory body and preparation of the preliminary PSA study and final PSA study (released in January 1994) for the nuclear power plant Dukovany with WWER-440 type 213 reactor is described. A brief information about the NPP Temelin (with WWER-1000) PSA Study, shutdown and PSA risk monitor current activities for the NPP Dukovany, next PSA activities in 1994 and about planned PSA activities in future is attached. (author). 21 refs

  16. THE DISCRIMINATIVE ABILITY OF PERCENT FREE PSA IN ...

    African Journals Online (AJOL)

    Blood samples were collected from all patients, and total PSA, free PSA and % free PSA were calculated in all specimens. Total PSA was measured using the Imx ... Un prélèvement de sang a été réalisé chez tous les patients avec un dosage du PSA total et de la fraction libre de PSA. Le PSA total a été mesuré par un kit ...

  17. Cost and detection rate of glaucoma screening with imaging devices in a primary care center

    Directory of Open Access Journals (Sweden)

    Anton A

    2017-02-01

    Full Text Available Alfonso Anton,1–4 Monica Fallon,3,5 Francesc Cots,2 María A Sebastian,6 Antonio Morilla-Grasa,4 Sergi Mojal,3 Xavier Castells2 1Medicine School, Universidad Internacional de Cataluña, 2Servei d’Estudies, Parc de Salut Mar, 3Instituto Hospital del Mar de Investigaciones Médicas (IMIM, 4Glaucoma Department, Instituto Catalán de Retina (ICR, 5Universidad Autónoma de Barcelona, 6Centro de Atención Primaria Larrard, Barcelona, Spain Purpose: To analyze the cost and detection rate of a screening program for detecting glaucoma with imaging devices. Materials and methods: In this cross-sectional study, a glaucoma screening program was applied in a population-based sample randomly selected from a population of 23,527. Screening targeted the population at risk of glaucoma. Examinations included optic disk tomography (Heidelberg retina tomograph [HRT], nerve fiber analysis, and tonometry. Subjects who met at least 2 of 3 endpoints (HRT outside normal limits, nerve fiber index ≥30, or tonometry ≥21 mmHg were referred for glaucoma consultation. The currently established (“conventional” detection method was evaluated by recording data from primary care and ophthalmic consultations in the same population. The direct costs of screening and conventional detection were calculated by adding the unit costs generated during the diagnostic process. The detection rate of new glaucoma cases was assessed. Results: The screening program evaluated 414 subjects; 32 cases were referred for glaucoma consultation, 7 had glaucoma, and 10 had probable glaucoma. The current detection method assessed 677 glaucoma suspects in the population, of whom 29 were diagnosed with glaucoma or probable glaucoma. Glaucoma screening and the conventional detection method had detection rates of 4.1% and 3.1%, respectively, and the cost per case detected was 1,410 and 1,435€, respectively. The cost of screening 1 million inhabitants would be 5.1 million euros and would allow

  18. Qualification of calculation aids for PSA

    International Nuclear Information System (INIS)

    Goetz, K.; Hennigs, W.; Kirstein, B.M.; Reinhardt, C.

    1998-01-01

    In Germany Probabilistic Safety Analysis (PSA) are part of the evaluation of a nuclear power plants safety. The German PSA guide stipulates that the used software must enable a PSA according to the state of the art. This software must be qualified to assure that its features, mathematic methods and its performance enable a PSA like this. In this research work specifications and requirements are developed, which allow the testing of software. A procedure was developed to qualify PSA software according to the PSA guide and the experiences of users of PSA. Setting up a procedure, a tool for a systematic and uniform examination was crated. Additionally the options, mathematic fundamentals and performance of PSA-programs were analyzed. According to this all programs that were analyzed are capable to sovle their original task, that is the calculation of the safety of high available system based on high available components. Against that the requirements of modern PSA, e.g. to handle less available functions, HRA and fire analyses, based on the use of modern software and the implementation of new developments in the field of PSA are not supported adequately by all programs. (orig.) [de

  19. Use of PSA in a regulatory framework

    International Nuclear Information System (INIS)

    Ross, P.J.

    1994-01-01

    The paper will briefly describe the use of PSA in the licensing process for the Sizewell 'B' PWR Power Station currently under construction in the U.K. There are two distinct phases in the licensing process - (i) A PSA has been performed to support the application to construct Sizewell 'B'. At that stage the PSA was used as a design tool (along with deterministic design requirements) for Sizewell 'B' and as such lead to a number of significant design changes in the early design process. (ii) A PSA is currently being performed to support the application to operate Sizewell 'B'. The PSA is required to support the claim that the design has included all reasonably practical measures to prevent and mitigate accidents. The comprehensive PSA being produced for the second phase of the licensing process will be described. The way the regulators/designer/analysts have interacted over the years has affected the scope, complexity, detail and bias of the comprehensive PSA. The paper will discuss these issues and highlight some of the more significant ones. The benefits and drawbacks of providing a PSA in a regulatory framework will be discussed. One of the conclusions of the paper is that the use of true ''best-estimates'' in the PSA is difficult to achieve in a regulatory framework where persistent bias to the conservative side is apparent in the designers, analysts and regulators judgements. The usefulness of the PSA is therefore, potentially, compromised by giving misleading outputs or diverting resources to unnecessary areas. (author)

  20. Incorporating Level-2 PSA Feature of CONPAS into AIMS-PSA Software

    International Nuclear Information System (INIS)

    Han, Sang Hoon; Lim, Hogon; Ahn, Kwang Il

    2014-01-01

    CONPAS (CONtainment Performance Analysis System) utilizes a methodology to treat containment phenomena in detail like APET but in simple way. In mid 2000's, KAERI has developed very fast cut set generator FTREX and PC's OS (Operating system) has changed into Windows 95. Thus, KAERI has developed new Level-1 PSA software, called AIMS-PSA (Advanced Information Management System for PSA) to replace KIRAP. Recently, KAERI has been developing an integrated PSA platform, called OCEANS (On-line Consolidator and Evaluator of All mode risk for Nuclear System), for the risk assessment of all power modes and all hazards. CONPAS for Level-2 PSA was developed in 1990's using the Visual Basic 6.0 compiler which is not supported any more. It needs to be updated for the integrated PSA software framework. This paper describes a study to incorporate the features of CONPAS into AIMS-PSA. The basic idea is to follow the approach of CONPAS, but in the integrated way. Various approaches for Level-2 PSA have been used since WASH-1400. APET approach of NUREG-1150 study would be most comprehensive and complex methodology for containment event tree analysis. CONPAS is the Level-2 PSA software to utilize an approach to treat containment phenomena in detail like APET but in simple way. But, new Level-2 PSA software is required to develop more integrated PSA framework. A modified approach of CONPAS is developed and incorporated in AIMS-PSA software that can handle Level-1 and Level-2 PSA in the integrated way (from the viewpoint of event tree and fault tree). AIMS-PSA combines whole Level-2 PSA model to produce a One Top fault tree and to generate cut sets in the same way as Level-1 PSA. Quantification results of Level-2 PSA such as frequency for each STC can be calculated from the minimal cut sets

  1. Antigenic determinants of prostate-specific antigen (PSA) and development of assays specific for different forms of PSA.

    OpenAIRE

    Nilsson, O.; Peter, A.; Andersson, I.; Nilsson, K.; Grundstr?m, B.; Karlsson, B.

    1997-01-01

    Monoclonal antibodies were raised against prostate-specific antigen (PSA) by immunization with purified free PSA, i.e. not in complex with any protease inhibitor (F-PSA) and PSA in complex with alpha1-anti-chymotrypsin (PSA-ACT). Epitope mapping of PSA using the established monoclonal antibody revealed a complex pattern of independent and partly overlapping antigenic domains in the PSA molecule. Four independent antigenic domains and at least three partly overlapping domains were exposed both...

  2. Contribution of screening and survival differences to racial disparities in colorectal cancer rates

    NARCIS (Netherlands)

    I. Lansdorp-Vogelaar (Iris); K.M. Kuntz (Karen); A.B. Knudsen (Amy); M. van Ballegooijen (Marjolein); A. Zauber (Ann); A. Jemal (Ahmedin)

    2012-01-01

    textabstractBackground: Considerable disparities exist in colorectal cancer (CRC) incidence and mortality rates between blacks and whites in the United States. We estimated how much of these disparities could be explained by differences in CRC screening and stage-specific relative CRC survival.

  3. Opium consumption is negatively associated with serum prostate-specific antigen (PSA), free PSA, and percentage of free PSA levels.

    Science.gov (United States)

    Safarinejad, Mohammad Reza; Asgari, Seyyed Alaeddin; Farshi, Alireza; Iravani, Shahrokh; Khoshdel, Alireza; Shekarchi, Babak

    2013-01-01

    Addiction to opium continues to be a major worldwide medical and social problem. The study addressing the association between opium consumption and serum prostate-specific antigen (PSA) level is lacking. We determined the effects of opium consumption on serum PSA levels in opium-addict men. Our study subjects comprised 438 opium-addict men with a mean age of 52.2 ± 6.4 years (group 1). We compared these men with 446 men who did not indicate current or past opium use (group 2). Serum total PSA (tPSA), free PSA (fPSA), % fPSA, and sex hormones were compared between the 2 groups. The mean serum tPSA level was significantly lower in group 1 (1.05 ng/mL) than in controls (1.45 ng/mL) (P = 0.001). Opium consumption was also associated with lower fPSA (P = 0.001) and % fPSA (P = 0.001). Serum free testosterone level in opium-addict patients (132.5 ± 42 pg/mL) was significantly lower than that in controls (156.2 ± 43 pg/mL) (P = 0.03). However, no significant correlation existed between tPSA and free testosterone levels (r = 0.28, 95% CI, -0.036 to 0.51, P = 0.34). Among the patients with cancer in group 1, 35% were found to have high-grade tumor (Gleason score ≥ 7) compared with 26.7% in group 2 (P = 0.02). Total PSA and fPSA were strongly correlated with duration of opium use (r = -0.06, 95% CI, -0.04 to -0.08, P = 0.0001; and r = -0.05, 95% CI, -0.03 to -0.07, P = 0.0001, respectively). Opium consumption is independently and negatively associated with serum tPSA, fPSA, and % fPSA levels.

  4. 'Show me the money': financial incentives increase chlamydia screening rates among tertiary students: a pilot study.

    Science.gov (United States)

    Currie, Marian J; Schmidt, Matthias; Davis, Belinda K; Baynes, Anne M; O'Keefe, Elissa J; Bavinton, Tim P; McNiven, Michelle; Martin, Sarah J; Bowden, Francis J

    2010-03-01

    We hypothesise that text-messaging and financial incentives would increase tertiary student participation in chlamydia screening. A cross-sectional study was conducted over two phases on eight tertiary campuses during 2007. During Phase 1 (6 months) study activities were advertised through student organisations and media. Education and screening were offered during a range of student activities. During Phase 2 (4 days) education and screening were offered via text messages. Non-financial incentives were offered during Phase 1 and a $10 cash incentive was offered during Phase 2. Rates of specimens provided by students and the direct costs incurred during each phase were compared. 2786 students attended the 31 activities conducted in Phase 1. Of these, 627 students (22.5%) provided urine specimens for chlamydia testing. During Phase 2, the dissemination of 866 text messages resulted in urine specimens from 392 students (45.3%). Costs per test were AUD $175.11 in Phase 1 and AUD $27.13 in Phase 2. Compared with more labour intensive (and therefore more expensive) screening activities conducted over a 6-month period, offering a small financial incentive to tertiary students through text messaging over a 4-day period significantly increased participation in on-campus chlamydia screening. This model could readily be applied to other populations to increase participation in chlamydia screening.

  5. Depression Screening Using Daily Mental-Health Ratings from a Smartphone Application for Breast Cancer Patients.

    Science.gov (United States)

    Kim, Junetae; Lim, Sanghee; Min, Yul Ha; Shin, Yong-Wook; Lee, Byungtae; Sohn, Guiyun; Jung, Kyung Hae; Lee, Jae-Ho; Son, Byung Ho; Ahn, Sei Hyun; Shin, Soo-Yong; Lee, Jong Won

    2016-08-04

    Mobile mental-health trackers are mobile phone apps that gather self-reported mental-health ratings from users. They have received great attention from clinicians as tools to screen for depression in individual patients. While several apps that ask simple questions using face emoticons have been developed, there has been no study examining the validity of their screening performance. In this study, we (1) evaluate the potential of a mobile mental-health tracker that uses three daily mental-health ratings (sleep satisfaction, mood, and anxiety) as indicators for depression, (2) discuss three approaches to data processing (ratio, average, and frequency) for generating indicator variables, and (3) examine the impact of adherence on reporting using a mobile mental-health tracker and accuracy in depression screening. We analyzed 5792 sets of daily mental-health ratings collected from 78 breast cancer patients over a 48-week period. Using the Patient Health Questionnaire-9 (PHQ-9) as the measure of true depression status, we conducted a random-effect logistic panel regression and receiver operating characteristic (ROC) analysis to evaluate the screening performance of the mobile mental-health tracker. In addition, we classified patients into two subgroups based on their adherence level (higher adherence and lower adherence) using a k-means clustering algorithm and compared the screening accuracy between the two groups. With the ratio approach, the area under the ROC curve (AUC) is 0.8012, indicating that the performance of depression screening using daily mental-health ratings gathered via mobile mental-health trackers is comparable to the results of PHQ-9 tests. Also, the AUC is significantly higher (P=.002) for the higher adherence group (AUC=0.8524) than for the lower adherence group (AUC=0.7234). This result shows that adherence to self-reporting is associated with a higher accuracy of depression screening. Our results support the potential of a mobile mental

  6. Two-Step Process for ED UTI Screening in Febrile Young Children: Reducing Catheterization Rates.

    Science.gov (United States)

    Lavelle, Jane M; Blackstone, Mercedes M; Funari, Mary Kate; Roper, Christine; Lopez, Patricia; Schast, Aileen; Taylor, April M; Voorhis, Catherine B; Henien, Mira; Shaw, Kathy N

    2016-07-01

    Urinary tract infection (UTI) screening in febrile young children can be painful and time consuming. We implemented a screening protocol for UTI in a high-volume pediatric emergency department (ED) to reduce urethral catheterization, limiting catheterization to children with positive screens from urine bag specimens. This quality-improvement initiative was implemented using 3 Plan-Do-Study-Act cycles, beginning with a small test of the proposed change in 1 ED area. To ensure appropriate patients received timely screening, care teams discussed patient risk factors and created patient-specific, appropriate procedures. The intervention was extended to the entire ED after providing education. Finally, visual cues were added into the electronic health record, and nursing scripts were developed to enlist family participation. A time-series design was used to study the impact of the 6-month intervention by using a p-chart to determine special cause variation. The primary outcome measure for the study was defined as the catheterization rate in febrile children ages 6 to 24 months. The ED reduced catheterization rates among febrile young children from 63% to UTIs among those followed within the hospital's network. A 2-step less-invasive process for screening febrile young children for UTI can be instituted in a high-volume ED without increasing length of stay or missing cases of UTI. Copyright © 2016 by the American Academy of Pediatrics.

  7. Delay in diabetic retinopathy screening increases the rate of detection of referable diabetic retinopathy.

    Science.gov (United States)

    Scanlon, P H; Aldington, S J; Stratton, I M

    2014-04-01

    To assess whether there is a relationship between delay in retinopathy screening after diagnosis of type 2 diabetes and level of retinopathy detected. Patients were referred from 88 primary care practices to an English National Health Service diabetic eye screening programme. Data for screened patients were extracted from the primary care databases using semi-automated data collection algorithms supplemented by validation processes. The programme uses two-field mydriatic digital photographs graded by a quality assured team. Data were available for 8183 screened patients with diabetes newly diagnosed in 2005, 2006 or 2007. Only 163 with type 1 diabetes were identified and were insufficient for analysis. Data were available for 8020 with newly diagnosed type 2 diabetes. Of these, 3569 were screened within 6 months, 2361 between 6 and 11 months, 1058 between 12 and 17 months, 366 between 18 and 23 months, 428 between 24 and 35 months, and 238 at 3 years or more after diagnosis. There were 5416 (67.5%) graded with no retinopathy, 1629 (20.3%) with background retinopathy in one eye, 753 (9.4%) with background retinopathy in both eyes and 222 (2.8%) had referable diabetic retinopathy. There was a significant trend (P = 0.0004) relating time from diagnosis to screening detecting worsening retinopathy. Of those screened within 6 months of diagnosis, 2.3% had referable retinopathy and, 3 years or more after diagnosis, 4.2% had referable retinopathy. The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of type 2 diabetes. © 2013 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  8. Use of RIA (radioimmunoassay) for the screening o prostate cancer in lebanon

    International Nuclear Information System (INIS)

    El Ezzi, A.A.

    2003-01-01

    The incidence of prostate cancer is known to be high in USA and europpe and very low in asia. There are lots of controversies about the early screening programs of this cancer because of the low cost effctiveness and the limited choices of treatment. However, in USA, early screening programs have helped in increasing the ratee of eaarly detection of this cancer. Actually, 75% of patients are detected when their cancer is still organ confined. This rate was 25% before this program. There is no statistical data in lebanon or any other arabic country about the incidence of this cancer. In this study, 300 men aged 40 years and more from the area of mount lebanon were screened for prostate cancer. This was done by digital rectal examination (DRE) followed by blood withdrawal for PSA (prostate specific antigen) test. IRMA technique was used for assaying PSA by kits fromimmunotech. 23 men have abnormal PSA values. Results of this study showed the presence of two cases of prostate cancer, 3 cases of prostatitis and 8 cases of BPH (being prostate hypeeerplasial0, which proof that the incidence of prostate cancer is not low as expected (in japan, the rate of cancer is 1:50 000 men) and that the early screening is very important in our country at least to increase the awareness from this cancer. Because purchasing kits from international sources is very expensive, local preparation of PSA kits is a necessity to overcome this problem

  9. Development and perspectives of PSA in Cuba

    International Nuclear Information System (INIS)

    1996-01-01

    During the last decade the GDA/PSA has carried out the pre-operational PSA task for the Juragua Nuclear Power Plant. Since 1991 the work has been accomplished in the frames of the IAEA Technical Assistance Project CUB/9/008. The paper describes the stages of this study, (concluding with the Final Report of the pre-operational Level 1 PSA Rev. O), its assumptions, limitations and the main results and concluding remarks

  10. PSA, subjective probability and decision making

    International Nuclear Information System (INIS)

    Clarotti, C.A.

    1989-01-01

    PSA is the natural way to making decisions in face of uncertainty relative to potentially dangerous plants; subjective probability, subjective utility and Bayes statistics are the ideal tools for carrying out a PSA. This paper reports that in order to support this statement the various stages of the PSA procedure are examined in detail and step by step the superiority of Bayes techniques with respect to sampling theory machinery is proven

  11. Effect of recall rate on earlier screen detection of breast cancers based on the Dutch performance indicators.

    NARCIS (Netherlands)

    Otten, J.D.M.; Karssemeijer, N.; Hendriks, J.H.C.L.; Groenewoud, J.H.; Fracheboud, J.; Verbeek, A.L.M.; Koning, H.J. de; Holland, R.

    2005-01-01

    BACKGROUND: The recall rate (i.e., the rate at which mammographically screened women are recalled for additional assessment) in the Dutch breast screening program (0.89% in 2000 for subsequent examinations) is the lowest worldwide, with possible consequences including higher rates of late-detected

  12. Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme

    Science.gov (United States)

    Dibden, A; Offman, J; Parmar, D; Jenkins, J; Slater, J; Binysh, K; McSorley, J; Scorfield, S; Cumming, P; Liao, X-H; Ryan, M; Harker, D; Stevens, G; Rogers, N; Blanks, R; Sellars, S; Patnick, J; Duffy, S W

    2014-01-01

    Background: The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. Methods: Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50–64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. Results: The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1 000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15–20% reduction in interval cancer rates in the NHSBSP. Conclusion: The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens. PMID:24366303

  13. REVIEW ARTICLE: PROSTATE CANCER SCREENING USING ...

    African Journals Online (AJOL)

    FOBUR

    ABSTRACT. Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is key to cure and survival but its screening through prostate specific antigen (PSA) has remain controversial in literature. Screening with prostate specific antigen (PSA) has led to more men diagnosed with ...

  14. Status and use of PSA in Sweden

    International Nuclear Information System (INIS)

    Knochenhauer, M.

    1996-05-01

    The performance and use of PSA:s in Sweden goes back about two decades. During all of this time, the field of PSA has been developing intensively, both internationally and within Sweden. The latest years have been characterised by an increased use of PSA models and results, and by major extensions of existing PSA models. The aim of this document is to describe PSA in Sweden with respect to development, scope and maturity, as well as to the contents of the analyses and the use of results. PSA activities will be described from the point of view of both the authorities and the utilities. The report gives an overview of the development within the area of PSA in Sweden both its history and current trends. The aim has been to include a reasonable amount of detail, both on the methods and results in PSA:s performed and on the numerous supporting research programs dealing with various aspects of PSA. 39 refs 39 refs

  15. Status and use of PSA in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Knochenhauer, M

    1996-05-01

    The performance and use of PSA:s in Sweden goes back about two decades. During all of this time, the field of PSA has been developing intensively, both internationally and within Sweden. The latest years have been characterised by an increased use of PSA models and results, and by major extensions of existing PSA models. The aim of this document is to describe PSA in Sweden with respect to development, scope and maturity, as well as to the contents of the analyses and the use of results. PSA activities will be described from the point of view of both the authorities and the utilities. The report gives an overview of the development within the area of PSA in Sweden both its history and current trends. The aim has been to include a reasonable amount of detail, both on the methods and results in PSA:s performed and on the numerous supporting research programs dealing with various aspects of PSA. 39 refs 39 refs.

  16. Model engineering in a modular PSA

    International Nuclear Information System (INIS)

    Friedlhuber, Thomas

    2014-01-01

    For the purpose of PSA (Probabilistic Safety Analysis) for complex industrial systems, often PSA models in the form of fault and event trees are developed to model the risk of unwanted situations (hazards). While the recent decades, PSA models have gained high acceptance and have been developed massively. This lead to an increase in model sizes and complexity. Today, PSA models are often difficult to understand and maintain. This manuscript presents the concept of a modular PSA. A modular PSA tries to cope with the increased complexity by the techniques of modularization and instantiation. Modularization targets to treat a model by smaller pieces (the 'modules') to regain control over models. Instantiation aims to configure a generic model to different contexts. Both try to reduce model complexity. A modular PSA proposes new functionality to manage PSA models. Current model management is rather limited and not efficient. This manuscript shows new methods to manage the evolutions (versions) and deviations (variants) of PSA models in a modular PSA. The concepts of version and variant management are presented in this thesis. In this context, a model comparison and fusion of PSA models is precised. Model comparison provides important feedback to model engineers and model fusion kind of combines the work from different model engineers (concurrent model engineering). Apart from model management, methods to understand the content of PSA models are presented. The methods focus to highlight the dependencies between modules rather than their contents. Dependencies are automatically derived from a model structure. They express relations between model objects (for example a fault tree may have dependencies to basic events). To visualize those dependencies (for example in form of a model cartography) can constitute a crucial aid to model engineers for understanding complex interrelations in PSA models. Within the scope of this thesis, a software named 'Andromeda' has been

  17. Questionnaire survey of current status and reserve for breast cancer screening in Mie prefecture. Achievement of a 50% participation rate

    International Nuclear Information System (INIS)

    Kobayashi, Shigeki; Tanaka, Yukio; Matsuo, Michiko

    2012-01-01

    Mie Medical Network of Breast Cancer Screening, a NPO, was assigned the task of breast cancer screening in Mie prefecture in April, 2010. For breast cancer screening in Mie prefecture in 2009, a questionnaire survey was performed toward both consigner and consignee. Consigners were local public offices managing breast cancer screening for local inhabitants, and consignees were facilities offering breast cancer screening. The number of breast cancer screening was investigated toward all 29 of consigners in Mie prefecture. The questionnaire survey was conducted toward all 52 of the facilities possessing mammography systems (breast cancer screening being performed at 48 of them) in Mie prefecture in 2009. We investigated the predictive additional number of breast cancer screening and also investigated the requisite number of staff to achieve the predictive maximum number of breast cancer screening. As a result, the total number of breast cancer screenings was 93,525, and the participation rate was 27.5% which was calculated by reduction of continuator in Mie prefecture in 2009. The continuator accounted for over 30% of all breast cancer screenings. The predictive additional number was 126,950, this indicates that a possible participation rate of 75.2% after 2011. To achieve this high participation rate, active support is essential for short-handed facilities, and about 20% increase of medical staff is necessary. To achieve a participation rate of over 50% as a goal, new screenees should be recruited and breast cancer screening of every other year should be enlightened. (author)

  18. Too Much Sodium PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-02-07

    This 60 second PSA is based on the February 2012 CDC Vital Signs report. Ninety percent of Americans age two and older eat too much sodium which can increase your risk for high blood pressure and often leads to heart disease and stroke, two leading causes of death in the US. Learn several small steps you can take to reduce the amount of sodium in your diet.  Created: 2/7/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/7/2012.

  19. Evaluating the impact of an educational intervention to increase CRC screening rates in the African American community: a preliminary study.

    Science.gov (United States)

    Philip, Errol J; DuHamel, Katherine; Jandorf, Lina

    2010-10-01

    Despite the acknowledged importance of colorectal cancer (CRC) screening and its proven prognostic benefit, African American men and women simultaneously possess the highest rates of CRC-related incidence and mortality (Swan et al. in Cancer 97(6):1528-1540, 2003) and lowest screening rates in the United States (Polite et al. in Med Clin N Am 89(4):771-793, 2005). Effective, targeted interventions that promote CRC screening for this community are therefore critical. The current study evaluated the impact of a print-based educational intervention on screening behavior and associated patient-based factors, including cancer-related knowledge, fatalism, worry, and decisional balance (pros-cons). One hundred and eighteen individuals (mean age = 56.08, SD = 5.58) who had not undergone screening were recruited from two health clinics in New York City. Each participant received educational print materials regarding the need for screening, the process of undergoing screening, and the benefits of regular CRC screening. One in four individuals had undergone post-intervention screening at a three-month follow-up. Whereas all participants reported a decrease in cancer-related worry (p benefits and barriers of screening may be critical in the decision to undergo CRC screening. Future interventions to increase CRC-screening rates for this community may be improved by focusing on these patient-based factors.

  20. PSA Duration: Conquering the Prepayment Risk of Mortgage Portfolios

    OpenAIRE

    Boleslav Gulko

    1996-01-01

    Money managers have little control over the values of their individual holdings, but they have considerable control over the risk exposure of their portfolios. This article introduces new tools for the risk management of mortgage portfolios. We extend the traditional duration analysis to two dimensions, interest rates and mortgage prepayments, and develop independent hedging rules for the interest rate risk and the prepayment risk. In particular, we define the PSA duration as a formal measure...

  1. Mammography Clinical Image Quality and the False Positive Rate in a Canadian Breast Cancer Screening Program.

    Science.gov (United States)

    Guertin, Marie-Hélène; Théberge, Isabelle; Zomahoun, Hervé Tchala Vignon; Dufresne, Michel-Pierre; Pelletier, Éric; Brisson, Jacques

    2018-05-01

    The study sought to determine if mammography quality is associated with the false positive (FP) rate in the Quebec breast cancer screening program in 2004 and 2005. Mammography quality of a random sample of screen-film mammograms was evaluated by an expert radiologist following the criteria of the Canadian Association of Radiologists. For each screening examination, scores ranging from 1 (poor quality) to 5 (excellent quality) were attributed for positioning, compression, contrast, exposure level, sharpness, and artifacts. A final overall quality score (lower or higher) was also given. Poisson regression models with robust estimation of variance and adjusted for potential confounding factors were used to assess associations of mammography quality with the FP rate. Among 1,209 women without cancer, there were 104 (8.6%) FPs. Lower overall mammography quality is associated with an increase in the FP rate (risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-2.1; P = .07) but this increase was not statistically significant. Artifacts were associated with an increase in the FP rate (RR, 2.1; 95% CI, 1.3-3.3; P = .01) whereas lower quality of exposure level was related to a reduction of the FP rate (RR, 0.4; 95% CI, 0.1-1.0; P = .01). Lower quality scores for all other quality attributes were related to a nonstatistically significant increase in the FP rate of 10%-30%. Artifacts can have a substantial effect on the FP rate. The effect of overall mammography quality on the FP rate may also be substantial and needs to be clarified. Copyright © 2017 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Screening uptake rates and the clinical and cost effectiveness of screening for gestational diabetes mellitus in primary versus secondary care: study protocol for a randomised controlled trial.

    LENUS (Irish Health Repository)

    O Dea, Angela

    2014-01-17

    The risks associated with gestational diabetes mellitus (GDM) are well recognized, and there is increasing evidence to support treatment of the condition. However, clear guidance on the ideal approach to screening for GDM is lacking. Professional groups continue to debate whether selective screening (based on risk factors) or universal screening is the most appropriate approach. Additionally, there is ongoing debate about what levels of glucose abnormalities during pregnancy respond best to treatment and which maternal and neonatal outcomes benefit most from treatment. Furthermore, the implications of possible screening options on health care costs are not well established. In response to this uncertainty there have been repeated calls for well-designed, randomised trials to determine the efficacy of screening, diagnosis, and management plans for GDM. We describe a randomised controlled trial to investigate screening uptake rates and the clinical and cost effectiveness of screening in primary versus secondary care settings. The objective of this study is to assess screening uptake rates, and the clinical and cost effectiveness of screening for GDM in primary versus secondary care.

  3. PSA Level 2:Scope And Method Of PSA Level 2 For Nuclear Power Plant

    International Nuclear Information System (INIS)

    Widodo, Surip; Antariksawan, Anhar R.

    2001-01-01

    A study of scope and method of PSA Level 2 had been conducted. The background of the study is the need to gain the capability to well perform PSA Level 2 for nuclear facilities. This study is a literature survey. The scope of PSA Level 2 consists of generating plant damage states, accident progression analysis, and grouping source terms. Concerning accident progression analysis, several methods are used, among others event tree method, named accident progression event tree (APET) or containment event tree (CET), and fault tree method. The end result of PSA Level 2 is release end states which is grouped into release bins. The results will be used for PSA Level 3

  4. [PSA interest and prostatitis: literature review].

    Science.gov (United States)

    Bruyère, F; Amine Lakmichi, M

    2013-12-01

    Prostatitis is easily diagnosed but sometimes associated with PSA measurement. An increased PSA in an asymptomatic patient may be associated with antibiotic use to eliminate the inflammatory part and to confirm prostate biopsy. It seems interesting to confirm or infirm these attitudes with a systematic review of the literature We performed a literature review using the words [prostatitis], [acute prostatitis], [prostate specific antigen], [PSA], in the MEDLINE, Pubmed and AMBASE database searching for articles in French or English published in the past 20 years. PSA is not always increased during an acute prostatitis episode. An increased PSA in an asymptomatic man does not seem to be systematically correlated to prostate inflammation. Analyzing the studies, it seems inaccurate to measure PSA value during a febrile urinary infection episode in men. Systematic use of antibiotic to decrease PSA and not performing prostate biopsy is not relevant and may induce resistance to antibiotic and doesn't induce a reduction risk of having prostate biopsy. PSA is unnecessary in case of febrile urinary tract infection in men. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. Nutritional screening and dietitian consultation rates in a geriatric evaluation and management unit.

    Science.gov (United States)

    Dent, Elsa; Wright, Olivia; Hoogendijk, Emiel O; Hubbard, Ruth E

    2018-02-01

    Nutritional screening may not always lead to intervention. The present study aimed to determine: (i) the rate of nutritional screening in hospitalised older adults; (ii) whether nutritional screening led to dietitian consultation and (iii) factors associated with malnutrition. In this prospective study of patients aged ≥70 years admitted to a Geriatric Evaluation and Management Unit (GEMU), malnutrition was screened for using the Mini Nutritional Assessment Short Form (MNA-SF) and identified using the Mini Nutritional Assessment (MNA). Of the 172 patients participating in the study, 53 (30.8%) patients were malnourished, and 84 (48.8%) were at risk of malnutrition. Mean (SD) age was 85.2 (6.4 years), with 131 patients (76.2%) female. Nutritional screening was performed for all patients; however, it was incomplete in 59 (34.3%) because of omission of the anthropometric measurement. Overall, 62 (36.0%) of the total number of patients were seen by the dietitian, which included 26 (49%) of malnourished patients, 27 (32%) of at-risk patients and 9 (26%) of the well-nourished patients. No patients lost >1% of body weight during GEMU stay. Malnourished patients were more likely to be frail, have poor appetite, depression, and have lower levels of: albumin, cognition, physical function, grip strength and quality of life. The full benefits of nutritional screening by MNA-SF may not be realised if it does not result in malnourished patients receiving a dietitian consultation. However, it is possible that enrichment of the foodservice with high protein/high-energy options minimised patient weight loss in the GEMU. © 2017 Dietitians Association of Australia.

  6. 40 CFR Appendix III to Part 266 - Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride III Appendix III to Part 266 Protection of Environment... to Part 266—Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride Terrain...

  7. Performance of serum prostate-specific antigen isoform [-2]proPSA (p2PSA) and the prostate health index (PHI) in a Chinese hospital-based biopsy population.

    Science.gov (United States)

    Na, Rong; Ye, Dingwei; Liu, Fang; Chen, Haitao; Qi, Jun; Wu, Yishuo; Zhang, Guiming; Wang, Meilin; Wang, Wenying; Sun, Jielin; Yu, Guopeng; Zhu, Yao; Ren, Shancheng; Zheng, S Lilly; Jiang, Haowen; Sun, Yinghao; Ding, Qiang; Xu, Jianfeng

    2014-11-01

    The use of serum [-2]proPSA (p2PSA) and its derivative, the prostate health index (PHI), in detecting prostate cancer (PCa) have been consistently shown to have better performance than total prostate-specific antigen (tPSA) in discriminating biopsy outcomes in western countries. However, little is known about their performance in Chinese men. Our objective is to test the performance of p2PSA and PHI and their added value to tPSA in discriminating biopsy outcomes in Chinese men. Consecutive patients who underwent prostate biopsy in three tertiary hospitals in Shanghai, China during 2012-2013 were recruited. Serum tPSA, free PSA (fPSA), and p2PSA were measured centrally using Beckman Coulter's DxI 800 Immunoassay System. The primary outcome is PCa and the secondary outcome is high-grade PCa (Gleason Score of 4 + 3 or worse). Discriminative performance was assessed using the area under the receiver operating characteristic curve (AUC), detection rate and Decision Curve Analysis (DCA). Among 636 patients who underwent prostate biopsy, PHI was a significant predictor of biopsy outcomes, independent of other clinical variables. The AUC in discriminating PCa from non-PCa was consistently higher for PHI than tPSA in the entire cohort (0.88 vs. 0.81) as well as in patients with tPSA at 2-10 ng/ml (0.73 vs. 0.53), at 10.1-20 ng/ml (0.81 vs. 0.58), and at tPSA >20 ng/ml (0.90 vs. 0.80). The differences were statistically significant in all comparisons, P prostate biopsy in China. © 2014 Wiley Periodicals, Inc.

  8. Extent of disease in recurrent prostate cancer determined by [(68)Ga]PSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score.

    Science.gov (United States)

    Verburg, Frederik A; Pfister, David; Heidenreich, Axel; Vogg, Andreas; Drude, Natascha I; Vöö, Stefan; Mottaghy, Felix M; Behrendt, Florian F

    2016-03-01

    To examine the relationship between the extent of disease determined by [(68)Ga]PSMA-HBED-CC-PET/CT and the important clinical measures prostate-specific antigen (PSA), PSA doubling time (PSAdt) and Gleason score. We retrospectively studied the first 155 patients with recurrent prostate cancer (PCA) referred to our university hospital for [(68)Ga]PSMA-HBED-CC PET/CT. PET/CT was positive in 44%, 79% and 89% of patients with PSA levels of ≤1, 1-2 and ≥2 ng/ml, respectively. Patients with high PSA levels showed higher rates of local prostate tumours (p PSA and PSAdt were independent determinants of scan positivity and of extrapelvic lymph node metastases. PSAdt was the only independent marker of bone metastases (p = 0.001). Of 20 patients with a PSAdt PSA ≥2 ng/ml, 19 (95%) had a positive scan and 12 (60%) had M1a disease. Of 14 patients with PSA 6 months, only 5 (36%) had a positive scan and 1 (7%) had M1a disease. [(68)Ga]PSMA-HBED-CC PET/CT will identify PCA lesions even in patients with very low PSA levels. Higher PSA levels and shorter PSAdt are independently associated with scan positivity and extrapelvic metastases, and can be used for patient selection for [(68)Ga]PSMA-HBED-CC PET/CT.

  9. Prostate-specific antigen (PSA) as a possible biomarker in non-prostatic cancer: A review.

    Science.gov (United States)

    Pérez-Ibave, Diana Cristina; Burciaga-Flores, Carlos Horacio; Elizondo-Riojas, Miguel-Ángel

    2018-06-01

    Prostate-specific antigen (PSA) is a serine protease produced by epithelial prostatic cells and its main function is to liquefy seminal coagulum. Currently, PSA is a biomarker for the diagnosis and screening of prostate cancer and it was the first cancer biomarker approved by the FDA. The quantity and serum isoforms of male PSA, allows distinguishing between carcinoma and benign inflammatory disease of the prostate. Initially, it was thought that PSA was produced only by the prostate, and thus, a protein that was expressed exclusively in men. However, several authors report that PSA is a protein that is expressed by multiple non-prostatic tissues not only in men but also in women. Some authors also report that in women, the expression of this protein is highly related to breast and colon cancer and therefore can act as a possible biomarker for early detection, diagnosis and prognosis of these cancers in women. In this review, we will focus on the characteristics of the PSA at a molecular level, its current clinical implications, the expression of this protein in non-prostatic tissues, and its relationship with cancer, especially in women. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. A Cost-Utility Analysis of Prostate Cancer Screening in Australia.

