93 research outputs found
Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists.
BackgroundAn alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries.MethodsWe evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed.ResultsRadiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms.ConclusionsGiven the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography
Accelerated inbreeding depression suggests synergistic epistasis for deleterious mutations in Drosophila melanogaster
Epistasis may have important consequences for a number of issues in quantitative genetics and evolutionary biology. In
particular, synergistic epistasis for deleterious alleles is relevant to the mutation load paradox and the evolution of sex and
recombination. Some studies have shown evidence of synergistic epistasis for spontaneous or induced deleterious mutations
appearing in mutation-accumulation experiments. However, many newly arising mutations may not actually be segregating
in natural populations because of the erasing action of natural selection. A demonstration of synergistic epistasis for naturally
segregating alleles can be achieved by means of inbreeding depression studies, as deleterious recessive allelic effects are
exposed in inbred lines. Nevertheless, evidence of epistasis from these studies is scarce and controversial. In this paper, we
report the results of two independent inbreeding experiments carried out with two different populations of Drosophila
melanogaster. The results show a consistent accelerated inbreeding depression for fitness, suggesting synergistic epistasis
among deleterious alleles. We also performed computer simulations assuming different possible models of epistasis and
mutational parameters for fitness, finding some of them to be compatible with the results observed. Our results suggest that
synergistic epistasis for deleterious mutations not only occurs among newly arisen spontaneous or induced mutations, but
also among segregating alleles in natural populationsWe acknowledge the support by Uvigo
Marine Research Centre funded by the âExcellence in Research
(INUGA)â Programme from the Regional Council of Culture, Education and Universities, with co-funding from the European Union
through the ERDF Operational Programme Galicia 2014-2020. This
work was funded by Agencia Estatal de InvestigacioÌn (AEI) (CGL2016-75904-C2-1-P), Xunta de Galicia (ED431C 2016-037) and
Fondos Feder: âUnha maneira de facer Europa.â SD was founded by a
predoctoral (FPI) grant from Ministerio de EconomĂa y
Competitividad, SpainS
Interfaces entre territĂłrio, ambiente e saĂșde na atenção primĂĄria: uma leitura bioĂ©tica
A new chronobiological approach to discriminate between acute and chronic depression using peripheral temperature, rest-activity, and light exposure parameters
Development, validity, and reliability of the General Activities of Daily Living Scale: a multidimensional measure of activities of daily living for older people
Individual differences in the Behavioral Inhibition System are associated with orbitofrontal cortex and precuneus gray matter volume
Pathways towards coexistence with large carnivores in production systems
Coexistence between livestock grazing and carnivores in rangelands is a major challenge in terms of sustainable agriculture, animal welfare, species conservation and ecosystem function. Many effective non-lethal tools exist to protect livestock from predation, yet their adoption remains limited. Using a social-ecological transformations framework, we present two qualitative models that depict transformative change in rangelands grazing. Developed through participatory processes with stakeholders from South Africa and the United States of America, the models articulate drivers of change and the essential pathways to transition from routine lethal management of carnivores towards mutually beneficial coexistence. The pathways define broad actions that incorporate multiple values in grazing systems including changes to livestock management practices, financial support, industry capacity building, research, improved governance and marketing initiatives. A key fnding is the new concept of âPredator Smart Farmingâ, a holistic and conscientious approach to agriculture, which increases the resilience of landscapes, animals (domesticated and wild) and rural livelihoods. Implementation of these multiple pathways would lead to a future system that ensures thriving agricultural communities, secure livelihoods, reduced violence toward animals, and landscapes that are productive and support species conservation and coexistence
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