Joint Active and Passive Beamforming Design for Hybrid RIS-Aided Integrated Sensing and Communication

Integrated sensing and communication(ISAC) is considered an effective technique to solve spectrum congestion in the future. In this paper, we consider a hybrid reconfigurable intelligent surface(RIS)-assisted downlink ISAC system that simultaneously serves multiple single-antenna communication users and senses multiple targets. Hybrid RIS differs from fully passive RIS in that it is composed of both active and passive elements, with the active elements having the effect of amplifying the signal in addition to phase-shifting. We maximize the achievable sum rate of communication users by collaboratively improving the beamforming matrix at the dual function base station(DFBS) and the phase-shifting matrix of the hybrid RIS, subject to the transmit power constraint at the DFBS, the signal-to-interference-plus-noise-ratio(SINR) constraint of the radar echo signal and the RIS constraint are satisfied at the same time. The builtin RIS-assisted ISAC design problem model is significantly non-convex due to the fractional objective function of this optimization problem and the coupling of the optimization variables in the objective function and constraints. As a result, we provide an effective alternating optimization approach based on fractional programming(FP) with block coordinate descent(BCD)to solve the optimization variables. Results from simulations show that the hybrid RIS-assisted ISAC system outperforms the other benchmark solutions.

Batch Active Learning for Multispectral and Hyperspectral Image Segmentation Using Similarity Graphs

Graph learning,when used as a semi-supervised learning(SSL)method,performs well for classification tasks with a low label rate.We provide a graph-based batch active learning pipeline for pixel/patch neighborhood multi-or hyperspectral image segmentation.Our batch active learning approach selects a collection of unlabeled pixels that satisfy a graph local maximum constraint for the active learning acquisition function that determines the relative importance of each pixel to the classification.This work builds on recent advances in the design of novel active learning acquisition functions(e.g.,the Model Change approach in arXiv:2110.07739)while adding important further developments including patch-neighborhood image analysis and batch active learning methods to further increase the accuracy and greatly increase the computational efficiency of these methods.In addition to improvements in the accuracy,our approach can greatly reduce the number of labeled pixels needed to achieve the same level of the accuracy based on randomly selected labeled pixels.

Passive activity enhances residual control ability in patients with complete spinal cord injury

Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.

Vulnerable brain regions in adolescent major depressive disorder:A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis

BACKGROUND Adolescent major depressive disorder(MDD)is a significant mental health concern that often leads to recurrent depression in adulthood.Resting-state functional magnetic resonance imaging(rs-fMRI)offers unique insights into the neural mechanisms underlying this condition.However,despite previous research,the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated.AIM To identify consistent vulnerable brain regions in adolescent MDD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We performed a comprehensive literature search through July 12,2023,for studies investigating brain functional changes in adolescent MDD patients.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with MDD vs healthy controls(HCs)using ALE.RESULTS Ten studies(369 adolescent MDD patients and 313 HCs)were included.Combining the ReHo and ALFF/fALFF data,the results revealed that the activity in the right cuneus and left precuneus was lower in the adolescent MDD patients than in the HCs(voxel size:648 mm3,P<0.05),and no brain region exhibited increased activity.Based on the ALFF data,we found decreased activity in the right cuneus and left precuneus in adolescent MDD patients(voxel size:736 mm3,P<0.05),with no regions exhibiting increased activity.CONCLUSION Through ALE meta-analysis,we consistently identified the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD patients,increasing our understanding of the neuropathology of affected adolescents.

Investigation of Experimental Devices for Finger Active and Passive Tactile Friction Analysis

Complicated tribological behavior occurs when human fingers touch and perceive the surfaces of objects.In this process,people use their exploration style with different conditions,such as contact load,sliding speed,sliding direction,and angle of orientation between fingers and object surface consciously or unconsciously.This work addressed interlaboratory experimental devices for finger active and passive tactile friction analysis,showing two types of finger movement.In active sliding experiment,the participant slid their finger freely against the object surface,requiring the subject to control the motion conditions themselves.For passive sliding experiments,these motion conditions were adjusted by the device.Several analysis parameters,such as contact force,vibration acceleration signals,vibration magnitude,and fingerprint deformation were recorded simultaneously.Noticeable friction differences were observed when comparing active sliding and passive sliding.For passive sliding,stick-slip behavior occurred when sliding in the distal direction,evidenced by observing the friction force and the related deformation of the fingerprint ridges.The employed devices showed good repeatability and high reliability,which enriched the design of the experimental platform and provided guidance to the standardization research in the field of tactile friction.