    Science.gov (United States)

    Keller, Andrew; Gericke, Christian; Whitty, Jennifer A; Yaxley, John; Kua, Boon; Coughlin, Geoff; Gianduzzo, Troy

    2017-02-01

    The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. A decision model that incorporated Markov processes was developed from a health system perspective. The base-case scenario compared a population-based screening programme with current opportunistic screening practices. Costs, utility values, treatment patterns and background mortality rates were derived from Australian data. All costs were adjusted to reflect July 2015 Australian dollars (A$). An alternative scenario compared systematic with opportunistic screening but with optimisation of active surveillance (AS) uptake in both groups. A discount rate of 5 % for costs and benefits was utilised. Univariate and probabilistic sensitivity analyses were performed to assess the effect of variable uncertainty on model outcomes. Our model very closely replicated the number of deaths from both prostate cancer and background mortality in the Göteborg study. The incremental cost per quality-adjusted life-year (QALY) for PSA screening was A$147,528. However, for years of life gained (LYGs), PSA-based screening (A$45,890/LYG) appeared more favourable. Our alternative scenario with optimised AS improved cost utility to A$45,881/QALY, with screening becoming cost effective at a 92 % AS uptake rate. Both modelled scenarios were most sensitive to the utility of patients before and after intervention, and the discount rate used. PSA-based screening is not cost effective compared with Australia's assumed willingness-to-pay threshold of A$50,000/QALY. It appears more cost effective if LYGs are used as the relevant outcome, and is more cost effective than the

  11. A System Dynamics Model of Serum Prostate-Specific Antigen Screening for Prostate Cancer.

    Science.gov (United States)

    Palma, Anton; Lounsbury, David W; Schlecht, Nicolas F; Agalliu, Ilir

    2016-02-01

    Since 2012, US guidelines have recommended against prostate-specific antigen (PSA) screening for prostate cancer. However, evidence of screening benefit from the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial and the European Randomized Study of Screening for Prostate Cancer has been inconsistent, due partly to differences in noncompliance and contamination. Using system dynamics modeling, we replicated the PLCO trial and extrapolated follow-up to 20 years. We then simulated 3 scenarios correcting for contamination in the PLCO control arm using Surveillance, Epidemiology, and End Results (SEER) incidence and survival data collected prior to the PSA screening era (scenario 1), SEER data collected during the PLCO trial period (1993-2001) (scenario 2), and data from the European trial's control arm (1991-2005) (scenario 3). In all scenarios, noncompliance was corrected using incidence and survival rates for men with screen-detected cancer in the PLCO screening arm. Scenarios 1 and 3 showed a benefit of PSA screening, with relative risks of 0.62 (95% confidence interval: 0.53, 0.72) and 0.70 (95% confidence interval: 0.59, 0.83) for cancer-specific mortality after 20 years, respectively. In scenario 2, however, there was no benefit of screening. This simulation showed that after correcting for noncompliance and contamination, there is potential benefit of PSA screening in reducing prostate cancer mortality. It also demonstrates the utility of system dynamics modeling for synthesizing epidemiologic evidence to inform public policy. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Decision criteria in PSA applications

    International Nuclear Information System (INIS)

    Holmberg, J.E.; Pulkkinen, U.; Rosqvist, T.; Simola, K.

    2001-11-01

    Along with the adoption of risk informed decision making principles, the need for formal probabilistic decision rule or criteria has been risen. However, there are many practical and theoretical problems in the application of probabilistic criteria. One has to think what is the proper way to apply probabilistic rules together with deterministic ones and how the criteria are weighted with respect to each other. In this report, we approach the above questions from the decision theoretic point of view. We give a short review of the most well known probabilistic criteria, and discuss examples of their use. We present a decision analytic framework for evaluating the criteria, and we analyse how the different criteria behave under incompleteness or uncertainty of the PSA model. As the conclusion of our analysis we give recommendations on the application of the criteria in different decision situations. (au)

  13. Losing the Dark: A Planetarium PSA about Light Pollution

    Science.gov (United States)

    Petersen, Carolyn Collins; Walker, Constance

    2015-03-01

    Losing the Dark is a six-minute PSA video created for fulldome theaters by Loch Ness Productions, the International Dark Sky Association Education Committee headed by Dr. Constance Walker of the National Optical Astronomy Observatories, Dome3, Adler Planetarium, and Babak Tafreshi (The World at Night). It explains light pollution, its effects, and ways to implement ``wise lighting`` practices to mitigate light pollution. The show is also made in flat-screen HD format for classical planetariums, non-dome theaters, and for presentatons by IDA speakers.

  14. Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the Göteborg randomized population-based prostate cancer screening trial.

    Science.gov (United States)

    Arnsrud Godtman, Rebecka; Holmberg, Erik; Lilja, Hans; Stranne, Johan; Hugosson, Jonas

    2015-09-01

    It has been shown that organized screening decreases prostate cancer (PC) mortality, but the effect of opportunistic screening is largely unknown. To compare the ability to reduce PC mortality and the risk of overdiagnosis between organized and opportunistic screening. The Göteborg screening study invited 10 000 randomly selected men for prostate-specific antigen (PSA) testing every 2 yr since 1995, with a prostate biopsy recommended for men with PSA ≥2.5 ng/ml. The control group of 10 000 men not invited has been exposed to a previously reported increased rate of opportunistic PSA testing. Both groups were followed until December 31, 2012. Observed cumulative PC incidence and mortality rates in both groups were calculated using the actuarial method. Using historical data from 1990-1994 (pre-PSA era), we calculated expected PC incidence and mortality rates in the absence of any PSA testing. The number needed to invite (NNI) and the number needed to diagnose (NND) were calculated by comparing the expected versus observed incidence and mortality rates. At 18 yr, 1396 men were diagnosed with PC and 79 men died of PC in the screening group, compared to 962 and 122, respectively, in the control group. In the screening group, the observed cumulative PC incidence/mortality was 16%/0.98% compared to expected values of 6.8%/1.7%. The corresponding values for the control group were 11%/1.5% and 6.9%/1.7%. Organized screening was associated with an absolute PC-specific mortality reduction of 0.72% (95% confidence interval [CI] 0.50-0.94%) and relative risk reduction of 42% (95% CI 28-54%). There was an absolute reduction in PC deaths of 0.20% (95% CI -0.06% to 0.47%) and a relative risk reduction of 12% (95% CI -5 to 26%) associated with opportunistic PSA testing. NNI and NND were 139 (95% CI 107-200) and 13 for organized biennial screening and 493 (95% CI 213- -1563) and 23 for opportunistic screening. The extent of opportunistic screening could not be measured

  15. Emesis as a Screening Diagnostic for Low Dose Rate (LDR) Total Body Radiation Exposure.

    Science.gov (United States)

    Camarata, Andrew S; Switchenko, Jeffrey M; Demidenko, Eugene; Flood, Ann B; Swartz, Harold M; Ali, Arif N

    2016-04-01

    Current radiation disaster manuals list the time-to-emesis (TE) as the key triage indicator of radiation dose. The data used to support TE recommendations were derived primarily from nearly instantaneous, high dose-rate exposures as part of variable condition accident databases. To date, there has not been a systematic differentiation between triage dose estimates associated with high and low dose rate (LDR) exposures, even though it is likely that after a nuclear detonation or radiologic disaster, many surviving casualties would have received a significant portion of their total exposure from fallout (LDR exposure) rather than from the initial nuclear detonation or criticality event (high dose rate exposure). This commentary discusses the issues surrounding the use of emesis as a screening diagnostic for radiation dose after LDR exposure. As part of this discussion, previously published clinical data on emesis after LDR total body irradiation (TBI) is statistically re-analyzed as an illustration of the complexity of the issue and confounding factors. This previously published data includes 107 patients who underwent TBI up to 10.5 Gy in a single fraction delivered over several hours at 0.02 to 0.04 Gy min. Estimates based on these data for the sensitivity of emesis as a screening diagnostic for the low dose rate radiation exposure range from 57.1% to 76.6%, and the estimates for specificity range from 87.5% to 99.4%. Though the original data contain multiple confounding factors, the evidence regarding sensitivity suggests that emesis appears to be quite poor as a medical screening diagnostic for LDR exposures.

  16. Effects of transient blur and VDT screen luminance changes on eyeblink rate.

    Science.gov (United States)

    Cardona, Genís; Gómez, Marcelo; Quevedo, Lluïsa; Gispets, Joan

    2014-10-01

    A study was designed to evaluate the efficacy of three different strategies aiming at increasing spontaneous eyeblink rate (SEBR) during computer use. A total of 12 subjects (5 female) with a mean age of 28.7 years were instructed to read a text presented on a computer display terminal during 15min. Four reading sessions (reference and three "blinking events" [BE]) were programmed in which SEBR was digitally recorded. "Blinking events" were based on either a slight distortion of the text characters or on the presentation of a white screen instead of the text, with or without accompanying blinking instructions. All BE had a duration of 20ms and occurred every 15s. Participants graded the intrusiveness of each BE configuration, and the number of lines participants read in each session was recorded. Data from 11 subjects was analysed. A statistically significant difference in SEBR was encountered between the experimental configuration consisting on a white screen plus blinking instructions (7.8 blinks/min) and both reference (5.2 blinks/min; p=0.049) and white screen without blinking instructions (4.8 blinks/min; p=0.038). All three BE had superior levels of intrusiveness than reference conditions, although the performance of participants (line count) was not compromised. The joint contribution of white screen and blinking instructions has been shown to result in a short term improvement in blinking rate in the present sample of non-dry eye computer users. Further work is necessary to improve the acceptance of any BE aiming at influencing SEBR. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  17. Real-life experience of using conventional disease-modifying anti-rheumatic drugs (DMARDs) in psoriatic arthritis (PsA). Retrospective analysis of the efficacy of methotrexate, sulfasalazine, and leflunomide in PsA in comparison to spondyloarthritides other than PsA and literature review of the use of conventional DMARDs in PsA

    Science.gov (United States)

    Roussou, Euthalia; Bouraoui, Aicha

    2017-01-01

    Objective With the aim of assessing the response to treatment with conventional disease-modifying anti-rheumatic drugs (DMARDs) used in patients with psoriatic arthritis (PsA), data on methotrexate, sulfasalazine (SSZ), and leflunomide were analyzed from baseline and subsequent follow-up (FU) questionnaires completed by patients with either PsA or other spondyloarthritides (SpAs). Material and Methods A single-center real-life retrospective analysis was performed by obtaining clinical data via questionnaires administered before and after treatment. The indices used were erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), wellbeing (WB), and treatment effect (TxE). The indices measured at baseline were compared with those measured on one occasion in a FU visit at least 1 year later. Results A total of 73 patients, 51 with PsA (mean age 49.8±12.8 years; male-to-female ratio [M:F]=18:33) and 22 with other SpAs (mean age 50.6±16 years; M:F=2:20), were studied. BASDAI, BASFI, and WB displayed consistent improvements during FU assessments in both PsA patients and controls in comparison to baseline values. SSZ exhibited better efficacy as confirmed by TxE in both PsA patients and controls. ESR and CRP displayed no differences in either the PsA or the SpA group between the cases before and after treatment. Conclusion Real-life retrospective analysis of three DMARDs used in PsA (and SpAs other than PsA) demonstrated that all three DMARDs that were used brought about improvements in BASDAI, BASFI, TxE, and WB. However, the greatest improvements at FU were seen with SSZ use in both PsA and control cohorts. PMID:28293446

  18. Radiometric assays for the measurement of PSA

    International Nuclear Information System (INIS)

    Venkatesh, M.

    1997-01-01

    Prostate Specific Antigen, a serine protease enzyme, of M.W. ∼ 26-33 kDa, is widely considered to be a very useful marker for prostate cancer. It satisfies nearly all the requirements of an ideal 'Tumour Marker' and has hence attracted a lot of attention in the past decade. PSA is present in multiple forms in serum, with an appreciable fraction bound to the protease inhibitor α-1-antichymotrypsin (ACT) and to a small extent to other proteins such as α-2-macroglobulin (AMG) leaving the rest in the free form. The total PSA levels have been reported to have 80% sensitivity and 60% specificity towards the detection of prostate cancer. The lack of specificity occurs mainly due to the high levels of t-PSA in benign prostatic hypertrophy(BPH) apart from the cancer. The concept of free PSA has been introduced in the recent past and the ratio of free/total PSA levels have been shown to be advantageous in the differential diagnosis of BPH from prostate cancer. The f/t ratio is considered to be particularly useful in the grey zones of decision making (t-PSA levels 4-20 ng/mL). The need for the development of assays for total and free PSA is felt due to: a. the high incidence of prostate cancers being detected currently; b. the high cost of tests (higher for free PSA assay, and the cost becomes an important parameter when a patient has to be regularly monitored after therapy) that is not affordable for many patients; c. the potential for research in the area of prostate cancer management where the PSA (total and free) assays will be of great help

  19. Prostate-specific antigen (PSA/hK3): a further player in the field of breast cancer diagnostics?

    OpenAIRE

    Mannello, Ferdinando; Gazzanelli, Giancarlo

    2001-01-01

    Since its identification, much information has been obtained about prostate-specific antigen (PSA, or human glandular kallikrein 3 [hK3]), a kallikrein-like serine protease that is the most valuable tumour marker for the screening, diagnosis and management of human prostate carcinoma. Recently, it has become widely accepted that PSA is also present in many nonprostatic sources, casting doubts about the specificity of its tissue expression. Here we summarize the findings on the biomolecular ex...

  20. The clinical study of serum PSA and fPSA assayed by CLIA in diagnosing prostate disease

    International Nuclear Information System (INIS)

    Xiong Jiang; Qian Xiaoyu; Ji Hong; Yang Su; Ding Ying; Zhu Ruisen; Chen Zhong

    2003-01-01

    The purpose of this study is to evaluate the clinical value of PSA (prostate specific antigen) and fPSA(free prostate specific antigen) in differentiating prostate disease. CLIA was used to quantitatively assay PSA, fPSA and fPSA/PSA in 30 cases of normal controls, 32 cases of prostate cancer patients and 76 cases of BPH patients. The result showed that if liminal value of PSA was set at 4 ng/mL, the diagnostic sensitivity and specificity of prostate cancer were 100% and 50.6% respectively. Meanwhile, if liminal value of fPSA/PSA set at 16% was added, the diagnostic sensitivity and specificity of prostate cancer were 100% and 85.3% respectively. It was concluded that the combining assay of PSA and fPSA could increase the diagnostic specificity of prostate cancer in a certain degree

  1. PSA as a tool for decision making

    International Nuclear Information System (INIS)

    Niehaus, F.; Lederman, L.

    1986-01-01

    The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods. (orig.)

  2. PSA as a tool for decision making

    Energy Technology Data Exchange (ETDEWEB)

    Niehaus, F; Lederman, L

    1986-05-01

    The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods.

  3. Consensus review of discordant findings maximizes cancer detection rate in double-reader screening mammography: Irish National Breast Screening Program experience.

    Science.gov (United States)

    Shaw, Colette M; Flanagan, Fidema L; Fenlon, Helen M; McNicholas, Michelle M

    2009-02-01

    To assesses consensus review of discordant screening mammography findings in terms of its sensitivity, safety, and effect on overall performance in the first 6 years of operation of the Irish National Breast Screening Program (NBSP). Women who participated in the Irish NBSP gave written informed consent for use of their data for auditing purposes. Local ethics committee approval was obtained. The study population consisted of women who participated in the Irish NBSP and underwent initial screening mammography at one of the two screening centers serving the eastern part of Ireland between 2000 and 2005. Independent double reading of mammograms was performed. When the readers disagreed regarding referral, the case was reviewed by a consensus panel. Of the 128 569 screenings performed, 1335 (1%) were discussed by consensus. Of the 1335 cases discussed by consensus, 606 (45.39%) were recalled for further assessment. This resulted in an overall recall rate of 4.41%. In those recalled to assessment, 71 cases of malignant disease were diagnosed (ductal carcinoma in situ, n = 24; invasive cancer, n = 47). The remaining 729 patients were returned to biennial screening. Of these 729 patients, seven had false-negative findings that were identified in the subsequent screening round. Use of the highest reader recall method, in which a patient is recalled if her findings are deemed abnormal by either reader, could potentially increase the cancer detection rate by 0.6 per 1000 women screened but would increase the recall rate by 12.69% and the number of false-positive findings by 15.37%. The consensus panel identified 71 (7.33%) of 968 cancers diagnosed. Consensus review substantially reduced the number of cases recalled and was associated with a low false-negative rate.

  4. High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2013-05-01

    The objectives of this study were to: (1) assess the prevalence of psoriatic arthritis (PsA) among Psoriasis (Ps) patients attending dermatology clinics; (2) identify clinical predictors of the development of PsA; and (3) compare the performance of three PsA screening questionnaires: Psoriatic Arthritis Screening and Evaluation (PASE), Psoriasis Epidemiology Screening Tool (PEST) and Toronto Psoriatic Arthritis Screening (ToPAS).

  5. The diagnostic value of PSA, cPSA and bone scintigraphy for early skeletal metastasis of prostate cancer

    International Nuclear Information System (INIS)

    Xue Zhongguang

    2007-01-01

    Objective: To evaluate the value of prostate specific antigen (PSA), complexed prostate specific antigen (cPSA) and bone scintigraphic imaging in diagnosis of early skeletal metastasis of prostate cancer. Methods: 152 patients (74 with prostate cancer, 78 with benign prostate disease) and 90 controls were examined for the serum concentrations of PSA and cPSA. At the same time, the 74 patients with PCa were examined with bone scintigraphy. The cPSA/PSA ratio was calculated. Results: Serum PSA, cPSA levels and cPSA/PSA ratio of patients with prostate cancer were significantly higher than those in benign prostate patients and controls. In addition, the serum PSA, cPSA levels and cPSA/PSA ratio in prostate cancer patients with skeletal metastasis were remarkably higher than those in patients without skeletal metastasis, and the differences were significant (P 20 μg/L, cPSA>10 μg/L, cPSA/PSA>0.80, there is a high probability that skeletal metastasis of prostate cancer would be present and bone scintigraphy should be performed. (authors)

  6. Methodology for Selecting Initiating Events and Hazards for Consideration in an Extended PSA

    International Nuclear Information System (INIS)

    Wielenberg, A.; Hage, M.; Loeffler, H.; Alzbutas, R.; Apostol, M.; Bareith, A.; Siklossy, T.; Brac, P.; Burgazzi, L.; Cazzoli, E.; Vitazkova, J.; Cizelj, L.; Prosek, A.; Volkanovski, A.; Hashimoto, K.; Godefroy, F.; Gonzalez, M.; Groudev, P.; Kolar, L.; Kumar, M.; Nitoi, M.; Raimond, E.

    2016-01-01

    An extended PSA applies to a site of one or several Nuclear Power Plant unit(s) and its environment. It intends to calculate the risk induced by the main sources of radioactivity (reactor core and spent fuel storages) on the site, taking into account all operating states for each main source and all possible relevant accident initiating events (both internal and external) affecting one unit or the whole site. The combination between hazards or initiating events and their impact on a unit or the whole site is a crucial issue for an extended PSA. The report tries to discuss relevant methodologies for this purpose. The report proposes a methodology to select initiating events and hazards for the development of an extended PSA. The proposed methodology for initiating events identification, screening and bounding analysis for an extended PSA consists of four major steps: 1. A comprehensive identification of events and hazards and their respective combinations applicable to the plant and site. Qualitative screening criteria will be applied, 2. The calculation of initial (possibly conservative) frequency claims for events and hazards and their respective combinations applicable to the plant and the site. Quantitative screening criteria will be applied, 3. An impact analysis and bounding assessment for all applicable events and scenarios. Events are either screened out from further more detailed analysis, or are assigned to a bounding event (group), or are retained for detailed analysis, 4. The probabilistic analysis of all retained (bounding) events at the appropriate level of detail. (authors)

  7. Cancer - What You Don't Know Can Kill You PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-07-22

    This 60 second PSA is based on the July 2010 CDC Vital Signs report which provides information on colorectal and breast cancer and the importance of getting screened.  Created: 7/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/22/2010.

  8. Non-operative diagnosis - effect on repeat-operation rates in the UK breast screening programme

    International Nuclear Information System (INIS)

    Wallis, M.G.; Cheung, S.; Kearins, O.; Lawrence, G.M.

    2009-01-01

    Non-operative diagnosis rates in the UK breast screening programme have improved dramatically from 48.8% in 1994/95 (only nine units achieved the then minimum standard of 70%) to 94% in 2005/06 (only seven units failed to achieve the target of 90%). Preoperative and operative history of all 120,550 women diagnosed with screen-detected breast cancer in the UK between April 1994 and March 2006 was derived from different national databases. In 2005/06, 2,790 (17.8%) of the 15,688 women having surgery needed two or more operations. In 2001/02 (non-operative diagnosis rate 87%), the re-operation rate was 23.8% (2,377 of 9,969). Extrapolation backwards to 1994/95 (non-operative diagnosis rate 48.8%) suggests a re-operation rate of 62%. Analysis over the 4 years from April 2002 (n=34,198) demonstrates that 4,089 (12%) women with a correct non-operative diagnosis of invasive disease required additional surgery compared to 1,166 (48%) of women who were under-staged (diagnosed as non-invasive based on core biopsy, but actually suffering from invasive disease). Failure to achieve a non-operative diagnosis of invasive disease (n=1,542) or non-invasive disease (n=2,247) resulted in re-operation rates of 65 and 43% respectively. Given the impact of not having a diagnosis pre-operatively, or of under-staging invasive carcinoma, it seems timely to introduce more sophisticated standards. (orig.)

  9. PET/CT with (18)F-choline after radical prostatectomy in patients with PSA ≤2 ng/ml. Can PSA velocity and PSA doubling time help in patient selection?

    Science.gov (United States)

    Chiaravalloti, Agostino; Di Biagio, Daniele; Tavolozza, Mario; Calabria, Ferdinando; Schillaci, Orazio

    2016-07-01

    To investigate the performance of (18)F-fluorocholine ((18)F-FCH) PET/CT in relation to the prostate-specific antigen (PSA) kinetic indexes, PSA doubling time (PSAdt) and PSA velocity (PSAve), in detecting recurrent prostate cancer (PC) in a selected population of patients treated with radical prostatectomy and with PSA ≤2 ng/ml. The study group comprised 79 patients (mean age 70 ± 7 years, range 58 - 77 years) who had been treated with radical surgery 30 to 90 months previously and with biochemical failure (defined as a measurable serum PSA level) who were evaluated with (18)F-FCH PET/CT. In order to establish the optimal threshold for PSAdt and PSAve, the diagnostic performance of PSA, PSAdt and PSAve were compared by receiver operating characteristic analysis. In the population examined, PSA (mean ± SD) was 1.37 ± 0.44 ng/ml (range 0.21 - 2 ng/ml) before PET/CT examination, PSAdt was 10.04 ± 16.67 months and PSAve was 2.75 ± 3.11 ng/ml per year. (18)F-FCH PET/CT was positive in 44 patients (55 %). PSAve and PSAdt were significantly different between patients with a positive and a negative (18)F-FCH PET/CT scan. Thresholds of 6 months for PSAdt and 1 ng/ml per year for PSAve were selected. For PSAdt ≤6 months the detection rate (DR) was 65 %, and for PSAve >1 ng/ml per year the DR was 67 %. PSA values were not significantly different between patients with a positive and a negative PET/CT scan. The results of our study suggest that (18)F-FCH PET/CT could be considered for the evaluation of patients with biochemical recurrence of PC and with low PSA levels. Fast PSA kinetics could be useful in the selection of these patients.

  10. Has prenatal screening influenced the prevalence of comorbidities associated with Down syndrome and subsequent survival rates?

    Science.gov (United States)

    Halliday, Jane; Collins, Veronica; Riley, Merilyn; Youssef, Danielle; Muggli, Evelyne

    2009-01-01

    With this study we aimed to compare survival rates for children with Down syndrome in 2 time periods, 1 before prenatal screening (1988-1990) and 1 contemporaneous with screening (1998-2000), and to examine the frequency of comorbidities and their influence on survival rates. Record-linkage was performed between the population-based Victorian Birth Defects Register and records of deaths in children up to 15 years of age collected under the auspice of the Consultative Council on Obstetric and Pediatric Mortality and Morbidity. Cases of Down syndrome were coded according to the presence or absence of comorbidities by using the International Classification of Diseases, Ninth Revision classification of birth defects. Kaplan-Meier survival functions and log rank tests for equality of survival distributions were performed. Of infants liveborn with Down syndrome in 1998-2000, 90% survived to 5 years of age, compared with 86% in the earlier cohort. With fetal deaths excluded, the proportion of isolated Down syndrome cases in the earlier cohort was 48.7% compared with 46.1% in the most recent cohort. In 1988-1990 there was at least 1 cardiac defect in 41.1% of cases and in 45.4% in 1998-2000. There was significant variation in survival rates for the different comorbidity groupings in the 1988-1990 cohort, but this was not so evident in the 1998-2000 cohort. Survival of children with Down syndrome continues to improve, and there is an overall survival figure of 90% to at least 5 years of age. It is clear from this study that prenatal screening technologies are not differentially ascertaining fetuses with Down syndrome and additional defects, because there has been no proportional increase in births of isolated cases with Down syndrome.

  11. Improving rates of screening and prevention by leveraging existing information systems.

    Science.gov (United States)

    Neil, Nancy

    2003-11-01

    In 1997 Virginia Mason Health System (VMMC), a vertically integrated hospital and multispecialty group practice, had no process or system to deliver the right patient clinical data, in the right form, at the right place--when providers needed it for effective patient care. Without any new investment in technology, a work group of five individuals leveraged existing, primarily paper-based information systems to launch development and implementation of a provider prompting tool--a primary care and prevention (PCP) report--which prompted providers to complete screening, prevention, and disease management services at every patient appointment. The work group developed and pilot tested the report and created a mechanism by which the report could be delivered just in time before each patient's appointment. The report integrated information from independent appointment scheduling, laboratory results reporting, patient demographics, and billing data sources. MEASURING THE PCP REPORT'S IMPACT: The results of two separate analyses demonstrate improvement in rates of screening and prevention across VMMC soon after the PCP report became available. These results led senior leadership to make the PCP report's utilization a systemwide imperative. The PCP report is used by nearly all primary care providers as a prompt to complete screening, prevention, and disease management services at every patient appointment.

  12. Flooding PSA by considering the operating experience data of Korean PWRs

    International Nuclear Information System (INIS)

    Choi, Sun Yeong; Yang, Joon Eon

    2007-01-01

    The existing flooding Probabilistic Safety Analysis (PSA) was updated to reflect the Korean plant specific operating experience data into the flooding frequency to improve the PSA quality. Both the Nuclear Power Experience (NPE) database and the Korea Nuclear PIPE Failure Database (NuPIPE) databases were used in this study, and from these databases, only the Pressurized Water Reactor (PWR) data were used for the flooding frequencies of the flooding areas in the primary auxiliary building. With these databases and a Bayesian method, the flooding frequencies for the flooding areas were estimated. Subsequently, the Core Damage Frequency (CDF) for the flooding PSA of the UlChiN (UCN) unit 3 and 4 plants based on the Korean Standard Nuclear power Plant (KSNP) internal full-power PSA model was recalculated. The evaluation results showed that sixteen flooding events are potentially significant according to the screening criterion, while there were two flooding events exceeding the screening criterion of the existing UCN 3 and 4 flooding PSA. The result was compared with two kinds of cases: 1) the flooding frequency and CDF from the method of the existing flooding PSA with the PWR and Boiled Water Reactor (BWR) data of the NPE database and the Maximum Likelihood Estimate (MLE) method and 2) the flooding frequency and CDF with the NPE database (PWR and BWR data), NuPIPE database, and a Bayesian method. From the comparison, a difference in CDF results was revealed more clearly between the CDF from this study and case 2) than between case 1) and case 2). That is, the number of flooding events exceeding the screen criterion further increased when only the PWR data were used for the primary auxiliary building than when the Korean specific data were used

  13. More Adults Are Walking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second PSA is based on the August 2012 CDC Vital Signs report. While more adults are walking, only half get the recommended amount of physical activity. Listen to learn how communities, employers, and individuals may help increase walking.

  14. Methodology for fire PSA during design process

    International Nuclear Information System (INIS)

    Kollasko, Heiko; Blombach, Joerg

    2009-01-01

    Fire PSA is an essential part of a full scope level 1 PSA. Cable fires play an important role in fire PSA. Usually, cable routing is therefore modeled in detail. During the design of new nuclear power plants the information on cable routing is not yet available. However, for the use of probabilistic safety insights during the design and for licensing purposes a fire PSA may be requested. Therefore a methodology has been developed which makes use of the strictly divisional separation of redundancies in the design of modern nuclear power plants: cable routing is not needed within one division but replaced by the conservative assumption that all equipment fails due to a fire in the concerned division; critical fire areas are defined where components belonging to different divisions may be affected by a fire. For the determination of fire frequencies a component based approach is proposed. The resulting core damage frequencies due to fire are conservative. (orig.)

  15. A preliminary investigation of PSA validation methods

    Energy Technology Data Exchange (ETDEWEB)

    Unwin, S D [Science Applications International Corp., (United States)

    1995-09-01

    This document has been prepared to support the initial phase of the Atomic Energy Control Board`s program to review and evaluate Probabilistic Safety Assessment (PSA) studies conducted by nuclear generating station designers and licensees. The document provides (1) a review of current and prospective applications of PSA technology in the Canadian nuclear power industry; (2) an assessment of existing practices and techniques for the review or risk and hazard identification studies in the international nuclear power sector and other technological sectors; and (3) proposed analytical framework in which to develop systematic techniques for the scrutiny and evaluation of a PSA model. These frameworks are based on consideration of the mathematical structure of a PSA model and are intended to facilitate the development of methods to evaluate a model relative to intended end-uses. (author). 34 refs., 10 tabs., 3 figs.

  16. A preliminary investigation of PSA validation methods

    International Nuclear Information System (INIS)

    Unwin, S.D.

    1995-09-01

    This document has been prepared to support the initial phase of the Atomic Energy Control Board's program to review and evaluate Probabilistic Safety Assessment (PSA) studies conducted by nuclear generating station designers and licensees. The document provides (1) a review of current and prospective applications of PSA technology in the Canadian nuclear power industry; (2) an assessment of existing practices and techniques for the review or risk and hazard identification studies in the international nuclear power sector and other technological sectors; and (3) proposed analytical framework in which to develop systematic techniques for the scrutiny and evaluation of a PSA model. These frameworks are based on consideration of the mathematical structure of a PSA model and are intended to facilitate the development of methods to evaluate a model relative to intended end-uses. (author). 34 refs., 10 tabs., 3 figs

  17. PDS4 Challenges in the PSA

    Science.gov (United States)

    Saiz, J.; Barbarisi, I.; Docasal, R.; Rios, C.; Montero, A.; Macfarlane, A.; Laantee, C.; Besse, S.; Vallat, C.; Marcos, J.; Arenas, J.; Osinde, J.; Arviset, C.

    2018-04-01

    The Planetary Science Archive (PSA) stores products from all planetary ESA missions. Adopting PDS4 as the standard for new missions, while being compatible with existing PDS3 products, has driven a design with several difficulties to overcome.

  18. Proceedings of the 10th Korea-Japan joint workshop on PSA. For Asian PSA network

    International Nuclear Information System (INIS)

    Yang, Joon-Eon; Homma, Toshimitsu

    2009-12-01

    The tenth Korea-Japan Joint Workshop on Probabilistic Safety Assessment (PSA) was held in the Jeju island of Korea, on May 18-20, 2009 organized by Korea Atomic Energy Research Institute (KAERI). The purpose of the workshop was to provide a forum for presentation and discussions on experiences and technical achievements related to PSA, risk-informed and performance-based approach, and other relevant issues in both countries. Since the first Korea-Japan Joint Workshop on PSA started in 1992, the workshops have provided an important and timely opportunity for exchange and discussion of the relevant information to all PSA practitioners and users of risk information in the industry, research, academia and regulatory arena. This was the tenth anniversary of the Joint Workshop with the main theme of 'For Asian PSA Network' and participants included those from China, Taiwan and the United States of America besides Korea and Japan. Two keynote speeches were presented by the former chairmen of this workshop, Prof. Chang-Sun Kang of Seoul National University and Prof. emeritus Shunsuke Kondo of Tokyo University. We had two special lectures, 70 papers presented by experts at 10 technical sessions related PSA, the special session on the status of PSA in Korea, Japan, China and Taiwan and panel discussion on their cooperation in PSA. This report provides the summary of each session, and all the presentation materials presented in the 10th Korea-Japan Joint Workshop on PSA. (author)

  19. IAEA work with guides for PSA quality

    International Nuclear Information System (INIS)

    Hellstroem, Per

    2004-09-01

    IAEA has a project on development of a TECDOC 'PSA Quality for Various Applications'. The project develops the guidance document in stages with intermediate meetings with exchange of ideas, thoughts and experience. Draft versions are being produced successively. The objective with the project is to use attributes to describe the quality of different elements of a PSA (Analysis of initiating events, accident progression, system, data, human reliability, etc) making the PSA suitable for application in various risk informed activities. Two of the meetings in this project took place in February 2004 and in July 2004. The February meeting discussed different aspects of PSA quality in relation to applications and a draft of the TECDOC was reviewed. The meeting made recommendations for preparation of a final document and set priorities for further work in the area. The July meeting elaborated the document further in a small working group and a new draft version was prepared. A final version is expected to be published during 2005. The project has come to the conclusion that it is a limited number of PSA element attributes that are specific for a certain application. Most of the attributes concern plant specificity, realism and level of detail in a general manner, how plant specific is the model, how realistic and how detailed? Many attributes have the characteristic that they are good to have, but not necessarily needed to do the job. This last statement is valid both for a baseline PSA and a PSA application. The IAEA project has identified a limited number of attributes that are necessary to describe characteristics needed for specific applications. The PSA scope needed for a specific application is not covered by the project/document, even though it is obvious that different applications will need different scope or approaches to handle scope limitations. The guidance on performing a PSA available today is old. It is a need to review these guides and update with regard

  20. Detection of prostate cancer by an FDG-PET cancer screening program: results from a Japanese nationwide survey

    International Nuclear Information System (INIS)

    Minamimoto, Ryogo; Senda, Michio; Jinnouchi, Seishi; Terauchi, Takashi; Inoue, Tomio

    2014-01-01

    The aim of this study was to analyze detection rates and effectiveness of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) cancer screening program for prostate cancer in Japan, which is defined as a cancer-screening program for subjects without known cancer. It contains FDG-PET aimed at detection of cancer at an early stage with or without additional screening tests such as prostate-specific antigen (PSA) and magnetic resonance imaging (MRI). A total of 92,255 asymptomatic men underwent the FDG-PET cancer screening program. Of these, 504 cases with findings of possible prostate cancer in any screening method were analyzed. Of the 504 cases, 165 were verified as having prostate cancer. Of these, only 61 cases were detected by FDG-PET, which result in 37.0% relative sensitivity and 32.8% positive predictive value (PPV). The sensitivity of PET/computed tomography (CT) scanner was higher than that of dedicated PET (44.0% vs. 20.4%). However, the sensitivity of FDG-PET was lower than that of PSA and pelvic MRI. FDG-PET did not contribute to improving the sensitivity and PPV when performed as combined screening. PSA should be included in FDG-PET cancer screening programs to screen for prostate cancer

  1. Review of APR+ Level 2 PSA

    International Nuclear Information System (INIS)

    Lehner, J.R.; Mubayi, V.; Pratt, W.T.

    2012-01-01

    Brookhaven National Laboratory (BNL) assisted the Korea Institute of Nuclear Safety (KINS) in reviewing the Level 2 Probabilistic Safety Assessment (PSA) of the APR+ Advanced Pressurized Water Reactor (PWR) prepared by the Korea Hydro and Nuclear Power Co., Ltd (KHNP) and KEPCO Engineering and Construction Co., Inc. (KEPCO-E and C). The work described in this report involves a review of the APR+ Level 2 PSA submittal (Ref. 1). The PSA and, therefore, the review is limited to consideration of accidents initiated by internal events. As part of the review process, the review team also developed three sets of Requests for Additional Information (RAIs). These RAIs were provided to KHNP and KEPCO-E and C for their evaluation and response. This final detailed report documents the review findings for each technical element of the PSA and includes consideration of all of the RAIs made by the reviewers as well as the associated responses. This final report was preceded by an interim report (Ref. 2) that focused on identifying important issues regarding the PSA. In addition, a final meeting on the project was held at BNL on November 21-22, 2011, where BNL and KINS reviewers discussed their preliminary review findings with KHNP and KEPCO-E and C staffs. Additional information obtained during this final meeting was also used to inform the review findings of this final report. The review focused not only on the robustness of the APR+ design to withstand severe accidents, but also on the capability and acceptability of the Level 2 PSA in terms of level of detail and completeness. The Korean nuclear regulatory authorities will decide whether the PSA is acceptable and the BNL review team is providing its comments for KINS consideration. Section 2.0 provides the basis for the BNL review. Section 3.0 presents the review of each technical element of the PSA. Conclusions and a summary are presented in Section 4.0. Section 5.0 contains the references.

  2. State of the art of probabilistic safety analysis (PSA) in the FRG, and principles of a PSA-guideline

    International Nuclear Information System (INIS)

    Balfanz, H.P.

    1987-01-01

    Contents of the articles: Survey of PSA performed during licensing procedures of an NPP; German Nuclear Standards' requirements on the reliability of safety systems; PSA-guideline for NPP: Principles and suggestions; Motivation and tasks of PSA; Aspects of the methodology of safety analyses; Structure of event tree and fault tree analyses; Extent of safety analyses; Performance and limits of PSA. (orig./HSCH)

  3. Development of multipurpose regulatory PSA model

    International Nuclear Information System (INIS)

    Lee, Chang Ju; Sung, Key Yong; Kim, Hho Jung; Yang, Joon Eon; Ha, Jae Joo

    2004-01-01

    Generally, risk information for nuclear facilities comes from the results of Probabilistic safety assessment (PSA). PSA is a systematic tool to ensure the safety of nuclear facilities, since it is based on thorough and consistent application of probability models. In particular, the PSA has been widely utilized for risk-informed regulation (RIR), including various licensee-initiated risk-informed applications (RIA). In any regulatory decision, the main goal is to make a sound safety decision based on technically defensible information. Also, due to the increased public requests for giving a safety guarantee, the regulator should provide the visible means of safety. The use of PSA by the regulator can give the answer on this problem. Therefore, in order to study the applicability of risk information for regulatory safety management, it is a demanding task to prepare a well-established regulatory PSA model and tool. In 2002, KINS and KAERI together made a research cooperation to form a working group to develop the regulatory PSA model - so-called MPAS model. The MPAS stands for multipurpose probabilistic analysis of safety. For instance, a role of the MPAS model is to give some risk insights in the preparation of various regulatory programs. Another role of this model is to provide an independent risk information to the regulator during regulatory decision-making, not depending on the licensee's information

  4. Development of seismic PSA methodology at JAERI

    International Nuclear Information System (INIS)

    Muramatsu, K.; Ebisawa, K.; Matsumoto, K.; Oikawa, T.; Kondo, M.

    1995-01-01

    The Japan Atomic Energy Research Institute (JAERI) is developing a methodology for seismic probabilistic safety assessment (PSA) of nuclear power plants, aiming at providing a set of procedures, computer codes and data suitable for performing seismic PSA in Japan. In order to demonstrate the usefulness of JAERI's methodology and to obtain better understanding on the controlling factors of the results of seismic PSAs, a seismic PSA for a BWR is in progress. In the course of this PSA, various improvements were made on the methodology. In the area of the hazard analysis, the application of the current method to the model plant site is being carried out. In the area of response analysis, the response factor method was modified to consider the non-linear response effect of the building. As for the capacity evaluation of components, since capacity data for PSA in Japan are very scarce, capacities of selected components used in Japan were evaluated. In the systems analysis, the improvement of the SECOM2 code was made to perform importance analysis and sensitivity analysis for the effect of correlation of responses and correlation of capacities. This paper summarizes the recent progress of the seismic PSA research at JAERI with emphasis on the evaluation of component capacity and the methodology improvement of systems reliability analysis. (author)

  5. A national multicenter phase 2 study of prostate-specific antigen (PSA) pox virus vaccine with sequential androgen ablation therapy in patients with PSA progression: ECOG 9802.

