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1.
Prostate-specific antigen (PSA)-based screening for prostate cancer (PCa) can reduce PCa mortality, but also involves overdetection of low-risk disease with potential adverse effects. We evaluated PCa incidence among men with PSA below 3 ng/mL and no PCa diagnosis at the first screening round of the Finnish Randomized Study of Screening for PCa. Follow-up started at the first screening attendance and ended at PCa diagnosis, emigration, death or the common closing date (December 2016), whichever came first. Cox regression analysis was used to estimate hazard ratios and their confidence intervals (CI). Among men with PSA <3 ng/mL, cumulative PCa incidence was 9.1% after 17.6 years median follow-up. Cumulative incidence was 3.6% among men with baseline PSA 0 to 0.99 ng/mL, 11.5% in those with PSA 1.0 to 1.99 ng/mL and 25.7% among men with PSA 2 to 2.99 ng/mL (hazard ratio 9.0, 95% CI: 7.9-10.2 for the latter). The differences by PSA level were most striking for low-risk disease based on Gleason score and EAU risk group. PSA values <1 ng/mL indicate a very low 20-year risk, while at PSA 2 to 2.99 ng/mL risks are materially higher, with 4- to 5-fold risk for aggressive disease. Using risk-stratification and appropriate rescreening intervals will reduce screening intensity and overdetection. Using cumulative incidence of clinically significant PCa (csPCa) as the criterion, rescreening intervals could range from approximately 3 years for men with initial PSA 2 to 2.99 ng/mL, 6 years for men with PSA 1 to 1.99 ng/mL to 10 years for men with PSA <1 ng/mL.  相似文献   
2.
ObjectiveIdentifying early signs of developmental dyslexia, associated with deficient speech-sound processing, is paramount to establish early interventions. We aimed to find early speech-sound processing deficiencies in dyslexia, expecting diminished and atypically lateralized event-related potentials (ERP) and mismatch responses (MMR) in newborns at dyslexia risk.MethodsERPs were recorded to a pseudoword and its variants (vowel-duration, vowel-identity, and syllable-frequency changes) from 88 newborns at high or no familial risk. The response significance was tested, and group, laterality, and frontality effects were assessed with repeated-measures ANOVA.ResultsAn early positive and right-lateralized ERP component was elicited by standard pseudowords in both groups, the response amplitude not differing between groups. Early negative MMRs were absent in the at-risk group, and MMRs to duration changes diminished compared to controls. MMRs to vowel changes had significant laterality × group interactions resulting from right-lateralized MMRs in controls.ConclusionsThe MMRs of high-risk infants were absent or diminished, and morphologically atypical, suggesting atypical neural speech-sound discrimination.SignificanceThis atypical neural basis for speech discrimination may contribute to impaired language development, potentially leading to future reading problems.  相似文献   
3.

Objectives

To investigate the incidence and characteristics of acute time-loss injuries in Finnish junior floorball league players.

Design

Prospective cohort study with 3-year follow-up.

Methods

One hundred and eighty-six female and male players (mean age 16.6 ± 1.4) took part in the follow-up study (2011–2014). The training hours and games were recorded on a team diary. Floorball related acute injuries were registered and verified by a research physician. The injury incidence was expressed as the number of injuries per 1000 h of exposure. Incidence rate was calculated separately for games and practices, and for males and females.

Results

One hundred and forty-four acute time-loss injuries occurred. Injury incidence was 26.87 (95% CI 20.10–33.63) in junior league games, and 1.25 (95% CI 0.99–1.52) in team practices. Female players had significantly higher game injury rate (IRR 1.88, 1.12–3.19) and joint/ligament injury rate (IRR 1.70, 1.07–2.73) compared to males. Eighty-one percent of the injuries affected the lower limbs. The ankle (37%), knee (18%), and thigh (14%) were the most commonly injured body sites. More than half of injuries involved joint or ligaments (54%). Twenty-six percent of the injuries were severe causing more than 28 days absence from sports. Eight anterior cruciate ligament ruptures of the knee occurred among seven female players.

