Given a passage with a context and an answer, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
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Question: Context: The aim of this study was to visualize early stage prostate cancer (Cap) in a clinical setting. In previous studies, the results of magnetic resonance imaging (MRI) for screening Cap have rarely been confirmed by well-designed multisite prostate biopsy.', 'The prostate glands of 90 men with elevated prostate-specific antigen (PSA) were imaged by dynamic contrast-enhanced MRI (DCE-MRI) before transrectal ultrasound-guided 14-cores prostate biopsy. Each core was divided into three subcore fractions (total of 42 fractions) to generate a histological localization diagram, which was compared with localization-visualized DCE-MRI.', "The detection rate of Cap in 57 patients with PSA < 10.0 ng/ml was 36.8% as determined by the initial biopsy. DCE-MRI uncovered 92.9% of the clinically significant Caps and its specificity was 96.2% for the first biopsy session. One case with positive DCE-MRI and a negative primary biopsy was positive with additional biopsies. All of 26 DCE-MRI positive cases had significant Cap, and two of eight patients with histological Cap and negative or equivocal imaging had significant cancer. In total, 9 of 20 cases with DCE-MRI stage T2 underwent radical prostatectomy. All of them had organ-confined disease, although 33-77% (mean 63%) of them were expected to be rated T3 or higher by Partin's table.
Answer: DCE-MRI can identify early stage Cap with high sensitivity and specificity, and can predict the histological grade to some extent. DCE-MRI prior to biopsy should be applied to younger patients with surgical indications. Otherwise, we recommend the definitive diagnosis of Cap by utilizing DCE-MRI alone.

Answer: Is dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI ) a useful modality for the precise detection and staging of early prostate cancer?


Question: Context: Spinal anesthesia can be challenging in patients undergoing total joint arthroplasty because of poorly palpable surface landmarks and age-related changes in the lumbar spine. We hypothesized that pre-procedural ultrasound imaging would be effective in identifying the lumbar intervertebral spaces and would provide an accurate measure of the depth to the intrathecal space.', "Fifty patients undergoing elective total joint arthroplasty were recruited in this prospective descriptive study. Using a curved-array 2-5 MHz transducer, the lumbar spine was imaged in two views, i.e., longitudinal parasagittal (LP) and transverse midline (TM). The intervertebral levels were identified by counting upwards from the sacrum. The locations of the interlaminar spaces were identified by visualizing the ligamentum flavum-dura mater complex and the posterior aspect of the vertebral body. The needle insertion point for a midline approach was determined from the ultrasound examination and was marked on the skin of the patient's back.", 'The mean patient age was 67 +/- 10 yr, and 46% of the patients had a body mass index >30 kg . m(-2). Surface landmarks were difficult or impossible to palpate in 38% of the patients. The scan quality on the LP and TM views was adequate or better in 100 and 98% of the patients, respectively. Dural puncture was achieved with one needle insertion attempt and within two needle insertion attempts in 84% and 98% of the patients, respectively. The ultrasound-measured depth to the intrathecal space correlated well with the actual needle insertion depth (concordance correlation coefficient = 0.82, accuracy 0.95, precision 0.86), with a tendency to overestimate the depth by just 2.1 +/- 5.4 mm.
Answer: Ultrasound imaging of the lumbar spine provides clinically useful information that can facilitate spinal anesthesia in the older orthopedic patient population.

Answer: Does an ultrasound-assisted approach facilitate spinal anesthesia for total joint arthroplasty?


Question: Context: Stimuli that predict rewarding events can control choice between future actions, and this control could be mediated by δ-opioid receptors in the nucleus accumbens shell (NAc-S). Stimuli predicting the absence of important events can also guide choice, although it remains unknown whether they do so via changes in an accumbal δ-opioid receptor-related process.', 'δ-opioid receptor-eGFP mice were trained to perform two instrumental actions that delivered different food outcomes. Choice between the two actions was then tested in the presence of stimuli paired with either the delivery or the non-delivery of each of the two outcomes. Bilateral infusions of the δ-opioid receptor antagonist naltrindole into the NAc-S were used to determine the role of these receptors at the time of choice and δ-opioid receptor expression in the NAc-S used to assess functional activity.', 'A stimulus predicting a specific outcome biased choice performance towards the action previously earning that same outcome. In contrast, a stimulus signalling the absence of that outcome biased performance away from the action that delivered that outcome towards actions associated with the absence of that outcome. Both effects were associated with increased δ-opioid receptor expression on the membrane of cholinergic interneurons within the NAc-S. Furthermore, both effects were blocked by naltrindole infused into the NAc-S.
Answer: These findings suggest that δ-opioid receptors in the NAc-S were involved in the effects of predictive learning on choice between actions, whether those predictions involve the presence or absence of specific rewarding events.

Answer:
Do δ-Opioid receptors in the accumbens shell mediate the influence of both excitatory and inhibitory predictions on choice?