New theological understanding can emerge with the advancement of scientific knowledge and the use of new concepts, or older concepts in new ways. Here, the authors present a proposal to extend the ...concept of “rescue and recovery” found in the United Nations Law of the High Seas, off‐world and within a broader purview of other intelligent and self‐aware species that humans may someday encounter. The notion of a morality that extends to off‐world species is not new, but in this analysis, rescue and recovery become an imperative when any intelligent and self‐aware species is in harm's way. Rescue and recovery encompass a necessary action component except perhaps in those cases where rescuers are in danger. The authors explore three biblical examples of rescue and recovery to derive a fundamental meaning of the concept.
As the number of detected Earth-like exoplanets keeps increasing, the prospect of contact with extraterrestrial civilizations becomes day after day more plausible. It has been noticed that the ...encounter between space civilizations implies a fusion of Big Histories. By following Teilhard, the authors argue that the hypothetical contact with alien intelligent life would also result in a merging of the noospheres. The long-term perspective of this process is the awakening of the entire universe. This article provides a history of the idea of noosphere, a reconstruction of Teilhard's "sociological theory," and an exploration of the theological consequences of his theory.
The PRECISE score estimates the likelihood of radiological progression in patients on active surveillance (AS) for prostate cancer (PCa) with serial multiparametric magnetic resonance imaging ...(mpMRI). A PRECISE score of 1 or 2 denotes radiological regression, PRECISE 3 indicates stability and PRECISE 4 or 5 implies progression.
We evaluated the inter-reader reproducibility of different apparent diffusion coefficient (ADC) calculations and their relationship to the PRECISE score.
Baseline and follow-up scans (on the same MR systems) of 30 patients with visible lesions from two different institutions (University College London and Sapienza University of Rome) were analysed by two radiologists (one from each site). The PRECISE score was initially assessed in consensus. At least six weeks later, to reduce the likelihood of being influenced by the consensus PRECISE reading, each radiologist independently calculated ADC for the following: lesion, non-cancerous tissue and urine in the bladder. Normalised ADC ratios were calculated with respect to normal prostatic tissue (npADC) and urine. Spearman's correlation (ρ), intraclass correlation coefficients (ICC), differences in ADC and ROC curves were computed.
Interobserver reproducibility was very good (ρ > 0.8; ICC > 0.90). Lesion ADC (0.91 vs 0.73 × 10−3 mm2/s; p=0.025) and npADC ratio (0.68 vs 0.53; p=0.012) at follow-up mpMRI were different between patients with radiological regression or stability vs progression. Cut-offs of 0.77 × 10−3 mm2/s (lesion ADC) and 0.59 (npADC ratio) could differentiate the two groups (area under the curve: 0.74 and 0.77, respectively).
The ADC, npADC ratio and the PRECISE score should be recorded for MRI-based AS.
•ADC values are inversely correlated with the PRECISE score.•Lower ADC values on follow-up imaging are associated with radiological progression.•The role of ADC in serial MR scans during AS should be further investigated.
Purpose
To validate a novel consensus method, called target-in-target, combining human analysis of mpMRI with automated CAD system analysis, with the aim to increasing the prostate cancer detection ...rate of targeted biopsies.
Methods
A cohort of 420 patients was enrolled and 253 patients were rolled out, due to exclusion criteria. 167 patients, underwent diagnostic 3T MpMRI. Two expert radiologists evaluated the exams adopting PI-RADSv2 and CAD system. When a CAD target overlapped with a radiologic one, we performed the biopsy in the overlapping area which we defined as target-in-target. Targeted TRUS-MRI fusion biopsy was performed in 63 patients with a total of 212 targets. The MRI data of all targets were quantitatively analyzed, and diagnostic findings were compared to pathologist’s biopsy reports.
Results
CAD system diagnostic performance exhibited sensitivity and specificity scores of 55.2% and 74.1% AUC = 0.63 (0.54 ÷ 0.71) , respectively. Human readers achieved an AUC value, in ROC analysis, of 0.71 (0.63 ÷ 0.79). The target-in-target method provided a detection rate per targeted biopsy core of 81.8 % vs. a detection rate per targeted biopsy core of 68.6 % for pure PI-RADS based on target definitions. The higher per-core detection rate of the target-in-target approach was achieved irrespective of the presence of technical flaws and artifacts.
Conclusions
A novel consensus method combining human reader evaluation with automated CAD system analysis of mpMRI to define prostate biopsy targets was shown to improve the detection rate per biopsy core of TRUS-MRI fusion biopsies. Results suggest that the combination of CAD system analysis and human reader evaluation is a winning strategy to improve targeted biopsy efficiency.