Conclusion

The study revealed that risk of ankle and knee ligament injuries is high in adolescent floorball, specifically among female players.  相似文献   
4.
We investigated neural distinctions between inflectional and derivational morphology and their interaction with lexical frequency using the mismatch negativity (MMN), an established neurophysiological index of experience-dependent linguistic memory traces and automatic syntactic processing. We presented our electroencephalography (EEG) study participants with derived and inflected words of variable lexical frequencies against their monomorphemic base forms in a passive oddball paradigm, along with acoustically matched pseudowords. Sensor space and distributed source modelling results showed that at 100–150 msec after the suffix onset, derived words elicited larger responses than inflected words. Furthermore, real derived words showed advantage over pseudo-derivations and frequent derivations elicited larger activation than less frequent ones. This pattern of results is fully in line with previous research that explained lexical MMN enhancement by an activation of strongly connected word-specific long-term memory circuits, and thus suggests stronger lexicalisation for frequently used complex words. At the same time, a strikingly different pattern was found for inflectional forms: higher response amplitude for pseudo-inflections than for real inflected words, with no clear frequency effects. This is fully in line with previous MMN results on combinatorial processing of (morpho)syntactic stimuli: higher response to ungrammatical morpheme strings than grammatical ones, which does not depend on the string's surface frequency. This pattern suggests that, for inflectional forms, combinatorial processing route dominates over whole-form storage and access. In sum, our results suggest that derivations are more likely to form unitary representations than inflections which are likely to be processed combinatorially, and imply at least partially distinct brain mechanisms for the processing and representation of these two types of morphology. These dynamic mechanisms, underpinned by perisylvian networks, are activated rapidly, at 100–150 msec after the information arrives at the input, and in a largely automatic fashion, possibly providing neural basis for the first-pass morphological processing of spoken words.  相似文献   
5.
The histopathological examination of a prostate biopsy is the basis of prostate cancer diagnostics. Prostate cancer grade and extent of cancer in the diagnostic biopsy are important determinants of patient management. Quality of the prostate biopsy and its processing may influence the outcome of the histopathological evaluation. Further, an unambiguous and concise pathology reporting is essential for an appropriate clinical decision process. Since our initial report in 2003, there have been several practice changes, including the increased uptake of follow-up biopsies of patients who are under active surveillance, increasingly taken under guidance of MRI, or who underwent a prostate-sparing therapy. Therefore, we investigated the literature on the current pathology practices and recommendations with regard to prostate biopsy processing and reporting, both at initial diagnosis and in the context of follow-up biopsies in order to update our guidelines on the optimal processing and reporting of prostate biopsies.  相似文献   
6.
7.
Electrophysiological oscillatory coherence between brain regions has been proposed to facilitate functional long‐range connectivity within neurocognitive networks. This notion is supported by intracortical recordings of coherence in singled‐out corticocortical connections in the primate cortex. However, the manner in which this operational principle manifests in the task‐sensitive connectivity that supports human naturalistic performance remains undercharacterized. Here, we demonstrate task‐sensitive reconfiguration of global patterns of coherent connectivity in association with a set of easier and more demanding naturalistic tasks, ranging from picture comparison to speech comprehension and object manipulation. Based on whole‐cortex neuromagnetic recording in healthy behaving individuals, the task‐sensitive component of long‐range corticocortical coherence was mapped at spectrally narrow‐band oscillatory frequencies between 6 and 20 Hz (theta to alpha and low‐beta bands). This data‐driven cortical mapping unveiled markedly distinct and topologically task‐relevant spatiospectral connectivity patterns for the different tasks. The results demonstrate semistable oscillatory states relevant for neurocognitive processing. The present findings decisively link human behavior to corticocortical coherence at oscillatory frequencies that are widely thought to convey long‐range, feedback‐type neural interaction in cortical functional networks. Hum Brain Mapp 36:2455–2469, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. .  相似文献   