    Science.gov (United States)

    DiPaola, Robert S; Chen, Yu-Hui; Bubley, Glenn J; Stein, Mark N; Hahn, Noah M; Carducci, Michael A; Lattime, Edmund C; Gulley, James L; Arlen, Philip M; Butterfield, Lisa H; Wilding, George

    2015-09-01

    E9802 was a phase 2 multi-institution study conducted to evaluate the safety and effectiveness of vaccinia and fowlpox prostate-specific antigen (PSA) vaccine (step 1) followed by combination with androgen ablation therapy (step 2) in patients with PSA progression without visible metastasis. To test the hypothesis that vaccine therapy in this early disease setting will be safe and have a biochemical effect that would support future studies of immunotherapy in patients with minimal disease burden. Patients who had PSA progression following local therapy were treated with PROSTVAC-V (vaccinia)/TRICOM on cycle 1 followed by PROSTVAC-F (fowlpox)/TRICOM for subsequent cycles in combination with granulocyte-macrophage colony-stimulating factor (step 1). Androgen ablation was added on progression (step 2). Step 1 primary end points included progression at 6 mo and characterization of change in PSA velocity pretreatment to post-treatment. Step 2 end points included PSA response with combined vaccine and androgen ablation. In step 1, 25 of 40 eligible patients (63%) were progression free at 6 mo after registration (90% confidence interval [CI], 48-75). The median pretreatment PSA velocity was 0.13 log(PSA)/mo, in contrast to median postregistration velocity of 0.09 log(PSA)/mo (p=0.02), which is an increase in median PSA doubling time from 5.3 mo to 7.7 mo. No grade ≥4 treatment-related toxicity was observed. In the 27 patients eligible and treated for step 2, 20 patients achieved a complete response (CR) at 7 mo (CR rate: 74%; 90% CI, 57-87). Although supportive of larger studies in the cooperative group setting, this study is limited by the small number of patients and the absence of a control group as in a phase 3 study. A viral PSA vaccine can be administered safely in the multi-institutional cooperative group setting to patients with minimal disease volume alone and combined with androgen ablation, supporting the feasibility of future phase 3 studies in this

  6. External events analysis in PSA studies for Czech NPPs

    International Nuclear Information System (INIS)

    Holy, J.; Hustak, S.; Kolar, L.; Jaros, M.; Hladky, M.; Mlady, O.

    2014-01-01

    The purpose of the paper is to summarize current status of natural external hazards analysis in the PSA projects maintained in Czech Republic for both Czech NPPs - Dukovany and Temelin. The focus of the presentation is put upon the basic milestones in external event analysis effort - identification of external hazards important for Czech NPPs sites, screening out of the irrelevant hazards, modeling of plant response to the initiating events, including the basic activities regarding vulnerability and fragility analysis (supported with on-site analysis), quantification of accident sequences, interpretation of results and development of measures decreasing external events risk. The following external hazards are discussed in the paper, which have been addressed during several last years in PSA projects for Czech NPPs: 1)seismicity, 2)extremely low temperature 3)extremely high temperature 4)extreme wind 5)extreme precipitation (water, snow) 6)transport of dangerous substances (as an example of man-made hazard with some differences identified in comparison with natural hazards) 7)other hazards, which are not considered as very important for Czech NPPs, were screened out in the initial phase of the analysis, but are known as potential problem areas abroad. The paper is a result of coordinated effort with participation of experts and staff from engineering support organization UJV Rez, a.s. and NPPs located in Czech Republic - Dukovany and Temelin. (authors)

  7. Inconsistencies in patient perceptions and observer ratings of shared decision making: the case of colorectal cancer screening.

    Science.gov (United States)

    Wunderlich, Tracy; Cooper, Gregory; Divine, George; Flocke, Susan; Oja-Tebbe, Nancy; Stange, Kurt; Lafata, Jennifer Elston

    2010-09-01

    To compare patient-reported and observer-rated shared decision making (SDM) use for colorectal cancer (CRC) screening and evaluate patient, physician and patient-reported relational communication factors associated with patient-reported use of shared CRC screening decisions. Study physicians are salaried primary care providers. Patients are insured, aged 50-80 and due for CRC screening. Audio-recordings from 363 primary care visits were observer-coded for elements of SDM. A post-visit patient survey assessed patient-reported decision-making processes and relational communication during visit. Association of patient-reported SDM with observer-rated elements of SDM, as well as patient, physician and relational communication factors were evaluated using generalized estimating equations. 70% of patients preferred SDM for preventive health decisions, 47% of patients reported use of a SDM process, and only one of the screening discussions included all four elements of SDM per observer ratings. Patient report of SDM use was not associated with observer-rated elements of SDM, but was significantly associated with female physician gender and patient-reported relational communication. Inconsistencies exist between patient reports and observer ratings of SDM for CRC screening. Future studies are needed to understand whether SDM that is patient-reported, observer-rated or both are associated with informed and value-concordant CRC screening decisions. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Year of treatment as independent predictor of relapse-free survival in patients with localized prostate cancer treated with definitive radiotherapy in the PSA era

    International Nuclear Information System (INIS)

    Kupelian, Patrick; Thames, Howard; Levy, Larry; Horwitz, Eric; Martinez, Alvaro; Michalski, Jeff; Pisansky, Thomas; Sandler, Howard; Shipley, William; Zelefsky, Michael; Zietman, Anthony; Kuban, Deborah

    2005-01-01

    <72 Gy using the same variables except for radiation dose. Results: For all 4,537 patients, the 5- and 8-year PSA-DFS estimate using definition A (ASTRO consensus definition) was 60% and 55%, respectively. The 8-year PSA-DFS estimate for Yr <93 vs. Yr ≥93 was 52% vs. 57%, respectively (p < 0.001). In the subgroup of patients receiving <72 Gy, the 8-year PSA-DFS estimate for Yr <93 vs. Yr ≥93 was 52% and 55%, respectively (p = 0.004). The differences in PSA-DFS rates in the different subgroups were similar when definition B was used. The multivariate analyses for all 4,537 cases with either PSA-DFS definition revealed T stage (p < 0.001), pretherapy PSA level (p < 0.001), Gleason score (p < 0.001), radiation dose (p < 0.001), and year of treatment (p < 0.001) to be independent predictors of outcomes. The multivariate analyses restricted to the 3,897 cases receiving <72 Gy still revealed year of treatment to be an independent predictor of outcomes (p < 0.001), in addition to T stage (p < 0.001), pretherapy PSA level (p < 0.001), and Gleason score (p < 0.001). Conclusions: Independent of tumor stage, radiation dose, failure definition, and follow-up parameters, the year in which RT was performed was an independent predictor of outcomes. These findings indicate a more favorable presentation of localized prostate cancer in current years that is not necessarily reflected in the patients' PSA levels or Gleason scores. This phenomenon is probably related to a combination of factors, such as screening, increased patient awareness leading to earlier biopsies and earlier diagnosis, more aggressive pretherapy staging, and unrecognized improvements in therapy, but perhaps also to changing tumor biology. Outcomes predictionsshould be based on contemporaneous series. Alternatively, the year of therapy could be incorporated as a variable in outcomes analyses of localized prostate cancer patients treated in different periods within the PSA era

  9. Combination of Autoantibody Signature with PSA Level Enables a Highly Accurate Blood-Based Differentiation of Prostate Cancer Patients from Patients with Benign Prostatic Hyperplasia.

    Directory of Open Access Journals (Sweden)

    Petra Leidinger

    Full Text Available Although an increased level of the prostate-specific antigen can be an indication for prostate cancer, other reasons often lead to a high rate of false positive results. Therefore, an additional serological screening of autoantibodies in patients' sera could improve the detection of prostate cancer. We performed protein macroarray screening with sera from 49 prostate cancer patients, 70 patients with benign prostatic hyperplasia and 28 healthy controls and compared the autoimmune response in those groups. We were able to distinguish prostate cancer patients from normal controls with an accuracy of 83.2%, patients with benign prostatic hyperplasia from normal controls with an accuracy of 86.0% and prostate cancer patients from patients with benign prostatic hyperplasia with an accuracy of 70.3%. Combining seroreactivity pattern with a PSA level of higher than 4.0 ng/ml this classification could be improved to an accuracy of 84.1%. For selected proteins we were able to confirm the differential expression by using luminex on 84 samples. We provide a minimally invasive serological method to reduce false positive results in detection of prostate cancer and according to PSA screening to distinguish men with prostate cancer from men with benign prostatic hyperplasia.

  10. Review article: Prostate cancer screening using prostate specific ...

    African Journals Online (AJOL)

    Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is key to cure and survival but its screening through prostate specific antigen (PSA) has remain controversial in literature. Screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than ...

  11. Low Rates of Dermatologic Care and Skin Cancer Screening Among Inflammatory Bowel Disease Patients.

    Science.gov (United States)

    Anderson, Alyce; Ferris, Laura K; Click, Benjamin; Ramos-Rivers, Claudia; Koutroubakis, Ioannis E; Hashash, Jana G; Dunn, Michael; Barrie, Arthur; Schwartz, Marc; Regueiro, Miguel; Binion, David G

    2018-04-30

    Dermatologic manifestations of inflammatory bowel disease (IBD) are common, and certain IBD medications increase the risk of skin cancer. To define the rates of care and factors associated with dermatologic utilization with a focus on skin cancer screening. We utilized a prospective, natural history IBD research registry to evaluate all outpatient healthcare encounters from 2010 to 2016. Gastrointestinal, dermatologic and primary care visits per individual were identified. We calculated the proportion of patients obtaining care, categorized primary indications for dermatologic visits, determined the incidence of melanoma and non-melanoma skin cancers, and used logistic regression to determine factors associated with dermatology utilization. Of the 2127 IBD patients included, 452 (21.3%) utilized dermatology over the study period, and 55 (2.6%) had a total body skin examination at least once. The 452 patients incurred 1633 dermatology clinic visits, 278 dermatologic procedures, and 1108 dermatology telephone encounters. The most frequent indication was contact dermatitis or dermatitis. Factors associated with dermatology use were family history of skin cancer, employment, systemic steroids, longer disease duration, emergency room use, and the number of IBD-related clinic visits. Between 8.3 and 11% of IBD patients recommended for skin cancer screening visited dermatology each year, and the resulting incidence of non-melanoma skin cancer was 35.4/10,000 [95% CI 23.3-51.5] and melanoma was 6.56/10,000 [95% CI 2.1-15.3]. Less than one in ten IBD patients obtain dermatologic care. Given the increased risk of skin cancers among IBD patients, an emphasis on education, prevention, and screening merits attention.

  12. Evaluation of total PSA assay on vitros ECi and correlation with Kryptor-PSA assay.

    Science.gov (United States)

    Cassinat, B; Wacquet, M; Toubert, M E; Rain, J D; Schlageter, M H

    2001-01-01

    An increasing number of multiparametric immuno-analysers for PSA assays are available. As different immuno-assays may vary in their analytical quality and their accuracy for the follow-up of patients, expertise is necessary for each new assay. The PSA assay on the Vitros-ECi analyser has been evaluated and compared with the PSA assay from the Kryptor analyser. Variation coefficients were 0.91 to 1.98% for within-run assays, and 4.2% to 5.4% for interassay (PSA levels = 0.8 microgram/L to 33.6 micrograms/L). Dilution tests showed 93 to 136% recovery until 70 micrograms/L PSA. Functional sensitivity was estimated at 0.03 microgram/L. Equimolarity of the test was confirmed. Correlation of PSA levels measured with Vitros-ECi and Kryptor analysers displayed a correlation coefficient r2 of 0.9716. The half-lives and doubling times of PSA were similar using both methods. Vitros-ECi PSA assay meets the major criteria for the management of prostate cancer patients.

  13. Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis

    NARCIS (Netherlands)

    S. Carlsson (Sigrid); T.M. de Carvalho Delgado Marques (Tiago); M.J. Roobol-Bouts (Monique); J. Hugosson (Jonas); A. Auvinen (Anssi); M. Kwiatkowski (Maciej); A. Villers (Arnoud); M. Zappa (Marco); V. Nelen (Vera); A. Páez (Alvaro); J.A. Eastham (James); H. Lilja (Hans); H.J. de Koning (Harry); A.J. Vickers (Andrew); E.A.M. Heijnsdijk (Eveline)

    2016-01-01

    textabstractBACKGROUND: Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus “good practice.”. METHODS: Microsimulation screening analysis (MISCAN)

  14. Purification of PSA from human semen

    International Nuclear Information System (INIS)

    Venkatesh, M.

    1997-01-01

    Full text: 1. Human seminal plasma collected from many volunteers are pooled and passed through a column of phenyl sepharose equilibrated with 1.25 M ammonium sulphate. Elution is carried out with 1.25 M ammonium sulphate initially, to remove the bulk non-adsorbing proteins. Gradient elution of the absorbed proteins with 0.01 M Tris-HCl, 0.25 M NaCl, pH 7.0 buffer gives a sharp peak containing PSA. At each stage, PSA has to be identified by an independent method such as immunodiffusion or an immunoassay. 2. The absorbed protein peak containing PSA is then lyophilised, redissolved in Tris-HCl buffer and chromatographed in a Superdex-75 or Sephadex-75 column. The absorbed proteins elute out as multiple peaks and PSA is eluted as a sharp peak.At each stage, PSA has to be identified by an independent method such as immunodiffusion or an immunoassay. 3. Step 2 is repeated for better purity. 4. The PSA peak is lyophilised, dissolved in Tris-HCl buffer without NaCl and further purified on an ion exchange column (either anion or cation exchange columns such as DEAE Sephadex or CM-Sephadex or Mono Q). Gradient elution using Tris-HCl buffer without NaCl and Tris-HCl buffer with 0.25 M NaCl resulted in a sharp pure PSA peak (homogenous, sharp single band on SDS-PAGE). This procedure is based on that reported by Wang et al., Oncology, 39,1,1982

  15. Perspectives of Living PSA in NPP Krsko

    International Nuclear Information System (INIS)

    Vrbanic, I.; Kastelan, M.

    1996-01-01

    Nuclear power plant Krsko has completed the Level 1/Level 2 Probabilistic Safety Analysis (PSA) for internal initiating events and is in the process of completing the same for the external initiators. The analysis completed up to now has provided a valuable insight into a plant risk profile. In NPP Krsko there is a plan to use the PSA model as a permanent tool for the risk based applications and incorporate it into a decision making process. In order to achieve this there is a need to permanently maintain the PSA model in a manner that it reflects both the plan configuration/design at a time point and the operational experience up to the time point. All the activities aimed toward keeping the PSA model up-to-dated in this sense are usually referred to as a Living PSA (LPSA) program. NPP Krsko is in the process of defining and proceduralizing a LPSA program that would be plant specific and based on known world practices. Further, in order to be suitable for risk based applications the PSA model must be flexible in a sense that modifications to the base case model may be done easily and requantifications performed quickly as to evaluate various conditions imposed by real or hypothetical situations. NPP Krsko PSA model has been based on licensing type software. The requirements specified above dictate the transfer of the overall model to an application oriented software of newer generation with larger capabilities. The transfer becomes a part of a mentioned ongoing effort aimed at establishing LPSA model and concept. The paper present this effort and the perspectives of LPSA concept and risk based applications in NPP Krsko. (author)

  16. A project for increasing the rate of participation in mammographic breast cancer screening in Kyoto prefecture to 50%

    International Nuclear Information System (INIS)

    Nakajima, Hiroo; Fujiwara, Ikuya; Mizuta, Naruhiko; Sakaguchi, Koichi; Hachimine, Yasushi; Kageyama, Norio; Sawai, Kiyoshi; Nishida, Naoko

    2007-01-01

    The rate of participation in breast cancer screening carried out by inspection and palpation associated with mammography in Kyoto Prefecture has been still low. In order to decrease the rate of breast cancer death, a high rate of screening participation must be achieved. We have organized the Kyoto Executive Committee of Pink Ribbon Activity aiming at the goal of achieving a 50% rate of participation in mammography screening by the end of 2010, and undertaken the following campaign activities: performing free screening, distribution and display of posters and leaflets about breast cancer screening, cooperation with various media to spread educational and informative messages, cooperation with a commercial institute in Kyoto City to distribute useful information, performing free breast cancer screening, and holding public lecture meetings, distribution of leaflets at student festivals at universities and colleges in Kyoto, and holding a ''Pink Ribbon symposium'' in a cosponsored company. All the above projects were performed successfully and many participants attended. We will continue these activities until the 50% participation rate is achieved. (author)

  17. Report 5: Guidance document. Implementation of biological infestation hazards in extended PSA

    International Nuclear Information System (INIS)

    Hasnaoui, C.; Georgescu, G.; Joel, P.; Sperbeck, S.; Kollasko, H.; Kumar, M.

    2016-01-01

    This report covers the assessment of biological hazards with PSA. It provides an overview of the available data and available practices in modelling this type of hazard. First researches in the national and international literature regarding PSA for external and internal hazards shows that probabilistic analyses were very rarely carried out in order to quantify the risk induced by biological hazards. Nevertheless, Section 3 provides some data from some countries. History has shown that this hazard can happened and can be highly safety significant. Screening out this event must be done with great care. The overall analysis approach for Level 1 PSA for internal events can be used for the biological hazards with some care to take into impact the nature of the hazard as it impacts many systems at different times and duration. A proposed detailed methodology is described in Section 4. Still some open issues remain: the methodology must also consider event combination of biological infestation with other external hazards wind or flooding or rainfall and multi-units impact. These aspects present still a lot of challenges to PSA developers. The ASAMPSA-E report recommends that further emphasis shall be put on these two aspects of PSA modelling: multi-units site impact and hazards combinations. (authors)

  18. Vergleichende Einschätzung der diagnostischen Aussagekraft der Kenngrößen freies PSA, Alpha1-Antichymotrypsin-PSA und komplexiertes PSA in der Diagnostik des Prostatakarzinoms

    OpenAIRE

    Baumgart E; Deger S; Jung K; Lein M; Loening SA; Schnorr D

    2001-01-01

    Ziel der Studie war die vergleichende Einschätzung der diagnostischen Aussagekraft von Gesamt-PSA (tPSA), freiem PSA (fPSA), alpha1-Antichymotrypsin-PSA (ACT-PSA) und komplexiertem PSA (cPSA) sowie der entsprechenden Quotienten zur Differenzierung zwischen einem Prostatakarzinom (PCa) und einer Benignen Prostatahyperplasie (BPH). Die Bestimmung erfolgte bei insgesamt 324 Männern (PCa: n = 144; BPH: n = 89; Kontrollen: n = 91). Die tPSA- und cPSA-Konzentrationen wurden mit dem Bayer Immuno 1 S...

  19. Evaluation of Estimating Missed Answers in Conners Adult ADHD Rating Scale (Screening Version)

    Science.gov (United States)

    Ghassemi, Farnaz; Moradi, Mohammad Hassan; Tehrani-Doost, Mehdi

    2010-01-01

    Objective Conners Adult ADHD Rating Scale (CAARS) is among the valid questionnaires for evaluating Attention-Deficit/Hyperactivity Disorder in adults. The aim of this paper is to evaluate the validity of the estimation of missed answers in scoring the screening version of the Conners questionnaire, and to extract its principal components. Method This study was performed on 400 participants. Answer estimation was calculated for each question (assuming the answer was missed), and then a Kruskal-Wallis test was performed to evaluate the difference between the original answer and its estimation. In the next step, principal components of the questionnaire were extracted by means of Principal Component Analysis (PCA). Finally the evaluation of differences in the whole groups was provided using the Multiple Comparison Procedure (MCP). Results Findings indicated that a significant difference existed between the original and estimated answers for some particular questions. However, the results of MCP showed that this estimation, when evaluated in the whole group, did not show a significant difference with the original value in neither of the questionnaire subscales. The results of PCA revealed that there are eight principal components in the CAARS questionnaire. Conclusion The obtained results can emphasize the fact that this questionnaire is mainly designed for screening purposes, and this estimation does not change the results of groups when a question is missed randomly. Notwithstanding this finding, more considerations should be paid when the missed question is a critical one. PMID:22952502

  20. Lineage-specific evolutionary rate in plants: Contributions of a screening for Cereus (Cactaceae)1

    Science.gov (United States)

    Romeiro-Brito, Monique; Moraes, Evandro M.; Taylor, Nigel P.; Zappi, Daniela C.; Franco, Fernando F.

    2016-01-01

    Premise of the study: Predictable chloroplast DNA (cpDNA) sequences have been listed for the shallowest taxonomic studies in plants. We investigated whether plastid regions that vary between closely allied species could be applied for intraspecific studies and compared the variation of these plastid segments with two nuclear regions. Methods: We screened 16 plastid and two nuclear intronic regions for species of the genus Cereus (Cactaceae) at three hierarchical levels (species from different clades, species of the same clade, and allopatric populations). Results: Ten plastid regions presented interspecific variation, and six of them showed variation at the intraspecific level. The two nuclear regions showed both inter- and intraspecific variation, and in general they showed higher levels of variability in almost all hierarchical levels than the plastid segments. Discussion: Our data suggest no correspondence between variation of plastid regions at the interspecific and intraspecific level, probably due to lineage-specific variation in cpDNA, which appears to have less effect in nuclear data. Despite the heterogeneity in evolutionary rates of cpDNA, we highlight three plastid segments that may be considered in initial screenings in plant phylogeographic studies. PMID:26819857

  1. Lineage-specific evolutionary rate in plants: Contributions of a screening for Cereus (Cactaceae).

    Science.gov (United States)

    Romeiro-Brito, Monique; Moraes, Evandro M; Taylor, Nigel P; Zappi, Daniela C; Franco, Fernando F

    2016-01-01

    Predictable chloroplast DNA (cpDNA) sequences have been listed for the shallowest taxonomic studies in plants. We investigated whether plastid regions that vary between closely allied species could be applied for intraspecific studies and compared the variation of these plastid segments with two nuclear regions. We screened 16 plastid and two nuclear intronic regions for species of the genus Cereus (Cactaceae) at three hierarchical levels (species from different clades, species of the same clade, and allopatric populations). Ten plastid regions presented interspecific variation, and six of them showed variation at the intraspecific level. The two nuclear regions showed both inter- and intraspecific variation, and in general they showed higher levels of variability in almost all hierarchical levels than the plastid segments. Our data suggest no correspondence between variation of plastid regions at the interspecific and intraspecific level, probably due to lineage-specific variation in cpDNA, which appears to have less effect in nuclear data. Despite the heterogeneity in evolutionary rates of cpDNA, we highlight three plastid segments that may be considered in initial screenings in plant phylogeographic studies.

  2. Evaluation of Estimating Missed Answers in Conners Adult ADHD Rating Scale (Screening Version

    Directory of Open Access Journals (Sweden)

    Vahid Abootalebi

    2010-08-01

    Full Text Available "n Objective: Conners Adult ADHD Rating Scale (CAARS is among the valid questionnaires for evaluating Attention-Deficit/Hyperactivity Disorder in adults. The aim of this paper is to evaluate the validity of the estimation of missed answers in scoring the screening version of the Conners questionnaire, and to extract its principal components. "n Method: This study was performed on 400 participants. Answer estimation was calculated for each question (assuming the answer was missed, and then a Kruskal-Wallis test was performed to evaluate the difference between the original answer and its estimation. In the next step, principal components of the questionnaire were extracted by means of Principal Component Analysis (PCA. Finally the evaluation of differences in the whole groups was provided using the Multiple Comparison Procedure (MCP. Results: Findings indicated that a significant difference existed between the original and estimated answers for some particular questions. However, the results of MCP showed that this estimation, when evaluated in the whole group, did not show a significant difference with the original value in neither of the questionnaire subscales. The results of PCA revealed that there are eight principal components in the CAARS questionnaire. Conclusion: The obtained results can emphasize the fact that this questionnaire is mainly designed for screening purposes, and this estimation does not change the results of groups when a question is missed randomly. Notwithstanding this finding, more considerations should be paid when the missed question is a critical one.

  3. Relationship of detection rate of PET cancer screening examinees and risk factors. Analysis of background of examinees

    International Nuclear Information System (INIS)

    Shibata, Koji; Uno, Kimiichi; Arai, Masami; Matsuura, Masaaki; Yoshida, Teruhiko; Momose, Toshimitsu; Ohtomo, Kuni

    2011-01-01

    Positron emission tomography (PET) cancer screening is performed widely in Japan as opportunistic screening, but no study has focused on the correlation with various cancer risk factors and the seeking bias of examinees and cancer detection rate. Analyzing our large series of PET cancer screening data, correlations with cancer detection rates according to general cancer risk factors and PET detection survey were reviewed, and the selection bias of the medical examinees was determined. 19189 examinees who underwent PET cancer screening were enrolled. Using logistic-regression analysis, we analyzed correlations between smoking history/drinking history/cancer family history and detection rates of thyroid cancer/breast cancer/colorectal cancer/lung cancer, which are the main malignancies detected in PET cancer screening. In addition, we evaluated seeking bias of examinees, analyzing correlations between the presence of cancer risk factors and prior screening checkups at other institutions to our PET cancer screening using a matched case-control study. Cancer detection rates by FDG-PET were 1.17% (224/19189), being much higher than those of standard cancer mass screenings. In males, statistically significant correlations were seen between lung cancer and smoking, and between prostate cancer and a family history of prostate cancer, but not between the detection rates of three other types of cancer (thyroid cancer/lung cancer/colorectal cancer) and other cancer risk factors. In females, detection rates of four types of cancer (thyroid cancer/lung cancer/colorectal cancer/breast cancer) were significantly higher in the examinees without cancer risks, and subgroup analysis according to types of cancer did not indicate significant correlations either. The matched case-control study evaluating seeking bias indicated that a significant proportion of the examinees with cancer risks had undergone prior cancer screening at other institutions. Our study indicated that there was

  4. Correlative study of SPECT bone scan, serum tPSA and fPSA/tPSA ratio and the pathological grade of prostate cancer with bone metastasis

    International Nuclear Information System (INIS)

    Xu Haiqing; Duan Jun

    2011-01-01

    Objective: To study the rules and characteristics of SPECT bone scan, serum TPSA, fPSA/tPSA ratio and the pathological grade of prostate cancer with bone metastasis. Methods: Nuclear medicine SPECT bone scan as the gold standard, retrospective analysis of the in vitro radioimmunoassay in 107 patients with prostate cancer serum PSA (prostate specific antigen) levels, serum fPSA/tPSA ratio and whole body bone imaging studies and pathological classification. Results: 107 patients with prostate cancer : 49 patients had bone metastases, accounting for 45.8% (49/107), in which groups of different pathological comparison between the incidence of bone metastasis significantly, the lower the degree of differentiation, the more the incidence of bone metastases high; with elevated levels of tPSA, the incidence of bone metastasis increased significantly; serum tPSA 4 - 40 ng/ml, the use of fPSA/tPSA ratio may improve the diagnostic specificity of prostate cancer. Conclusion: Patients with bone metastases of prostate cancer incidence and degree of differentiation of prostate cancer, serum PSA levels and fPSA/tPSA ratio of a certain relationship. The lower degree of differentiation,the higher the incidence of bone metastasis. (authors)

  5. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Science.gov (United States)

    2011-01-01

    Background Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should

  6. Increased PSA expression on prostate cancer exosomes in in vitro condition and in cancer patients.

    Science.gov (United States)

    Logozzi, Mariantonia; Angelini, Daniela F; Iessi, Elisabetta; Mizzoni, Davide; Di Raimo, Rossella; Federici, Cristina; Lugini, Luana; Borsellino, Giovanna; Gentilucci, Alessandro; Pierella, Federico; Marzio, Vittorio; Sciarra, Alessandro; Battistini, Luca; Fais, Stefano

    2017-09-10

    exosomes, such as PSA-exosomes, may represent a novel, non-invasive clinical tool for the screening and early diagnosis of prostate cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Insulin promotes cell migration by regulating PSA-NCAM

    Energy Technology Data Exchange (ETDEWEB)

    Monzo, Hector J.; Coppieters, Natacha [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Park, Thomas I.H. [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Pharmacology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Dieriks, Birger V.; Faull, Richard L.M. [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Dragunow, Mike [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Pharmacology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Curtis, Maurice A., E-mail: m.curtis@auckland.ac.nz [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand)

    2017-06-01

    Cellular interactions with the extracellular environment are modulated by cell surface polysialic acid (PSA) carried by the neural cell adhesion molecule (NCAM). PSA-NCAM is involved in cellular processes such as differentiation, plasticity, and migration, and is elevated in Alzheimer's disease as well as in metastatic tumour cells. Our previous work demonstrated that insulin enhances the abundance of cell surface PSA by inhibiting PSA-NCAM endocytosis. In the present study we have identified a mechanism for insulin-dependent inhibition of PSA-NCAM turnover affecting cell migration. Insulin enhanced the phosphorylation of the focal adhesion kinase leading to dissociation of αv-integrin/PSA-NCAM clusters, and promoted cell migration. Our results show that αv-integrin plays a key role in the PSA-NCAM turnover process. αv-integrin knockdown stopped PSA-NCAM from being endocytosed, and αv-integrin/PSA-NCAM clusters co-labelled intracellularly with Rab5, altogether indicating a role for αv-integrin as a carrier for PSA-NCAM during internalisation. Furthermore, inhibition of p-FAK caused dissociation of αv-integrin/PSA-NCAM clusters and counteracted the insulin-induced accumulation of PSA at the cell surface and cell migration was impaired. Our data reveal a functional association between the insulin/p-FAK-dependent regulation of PSA-NCAM turnover and cell migration through the extracellular matrix. Most importantly, they identify a novel mechanism for insulin-stimulated cell migration. - Highlights: • Insulin modulates PSA-NCAM turnover through upregulation of p-FAK. • P-FAK modulates αv-integrin/PSA-NCAM clustering. • αv-integrin acts as a carrier for PSA-NCAM endocytosis. • Cell migration is promoted by cell surface PSA. • Insulin promotes PSA-dependent migration in vitro.

  8. Insulin promotes cell migration by regulating PSA-NCAM

    International Nuclear Information System (INIS)

    Monzo, Hector J.; Coppieters, Natacha; Park, Thomas I.H.; Dieriks, Birger V.; Faull, Richard L.M.; Dragunow, Mike; Curtis, Maurice A.

    2017-01-01

    Cellular interactions with the extracellular environment are modulated by cell surface polysialic acid (PSA) carried by the neural cell adhesion molecule (NCAM). PSA-NCAM is involved in cellular processes such as differentiation, plasticity, and migration, and is elevated in Alzheimer's disease as well as in metastatic tumour cells. Our previous work demonstrated that insulin enhances the abundance of cell surface PSA by inhibiting PSA-NCAM endocytosis. In the present study we have identified a mechanism for insulin-dependent inhibition of PSA-NCAM turnover affecting cell migration. Insulin enhanced the phosphorylation of the focal adhesion kinase leading to dissociation of αv-integrin/PSA-NCAM clusters, and promoted cell migration. Our results show that αv-integrin plays a key role in the PSA-NCAM turnover process. αv-integrin knockdown stopped PSA-NCAM from being endocytosed, and αv-integrin/PSA-NCAM clusters co-labelled intracellularly with Rab5, altogether indicating a role for αv-integrin as a carrier for PSA-NCAM during internalisation. Furthermore, inhibition of p-FAK caused dissociation of αv-integrin/PSA-NCAM clusters and counteracted the insulin-induced accumulation of PSA at the cell surface and cell migration was impaired. Our data reveal a functional association between the insulin/p-FAK-dependent regulation of PSA-NCAM turnover and cell migration through the extracellular matrix. Most importantly, they identify a novel mechanism for insulin-stimulated cell migration. - Highlights: • Insulin modulates PSA-NCAM turnover through upregulation of p-FAK. • P-FAK modulates αv-integrin/PSA-NCAM clustering. • αv-integrin acts as a carrier for PSA-NCAM endocytosis. • Cell migration is promoted by cell surface PSA. • Insulin promotes PSA-dependent migration in vitro.

  9. A methodology for PSA model validation

    International Nuclear Information System (INIS)

    Unwin, S.D.

    1995-09-01

    This document reports Phase 2 of work undertaken by Science Applications International Corporation (SAIC) in support of the Atomic Energy Control Board's Probabilistic Safety Assessment (PSA) review. A methodology is presented for the systematic review and evaluation of a PSA model. These methods are intended to support consideration of the following question: To within the scope and depth of modeling resolution of a PSA study, is the resultant model a complete and accurate representation of the subject plant? This question was identified as a key PSA validation issue in SAIC's Phase 1 project. The validation methods are based on a model transformation process devised to enhance the transparency of the modeling assumptions. Through conversion to a 'success-oriented' framework, a closer correspondence to plant design and operational specifications is achieved. This can both enhance the scrutability of the model by plant personnel, and provide an alternative perspective on the model that may assist in the identification of deficiencies. The model transformation process is defined and applied to fault trees documented in the Darlington Probabilistic Safety Evaluation. A tentative real-time process is outlined for implementation and documentation of a PSA review based on the proposed methods. (author). 11 refs., 9 tabs., 30 refs

  10. Professional's Attitudes Do Not Influence Screening and Brief Interventions Rates for Hazardous and Harmful Drinkers: Results from ODHIN Study.

    Science.gov (United States)

    Bendtsen, Preben; Anderson, Peter; Wojnar, Marcin; Newbury-Birch, Dorothy; Müssener, Ulrika; Colom, Joan; Karlsson, Nadine; Brzózka, Krzysztof; Spak, Fredrik; Deluca, Paolo; Drummond, Colin; Kaner, Eileen; Kłoda, Karolina; Mierzecki, Artur; Okulicz-Kozaryn, Katarzyna; Parkinson, Kathryn; Reynolds, Jillian; Ronda, Gaby; Segura, Lidia; Palacio, Jorge; Baena, Begoña; Slodownik, Luiza; van Steenkiste, Ben; Wolstenholme, Amy; Wallace, Paul; Keurhorst, Myrna N; Laurant, Miranda G H; Gual, Antoni

    2015-07-01

    To determine the relation between existing levels of alcohol screening and brief intervention rates in five European jurisdictions and role security and therapeutic commitment by the participating primary healthcare professionals. Health care professionals consisting of, 409 GPs, 282 nurses and 55 other staff including psychologists, social workers and nurse aids from 120 primary health care centres participated in a cross-sectional 4-week survey. The participants registered all screening and brief intervention activities as part of their normal routine. The participants also completed the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ), which measure role security and therapeutic commitment. The only significant but small relationship was found between role security and screening rate in a multilevel logistic regression analysis adjusted for occupation of the provider, number of eligible patients and the random effects of jurisdictions and primary health care units (PHCU). No significant relationship was found between role security and brief intervention rate nor between therapeutic commitment and screening rate/brief intervention rate. The proportion of patients screened varied across jurisdictions between 2 and 10%. The findings show that the studied factors (role security and therapeutic commitment) are not of great importance for alcohol screening and BI rates. Given the fact that screening and brief intervention implementation rate has not changed much in the last decade in spite of increased policy emphasis, training initiatives and more research being published, this raises a question about what else is needed to enhance implementation. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  11. Racial and ethnic disparities in U.S. cancer screening rates

    Science.gov (United States)

    The percentage of U.S. citizens screened for cancer remains below national targets, with significant disparities among racial and ethnic populations, according to the first federal study to identify cancer screening disparities among Asian and Hispanic gr

  12. Proteolytic activity of prostate-specific antigen (PSA towards protein substrates and effect of peptides stimulating PSA activity.

    Directory of Open Access Journals (Sweden)

    Johanna M Mattsson

    Full Text Available Prostate-specific antigen (PSA or kallikrein-related peptidase-3, KLK3 exerts chymotrypsin-like proteolytic activity. The main biological function of PSA is the liquefaction of the clot formed after ejaculation by cleavage of semenogelins I and II in seminal fluid. PSA also cleaves several other substrates, which may explain its putative functions in prostate cancer and its antiangiogenic activity. We compared the proteolytic efficiency of PSA towards several protein and peptide substrates and studied the effect of peptides stimulating the activity of PSA with these substrates. An endothelial cell tube formation model was used to analyze the effect of PSA-degraded protein fragments on angiogenesis. We showed that PSA degrades semenogelins I and II much more efficiently than other previously identified protein substrates, e.g., fibronectin, galectin-3 and IGFBP-3. We identified nidogen-1 as a new substrate for PSA. Peptides B2 and C4 that stimulate the activity of PSA towards small peptide substrates also enhanced the proteolytic activity of PSA towards protein substrates. Nidogen-1, galectin-3 or their fragments produced by PSA did not have any effect on endothelial cell tube formation. Although PSA cleaves several other protein substrates, in addition to semenogelins, the physiological importance of this activity remains speculative. The PSA levels in prostate are very high, but several other highly active proteases, such as hK2 and trypsin, are also expressed in the prostate and may cleave protein substrates that are weakly cleaved by PSA.

  13. Proteolytic Activity of Prostate-Specific Antigen (PSA) towards Protein Substrates and Effect of Peptides Stimulating PSA Activity

    Science.gov (United States)

    Mattsson, Johanna M.; Ravela, Suvi; Hekim, Can; Jonsson, Magnus; Malm, Johan; Närvänen, Ale; Stenman, Ulf-Håkan; Koistinen, Hannu

    2014-01-01

    Prostate-specific antigen (PSA or kallikrein-related peptidase-3, KLK3) exerts chymotrypsin-like proteolytic activity. The main biological function of PSA is the liquefaction of the clot formed after ejaculation by cleavage of semenogelins I and II in seminal fluid. PSA also cleaves several other substrates, which may explain its putative functions in prostate cancer and its antiangiogenic activity. We compared the proteolytic efficiency of PSA towards several protein and peptide substrates and studied the effect of peptides stimulating the activity of PSA with these substrates. An endothelial cell tube formation model was used to analyze the effect of PSA-degraded protein fragments on angiogenesis. We showed that PSA degrades semenogelins I and II much more efficiently than other previously identified protein substrates, e.g., fibronectin, galectin-3 and IGFBP-3. We identified nidogen-1 as a new substrate for PSA. Peptides B2 and C4 that stimulate the activity of PSA towards small peptide substrates also enhanced the proteolytic activity of PSA towards protein substrates. Nidogen-1, galectin-3 or their fragments produced by PSA did not have any effect on endothelial cell tube formation. Although PSA cleaves several other protein substrates, in addition to semenogelins, the physiological importance of this activity remains speculative. The PSA levels in prostate are very high, but several other highly active proteases, such as hK2 and trypsin, are also expressed in the prostate and may cleave protein substrates that are weakly cleaved by PSA. PMID:25237904

  14. Neonatal hearing screening of high-risk infants using automated auditory brainstem response: a retrospective analysis of referral rates.

    LENUS (Irish Health Repository)

    McGurgan, I J

    2013-10-07

    The past decade has seen the widespread introduction of universal neonatal hearing screening (UNHS) programmes worldwide. Regrettably, such a programme is only now in the process of nationwide implementation in the Republic of Ireland and has been largely restricted to one screening modality for initial testing; namely transient evoked otoacoustic emissions (TEOAE). The aim of this study is to analyse the effects of employing a different screening protocol which utilises an alternative initial test, automated auditory brainstem response (AABR), on referral rates to specialist audiology services.