Single exposure passive three-dimensional information reconstruction based on an ordinary imaging system

Existing three-dimensional(3D) imaging technologies have issues such as requiring active illumination, multiple exposures, or coding modulation. We propose a passive single 3D imaging method based on an ordinary imaging system.Using the point spread function of the imaging system to realize the non-coding measurement on the target, the full-focus images and depth information of the 3D target can be extracted from a single two-dimensional(2D) image through the compressed sensing algorithm. Simulation and experiments show that this approach can complete passive 3D imaging based on an ordinary imaging system without any coding operations. This method can achieve millimeter-level vertical resolution under single exposure conditions and has the potential for real-time dynamic 3D imaging. It improves the efficiency of 3D information detection, reduces the complexity of the imaging system, and may be of considerable value to the field of computer vision and other related applications.

Task-Oriented Topology System Synthesis of Reconfigurable Legged Mobile Lander Integrating Active and Passive Metamorphoses

To explore hostile extraterrestrial landforms and construct an engineering prototype,this paper presents the task-oriented topology system synthesis of reconfigurable legged mobile lander(ReLML)with three operation modes from adjusting,landing,to roving.Compared with our preceding works,the adjusting mode with three rotations(3R)provides a totally novel exploration approach to geometrically matching and securely arriving at complex terrains dangerous to visit currently;the landing mode is redefined by two rotations one translation(2R1T),identical with the tried-and-tested Apollo and Chang'E landers to enhance survivability via reasonable touchdown buffering motion;roving mode also utilizes 2R1T motion for good motion and force properties.The reconfigurable mechanism theory is first brought into synthesizing legged mobile lander integrating active and passive metamorphoses,composed of two types of metamorphic joints and metamorphic execution and transmission mechanisms.To reveal metamorphic principles with multiple finite motions,the finite screw theory is developed to present the procedure from unified mathematical representation,modes and source phase derivations,metamorphic joint and limb design,to final structure assembly.To identify the prototype topology,the 3D optimal selection matrix method is proposed considering three operation modes,five evaluation criteria,and two topological subsystems.Finally,simulation verifies the whole task implementation process to ensure the reasonability of design.

Highly Sensitive Ammonia Gas Sensors at Room Temperature Based on the Catalytic Mechanism of N,C Coordinated Ni Single-Atom Active Center

Significant challenges are posed by the limitations of gas sensing mechanisms for trace-level detection of ammonia(NH3).In this study,we propose to exploit single-atom catalytic activation and targeted adsorption properties to achieve highly sensitive and selective NH3 gas detection.Specifically,Ni singleatom active sites based on N,C coordination(Ni-N-C)were interfacially confined on the surface of two-dimensional(2D)MXene nanosheets(Ni-N-C/Ti_(3)C_(2)Tx),and a fully flexible gas sensor(MNPE-Ni-N-C/Ti_(3)C_(2)Tx)was integrated.The sensor demonstrates a remarkable response value to 5 ppm NH3(27.3%),excellent selectivity for NH3,and a low theoretical detection limit of 12.1 ppb.Simulation analysis by density functional calculation reveals that the Ni single-atom center with N,C coordination exhibits specific targeted adsorption properties for NH3.Additionally,its catalytic activation effect effectively reduces the Gibbs free energy of the sensing elemental reaction,while its electronic structure promotes the spill-over effect of reactive oxygen species at the gas-solid interface.The sensor has a dual-channel sensing mechanism of both chemical and electronic sensitization,which facilitates efficient electron transfer to the 2D MXene conductive network,resulting in the formation of the NH3 gas molecule sensing signal.Furthermore,the passivation of MXene edge defects by a conjugated hydrogen bond network enhances the long-term stability of MXene-based electrodes under high humidity conditions.This work achieves highly sensitive room-temperature NH3 gas detection based on the catalytic mechanism of Ni single-atom active center with N,C coordination,which provides a novel gas sensing mechanism for room-temperature trace gas detection research.