8.
Family history (FH) is one of the few known risk factors for prostate cancer (PC). There is also new evidence about mortality reduction in screening of PC with prostate‐specific antigen (PSA). Therefore, we conducted a prospective study in the Finnish Prostate Cancer Screening Trial to evaluate the impact of FH on outcomes of PC screening. Of the 80,144 men enrolled, 31,866 men were randomized to the screening arm and were invited for screening with PSA test (cut‐off 4 ng/ml) every 4 years. At the time of each invitation, FH of PC (FH) was assessed through a questionnaire. The analysis covered a follow‐up of 12 years from randomization for all men with data on FH. Of the 23,702 (74.3%) invited men attending screening, 22,756 (96.0%) provided information of their FH. Altogether 1,723 (7.3%) men reported at least one first‐degree relative diagnosed with PC and of them 235 (13.6%) were diagnosed with PC. Men with a first‐degree FH had increased risk for PC (risk ratio (RR) 1.31, p < 0.001) and the risk was especially elevated for interval cancer (RR 1.65, 95% CI 1.27–2.15). Risk for low‐grade (Gleason 2–6) tumors was increased (RR 1.46, 95% CI 1.15–1.69), but it was decreased for Gleason 8–10 tumors (RR 0.48, 95% CI 0.25–0.95). PSA test performance (sensitivity and specificity) was slightly inferior for FH positives. No difference in PC mortality was observed in terms of FH. Our findings provide no support for selective PSA screening targeting men with FH of PC.  相似文献   
9.
The tumour, node, metastasis (TNM) classification is a universal cancer staging system, which has been used for five decades. The current seventh edition became effective in 2010 and covers six ophthalmic sites: eyelids, conjunctiva, uvea, retina, orbit, and lacrimal gland; and five cancer types: carcinoma, sarcoma, melanoma, retinoblastoma, and lymphoma. The TNM categories are based on the anatomic extent of the primary tumour (T), regional lymph node metastases (N), and systemic metastases (M). The T categories of ophthalmic cancers are based on the size of the primary tumour and any invasion of periocular structures. The anatomic category is used to determine the TNM stage that correlates with survival. Such staging is currently implemented only for carcinoma of the eyelid and melanoma of the uvea. The classification of ciliary body and choroidal melanoma is the only one based on clinical evidence so far: a database of 7369 patients analysed by the European Ophthalmic Oncology Group. It spans a prognosis from 96% 5-year survival for stage I to 97% 5-year mortality for stage IV. The most accurate criterion for prognostication in uveal melanoma is, however, analysis of chromosomal alterations and gene expression. When such data are available, the TNM stage may be used for further stratification. Prognosis in retinoblastoma is frequently assigned by using an international classification, which predicts conservation of the eye and vision, and an international staging separate from the TNM system, which predicts survival. The TNM cancer staging manual is a useful tool for all ophthalmologists managing eye cancer.  相似文献   
10.
Abstract

Deviant tones randomly embedded in a sequence of standard tones elicit an event-related potential (ERP) called the mismatch negativity (MMN), which reflects automatic stimulus-change detection in the human auditory system. When the tones are attended, deviant tones elicit also an N2b component that partly overlaps the MMN. Sequences of standard and deviant (probability 0.15) tones were presented to 13 healthy younger and 13 older subjects. Deviant stimuli were, in separate blocks, either occasional shorter duration or higher frequency tones. The interstimulus interval (ISI) was, in separate blocks, either 0.5 s or 1.5 s, and in the frequency-change condition also 4.5 s. Aging affected neither frequency nor duration of MMN with the 0.5 s ISI. This finding indicates that automatic stimulus discrimination per se is not impaired with normal aging. However, with a 4.5-s ISI the MMN/N2b-complex attenuated significantly more in the older than younger subjects. This suggests that the stimulus trace decays faster or that involuntary attention switching is less sensitive with aging.  相似文献   
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