Introduction: European Association of Urology and UK National Institute for Health and Care Excellence guidelines recommend that all men with suspicions of prostate cancer should undergo prebiopsy contrast enhanced, that is, multiparametric prostate MRI. Subsequent prostate biopsies should also be performed if MRI is positive, that is, Prostate Imaging-Reporting and Data System (PI-RADS) scores 3-5. However, several retrospective post hoc analyses have shown that this approach still leads to many unnecessary biopsy procedures. For example, 88%-96% of men with PI-RADS, three findings are still diagnosed with clinically non-significant prostate cancer or no cancer at all.
Findings 2.0.4
Methods and analysis: This is a prospective, randomised, controlled, multicentre trial, being conducted in Finland, to demonstrate non-inferiority in clinically significant cancer detection rates among men undergoing prostate biopsies post-MRI and men undergoing prostate biopsies post-MRI only after a shared decision based on individualised risk estimation. Men without previous diagnosis of prostate cancer and with abnormal digital rectal examination findings and/or prostate-specific antigen between 2.5 ug/L and 20.0 ug/L are included. We aim to recruit 830 men who are randomised at a 1:1 ratio into control (all undergo biopsies after MRI) and intervention arms (the decision to perform biopsies is based on risk estimation and shared decision-making). The primary outcome of the study is the proportion of men with clinically significant prostate cancer (Gleason 4+3 prostate cancer or higher). We will also compare the overall biopsy rate, benign biopsy rate and the detection of non-significant prostate cancer between the two study groups.
A metastatic workup should be initiated if physical findings or symptoms suggest the presence of metastasis at the time of diagnosis or for concern of metastatic disease recurrence following initial treatment of cutaneous melanoma. Distant metastasis work-up with CT (chest/abdomen/pelvis) or PET-CT may be considered if the patient has documented regional nodal micrometastasis based on results from the SLNB, although the yield is low (0.5-3.7%) and correlates with increasing tumor thickness, ulceration of the primary tumor, and/or large tumor burden in the sentinel lymph node(s). [65]
Current NCCN guidelines recommend the use of regional nodal ultrasound in certain clinical settings, including physical examination with equivocal lymph node findings. Regional nodal ultrasound has shown to be superior to palpation alone for assessment of regional lymph node metastasis and surveillance of the regional nodes. A meta-analysis of 74 studies conducted between 1990 and 2009 encompassing 10,528 patients demonstrated the superiority of ultrasonography over CT, PET, and PET-CT for detecting lymph node metastasis. [70] As such, NCCN guidelines recommend consideration of regional nodal ultrasound in patients (1) with an equivocal lymph node examination, (2) who were offered but did not undergo SLNB staging, (3) in whom SLNB was not possible or technically successful, and (4) with apositive SLNB who did not undergo complete lymph node dissection, a practice which is now typical for most SLNB-positive melanomas. [69]
I was seeing identical symptoms as waterwingz. I am on windows 10 using IDE 2.0.3 (tried build 2.0.4-nightly-20230129 with same results. (also I read somewhere that IDE 1.x does not use the pluggable msdn-discovery, but has built in msdn discovery, that explains the difference). So I will describe the symptoms first then tell you the work around. With ide 1.8.19 I get very responsive discovery but like waterwingz they don't go away very responsive. Using the Bonjour browser (has a refresh button) always sees both my network nodeMCU's and removal when turned off, pretty in sync with IDE 1.x. IDE 2.0.x I would wait hours before one would show up and disappear randomly. Running mdns-discovery.exe saw the same rarely add and usually remove soon after. I tried msdn-discovery 1.6 and 1.5 with same results. i noticed on one of the early build release notes it said query all network interfaces. So looking through the code I see it queries every 30 sec, but those queries time out after 15 secs. putting those together made me wonder if the problem was related to multiply network interfaces. IT WAS/IS. So I have a virtual interface for Docker that shows as active even when Docker is shut down. when I went to the netwoks interfaces page in settings i was able to right click and disable it, leaving only one network interface. bang mdns-discovery pick up both nodemcu's right away. I was running both V1.0.5 and V1,0,6 it was interesting that 1.0.5 was slightly more responsive than 1.0.6. hope this work around helps someone. I should probably jump on github and report an issue and the work around.
Can you share the seadrive.log when you initiate these operations? This is usually caused by failure to cache a file or uncache a file. In 2.0.4 we retry failed cache operations but not uncache operations.
@JonathanHere the log files:Seadrive.log[07/18/20 11:04:03] Starting SeaDrive client 2.0.4[07/18/20 11:04:03] rpc server started.[07/18/20 11:04:04] start to serve on pipe client[07/18/20 11:04:05] start to serve on pipe client[07/18/20 11:04:05] switching account to :445 user@account.com.[07/18/20 11:04:05] libcurl failed to GET :445/api2/repos/: SSL peer certificate or SSH remote key was not OK.[07/18/20 11:04:06] libcurl failed to GET :445/seafhttp/protocol-version: SSL peer certificate or SSH remote key was not OK.
The graph shows a scenario with 450 nodes at a throughput of 50 mps, at which the two networks consume approximately the same energy. This example highlights the above-mentioned effect, where improvement in the energy consumption of issuing a message becomes insignificant in larger networks. Although this might seem disappointing at first sight, these findings are in fact great news, because it shows that, despite GoShimmer having increased in complexity due to new protocol components, it still consumes approximately the same energy as Chrysalis! Moreover, the prototype code has yet to undergo improvements similar to the current mainnet node software upgrades that were brought about by Chrysalis. As such the IOTA 2.0 solution has additional room for energy efficiency improvements. Also, it is possible that the PoW difficulty in Chrysalis may have to be increased if the network becomes subject to spam attacks, thus increasing the energy consumed.
Overall the findings are great news, as the current IOTA mainnet shows a similar amount of nodes and network activity to the values used in the hypothetical IOTA network calculations. Moreover, GoShimmer is a research prototype, and can yet be optimized to improve efficiency. This provides an optimistic outlook for the future, as we can expect further improvements to the energy consumption of IOTA.
These findings are good news for anyone concerned about the environmental impact of blockchain and other DLTs. And people are right to be worried about distributed ledgers that use Proof of Work (PoW) as a consensus mechanism: such systems are known to be major contributors to environmental problems as they consume immense amounts of energy and produce lots of electronic waste. Especially given the urgency of climate change, we must re-evaluate the energy consumption and efficiency of the products and services that underpin our daily lives, including, increasingly, DLT.
Scientists of all sorts increasingly recognize the existence of systemic problems in science, and that as a consequence of these problems we cannot trust the results we read in journal articles. One of the biggest problems is the file-drawer problem. Indeed, it is mostly as a consequence of the file-drawer problem that in many areas most published findings are false.
Updated packages (2.0.4-0ubuntu3) are uploaded to edgy-proposed; to enter edgy-updates at least two or three independent confirmations for each bug report mentioned in the changelog with a bug number are required. To install these packages please make sure that the edgy-proposed packet is enabled in your /etc/apt/sources-listfile: 2ff7e9595c
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