  15. Design review of SPWR with PSA methodology

    International Nuclear Information System (INIS)

    Oikawa, Tetsukuni; Muramatsu, Ken; Iwamura, Takamichi; Tone, Tatsuzo; Kasahara, Takeo; Mizuno, Yoshio

    1993-01-01

    This paper presents the procedures and results of a PSA (Probabilistic Safety Assessment) of the SPWR (System-Integrated PWR), which is being developed at the Japan Atomic Energy Research Institute (JAERI) as a medium sized innovative passive safe reactor, to assist in the design improvement of the SPWR by reviewing the design and identifying the design weaknesses. This PSA was performed in four steps: (1) identification of initiating events by the failure mode effect analysis and other methods, (2) delineation of accident sequences for three selected initiating events using accident progression flow charts and event trees, (3) quantification of event trees based on the review of past PSAs for LWRs, and (4) sensitivity analysis and interpretation of results. Qualitative and quantitative results of PSA provided very useful information for decision makings of design improvement and recommendations for further consideration in the process of detailed design

  16. A Preliminary Fire PSA on PGSFR

    International Nuclear Information System (INIS)

    Kim, Kilyoo; Han, Sanghoon; Lee, KwiLim

    2017-01-01

    A Prototype Generation IV Sodium Fast Reactor (PGSFR) is under design with defense in depth concept with active, passive, and inherent safety features to acquire a design approval for PGSFR from Korean regulatory authority by around 2017. A preliminary fire PSA on PGSFR is done in 2016 and a final fire PSA of PGSFR will be done in 2017. The characteristics of the preliminary fire PSA on PGSFR are described in this paper. Since PGSFR is very safe reactor, it is not bad approach to use a conservative assumption in the preliminary PSA. In addition, several drawings including cable routing are not yet issued, a conservative calculation for CDF is performed. As shown in Table 2, the CDF caused by the fire in the control room takes 89% portion of total CDF. Thus, a detailed fire modeling for control room is necessary for the final fire PSA on PGSFR. Also, the increased ignition frequency due to sodium leak would be derived by considering the sodium piping complexity in the final fire PSA on PGSFR. The 4th column of Table 2 is derived the 3rd column by multiplying the factor (592/1177). The 5th column is the ignition frequency caused by the sodium leak. The 6th column is derived by summing the 4th column and the 5th column. The 7th column is the CDF portion of each fire area. The control room (fire area F-A404A) is the most important area since the control room fire takes 89% portion of total CDF.

  17. Rates of Delirium Diagnosis Do Not Improve with Emergency Risk Screening: Results of the Emergency Department Delirium Initiative Trial.

    Science.gov (United States)

    Arendts, Glenn; Love, Jennefer; Nagree, Yusuf; Bruce, David; Hare, Malcolm; Dey, Ian

    2017-08-01

    To determine whether a bundled risk screening and warning or action card system improves formal delirium diagnosis and person-centered outcomes in hospitalized older adults. Prospective trial with sequential introduction of screening and interventional processes. Two tertiary referral hospitals in Australia. Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905). Formal ED delirium screening algorithm and use of a risk warning card with a recommended series of actions for the prevention and management of delirium during the subsequent admission MEASUREMENTS: Delirium diagnosis at hospital discharge, proportion discharged to new assisted living arrangements, in-hospital complications (use of sedation, falls, aspiration pneumonia, death), hospital length of stay. Participants with a positive risk screen were significantly more likely (relative risk = 6.0, 95% confidence interval = 4.9-7.3) to develop delirium, and the proportion of at-risk participants with a positive screen was constant across three study phases. Delirium detection rate in participants undergoing the final intervention (Phase 3) was 12.1% (a 2% absolute and 17% relative increase from the baseline rate) but this was not statistically significant (P = .29), and a similar relative increase was seen over time in participants not receiving the intervention CONCLUSION: A risk screening and warning or action card intervention in the ED did not significantly improve rates of delirium detection or other important outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  18. Quality of prostate cancer screening information on the websites of nationally recognized cancer centers and health organizations.

    Science.gov (United States)

    Manole, Bogdan-Alexandru; Wakefield, Daniel V; Dove, Austin P; Dulaney, Caleb R; Marcrom, Samuel R; Schwartz, David L; Farmer, Michael R

    2017-12-24

    The purpose of this study was to survey the accessibility and quality of prostate-specific antigen (PSA) screening information from National Cancer Institute (NCI) cancer center and public health organization Web sites. We surveyed the December 1, 2016, version of all 63 NCI-designated cancer center public Web sites and 5 major online clearinghouses from allied public/private organizations (cancer.gov, cancer.org, PCF.org, USPSTF.org, and CDC.gov). Web sites were analyzed according to a 50-item list of validated health care information quality measures. Web sites were graded by 2 blinded reviewers. Interrater agreement was confirmed by Cohen kappa coefficient. Ninety percent of Web sites addressed PSA screening. Cancer center sites covered 45% of topics surveyed, whereas organization Web sites addressed 70%. All organizational Web pages addressed the possibility of false-positive screening results; 41% of cancer center Web pages did not. Forty percent of cancer center Web pages also did not discuss next steps if a PSA test was positive. Only 6% of cancer center Web pages were rated by our reviewers as "superior" (eg, addressing >75% of the surveyed topics) versus 20% of organizational Web pages. Interrater agreement between our reviewers was high (kappa coefficient = 0.602). NCI-designated cancer center Web sites publish lower quality public information about PSA screening than sites run by major allied organizations. Nonetheless, information and communication deficiencies were observed across all surveyed sites. In an age of increasing patient consumerism, prospective prostate cancer patients would benefit from improved online PSA screening information from provider and advocacy organizations. Validated cancer patient Web educational standards remain an important, understudied priority. Copyright © 2018. Published by Elsevier Inc.

  19. Effects of increasing the PSA cutoff to perform additional biomarker tests before prostate biopsy.

    Science.gov (United States)

    Nordström, Tobias; Adolfsson, Jan; Grönberg, Henrik; Eklund, Martin

    2017-10-03

    Multi-step testing might enhance performance of the prostate cancer diagnostic pipeline. Using PSA >1 ng/ml for first-line risk stratification and the Stockholm 3 Model (S3M) blood-test >10% risk of Gleason Score > 7 prostate cancer to inform biopsy decisions has been suggested. We aimed to determine the effects of changing the PSA cutoff to perform reflex testing with S3M and the subsequent S3M cutoff to recommend prostate biopsy while maintaining the sensitivity to detect Gleason Score ≥ 7 prostate cancer. We used data from the prospective, population-based, paired, diagnostic Stockholm 3 (STHLM3) study with participants invited by date of birth from the Swedish Population Register during 2012-2014. All participants underwent testing with PSA and S3M (a combination of plasma protein biomarkers [PSA, free PSA, intact PSA, hK2, MSMB, MIC1], genetic polymorphisms, and clinical variables [age, family, history, previous prostate biopsy, prostate exam]). Of 47,688 men in the STHLM3 main study, we used data from 3133 men with S3M >10% and prostate biopsy data. Logistic regression models were used to calculate prostate cancer detection rates and proportion saved biopsies. 44.2%, 62.5% and 67.9% of the participants had PSA PSA cut-off for additional work-up from 1 ng/ml to 1.5 ng/ml would thus save 18.3% of the performed tests, 4.9% of the biopsies and 1.3% (10/765) of Gleason Grade ≥ 7 cancers would be un-detected. By lowering the S3M cutoff to recommend biopsy, sensitivity to high-grade prostate cancer can be restored, to the cost of increasing the number of performed biopsies modestly. The sensitivity to detect prostate cancer can be maintained when using different PSA cutoffs to perform additional testing. Biomarker cut-offs have implications on number of tests and prostate biopsies performed. A PSA cutoff of 1.5 ng/ml to perform additional testing such as the S3M test might be considered. ISRCTN84445406 .

  20. Pre-equilibrium competitive library screening for tuning inhibitor association rate and specificity toward serine proteases.

    Science.gov (United States)

    Cohen, Itay; Naftaly, Si; Ben-Zeev, Efrat; Hockla, Alexandra; Radisky, Evette S; Papo, Niv

    2018-04-16

    High structural and sequence similarity within protein families can pose significant challenges to the development of selective inhibitors, especially toward proteolytic enzymes. Such enzymes usually belong to large families of closely similar proteases and may also hydrolyze, with different rates, protein- or peptide-based inhibitors. To address this challenge, we employed a combinatorial yeast surface display library approach complemented with a novel pre-equilibrium, competitive screening strategy for facile assessment of the effects of multiple mutations on inhibitor association rates and binding specificity. As a proof of principle for this combined approach, we utilized this strategy to alter inhibitor/protease association rates and to tailor the selectivity of the amyloid β-protein precursor Kunitz protease inhibitor domain (APPI) for inhibition of the oncogenic protease mesotrypsin, in the presence of three competing serine proteases, anionic trypsin, cationic trypsin and kallikrein-6. We generated a variant, designated APPI P13W/M17G/I18F/F34V , with up to 30-fold greater specificity relative to the parental APPI M17G/I18F/F34V protein, and 6500- to 230 000-fold improved specificity relative to the wild-type APPI protein in the presence of the other proteases tested. A series of molecular docking simulations suggested a mechanism of interaction that supported the biochemical results. These simulations predicted that the selectivity and specificity are affected by the interaction of the mutated APPI residues with nonconserved enzyme residues located in or near the binding site. Our strategy will facilitate a better understanding of the binding landscape of multispecific proteins and will pave the way for design of new drugs and diagnostic tools targeting proteases and other proteins. © 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society.

  1. Seminal plasma PSA in spinal cord injured men

    DEFF Research Database (Denmark)

    Brasso, K; Sønksen, J; Sommer, P

    1998-01-01

    The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration.......The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration....

  2. Regulatory requirements on PSA level 2: Review, aspects and applications

    International Nuclear Information System (INIS)

    Husarcek, J.

    2003-01-01

    The general requirements concerning utility obligations, probabilistic safety criteria (CDF should not exceed 1.0E-4/reactor year and LERF should not exceed 1.0E-5/reactor year), documentation and results, living PSA requirements and major steps in level 2 PSA are presented. PSA developments in Slovakia, collection and assembly of information, plant damage states, containment performance and failure modes, severe accident progression analyses, containment failure modes and source terms as a part of performed level 2 PSA are discussed. The PSA applications in design and operation evaluation, support to plant upgrade and modifications are also described. At the end, the following conclusion is made: more extensive PSA application needs to foster the exchange of experience and communication between PSA specialists, non-PSA engineers, designers, and the regulatory body staff responsible for safety assessment, inspection and enforcement

  3. Use of PSA to support accident management at NPPs

    International Nuclear Information System (INIS)

    Gomez Cobo, A.

    1997-01-01

    The presentation discusses the following: Overview of PSA level 2; Introduction: Framework; Accident Progression Phenomena in the Confinement/containment; Severe Accident Sequences; Examples; Results and Insights. Accident Management: Concepts; Process; Use of PSA to support Accident; Management

  4. A comparison of cervical cancer screening rates among women with traumatic spinal cord injury and the general population.

    Science.gov (United States)

    Guilcher, Sara J T; Newman, Alice; Jaglal, Susan B

    2010-01-01

    Previous qualitative and survey studies have suggested women with spinal cord injury (SCI) are screened less often for cervical cancer compared with the general population. We investigated whether cervical cancer screening rates differ between population-based women with and without traumatic SCI, matched for age and geography. A double cohort design was used, comparing women with SCI to the general population (1:4) using administrative data for Ontario, Canada. Women with SCI, identified using the Discharge Abstract Database for the fiscal years 1995-1996 to 2001-2002, were female residents of Ontario between the ages of 25 and 66, admitted to an acute care facility with a traumatic SCI (ICD-9 CM code 806 or 952). Women in the general Ontario population were randomly matched by age and geography. Screening rates were calculated from fee codes related to Papanicolaou (Pap) smear tests for a 3-year period preinjury and postinjury. There were 339 women with SCI matched to 1506 women in the general Ontario population. Screening rates pre-SCI were 55% for women with SCI and 57% during this same time period for matched women in the general population; post-SCI rates were 58% for both the two groups. Factors predicting the likelihood of receiving a Pap test for SCI cases included younger age and higher socioeconomic status. Utilization data suggest that there are no significant differences in screening rates for women with SCI compared with the general population. However, screening rates for women with SCI were significantly influenced by age as well as income.

  5. PSA response signatures - a powerful new prognostic indicator after radiation for prostate cancer?

    International Nuclear Information System (INIS)

    Denham, James W.; Lamb, David S.; Joseph, David; Matthews, John; Atkinson, Chris; Spry, Nigel A.; Duchesne, Gillian; Ebert, Martin; Steigler, Allison; D'Este, Catherine

    2009-01-01

    Background: We sought to determine whether inter-patient variations in pattern of PSA changes after radiation exist and, if so, are they prognostically significant. Methods: In the Trans-Tasman Radiation Oncology Group (TROG) 96.01 randomized controlled trial, patients with T2b,c,3,4 N0 prostate cancer (PC) were randomised to 0, 3 or 6 months maximal androgen deprivation prior to 66 Gy to the prostate and seminal vesicles (XRT). Patterns of anatomical site of failure were one of the trial endpoints. Serial serum PSA's were mandated at all follow-up visits. Pattern recognition software was developed to characterize PSA response 'signatures' (PRS) after therapy in individual patients. Results: By 2000, 270 eligible patients were randomised to radiation alone. Individual patient PSA values were observed to descend after radiation according to one of two characteristic 'signatures': single exponential (PRS Type 1), non-exponential (PRS Type 2). Compared to PRS Type 1, men with PRS Type 2 (50% of the group) had lower PSA nadir (nPSA) levels (p < .0001), longer doubling times on relapse (p = .006) and significantly lower rates of local (hazard ratio [HR]: 0.47, 95% confidence interval [0.30-0.75], p = .0014) and distant failure (HR: 0.25[0.13-0.46], p < .0001), death due to PC (HR: 0.20[0.10-0.42], p < .0001) and death due to any cause (HR: 0.37 [0.23-0.60], p < .0001). PRS retained its powerful prognostic significance in Cox models that incorporated all key pre-treatment covariates and nPSA. Conclusions: PRS reflect the presence of tumor phenotypes that vary substantially in their clinical behavior and response to XRT. Molecular characterization is now necessary

  6. The use of PSA in the French regulatory practice

    International Nuclear Information System (INIS)

    Mennesiez, H.

    1994-01-01

    The presentation gives a description of fundamental documents (since 1977-1978) through which have been set up in France probabilistic objectives, and PSAs, including shutdown states, performed for 900-1300 MWe PWR-type nuclear power plants. PSA developments and use, including fire PSA, level 2 and PSA for the future French-German European Pressurized Reactor (EPR) are also discussed

  7. PSA methodology development and application in Japan

    International Nuclear Information System (INIS)

    Kazuo Sato; Toshiaki Tobioka; Kiyoharu Abe

    1987-01-01

    The outlines of Japanese activities on development and application of probabilistic safety assessment (PSA) methodologies are described. First the activities on methodology development are described for system reliability analysis, operational data analysis, core melt accident analysis, environmental consequence analysis and seismic risk analysis. Then the methodoligy application examples by the regulatory side and the industry side are described. (author)

  8. French 900 MWe PWR PSA preliminary results

    International Nuclear Information System (INIS)

    Lanore, J.M.; Brisbois, J.

    1988-10-01

    A PSA is performed by the Safety Assessment Department of CEA for a 900 MWe standardized plant. The paper presents the objectives, the scope of the study and the relative preliminary results. Some general insights are drawn, especially the benefit related to the implementation of emergency procedures

  9. Deepwater Horizon Oil Spill PSA (:24)

    Centers for Disease Control (CDC) Podcasts

    This 24 second PSA from Dr. Regina Benjamin, U.S. Surgeon General, encourages people to get help if they are feeling sad, angry, depressed, or stressed as a result of the Gulf oil spill. It was recorded so that localities can add their own "For more information" at the end, as appropriate.

  10. Take Charge. Take the Test. PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    As part of the Take Charge. Take the Test. campaign, this 30 second PSA encourages African American women to get tested for HIV. Locations for a free HIV test can be found by visiting hivtest.org/takecharge or calling 1-800-CDC-INFO (1-800-232-4636).

  11. Communication Can Save Lives PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement (PSA) is based on the August 2015 CDC Vital Signs report. Antibiotic-resistant germs cause at least 23,000 deaths each year. Learn how public health authorities and health care facilities can work together to save lives.

  12. Safer Food Saves Lives PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second PSA is based on the November 2015 CDC Vital Signs report. Contaminated food sent to several states can cause multistate outbreaks of foodborne illness and make a lot of people seriously ill. Learn what can be done to prevent and stop outbreaks.

  13. Interoperability in the Planetary Science Archive (PSA)

    Science.gov (United States)

    Rios Diaz, C.

    2017-09-01

    The protocols and standards currently being supported by the recently released new version of the Planetary Science Archive at this time are the Planetary Data Access Protocol (PDAP), the EuroPlanet- Table Access Protocol (EPN-TAP) and Open Geospatial Consortium (OGC) standards. We explore these protocols in more detail providing scientifically useful examples of their usage within the PSA.

  14. Secundaire analyses organisatiebeleid psychosociale arbeidsbelasting (PSA)

    NARCIS (Netherlands)

    Kraan, K.O.; Houtman, I.L.D.

    2016-01-01

    Hoe het organisatiebeleid rond psychosociale arbeidsbelasting (PSA) eruit ziet anno 2014 en welke samenhang er is met ander beleid en uitkomstmaten, zijn de centrale vragen in dit onderzoek. De resultaten van deze verdiepende analyses kunnen ten goede komen aan de lopende campagne ‘Check je

  15. STD Awareness PSA - College 2 (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-04-22

    This PSA, targeted to college-aged youth and young adults, encourages listeners to get tested for STDs.  Created: 4/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/22/2010.

  16. STD Awareness PSA - College 1 (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-04-22

    This PSA, targeted to college-aged youth and young adults, encourages listeners to get tested for STDs.  Created: 4/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/22/2010.

  17. STD Awareness PSA - Male Announcer 2 (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-04-22

    This PSA encourages listeners to get tested for STDs. Target - Men who have sex with other men.  Created: 4/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/22/2010.

  18. Stop C. difficile Infections PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second PSA is based on the March 2012 CDC Vital Signs report. C. difficile is a germ that causes diarrhea linked to 14,000 deaths in the US each year. This podcast helps health care professionals learn how to prevent C. difficile infections.

  19. PSA levels as a predictor of 68Ga PSMA PET/CT positivity in patients with prostate cancer?

    Science.gov (United States)

    Soydal, Cigdem; Urun, Yuksel; Suer, Evren; Nak, Demet; Ozkan, Elgin; Kucuk, Ozlem N

    2018-05-10

    The aim of this study is to evaluate predictive factors of 68Gallium (68Ga) Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET)/Computed Tomography (CT) positivity. Relationships between serum Prostate Specific Antigen (PSA), Lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) levels, Gleason Score (GS) and positivity of 68Ga PSMA PET in patients who underwent 68Ga PSMA PET/CT for restaging for PCa were evaluated retrospectively. One hundred and four (median age: 67; range: 51-88) patients were included in this study. Of these patients, PSMA PET was positive in 75 (72%) patients. Mean serum PSA levels for PET negative and positive groups were 0.76±1.00 and 180.85±324.93 ng/ml (pPSA cut-off and 92% and 90%, respectively, for the 2 ng/ml PSA cut-off values. The positivity rates for patients with PSA levels PSA recurrence. Patients with higher GS and early PSA recurrence could benefit from 68Ga PSMA PET/CT.

  20. The DnaJ-like zinc finger domain protein PSA2 affects light acclimation and chloroplast development in Arabidopsis thaliana

    Directory of Open Access Journals (Sweden)

    Yan-Wen eWang

    2016-03-01

    Full Text Available The biosynthesis of chlorophylls and carotenoids and the assembly of thylakoid membranes are critical for the photoautotrophic growth of plants. Different factors are involved in these two processes. In recent years, members of the DnaJ-like zinc finger domain proteins have been found to take part in the biogenesis and/or the maintenance of plastids. One member of this family of proteins, PSA2, was recently found to localize to the thylakoid lumen and regulate the accumulation of photosystem I. In this study, we report that the silencing of PSA2 in Arabidopsis thaliana resulted in variegated leaves and retarded growth. Although both chlorophylls and total carotenoids decreased in the psa2 mutant, violaxanthin and zeaxanthin accumulated in the mutant seedlings grown under growth condition. Lower levels of non-photochemical quenching and electron transport rate were also found in the psa2 mutant seedlings under growth condition compared with those of the wild-type plants, indicating an impaired capability to acclimate to normal light irradiance when PSA2 was silenced. Moreover, we also observed an abnormal assembly of grana thylakoids and poorly developed stroma thylakoids in psa2 chloroplasts. Taken together, our results demonstrate that PSA2 is a member of the DnaJ-like zinc finger domain protein family that affects light acclimation and chloroplast development.

  1. Evaluation of [-2] proPSA and Prostate Health Index (phi) for the detection of prostate cancer: a systematic review and meta-analysis.

    Science.gov (United States)

    Filella, Xavier; Giménez, Nuria

    2013-04-01

    The usefulness of %[-2] proPSA and Prostate Health Index (phi) in the detection of prostate cancer are currently unknown. It has been suggested that these tests can distinguish prostate cancer from benign prostatic diseases better than PSA or %fPSA. We performed a systematic review and meta-analysis of the available scientific evidence to evaluate the clinical usefulness of %[-2] proPSA and phi. Relevant published papers were identified by searching computerized bibliographic systems. Data on sensitivity and specificity were extracted from 12 studies: 10 studies about %[-2] proPSA (3928 patients in total, including 1762 with confirmed prostate cancer) and eight studies about phi (2919 patients in total, including 1515 with confirmed prostate cancer). The sensitivity for the detection of prostate cancer was 90% for %[-2] proPSA and phi, while the pooled specificity was 32.5% (95% CI 30.6-34.5) and 31.6% (95% CI 29.2-34.0) for %[-2] proPSA and phi, respectively. The measurement of %[-2] proPSA improves the accuracy of prostate cancer detection in comparison with PSA or %fPSA, particularly in the group of patients with PSA between 2 μg/L and 10 μg/L. Similar results were obtained measuring phi. Using these tests, it is possible to reduce the number of unnecessary biopsies, maintaining a high cancer detection rate. Published results also showed that %[-2] proPSA and phi are related to the aggressiveness of the tumor.

  2. The WERCAP Screen and the WERC Stress Screen: psychometrics of self-rated instruments for assessing bipolar and psychotic disorder risk and perceived stress burden.

    Science.gov (United States)

    Mamah, Daniel; Owoso, Akinkunle; Sheffield, Julia M; Bayer, Chelsea

    2014-10-01

    Identification of individuals in the prodromal phase of bipolar disorder and schizophrenia facilitates early intervention and promises an improved prognosis. There are no current assessment tools for clinical risk symptoms of bipolar disorder, and psychosis-risk assessment generally involves semi-structured interviews, which are time consuming and rater dependent. We present psychometric data on two novel quantitative questionnaires: the Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen for assessing bipolar and psychotic disorder risk traits, and the accompanying WERC Stress Screen for assessing individual and total psychosocial stressor severities. Prevalence rates of the WERCAP Screen were evaluated among 171 community youth (aged 13-24 years); internal consistency was assessed and k-means cluster analysis was used to identify symptom groups. In 33 participants, test-retest reliability coefficients were assessed, and ROC curve analysis was used to determine the validity of the psychosis section of the WERCAP Screen (pWERCAP) against the Structured Interview of Psychosis-Risk Symptoms (SIPS). Correlations of the pWERCAP, the affectivity section of the WERCAP Screen (aWERCAP) and the WERC Stress Screen were examined to determine the relatedness of scores with cognition and clinical measures. Cluster analysis identified three groups of participants: a normative (47%), a psychosis-affectivity (18%) and an affectivity only (35%) group. Internal consistency of the aWERCAP and pWERCAP resulted in alphas of 0.87 and 0.92, and test-retest reliabilities resulted in intraclass correlation coefficients of 0.76 and 0.86 respectively. ROC curve analysis showed the optimal cut-point on the pWERCAP as a score of >30 (sensitivity: 0.89; specificity: 1.0). There was a significant negative correlation between aWERCAP scores and total cognition (R=-0.42), and between pWERCAP scores and sensorimotor processing speed. Total stress scores correlated

  3. ``Losing the Dark:'' A Planetarium PSA about Light Pollution

    Science.gov (United States)

    Productions, L. N.; Walker, D. C.

    2013-04-01

    Losing the Dark is a PSA video being created for fulldome theaters by Loch Ness Productions under the direction of the International Dark Sky Association Education Committee headed by Dr. Constance Walker of the National Optical Astronomy Observatories. It explains the problems with light pollution, its effects on life, and three ways in which people can implement “wise lighting” practices to mitigate light pollution. The show is also being produced in a flat-screen HD format for use in classical planetarium and non-dome theaters, for presentations by IDA speakers when addressing planning boards, etc. and will be posted on the IDA and other web sites. The final length is six minutes for both versions. Funding has been provided by The International Planetarium Society and the International Dark-Sky Association.

  4. PSA testing anxiety, psychological morbidity, and PSA utility in the management of prostate cancer.

    OpenAIRE

    Micsunescu, Anamaria Elia

    2017-01-01

    Anecdotal reports from urologists and medical oncologists have suggested that patients with prostate cancer (PCa) often present with anxiety related to ongoing monitoring of their PSA levels as part of their disease management. The purpose of the current study, therefore, was to determine the prevalence and severity of prostate specific antigen (PSA) testing anxiety in a population of patients with either localised or metastatic PCa living in Australia. Other aspects of psychological morbidit...

  5. Pre-screening Discussions and Prostate-Specific Antigen Testing for Prostate Cancer Screening.

    Science.gov (United States)

    Li, Jun; Zhao, Guixiang; Hall, Ingrid J

    2015-08-01

    For many men, the net benefit of prostate cancer screening with prostate-specific antigen (PSA) tests may be small. Many major medical organizations have issued recommendations for prostate cancer screening, stressing the need for shared decision making before ordering a test. The purpose of this study is to better understand associations between discussions about benefits and harms of PSA testing and uptake of the test among men aged ≥40 years. Associations between pre-screening discussions and PSA testing were examined using self-reported data from the 2012 Behavioral Risk Factor Surveillance System. Unadjusted prevalence of PSA testing was estimated and AORs were calculated using logistic regression in 2014. The multivariate analysis showed that men who had ever discussed advantages of PSA testing only or discussed both advantages and disadvantages were more likely, respectively, to report having had a test within the past year than men who had no discussions (ptesting with their healthcare providers were more likely (AOR=2.75, 95% CI=2.00, 3.79) to report getting tested than men who had no discussions. Discussions of the benefits or harms of PSA testing are positively associated with increased uptake of the test. Given the conflicting recommendations for prostate cancer screening and increasing importance of shared decision making, this study points to the need for understanding how pre-screening discussions are being conducted in clinical practice and the role played by patients' values and preferences in decisions about PSA testing. Published by Elsevier Inc.

  6. Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview.

    Science.gov (United States)

    IJspeert, J E G; Bevan, R; Senore, C; Kaminski, M F; Kuipers, E J; Mroz, A; Bessa, X; Cassoni, P; Hassan, C; Repici, A; Balaguer, F; Rees, C J; Dekker, E

    2017-07-01

    The role of serrated polyps (SPs) as colorectal cancer precursor is increasingly recognised. However, the true prevalence SPs is largely unknown. We aimed to evaluate the detection rate of SPs subtypes as well as serrated polyposis syndrome (SPS) among European screening cohorts. Prospectively collected screening cohorts of ≥1000 individuals were eligible for inclusion. Colonoscopies performed before 2009 and/or in individuals aged below 50 were excluded. Rate of SPs was assessed, categorised for histology, location and size. Age-sex-standardised number needed to screen (NNS) to detect SPs were calculated. Rate of SPS was assessed in cohorts with known colonoscopy follow-up data. Clinically relevant SPs (regarded as a separate entity) were defined as SPs ≥10 mm and/or SPs >5 mm in the proximal colon. Three faecal occult blood test (FOBT) screening cohorts and two primary colonoscopy screening cohorts (range 1.426-205.949 individuals) were included. Rate of SPs ranged between 15.1% and 27.2% (median 19.5%), of sessile serrated polyps between 2.2% and 4.8% (median 3.3%) and of clinically relevant SPs between 2.1% and 7.8% (median 4.6%). Rate of SPs was similar in FOBT-based cohorts as in colonoscopy screening cohorts. No apparent association between the rate of SP and gender or age was shown. Rate of SPS ranged from 0% to 0.5%, which increased to 0.4% to 0.8% after follow-up colonoscopy. The detection rate of SPs is variable among screening cohorts, and standards for reporting, detection and histopathological assessment should be established. The median rate, as found in this study, may contribute to define uniform minimum standards for males and females between 50 and 75 years of age. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Performance indicators at Embalse NPP: PSA and safety system indicators based on PSA models

    International Nuclear Information System (INIS)

    Fornero, D.A.

    2001-01-01

    Several indicators have been implemented at Embalse NPP. The objective was selecting some representative parameters to evaluate the performance of both the plant and the personnel activities, important for safety. A first set of indicators was defined in accordance with plant technical staff criteria. A complementary set of them was addressed later based on WANO guidance. This report presents the set of indicators used at Embalse NPP, centering the description to related to safety systems performance indicators (SSPI). Some considerations are done about the calculation methods, the need for aligning and updating their values following Embalse Probabilistic Safety Assessment (PSA) development, and some pros and cons of using the PSA model for getting systems indicators. Owing to the fact that PSA ownership by utilities is also a subject of the meeting, some characteristics of the organization of the PSA Project are described at the beginning of the report. At Embalse NPP a Level 1 PSA has been developed under the responsibility of its own plant and with an important contribution from the IAEA. PSA was developed at the site, conducting this to a study strongly interactive with the station staff. (author)

  8. Management and organisational factors in PSA; Organisations- und Management-Faktoren in der PSA

    Energy Technology Data Exchange (ETDEWEB)

    Balfanz, H.P. [TUEV Nord e.V., Hamburg (Germany)

    1999-04-01

    The constraints of PSA are increasingly considered with increasing application of PSA for the safety management of nuclear power plants (see US-NRC, 'Risk Informed Regulation', NRC-1). There is a vivid international discourse about the applicability of the variables of plant management and organisation in PSAs, which has lead to a great variety of research activities into this matter (see PSAM 4). This paper here summarizes the current state of progress of research work and discusses the applicability of results. The studies for comparative assessment of methodology and results were performed by the TUeV Nord under the roof of the BMU/BfS-sponsored project SR 2260, ''Further development of probabilistic methods for nuclear power plant safety assessment. (orig./CB) [German] Mit zunehmender Anwendung der PSA (Probabilistische Sicherheitsanalyse) im Sicherheitsmanagement von KKW (vergl. US-NRC, Einfuehrung des Konzepts 'Risk Informed Regulation' NRC-1) gewinnt die Beachtung der Grenzen der PSA zusaetzliche Bedeutung. International ist eine intensive Diskussion ueber die Moeglichkeiten einer Einbindung der Einflussgroesse von Organisation und Management in der PSA zu verzeichnen und wird belegt durch vielfaeltige Forschungs- und Entwicklungsarbeiten (vergl. PSAM 4). Dieser Beitrag setzt sich in erster Linie mit diesem Entwicklungsstand auseinander und diskutiert seinen Anwendungsstand fuer die PSA. Die hierzu vom TUeV Nord durchgefuehrten Arbeiten basieren auf dem BMU/BfS-Vorhaben SR 2260, 'Weiterentwicklung probabilistischer Methoden zur Sicherheitsbeurteilung von KKW'. (orig.)

  9. Enhanced detection sensitivity of prostate-specific antigen via PSA-conjugated gold nanoparticles based on localized surface plasmon resonance: GNP-coated anti-PSA/LSPR as a novel approach for the identification of prostate anomalies.

    Science.gov (United States)

    Jazayeri, M H; Amani, H; Pourfatollah, A A; Avan, A; Ferns, G A; Pazoki-Toroudi, H

    2016-10-01

    Prostate-specific antigen (PSA) is used to screen for prostate disease, although it has several limitations in its application as an organ-specific or cancer-specific marker. Furthermore, a highly specific/sensitive and/or label-free identification of PSA still remains a challenge in the diagnosis of prostate anomalies. We aimed to develop a gold nanoparticle (GNP)-conjugated anti-PSA antibody-based localized surface plasmon resonance (LSPR) as a novel approach to detect prostatic disease. A total of 25 nm colloidal gold particles were prepared followed by conjugation with anti-PSA pAb (GNPs-PSA pAb). LSPR was used to monitor the absorption changes of the aggregation of the particles. The size, shape and stability of the GNP-anti-PSA were evaluated by dynamic light scattering transmission electron microscopy (TEM) and zetasizer. The GNPs-conjugated PSA-pAb was successfully synthesized and subsequently characterized using ultraviolet absorption spectroscopy and TEM to determine the size distribution, crystallinity and stability of the particles (for example, stability of GNP: 443 mV). To increase the stability of the particles, we pegylated GNPs using an N-(3-dimethylaminopropyl)-N*-ethylcarbodiimide hydrochloride (EDC)/N-hydroxylsuccinimide (NHS) linker (for example, stability of GNP after pegylation: 272 mV). We found a significant increase in the absorbance and intensity of the particles with extinction peak at 545/2 nm, which was shifted by ~1 nm after conjugation. To illustrate the potential of the GNPs-PSA pAb to bind specifically to PSA, LSPR was used. We found that the extinction peak shifted 3 nm for a solution of 100 nM unlabeled antigen. In summary, we have established a novel approach for improving the efficacy/sensitivity of PSA in the assessment of prostate disease, supporting further investigation on the diagnostic value of GNP-conjugated anti-PSA/LSPR for the detection of prostate cancer.

  10. Low hepatitis C antibody screening rates among an insured population of Tennessean Baby Boomers.

    Directory of Open Access Journals (Sweden)

    James G Carlucci

    Full Text Available Chronic Hepatitis C Virus (HCV infection is common and can cause liver disease and death. Persons born from 1945 through 1965 ("Baby Boomers" have relatively high prevalence of chronic HCV infection, prompting recommendations that all Baby Boomers be screened for HCV. If chronic HCV is confirmed, evaluation for antiviral treatment should be performed. Direct-acting antivirals can cure more than 90% of people with chronic HCV. This sequence of services can be referred to as the HCV "cascade of cure" (CoC. The Tennessee (TN Department of Health (TDH and a health insurer with presence in TN aimed to determine the proportion of Baby Boomers who access HCV screening services and appropriately navigate the HCV CoC in TN.TDH surveillance data and insurance claim records were queried to identify the cohort of Baby Boomers eligible for HCV testing. Billing codes and pharmacy records from 2013 through 2015 were used to determine whether HCV screening and other HCV-related services were provided. The proportion of individuals accessing HCV screening and other steps along the HCV CoC was determined. Multivariable analyses were performed to identify factors associated with HCV screening and treatment.Among 501,388 insured Tennessean Baby Boomers, 7% were screened for HCV. Of the 40,019 who received any HCV-related service, 86% were screened with an HCV antibody test, 20% had a confirmatory HCV PCR, 9% were evaluated for treatment, and 4% were prescribed antivirals. Hispanics were more likely to be screened and treated for HCV than non-Hispanic whites. HCV screening was more likely to occur in the Nashville-Davidson region than in other regions of TN, but there were regional variations in HCV treatment.Many insured Tennessean Baby Boomers do not access HCV screening services, despite national recommendations. Demographic and regional differences in uptake along the HCV CoC should inform public health interventions aimed at mitigating the effects of chronic

  11. Generation of monoclonal antibodies against prostate specific antigen (PSA) for the detection of PSA and its purification

    International Nuclear Information System (INIS)

    Acevedo Castro, Boris Ernesto

    2012-01-01

    The prostate cancer in Cuba is a problem of health (2672 diagnosed cases and 2769 deaths in 2007). Various diagnostic methods have been implemented for the detection and management of this disease, emphasizing among them (PSA) prostate-specific antigen serological determination. At this work was generated and characterized a panel of 11 antibodies (AcMs) monoclonal IgG1 detected with high affinity described major epitopes of the PSA, both in solution and attached to the test plate. From the panel obtained AcMs was the standardization of an essay type ELISA for the detection of serum total PSA (associated and free) equimolar, based on antibody monoclonal CB-PSA.4 in the coating and the CB-PSA.9 coupled with biotin as liner, with a detection limit of 0.15 ng/mL. Similarly, standardized system for detection in serum free PSA, based on the AcMs CB-PSA.4 (coating) and CB-PSA.2 coupled with biotin (liner), with a detection limit of 0.5 ng/mL. Finally, with the purpose of using PSA as standard in trials type ELISA, developed a simple method of inmunopurificación based on the AcM, CB-PSA.2, which was obtained the PSA with a purity exceeding 90%. Immunoassay Centre on the basis of the AcMs panel and the results of this study, developed and recorded two diagnostic systems for the detection of PSA in human serum. (author)

  12. Evaluation of prostate cancer prevalence in Iranian male population with increased PSA level, a one center experience

    International Nuclear Information System (INIS)

    Moslemi, Mohammad Kazem; Lotfi, Fariborz; Tahvildar, Seyed Ali

    2011-01-01

    This study was conducted to evaluate the incidence of prostate cancer (PCa) in Iranian male patients with increased prostate-specific antigen (PSA), and normal or abnormal digital rectal examination (DRE) that underwent prostate biopsy. From March 2006 to April 2009, a total of 346 consecutive males suspected of having PCa due to increased PSA levels underwent transrectal ultrasonography (TRUS)-guided sextant biopsy of the prostate. The total PSA (tPSA), demographic data, incidence of PCa, benign prostate hyperplasia (BPH), and prostatitis were assessed. The patients were divided into two groups according to their PSA values (group A serum tPSA level, 4–10 ng/mL; group B serum tPSA level, 10.1–20.0 ng/mL). Of the 346 biopsied cases, 193 cases (56%) had PCa, 80 cases (23%) had BPH, and 73 cases (21%) had prostatitis. The mean PSA and the age of the carcinoma group were significantly higher than those of the benign group (P < 0.01). The biopsy results were grouped as PCa, BPH, and prostatitis. Incidence of PCa for group A and group B cases were 115 cases (51%), and 78 cases (65%), respectively. In the case of PCa, BPH, and prostatitis, the mean PSAs were 10.02 ng/mL, 8.76 ng/mL, and 8.41 ng/mL, respectively (P < 0.40). TRUS-guided prostate biopsy and interpretation by a skilled team is highly recommended for early detection of PCa or its ruling-out. It seems that a PSA cutoff value of 4 ng/mL may be applied to the Iranian population. Although the chance of PCa is high in the PSA levels of 4–10 ng/mL, the combination of some data, like age and prostate volume, can decrease the rate of unnecessary prostate biopsies. We recommend prostate biopsy when PSA and/or DRE is elevated in symptomatic patients with obstructive and/or irritative lower urinary tract symptoms (LUTS) such as dysuria, frequency, or nocturia. Due to the very high incidence of PCa in the patients with PSA greater than 10 ng/mL, TRUS-guided biopsy is indicated, whatever the findings on DRE and

  13. Reappraisal of the application of total and free PSA estimation for diagnosis of prostate cancer in Chinese

    International Nuclear Information System (INIS)

    Chu, L.S.; Liu, R.S.; Yang, C.S.; Chen, G.K.; Liao, S.Q.

