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Further, health concerns, social expectancies, and/or perceived severity of cravings did not account for the effect of age on pre quit-day attrition. These findings highlight the importance of identifying empirically and theoretically informed variables associated with the pre quit-day attrition problem of young smokers.PURPOSE We investigated the ability of prostate MRI to detect Gleason Grade Group (GG) ≥2 cancer in a standardized, multi-institutional active surveillance cohort. MATERIAL AND METHODS We evaluated men enrolled in Canary Prostate Active Surveillance Study (PASS) with GG less then 2 and who underwent a biopsy within 12 months of a multiparametric MRI. Our primary outcome was biopsy reclassification to GG2 or greater. We evaluated the performance of MRI PIRADS score and clinical factors. Multivariable logistic regression models were fit with MRI and clinical factors and used to perform receiver operating curve analyses. RESULTS There were 361 participants with 395 prostate MRIs with a median follow-up of 4.1 (IQR 2.0-7.6) years. Overall, 108/395 (27%) biopsies showed reclassification. Defining positive MRI as PIRADS 3-5, the NPV and PPV for detecting GG ≥2 cancer was 83% (95% CI 76-90%) and 31% (95% CI 26-37%), respectively. PIRADS was significantly associated with reclassification (PIRADS 5 versus 1 and 2 OR = 2.71; 95% CI 1.21-6.17, p = 0.016) in a multivariable model but did not improve upon a model with only clinical factors (AUC 0.768 versus 0.762). In 194 fusion biopsies, higher grade cancer was found in targeted cores in 21 (11%) instances, while 25 (13%) had higher grade cancer found in the systematic cores. CONCLUSIONS This study adds the largest cohort data to the body of literature for MRI in active surveillance, recommending systematic biopsy in patients with a negative MRI and the inclusion of systematic biopsy in patients with a positive MRI.At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic.Introduction Orally-administered antipsychotics are effective in the management of psychosis-related disorders although generation-specific adverse drug reactions (ADRs) significantly hinder clinical outcomes, driven by issues such as patient non-compliance. Direct nose-to-brain (N2B) delivery of antipsychotics via the olfactory epithelium could avert peripheral ADRs by maximizing cerebral drug concentrations, and reducing drug levels in the periphery. However, there exist physicochemical challenges related to psychotropic drugs, alongside biochemical barriers associated with targeting the olfactory region. Nanotechnological approaches present a viable strategy for the development of intranasal antipsychotic formulations where drug stability, mucosal absorption and cerebrospinal fluid (CSF)-bioavailability can be optimized.Areas covered This review explores the unique anatomical features of the nasal cavity as a pathway for antipsychotic drug delivery to the brain. Nanocarrier-based approaches to encapsulate antipsychotics, and enhance stability, absorption and bioavailability are explored. The aim of this review is to determine current knowledge gaps for direct N2B psychotropic drug delivery, and identify clinically acceptable strategies to overcome them.Expert opinion The olfactory epithelium may be the most effective and direct administration route for antipsychotic delivery to the central nervous system (CNS). This research is novel and has the potential to revolutionize the mode of delivery of neurological medicines to the CNS in the future.Ice hockey helmet standards have primarily been developed to reduce risk of traumatic brain injury (TBI). While severe TBI has become a rare event in ice hockey, concussion, a type of mild TBI, remains a common head injury. Concussions, in ice hockey result from a number of head impact events including, collisions, stick impacts, puck impacts, falls into the boards, impacts to the glass, and falls to the ice. Helmet testing methods need to represent the impact events creating concussions in ice hockey. The purpose of this research was to develop a helmet test protocol and performance metric for concussive impacts in ice hockey. A protocol using concussion impact parameters from published literature was created that used monorail and linear impactors to impact a helmeted Hybrid III headform. The linear and rotational acceleration time curves were then used to calculate brain tissue strain using the University College Brain Trauma Model. The proposed test protocols created kinematic responses that were representative of levels associated with concussion in ice hockey. Rotational velocity and rotational acceleration were both identified as useful performance metrics representing levels of risk for concussion.Objective To explore whether distinct prostate cancer (PCa) prognoses between ethnicities could be explained by diverse characteristics in the prostate biopsy.Methods Clinical, prostate biopsy and surgical single-institution data of whites and African descendants with similar access to the health system who underwent radical prostatectomy whole gland histopathology within 60 days after biopsy from 2010 to 2011 and followed for 5 years minimum were compared.Results Among 203 included patients, 153 (75.4%) were whites and 50 (24.6%) were African descendants. The mean patients' age was 63.7 (± 6.8) years. this website Digital rectal examination (DRE) was suspected of cancer in 45.2% of the patients. The prostate biopsy core length was smaller in African descendants than in whites, overall 11.0 ± 3.2 vs 12.0 ± 2.9 mm, p = 0.037, and without neoplasia, 10.4 ± 3.8 vs 11.7 ± 3.1 mm, p = 0.038, respectively. Also, suspicious DRE showed smaller biopsy core length, overall 11.1 ± 3.2 mm vs 12.4 ± 2.6, p = 0.003, cancer positive 12.