Research on classification method of high myopic maculopathy based on retinal fundus images and optimized ALFA-Mix active learning algorithm

AIM:To conduct a classification study of high myopic maculopathy(HMM)using limited datasets,including tessellated fundus,diffuse chorioretinal atrophy,patchy chorioretinal atrophy,and macular atrophy,and minimize annotation costs,and to optimize the ALFA-Mix active learning algorithm and apply it to HMM classification.METHODS:The optimized ALFA-Mix algorithm(ALFAMix+)was compared with five algorithms,including ALFA-Mix.Four models,including Res Net18,were established.Each algorithm was combined with four models for experiments on the HMM dataset.Each experiment consisted of 20 active learning rounds,with 100 images selected per round.The algorithm was evaluated by comparing the number of rounds in which ALFA-Mix+outperformed other algorithms.Finally,this study employed six models,including Efficient Former,to classify HMM.The best-performing model among these models was selected as the baseline model and combined with the ALFA-Mix+algorithm to achieve satisfactor y classification results with a small dataset.RESULTS:ALFA-Mix+outperforms other algorithms with an average superiority of 16.6,14.75,16.8,and 16.7 rounds in terms of accuracy,sensitivity,specificity,and Kappa value,respectively.This study conducted experiments on classifying HMM using several advanced deep learning models with a complete training set of 4252 images.The Efficient Former achieved the best results with an accuracy,sensitivity,specificity,and Kappa value of 0.8821,0.8334,0.9693,and 0.8339,respectively.Therefore,by combining ALFA-Mix+with Efficient Former,this study achieved results with an accuracy,sensitivity,specificity,and Kappa value of 0.8964,0.8643,0.9721,and 0.8537,respectively.CONCLUSION:The ALFA-Mix+algorithm reduces the required samples without compromising accuracy.Compared to other algorithms,ALFA-Mix+outperforms in more rounds of experiments.It effectively selects valuable samples compared to other algorithms.In HMM classification,combining ALFA-Mix+with Efficient Former enhances model performance,further demonstrating the effectiveness of ALFA-Mix+.

Alterations of sleep deprivation on brain function:A coordinatebased resting-state functional magnetic resonance imaging metaanalysis

BACKGROUND Sleep deprivation is a prevalent issue that impacts cognitive function.Although numerous neuroimaging studies have explored the neural correlates of sleep loss,inconsistencies persist in the reported results,necessitating an investigation into the consistent brain functional changes resulting from sleep loss.AIM To establish the consistency of brain functional alterations associated with sleep deprivation through systematic searches of neuroimaging databases.Two metaanalytic methods,signed differential mapping(SDM)and activation likelihood estimation(ALE),were employed to analyze functional magnetic resonance imaging(fMRI)data.METHODS A systematic search performed according to PRISMA guidelines was conducted across multiple databases through July 29,2023.Studies that met specific inclusion criteria,focused on healthy subjects with acute sleep deprivation and reported whole-brain functional data in English were considered.A total of 21 studies were selected for SDM and ALE meta-analyses.RESULTS Twenty-one studies,including 23 experiments and 498 subjects,were included.Compared to pre-sleep deprivation,post-sleep deprivation brain function was associated with increased gray matter in the right corpus callosum and decreased activity in the left medial frontal gyrus and left inferior parietal lobule.SDM revealed increased brain functional activity in the left striatum and right central posterior gyrus and decreased activity in the right cerebellar gyrus,left middle frontal gyrus,corpus callosum,and right cuneus.CONCLUSION This meta-analysis consistently identified brain regions affected by sleep deprivation,notably the left medial frontal gyrus and corpus callosum,shedding light on the neuropathology of sleep deprivation and offering insights into its neurological impact.