    2002-01-01

    Objectives: Prostate-specific antigen (PSA) test has become one of the most cost effective tools for detecting early prostate cancer. In general, a diagnosis of prostate cancer is uncommon at serum levels of total PSA (TPSA) at or below 4 ng/mL and is common at levels above 10 ng/mL. The diagnostic gray zone is between 4.0 and 10.0 ng/mL, where the differential diagnosis of prostate cancer is most difficult. For such patients ratio of free-to-total PSA (F/TPSA) can be useful in differentiating prostate cancer from benign prostate hypertrophy (BPH). However, screen for prostate cancer with PSA remains controversial. Thirty-five percent of the patients with clinically localized prostate cancer present with serum PSA levels below 4 ng/mL. What is the optimal 'reflex' total PSA at which we should implement use of the F/T PSA? The purpose of this study is to assess the usefulness of F/TPSA in patients with TPSA less than 4 ng/mL. Methods: A total of 101 high-risk patients of prostate cancer underwent transrectal ultrasonography and biopsy or transurethral resection of prostate were studied. Sixty-eight patients were proved to have BPH only and 33 patients were proved to have prostate cancer. TPSA and F/TPSA were determined using a immunoradiometric assay (PSA-RIACT, FPSA-RIACT, CIS). The appropriate cut-off value of F/TPSA in diagnosis of prostate cancer determined by receiver-operating characteristic (ROC) curve was 0.19. Results: The TPSA value of the subjects ranged from 0 to 15 ng/mL. Seventeen cases (26%) of prostate cancer were disclosed in 65 patients with TPSA > 4 ng/mL. Thirty-six patients had TPSA 0.19 were proved to have prostate cancer. Conclusion: Thirty-nine per cent of high-risk patients with TPSA < 4.0 ng/mL and F/T PSA < 0.19 was found to have prostate cancer. F/T PSA should be determined in Chinese patients with TPSA < 10 ng/mL instead of the algorithm of combined use of F/T PSA and TPSA between 4-10 ng/mL

  14. Background parenchymal enhancement on baseline screening breast MRI: impact on biopsy rate and short-interval follow-up.

    LENUS (Irish Health Repository)

    Hambly, Niamh M

    2011-01-01

    Background parenchymal enhancement on breast MRI refers to normal enhancement of the patient\\'s fibroglandular tissue. The aim of this study was to determine the effect of background parenchymal enhancement on short-interval follow-up, biopsy, and cancer detection rate on baseline screening MRI in a high-risk group.

  15. Increased Cancer Detection Rate and Variations in the Recall Rate Resulting from Implementation of 3D Digital Breast Tomosynthesis into a Population-based Screening Program

    Science.gov (United States)

    Venkataraman, Shambavi; Phillips, Jordana; Dialani, Vandana; Fein-Zachary, Valerie J.; Prakash, Seema; Slanetz, Priscilla J.; Mehta, Tejas S.

    2016-01-01

    Purpose To compare the recall and cancer detection rates (CDRs) at screening with digital breast tomosynthesis (DBT) with those at screening with two-dimensional (2D) mammography and to evaluate variations in the recall rate (RR) according to patient age, risk factors, and breast density and among individual radiologists at a single U.S. academic medical center. Materials and Methods This institutional review board–approved, HIPAA-compliant prospective study with a retrospective cohort included 85 852 asymptomatic women who presented for breast cancer screening over a 3-year period beginning in 2011. A DBT unit was introduced into the existing 2D mammography screening program, and patients were assigned to the first available machine. Ten breast-subspecialized radiologists interpreted approximately 90% of the examinations. RRs were calculated overall and according to patient age, breast density, and individual radiologist. CDRs were calculated. Single and multiple mixed-effect logistic regression analyses, χ2 tests, and Bonferroni correction were utilized, as appropriate. Results The study included 5703 (6.6%) DBT examinations and 80 149 (93.4%) 2D mammography examinations. The DBT subgroup contained a higher proportion of patients with risk factors for breast cancer and baseline examinations. DBT was used to detect 54.3% more carcinomas (+1.9 per 1000, P < .0018) than 2D mammography. The RR was 7.51% for 2D mammography and 6.10% for DBT (absolute change, 1.41%; relative change, –18.8%; P < .0001). The DBT subgroup demonstrated a significantly lower RR for patients with extremely or heterogeneously dense breasts and for patients in their 5th and 7th decades. Conclusion Implementing DBT into a U.S. breast cancer screening program significantly decreased the screening RR overall and for certain patient subgroups, while significantly increasing the CDR. These findings may encourage more widespread adoption and reimbursement of DBT and facilitate improved patient

  16. Clinicians' perceptions of the benefits and harms of prostate and colorectal cancer screening.

    Science.gov (United States)

    Elstad, Emily A; Sutkowi-Hemstreet, Anne; Sheridan, Stacey L; Vu, Maihan; Harris, Russell; Reyna, Valerie F; Rini, Christine; Earp, Jo Anne; Brewer, Noel T

    2015-05-01

    Clinicians' perceptions of screening benefits and harms influence their recommendations, which in turn shape patients' screening decisions. We sought to understand clinicians' perceptions of the benefits and harms of cancer screening by comparing 2 screening tests that differ in their balance of potential benefits to harms: colonoscopy, which results in net benefit for many adults, and prostate-specific antigen (PSA) testing, which may do more harm than good. In this cross-sectional study, 126 clinicians at 24 family/internal medicine practices completed surveys in which they listed and rated the magnitude of colonoscopy and PSA testing benefits and harms for a hypothetical 70-year-old male patient and then estimated the likelihood that these tests would cause harm and lengthen the life of 100 similar men in the next 10 years. We tested the hypothesis that the availability heuristic would explain the association of screening test to perceived likelihood of benefit/harm and a competing hypothesis that clinicians' gist of screening tests as good or bad would mediate this association. Clinicians perceived PSA testing to have a greater likelihood of harm and a lower likelihood of lengthening life relative to colonoscopy. Consistent with our gist hypothesis, these associations were mediated by clinicians' gist of screening (balance of perceived benefits to perceived harms). Generalizability beyond academic clinicians remains to be established. Targeting clinicians' gist of screening, for example through graphical displays that allow clinicians to make gist-based relative magnitude comparisons, may influence their risk perception and possibly reduce overrecommendation of screening. © The Author(s) 2015.

  17. A Joint Report on PSA for New and Advanced Reactors

    International Nuclear Information System (INIS)

    2013-01-01

    This report addresses the application of Probabilistic Safety Assessment (PSA) to new and advanced nuclear reactors. As far as advanced reactors are concerned, the objectives were to characterize the ability of current PSA technology to address key questions regarding the development, acceptance and licensing of advanced reactor designs, to characterize the potential value of advanced PSA methods and tools for application to advanced reactors, and to develop recommendations for any needed developments regarding PSA for these reactors. As far as the design and commissioning of new nuclear power plants is concerned, the objectives were to identify and characterize current practices regarding the role of PSA, to identify key technical issues regarding PSA, lessons learned and issues requiring further work; to develop recommendations regarding the use of PSA, and to identify future international cooperative work on the identified issues. In order to reach these objectives, questionnaires had been sent to participating countries and organisations

  18. Baseline PSA in a Spanish male population aged 40-49 years anticipates detection of prostate cancer.

    Science.gov (United States)

    Angulo, J C; Viñas, M A; Gimbernat, H; Fata, F Ramón de; Granados, R; Luján, M

    2015-12-01

    We researched the usefulness of optimizing prostate cancer (PC) screening in our community using baseline PSA readings in men between 40-49 years of age. A retrospective study was performed that analyzed baseline PSA in the fifth decade of life and its ability to predict the development of PC in a population of Madrid (Spain). An ROC curve was created and a cutoff was proposed. We compared the evolution of PSA from baseline in patients with consecutive readings using the Friedman test. We established baseline PSA ranges with different risks of developing cancer and assessed the diagnostic utility of the annual PSA velocity (PSAV) in this population. Some 4,304 men aged 40-49 years underwent opportunistic screening over the course of 17 years, with at least one serum PSA reading (6,001 readings) and a mean follow-up of 57.1±36.8 months. Of these, 768 underwent biopsy of some organ, and 104 underwent prostate biopsy. Fourteen patients (.33%) were diagnosed with prostate cancer. The median baseline PSA was .74 (.01-58.5) ng/mL for patients without PC and 4.21 (.76-47.4) ng/mL for those with PC. The median time from the reading to diagnosis was 26.8 (1.5-143.8) months. The optimal cutoff for detecting PC was 1.9ng/mL (sensitivity, 92.86%; specificity, 92.54%; PPV, 3.9%; NPV, 99.97%), and the area under the curve was 92.8%. In terms of the repeated reading, the evolution of the PSA showed no statistically significant differences between the patients without cancer (p=.56) and those with cancer (P=.64). However, a PSAV value >.3ng/mL/year revealed high specificity for detecting cancer in this population. A baseline PSA level ≥1.9ng/mL in Spanish men aged 40-49 years predicted the development of PC. This value could therefore be of use for opportunistic screening at an early age. An appropriate follow-up adapted to the risk of this population needs to be defined, but an annual PSAV ≥.3ng/mL/year appears of use for reaching an early diagnosis. Copyright © 2015 AEU

  19. Experience from the comparison of two PSA-studies

    International Nuclear Information System (INIS)

    Holmberg, J.; Pulkkinen, U.

    2001-03-01

    Two probabilistic safety assessments (PSA) made for nearly identical reactors units (Forsmark 3 and Oskarshamn 3) have been compared. Two different analysis teams made the PSAs, and the analyses became quite different. The goal of the study is to identify, clarify and explain differences between PSA-studies. The purpose is to understand limitations and uncertainties in PSA, to explain reasons for differences between PSA-studies, and to give recommendations for comparison of PSA-studies and for improving the PSA-methodology. The reviews have been made by reading PSA-documentation, using the computer model and interviewing persons involved in the projects. The method and findings have been discussed within the project group. Both the PSA-project and various parts in the PSA-model have been reviewed. A major finding was that the two projects had different purpose and thus had different resources, scope and even methods in their study. The study shows that comparison of PSA results from different plants is normally not meaningful. It takes a very deep knowledge of the PSA studies to make a comparison of the results and usually one has to ensure that the compared studies have the same scope and are based on the same analysis methods. Harmonisation of the PSA-methodology is recommended in the presentation of results, presentation of methods, scope main limitation and assumption, and definitions for end states, initiating events and common cause failures. This would facilitate the comparison of the studies. Methods for validation of PSA for different application areas should be developed. The developed PSA review standards can be applied for a general validation of a study. The most important way to evaluate the real feasibility of PSA can take place only with practical applications. The PSA-documentation and models can be developed to facilitate the communication between PSA-experts and users. In any application consultation with the PSA-expert is however needed. Many

  20. Awareness and uptake of colorectal, breast, cervical and prostate cancer screening tests in Spain.

    Science.gov (United States)

    Carrasco-Garrido, Pilar; Hernandez-Barrera, Valentın; Lopez de Andres, Ana; Jimenez-Trujillo, Isabel; Gallardo Pino, Carmen; Jimenez-Garcıa, Rodrigo

    2014-04-01

    We aim to describe levels of awareness and uptake of colorectal, breast, cervical and prostate cancer screening tests and to analyze the association to socio-demographic and health-related variables. Population-based cross-sectional study conducted using a home-based personal interview survey on a nationwide representative sample (n = 7938) of population aged ≥18 years (Oncobarometro Survey). Awareness was assessed by asking participants: Now I am going to mention several medical tests for cancer detection, please tell me if you already know about them or if this is the first time you have heard of them? The tests mentioned were faecal occult blood test (FOBT), mammography, Pap smear and prostate-specific antigen (PSA). Cancer screening uptake was assessed by asking participants whether they had received tests within the previous 2 years. Awareness rates of 38.55% for FOBT, 95.03% for mammography, 70.84% for Pap smears and 54.72% for PSA were found. Uptake mammography was 74.46%, Pap smears 65.57%, PSA 35.19% and FOBT 9.40%. Factors such as immigration status, lower educational level or income and not suffering from chronic conditions are negative predictors for uptake. Awareness and uptake results showed acceptable figures for mammography, moderate for Pap smears and unacceptably low for FOBT. Inequalities exist in uptake of cancer screening. It is necessary to develop public health educational programmes, especially for the vulnerable populations, aiming to inform and motivate them to use screening services on a regular basis. Our data suggest that although PSA is not recommended, this opportunistic screening is frequently used in Spain.

  1. The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure as a Screening Tool.

    Science.gov (United States)

    Bastiaens, Leo; Galus, James

    2018-03-01

    The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure was developed to aid clinicians with a dimensional assessment of psychopathology; however, this measure resembles a screening tool for several symptomatic domains. The objective of the current study was to examine the basic parameters of sensitivity, specificity, positive and negative predictive power of the measure as a screening tool. One hundred and fifty patients in a correctional community center filled out the measure prior to a psychiatric evaluation, including the Mini International Neuropsychiatric Interview screen. The above parameters were calculated for the domains of depression, mania, anxiety, and psychosis. The results showed that the sensitivity and positive predictive power of the studied domains was poor because of a high rate of false positive answers on the measure. However, when the lowest threshold on the Cross-Cutting Symptom Measure was used, the sensitivity of the anxiety and psychosis domains and the negative predictive values for mania, anxiety and psychosis were good. In conclusion, while it is foreseeable that some clinicians may use the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure as a screening tool, it should not be relied on to identify positive findings. It functioned well in the negative prediction of mania, anxiety and psychosis symptoms.

  2. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    Energy Technology Data Exchange (ETDEWEB)

    Bluekens, Adriana M.J. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); St. Elisabeth Hospital, Department of Radiology, Tilburg (Netherlands); Karssemeijer, Nico [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Beijerinck, David; Deurenberg, Jan J.M. [Preventicon Screening Centre/Mid-West, Utrecht (Netherlands); Engen, Ruben E. van [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Broeders, Mireille J.M. [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Radboud University Nijmegen Medical Centre, Department of Epidemiology, Biostatistics and HTA, Nijmegen (Netherlands); Heeten, Gerard J. den [National Expert and Training Centre for Breast Cancer Screening, Nijmegen (Netherlands); Academic Medical Centre (AMC), Department of Radiology, Amsterdam (Netherlands)

    2010-09-15

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  3. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates.

    Science.gov (United States)

    Bluekens, Adriana M J; Karssemeijer, Nico; Beijerinck, David; Deurenberg, Jan J M; van Engen, Ruben E; Broeders, Mireille J M; den Heeten, Gerard J

    2010-09-01

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p < .001), with a significant increase in cancer detection (p = .010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection.

  4. Consequences of digital mammography in population-based breast cancer screening: initial changes and long-term impact on referral rates

    International Nuclear Information System (INIS)

    Bluekens, Adriana M.J.; Karssemeijer, Nico; Beijerinck, David; Deurenberg, Jan J.M.; Engen, Ruben E. van; Broeders, Mireille J.M.; Heeten, Gerard J. den

    2010-01-01

    To investigate the referral pattern after the transition to full-field digital mammography (FFDM) in a population-based breast cancer screening programme. Preceding the nationwide digitalisation of the Dutch screening programme, an FFDM feasibility study was conducted. Detection and referral rates for FFDM and screen-film mammography (SFM) were compared for first and subsequent screens. Furthermore, radiological characteristics of referrals in digital screening were assessed. A total of 312,414 screening mammograms were performed (43,913 digital and 268,501 conventional), with 4,473 consecutive referrals (966 following FFDM). Initially the FFDM referral rate peaked, and many false-positive results were noted as a consequence of pseudolesions and increased detection of (benign) microcalcifications. A higher overall referral rate was observed in FFDM screening in both first and subsequent examinations (p <.001), with a significant increase in cancer detection (p =.010). As a result of initial inexperience with digital screening images implementing FFDM in a population-based breast cancer screening programme may lead to a strong, but temporary increase in referral. Dedicated training in digital screening for radiographers and screening radiologists is therefore recommended. Referral rates decrease and stabilise (learning curve effect) at a higher level than in conventional screening, yet with significantly enhanced cancer detection. (orig.)

  5. Development of component reliability data for PSA and risk based management in Japan

    International Nuclear Information System (INIS)

    Yoshihiro Tomioka; Mitsumasa Hirano; Shunsuke Kondo

    1997-01-01

    The author presents the outline of development of the component reliability data for PSA and risk based management in Japan. In the first part following the introduction, the development process is described. The next part describes issues discussed in the course of the development, which are treatment of zero failure data, error factor, estimation of unavailable failure rate and integral test

  6. Towards a PSA harmonization French-Belgian comparison of the level 1 PSA for two similar PWR types

    International Nuclear Information System (INIS)

    Dupuy, P.; Corenwinder, F.; Lanore, J.M.; Gryffroy, D.; Gelder, P. de; Hulsmans, M.

    2002-06-01

    In the framework of the cooperation between French and Belgian regulatory authorities, a PSA (Probabilistic Safety Assessment) comparison exercise has been carried out for several years. This comparison deals with two PSA level 1 studies for internal events, performed for both power and shutdown states: the French PSA of the 900 MWe-series PWR, and the Belgian PSA of the Tihange 1 PWR, which both concern PWRs with a similar Framatome design. The purpose of this paper is to describe the PSA comparison methodology and to present, in a qualitative way, an overview of the insights obtained up to now. It also shows that such an 'a posteriori' benchmark exercise turns out to be a step towards PSA harmonization, and gives more confidence in the results of plant specific PSA when used for applications like precursor analysis or evaluations of importance to safety. (authors)

  7. Long-Term Effects of a Screening Intervention for Depression on Suicide Rates among Japanese Community-Dwelling Older Adults.

    Science.gov (United States)

    Oyama, Hirofumi; Sakashita, Tomoe

    2016-04-01

    To explore the long-term impact of a universal screening intervention for depression on suicide rates among older community-dwelling adults, with gender as an effect modifier. Controlled cohort study reporting long-term follow-up of previous research. Two sets of three municipalities in Japan were assigned as intervention and control regions and compared with the surrounding zone and prefecture. Intervention area residents aged 60 years and older (14,291) were invited to participate in a 2-year intervention (2005-2006). Four population-based dynamic cohorts of residents aged 65 years and older (1999-2010) were included as subjects, 6 years before and after the intervention started. At-risk residents within the intervention region (4,918) were invited for a two-step screening program; 2,552 participated in the program linked with care/support services for 2 years. An education program open to the public was held. Changes in suicide from a 6-year baseline to the 2-year intervention and a 4-year follow-up in the intervention region (11,700 adults ≥65 years) were compared with a matched control and two comparison areas using mixed-effects negative binomial regression models. Suicide rates among older adults exposed to screening were compared with those of the control region. Suicide rates in the intervention region decreased by 48%, which was significantly greater than in the three comparison areas. The program's benefits lasted longer for women than men. Screening exposure may be associated with decreased suicide risk over the 4-year follow-up. Universal screening may decrease suicide rates among older adults, with potential gender differences in treatment response. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. The effectiveness of policy changes designed to increase the attendance rate for outpatient retinopathy of prematurity (ROP) screening examinations.

    Science.gov (United States)

    Barry, Gerard P; Tauber, Kate; Emmanuel, Gregory; Horgan, Michael J; Simon, John W

    2013-06-01

    To determine the effectiveness of a series of policy changes designed to increase the attendance rate for outpatient retinopathy of prematurity (ROP) screening examinations. We retrospectively reviewed the records of consecutive neonatal intensive care unit patients before and after the implementation of policy changes. Policy changes included parent education forms, streamlined scheduling, and creation of a log for all patients seen. The primary outcome measure was attendance rates for the first outpatient appointment after discharge. The Fisher exact test was used to compare rates between the two groups. Before the policy was implemented, 22 of 52 (42%) neonates and their caregivers attended their first outpatient ROP screening examination on the recommended date. This rate improved significantly after policy implementation, when 46 of 57 (81%) neonates and their caregivers were seen on the recommended date (P attendance rates for initial outpatient ROP examinations and the number of patients who ultimately met criteria for conclusion of acute retinal screening examinations significantly improved after the implementation of new policies. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

  9. Management and organisational factors in PSA

    International Nuclear Information System (INIS)

    Balfanz, H.P.

    1999-01-01

    The constraints of PSA are increasingly considered with increasing application of PSA for the safety management of nuclear power plants (see US-NRC, 'Risk Informed Regulation', NRC-1). There is a vivid international discourse about the applicability of the variables of plant management and organisation in PSAs, which has lead to a great variety of research activities into this matter (see PSAM 4). This paper here summarizes the current state of progress of research work and discusses the applicability of results. The studies for comparative assessment of methodology and results were performed by the TUeV Nord under the roof of the BMU/BfS-sponsored project SR 2260, ''Further development of probabilistic methods for nuclear power plant safety assessment. (orig./CB) [de

  10. Effectiveness of school dental screening on stimulating dental attendance rates in Vikarabad town: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Gadde Praveen

    2014-01-01

    Full Text Available Background: The school dental screening program has been in existence from the beginning of 20 th century. Its value in encouraging attendance among school children is not fully established. Aim: The aim was to determine the effectiveness of school dental screening on stimulating dental attendance rates among school children in Vikarabad town. Objectives: (a To compare the dental attendance rates between 6-9 and 10-13 years old age groups, among male and female school children in Vikarabad town. (b To identify the type of dental treatment received by the school children. Materials and Methods: A randomized controlled trial was conducted among school children aged 6-13 years old from 16 schools that were randomly selected and divided into two groups. Eight schools had a dental screening program (study group = 300 children and had blanket referral cards and 8 schools that did not have the intervention (control group = 300. The dental attendance rates were determined after 3 months of follow-up period by evaluating the blanket referral cards for the study group and by an oral questionnaire for the control group. Results: The dental attendance rate was 27% for the study group and 18% for the control group which is statistically significant. The attendance rate was higher among 10-13 years of children both in test group and control groups. Among the children who visited the dentist, 53% in the control group and 69% from the test group got simple amalgam and glass ionomer cement restorations. Conclusion: The dental attendance rates were improved following school dental screening.

  11. Safer Food Saves Lives PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-11-03

    This 60 second PSA is based on the November 2015 CDC Vital Signs report. Contaminated food sent to several states can cause multistate outbreaks of foodborne illness and make a lot of people seriously ill. Learn what can be done to prevent and stop outbreaks.  Created: 11/3/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/3/2015.

  12. Communication Can Save Lives PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-08-04

    This 60 second public service announcement (PSA) is based on the August 2015 CDC Vital Signs report. Antibiotic-resistant germs cause at least 23,000 deaths each year. Learn how public health authorities and health care facilities can work together to save lives.  Created: 8/4/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/4/2015.

  13. Take Charge. Take the Test. PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2012-03-07

    As part of the Take Charge. Take the Test. campaign, this 30 second PSA encourages African American women to get tested for HIV. Locations for a free HIV test can be found by visiting hivtest.org/takecharge or calling 1-800-CDC-INFO (1-800-232-4636).  Created: 3/7/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/7/2012.

  14. Prioritization of design changes based on PSA

    International Nuclear Information System (INIS)

    Krajnc, B.; Mavko, B.

    1996-01-01

    Effective use of Probabilistic Safety Analyses (PSA) in the day to day plant operation is subject of intensive discussions among plant operators and regulators. There are several possible applications in which the PSA can be used, among those also to use the PSA approach for the quantification of influence of different proposed design changes to nuclear safety - influence on public safety - health. NPP Krsko is one of those plants that successfully completed its PSA project, with Level 1 and Level 2 analyses and effective know-how transfer. It also faces a number of regulatory and internally generated requirements for different design changes, mainly due to the fact that the plant is committed to continuous augmentation of nuclear safety. It is considered that the available tools and knowledge should be used and therefore applicable methodology should be developed for effective prioritization of proposed design changes by performing cost-benefit analyses for all major modifications - focusing on their influence on nuclear safety. Based on the above a new method for prioritization of design changes is proposed. The method uses Level 1 results (in the sense of plant damage states and their frequencies) directly as an input for further processing - first decision step to decide whether the proposed modification has or has no influence on nuclear safety. In Level 2 analyses the combination of probabilistic and deterministic approach was adopted. In fact the results of the deterministic analyses of severe accidents are treated in probabilistic manner due to large uncertainty of results. Finally to be able to perform plant specific cost benefit analyses so called partial Level 3 was defined. The proposed methods was preliminary tested and it gave favorable results. (author)

  15. More Adults Are Walking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-07-31

    This 60 second PSA is based on the August 2012 CDC Vital Signs report. While more adults are walking, only half get the recommended amount of physical activity. Listen to learn how communities, employers, and individuals may help increase walking.  Created: 7/31/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/7/2012.

  16. Stop C. difficile Infections PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-03-06

    This 60 second PSA is based on the March 2012 CDC Vital Signs report. C. difficile is a germ that causes diarrhea linked to 14,000 deaths in the US each year. This podcast helps health care professionals learn how to prevent C. difficile infections.  Created: 3/6/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/6/2012.

  17. Advanced breast cancer rates in the epoch of service screening: The 400,000 women cohort study from Italy.

    Science.gov (United States)

    Puliti, Donella; Bucchi, Lauro; Mancini, Silvia; Paci, Eugenio; Baracco, Susanna; Campari, Cinzia; Canuti, Debora; Cirilli, Claudia; Collina, Natalina; Conti, Giovanni Maria; Di Felice, Enza; Falcini, Fabio; Michiara, Maria; Negri, Rossella; Ravaioli, Alessandra; Sassoli De' Bianchi, Priscilla; Serafini, Monica; Zorzi, Manuel; Caldarella, Adele; Cataliotti, Luigi; Zappa, Marco

    2017-04-01

    The objective of this study was to evaluate if mammography screening attendance is associated with a reduction in late-stage breast cancer incidence. The cohort included over 400,000 Italian women who were first invited to participate in regional screening programmes during the 1990s and were followed for breast cancer incidence for 13 years. We obtained individual data on their exposure to screening and correlated this with total and stage-specific breast cancer incidence. Socio-economic status and pre-screening incidence data were used to assess the presence of self-selection bias. Overall, screening attendance was associated with a 10% excess risk of in situ and invasive breast cancer (IRR = 1.10; 95% confidence interval (CI): 1.06-1.14), which dropped to 5% for invasive cancers only (IRR = 1.05; 95% CI: 1.01-1.09). There were significant reductions among attenders for specific cancer stages; we observed a 39% reduction for T2 or larger (IRR = 0.61; 95% CI: 0.57-0.66), 19% for node positives (IRR = 0.81; 95% CI: 0.76-0.86) and 28% for stage II and higher (IRR = 0.72; 95% CI: 0.68-0.76). Our data suggest that the presence of self-selection bias is limited and, overall, invited women experienced a 17% reduction of advanced cancers compared with pre-screening rates. Comparing attenders' and non-attenders' stage-specific breast cancer incidence, we have estimated that screening attendance is associated with a reduction of nearly 30% for stages II+. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. PSA application on the Tokai Reprocessing Plant

    International Nuclear Information System (INIS)

    Ishida, Michihiko; Nakano, Takafumi; Morimoto, Kazuyuki; Nojiri, Ichiro

    2003-01-01

    The Periodic Safety Review (PSR) of the Tokai Reprocessing Plant (TRP) has been carrying out to obtain an overall view of actual plant safety. As a part of the PSR, Probabilistic Safety Assessment (PSA) methodology has been applied to evaluate the relative importance of safety functions that prevent the progress of events causing to postulated accidents. Based on the results of the safety reassessments of the TRP that was carried out in 1999, event trees were developed to model sequences of postulated accidents. Event trees were quantified by using the results of fault tree analysis and human reliability analysis. In the quantification, the reliability data generally used in PSA of nuclear power plants were mainly used. Operating experiences of the TRP were also utilized to evaluated both component/system reliability and human reliability. The relative importance of safety functions was evaluated by using two major importance measures, Fussell-Vesely and Risk Achievement Worth both generally used in PSA of nuclear power plants. Through these evaluations, some useful insights into the safety of the TRP have been obtained. The results of the relative importance measures would be utilized to qualify TRP component/equipment important to the safety. (author)

  19. The organizational factor in PSA framework

    Energy Technology Data Exchange (ETDEWEB)

    Farcasiu, Mita, E-mail: mmfarcasiu@yahoo.com; Nitoi, Mirela

    2015-11-15

    The goals of the Man–Machine–Organization system analysis are to develop the suitable studies and techniques to identify, prevent and predict the cause of system unavailability. A descriptive concept of man–machine–organization system was developed. MMOS is defined in probability theory in the attempt to find ways for its qualitative and quantitative quantification in a PSA framework. The need for this study was demonstrated by analysis of variance of the complex system unavailability in relation to human error probability (HEP) and organizational error probability (OMP). The PSA model proposed in this paper assesses the organizational factor in MMOS by observing its influence on the human factor and equipment. Thus the influence of organizational factors is evaluated not only on component but also on the human performance. The study highlights the need to improve the understanding of the influence of organizational factors on the safe operation of nuclear installations. Using MMOS concept in PSA could identify any serious deficiencies of human and equipment performance which can sometime be corrected by improvement of the organizational factor.

  20. The organizational factor in PSA framework

    International Nuclear Information System (INIS)

    Farcasiu, Mita; Nitoi, Mirela

    2015-01-01

    The goals of the Man–Machine–Organization system analysis are to develop the suitable studies and techniques to identify, prevent and predict the cause of system unavailability. A descriptive concept of man–machine–organization system was developed. MMOS is defined in probability theory in the attempt to find ways for its qualitative and quantitative quantification in a PSA framework. The need for this study was demonstrated by analysis of variance of the complex system unavailability in relation to human error probability (HEP) and organizational error probability (OMP). The PSA model proposed in this paper assesses the organizational factor in MMOS by observing its influence on the human factor and equipment. Thus the influence of organizational factors is evaluated not only on component but also on the human performance. The study highlights the need to improve the understanding of the influence of organizational factors on the safe operation of nuclear installations. Using MMOS concept in PSA could identify any serious deficiencies of human and equipment performance which can sometime be corrected by improvement of the organizational factor.

  1. Active Choice and Financial Incentives to Increase Rates of Screening Colonoscopy-A Randomized Controlled Trial.

    Science.gov (United States)

    Mehta, Shivan J; Feingold, Jordyn; Vandertuyn, Matthew; Niewood, Tess; Cox, Catherine; Doubeni, Chyke A; Volpp, Kevin G; Asch, David A

    2017-11-01

    Behavioral economic approaches could increase uptake for colorectal cancer screening. We performed a randomized controlled trial of 2245 employees to determine whether an email containing a phone number for scheduling (control), an email with the active choice to opt in or opt out (active choice), or the active choice email plus a $100 incentive (financial incentive) increased colonoscopy completion within 3 months. Higher proportions of participants in the financial incentive group underwent screening (3.7%) than in the control (1.6%) or active choice groups (1.5%) (P = .01 and P < .01). We found no difference in uptake of screening between the active choice and control groups (P = .88). The $100 conditional incentive modestly but significantly increased colonoscopy use. ClinicalTrials.gov no: NCT02660671. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  2. PSA Nadir of <0.5 ng/mL Following Brachytherapy for Early-Stage Prostate Adenocarcinoma is Associated With Freedom From Prostate-Specific Antigen Failure

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Eric C. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Stone, Nelson N. [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States); Department of Urology, Mount Sinai Medical Center, New York, NY (United States); Stock, Richard G., E-mail: Richard.Stock@mountsinai.org [Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY (United States)

    2012-06-01

    Purpose: Because limited information exists regarding whether the rate or magnitude of PSA decline following brachytherapy predicts long-term clinical outcomes, we evaluated whether achieving a prostate-specific antigen (PSA) nadir (nPSA) <0.5 ng/mL following brachytherapy is associated with decreased PSA failure and/or distant metastasis. Methods and Materials: We retrospectively analyzed our database of early-stage prostate adenocarcinoma patients who underwent brachytherapy, excluding those receiving androgen-deprivation therapy and those with <2 years follow-up. Median and mean pretreatment PSA were 6 ng/mL and 7.16 ng/mL, respectively. By clinical stage, 775 were low risk ({<=}T2a), 126 were intermediate risk (T2b), and 20 were high risk (>T2b). By Gleason score, 840 were low risk ({<=}6), 71 were intermediate risk (7), and 10 were high risk (>7). Patients were treated with brachytherapy only (I-125, n = 779, or Pd-103, n = 47), or brachytherapy + external-beam radiation therapy (n = 95). Median follow-up was 6.3 years. We noted whether nPSA <0.5 ng/mL was achieved and the time to achieve this nadir and tested for associations with pretreatment risk factors. We also determined whether this PSA endpoint was associated with decreased PSA failure or distant metastasis. Results: Absence of high-risk factors in clinical stage ({<=}T2b), Gleason score ({<=}7), and pretreatment PSA ({<=}20 ng/mL) was significantly associated with achieving nPSA <0.5 ng/mL. By Kaplan-Meier analysis, patients achieving nPSA <0.5 ng/mL had significantly higher long-term freedom from biochemical failure (FFBF) than nonresponders (5-year FFBF: 95.2 {+-} 0.8% vs. 71.5 {+-} 6.7%; p < 0.0005). Among responders, those who achieved nPSA <0.5 ng/mL in {<=}5 years had higher FFBF than those requiring >5 years (5-year FFBF: 96.7 {+-} 0.7% vs. 80.8 {+-} 4.6%; p < 0.0005). On multivariate analysis, patients who achieved nPSA <0.5 ng/mL in {<=}5 years had significantly higher FFBF than other

  3. Increasing Fractional Doses Increases the Probability of Benign PSA Bounce in Patients Undergoing Definitive HDR Brachytherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hauck, Carlin R.; Ye, Hong; Chen, Peter Y.; Gustafson, Gary S.; Limbacher, Amy; Krauss, Daniel J., E-mail: Daniel.krauss@beaumont.edu

    2017-05-01

    Purpose: Prostate-specific antigen (PSA) bounce is a temporary elevation of the PSA level above a prior nadir. The purpose of this study was to determine whether the frequency of a PSA bounce following high-dose-rate (HDR) interstitial brachytherapy for the treatment of prostate cancer is associated with individual treatment fraction size. Methods and Materials: Between 1999 and 2014, 554 patients underwent treatment of low- or intermediate-risk prostate cancer with definitive HDR brachytherapy as monotherapy and had ≥3 subsequent PSA measurements. Four different fraction sizes were used: 950 cGy × 4 fractions, 1200 cGy × 2 fractions, 1350 cGy × 2 fractions, 1900 cGy × 1 fraction. Four definitions of PSA bounce were applied: ≥0.2, ≥0.5, ≥1.0, and ≥2.0 ng/mL above the prior nadir with a subsequent return to the nadir. Results: The median follow-up period was 3.7 years. The actuarial 3-year rate of PSA bounce for the entire cohort was 41.3%, 28.4%, 17.4%, and 6.8% for nadir +0.2, +0.5, +1.0, and +2.0 ng/mL, respectively. The 3-year rate of PSA bounce >0.2 ng/mL was 42.2%, 32.1%, 41.0%, and 59.1% for the 950-, 1200-, 1350-, and 1900-cGy/fraction levels, respectively (P=.002). The hazard ratio for bounce >0.2 ng/mL for patients receiving a single fraction of 1900 cGy compared with those receiving treatment in multiple fractions was 1.786 (P=.024). For patients treated with a single 1900-cGy fraction, the 1-, 2-, and 3-year rates of PSA bounce exceeding the Phoenix biochemical failure definition (nadir +2 ng/mL) were 4.5%, 18.7%, and 18.7%, respectively, higher than the rates for all other administered dose levels (P=.025). Conclusions: The incidence of PSA bounce increases with single-fraction HDR treatment. Knowledge of posttreatment PSA kinetics may aid in decision making regarding management of potential biochemical failures.

  4. Increasing Fractional Doses Increases the Probability of Benign PSA Bounce in Patients Undergoing Definitive HDR Brachytherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Hauck, Carlin R.; Ye, Hong; Chen, Peter Y.; Gustafson, Gary S.; Limbacher, Amy; Krauss, Daniel J.

    2017-01-01

    Purpose: Prostate-specific antigen (PSA) bounce is a temporary elevation of the PSA level above a prior nadir. The purpose of this study was to determine whether the frequency of a PSA bounce following high-dose-rate (HDR) interstitial brachytherapy for the treatment of prostate cancer is associated with individual treatment fraction size. Methods and Materials: Between 1999 and 2014, 554 patients underwent treatment of low- or intermediate-risk prostate cancer with definitive HDR brachytherapy as monotherapy and had ≥3 subsequent PSA measurements. Four different fraction sizes were used: 950 cGy × 4 fractions, 1200 cGy × 2 fractions, 1350 cGy × 2 fractions, 1900 cGy × 1 fraction. Four definitions of PSA bounce were applied: ≥0.2, ≥0.5, ≥1.0, and ≥2.0 ng/mL above the prior nadir with a subsequent return to the nadir. Results: The median follow-up period was 3.7 years. The actuarial 3-year rate of PSA bounce for the entire cohort was 41.3%, 28.4%, 17.4%, and 6.8% for nadir +0.2, +0.5, +1.0, and +2.0 ng/mL, respectively. The 3-year rate of PSA bounce >0.2 ng/mL was 42.2%, 32.1%, 41.0%, and 59.1% for the 950-, 1200-, 1350-, and 1900-cGy/fraction levels, respectively (P=.002). The hazard ratio for bounce >0.2 ng/mL for patients receiving a single fraction of 1900 cGy compared with those receiving treatment in multiple fractions was 1.786 (P=.024). For patients treated with a single 1900-cGy fraction, the 1-, 2-, and 3-year rates of PSA bounce exceeding the Phoenix biochemical failure definition (nadir +2 ng/mL) were 4.5%, 18.7%, and 18.7%, respectively, higher than the rates for all other administered dose levels (P=.025). Conclusions: The incidence of PSA bounce increases with single-fraction HDR treatment. Knowledge of posttreatment PSA kinetics may aid in decision making regarding management of potential biochemical failures.

  5. Upgrade of internal events PSA model using the AESJ level-1 PSA standard for operating state

    International Nuclear Information System (INIS)

    Sato, Teruyoshi; Yoneyama, Mitsuru; Hirokawa, Naoki; Sato, Chikahiro; Sato, Eisuke; Tomizawa, Shigeatsu

    2009-01-01

    In 2003, the Atomic Energy Society of Japan (AESJ) started to develop the Level-1 Probabilistic Safety Assessment (PSA) standard of internal events for operating state (AESJ standard). The AESJ standard has been finished to be asked for public comment. Using the AESJ standard (draft version), the authors have upgraded the PSA model for Tokyo Electric Power Company (TEPCO) BWR-5 plant not only to reflect latest knowledge but also to ensure high quality of PSA model (not yet peer-reviewed) for the purpose of better operation and maintenance management of TEPCO BWR plants. For example, the categorization of structures, systems and components (SSCs) will be performed to improve nuclear reactor safety using information of risk importance. (author)

  6. Development of PSA audit guideline and regulatory PSA model for SMART

    International Nuclear Information System (INIS)

    Cho, Namchul; Lee, Chang-Ju; Kim, I.S.

    2012-01-01

    SMART is under development for dual purposes of power generation and seawater desalination in Korea. It is an integral reactor type with a thermal power output of 330 MW and employs advanced design features such as a passive system for the removal of residual heat and also the setting of all the components of the primary system inside the reactor pressure vessel. It is essential to develop new probabilistic safety assessment (PSA) validation guidance for SMART. For the purpose of regulatory verification to the risk level of SMART, the insights and key issues on the PSA are identified with referring some worldwide safety guides as well as its design characteristics. Regulatory PSA model under the development for the design confirmation and its preliminary result are also described. (authors)

  7. Hearing screening follow-up return rate in a very low birth weight ...

    African Journals Online (AJOL)

    These may involve parental education and counselling, as well as involvement of nursing staff and medical professionals in implementation of EHDI programmes. It may be possible to improve followup by aligning follow-up screening with the day of neonatal follow-up clinics in provincial hospitals where such services are ...

