More than 1,000,000 men undergo prostate biopsy each year in the United States, most for “elevated” serum prostate specific antigen (PSA). Given the lack of specificity and unclear mortality benefit of PSA testing, methods to individualize management of elevated PSA are needed. Greater than 50% of PSA-screened prostate cancers harbor fusions between the transmembrane protease, serine 2 (TMPRSS2) and v-ets erythroblastosis virus E26 oncogene homolog (avian) (ERG) genes. Here, we report a clinical-grade, transcription-mediated amplification assay to risk stratify and detect prostate cancer noninvasively in urine. The TMPRSS2:ERG fusion transcript was quantitatively measured in prospectively collected whole urine from 1312 men at multiple centers. Urine TMPRSS2:ERG was associated with indicators of clinically significant cancer at biopsy and prostatectomy, including tumor size, high Gleason score at prostatectomy, and upgrading of Gleason grade at prostatectomy. TMPRSS2:ERG, in combination with urine prostate cancer antigen 3 (PCA3), improved the performance of the multivariate Prostate Cancer Prevention Trial risk calculator in predicting cancer on biopsy. In the biopsy cohorts, men in the highest and lowest of three TMPRSS2:ERG+PCA3 score groups had markedly different rates of cancer, clinically significant cancer by Epstein criteria, and high-grade cancer on biopsy. Our results demonstrate that urine TMPRSS2:ERG, in combination with urine PCA3, enhances the utility of serum PSA for predicting prostate cancer risk and clinically relevant cancer on biopsy.

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90 participants enrolled, and 46 scored in a moderate-to-severe-risk category; of those, 42 were referred to nutrition services.

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Background/Objective: The two most common reported barriers to nursing education are limited faculty and clinical resources. This study evaluated a new curriculum designed to immerse students in full-time clinical experiences in their final semester. Methods:This was a randomized controlled trial with a repeated-measures design. Students entering a BSN program were randomly assigned to either the new Pacesetter curriculum (50 students) or the traditional curriculum (92 students). Students in the traditional curriculum had didactic and clinical experiences each semester for four semesters. Pacesetter students completed didactic courses in the first three semesters and were in clinical 36 to 40 hours/week for the entire fourth semester. Outcome variables included course grades, HESI scores, NCLEX pass rates, graduation rates, first-year job retention rates, and PBDS performance. The data were analyzed by use of t-tests with a significance level of p < .05. Results:Pacesetter students had significantly higher HESI scores (936) in the psychiatric nursing course than the traditional students (873) (p < .05), and the traditional students had significantly higher HESI maternity nursing scores (1002) than the Pacesetter students (932) (p < .05). There were no significant differences in course grades, graduation rates, or NCLEX pass rates. First-year job retention rates were 63% for traditional students and 100% for Pacesetter students (p < .05). Conclusions:The Pacesetter students' clinical experiences allowed immersion in a clinical agency for an entire semester. Implications for nursing education include the redesign of nursing curriculum to allow total immersion in the clinical agency in the last semester.