Exploring Passive Exoskeleton-Induced Changes in Lumbar Muscle Activity

Purpose: The purpose of this study was to evaluate the effect of using a passive exoskeleton on lumbar muscle activity during lifting movements, and to determine whether muscle activity remains altered after exoskeleton removal. This study sought to identify the potential risks and benefits associated with the use of passive exoskeletons for the prevention and treatment of low back pain. Methods: Eighteen healthy adult participants lifted a 10 kg suitcase while wearing a passive exoskeleton. Muscle activity and postures were measured during lifting and before, during, and after exoskeleton use. This study examined whether the reduced muscle activity observed during exoskeleton use persisted after exoskeleton removal. Muscle activity was assessed using electromyography and postures were recorded using reflective markers and a camera. Results: The study found that Lumbar muscle activity decreased significantly (approximately 40%) during exoskeleton use compared to that without exoskeleton use. Importantly, lumbar muscle activity remained low after exoskeleton removal, at levels similar to those observed during exoskeleton use. This suggests that individuals adapted to the exoskeleton support and maintained altered muscle control, even without the exoskeleton. Conclusion: This study demonstrates that passive exoskeletons significantly reduce lumbar muscle activity during lifting tasks, and that this altered muscle control persists after exoskeleton removal. These findings contribute to the understanding of the risks and benefits of passive exoskeletons, potentially aiding their development and informing their use in the prevention and treatment of low back pain.

HPR1000： Advanced Pressurized Water Reactor with Active and Passive Safety

HPR1000 is an advanced nuclear power plant(NPP)with the significant feature of an active and passive safety design philosophy,developed by the China National Nuclear Corporation.On one hand,it is an evolutionary design based on proven technology of the existing pressurized water reactor NPP;on the other hand,it incorporates advanced design features including a 177-fuel-assembly core loaded with CF3 fuel assemblies,active and passive safety systems,comprehensive severe accident prevention and mitigation measures,enhanced protection against external events,and improved emergency response capability.Extensive verification experiments and tests have been performed for critical innovative improvements on passive systems,the reactor core,and the main equipment.The design of HPR1000fulfills the international utility requirements for advanced light water reactors and the latest nuclear safety requirements,and addresses the safety issues relevant to the Fukushima accident.Along with its outstanding safety and economy,HPR1000 provides an excellent and practicable solution for both domestic and international nuclear power markets.

Effects of active and passive training apparatus combined with rehabilitation training on lower limb function of stroke patients during recovery period

Stroke patients always spontaneously do some learning and training of motor functions; however, learning and training are not prompt and right, while patients do not have enough activity amounts. Active and passive motor training apparatus is aimed directly at lower limb training so as to stimulate nerve function through stimulating muscular movement. Based on motor mileage, motor time, various power supplies and velocity of active and passive training apparatus, we can understand the training condition and adjust training program. OBJECTIVE： To observe the effects of grade-III rehabilitation training combining with active and passive training apparatus on lower limb function, muscle strength and activity of daily living （ADL） in stroke patients during recovery period. DESIGN： Contrast observation. SETTING： Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine. PARTICIPANTS： A total of 80 patients with stroke-induced hemiplegia after stabilizing vital signs for 2 weeks were selected from Department of Rehabilitation, Jilin Academic Institute of Traditional Chinese Medicine from January to June 2007. There were 47 males and 33 females, and their ages ranged from 41 to 75 years. All patients met the diagnostic criteria of the Fourth National Cerebrovascular Disease Academic Meeting in 1995 and were diagnosed as cerebral hemorrhage or cerebral infarction through CT or MRI examinations in clinic. Patients and their parents provided the confirmed consent. Based on therapeutic orders of hospitalization, patients were randomly divided into treatment group and control group with 40 patients in each group. METHODS： Patients in the control group received physical therapy and occupational therapy combining with rehabilitative treatment based on grade-III rehabilitative treatment program, which was set by the National Cerebrovascular Disease Topic Group. In addition, patients in the treatment group were trained with active and passive motor training apparatus based on therapeutic procedures in the control group. The active and passive motor training apparatus was designed as the therapeutic style of nervous system; otherwise, the treatment was performed once a day, 30 minutes once and 6 times per week. Four weeks were regarded as a course. MAIN OUTCOME MEASURES： Before treatment, at 2 weeks after treatment and after the first course, bare-handed muscle strength examination was used to check muscle strength and muscular tension; in addition, simple Fugl-Meyer assessment （FMA） and diagnostic criteria which were set by the Fourth National Cerebrovascular Disease Academic Meeting were used to evaluate motor function of limbs and total ADL. RESULTS： All 80 stroke patients were involved in the final analysis. ① Muscle strength of lower limbs was improved in both treatment group and control group. After the first course, muscle strength in the treatment group was obviously superior to that in the control group （ x^2=6.64, P 〈 0.05）. ② After the first course, Fugl-Meyer scores in the treatment group were higher than those in the control group, and there was significant difference （t =2.82, P 〈 0.05）. ③ Muscular tension of lower limbs was not changed in both treatment group and control group after treatment （P 〉 0.05）. ④ After the first course, ADL in the treatment group was superior to that in the control group （P 〈 0.05）. Among patients in the treatment group, 24 cases （60%） had obvious progress, 16 （40%） had progress, and 0 （0%） did not have any changes. On the other hand, among patients in the control group, 13 cases （32.5%） had obvious progress, 26 （65%） had progress, and 1 （2.5%） did not have any changes. CONCLUSION： Rehabilitation training combining with active and passive motor training apparatus can promote the recovery of lower limb disorder, increase muscle strength, control spasm, improve ADL and cause satisfactorily clinical effects in stroke patients during recovery period.