  8. High-content screening of Aspergillus niger with both increased production and high secretion rate of glucose oxidase.

    Science.gov (United States)

    Zhu, Xudong; Sun, Jingchun; Chu, Ju

    2018-01-01

    To develop a rapid, dual-parameter, plate-based screening process to improve production and secretion rate of glucose oxidase simultaneously in Aspergillus niger. A morphology engineering based on CaCO 3 was implemented, where the yield of GOD by A. niger was increased by up to 50%. Analysis of extracellular GOD activity was achieved in 96-well plates. There was a close negative correlation between the total GOD activity and its residual glucose of the fermentation broth. Based on this, a rapid, plate-based, qualitative analysis method of the total GOD activity was developed. Compared with the conventional analysis method using o-dianisidine, a correlation coefficient of -0.92 by statistical analysis was obtained. Using this dual-parameter screening method, we acquired a strain with GOD activity of 3126 U l -1 , which was 146% higher than the original strain. Its secretion rate of GOD was 83, 32% higher than the original strain.

  9. PSA-operations synergism for the advanced test reactor shutdown operations PSA

    International Nuclear Information System (INIS)

    Atkinson, S.A.

    1996-01-01

    The Advanced Test Reactor (ATR) Probabilistic Safety Assessment (PSA) for shutdown operations, cask handling, and canal draining is a successful example of the importance of good PSA-operations synergism for achieving a realistic and accepted assessment of the risks and for achieving desired risk reduction and safety improvement in a best and cost-effective manner. The implementation of the agreed-upon upgrades and improvements resulted in the reductions of the estimated mean frequency for core or canal irradiated fuel uncovery events, a total reduction in risk by a factor of nearly 1000 to a very low and acceptable risk level for potentially severe events

  10. Workshop on PSA for New and Advanced Reactors

    International Nuclear Information System (INIS)

    2012-01-01

    This workshop was organized by the NEA Working Group on Risk Assessment (WGRISK). The key objective of the workshop was to share the current state-of-the art on the PSA (Probabilistic Safety Assessment) applied for new reactors and advanced reactors. Fifty experts from 13 countries and one international organization (IAEA) participated in the present workshop, and 35 technical papers were presented. The main topics of interest, discussed during the workshop, included the followings: regulatory aspects, risk-informed methods, technical aspects of the PSA for new and advanced reactors, hazards of PSA (internal and external), severe accident/source term/Level 2 PSA, and consequence analysis/Level 3 PSA. Among the technical aspects of the PSA, the assessment of the reliability of passive safety systems appears to be a recurrent issue

  11. Lessons learned form IRSN review of Flamanville 3 Level PSA

    International Nuclear Information System (INIS)

    Georgescu, G.; Corenwinder, F.

    2012-01-01

    In the frame of the construction and licensing of Flamanville 3 NPP the PSA (Probabilistic Safety Assessment)plays an important role for the EPR Project assessment. The PSA was used for early design verification of EPR Reactor, several design improvement being defined based on these PSA insights and following the discussions with the French and German safety authorities. IRSN, as the French Safety Authority (ASN) technical support organization, performs the review of the PSA developed by the plant operator (EDF). The paper presents the main issues regarding the using of 'design PSA', identified by IRSN following the review of the internal events Level 1 PSA transmitted by EDF in the frame of the anticipated instruction of the application for operating license of the Flamanville 3 reactor. (authors)

  12. Elevation of PSA after prostate radiotherapy: Rebound or biochemical recurrence?

    International Nuclear Information System (INIS)

    Toledano, A.; Kanoui, A.; Chiche, R.; Lamallem, H.; Beley, S.; Thibault, F.; Sebe, P.

    2008-01-01

    The fact that external beam radiotherapy and brachytherapy are now considered to be curative techniques has led to major review of the modalities of follow-up after radiotherapy for prostate cancer. The problem concerns both the diagnosis of recurrence, rapidly announced by elevation of prostatic-specific antigen (PSA), usually at a subclinical stage, and the validity of criteria of biochemical recurrence to allow comparison of various study. Physicians involved in follow-up should be aware of the potential of bounce in PSA follow-up after external beam radiotherapy or brachytherapy. The PSA bounce phenomenon was defined by a rise of PSA values (+ 0.1 -0.8 ng/ml) with a subsequent fall. Biochemical failure after external beam radiotherapy or brachytherapy (with or without hormonotherapy) was defined by Phoenix criteria by a rise of 2 ng/ml above an initial PSA nadir. This definition was more correlated to PSA bounce phenomenon. (authors)

  13. Evaluating the Phoenix definition of biochemical failure after (125)I prostate brachytherapy: Can PSA kinetics distinguish PSA failures from PSA bounces?

    Science.gov (United States)

    Thompson, Anna; Keyes, Mira; Pickles, Tom; Palma, David; Moravan, Veronika; Spadinger, Ingrid; Lapointe, Vincent; Morris, W James

    2010-10-01

    To evaluate the prostate-specific antigen (PSA) kinetics of PSA failure (PSAf) and PSA bounce (PSAb) after permanent (125)I prostate brachytherapy (PB). The study included 1,006 consecutive low and "low tier" intermediate-risk patients treated with (125)I PB, with a potential minimum follow-up of 4 years. Patients who met the Phoenix definition of biochemical failure (nadir + 2 ng/mL(-1)) were identified. If the PSA subsequently fell to ≤0.5 ng/mL(-1)without intervention, this was considered a PSAb. All others were scored as true PSAf. Patient, tumor and dosimetric characteristics were compared between groups using the chi-square test and analysis of variance to evaluate factors associated with PSAf or PSAb. Median follow-up was 54 months. Of the 1,006 men, 57 patients triggered the Phoenix definition of PSA failure, 32 (56%) were true PSAf, and 25 PSAb (44%). The median time to trigger nadir + 2 was 20.6 months (range, 6-36) vs. 49 mo (range, 12-83) for PSAb vs. PSAf groups (p < 0.001). The PSAb patients were significantly younger (p < 0.0001), had shorter time to reach the nadir (median 6 vs. 11.5 months, p = 0.001) and had a shorter PSA doubling time (p = 0.05). Men younger than age 70 who trigger nadir +2 PSA failure within 38 months of implant have an 80% likelihood of having PSAb and 20% chance of PSAf. With adequate follow-up, 44% of PSA failures by the Phoenix definition in our cohort were found to be benign PSA bounces. Our study reinforces the need for adequate follow-up when reporting PB PSA outcomes, to ensure accurate estimates of treatment efficacy and to avoid unnecessary secondary interventions. 2010. Published by Elsevier Inc. All rights reserved.

  14. Evaluating the Phoenix Definition of Biochemical Failure After 125I Prostate Brachytherapy: Can PSA Kinetics Distinguish PSA Failures From PSA Bounces?

    International Nuclear Information System (INIS)

    Thompson, Anna; Keyes, Mira; Pickles, Tom

    2010-01-01

    Purpose: To evaluate the prostate-specific antigen (PSA) kinetics of PSA failure (PSAf) and PSA bounce (PSAb) after permanent 125 I prostate brachytherapy (PB). Methods and Materials: The study included 1,006 consecutive low and 'low tier' intermediate-risk patients treated with 125 I PB, with a potential minimum follow-up of 4 years. Patients who met the Phoenix definition of biochemical failure (nadir + 2 ng/mL -1 ) were identified. If the PSA subsequently fell to ≤0.5 ng/mL -1 without intervention, this was considered a PSAb. All others were scored as true PSAf. Patient, tumor and dosimetric characteristics were compared between groups using the chi-square test and analysis of variance to evaluate factors associated with PSAf or PSAb. Results: Median follow-up was 54 months. Of the 1,006 men, 57 patients triggered the Phoenix definition of PSA failure, 32 (56%) were true PSAf, and 25 PSAb (44%). The median time to trigger nadir + 2 was 20.6 months (range, 6-36) vs. 49 mo (range, 12-83) for PSAb vs. PSAf groups (p < 0.001). The PSAb patients were significantly younger (p < 0.0001), had shorter time to reach the nadir (median 6 vs. 11.5 months, p = 0.001) and had a shorter PSA doubling time (p = 0.05). Men younger than age 70 who trigger nadir +2 PSA failure within 38 months of implant have an 80% likelihood of having PSAb and 20% chance of PSAf. Conclusions: With adequate follow-up, 44% of PSA failures by the Phoenix definition in our cohort were found to be benign PSA bounces. Our study reinforces the need for adequate follow-up when reporting PB PSA outcomes, to ensure accurate estimates of treatment efficacy and to avoid unnecessary secondary interventions.

  15. Validation of Association of Genetic Variants at 10q with PSA Levels in Men at High Risk for Prostate Cancer

    Science.gov (United States)

    Chang, Bao-Li; Hughes, Lucinda; Chen, David Y. T.; Gross, Laura; Ruth, Karen; Giri, Veda N.

    2013-01-01

    Objectives Men with a family history of prostate cancer and African American men are at increased risk for prostate cancer and stand to benefit from individualized interpretation of PSA to guide screening strategies. The purpose of this study was to validate six previously identified markers among high-risk men enrolled in the Prostate Cancer Risk Assessment Program - a prostate cancer screening study. Patients and Methods Eligibility for PRAP includes men ages 35–69 years with a family history of prostate cancer, any African American male regardless of family history, and men with known BRCA gene mutations. GWAS markers assessed included rs2736098 (5p15.33), rs10993994 (10q11), rs10788160 (10q26), rs11067228 (12q24), rs4430796 (17q12), and rs17632542 (19q13.33). Genotyping methods included either Taqman® SNP Genotyping Assay (Applied Biosystems) or pyrosequencing. Linear regression models were used to evaluate the association between individual markers and log-transformed baseline PSA levels, while adjusting for potential confounders. Results 707 participants (37% Caucasian, 63% African American) with clinical and genotype data were included in the analysis. Rs10788160 (10q26) strongly associated with PSA levels among high-risk Caucasian participants (p<0.01), with a 33.2% increase in PSA level with each A-allele carried. Furthermore, rs10993994 (10q11) demonstrated an association to PSA level (p=0.03) in high-risk Caucasian men, with a 15% increase in PSA with each T-allele carried. A PSA adjustment model based on allele carrier status at rs10788160 and rs10993994 is proposed specific to high-risk Caucasian men. Conclusion Genetic variation at 10q may be particularly important in personalizing interpretation of PSA for high-risk Caucasian men. Such information may have clinical relevance in shared decision-making and individualized prostate cancer screening strategies for high-risk Caucasian men. Further study is warranted. PMID:23937305

  16. PSA testing without clinical indication for prostate cancer in relation to socio-demographic and clinical characteristics in the Danish Diet, Cancer and Health Study

    DEFF Research Database (Denmark)

    Karlsen, Randi V; Larsen, Signe B; Christensen, Jane

    2013-01-01

    Background. Social differences in prostate cancer (PC) incidence and mortality might be related to testing for prostate-specific antigen (PSA). Although routine PSA screening is not recommended in Denmark, testing without clinical indication increased during the past decade. We evaluated...... associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Material and methods. In the Danish Diet, Cancer and Health Cohort, we identified 1051 men with PC diagnosed in 1993-2008. Diagnostic and clinical characteristics were obtained from medical records......, and socio-demographic information was retrieved from administrative registers. We used general logistic regression analysis to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between socio-demographic or clinical characteristics and PSA testing without clinical indication. Cox...

  17. Rates of sexual history taking and screening in HIV-positive men who have sex with men.

    Science.gov (United States)

    MacRae, Alasdair; Lord, Emily; Forsythe, Annabel; Sherrard, Jackie

    2017-03-01

    A case note audit was undertaken of HIV-positive men who have sex with men (MSM) to ascertain whether national guidelines for taking sexual histories, including recreational drug use and sexually transmitted infection (STI) screening were being met. The notes of 142 HIV-positive men seen in 2015 were available, of whom 85 were MSM. Information was collected regarding sexual history, recreational drug use documentation, sexually transmitted infection screen offer and test results. Seventy-seven (91%) of the MSM had a sexual history documented, of whom 60 (78%) were sexually active. STI screens were offered to 58/60 (97%) of those who were sexually active and accepted by 53 (91%). Twelve (23%) of these had an STI. A recreational drug history was taken in 63 (74%) with 17 (27%) reporting use and 3 (5%) chemsex. The high rate of STIs highlights that regular screening in this group is essential. Additionally, the fact that over a quarter reported recreational drug use and given the increasing concern around chemsex, questions about this should be incorporated into the sexual history proforma.

  18. Low Power Shutdown PSA for CANDU Type Plants

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Yeon Kyoung; Kim, Myung Su [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    KHNP also have concentrated on full power PSA. Some recently constructed OPR1000 type plants and APR1400 type plants have performed the low power and shutdown (LPSD) PSA. The purpose of LPSD PSA is to identify the main contributors on the accident sequences of core damage and to find the measure of safety improvement. After the Fukushima accident, Korean regulatory agency required the shutdown severe accident management guidelines (SSAMG) development for safety enhancement. For the reliability of SSAMG, KHNP should develop the LPSD PSA. Especially, the LPSD PSA for CANDU type plant had developed for the first time in Korea. This paper illustrates how the LPSD PSA for CANDU type developed and the core damage frequency (CDF) is different with that of full power PSA. KHNP performed LPSD PSA to develop the SSAMG after the Fukushima accidents. The results show that risk at the specific operation mode during outage is higher than that of full power operation. Also, the results indicated that recovery failure of class 4 power at the POS 5A, 5B contribute dominantly to the total CDF from importances analysis. LPSD PSA results such as CDF with initiating events and POSs, risk results with plant damage state, and containment failure probability and frequency with POSs can be used by inputs for developing the SSAMG.

  19. PSA data base, comparison of the German and French approach

    International Nuclear Information System (INIS)

    Kreuser, A.; Tirira, J.

    2001-01-01

    The results of probabilistic safety assessments (PSA) of nuclear power plants strongly depend on the reliability data used. This report describes coarsely the general process to generate reliability data for components and resumes the differences between the German and French approaches. As has been shown in former studies which compared international PSA data, PSA data are closely related to the model definitions of the PSA. Therefore single PSA data cannot be compared directly without regard e.g. to the corresponding fault trees. These findings are confirmed by this study. The comparison of German and French methods shows a lot of differences concerning various details of the data generation process. Some differences between single reliability data should be eliminated when taking into account the complete fault tree analysis. But there are some other differences which have a direct impact on the obtained results of a PSA. In view of the all differences between both approaches concerning the definition of data and the data collection process, it is not possible to compare directly German and French PSA data. However, the database differences give no indication on the influence on the PSA results. Therefore, it is a need to perform a common IPSN/GRS assessment on how the different databases impact the PSA results. (orig.)

  20. Use of PSA for improving the safety of French PWRs

    International Nuclear Information System (INIS)

    Lanore, J.M.; Chambon, J.L.

    1994-06-01

    Two French PWR Probabilistic Safety Assessment (PSA) studies were conducted for the standardized PWR series of 900 and 1300 MWe. Both PSA 900 and PSA 1300 are level 1 PSAs, that means their objective is the evaluation of core meltdown frequency. These studies have some specific features, in particular the treatment of shutdown conditions, the treatment of long term post-accidental situations, and a wide use of French experience feedback. The PSAs are used for safety improvements of the French PWRs. Following the PSA results, several modifications to plants concerning the dominant sequences were decided. (R.P.). 2 refs., 4 figs

  1. DIAGNOSTIC AND PROGNOSTIC UTILITY OF SERUM PSA IN BREAST CANCER

    Institute of Scientific and Technical Information of China (English)

    张淑群; 强水云; 李妙羡; 纪宗正

    2004-01-01

    Objective To investigate the diagnostic and prognostic value of total and free prostate-specific antigen (PSA) in breast cancer women. Methods Using the microparticle enzyme immunoassay system, we measured the concentrations of these markers in the sera of 85 women with breast cancer and in 30 healthy women.Results Free PSA levels were significantly higher in women with breast cancer than healthy women (P <0. 05 ).The percentage of free PSA predominant subjects was 37. 6% in breast cancer patients and 3. 3% in healthy women.In women with breast cancer,total PSA positivity was 23.5% and free PSA positivity was 27. 1%. When compared to negatives,total PSA positive patients had a higher percentage of lymph node involvement tamours ( P >0. 05).However, patients with predominant free PSA had a higher percentage of early stage than patients with predominant PSA-ACT. Conclusion This study indicate clinical significance of preoperative measurement of serum total and free PSA in diagnosis and prognosis of women with breast cancer. The expression of KLKs is correlated with carcinogenesis of breast cancer.

  2. Serum PSA levels in the Indian population: Is it different?

    Science.gov (United States)

    Agrawal, Amit; Karan, Shailesh Chandra

    2017-04-01

    Serum prostate-specific antigen (PSA) is an important tumour, marker which is widely used to trigger trans-rectal ultrasound (TRUS)-guided prostate biopsy. However, the PSA levels vary with race and ethnicity. Therefore, there is a need to have an Indian reference range. All adult male patients meeting the inclusion and exclusion criteria were enrolled in this study. They were subjected to assessment of serum total PSA, digital rectal examination and trans-abdominal ultrasound. If any one or more of these were found abnormal, then a TRUS-guided 12-core prostate biopsy was done. Patients who were detected to have prostatic cancer were excluded from the final analysis. The data so obtained was grouped among the following three age groups: 40-49, 50-59 and 60-70 years, and the age-specific PSA values, prostatic volume and PSA density were found. A total of 1772 patients were analysed. The mean serum total PSA was 1.76 ng/ml with a standard deviation of 2.566 ng/ml. Group-wise age distribution of the mean serum total PSA was 1.22, 1.97 and 2.08 ng/ml in 40-49, 50-59 and 60-70 years age groups. The mean total PSA and the age-specific PSA range tend to be lower in the Indians than the Western population.

  3. Institute of nuclear power operations perspectives on PSA applications

    International Nuclear Information System (INIS)

    Webster, W.E.; Miller, W.J. Jr.

    1996-01-01

    The investment to develop a PSA is very substantial, and therefore, there is motivation to recover this investment through further use of the techniques used to develop it. It is not surprising that nuclear power plant staff are beginning to use PSA to make operational decisions. The Institute of Nuclear Power Operations is interested in those factors that impact the conduct of plant operations and therefore is actively monitoring the increased usage of PSA techniques. The purpose of this paper is to provide some thoughts and perspectives on the use of PSA as a factor in operational decision making, including decision making in activities performed by engineering, maintenance and operation personnel. (author)

  4. Daily Pill Can Prevent HIV PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second public service announcement (PSA) is based on the November 24, 2015 CDC Vital Signs report. Preexposure prophylaxis, or PrEP, is a daily medicine that can be used to prevent getting HIV. PrEP is for people who don’t have HIV but who are at very high risk for getting it from sex or injection drug use. Unfortunately, many people who can benefit from PrEP aren’t taking it.

  5. Development of kits for total PSA monitoring

    International Nuclear Information System (INIS)

    Suprarop, P.

    1999-01-01

    The development of kits for Total PSA assay has shown promising results. All essential components of the assay were prepared with reproducibility and used to optimize the assay. By choosing two steps method, we could avoid the hook effect and obtain satisfactory Q.C. parameters of the standard curve i.e. blank = 0.8%, maximum binding = 65%. If reference material for calibration of the standard is agree upon, the validation could then be carried out with total confidence. Our final goal is to reduce the step of incubation to just one step with no interference from hook effect

  6. The Offer of Advanced Imaging Techniques Leads to Higher Acceptance Rates for Screening Colonoscopy - a Prospective Study.

    Science.gov (United States)

    Albrecht, Heinz; Gallitz, Julia; Hable, Robert; Vieth, Michael; Tontini, Gian Eugenio; Neurath, Markus Friedrich; Riemann, Jurgen Ferdinand; Neumann, Helmut

    2016-01-01

    Colonoscopy plays a fundamental role in early diagnosis and management of colorectal cancer and requires public and professional acceptance to ensure the ongoing success of screening programs. The aim of the study was to prospectively assess whether patient acceptance rates to undergo screening colonoscopy could be improved by the offer of advanced imaging techniques. Overall, 372 randomly selected patients were prospectively included. A standardized questionnaire was developed that inquired of the patients their knowledge regarding advanced imaging techniques. Second, several media campaigns and information events were organized reporting about advanced imaging techniques, followed by repeated evaluation. After one year the evaluation ended. At baseline, 64% of the patients declared that they had no knowledge about new endoscopic methods. After twelve months the overall grade of information increased significantly from 14% at baseline to 34%. The percentage of patients who decided to undergo colonoscopy because of the offer of new imaging methods also increased significantly from 12% at baseline to 42% after 12 months. Patients were highly interested in the offer of advanced imaging techniques. Knowledge about these techniques could relatively easy be provided using local media campaigns. The offer of advanced imaging techniques leads to higher acceptance rates for screening colonoscopies.

  7. Hybrid membrane--PSA system for separating oxygen from air

    Science.gov (United States)

    Staiger, Chad L [Albuquerque, NM; Vaughn, Mark R [Albuquerque, NM; Miller, A Keith [Albuquerque, NM; Cornelius, Christopher J [Blackburg, VA

    2011-01-25

    A portable, non-cryogenic, oxygen generation system capable of delivering oxygen gas at purities greater than 98% and flow rates of 15 L/min or more is described. The system consists of two major components. The first component is a high efficiency membrane capable of separating argon and a portion of the nitrogen content from air, yielding an oxygen-enriched permeate flow. This is then fed to the second component, a pressure swing adsorption (PSA) unit utilizing a commercially available, but specifically formulated zeolite compound to remove the remainder of the nitrogen from the flow. The system is a unique gas separation system that can operate at ambient temperatures, for producing high purity oxygen for various applications (medical, refining, chemical production, enhanced combustion, fuel cells, etc . . . ) and represents a significant advance compared to current technologies.

  8. Interval Breast Cancer Rates and Histopathologic Tumor Characteristics after False-Positive Findings at Mammography in a Population-based Screening Program.

    Science.gov (United States)

    Hofvind, Solveig; Sagstad, Silje; Sebuødegård, Sofie; Chen, Ying; Roman, Marta; Lee, Christoph I

    2018-04-01

    Purpose To compare rates and tumor characteristics of interval breast cancers (IBCs) detected after a negative versus false-positive screening among women participating in the Norwegian Breast Cancer Screening Program. Materials and Methods The Cancer Registry Regulation approved this retrospective study. Information about 423 445 women aged 49-71 years who underwent 789 481 full-field digital mammographic screening examinations during 2004-2012 was extracted from the Cancer Registry of Norway. Rates and odds ratios of IBC among women with a negative (the reference group) versus a false-positive screening were estimated by using logistic regression models adjusted for age at diagnosis and county of residence. Results A total of 1302 IBCs were diagnosed after 789 481 screening examinations, of which 7.0% (91 of 1302) were detected among women with a false-positive screening as the most recent breast imaging examination before detection. By using negative screening as the reference, adjusted odds ratios of IBCs were 3.3 (95% confidence interval [CI]: 2.6, 4.2) and 2.8 (95% CI: 1.8, 4.4) for women with a false-positive screening without and with needle biopsy, respectively. Women with a previous negative screening had a significantly lower proportion of tumors that were 10 mm or less (14.3% [150 of 1049] vs 50.0% [seven of 14], respectively; P false-positive screening with benign biopsy. A retrospective review of the screening mammographic examinations identified 42.9% (39 of 91) of the false-positive cases to be the same lesion as the IBC. Conclusion By using a negative screening as the reference, a false-positive screening examination increased the risk of an IBC three-fold. The tumor characteristics of IBC after a negative screening were less favorable compared with those detected after a previous false-positive screening. © RSNA, 2017 Online supplemental material is available for this article.

  9. Prostate health index significantly reduced unnecessary prostate biopsies in patients with PSA 2-10 ng/mL and PSA >10 ng/mL: Results from a Multicenter Study in China.

    Science.gov (United States)

    Na, Rong; Ye, Dingwei; Qi, Jun; Liu, Fang; Helfand, Brian T; Brendler, Charles B; Conran, Carly A; Packiam, Vignesh; Gong, Jian; Wu, Yishuo; Zheng, Siqun L; Mo, Zengnan; Ding, Qiang; Sun, Yinghao; Xu, Jianfeng

    2017-08-01

    The performance of prostate health index (phi) in predicting prostate biopsy outcomes has been well established for patients with prostate-specific antigen (PSA) values between 2 and 10 ng/mL. However, the performance of phi remains unknown in patients with PSA >10 ng/mL, the vast majority in Chinese biopsy patients. We aimed to assess the ability of phi to predict prostate cancer (PCa) and high-grade disease (Gleason Score ≥7) on biopsy in a Chinese population. This is a prospective, observational, multi-center study of consecutive patients who underwent a transrectal ultrasound guided prostate biopsy at four hospitals in Shanghai, China from August 2013 to December 2014. In the cohort of 1538 patients, the detection rate of PCa was 40.2%. phi had a significantly better predictive performance for PCa than total PSA (tPSA). The areas under the receiver operating characteristic curve (AUC) were 0.90 and 0.79 for phi and tPSA, respectively, P 10 ng/mL (N = 838, 54.5%). The detection rates of PCa were 35.9% and 57.7% in patients with tPSA 10.1-20 and 20.1-50 ng/mL, respectively. The AUCs of phi (0.79 and 0.89, for these two groups, respectively) were also significantly higher than tPSA (0.57 and 0.63, respectively), both P 10 ng/mL). © 2017 Wiley Periodicals, Inc.

  10. 3D label-free prostate specific antigen (PSA) immunosensor based on graphene-gold composites.

    Science.gov (United States)

    Jang, Hee Dong; Kim, Sun Kyung; Chang, Hankwon; Choi, Jeong-Woo

    2015-01-15

    Highly sensitive and label-free detection of the prostate specific antigen (PSA) remains a challenge in the diagnosis of prostate cancer. Here, a novel three-dimensional (3D) electrochemical immunosensor capable of sensitive and label-free detection of PSA is reported. This unique immunosensor is equipped with a highly conductive graphene (GR)-based gold (Au) composite modified electrode. The GR-based Au composite is prepared using aerosol spray pyrolysis and the morphology of the composite is the shape of a crumpled GR ball decorated with Au nanoparticles. Unlike the previous research, this novel 3D immunosensor functions very well over a broad linear range of 0-10 ng/mL with a low detection limit of 0.59 ng/mL; furthermore, it exhibits a significantly increased electron transfer and high sensitivity toward PSA. The highest rate of current change with respect to the PSA concentration is 5 μA/(ng/mL). Satisfactory selectivity, reproducibility, and stability of the 3D immunosensor are also exhibited. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Prostate-Specific Antigen (PSA) Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... medlineplus.gov/labtests/prostatespecificantigenpsatest.html Prostate-Specific Antigen (PSA) Test To use the sharing features on this ... enable JavaScript. What is a prostate-specific antigen (PSA) test? A prostate-specific antigen (PSA) test measures ...

  12. Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU.

    Science.gov (United States)

    Li, Pei-Chun; Chen, Wei-I; Huang, Chih-Ming; Liu, Ching-Ju; Chang, Hsiu-wen; Lin, Hung-Ching

    2016-01-01

    To determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU. It examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital's institutional review board (13MMHISO23). The screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference. The screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group.

  13. PSA - A utility perspective from the United Kingdom

    International Nuclear Information System (INIS)

    Ross, P.J.

    2004-01-01

    This paper provides an outline of the three stages of PSA used for the Sizewell B PWR. These stages cover the use of PSA during design, licensing and (in future) operation of Sizewell B. The paper discusses each of these stages in some detail, highlighting the differences in approach and lessons learnt at each stage. (author)

  14. Level 2 PSA methodology and severe accident management

    International Nuclear Information System (INIS)

    1997-01-01

    The objective of the work was to review current Level 2-PSA (Probabilistic Safety Assessment) methodologies and practices and to investigate how Level 2-PSA can support severe accident management programmes, i.e. the development, implementation, training and optimisation of accident management strategies and measures. For the most part, the presented material reflects the state in 1996. Current Level 2 PSA results and methodologies are reviewed and evaluated with respect to plant type specific and generic insights. Approaches and practices for using PSA results in the regulatory context and for supporting severe accident management programmes by input from level 2 PSAs are examined. The work is based on information contained in: PSA procedure guides, PSA review guides and regulatory guides for the use of PSA results in risk informed decision making; plant specific PSAs and PSA related literature exemplifying specific procedures, methods, analytical models, relevant input data and important results, use of computer codes and results of code calculations. The PSAs are evaluated with respect to results and insights. In the conclusion section, the present state of risk informed decision making, in particular in the level 2 domain, is described and substantiated by relevant examples

  15. Use of PSA in the development of SMRs

    International Nuclear Information System (INIS)

    Maioli, A.; Finnicum, D.J.; Lichtenstein, R.H.; Harsche, S.Y.

    2012-01-01

    This paper reviews the potential new scenarios where PSA (probabilistic safety assessment) may be of significant support to design and operation of SMRs (Small Modular Reactors); it reviews Westinghouse's experience and lessons learned in this endeavour and will discuss related challenges and what the PSA community is currently developing to address them. (authors)

  16. Child Injury: What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    This 60 second PSA is based on the April 2012 CDC Vital Signs report. Many childhood deaths and injuries are preventable, including those caused by crashes, suffocation, poisoning, drowning, fires, and falls. The PSA discusses ways to help prevent these deaths and injuries.

  17. Quality of the current low power and shutdown PSA practice

    International Nuclear Information System (INIS)

    Jang, Seung Cheol; Park, Jin Hee; Lim, Ho Gon; Kim, Tae Woon

    2004-01-01

    A probabilistic safety assessment (PSA) for the low-power and shutdown (LPSD) modes in a Korea standard nuclear power plant (KSNP) has been performed for the purpose of estimating the LPSD risk and identifying the vulnerabilities of LPSD operations. Both the operational experience and PSA results indicate that the risks from LPSD operations could be comparable with those from power operations. However, the application of the LPSD risk insights to risk-informed decision making has been slow to be adopted in practice. It is largely due to the question of whether the current LPSD PSA practice is appropriate for application to risk-informed decision making or not. Such a question has to do with the quality of the current LPSD PSA practice. In this paper, we have performed self-assessment of the KSNP LPSD PSA quality based on the ANS Standard (draft as of 13 Sep. 2002). The aims of the work are to find the LPSD PSA technical areas insufficient for application to risk-informed decision making and to efficiently allocate the limited research resources to improve the LPSD PSA model quality. Many useful findings regarding the current LPSD PSA quality are presented in this paper

  18. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

    LENUS (Irish Health Repository)

    Duffy, Michael J

    2012-02-01

    Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.

  19. Screening of lactic acid bacteria with high autolysis rate by N+-implantation

    International Nuclear Information System (INIS)

    Sun Jie; Lu Jiaping; Liu Lu; Zhang Shuwen

    2010-01-01

    In order to obtain lactic acid bacteria with high autolysis rate, Streptococcus salivarius ssp. thermophilus GS1 and Lactobacillus delbrueckii ssp. bulgaricus LD3 were mutated by 50 keV N + ions implantation. The results indicated that the survival rate curve took a saddle shape in the range of 1 x 2.6 x 10 13 ∼ 6 x 2.6 x 10 13 and the total mutation rate was 57% ∼ 74%. The survival rate were 25% ∼ 33% on the suitable dose 4 x 2.6 x 10 13 ion/cm 2 . Among the mutated strains with mutation rate in the range of 127.98% ∼-51.96%, the highest autolysis rate mutation strains were named LD3-A3 and GS1-B13. Compare with original strains, autolysis rates of LD3-A3 and GS1-B13 increased by 127.98% and 115.11% respectively. Fermentation properties of LD3-A3 and GS1-B13 were stable after 5 generation transfer inoculation. It indicates that the ion implantation technique is a feasible method in lactic acid bacteria breeding. (authors)

  20. Danish General Practitioners' Use of Prostate-Specific Antigen in Opportunistic Screening for Prostate Cancer

    DEFF Research Database (Denmark)

    Jessen, Kasper; Søndergaard, Jens; Larsen, Pia Veldt

    2013-01-01

    Background. The use of prostate-specific antigen test has markedly increased in Danish general practice in the last decade. Despite the national guidelines advice against PSA screening, opportunistic screening is supposed to be the primary reason for this increased number of PSA tests performed....... Aims. Based on the increase in the amount of PSA conducted, we aimed to analyse how GPs in Denmark use the PSA test. Methods. A self-administrated questionnaire concerning symptomatic and asymptomatic patient cases was developed based on the national and international guidelines and the extensive...... literature review, and an in-depth interview conducted with a GP was performed. Results. None of the GPs would do a PSA measurement for an asymptomatic 76-year-old man. For asymptomatic 55- and 42-year-old men, respectively, 21.9% and 18.6% of GPs would measure PSA. Patient request and concern could...

  1. PSA in design of passive/active safety reactors

    International Nuclear Information System (INIS)

    Sato, T.; Tanabe, A.; Kondo, S.

    1995-01-01

    PSAs in the design of advanced reactors are applied mainly in level 1 PSA areas. However, even in level 1 PSA, there are certain areas where special care must be taken depending on plant design concepts. This paper identifies these areas both for passive and active safety reactor concepts. For example, 'long-term PSA' and shutdown PSA are very important for a passive safety reactor concept from the standpoint of effectiveness of a grace period and passive safety systems. External events are also important for an active safety reactor concept. These kinds of special PSAs are difficult to conduct precisely in a conceptual design stage. This paper shows methods of conducting these kinds of special PSAs simply and conveniently and the use of acquired insights for the design of advanced reactors. This paper also clarifies the meaning or definition of a grace period from the standpoint of PSA

  2. Updating the Psoriatic Arthritis (PsA) Core Domain Set

    DEFF Research Database (Denmark)

    Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip J

    2017-01-01

    OBJECTIVE: To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). METHODS: At OMERACT 2016, research...... conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants. RESULTS: We conducted a systematic literature review of domains measured in PsA RCT and LOS, and identified 24 domains. We conducted...... and breakout groups at OMERACT 2016 in which findings were presented and discussed. The updated PsA Core Domain Set endorsed with 90% agreement by OMERACT 2016 participants included musculoskeletal disease activity, skin disease activity, fatigue, pain, patient's global assessment, physical function, health...

  3. Flooding PSA with Plant Specific Operating Experiences of Korean PWRs

    International Nuclear Information System (INIS)

    Choi, Sun Yeong; Yang, Joon Yull

    2006-01-01

    The purpose of this paper is to update the flooding PSA with Korean plant specific operating experience data and the appropriate estimation method for the flooding frequency to improve the PSA quality. The existing flooding PSA used the NPE (Nuclear Power Experience) database up to 1985 for the flooding frequency. They are all USA plant operating experiences. So an upgraded flooding frequency with Korean specific plant operation experience is required. We also propose a method of only using the PWR (Pressurized Water Reactor) data for the flooding frequency estimation in the case of the flooding area in the primary building even though the existing flooding PSA used both PWR and BWR (Boiled Water Reactor) data for all kinds of plant areas. We evaluate the CDF (Core Damage Frequency) with the modified flooding frequency and compare the results with that of the existing flooding PSA method

  4. The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy

    Directory of Open Access Journals (Sweden)

    Nadeem Shaida

    2009-01-01

    Full Text Available Transrectal ultrasound (TRUS–guided prostate biopsy is known to carry a significant false-negative rate, leading some patients to have multiple biopsies. We investigated cancer detection rates in patients with a PSA >20 ng/ml and a negative initial biopsy. We reviewed our database of 2396 TRUS-guided biopsies done between 1997 and 2002 in order to give a follow-up of at least 6 years. PSA, PSA density (PSAD, PSA velocity (PSAV, prostate volume, and DRE findings were analysed in relation to cancer status. Of the patients, 388 (16% had a PSA >20 ng/ml, including 99 (26% with benign biopsies. Of those, 67 were rebiopsied, including 19 (28% with cancer on the first rebiopsy and four (6% on further biopsies. PSAD, DRE, and volume significantly differed between rebiopsied patients with and without cancer (p 20 ng/ml and have an initial negative biopsy have a high chance of malignancy being detected on a second biopsy. However, if a second biopsy is also negative, then the chances of subsequent biopsies showing signs of cancer are very low if the DRE is normal and particularly if the PSAD is >0.35 ng/ml/cm3.

  5. The detection rates and tumor clinical/pathological stages of whole-body FDG-PET cancer screening

    International Nuclear Information System (INIS)

    Ono, Ken; Omagari, Junichi; Ochiai, Reiji; Yoshida, Tsuyoshi; Kitagawa, Mami; Kobayashi, Hisashi; Yamashita, Yasuyuki

    2007-01-01

    Fluorodeoxyglucose (FDG)-positron emission tomography (PET) has been used for cancer screening, mainly in East-Asia, and cancers are found not infrequently. However, their stages have not been clarified. We examined the detection rates of various cancers using whole-body PET for the screening of cancers in asymptomatic individuals, focusing on their clinical and pathological stages. Whole-body PET was obtained as a part of our cancer screening program among 3,426 healthy subjects. All subjects participated in a course of PET examination in conjunction with conventional examinations including a medical questionnaire, tumor markers, immunological fecal occult blood test, neck and abdominal ultrasonography and whole body computed tomography. A diagnosis and staging was obtained by an analysis of the pathological findings or by an analysis of the clinical follow-up data. Malignant tumors were discovered in 65 lesions found in 3,426 participants (1.90%). The PET findings were true-positive in 46 of the 65 cancer cases. The cancers were found in the following organs: the colon 14; thyroid gland 10; stomach 7; lung 5; liver 3; breast 2; and one each in the kidney, gallbladder, esophagus, pancreas and retroperitoneum. The stages were as follows: stage 0 5, stage I 17, stage II 10, stage III 7, and stage IV 6. One was an unknown primary. There were 19 false-negative findings (0.6%) on PET. Six cancers (0.18%) were missed in our screening program. PET imaging has the potential to detect a wide variety of cancers at potentially curative stages. Most PET-negative cancers are early stage cancers, and thus can be detected using other conventional examinations such as endoscopy. (author)

  6. Analytical tool for the periodic safety analysis of NPP according to the PSA guideline. Vol. 1

    International Nuclear Information System (INIS)

    Balfanz, H.P.; Boehme, E.; Musekamp, W.; Hussels, U.; Becker, G.; Behr, H.; Luettgert, H.

    1994-01-01

    The SAIS (Safety Analysis and Informationssystem) Programme System is based on an integrated data base, which consists of a plant-data and a PSA related data part. Using SAIS analyses can be performed by special tools, which are connected directly to the data base. Two main editors, RISA+ and DEDIT, are used for data base management. The access to the data base is done via different types of pages, which are displayed on a displayed on a computer screen. The pages are called data sheets. Sets of input and output data sheets were implemented, such as system or component data sheets, fault trees or event trees. All input information, models and results needed for updated results of PSA (Living PSA) can be stored in the SAIS. The programme system contains the editor KVIEW which guarantees consistency of the stored data, e.g. with respect to names and codes of components and events. The information contained in the data base are called in by a standardized users guide programme, called Page Editor. (Brunsbuettel on reference NPP). (orig./HP) [de

  7. SEPRA - shutdown PSA for the OLKILUOTO nuclear power plant

    International Nuclear Information System (INIS)

    Himanen, R.