Purpose
The aim of this study was to validate the role of MR/Ultrasound Fusion-Guided Targeted Biopsy as a first diagnostic modality in subjects with clinical suspicion of prostate cancer (PCa).
...Materials and methods
108 men (age range 46–78 years) with clinical suspicion for PCa (PSA > 4 ng/mL) underwent multiparametric MRI of the prostate (mpMRI) and, when suspicious lesion were found (according to the PIRADSv2 scoring system), targeted biopsy was performed. All patients without significant alteration patterns at mpMRI have been referred for follow-up at 1 year.
Results
91/108 patients showed on the mpMRI highly suspicious lesions (PIRADS 4 and 5); the remaining 17/108 patients revealed no significant alteration consistent with PCa (PIRADS 3). Among the first group of patients, 58/91 proved to be positive for PCa on the pathology report: 24 patients had a Gleason Score (GS) 6 (3 + 3); 18 patients GS 7 of which 7 (3 + 4) and 11 (4 + 3); 14 patients GS 8 (4 + 4); two patients GS 9 (5 + 4); 33 proved to be negative. Overall cancer detection rate (CDR) was 63%. However, the CDR rises significantly, up to 77%, after the 53 initial consecutive biopsies that were performed (
p
< 0,05) and thus identified as part of the learning curve. Patients of the second group (17/108) have been followed with serial PSA assessments, clinical reevaluation, and follow-up mpMRI.
Conclusion
Performing exclusively targeted MR/Ultrasound Fusion-Guided biopsies for the diagnosis of PCa in patients with suspicious PSA levels (> 4 ng/mL) increases the detection rate of clinically significant cancer, changing both the therapeutic options and the prognosis.
Los seres humanos llevan toda la vida experimentando modelos de gobernabilidad para garantizar un cierto equilibrio y una mínima satisfacción popular. Los griegos dieron con una fórmula y crearon ...Estados con una cierta representatividad del pueblo y nace lo que ellos llamaron demos Krátos, que significa algo así como gobierno del pueblo. Fue un gran invento para la gestión del pueblo por parte de los griegos, que luego se convierte en un anhelo de toda la humanidad. La democracia se expresa en el debate, en el que se supone que se manifiestan conjeturas diferentes e incluso opuestas. La arbitrariedad es defendida por las facciones opuestas, con el objetivo de delinear la geometría conceptual, sobre la cual converger temporalmente. Sin embargo, la democracia es también un espejismo de libertad (si es que ésta es realmente posible). Las diferentes conceptualizaciones y acepciones que se puedan desarrollar del mismo término pueden pervertir la esencia íntima del concepto. Y es que, de la democracia a la oligarquía hay un paso corto y una delgada línea divisoria. Con una acertada comunicación estratégica, es fácil convertirla una en la otra, y cubrir las acciones y decisiones de un gobierno autoritario con un delicado entramado mediático que difumine la verdad, si es que ésta existe. ¿Democracia para el siglo XXI? Oímos constantemente hablar de recesión, anomalías y déficits democráticos. Por eso es bueno cuestionarse y repensar los modelos democráticos. Y es lo que intentamos desgranar en este ensayo compartido, analizando recorridos históricos y escenarios contemporáneos para aventurarnos a profetizar buscando respuestas a modo de adivinación del futuro. Diferentes puntos de vista, diversas cosmogonías y distintos enfoques para reflexionar sobre un tema siempre candente y tan necesario ahora en cualquier rincón del planeta como hace 25 siglos cuando en el ágora ateniense comenzaron a plantear esta vía de gobernabilidad.
Please download the PDF to view the Editors of the XXIII International Conference "Culture, Personality, Society in the Conditions of Digitalization: Methodology and Experience of Empirical Research" ...named after professor L.N. Kogan.
LA DEMOCRACIA Riccardo Campa
Democracias emergentes y democracias en recesión. Semióticas de la transformación política,
05/2021
Book Chapter
La democracia se expresa en el debate, en el que se supone que se manifiestan conjeturas diferentes e incluso opuestas. La arbitrariedad es defendida por las facciones opuestas, con el objetivo de ...delinear la geometría conceptual, sobre la cual converger temporalmente. La pérdida de significado de la derecha y la izquierda es una función de la gestión de las infidelidades técnicas, utilizada para resolver los flujos migratorios, la equidad social y la aplicación erga omnes de los derechos positivos. Mientras que algunos argumentan el contraste entre igualdad y eficiencia, otros admiten que una distribución justa de los ingresos garantiza la
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