Detection efficiency characteristics of free-running InGaAs/InP single photon detector using passive quenching active reset IC

InGaAs/InP avalanche photodiodes （APD） are rarely used in a free-running regime for near-infrared single photon detection. In order to overcome the detrimental afterpulsing, we demonstrate a passive quenching active reset integrated circuit. Taking advantage of the inherent fast passive quenching process and active reset to reduce reset time, the integrated circuit is useful for reducing afterpulses and is also area-efficient. We investigate the free-running single photon detector＇s afterpulsing effect, de-trapping time, dark count rate, and photon detection efficiency, and also compare with gated regime operation. After correction for deadtime and afterpulse, we find that the passive quenching active reset free-running single photon detector＇s performance is consistent with gated operation.

Active hyperspectral imaging with a supercontinuum laser source in the dark

An active hyperspectral imaging(HSI) system was built with a supercontinuum(SC) laser illuminator and a visible/near-infrared hyperspectral camera, which was used for object spectrum detection in the dark. It was demonstrated that the Gaussian-like distribution of the SC illuminator can still be used for accurate reflectance spectrum measurement once the illuminator was characterized in advance. The validity of active HSI results was demonstrated by comparison with passive results. Then, the active HSI system was used to acquire reflectance spectra of different objects in just one pushbroom measurement successfully. With algorithms of principal component analysis clustering and unsupervised K-means spectral classification, this active HSI system with high spectral and spatial resolutions was demonstrated to be efficient and applicable for specific spectrum detections.

Hybrid Passive/Active Vibration Control of a Loosely Connected Spacecraft System

In this paper,a hybrid passive/active vibration(HPAV)controller of a loosely connected spacecraft consisting of a servicing satellite,a target and an X-shape structure isolator is first proposed to suppress vibrations of the system when subjected to the impulsive external excitations during the on-orbit missions.The passive dynamic response of the combined system can be adjusted appropriately to achieve the desired vibration isolation performance by tuning the structural parameters of the bio-inspired X-shape structure.Moreover,the adaptive control design through dynamic scaling technique is selected as the active component to maintain high vibration isolation performance in the presence of parameter uncertainties such as mass of the satellite platform,the damping and rotation friction coefficients of the X-shape structure.Compared with the pure passive system and the traditional spring-mass-damper(SMD)isolator,the HPAV strategy witnesses lower transmissibility,smaller vibration amplitude and higher convergence rate when subjected to the post-capture impact.Numerical simulations demonstrate the feasibility and validity of the proposed hybrid control scheme in suppressing vibrations of the free-floating spacecraft.

Passive multiple reverse time migration imaging based on wave decomposition and normalized imaging conditions

With the development of seismic exploration,passive-source seismic data has attracted increasing attention.Ambient noise passive seismic sources exists widely in nature and industrial production.Passive seismic data is important in logging while drilling(LWD),large-scale structural exploration,etc.In this paper,we proposed a passive multiple reverse time migration imaging(PMRTMI)method based on wavefield decomposition and normalized imaging conditions method.This method differs from seismic interferometry in that it can use raw passive seismic data directly in RTM imaging without reconstruction of virtual active gather,and we use the wavefield decomposition method to eliminate the low frequency noise in RTM.Further,the energy normalized imaging condition is used in full wavefield decomposition,which can not only enhance the image quality of both edge and deep information but also overcome the wrong energy problem caused by uneven distribution of passive sources;furthermore,this method exhibits high efficiency.Finally,numerical examples with the Marmousi model show the effectiveness of the method.

