IMPROVER (Involving Men with Prostate Cancer in Engaged Research): Assessing Patient Experience With Testing, Diagnosis, And Surveillance.

BACKGROUND: Our understanding of patient experiences with prostate cancer testing for diagnosis and surveillance is limited. The aim of this study was to collaborate with patients and clinicians to understand their lived experience and unmet needs around the early detection, diagnosis and monitoring (active surveillance) of prostate cancer. METHODS: Two focus groups were held with patients (n = 20) and healthcare professionals (n = 16), to identify the main challenges in prostate cancer detection, diagnosis, and monitoring. This information formed the basis of an online questionnaire for broader dissemination. RESULTS: A total of 1138 analyzable responses were obtained from people tested for prostate cancer (69% tested positive) in Europe and the US. Only 29 healthcare professionals completed the survey. Almost one-third of people reported knowing very little/nothing about prostate cancer prior to testing. Prior disease awareness was significantly higher in those who tested negative (P < .0001). Most respondents (n = 857; 75%) felt informed about the steps involved in testing. Receiving written information was a key factor; 91% of those who felt uninformed were not given any written information. Overall, most people felt "satisfied" with the typical prostate cancer tests: PSA, DRE, mpMRI, and biopsy. However, dissatisfaction for prostate biopsy (12%) was almost double that of other tests (P < .0001). Most patients understood why each test was done, and felt that their results and next steps were clearly explained to them; though PSA scored lowest in all of these fields. Apart from PSA, test satisfaction was lower when used repeatedly for surveillance, compared to once-off detection/diagnosis. CONCLUSIONS: Greater public awareness and education around prostate cancer, as well as clear and accessible written information for patients at the beginning of their cancer journey is needed. Further research is needed into alternative, less invasive tests, particularly when used repeatedly in the surveillance population.

Rapid changes in root hydraulic conductivity and aquaporin expression in rice (Oryza sativa L.) in response to shoot removal - xylem tension as a possible signal.

Background and Aims It is not clear how plants adjust the rate of root water uptake to that of shoot water loss. The aim of this study on rice was to test the idea that root aquaporins (AQPs) and xylem tension play a role in this adjustment. Methods Three-week-old rice (Oryza sativa L.) plants, which were grown hydroponically, had their entire shoot system removed, and root hydraulic conductivity (exudation analyses) and gene expression (quantitative real-time PCR) of root plasma membrane intrinsic aquaporin proteins (PIPs) was followed within 60 min after shoot excision. Key Results All three PIP1 genes (OsPIP1;1, OsPIP1;2 and OsPIP1;3) and three of the six PIP2 genes tested (OsPIP2;1, OsPIP2;4 and OsPIP2;5) showed a rapid (5 min) and lasting (60 min) decrease in gene expression. Expression decreased by up to 85 % within 60 min. The other three PIP2 genes tested (OsPIP2;2, OsPIP2;3 and OsPIP2;6) showed a varied response, with expression decreasing either only initially (5 min) or after 60 min, or not changing at all. In a follow-up experiment, plants had their shoot system removed and the detached root system immediately connected to a vacuum pump through which some tension (80 kPa) was applied. This application of tension prevented any significant decrease in PIP expression. Conclusions Shoot removal leads to a rapid decrease in expression of all PIP1s and some PIP2s in roots of rice. Xylem tension plays some role in this process.