107 research outputs found
Performance Benchmarks for Screening Mammography
PURPOSE: To retrospectively evaluate the range of performance outcomes of the radiologist in an audit of screening mammography by using a representative sample of U.S. radiologists to allow development of performance benchmarks for screening mammography.
MATERIALS AND METHODS: Institutional review board approval was obtained, and study was HIPAA compliant. Informed consent was or was not obtained according to institutional review board guidelines. Data from 188 mammographic facilities and 807 radiologists obtained between 1996 and 2002 were analyzed from six registries from the Breast Cancer Surveillance Consortium (BCSC). Contributed data included demographic information, clinical findings, mammographic interpretation, and biopsy results. Measurements calculated were positive predictive values (PPVs) from screening mammography (PPV(1)), biopsy recommendation (PPV(2)), biopsy performed (PPV(3)), recall rate, cancer detection rate, mean cancer size, and cancer stage. Radiologist performance data are presented as 50th (median), 10th, 25th, 75th, and 90th percentiles and as graphic presentations by using smoothed curves.
RESULTS: There were 2 580 151 screening mammographic studies from 1 117 390 women (age range, /=80 years). The respective means and ranges of performance outcomes for the middle 50% of radiologists were as follows: recall rate, 9.8% and 6.4%-13.3%; PPV(1), 4.8% and 3.4%-6.2%; and PPV(2), 24.6% and 18.8%-32.0%. Mean cancer detection rate was 4.7 per 1000, and the median [corrected] mean size of invasive cancers was 13 mm. The range of performance outcomes for the middle 80% of radiologists also was presented.
CONCLUSION: Community screening mammographic performance measurements of cancer outcomes for the majority of radiologists in the BCSC surpass performance recommendations. Recall rate for almost half of radiologists, however, is higher than the recommended rate
B2B e-marketplaces in the airline industry:process drivers and performance indicators
Competitive pressures are increasing within and between different strategically oriented groups of airlines. This paper focuses on the level of efficiency improvements gained by using e-Marketplaces in the procurement process. Findings from a survey among 88 international airlines reveal that the use of Business-to-Business (B2B) e-Marketplaces does play different roles across the various airline groupings. Airlines that are involved in strategic alliances show higher joint procurement activities than airlines that are not involved in strategic alliances. However, alliances are probably viewed as loose arrangements and thus airlines may be reluctant to share information on procurement prices and processes with another airline that could also be acting as a competitor. The financial involvement in or initiation of e-Marketplaces by airlines is very low. Low cost airlines show high use of e-Marketplaces, but demonstrate little financial involvement in contrast. Overall, the categories of spares and repairs, office supplies, tools and ground support equipment (GSE) show the greatest potential for reducing costs and increasing procurement process efficiencies. The intense competitive pressures facing carriers will make their search for tools to realise even incremental savings and efficiency gains ever more urgent. There is evidence that e-Marketplaces are one tool to improve such performance indicators
Advances in diffusion MRI acquisition and processing in the Human Connectome Project
The Human Connectome Project (HCP) is a collaborative 5-year effort to map human brain connections and their variability in healthy adults. A consortium of HCP investigators will study a population of 1200 healthy adults using multiple imaging modalities, along with extensive behavioral and genetic data. In this overview, we focus on diffusion MRI (dMRI) and the structural connectivity aspect of the project. We present recent advances in acquisition and processing that allow us to obtain very high-quality in-vivo MRI data, whilst enabling scanning of a very large number of subjects. These advances result from 2 years of intensive efforts in optimising many aspects of data acquisition and processing during the piloting phase of the project. The data quality and methods described here are representative of the datasets and processing pipelines that will be made freely available to the community at quarterly intervals, beginning in 2013
Finishing the euchromatic sequence of the human genome
The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers âŒ99% of the euchromatic genome and is accurate to an error rate of âŒ1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead
The IDENTIFY study: the investigation and detection of urological neoplasia in patients referred with suspected urinary tract cancer - a multicentre observational study
Objective
To evaluate the contemporary prevalence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC] and renal cancer) in patients referred to secondary care with haematuria, adjusted for established patient risk markers and geographical variation.
Patients and Methods
This was an international multicentre prospective observational study. We included patients aged â„16 years, referred to secondary care with suspected urinary tract cancer. Patients with a known or previous urological malignancy were excluded. We estimated the prevalence of bladder cancer, UTUC, renal cancer and prostate cancer; stratified by age, type of haematuria, sex, and smoking. We used a multivariable mixed-effects logistic regression to adjust cancer prevalence for age, type of haematuria, sex, smoking, hospitals, and countries.
Results
Of the 11 059 patients assessed for eligibility, 10 896 were included from 110 hospitals across 26 countries. The overall adjusted cancer prevalence (n = 2257) was 28.2% (95% confidence interval [CI] 22.3â34.1), bladder cancer (n = 1951) 24.7% (95% CI 19.1â30.2), UTUC (n = 128) 1.14% (95% CI 0.77â1.52), renal cancer (n = 107) 1.05% (95% CI 0.80â1.29), and prostate cancer (n = 124) 1.75% (95% CI 1.32â2.18). The odds ratios for patient risk markers in the model for all cancers were: age 1.04 (95% CI 1.03â1.05; P < 0.001), visible haematuria 3.47 (95% CI 2.90â4.15; P < 0.001), male sex 1.30 (95% CI 1.14â1.50; P < 0.001), and smoking 2.70 (95% CI 2.30â3.18; P < 0.001).
Conclusions
A better understanding of cancer prevalence across an international population is required to inform clinical guidelines. We are the first to report urinary tract cancer prevalence across an international population in patients referred to secondary care, adjusted for patient risk markers and geographical variation. Bladder cancer was the most prevalent disease. Visible haematuria was the strongest predictor for urinary tract cancer
Curvature variation along the tropomyosin molecule
Complementarity between the tropomyosin supercoil and the helical contour of actinâfilaments is
required for the binding interaction of actin and tropomyosin (Li et al., 2010). Clusters of small alanine
residues in place of canonical leucines along coiledâcoil tropomyosin may be responsible for preâshaping
tropomyosin and promoting conformational complementarity to Fâactin. A longitudinal displacement
between the two chains of the tropomyosin coiledâcoil induced by the alanine clusters could produce
localized bending or limited flexibility along tropomyosin needed to shape tropomyosin (Brown and
Cohen, 2005). To evaluate the influence of alanine clusters on tropomyosin curvature, we calculated
the longitudinal displacement between amino acid residues on adjacent chains of the tropomyosin
coiledâcoil and related this ââZâdisplacement" to the position of the alanine clusters. Measurements were
made on highâresolution crystal structures of tropomyosin fragments and on trajectories from molecular
dynamics simulations of fullâlength aaâtropomyosin. We found no strict oneâforâone spatial correlation
between alanine cluster position and the Zâdisplacement. Neither did we find any direct correspondence
between the clusters and the local curvature of tropomyosin. Rather than just causing specific local structural
effects, the overall influence of alanine clusters is complex and delocalized, leading to a gradually
changing bending pattern along the length of tropomyosi
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