    1995-01-01

    The utility TVO has extended the PSA study to the analysis of refueling, shutdown and startup. The Shutdown Event PRA (SEPRA) was reported to the authority in September 1992. The study consists of the analysis of leaks and loss of decay heat removal in the planned shutdown conditions. Special studies were performed for the cold pressurization, for local criticality events, for heavy load transport and for the transients during startup and shutdown. A remarkable effort was put to identify risks, i.e. to the qualitative analysis. The regular preventive maintenance tasks in the refueling outages were analyzed and the important tasks were selected for further studies. Besides the severe core damage risk the utility was interested in less grave consequences, e.g. the economic risks, causing significant extension of outages. The plant specific screening of initiators consisted of a study on the incident history and of interviewing the plant personnel on selected tasks. A number of thermohydraulic calculations were carried out to support the analysis of accident sequences. The operator actions after an initiating event were verified with the operating staff. The annual core damage risk from the refueling outage is about one forth of the total annual risk. The modifications decreased significantly the core damage frequency. It is foreseen that the SEPRA will form a basis of the procedure enhancement for the low power states. (author) 5 figs., 1 tab., 10 refs

  8. A screening approach for classroom acoustics using web-based listening tests and subjective ratings.

    Science.gov (United States)

    Persson Waye, Kerstin; Magnusson, Lennart; Fredriksson, Sofie; Croy, Ilona

    2015-01-01

    Perception of speech is crucial in school where speech is the main mode of communication. The aim of the study was to evaluate whether a web based approach including listening tests and questionnaires could be used as a screening tool for poor classroom acoustics. The prime focus was the relation between pupils' comprehension of speech, the classroom acoustics and their description of the acoustic qualities of the classroom. In total, 1106 pupils aged 13-19, from 59 classes and 38 schools in Sweden participated in a listening study using Hagerman's sentences administered via Internet. Four listening conditions were applied: high and low background noise level and positions close and far away from the loudspeaker. The pupils described the acoustic quality of the classroom and teachers provided information on the physical features of the classroom using questionnaires. In 69% of the classes, at least three pupils described the sound environment as adverse and in 88% of the classes one or more pupil reported often having difficulties concentrating due to noise. The pupils' comprehension of speech was strongly influenced by the background noise level (pcomprehension. Of the pupils' descriptions of acoustic qualities, clattery significantly (pcomprehension. Clattery was furthermore associated to difficulties understanding each other, while the description noisy was associated to concentration difficulties. The majority of classrooms do not seem to have an optimal sound environment. The pupil's descriptions of acoustic qualities and listening tests can be one way of predicting sound conditions in the classroom.

  9. Applications of probabilistic safety assessment (PSA) for nuclear power plants

    International Nuclear Information System (INIS)

    2001-02-01

    This report, which compiles information on a comprehensive set of PSA applications in the areas of NPP design, operation, and accident mitigation and management, is the culmination of an IAEA project on PSA Applications and Tools to Improve NPP Safety. In this regard, the Technical Committee Meeting (TCM) held in Madrid in February 1998 allowed participants to review and provide very valuable comments for this report. Several important facts related to PSA and its applications were highlighted during this TCM: living PSAs are the basis for the risk informed approach to decision making; development and use of safety/risk monitors as tools for configuration management is spreading fast; the different uses of PSA to support NPP testing and maintenance planning and optimization are amongst the most widespread PSA applications; plant specific PSAs are being used to support the safety upgrading programmes of plants built to earlier standards; not all countries have a regulatory framework for the use of the probabilistic approach in decision making. Some countries are still far from 'risk-informed' regulation, and this means that there is still considerable work ahead, both for regulators and utilities, to clarify approaches, to establish a framework and to reach a common understanding in relation to the use of PSA in decision making. This report is based on the premise that the use of PSA can provide useful information for the decision maker. This report is intended to provide an overview of current PSA applications. Section 2 addresses the PSA application process, outlines the general requirements for PSA tools and provides a discussion on PSA aspects such as PSA level, scope and level of detail, which have to be considered when planning/performing PSA applications. Section 3 discusses the technical aspects of individual applications and is divided into three parts. Section 3.1 is dedicated to the design related PSA applications. The second part of Section 3 considers

  10. The open PSA standard as a framework for migration of probabilistic models. Experiences with the KKB PSA

    International Nuclear Information System (INIS)

    Becker, G.; Hussels, U.; Epstein, S.; Rauzy, A.; Schubert, B.

    2008-01-01

    In its present state, the open PSA standard is helpful to determine capabilities of PSA approaches, which have been taken into account by those who formulated it. As soon, as tools come up, which can automatically bring a given PSA into the standard form, the data will be accessible by other software tools, which either are supplementary to the original one, or they may act in the context of quality control. Taking into account, that a PSA model represents a value of some two to ten person years (dependent on level of completeness and level of detail), it is important to have the data in a transparent way, which does not depend on proprietary formats, and can thus be used for more purposes than those, which are implemented in given PSA codes. (orig.)

  11. Stage T1-2 prostate cancer with pretreatment PSA 10 ng/ml or less: radiotherapy or surgery?

    International Nuclear Information System (INIS)

    Keyser, Douglas; Kupelian, Patrick; Zippe, Craig; Klein, Eric

    1996-01-01

    Purpose: Presently, patients with pretreatment PSA levels ≤10 ng/ml constitute the majority of cases presenting for definitive treatment. Our aim was to determine whether the type of treatment (radiotherapy versus surgery) affected biochemical failure rates in this group of patients. This study is based on 389 patients treated at a single institution. Material and Methods: The charts of all patients treated with either radiotherapy or prostatectomy alone between 1987 and 1993 were reviewed (n=811). Patients with clinical stage T1 or T2 disease, and a pretreatment PSA level (iPSA) of 10.0 or less were analyzed (n=389). Two hundred forty nine (64%) received radical prostatectomy and 140 (36%) received radiotherapy (median dose 66.6 Gy). Pretreatment patient characteristics including clinical stage, biopsy Gleason score (GS) and iPSA level were not significantly different between the radiation and surgery groups (Table 1). The patients treated with radiation were significantly older (median age 70 years vs. 64 years, p<0.05). A total of 37% of the prostatectomy patients had a positive margin. The median follow-up time was 33 months; 1458 follow-up PSA levels were available for analysis. Biochemical failure was defined as a rise in PSA level of 1.0 ng/ml above the nadir PSA level in radiotherapy cases, or any value above 0.2 ng/ml in the prostatectomy cases. Results: The overall 5 year actuarial biochemical relapse free survival (bRFS) rate was 70%. The 5-year bRFS rates for prostatectomy and radiotherapy were identical (70%) (Fig.1). The significant factors affecting bRFS rates were iPSA level (≤4 vs. 4-10 ng/ml) and Gleason score (≤6 vs. ≥7) (Table 2). The 5-year bRFS rates of patients with iPSA ≤4 vs. iPSA 4-10 ng/ml were 92% vs. 61% respectively, p<0.01. The 5-year clinical relapse free survival was 93%. All clinical failures were preceded by biochemical failure. Patients with positive surgical margins did significantly worse than those with negative

  12. Daily Pill Can Prevent HIV PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-11-24

    This 60 second public service announcement (PSA) is based on the November 24, 2015 CDC Vital Signs report. Preexposure prophylaxis, or PrEP, is a daily medicine that can be used to prevent getting HIV. PrEP is for people who don’t have HIV but who are at very high risk for getting it from sex or injection drug use. Unfortunately, many people who can benefit from PrEP aren’t taking it.  Created: 11/24/2015 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 11/24/2015.

  13. Policy and System Approach (PSA: A primer

    Directory of Open Access Journals (Sweden)

    Chandrakant Lahariya

    2017-01-01

    Full Text Available A number of public health challenges have emerged at global and national level in the last two decades. The response to these challenges has rarely been swift and often “knee-jerk.” The national and state level program officials responsible for the activities often apportion the blame on weak health systems or fragmented health service delivery mechanisms, amongst other. In India, the viral illnesses (including those due to dengue and chikungunya are becoming the increasing realities. The Public health response of early identification, disease surveillance, reporting and the preventive and curative measures, remains suboptimal. The health challenges which require multidimensional interventions are usuallyattempted to be resolved through piece meal solutions. This article proposes “policy and system approach (PSA,” combining concepts of “Health in all policies” for intersectoral coordination and “health system approach” for intra-sectoral tackling of the emerging and existing health challenges.

  14. Regulatory review of probabilistic safety assessment (PSA) Level 2

    International Nuclear Information System (INIS)

    2001-07-01

    Probabilistic safety assessment (PSA) is increasingly being used as part of the decision making process to assess the level of safety of nuclear power plants. The methodologies in use are maturing and the insights gained from the PSAs are being used along with those from deterministic analysis. Many regulatory authorities consider the current state of the art in PSA to be sufficiently well developed for results to be used centrally in the regulatory decision making process-referred to as risk informed regulation. For these applications to be successful, it will be necessary for the regulatory authority to have a high degree of confidence in the PSA. However, at the 1994 IAEA Technical Committee Meeting on Use of PSA in the Regulatory Process and at the OECD Nuclear Energy Agency Committee for Nuclear Regulatory Activities (CNRA) 'Special Issues' meeting in 1997 on Review Procedures and Criteria for Different Regulatory Applications of PSA, it was recognized that formal regulatory review guidance for PSA did not exist. The senior regulators noted that there was a need to produce some international guidance for reviewing PSAs to establish an agreed basis for assessing whether important technological and methodological issues in PSAs are treated adequately and to verify that conclusions reached are appropriate. In 1997, the IAEA and OECD Nuclear Energy Agency agreed to produce, in cooperation, guidance on Regulatory Review of PSA. This led to the publication of IAEA-TECDOC-1135 on the Regulatory Review of Probabilistic Safety Assessment (PSA) Level 1, which gives advice for the review of Level 1 PSA for initiating events occurring at power plants. This TECDOC extends the coverage to address the regulatory review of Level 2 PSA.These publications are intended to provide guidance to regulatory authorities on how to review the PSA for a nuclear power plant to gain confidence that it has been carried out to an acceptable level of quality so that it can be used as the

  15. A framework for a quality assurance programme for PSA

    International Nuclear Information System (INIS)

    1999-08-01

    Reviews organized by the IAEA of probabilistic safety assessments (PSAs) of nuclear facilities have, in the past years, shown significant progress in the technical methods and data used for these studies. The IAEA has made a considerable effort to support the development of technical capabilities for PSA in Member States and in writing technical procedures for carrying out PSAs. However, the reviews have also shown significant deficiencies in quality assurance (QA) for PSAs, ranging from no QA at all to inappropriate, inefficient or unbalanced QA. As a PSA represents a very complex model which describes the risk associated with a nuclear facility, an appropriate and efficient QA programme is crucial to obtain a quality PSA. Historically, in the first integral PSAs, many of the PSA elements were handled by independent groups. These elements were finally integrated and put together in the overall model. Many of the interfaces between the elements or tasks were handled as appropriate by exchanging information in oral or written form. Since WASH-1400, the first integral PSA, the process of constructing the PSA model has been further developed. PSA elements previously considered separately can now be handled together with the capable software developed in recent years. Software has made interface control and data transfer easier to perform, but also permits the development of more detailed and complex models. Previously, QA for PSA projects was organized in an ad hoc manner and was sometimes very limited. In recent years, increasingly comprehensive QA programmes have been developed and implemented for PSA projects. Today, a comprehensive, effective and performance-oriented QA is considered to be essential for a reliable and credible PSA. This report describes the framework for developing an adequate QA programme for PSA studies. The framework is based on and is in accordance with the related QA guidelines of the IAEA for safety in nuclear power plants and other nuclear

  16. Leadership training to improve adenoma detection rate in screening colonoscopy: A randomised trial

    NARCIS (Netherlands)

    M.F. Kaminski (Michal); J. Anderson (John); R.M. Valori (Roland ); E. Kraszewska (Ewa); M. Rupinski (Maciej); J. Pachlewski (Jacek); E. Wronska (Ewa); M. Bretthauer (Michael); S. Thomas-Gibson (Siwan); E.J. Kuipers (Ernst); J. Regula (J.)

    2016-01-01

    textabstractObjective Suboptimal adenoma detection rate (ADR) at colonoscopy is associated with increased risk of interval colorectal cancer. It is uncertain how ADR might be improved. We compared the effect of leadership training versus feedback only on colonoscopy quality in a countrywide

  17. The effect of information about false negative and false positive rates on people's attitudes towards colorectal cancer screening using faecal occult blood testing (FOBt).

    Science.gov (United States)

    Miles, Anne; Rodrigues, Vania; Sevdalis, Nick

    2013-11-01

    To examine the impact of numeric risk information about false negative (FN) and false positive (FP) rates in faecal occult blood testing (FOBt) on attitudes towards screening. 95 people aged 45-59, living in England, read 6 hypothetical vignettes presented online about the use of FOB testing to detect bowel cancer, in which information about FN and FP rates was systematically varied. Both verbal and numeric FN risk information reduced people's interest in screening compared with no FN information. Numeric FN risk information reduced people's perceptions of screening effectiveness and lowered perceived trust in the results of screening compared with both verbal FN information and no FN information. FP information did not affect attitudes towards FOB testing. There was limited evidence that FN information reduced interest and perceptions of screening effectiveness more in educated groups. Numeric FN risk information decreased people's perceptions of screening effectiveness and trust in the results of screening but did not affect people's interest in screening anymore than verbal FN risk information. Numeric FN information could be added to patient information without affecting interest in screening, although this needs to be replicated in a larger, more representative sample. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition.

    Science.gov (United States)

    Mikropoulos, Christos; Selkirk, Christina G Hutten; Saya, Sibel; Bancroft, Elizabeth; Vertosick, Emily; Dadaev, Tokhir; Brendler, Charles; Page, Elizabeth; Dias, Alexander; Evans, D Gareth; Rothwell, Jeanette; Maehle, Lovise; Axcrona, Karol; Richardson, Kate; Eccles, Diana; Jensen, Thomas; Osther, Palle J; van Asperen, Christi J; Vasen, Hans; Kiemeney, Lambertus A; Ringelberg, Janneke; Cybulski, Cezary; Wokolorczyk, Dominika; Hart, Rachel; Glover, Wayne; Lam, Jimmy; Taylor, Louise; Salinas, Monica; Feliubadaló, Lidia; Oldenburg, Rogier; Cremers, Ruben; Verhaegh, Gerald; van Zelst-Stams, Wendy A; Oosterwijk, Jan C; Cook, Jackie; Rosario, Derek J; Buys, Saundra S; Conner, Tom; Domchek, Susan; Powers, Jacquelyn; Ausems, Margreet Gem; Teixeira, Manuel R; Maia, Sofia; Izatt, Louise; Schmutzler, Rita; Rhiem, Kerstin; Foulkes, William D; Boshari, Talia; Davidson, Rosemarie; Ruijs, Marielle; Helderman-van den Enden, Apollonia Tjm; Andrews, Lesley; Walker, Lisa; Snape, Katie; Henderson, Alex; Jobson, Irene; Lindeman, Geoffrey J; Liljegren, Annelie; Harris, Marion; Adank, Muriel A; Kirk, Judy; Taylor, Amy; Susman, Rachel; Chen-Shtoyerman, Rakefet; Pachter, Nicholas; Spigelman, Allan; Side, Lucy; Zgajnar, Janez; Mora, Josefina; Brewer, Carole; Gadea, Neus; Brady, Angela F; Gallagher, David; van Os, Theo; Donaldson, Alan; Stefansdottir, Vigdis; Barwell, Julian; James, Paul A; Murphy, Declan; Friedman, Eitan; Nicolai, Nicola; Greenhalgh, Lynn; Obeid, Elias; Murthy, Vedang; Copakova, Lucia; McGrath, John; Teo, Soo-Hwang; Strom, Sara; Kast, Karin; Leongamornlert, Daniel A; Chamberlain, Anthony; Pope, Jenny; Newlin, Anna C; Aaronson, Neil; Ardern-Jones, Audrey; Bangma, Chris; Castro, Elena; Dearnaley, David; Eyfjord, Jorunn; Falconer, Alison; Foster, Christopher S; Gronberg, Henrik; Hamdy, Freddie C; Johannsson, Oskar; Khoo, Vincent; Lubinski, Jan; Grindedal, Eli Marie; McKinley, Joanne; Shackleton, Kylie; Mitra, Anita V; Moynihan, Clare; Rennert, Gad; Suri, Mohnish; Tricker, Karen; Moss, Sue; Kote-Jarai, Zsofia; Vickers, Andrew; Lilja, Hans; Helfand, Brian T; Eeles, Rosalind A

    2018-01-01

    Prostate-specific antigen (PSA) and PSA-velocity (PSAV) have been used to identify men at risk of prostate cancer (PrCa). The IMPACT study is evaluating PSA screening in men with a known genetic predisposition to PrCa due to BRCA1/2 mutations. This analysis evaluates the utility of PSA and PSAV for identifying PrCa and high-grade disease in this cohort. PSAV was calculated using logistic regression to determine if PSA or PSAV predicted the result of prostate biopsy (PB) in men with elevated PSA values. Cox regression was used to determine whether PSA or PSAV predicted PSA elevation in men with low PSAs. Interaction terms were included in the models to determine whether BRCA status influenced the predictiveness of PSA or PSAV. 1634 participants had ⩾3 PSA readings of whom 174 underwent PB and 45 PrCas diagnosed. In men with PSA >3.0 ng ml -l , PSAV was not significantly associated with presence of cancer or high-grade disease. PSAV did not add to PSA for predicting time to an elevated PSA. When comparing BRCA1/2 carriers to non-carriers, we found a significant interaction between BRCA status and last PSA before biopsy (P=0.031) and BRCA2 status and PSAV (P=0.024). However, PSAV was not predictive of biopsy outcome in BRCA2 carriers. PSA is more strongly predictive of PrCa in BRCA carriers than non-carriers. We did not find evidence that PSAV aids decision-making for BRCA carriers over absolute PSA value alone.

  19. Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition

    Science.gov (United States)

    Mikropoulos, Christos; Selkirk, Christina G Hutten; Saya, Sibel; Bancroft, Elizabeth; Vertosick, Emily; Dadaev, Tokhir; Brendler, Charles; Page, Elizabeth; Dias, Alexander; Evans, D Gareth; Rothwell, Jeanette; Maehle, Lovise; Axcrona, Karol; Richardson, Kate; Eccles, Diana; Jensen, Thomas; Osther, Palle J; van Asperen, Christi J; Vasen, Hans; Kiemeney, Lambertus A; Ringelberg, Janneke; Cybulski, Cezary; Wokolorczyk, Dominika; Hart, Rachel; Glover, Wayne; Lam, Jimmy; Taylor, Louise; Salinas, Monica; Feliubadaló, Lidia; Oldenburg, Rogier; Cremers, Ruben; Verhaegh, Gerald; van Zelst-Stams, Wendy A; Oosterwijk, Jan C; Cook, Jackie; Rosario, Derek J; Buys, Saundra S; Conner, Tom; Domchek, Susan; Powers, Jacquelyn; Ausems, Margreet GEM; Teixeira, Manuel R; Maia, Sofia; Izatt, Louise; Schmutzler, Rita; Rhiem, Kerstin; Foulkes, William D; Boshari, Talia; Davidson, Rosemarie; Ruijs, Marielle; Helderman-van den Enden, Apollonia TJM; Andrews, Lesley; Walker, Lisa; Snape, Katie; Henderson, Alex; Jobson, Irene; Lindeman, Geoffrey J; Liljegren, Annelie; Harris, Marion; Adank, Muriel A; Kirk, Judy; Taylor, Amy; Susman, Rachel; Chen-Shtoyerman, Rakefet; Pachter, Nicholas; Spigelman, Allan; Side, Lucy; Zgajnar, Janez; Mora, Josefina; Brewer, Carole; Gadea, Neus; Brady, Angela F; Gallagher, David; van Os, Theo; Donaldson, Alan; Stefansdottir, Vigdis; Barwell, Julian; James, Paul A; Murphy, Declan; Friedman, Eitan; Nicolai, Nicola; Greenhalgh, Lynn; Obeid, Elias; Murthy, Vedang; Copakova, Lucia; McGrath, John; Teo, Soo-Hwang; Strom, Sara; Kast, Karin; Leongamornlert, Daniel A; Chamberlain, Anthony; Pope, Jenny; Newlin, Anna C; Aaronson, Neil; Ardern-Jones, Audrey; Bangma, Chris; Castro, Elena; Dearnaley, David; Eyfjord, Jorunn; Falconer, Alison; Foster, Christopher S; Gronberg, Henrik; Hamdy, Freddie C; Johannsson, Oskar; Khoo, Vincent; Lubinski, Jan; Grindedal, Eli Marie; McKinley, Joanne; Shackleton, Kylie; Mitra, Anita V; Moynihan, Clare; Rennert, Gad; Suri, Mohnish; Tricker, Karen; Moss, Sue; Kote-Jarai, Zsofia; Vickers, Andrew; Lilja, Hans; Helfand, Brian T; Eeles, Rosalind A

    2018-01-01

    Background: Prostate-specific antigen (PSA) and PSA-velocity (PSAV) have been used to identify men at risk of prostate cancer (PrCa). The IMPACT study is evaluating PSA screening in men with a known genetic predisposition to PrCa due to BRCA1/2 mutations. This analysis evaluates the utility of PSA and PSAV for identifying PrCa and high-grade disease in this cohort. Methods: PSAV was calculated using logistic regression to determine if PSA or PSAV predicted the result of prostate biopsy (PB) in men with elevated PSA values. Cox regression was used to determine whether PSA or PSAV predicted PSA elevation in men with low PSAs. Interaction terms were included in the models to determine whether BRCA status influenced the predictiveness of PSA or PSAV. Results: 1634 participants had ⩾3 PSA readings of whom 174 underwent PB and 45 PrCas diagnosed. In men with PSA >3.0 ng ml−l, PSAV was not significantly associated with presence of cancer or high-grade disease. PSAV did not add to PSA for predicting time to an elevated PSA. When comparing BRCA1/2 carriers to non-carriers, we found a significant interaction between BRCA status and last PSA before biopsy (P=0.031) and BRCA2 status and PSAV (P=0.024). However, PSAV was not predictive of biopsy outcome in BRCA2 carriers. Conclusions: PSA is more strongly predictive of PrCa in BRCA carriers than non-carriers. We did not find evidence that PSAV aids decision-making for BRCA carriers over absolute PSA value alone. PMID:29301143

  20. Evaluation of the Prostate Cancer Prevention Trial Risk Calculator in a High-Risk Screening Population

    Science.gov (United States)

    Kaplan, David J.; Boorjian, Stephen A.; Ruth, Karen; Egleston, Brian L.; Chen, David Y.T.; Viterbo, Rosalia; Uzzo, Robert G.; Buyyounouski, Mark K.; Raysor, Susan; Giri, Veda N.

    2009-01-01

    Introduction Clinical factors in addition to PSA have been evaluated to improve risk assessment for prostate cancer. The Prostate Cancer Prevention Trial (PCPT) risk calculator provides an assessment of prostate cancer risk based on age, PSA, race, prior biopsy, and family history. This study evaluated the risk calculator in a screening cohort of young, racially diverse, high-risk men with a low baseline PSA enrolled in the Prostate Cancer Risk Assessment Program. Patients and Methods Eligibility for PRAP include men ages 35-69 who are African-American, have a family history of prostate cancer, or have a known BRCA1/2 mutation. PCPT risk scores were determined for PRAP participants, and were compared to observed prostate cancer rates. Results 624 participants were evaluated, including 382 (61.2%) African-American men and 375 (60%) men with a family history of prostate cancer. Median age was 49.0 years (range 34.0-69.0), and median PSA was 0.9 (range 0.1-27.2). PCPT risk score correlated with prostate cancer diagnosis, as the median baseline risk score in patients diagnosed with prostate cancer was 31.3%, versus 14.2% in patients not diagnosed with prostate cancer (p<0.0001). The PCPT calculator similarly stratified the risk of diagnosis of Gleason score ≥7 disease, as the median risk score was 36.2% in patients diagnosed with Gleason ≥7 prostate cancer versus 15.2% in all other participants (p<0.0001). Conclusion PCPT risk calculator score was found to stratify prostate cancer risk in a cohort of young, primarily African-American men with a low baseline PSA. These results support further evaluation of this predictive tool for prostate cancer risk assessment in high-risk men. PMID:19709072

  1. OBSERVER RATING VERSUS THREE-DIMENSIONAL MOTION ANALYSIS OF LOWER EXTREMITY KINEMATICS DURING FUNCTIONAL SCREENING TESTS: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Maclachlan, Liam; White, Steven G; Reid, Duncan

    2015-08-01

    Functional assessments are conducted in both clinical and athletic settings in an attempt to identify those individuals who exhibit movement patterns that may increase their risk of non-contact injury. In place of highly sophisticated three-dimensional motion analysis, functional testing can be completed through observation. To evaluate the validity of movement observation assessments by summarizing the results of articles comparing human observation in real-time or video play-back and three-dimensional motion analysis of lower extremity kinematics during functional screening tests. Systematic review. A computerized systematic search was conducted through Medline, SPORTSdiscus, Scopus, Cinhal, and Cochrane health databases between February and April of 2014. Validity studies comparing human observation (real-time or video play-back) to three-dimensional motion analysis of functional tasks were selected. Only studies comprising uninjured, healthy subjects conducting lower extremity functional assessments were appropriate for review. Eligible observers were certified health practitioners or qualified members of sports and athletic training teams that conduct athlete screening. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was used to appraise the literature. Results are presented in terms of functional tasks. Six studies met the inclusion criteria. Across these studies, two-legged squats, single-leg squats, drop-jumps, and running and cutting manoeuvres were the functional tasks analysed. When compared to three-dimensional motion analysis, observer ratings of lower extremity kinematics, such as knee position in relation to the foot, demonstrated mixed results. Single-leg squats achieved target sensitivity values (≥ 80%) but not specificity values (≥ 50%>%). Drop-jump task agreement ranged from poor ( 80%). Two-legged squats achieved 88% sensitivity and 85% specificity. Mean underestimations as large as 198 (peak knee flexion) were found in

  2. Results of level 1 PSA in Trillo 1 NPP

    International Nuclear Information System (INIS)

    Gomez, F.; Lopez, C.

    1998-01-01

    In July 1991, C. N. Trillo I was requested by the Spanish Regulatory Body (CSN) to perform a PSA that should include: - Level 1 PSA at power - Internal flooding analysis - Level 2 PSA including containment capacity analysis. - External event analyses (fires, external flooding, seismic events and other external events) - Risk analysis for off power conditions (shutdown and low power) - Risk analysis due to other sources of radioactivity In 1992 the Project Plan was issued and the PSA team for the performance of Level 1 PSA was established. Before finishing the Project, it was decided to develop a Phase B to take into account some important modifications that had been accomplished in the Plant and that, probably, could affect the results. Level 1 PSA was finished in March 1998. Both the results of the study and the main conclusions derived from the importance, uncertainty and sensibility analysis performed are presented in this paper. These results de not include the internal flooding analysis conclusions and correspond to PSA revision 0 that is currently being evaluated by the Spanish Regulatory Body. (Author)

  3. Ascertaining the international state of the art of PSA methodology

    International Nuclear Information System (INIS)

    Linden, J. von

    1998-01-01

    Plant-specific PSAs, to be performed within the framework of the Periodic Safety Review of German Nuclear Power Plants require further development of the methodology. For that purpose foreign PSA-guidelines and PSA-reviewes as well as relevant literature are examined and appropriate insights are adopted within task A.2 of project SR 2096. The main goal of these activities is to achieve a comparison of the state of the art of PSA-methodologies applied abroad and in Germany. The German state of the art refers to the extent as is documented in the German PSA Guide (Leitfaden Probabilistische Sicherheitsanalyse /PSUe97/) which has to be used for the Periodic Safety Review of German Nuclear Power Plants. The structure for the evaluation is based on the working steps of a PSA. In total, according to the objectives of the Periodic Safety Review the German approach for plant-specific PSAs based on the German PSA Guide is conform to the state of the art abroad. Identified deviations in some details are evaluated reflecting the view of GRS. Particular aspects resulting from the evaluation should be considered for further development of the German PSA Guide. (orig.) [de

  4. Retrospective observation on contribution and limitations of screening for breast cancer with mammography in Korea: detection rate of breast cancer and incidence rate of interval cancer of the breast.

    Science.gov (United States)

    Lee, Kunsei; Kim, Hyeongsu; Lee, Jung Hyun; Jeong, Hyoseon; Shin, Soon Ae; Han, Taehwa; Seo, Young Lan; Yoo, Youngbum; Nam, Sang Eun; Park, Jong Heon; Park, Yoo Mi

    2016-11-18

    The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography. Descriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rate of interval cancer of the breast were calculated. The crude detection rate of breast cancer screening per 100,000 participants increased from 126.3 in 2009 to 182.1 in 2014. The positive predictive value of breast cancer screening per 100,000 positives increased from 741.2 in 2009 to 1,367.9 in 2014. The incidence rate of interval cancer of the breast per 100,000 negatives increased from 51.7 in 2009 to 76.3 in 2014. The sensitivities of screening for breast cancer were 74.6% in 2009 and 75.1% in 2014 and the specificities were 83.1% in 2009 and 85.7% in 2014. To increase the detection rate of breast cancer by breast cancer screening using mammography, the participation rate should be higher and an environment where accurate mammography and reading can be performed and reinforcement of quality control are required. To reduce the incidence rate of interval cancer of the breast, it will be necessary to educate women after their 20s to perform self-examination of the breast once a month regardless of participation in screening for breast cancer.

  5. The treatment of nonpalpable PSA-detected adenocarcinoma of the prostate with 3-dimensional conformal radiation therapy

    International Nuclear Information System (INIS)

    Horwitz, Eric M.; Hanlon, Alexandra L.; Pinover, Wayne H.; Hanks, Gerald E.

    1998-01-01

    Purpose: We reviewed our institution's experience treating patients with nonpalpable PSA-detected prostate cancer with three-dimensional conformal radiation therapy (3DCRT) to determine prognostic factors that predict for biochemical-free survival (bNED) control and present the bNED control rates. Methods and Materials: Between May 1, 1990 and November 30, 1994, 160 patients with nonpalpable PSA-detected prostate cancer received 3DCRT at Fox Chase Cancer Center (median total dose 73 Gy; range: 67-78 Gy). bNED failure was defined as three consecutive increases in posttreatment PSA after achieving a nadir. bNED failure was recorded as the time midway between the nadir and the first consecutive rising PSA. Five-year actuarial rates of bNED control were calculated for pretreatment PSA (0-9.9 vs. 10-19.9 vs. ≥ 20 ng/ml), Gleason score (2-6 vs. 7-10), treatment field size (prostate vs. small pelvis), age ( 73 Gy) using Kaplan-Meier methods and compared using the Log rank test. The Cox model was used to multivariately establish independent predictors based on significant univariate factors. Median follow-up was 39 months (range: 2-84 months). Results: The 5-year actuarial rate of bNED control was 86% for the entire group of patients. The Cox Proportional Hazards model demonstrated that pretreatment PSA was an independent predictor of bNED control. Treatment field size was marginally predictive. There was no difference in bNED control when patients were stratified by the number of lobes positive for disease. Statistically different rates of bNED control were seen when the patients with nonpalpable disease were univariately compared to T2b and T2c patients. Three patients experienced Grade 3-4 genitourinary (GU) toxicity and 3 patients experienced Grade 3-4 gastrointestinal (GI) toxicity. Conclusions: Patients with nonpalpable PSA-detected prostate cancer can be effectively treated with 3DCRT with minimal morbidity and high rates of bNED control at 5 years. Pretreatment

  6. Outcomes after radical prostatectomy in the PSA era

    International Nuclear Information System (INIS)

    Scardino, Peter T.

    1996-01-01

    This year 317,000 men will be diagnosed with prostate cancer and 41,400 will die of this disease. Prostate cancer will kill nearly 1 million men alive today who are now over 50 years old. Since the mortality rate from prostate cancer increases more rapidly with age than any other cancer, and the most rapidly growing segment of the population is those > 80 years old, and mortality from other causes is declining, the number of deaths from prostate cancer is expected to increase inexorably for many years. Among the clinical prognostic factors that have been established as important predictors of the natural history of prostate cancer in conservatively treated patients, none is more important than the grade of the tumor. A similar influence of grade has been reported in patients treated surgically. At Baylor we assessed a variety of clinical prognostic factors in 728 men treated with radical prostatectomy and followed with serial PSA levels with no other therapy before proven recurrence of the cancer. While a variety of factors were significant in univariate analyses, in multivariate analysis only grade and serum PSA levels were significant clinical prognostic factors. Once the prostate was removed and pathologic information was available, however, pathologic stage became the most important factor (especially seminal vesicle or lymph node involvement), but Gleason grade was also a powerful independent factor. Surgical margin status and the presence of extracapsular extension were also independent predictors of recurrence, but total tumor volume added little additional information. Once the pathological information is available, none of the prognostic factors known before the operation, including PSA, PSA density, and clinical, have any independent power to predict prognosis. While radical prostatectomy may carry greater risk of complications than radiotherapy, its major advantage is the high probability that the cancer can be completely eradicated, especially if it is

  7. Clinical impact of body mass index on prostate biopsy in patients with intermediate PSA levels

    International Nuclear Information System (INIS)

    Sekita, Nobuyuki; Chin, Kensei; Fujimura, Masaaki; Mikami, Kazuo; Suzuki, Hiroyoshi; Kamijima, Shuichi

    2008-01-01

    From April 2005 to September 2007, 480 patients underwent transrectal prostate biopsy at our institution. The clinical data including age, serum prostate specific antigen (PSA) level, prostate volume and body mass index (BMI) were obtained, and the cancer detection rates and pathological findings were evaluated in 305 cases with a PSA concentration of 4.0 to 10.0 ng/ml. Prostate volume was calculated from magnetic resonance imaging (MRI) findings. The 305 patients were categorized according to their BMI into three groups (normal, less than 22 kg/m 2 ; overweight, 22-25 kg/m 2 ; and obese, more than 25 kg/m 2 ). Cancer detection rates and histopathologic findings were compared between the groups. Multivariate logistic regression analysis was also performed. Prostate cancer was detected in 127 patients. No significant differences in BMI were observed between biopsy-positive and biopsy-negative cases (p=0.965), and the detection rates of prostate cancer observed in the three groups were not significantly different. There was a significant association between BMI and the findings of high Gleason score (more than 4+3) (p=0.048). BMI was not a contributory factor of prostate cancer detection for cases with intermediate PSA levels; however, patients with high BMI may have high-grade malignancy features. (author)

  8. Impact of Prostatic-specific Antigen Threshold and Screening Interval in Prostate Cancer Screening Outcomes: Comparing the Swedish and Finnish European Randomised Study of Screening for Prostate Cancer Centres.

    Science.gov (United States)

    Saarimäki, Lasse; Hugosson, Jonas; Tammela, Teuvo L; Carlsson, Sigrid; Talala, Kirsi; Auvinen, Anssi

    2017-08-10

    The European Randomised Study of Screening for Prostate Cancer trial has shown a 21% reduction in prostate cancer (PC) mortality with prostate-specific antigen (PSA)-based screening. Sweden used a 2-yr screening interval and showed a larger mortality reduction than Finland with a 4-yr interval and higher PSA cut-off. To evaluate the impact of screening interval and PSA cut-off on PC detection and mortality. We analysed the core age groups (55-69 yr at entry) of the Finnish (N=31 866) and Swedish (N=5901) screening arms at 13 yr and 16 yr of follow-up. Sweden used a screening interval of 2 yr and a PSA cut-off of 3.0ng/ml, while in Finland the screening interval was 4 yr and the PSA cut-off 4.0ng/ml (or PSA 3.0-3.9ng/ml with free PSAprostate-specific antigen threshold of 3ng/ml versus 4ng/ml or a screening interval of 2 yr instead of 4 yr is unlikely to explain the larger mortality reduction achieved in Sweden compared with Finland. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  9. Application of PSA in risk informed decision making

    International Nuclear Information System (INIS)

    Hari Prasad, M.; Vinod, Gopika; Saraf, R.K.; Ghosh, A.K.; Kushwaha, H.S.

    2006-01-01

    Probabilistic Safety Assessment (PSA) models have been successfully employed during design evaluation to assess weak links and carry out design modifications to improve system reliability and safety. Recently, studies are directed towards applying PSA in various decision making issues concerned with plant operations and safety regulations. This necessitates development of software tools like Living PSA, Risk Monitor etc. Risk Monitor is a PC based tool developed to assess the risk, based on the actual status of systems and components. Such tools find wide application with plant personnel and regulatory authorities since they can provide solutions to various plant issues and regulatory decision making issues respectively. (author)

  10. Regulatory review of probabilistic safety assessment (PSA) level 1

    International Nuclear Information System (INIS)

    2000-02-01

    Probabilistic safety assessment (PSA) is increasingly being used as part of the decision making process to assess the level of safety of nuclear power plants. The methodologies in use are maturing and the insights gained from the PSAs are being used along with those from the deterministic analysis. Many regulatory authorities consider that the current state of the art in PSA (especially Level 1 PSA) is sufficiently well developed that it can be used centrally in the regulatory decision making process - referred to as 'risk informed regulation'. For these applications to be successful, it will be necessary for regulatory authorities to have a high degree of confidence in PSA. However, at the IAEA Technical Committee Meeting on Use of PSA in the Regulatory Process in 1994 and at the OECD Nuclear Energy Agency Committee for Nuclear Regulatory Activities (CNRA) 'Special Issues' Meeting in 1997 on Review Procedures and Criteria for Different Regulatory Applications of PSA, it was recognized that formal regulatory review guidance for PSA did not exist. The senior regulators noted that there was a need to produce some international guidance for reviewing PSAs to establish an agreed basis for assessing whether important technological and methodological issues in PSAs are treated adequately and to verify that conclusions reached are appropriate. In 1997 the IAEA and OECD Nuclear Energy Agency agreed to produce in co-operation a technical document on the regulatory review of PSA. This publication is intended to provide guidance to regulatory authorities on how to review the PSA for a nuclear power plant to gain confidence that it has been carried out to an acceptable standard so that it can be used as the basis for taking risk informed decisions within a regulatory decision making process. The document gives guidance on how to set about reviewing a PSA and on the technical issues that need to be addressed. This publication gives guidance for the review of Level 1 PSA for

  11. Quality assurance in the Juragua Nuclear Power Plant preoperational PSA

    International Nuclear Information System (INIS)

    Valhuerdi Debesa, C.

    1996-01-01

    Quality Assurance (QA) is nowadays an important requirement for the competence of any production or service, making possible to get the desired quality at the lowest cost In the case of PSA, which are multidisciplinary, very detailed and complex analysis, with many interfaces between analyst tasks, QA plays an important role as a tool for the analytical process management, and it is recognized as one of the PSA issues which require additional development In this paper the QA system developed for the Juragua NPP preoperational PSA, its antecedents and the experiences of its application are described

  12. Development of Tsunami PSA method for Korean NPP site

    International Nuclear Information System (INIS)

    Kim, Min Kyu; Choi, In Kil; Park, Jin Hee

    2010-01-01

    A methodology of tsunami PSA was developed in this study. A tsunami PSA consists of tsunami hazard analysis, tsunami fragility analysis and system analysis. In the case of tsunami hazard analysis, evaluation of tsunami return period is major task. For the evaluation of tsunami return period, numerical analysis and empirical method can be applied. The application of this method was applied to a nuclear power plant, Ulchin 56 NPP, which is located in the east coast of Korean peninsula. Through this study, whole tsunami PSA working procedure was established and example calculation was performed for one of real nuclear power plant in Korea

  13. Simulation of Unique Pressure Changing Steps and Situations in Psa Processes

    Science.gov (United States)

    Ebner, Armin D.; Mehrotra, Amal; Knox, James C.; LeVan, Douglas; Ritter, James A.