Effectiveness of a 12-Week Program of Active and Passive Stretching in Improving Low Back and Neck Pain in Japanese Sedentary Men

Purpose: Muscle stretching is frequently prescribed in physical therapy to manage lower back and neck pain. However, there is no clear evidence regarding the differences in effectiveness of active and passive stretching. Therefore, we aimed to evaluate the relative effectiveness of a 12-week program of active and passive stretching on selected physical and mental stress variables of sedentary men with lower back and neck pain. Methods: A cohort of 28 sedentary men, 30 - 49 years old, were divided into two intervention groups: the passive stretching group (PSG, n = 15) and the active stretching group (ASG, n = 13). A trainer assisted with static passive stretching, while participants in the ASG were provided with an instructional video. The following outcomes were measured at the start and end of the first and twelfth week of the stretching program: physical measures (visual analogue scale score of lower back and neck pain;finger-to-floor distance, gravimetric assessment of pelvic tilt, muscle hardness of the biceps femoris, and straight-leg raising) and mental stress measures (α-amylase and cortisol levels in saliva samples). Results: Although both active and passive stretching produced acute changes in lower back and neck pain, only passive stretching yielded long-term improvement in pain, finger-to-floor distance, pelvic tilt, hardness of biceps femoris muscle and cortisol levels (p Conclusion: Passive stretching is superior to active stretching in reducing pain, increasing muscle extensibility and correcting posture among a group of sedentary men with lower back and neck pain.

Active ferromagnetic shimming of the permanent magnet for magnetic resonance imaging scanner

This paper presents an approach of active ferromagnetic shimming for C-type permanent magnetic resonance imaging （MRI） magnet. It is designed to reduce inhomogeneity of magnetostatic field of C-type permanent magnet to meet the stringent requirement for MRI applications. An optimal configuration （locations and thicknesses） of active ferromagnetic pieces is generated through calculation according to the initial field map and the demanded final homo- geneity specifications. This approach uses a minimisation technique which makes the sum of squared magnetic moment minimum to restrict the amount of the active ferromagnetic material used and the maximal thickness of pieces stacked at each hole location in the shimming hoards. Simulation and experimental results verify that the method is valid and efficient.

Role of serial multiparametric magnetic resonance imaging in prostate cancer active surveillance

AIM:To examine whether addition of 3T multiparametric magnetic resonance imaging(mp MRI)to an active surveillance protocol could detect aggressive or progressive prostate cancer.METHODS:Twenty-three patients with low risk disease were enrolled on this active surveillance study,all of which had Gleason score 6 or less disease.All patients had clinical assessments,including digital rectal examination and prostate specific antigen(PSA)testing,every 6 mo with annual 3T mp MRI scans with gadolinium contrast and minimum sextant prostate biopsies.The MRI images were anonymized of patient identifiers and clinical information and each scan underwentradiological review without the other results known.Descriptive statistics for demographics and follow-up as well as the sensitivity and specificity of mp MRI to identify prostate cancer and progressive disease were calculated.RESULTS:During follow-up(median 24.8 mo)11 of 23 patients with low-risk prostate cancer had disease progression and were taken off study to receive definitive treatment.Disease progression was identified through upstaging of Gleason score on subsequent biopsies for all 11 patients with only 2 patients also having a PSA doubling time of less than 2 years.All 23 patients had biopsy confirmed prostate cancer but only 10 had a positive index of suspicion on mp MRI scans at baseline(43.5% sensitivity).Aggressive disease prediction from baseline mpM RI scans had satisfactory specificity(81.8%)but low sensitivity(58.3%).Twentytwo patients had serial mp MRI scans and evidence of disease progression was seen for 3 patients all of whom had upstaging of Gleason score on biopsy(30% specificity and 100% sensitivity).CONCLUSION:Addition of mp MRI imaging in active surveillance decision making may help in identifying aggressive disease amongst men with indolent prostate cancer earlier than traditional methods.