In recent years, linguists have increasingly turned to the cognitive sciences to broaden their investigation into the roots and development of language. With the advent of cognitive-linguistic, ...usage-based and complex-adaptive models of language, linguists today are utilizing approaches and insights from cognitive psychology, neuropsychology, social psychology and other related fields.
A key result of this interdisciplinary approach is the concept of entrenchment - the ongoing reorganization and adaptation of communicative knowledge. Entrenchment posits that our linguistic knowledge is continuously refreshed and reorganized under the influence of social interactions. It is part of a larger, ongoing process of lifelong cognitive reorganization whose course and quality is conditioned by exposure to and use of language, and by the application of cognitive abilities and processes to language.
This volume enlists more than two dozen experts in the fields of linguistics, psycholinguistics, neurology, and cognitive psychology in providing a realistic picture of the psychological and linguistic foundations of language. Contributors examine the psychological foundations of linguistic entrenchment processes, and the role of entrenchment in first-language acquisition, second language learning, and language attrition.
Critical views of entrenchment and some of its premises and implications are discussed from the perspective of dynamic complexity theory and radical embodied cognitive science.
► A comprehensive quality assessment strategy for long-term eddy-covariance measurement is developed. ► Fundamentally based tests and algorithms are applied. ► This strategy comprises tests on ...high-frequency data, tests on fluxes and quantification of uncertainty. ► Its robustness and effectiveness is demonstrated for five test data sets. ► The resulting data quality assessment parameters are compared with alternative approaches.
Eddy-covariance measurements are performed at several hundred sites all over the world on a long-term basis. The gathered data are used to characterise ecosystem exchanges of trace gases, water and energy and to validate or constrain process-based models. There is an increasing demand on standardised and comprehensive quality flagging and uncertainty quantification of these fluxes. In this paper, we review established quality assessment procedures and present a comprehensive newly composed strategy emphasising tests on high-frequency raw data, expanding existing tests on statistics, fluxes and corrections, plus quantification of errors. Moreover, representativity of fluxes is checked by footprint analysis. This strategy is applied within the recently launched TERENO network of ecosystem observatories, and its robustness is demonstrated for data acquired with different measurement set-ups. Four test data sets from TERENO and one data set from CarboEurope-IP were subjected to this quality assessment. The presented strategy is compared with established quality assessment schemes, and it is demonstrated that unrealistic fluxes are now efficiently excluded while retaining the largest possible amount of high quality data. Additionally, the algorithms applied provide comprehensive, reproducible, qualitative and quantitative uncertainty estimates for users of eddy-covariance flux data.
Objectives
To assess the quality of videos on the surgical treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) available on YouTube, given that such ...video‐sharing platforms are frequently used as sources of patient information and the therapeutic landscape of LUTS/BPH has evolved substantially during recent years.
Materials and Methods
A systematic search for videos on YouTube addressing treatment options for LUTS/BPH was performed in May 2019. Measures assessed included basic data (e.g. number of views), grade of misinformation and reporting of conflicts of interest. The quality of content was analysed using the validated DISCERN questionnaire. Data were analysed using descriptive statistics.
Results
A total of 159 videos with a median (range) of 8570 (648–2 384 391) views were included in the analysis. Only 21 videos (13.2%) were rated as containing no misinformation, 26 (16.4%) were free of commercial bias, and two (1.3%) disclosed potential conflicts of interest. According to DISCERN, the median overall quality of the videos was low (2 out of 5 points for question 16). Only four of the 15 assessed categories (bipolar and holmium laser enucleation of the prostate, transurethral resection of the prostate and patient‐based search terms) were scored as having moderate median overall quality (3 points).
Conclusion
Most videos on the surgical treatment of LUTS/BPH on YouTube had a low quality of content, provided misinformation, were subject to commercial bias and did not report on conflicts of interest. These findings emphasize the importance of thorough doctor–patient communication and active recommendation of unbiased patient education materials.
Objectives
To compare a customized 'suture stent' with a standard ureteric stent regarding stent‐related symptoms, safety and efficacy.