    2007-01-01

    A more rigorous cyclic adsorption process simulator is being developed for use in the development and understanding of new and existing PSA processes. Unique features of this new version of the simulator that Ritter and co-workers have been developing for the past decade or so include: multiple absorbent layers in each bed, pressure drop in the column, valves for entering and exiting flows and predicting real-time pressurization and depressurization rates, ability to account for choked flow conditions, ability to pressurize and depressurize simultaneously from both ends of the columns, ability to equalize between multiple pairs of columns, ability to equalize simultaneously from both ends of pairs of columns, and ability to handle very large pressure ratios and hence velocities associated with deep vacuum systems. These changes to the simulator now provide for unique opportunities to study the effects of novel pressure changing steps and extreme process conditions on the performance of virtually any commercial or developmental PSA process. This presentation will provide an overview of the cyclic adsorption process simulator equations and algorithms used in the new adaptation. It will focus primarily on the novel pressure changing steps and their effects on the performance of a PSA system that epitomizes the extremes of PSA process design and operation. This PSA process is a sorbent-based atmosphere revitalization (SBAR) system that NASA is developing for new manned exploration vehicles. This SBAR system consists of a 2-bed 3-step 3-layer system that operates between atmospheric pressure and the vacuum of space, evacuates from both ends of the column simultaneously, experiences choked flow conditions during pressure changing steps, and experiences a continuously changing feed composition, as it removes metabolic CO2 and H20 from a closed and fixed volume, i.e., the spacecraft cabin. Important process performance indicators of this SBAR system are size, and the

  14. Prostate cancer mortality in screen and clinically detected prostate cancer : Estimating the screening benefit

    NARCIS (Netherlands)

    van Leeuwen, Pim J.; Connolly, David; Gavin, Anna; Roobol, Monique J.; Black, Amanda; Bangma, Chris H.; Schroder, Fritz H.

    Background: To estimate the benefits of prostate-specific antigen (PSA) screening on prostate cancer (Pca) metastasis and Pca-specific mortality, we compared two populations with a well-defined difference in intensity of screening. Methods: Between 1997 and 1999, a total of 11,970 men, aged 55-74

  15. Characteristics Studies of 125I- and total PSA antibody's Binding with prostate specific antigen (PSA) in Human Uterus Tumors

    International Nuclear Information System (INIS)

    Al-Mudaffar, S.; Al-Salihi, J.

    2005-01-01

    Two groups of uterus tumors (benign and malignant) postmenopausal patients were used to investigate the presence of prostate specific antigen (PSA). Preliminary experiments were performed to follow the binding of '1 25 I-anti total PSA antibody with PSA in uterus tissues homogenates of the two groups with their corresponding antigen and found to be (8.8,7.1%) for benign and malignant tumors, respectively. An Immuno Radio Metric Assay (IRMA) procedure was developed for measuring PSA in benign and malignant uterus tumors homogenates. The optimum conditions of the binding of 125 I-anti total PSA antibody with PSA were as follows: PSA concentration (150,200 μg protein),tracer antibody concentration (125,250 μg protein), p H (7.6,7.2), temp (15,25?C) and time (1.5 hrs) for postmenopausal benign and malignant uterus tumors tissue homogenates, respectively. The use of different concentrations of Na + and Mg 2+ ions were shown to cause an increase in the binding at concentration of (125,75 mΜ) of Na 1+ ions (75,225 mΜ) of Mg 2+ ions for benign and malignant uterus tumors homogenates, respectively, while the use of different concentrations of urea and polyethylene glycol (PEG) Caused a decrease in the binding with the increase in the concentration of each of urea and PEG in the both cases

  16. Patient-specific prescriber feedback can increase the rate of osteoporosis screening and treatment: results from two national interventions.

    Science.gov (United States)

    Kalisch Ellett, Lisa M; Pratt, N L; Sluggett, J K; Ramsay, E N; Kerr, M; LeBlanc, V T; Barratt, J D; Roughead, E E

    2017-12-01

    Osteoporosis interventions targeting older Australians and clinicians were conducted in 2008 and 2011 as part of a national quality improvement program underpinned by behavioural theory and stakeholder engagement. Uptake of bone mineral density (BMD) tests among targeted men and women increased after both interventions and sustained increases in osteoporosis treatment were observed among men targeted in 2008. Educational interventions incorporating patient-specific prescriber feedback have improved osteoporosis screening and treatment among at-risk patients in clinical trials but have not been evaluated nationally. This study assessed uptake of BMD testing and osteoporosis medicines following two national Australian quality improvement initiatives targeting women (70-79 years) and men (75-85 years) at risk of osteoporosis. Administrative health claims data were used to determine monthly rates of BMD testing and initiation of osteoporosis medicines in the 9-months post-intervention among targeted men and women compared to older cohorts of men and women. Log binomial regression models were used to assess differences between groups. In 2008 91,794 patients were targeted and 52,427 were targeted in 2011. There was a twofold increase in BMD testing after each intervention among targeted patients compared to controls (p theory and stakeholder engagement that target both primary care clinicians and patients can improve osteoporosis screening and management at the national level.

  17. Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

    Directory of Open Access Journals (Sweden)

    Olga Moshkovich

    2015-01-01

    Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

  18. Ever and Annual Use of Prostate Cancer Screening in African American Men

    Science.gov (United States)

    Halbert, Chanita Hughes; Gattoni-Celli, Sebastiano; Savage, Stephen; Prasad, Sandip M.; Kittles, Rick; Briggs, Vanessa; Delmoor, Ernestine; Rice, LaShanta J.; Jefferson, Melanie; Johnson, Jerry C.

    2016-01-01

    Since prostate cancer continues to disproportionately affect African American men in terms of incidence, morbidity, and mortality, prostate-specific antigen (PSA) screening plays an important role in early detection, especially when men engage in informed decision making to accept or decline this test. The authors evaluated utilization of PSA testing among African American men based on factors that are important components of making informed decisions. Utilization of PSA testing was evaluated based on whether men had ever had PSA testing and PSA testing during the past year in a community-based sample of African American men ages 50 to 75 (n = 132). Overall, 64% of men (n = 85) reported that they had ever had a PSA test; the mean (SD) age for first use of PSA testing was 47.7 (SD = 7.4). The likelihood of ever having a PSA test increased significantly with physician communication (odds ratio [OR] = 14.2; 95% confidence interval [CI] = 4.20, 48.10; p = .0001) and with having an annual household income that was greater than $20,000 (OR = 9.80; 95% CI = 3.15, 30.51; p = .0001). The odds of ever having a PSA test were also decreased with each unit increase in future temporal orientation (OR = 0.66; 95% CI = 0.47, 0.93; p = .02). Of the men who had ever had PSA testing, 57% were screened during the past year. Only health insurance status had a significant independent association with having annual PSA testing (OR = 5.10; 95% CI = 1.67, 15.60; p = .004). Different factors were associated significantly with ever having PSA testing and annual testing among African American men. African American men may not be making an informed decision about prostate cancer screening. PMID:26240090

  19. Multiparameter FLAER-based flow cytometry for screening of paroxysmal nocturnal hemoglobinuria enhances detection rates in patients with aplastic anemia.

    Science.gov (United States)

    Sachdeva, Man Updesh Singh; Varma, Neelam; Chandra, Dinesh; Bose, Parveen; Malhotra, Pankaj; Varma, Subhash

    2015-05-01

    Flow cytometry is the gold standard methodology for screening of paroxysmal nocturnal hemoglobinuria. In the last few years, proaerolysin conjugated with fluorescein (FLAER) has become an important component of antibody panel used for the detection of paroxysmal nocturnal hemoglobinuria (PNH) clone. This study aimed to compare PNH clone detection by flow cytometry in the pre-FLAER era versus the FLAER era. This was a retrospective analysis of 4 years and included 1004 individuals screened for PNH clone, either presenting as hemolytic anemia or as aplastic anemia. In the pre-FLAER time period, the RBCs and neutrophils were screened with antibodies against CD55 and CD59. With the introduction of FLAER, neutrophils were screened with FLAER/CD24/CD15 and monocytes with FLAER/CD14/CD33 combination. A comparative analysis was done for detection of PNH clone in aplastic anemia patients versus non-aplastic anemia patients, as well as between pre-FLAER and FLAER era. Out of a total of 1004 individuals, 59 (5.8%) were detected to have PNH clone positivity. The frequency of PNH clone detected in aplastic anemia and non-aplastic anemia groups was 12.02 and 3.36%, respectively. The detection rate of PNH clone increased from 4.5% (32/711) in the pre-FLAER era to 9.2% (27/293) with the introduction of FLAER. However, this increase could be attributed to increased detection of PNH clone in the aplastic anemia group, which showed a significant increase from 8.3 to 18.2% after use of FLAER. In the non-aplastic group, PNH clone was detected with similar frequencies before and after use of FLAER (3.2 versus 3.8%, respectively). Mean PNH clone size was lower in the aplastic anemia group when compared with the non-aplastic group. RBCs always showed a lower clone size than neutrophils. PNH clone on neutrophils and monocytes was however similar. Inclusion of FLAER increases the sensitivity of the test which is especially useful in picking up small PNH clones in patients of aplastic anemia.

  20. Improved conversion rates in drug screening applications using miniaturized electrochemical cells with frit channels.

    Science.gov (United States)

    Odijk, Mathieu; Olthuis, Wouter; van den Berg, A; Qiao, Liang; Girault, Hubert

    2012-11-06

    This paper reports a novel design of a miniaturized three-electrode electrochemical cell, the purpose of which is aimed at generating drug metabolites with a high conversion efficiency. The working electrode and the counter electrode are placed in two separate channels to isolate the reaction products generated at both electrodes. The novel design includes connecting channels between these two electrode channels to provide a uniform distribution of the current density over the entire working electrode. In addition, the effect of ohmic drop is decreased. Moreover, two flow resistors are included to ensure an equal flow of analyte through both electrode channels. Total conversion of fast reacting ions is achieved at flow rates up to at least 8 μL/min, while the internal chip volume is only 175 nL. Using this electrochemical chip, the metabolism of mitoxantrone is studied by microchip electrospray ionization-mass spectrometry. At an oxidation potential of 700 mV, all known metabolites from direct oxidation are observed. The electrochemical chip performs equally well, compared to a commercially available cell, but at a 30-fold lower flow of reagents.

  1. Prostate Cancer Screening in Jamaica: Results of the Largest National Screening Clinic Prostate Cancer Screening in Jamaica: Results of the Largest National Screening Clinic

    International Nuclear Information System (INIS)

    Morrison, B. F.; Aiken, W.; Mayhew, R.; Gordon, Y.; Reid, M.

    2016-01-01

    Prostate cancer is highly prevalent in Jamaica and is the leading cause of cancer-related deaths. Our aim was to evaluate the patterns of screening in the largest organized screening clinic in Jamaica at the Jamaica Cancer Society. A retrospective analysis of all men presenting for screening at the Jamaica Cancer Society from 1995 to 2005 was done. All patients had digital rectal examinations (DRE) and prostate specific antigen (PSA) tests done. Results of prostate biopsies were noted. 1117 men of mean age 59.9 ± 8.2 years presented for screening. The median documented PSA was 1.6 ng/mL (maximum of 5170 ng/mL). Most patients presented for only 1 screen. There was a gradual reduction in the mean age of presentation for screening over the period. Prostate biopsies were requested on 11% of screening visits; however, only 59% of these were done. 5.6% of all persons screened were found to have cancer. Of the cancers diagnosed, Gleason 6 adenocarcinoma was the commonest grade and median PSA was 8.9 ng/mL (range 1.5-1059 ng/mL). Older men tend to screen for prostate cancer in Jamaica. However, compliance with regular maintenance visits and requests for confirmatory biopsies are poor. Screening needs intervention in the Jamaican population.

  2. Reliability of piping system components. Volume 1: Piping reliability - A resource document for PSA applications

    Energy Technology Data Exchange (ETDEWEB)

    Nyman, R; Erixon, S; Tomic, B; Lydell, B

    1995-12-01

    SKI has undertaken a multi-year research project to establish a comprehensive passive component failure database, validate failure rate parameter estimates and establish a model framework for integrating passive component failures in existing PSAs. Phase 1 of the project produced a relational database on worldwide piping system failure events in the nuclear and chemical industries. This phase 2 report gives a graphical presentation of piping system operating experience, and compares key failure mechanisms in commercial nuclear power plants and chemical process industry. Inadequacies of traditional PSA methodology are addressed, with directions for PSA methodology enhancements. A data-driven-and-systems-oriented analysis approach is proposed to enable assignment of unique identities to risk-significant piping system component failures. Sufficient operating experience does exist to generate quality data on piping failures. Passive component failures should be addressed by today`s PSAs to allow for aging analysis and effective, on-line risk management. 111 refs, 36 figs, 20 tabs.

  3. Reliability of piping system components. Volume 1: Piping reliability - A resource document for PSA applications

    International Nuclear Information System (INIS)

    Nyman, R.; Erixon, S.; Tomic, B.; Lydell, B.

    1995-12-01

    SKI has undertaken a multi-year research project to establish a comprehensive passive component failure database, validate failure rate parameter estimates and establish a model framework for integrating passive component failures in existing PSAs. Phase 1 of the project produced a relational database on worldwide piping system failure events in the nuclear and chemical industries. This phase 2 report gives a graphical presentation of piping system operating experience, and compares key failure mechanisms in commercial nuclear power plants and chemical process industry. Inadequacies of traditional PSA methodology are addressed, with directions for PSA methodology enhancements. A data-driven-and-systems-oriented analysis approach is proposed to enable assignment of unique identities to risk-significant piping system component failures. Sufficient operating experience does exist to generate quality data on piping failures. Passive component failures should be addressed by today's PSAs to allow for aging analysis and effective, on-line risk management. 111 refs, 36 figs, 20 tabs

  4. Pattern of Prostate-Specific Antigen (PSA) Failure Dictates the Probability of a Positive Bone Scan in Patients With an Increasing PSA After Radical Prostatectomy

    Science.gov (United States)

    Dotan, Zohar A.; Bianco, Fernando J.; Rabbani, Farhang; Eastham, James A.; Fearn, Paul; Scher, Howard I.; Kelly, Kevin W.; Chen, Hui-Ni; Schöder, Heiko; Hricak, Hedvig; Scardino, Peter T.; Kattan, Michael W.

    2007-01-01

    Purpose Physicians often order periodic bone scans (BS) to check for metastases in patients with an increasing prostate-specific antigen (PSA; biochemical recurrence [BCR]) after radical prostatectomy (RP), but most scans are negative. We studied patient characteristics to build a predictive model for a positive scan. Patients and Methods From our prostate cancer database we identified all patients with detectable PSA after RP. We analyzed the following features at the time of each bone scan for association with a positive BS: preoperative PSA, time to BCR, pathologic findings of the RP, PSA before the BS (trigger PSA), PSA kinetics (PSA doubling time, PSA slope, and PSA velocity), and time from BCR to BS. The results were incorporated into a predictive model. Results There were 414 BS performed in 239 patients with BCR and no history of androgen deprivation therapy. Only 60 (14.5%) were positive for metastases. In univariate analysis, preoperative PSA (P = .04), seminal vesicle invasion (P = .02), PSA velocity (P < .001), and trigger PSA (P < .001) predicted a positive BS. In multivariate analysis, only PSA slope (odds ratio [OR], 2.71; P = .03), PSA velocity (OR, 0.93; P = .003), and trigger PSA (OR, 1.022; P < .001) predicted a positive BS. A nomogram for predicting the bone scan result was constructed with an overfit-corrected concordance index of 0.93. Conclusion Trigger PSA, PSA velocity, and slope were associated with a positive BS. A highly discriminating nomogram can be used to select patients according to their risk for a positive scan. Omitting scans in low-risk patients could reduce substantially the number of scans ordered. PMID:15774789

  5. Hand Hygiene in Healthcare Settings 2 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.

  6. Hand Hygiene in Healthcare Settings 1 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.

  7. PSA Velocity Does Not Improve Prostate Cancer Detection

    Science.gov (United States)

    A rapid increase in prostate-specific antigen (PSA) levels is not grounds for automatically recommending a prostate biopsy, according to a study published online February 24, 2011, in the Journal of the National Cancer Institute.

  8. PSA LEVEL 3 DAN IMPLEMENTASINYA PADA KAJIAN KESELAMATAN PWR

    Directory of Open Access Journals (Sweden)

    Pande Made Udiyani

    2015-03-01

    Full Text Available Kajian keselamatan PLTN menggunakan metodologi kajian probabilistik sangat penting selain kajian deterministik. Metodologi kajian menggunakan Probabilistic Safety Assessment (PSA Level 3 diperlukan terutama untuk estimasi kecelakaan parah atau kecelakaan luar dasar desain PLTN. Metode ini banyak dilakukan setelah kejadian kecelakaan Fukushima. Dalam penelitian ini dilakukan implementasi PSA Level 3 pada kajian keselamatan PWR, postulasi kecelakan luar dasar desain PWR AP-1000 dan disimulasikan di contoh tapak Bangka Barat. Rangkaian perhitungan yang dilakukan adalah: menghitung suku sumber dari kegagalan teras yang terjadi, pemodelan kondisi meteorologi tapak dan lingkungan, pemodelan jalur paparan, analisis dispersi radionuklida dan transportasi fenomena di lingkungan, analisis deposisi radionuklida, analisis dosis radiasi, analisis perlindungan & mitigasi, dan analisis risiko. Kajian menggunakan rangkaian subsistem pada perangkat lunak PC Cosyma. Hasil penelitian membuktikan bahwa implementasi metode kajian keselamatan PSA Level 3 sangat efektif dan komprehensif terhadap estimasi dampak, konsekuensi, risiko, kesiapsiagaan kedaruratan nuklir (nuclear emergency preparedness, dan manajemen kecelakaan reaktor terutama untuk kecelakaan parah atau kecelakaan luar dasar desain PLTN. Hasil kajian dapat digunakan sebagai umpan balik untuk kajian keselamatan PSA Level 1 dan PSA Level 2. Kata kunci: PSA level 3, kecelakaan, PWR   Reactor safety assessment of nuclear power plants using probabilistic assessment methodology is most important in addition to the deterministic assessment. The methodology of Level 3 Probabilistic Safety Assessment (PSA is especially required to estimate severe accident or beyond design basis accidents of nuclear power plants. This method is carried out after the Fukushima accident. In this research, the postulations beyond design basis accidentsof PWR AP - 1000 would be taken, and simulated at West Bangka sample site. The

  9. The optimal timing to perform 18F/11C-choline PET/CT in patients with suspicion of relapse of prostate cancer: trigger PSA versus PSA velocity and PSA doubling time.

    Science.gov (United States)

    Calabria, Ferdinando; Rubello, Domenico; Schillaci, Orazio

    2014-12-09

    In the present short communication we considered the main publications focused on trigger prostate-specific antigen (PSA) and PSA kinetics that systematically compared 18F to 11C-choline PET/CT in order to establish the optimal time to perform choline PET/CT in relation to the trigger values and velocity, as well as doubling time of PSA serum levels.

  10. Activities relating to PSA in the regulatory process

    International Nuclear Information System (INIS)

    Campbell, J.F.; Grint, G.C.

    1994-01-01

    In addition to the IAEA activities concerning the use of PSA in the regulatory process there are two other international initiatives in this area by the European Commission and the OECD's Committee for Nuclear Regulatory Authorities (CRNA). The paper gives a brief outline of these activities as well as introducing an update on the regulatory use of PSA in the UK. 3 refs, 3 tabs

  11. Estimation of the uncertainties considered in NPP PSA level 2

    International Nuclear Information System (INIS)

    Kalchev, B.; Hristova, R.

    2005-01-01

    The main approaches of the uncertainties analysis are presented. The sources of uncertainties which should be considered in PSA level 2 for WWER reactor such as: uncertainties propagated from level 1 PSA; uncertainties in input parameters; uncertainties related to the modelling of physical phenomena during the accident progression and uncertainties related to the estimation of source terms are defined. The methods for estimation of the uncertainties are also discussed in this paper

  12. Child Injury: What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-04-16

    This 60 second PSA is based on the April 2012 CDC Vital Signs report. Many childhood deaths and injuries are preventable, including those caused by crashes, suffocation, poisoning, drowning, fires, and falls. The PSA discusses ways to help prevent these deaths and injuries.  Created: 4/16/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/16/2012.

  13. Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009

    Directory of Open Access Journals (Sweden)

    Kumban Walter Chuck

    2017-08-01

    Full Text Available OBJECTIVES To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS Data from the Korea National Health and Nutrition Examination Survey (2007-2009 were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer. Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001, breast cancer (38.8 vs. 44.6%, p<0.001, and cervical cancer (35.1 vs. 51.2%, p<0.001. In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9, and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9. CONCLUSIONS The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

  14. PSA Level 2 activities for RBMK reactors

    International Nuclear Information System (INIS)

    Gubler, R.

    1998-01-01

    Probabilistic safety analyses (PSAs) of the boiling water graphite moderated pressure tube reactors (RBMKs) have been developed only recently and they are limited to Level 1. Activities at the IAEA were first motivated because of the difficulties to characterize core damage for RBMK reactors. Core damage probability is used in documents of the IAEA as a convenient single valued measure, for example for probabilistic safety criteria. The limited number of PSAs that have been completed for the RBMK reactors have shown that several special features of these channel type reactors necessitate revisiting of the characterization of core damage for these reactors. Furthermore, it has become increasingly evident that detailed deterministic analysis of DBAs and beyond design basis accidents reveal considerable insights into RBMK response to various accident conditions. These analyses can also help in better characterizing the outstanding phenomenological uncertainties, improved EOPs and AM strategies, including potential risk-beneficial accident negative backfits. The deterministic efforts should be focused first on elucidating accident progression processes and phenomena, and second on finding, qualifying and implementing procedures to minimize the risk of severe accident states The IAEA PSA procedures were mainly developed in New of vessel type LWRs, and would therefore require extensions to make them directly applicable. to channel type reactors. (author) (author)

  15. Psychometric Evaluation of a Brief Parent- and Teacher-Rated Screen for Children at Risk of Conduct Disorder

    Science.gov (United States)

    Duncombe, Melissa E.; Havighurst, Sophie S.; Holland, Kerry A.; Frankling, Emma J.

    2012-01-01

    This study examined the psychometric properties of the Conduct Problems Risk Screen (CPRS), a seven-item screen derived from DSM-IV-TR criteria that can be completed by parents or teachers. The sample consisted of 4,752 Australian five- to nine-year-old primary school children. The results showed the parent and teacher screens had very good…

  16. Safety Goal, Multi-unit Risk and PSA Uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Joon-Eon [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    The safety goal is an answer of each country to the question 'How safe is safe enough?'. Table 1 shows some examples of the safety goal. However, many countries including Korea do not have the official safety goal for NPPs up to now since the establishment of safety goal is not just a technical issue but a very complex socio-technical issue. In establishing the safety goal for nuclear facilities, we have to consider various factors including not only technical aspects but also social, cultural ones. Recently, Korea is trying to establish the official safety goal. In this paper, we will review the relationship between the safety goal and Probabilistic Safety Assessment (PSA). We will also address some important technical issues to be considered in establishing the safety goal for NPPs from PSA point of view, i.e. a multi-unit risk issue and the uncertainty of PSA. In this paper, we reviewed some issues related to the safety goal and PSA. We believe that the safety goal is to be established in Korea considering the multi-unit risk. In addition, the relationship between the safety goal and PSA should be also defined clearly since PSA is the only way to answer to the question 'How safe is safe enough?'.

  17. Development of Integrated PSA Database and Application Technology

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sang Hoon; Park, Jin Hee; Kim, Seung Hwan; Choi, Sun Yeong; Jung, Woo Sik; Jeong, Kwang Sub; Ha Jae Joo; Yang, Joon Eon; Min Kyung Ran; Kim, Tae Woon

    2005-04-15

    The purpose of this project is to develop 1) the reliability database framework, 2) the methodology for the reactor trip and abnormal event analysis, and 3) the prototype PSA information DB system. We already have a part of the reactor trip and component reliability data. In this study, we extend the collection of data up to 2002. We construct the pilot reliability database for common cause failure and piping failure data. A reactor trip or a component failure may have an impact on the safety of a nuclear power plant. We perform the precursor analysis for such events that occurred in the KSNP, and to develop a procedure for the precursor analysis. A risk monitor provides a mean to trace the changes in the risk following the changes in the plant configurations. We develop a methodology incorporating the model of secondary system related to the reactor trip into the risk monitor model. We develop a prototype PSA information system for the UCN 3 and 4 PSA models where information for the PSA is inputted into the system such as PSA reports, analysis reports, thermal-hydraulic analysis results, system notebooks, and so on. We develop a unique coherent BDD method to quantify a fault tree and the fastest fault tree quantification engine FTREX. We develop quantification software for a full PSA model and a one top model.

  18. Development of PSA procedure for a criticality in reprocessing facilities

    International Nuclear Information System (INIS)

    Endo, Shigeki; Takanashi, Mitsuhiro; Ueda, Yoshinori

    2012-08-01

    Utilization of risk information for the nuclear safety regulation is being discussed in Japan. The development of probabilistic safety assessment (PSA) procedure is indispensable for the utilization of risk information. The Japan Nuclear Energy Safety Organization (JNES) has been conducting trial PSA to a model plant for major events, i.e. hydrogen explosion, solution boiling, rapid decomposition of TBP complexes, criticality, solvent fire, leakage of molten glass, leakage of high active concentrated liquid waste, loss of all AC electricity, drop of a fuel assembly, for the purpose of developing the PSA procedure for reprocessing facilities. For criticality events results of trial PSA were summarized as a report in which how to evaluate an amount of radioactive materials released from a facility and a health effect on the public were emphasized. Therefore, for criticality events the results of trial PSA were summarized in this report to emphasize procedures from making event progression scenarios to quantifying event sequences, which were not handled in the previous report, in a style of a document describing PSA procedures. (author)

  19. Generation of risk importance information from severe accident PSA model

    International Nuclear Information System (INIS)

    Seo, Mi Ro; Kim, Hyeong Taek; Moon, Chan Kook

    2012-01-01

    One of the important objects conducting Probabilistic Safety Assessment (PSA) is the relative evaluation of importance of the component or function that is greatly affected to the plant safety. This evaluation is performed by the importance assessment methods such as Risk Reduction Worth, Risk Achievement Worth, and Fuss el Vessley method from the aspect of core damage frequency (CDF). In the Level 1 PSA model, the importance of each component can be evaluated since the CDF is calculated by the combination of the branch probability of event tree and the component failure probability in the fault tree. But, the Level 2 PSA model in order to assess the containment integrity cannot evaluate the risk importance by the above methods because the model is consisted of 3 parts, plant damage status, containment event tree, and source term category. So, in the field that the Level 2 PSA risk importance information should be reflected, such as maintenance rule program, risk importance has been determined by the subjective judgment of the model developer. This study was performed in order to generate the risk importance information more objectively and systematically in the Level 2 PSA model, focused on the containment event tree in the domain PHWR Level 2 PSA model

  20. PSA Model Improvement Using Maintenance Rule Function Mapping

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Mi Ro [KHNP-CRI, Nuclear Safety Laboratory, Daejeon (Korea, Republic of)

    2011-10-15

    The Maintenance Rule (MR) program, in nature, is a performance-based program. Therefore, the risk information derived from the Probabilistic Safety Assessment model is introduced into the MR program during the Safety Significance determination and Performance Criteria selection processes. However, this process also facilitates the determination of the vulnerabilities in currently utilized PSA models and offers means of improving them. To find vulnerabilities in an existing PSA model, an initial review determines whether the safety-related MR functions are included in the PSA model. Because safety-related MR functions are related to accident prevention and mitigation, it is generally necessary for them to be included in the PSA model. In the process of determining the safety significance of each functions, quantitative risk importance levels are determined through a process known as PSA model basic event mapping to MR functions. During this process, it is common for some inadequate and overlooked models to be uncovered. In this paper, the PSA model and the MR program of Wolsong Unit 1 were used as references

  1. One Approach to the Fire PSA Uncertainty Analysis

    International Nuclear Information System (INIS)

    Simic, Z.; Mikulicic, V.; Vukovic, I.

    2002-01-01

    Experienced practical events and findings from the number of fire probabilistic safety assessment (PSA) studies show that fire has high relative importance for nuclear power plant safety. Fire PSA is a very challenging phenomenon and a number of issues are still in the area of research and development. This has a major impact on the conservatism of fire PSA findings. One way to reduce the level of conservatism is to conduct uncertainty analysis. At the top-level, uncertainty of the fire PSA can be separated in to three segments. The first segment is related to fire initiating events frequencies. The second uncertainty segment is connected to the uncertainty of fire damage. Finally, there is uncertainty related to the PSA model, which propagates this fire-initiated damage to the core damage or other analyzed risk. This paper discusses all three segments of uncertainty. Some recent experience with fire PSA study uncertainty analysis, usage of fire analysis code COMPBRN IIIe, and uncertainty evaluation importance to the final result is presented.(author)

  2. The influence of physician recommendation on prostate-specific antigen screening.

    Science.gov (United States)

    Pucheril, Daniel; Dalela, Deepansh; Sammon, Jesse; Sood, Akshay; Sun, Maxine; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas

    2015-10-01

    Prostate-specific antigen (PSA) screening is controversial, and little is known regarding a physician's effect on a patient's decision to undergo screening. This study's objective was to evaluate the effect of a patient's understanding of the risks and benefits of screening compared to the final recommendation of the provider on the patient's decision to undergo PSA screening. Using the 2012 Behavioral Risk Factor Surveillance System, men older than 55 years who did not have a history of prostate cancer/prostate "problem" and who reported a PSA test within the preceding year were considered to have undergone screening. The percentages of men informed and not informed of the risks and benefits of screening and the percentage men receiving recommendations for PSA screening from their provider were reported. Multivariable complex-sample logistic regression calculated the odds of undergoing screening. In all, 75% of men were informed of screening benefits; however, 32% were informed of screening risks. After being informed of both, 56% of men opted for PSA screening if the provider recommended it, compared with only 21% when not recommended. Men receiving a recommendation to undergo PSA testing had higher odds of undergoing screening (odds ratio [OR] = 4.98, 95% CI: 4.53-5.48) compared with those who were only informed about screening benefits (OR = 2.40, 95% CI: 2.18-2.65) or risks (OR = 0.92, 95% CI: 0.86-0.98). Significant limitations include recall and nonresponse bias. Patients' decision to undergo or forgo PSA screening is heavily influenced by the recommendation of their physician; it is imperative that physicians are cognizant of their biases and facilitate a shared decision-making process. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Prostate and Colorectal Cancer Screening Uptake among US and Foreign-Born Males: Evidence from the 2015 NHIS Survey.

    Science.gov (United States)

    Ilunga Tshiswaka, Daudet; Donley, Tiffany; Okafor, Anthony; Memiah, Peter; Mbizo, Justice

    2017-06-01

    Research suggests that prostate and colorectal cancers disproportionately affect men in the US, but little is known about the determinants of prostate-specific antigen (PSA) and colorectal cancer (CRC) screening uptake among US and foreign-born males. The purpose of this study was to investigate what factors influence prostate and colorectal cancer screening uptake among US-native born and foreign-born men. Using the 2015 National Health Interview Survey, we conducted bivariate and multivariate analyses to highlight factors associated with the uptake of prostate and colorectal cancer screening among US-native born and foreign-born men. The sample size consisted of 5651 men respondents, with the mean age of 59.7 years (SD = 12.1). Of these, more than two-fifths (42%) were aged 50-64 years old. With respect to race/ethnicity, the sample was predominantly non-Hispanic Whites (65.5%), 863 (15.6%) Hispanics, and 710 (12.4%) Blacks. Our analysis found higher rates of both US-born and foreign-born men aged 65 years or older, who had either a PSA or CRC screening tests than those aged <65 years. Results of the general multivariate model suggest that men under 50 years old, US-born and foreign-born alike, are statistically significantly less likely to have prostate or colorectal cancer screenings than men aged 65 years or above. This study highlights the influencing factors that encourage or discourage PSA and CRC screening uptake between US-native born and foreign-born men. The results of this inquiry provide an evidence-based blueprint for policymakers and interventionists seeking to address prostate and colorectal cancer among men.

  4. Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition

    DEFF Research Database (Denmark)

    Mikropoulos, Christos; Selkirk, Christina G Hutten; Saya, Sibel

    2018-01-01

    BACKGROUND: Prostate-specific antigen (PSA) and PSA-velocity (PSAV) have been used to identify men at risk of prostate cancer (PrCa). The IMPACT study is evaluating PSA screening in men with a known genetic predisposition to PrCa due to BRCA1/2 mutations. This analysis evaluates the utility of PSA...... and PSAV for identifying PrCa and high-grade disease in this cohort. METHODS: PSAV was calculated using logistic regression to determine if PSA or PSAV predicted the result of prostate biopsy (PB) in men with elevated PSA values. Cox regression was used to determine whether PSA or PSAV predicted PSA...... elevation in men with low PSAs. Interaction terms were included in the models to determine whether BRCA status influenced the predictiveness of PSA or PSAV. RESULTS: 1634 participants had ⩾3 PSA readings of whom 174 underwent PB and 45 PrCas diagnosed. In men with PSA >3.0 ng ml-l, PSAV...

  5. Congenital toxoplasma infection: monthly prenatal screening decreases transmission rate and improves clinical outcome at age 3 years.

    Science.gov (United States)

    Wallon, M; Peyron, F; Cornu, C; Vinault, S; Abrahamowicz, M; Kopp, C Bonithon; Binquet, C

    2013-05-01

    Toxoplasma infection during pregnancy exposes the fetus to risks of congenital infection and sequelae that depend heavily on gestational age (GA) at time of infection. Accurate risk estimates by GA are necessary to counsel parents and improve clinical decisions. We analyzed data from pregnant women diagnosed with acute Toxoplasma infection in Lyon (France) from 1987 to 2008 and assessed how the risks of congenital toxoplasmosis and of clinical signs at age 3 years vary depending on GA at the time of maternal infection. Among 2048 mother-infant pairs, 93.2% of mothers received prenatal treatment and 513 (24.7%) fetuses were infected. Because of a significant reduction in risk since 1992 when monthly screening was introduced (59.4% vs 46.6% at 26 GA weeks; P = .038), probabilities of infection were estimated on the basis of maternal infections diagnosed after mid-1992 (n = 1624). Probabilities of congenital infection were <10% for maternal infections before 12 weeks of gestation, rose to 20.0% at 19 weeks, and then continued increasing to 52.3% and almost 70% at 28 and 39 GA weeks, respectively. Because of a significant reduction in risk of clinical signs of congenital toxoplasmosis in infected children born from mothers diagnosed after 1995 when polymerase chain reaction testing on amniotic fluid was initiated (87/794 vs 46/1150; P = .012), probabilities of clinical signs at 3 years were estimated based on 1015 maternal infections diagnosed after 1995 including 207 infected children, with symptoms in 46 (22.2%). These analyses demonstrated that introduction of monthly prenatal screening and improvement in antenatal diagnosis were associated with a significant reduction in the rate of congenital infection and a better outcome at 3 years of age in infected children. Our updated estimates will improve individual management and counseling in areas where genotype II Toxoplasma is predominant.

  6. Predictor of response to salvage radiotherapy in patients with PSA recurrence after radical prostatectomy. The usefulness of PSA doubling time

    International Nuclear Information System (INIS)

    Numata, Kousaku; Azuma, Koji; Hashine, Katsuyoshi; Sumiyoshi, Yoshiteru

    2005-01-01

    We assessed predictors of response to salvage radiotherapy (sRT) in patients with prostate-specific antigen (PSA) recurrence after radical prostatectomy. A total of 21 patients receiving sRT for PSA recurrence without systemic progression after radical prostatectomy had medical records available for retrospective review. We defined sRT as external beam radiotherapy for patients with a continuous increase in PSA level≥0.2 ng/ml after radical prostatectomy. Response was defined as achievement of a PSA nadir of ≤0.1 ng/ml. Various pre-treatment parameters were evaluated retrospectively. The median follow-up period after sRT was 38 months. Of the 21 patients, 15 were good responders (71%). The only predictive factor was PSA doubling time (PSADT). Age and PSA level at diagnosis, Gleason score and surgical margin status were not significant predictors of response. The median PSADT in responders was 6.2 months versus 1.9 months in non-responders (P=0.019). The patients with a PSADT of ≥5 months were all responders. PSADT appears to be a good predictor of response to sRT. sRT was especially effective when PSADT was ≥5 months. (author)

  7. Murine polyomavirus virus-like particles carrying full-length human PSA protect BALB/c mice from outgrowth of a PSA expressing tumor.

    Directory of Open Access Journals (Sweden)

    Mathilda Eriksson

    Full Text Available Virus-like particles (VLPs consist of capsid proteins from viruses and have been shown to be usable as carriers of protein and peptide antigens for immune therapy. In this study, we have produced and assayed murine polyomavirus (MPyV VLPs carrying the entire human Prostate Specific Antigen (PSA (PSA-MPyVLPs for their potential use for immune therapy in a mouse model system. BALB/c mice immunized with PSA-MPyVLPs were only marginally protected against outgrowth of a PSA-expressing tumor. To improve protection, PSA-MPyVLPs were co-injected with adjuvant CpG, either alone or loaded onto murine dendritic cells (DCs. Immunization with PSA-MPyVLPs loaded onto DCs in the presence of CpG was shown to efficiently protect mice from tumor outgrowth. In addition, cellular and humoral immune responses after immunization were examined. PSA-specific CD4(+ and CD8(+ cells were demonstrated, but no PSA-specific IgG antibodies. Vaccination with DCs loaded with PSA-MPyVLPs induced an eight-fold lower titre of anti-VLP antibodies than vaccination with PSA-MPyVLPs alone. In conclusion, immunization of BALB/c mice with PSA-MPyVLPs, loaded onto DCs and co-injected with CpG, induces an efficient PSA-specific tumor protective immune response, including both CD4(+ and CD8(+ cells with a low induction of anti-VLP antibodies.

  8. Murine Polyomavirus Virus-Like Particles Carrying Full-Length Human PSA Protect BALB/c Mice from Outgrowth of a PSA Expressing Tumor

    Science.gov (United States)

    Eriksson, Mathilda; Andreasson, Kalle; Weidmann, Joachim; Lundberg, Kajsa; Tegerstedt, Karin

    2011-01-01

    Virus-like particles (VLPs) consist of capsid proteins from viruses and have been shown to be usable as carriers of protein and peptide antigens for immune therapy. In this study, we have produced and assayed murine polyomavirus (MPyV) VLPs carrying the entire human Prostate Specific Antigen (PSA) (PSA-MPyVLPs) for their potential use for immune therapy in a mouse model system. BALB/c mice immunized with PSA-MPyVLPs were only marginally protected against outgrowth of a PSA-expressing tumor. To improve protection, PSA-MPyVLPs were co-injected with adjuva