The impact of mammography screening programmes on incidence of advanced breast cancer in Europe: a literature review.

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were madeBACKGROUND: Observational studies have reported conflicting results on the impact of mammography service screening programmes on the advanced breast cancer rate (ABCR), a correlation that was firmly established in randomized controlled trials. We reviewed and summarized studies of the effect of service screening programmes in the European Union on ABCR and discussed their limitations. METHODS: The PubMed database was searched for English language studies published between 01-01-2000 and 01-06-2018. After inspection of titles and abstracts, 220 of the 8644 potentially eligible papers were considered relevant. Their abstracts were reviewed by groups of two authors using predefined criteria. Fifty studies were selected for full paper review, and 22 of these were eligible. A theoretical framework for their review was developed. Review was performed using a ten-point checklist of the methodological caveats in the analysis of studies of ABCR and a standardised assessment form designed to extract quantitative and qualitative information. RESULTS: Most of the evaluable studies support a reduction in ABCR following the introduction of screening. However, all studies were challenged by issues of design and analysis which could at least potentially cause bias, and showed considerable variation in the estimated effect. Problems were observed in duration of follow-up time, availability of reliable reference ABCR, definition of advanced stage, temporal variation in the proportion of unknown-stage cancers, and statistical approach. CONCLUSIONS: We conclude that much of the current controversy on the impact of service screening programmes on ABCR is due to observational data that were gathered and/or analysed with methodological approaches which could not capture stage effects in full. Future research on this important early indicator of screening effectiveness should focus on establishing consensus in the correct methodology

Microblogging and Nanotweets: Nanotechnology on Twitter

The social web represents a new arena for local, national and global conversations and will play an increasing role in the public understanding of science. This paper presents an analysis of the representations of nanotechnology on Twitter, analysing over 24,000 tweets in terms of web metrics, latent semantic and sentiment analysis. Results indicate that most active users on nanotechnology are distributed according to a power law distribution and that web metric indicators suggest little conversation on the topic. In terms of content, there is a remarkable similarity with previous studies of nanotechnology’s representations in other media outlets. Related to content is the sentiment analysis that indicates predominantly positively loaded words in the corpus. Negative sentiments mainly took the form of uncertainty and fear of the unknown rather than open hostility

Digital breast tomosynthesis (DBT): recommendations from the Italian College of Breast Radiologists (ICBR) by the Italian Society of Medical Radiology (SIRM) and the Italian Group for Mammography Screening (GISMa)

This position paper, issued by ICBR/SIRM and GISMa, summarizes the evidence on DBT and provides recommendations for its use. In the screening setting, DBT in adjunct to digital mammography (DM) increased detection rate by 0.5\u20132.7\u2030 and decreased false positives by 0.8\u20133.6% compared to DM alone in observational and double-testing experimental studies. The reduction in recall rate could be less prominent in those screening programs which already have low recall rates with DM. The increase in radiation exposure associated with DM/DBT protocols has been solved by the introduction of synthetic mammograms (sDM) reconstructed from DBT datasets. Thus, whenever possible, sDM/DBT should be preferred to DM/DBT. However, before introducing DBT as a routine screening tool for average-risk women, we should wait for the results of randomized controlled trials and for a statistically significant and clinically relevant reduction in the interval cancer rate, hopefully associated with a reduction in the advanced cancer rate. Otherwise, a potential for overdiagnosis and overtreatment cannot be excluded. Studies exploring this issue are ongoing. Screening of women at intermediate risk should follow the same recommendations, with particular protocols for women with previous BC history. In high-risk women, if mammography is performed as an adjunct to MRI or in the case of MRI contraindications, sDM/DBT protocols are suggested. Evidence exists in favor of DBT usage in women with clinical symptoms/signs and asymptomatic women with screen-detected findings recalled for work-up. The possibility to perform needle biopsy or localization under DBT guidance should be offered when DBT-only findings need characterization or surger

Cardiac Functions of Voltage-Gated Ca2+ Channels: Role of the Pharmacoresistant Type (E-/R-Type) in Cardiac Modulation and Putative Implication in Sudden Unexpected Death in Epilepsy (SUDEP)

Voltage-gated Ca2+ channels (VGCCs) are ubiquitous in excitable cells. These channels play key roles in many physiological events like cardiac regulation/ pacemaker activity due to intracellular Ca2+ transients. In the myocardium, the Cayl subfamily (L-type: C41.2 and C41.3) is the main contributor to excitation contraction coupling and/or pacemaking, whereas the Ca(v)3 subfamily (T-type: Cay3.1 and Cay3.2) is important in rhythmically firing of the cardiac nodal cells. No established cardiac function has been attributed to the Ca(v)2 family (E-/R-type: Ca(v)2.3) despite accumulating evidence of cardiac dysregulation observed upon deletion of the Ca(v)2.3 gene, the only member of this family so far detected in cardiomyocytes. In this review, we summarize the pathophysiological changes observed after ablation of the E-/R-type VGCC and propose a cardiac mechanism of action for this channel. Also, considering the role played by this channel in epilepsy and its reported sensitivity to antiepileptic drugs, a putative involvement of this channel in the cardiac mechanism of sudden unexpected death in epilepsy is also discussed