Materials and Methods
Patients with urolithiasis located ...proximal to the iliac vessel crossing, requiring stenting in preparation for secondary ureterorenoscopy (URS) were randomized to standard ureteric stenting or a suture stent. Secondary ureterorenoscopy was performed 2–6 weeks later. The Ureteral Stent Symptoms Questionnaire (USSQ) was completed after 1 week, on the day before URS and 2–6 weeks after stent removal. Stent efficacy and safety were systematically assessed.
Results
A total of 88 patients were included in the analysis. The median (range) suture stent length was 10 (5–25) cm vs 26 cm for standard stents. Operation time was longer for insertion of the suture stent (24.0 vs 14.5 min; P < 0.001). Patients with a suture stent had a significantly lower USSQ urinary symptoms score 1 week after stent insertion, adjusted for baseline symptoms by subtracting scores from the final visit without indwelling stent (mean 7.1 vs 13.7, difference −6.6, 95% confidence interval CI −3.4 to −9.8; P < 0.001). Prior to secondary URS (after 2–6 weeks), baseline‐adjusted urinary symptoms (mean 4.7 vs 12.2, difference −7.5, 95% CI −4.5 to −10.4; P < 0.001) and pain subscores (11.5 vs 17.6, difference −6.1, 95% CI −0.7 to −11.6; P = 0.004) were significantly lower in the suture stent group. All other USSQ subscores showed no significant differences. Adverse events occurred in 15 patients and were similarly frequent in the two groups. No significant differences were found between the groups regarding ureteric access during secondary URS.
Conclusion
Replacement of the distal part of ureteric stents by a suture can reduce stent‐associated symptoms without restrictions regarding secondary stone removal or safety.
Temporary drainage of the upper urinary tract by internal ureteral stents is a routine procedure in endourology. However, it is associated with a clear side‐effect profile. Our aim was to evaluate ...prevention and treatment options of stent‐related symptoms. We carried out a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines using MEDLINE and SCOPUS, and identified 107 appropriate records. A high number of these studies showed clear methodological limitations. Available data clearly support the use of α1‐blockers in patients suffering from stent‐related symptoms. It seems that antimuscarinic monotherapy or combination with α1‐blockers might also play an important role, whereas the use of classical analgesics in the treatment of stent‐related symptoms has not been assessed systematically within clinical trials so far. Improvements in stent design and material seem to have the potential to reduce stent‐related symptoms. However, so far there is no type of stent with outstanding characteristics and clear evidence suggesting fundamental advantages compared with a standard double pigtail stent. Although stent diameter does not seem to influence patients’ comfort, it seems to be beneficial to choose a proper stent‐length. Coated and drug‐eluting stents, as well as intravesical drug application, seem to be promising concepts to prevent stent‐related symptoms, but still have to be considered as experimental approaches. Furthermore, thorough patient education has the potential to reduce the morbidity associated with ureteral stenting. Further research in the field seems to be mandatory.
Abstract Objective Our aim was to present a summary of the 2010 version of the European Association of Urology (EAU) guidelines on the screening, diagnosis, and treatment of clinically localised ...cancer of the prostate (PCa). Methods The working panel performed a literature review of the new data emerging from 2007 to 2010. The guidelines were updated, and level of evidence and grade of recommendation were added to the text based on a systematic review of the literature, which included a search of online databases and bibliographic reviews. Results A full version is available at the EAU office or Web site ( www.uroweb.org ). Current evidence is insufficient to warrant widespread population-based screening by prostate-specific antigen (PSA) for PCa. A systematic prostate biopsy under ultrasound guidance and local anaesthesia is the preferred diagnostic method. Active surveillance represents a viable option in men with low-risk PCa and a long life expectancy. PSA doubling time in <3 yr or a biopsy progression indicates the need for active intervention. In men with locally advanced PCa in whom local therapy is not mandatory, watchful waiting (WW) is a treatment alternative to androgen-deprivation therapy (ADT) with equivalent oncologic efficacy. Active treatment is mostly recommended for patients with localised disease and a long life expectancy with radical prostatectomy (RP) shown to be superior to WW in a prospective randomised trial. Nerve-sparing RP represents the approach of choice in organ-confined disease; neoadjuvant androgen deprivation demonstrates no improvement of outcome variables. Radiation therapy should be performed with at least 74 Gy and 78 Gy in low-risk and intermediate/high-risk PCa, respectively. For locally advanced disease, adjuvant ADT for 3 yr results in superior disease-specific and overall survival rates and represents the treatment of choice. Follow-up after local therapy is largely based on PSA, and a disease-specific history with imaging is indicated only when symptoms occur. Conclusions The knowledge in the field of PCa is rapidly changing. These EAU guidelines on PCa summarise the most recent findings and put them into clinical practice.
Good powder flowability is a key prerequisite for laser sintering powders. In this paper, the influence of rheological properties on powder behavior during dosing and coating steps was investigated ...and related to the build behavior and part properties. Five mixtures of Polyamide 11 powder with 0–0.068 wt% flow agent were tested. An insufficient amount of flow agent resulted in less powder being dosed, which further decreased with subsequent dosing steps. Flow behavior of the powder in the recoater and the amount of powder deposited was evaluated both at room temperature and at 181 °C. At operating temperature, the filling level and amount of flow agent significantly influenced powder flow in the recoater and amount of powder deposited. Test jobs indicated that good flowability impacts the stability of the building process rather than part properties. In addition, the importance of temperature dependent powder flow measurements for powder development could be shown.
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•Study of the influence of flow additives on processability of laser sintering powders•Powder rheological parameters could be correlated to process behavior on LS system•Powder movement in the recoater is essential for powder deposition•Temperature has a tremendous impact on powder rheology and powder processability
Prostatic artery embolisation (PAE) for the treatment of lower urinary tract symptoms secondary to benign prostatic obstruction (LUTS/BPO) still remains under investigation.
To compare the efficacy ...and safety of PAE and transurethral resection of the prostate (TURP) in the treatment of LUTS/BPO at 2 yr of follow-up.
A randomised, open-label trial was conducted. There were 103 participants aged ≥40 yr with refractory LUTS/BPO.
PAE versus TURP.
International Prostate Symptoms Score (IPSS) and other questionnaires, functional measures, prostate volume, and adverse events were evaluated. Changes from baseline to 2 yr were tested for differences between the two interventions with standard two-sided tests.
The mean reduction in IPSS after 2 yr was 9.21 points after PAE and 12.09 points after TURP (difference of 2.88 95% confidence interval 0.04–5.72; p = 0.047). Superiority of TURP was also found for most other patient-reported outcomes except for erectile function. PAE was less effective than TURP regarding the improvement of maximum urinary flow rate (3.9 vs 10.23 ml/s, difference of –6.33 –10.12 to –2.54; p < 0.001), reduction of postvoid residual urine (62.1 vs 204.0 ml; 141.91 43.31–240.51; p = 0.005), and reduction of prostate volume (10.66 vs 30.20 ml; 19.54 7.70–31.38; p = 0.005). Adverse events were less frequent after PAE than after TURP (total occurrence n = 43 vs 78, p = 0.005), but the distribution among severity classes was similar. Ten patients (21%) who initially underwent PAE required TURP within 2 yr due to unsatisfying clinical outcomes, which prevented further assessment of their outcomes and, therefore, represents a limitation of the study.
Inferior improvements in LUTS/BPO and a relevant re-treatment rate are found 2 yr after PAE compared with TURP. PAE is associated with fewer complications than TURP. The disadvantages of PAE regarding functional outcomes should be considered for patient selection and counselling.
Prostatic artery embolisation is safe and effective. However, compared with transurethral resection of the prostate, its disadvantages regarding subjective and objective outcomes should be considered for individual treatment choices.
A marked improvement of lower urinary tract symptoms secondary to benign prostatic obstruction can be found 24 mo after prostatic artery embolisation (PAE), and the procedure is associated with fewer adverse events than transurethral resection of the prostate (TURP). However, improvements of subjective and objective outcomes are superior after TURP, and PAE might not represent a definitive treatment for a relevant proportion of patients. This should be considered for patient selection and counselling.
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