Finding cancer in mammograms : if you know it’s there, do you know where?

Humans can extract considerable information from scenes, even when these are presented extremely quickly. The ability of an experienced radiologist to rapidly detect an abnormality on a mammogram may build upon this general capacity. Although radiologists have been shown to be able to detect an abnormality ‘above chance’ at short durations, the extent to which abnormalities can be localised at brief presentations is less clear. Extending previous work, we presented radiologists with unilateral mammograms, 50% containing a mass, for 250 or 1000 ms. As the female breast varies with respect to the level of normal fibroglandular tissue, the images were categorised into high and low density (50% of each), resulting in difficult and easy searches, respectively. Participants were asked to decide whether there was an abnormality (detection) and then to locate the mass on a blank outline of the mammogram (localisation). We found both detection and localisation information for all conditions. Although there may be a dissociation between detection and localisation on a small proportion of trials, we find a number of factors that lead to the underestimation of localisation including stimulus variability, response imprecision and participant guesses. We emphasise the importance of taking these factors into account when interpreting results. The effect of density on detection and localisation highlights the importance of considering breast density in medical screening

Possible observation of phase separation near a quantum phase transition in doubly connected ultrathin superconducting cylinders of aluminum

The kinetic energy of superconducting electrons in an ultrathin, doubly connected superconducting cylinder, determined by the applied flux, increases as the cylinder diameter decreases, leading to a destructive regime around half-flux quanta and a superconductor to normal metal quantum phase transition (QPT). Regular step-like features in resistance vs. temperature curves taken at fixed flux values were observed near the QPT in ultrathin Al cylinders. It is proposed that these features are most likely resulted from a phase separation near the QPT in which normal regions nucleate in a homogeneous superconducting cylinder.Comment: 4 pages, 4 figures, to appear in Phys. Rev. Let

Thermal properties of vesicular rhyolite

Thermal diffusivity of rhyolite melt and rhyolite foam (70–80% porosity) has been measured using the radial heat transfer method. Cylindrical samples (length 50–55 mm, diameter 22 mm) of rhyolite melt and foam have been derived by heating samples of Little Glass Mountain obsidian. Using available data on heat capacity and density of rhyolite melt, the thermal conductivity of samples has been determined. The difference in thermal conductivity between rhyolite melt and foam at igneous temperatures ( 1000°C) is about one order of magnitude. The effect of thermal insulation of magmas due to vesiculation and foaming of the top layer is discussed in terms of the data obtained using a simple illustrative model of magma chamber convection

Premature death among primary care patients with a history of self-harm

PURPOSE Self-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves. METHODS During 2001–2013, a total of 385 general practices in England contributed data to the Clinical Practice Research Datalink with linkage to Office for National Statistics mortality records. We identified 30,017 persons aged 15 to 64 years with a recorded episode of self-harm. We estimated the relative risks of all-cause and cause-specific natural and unnatural mortality using a comparison cohort of 600,258 individuals matched on age, sex, and general practice. RESULTS We found an elevated risk of dying prematurely from any cause among the self-harm cohort, especially in the first year of follow-up (adjusted hazard ratio for that year, 3.6; 95% CI, 3.1–4.2). In particular, suicide risk was especially high during the first year (adjusted hazard ratio, 54.4; 95% CI, 34.3–86.3); although it declined sharply, it remained much higher than that in the comparison cohort. Large elevations of risk throughout the follow-up period were also observed for accidental, alcohol-related, and drug poisoning deaths. At 10 years of follow-up, cumulative incidence values were 6.5% (95% CI, 6.0%–7.1%) for all-cause mortality and 1.3% (95% CI, 1.2%–1.5%) for suicide. CONCLUSIONS Primary care patients who have harmed themselves are at greatly increased risk of dying prematurely by natural and unnatural causes, and especially within a year of a first episode. These individuals visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. Primary care patients with myriad comorbidities, including self-harming behavior, mental disorder, addictions, and physical illnesses, will require concerted, multipronged, multidisciplinary collaborative care approaches

Factors associated with alcohol reduction in harmful and hazardous drinkers following alcohol brief intervention in Scotland: a qualitative enquiry

Background: Alcohol Brief Intervention (ABI) uses a motivational counselling approach to support individuals to reduce excessive alcohol consumption. There is growing evidence on ABI’s use within various health care settings, although how they work and which components enhance success is largely unknown. This paper reports on the qualitative part of a mixed methods study. It explores enablers and barriers associated with alcohol reduction following an ABI. It focuses on alcohol’s place within participants’ lives and their personal perspectives on reducing consumption. There are a number of randomised controlled trials in this field though few ABI studies have addressed the experiences of hazardous/harmful drinkers. This study examines factors associated with alcohol reduction in harmful/hazardous drinkers following ABI. Methods: This qualitative study was underpinned by a realist evaluation approach and involved semistructured interviews with ten harmful or hazardous alcohol drinkers. Participants (n = 10) were from the intervention arm of a randomised controlled trial (n = 124). All had received ABI, a 20 min motivational counselling interview, six months previously, and had reduced their alcohol consumption. Interviews were recorded, transcribed verbatim and thematically analysed. Results: Participants described their views on alcohol, its’ place in their lives, their personal perspectives on reducing their consumption and future aspirations. Conclusions: The findings provide an insight into participants’ views on alcohol, ABI, and the barriers and enablers to change. Participants described a cost benefit analysis, with some conscious consideration of the advantages and disadvantages of reducing intake or abstaining from alcohol. Findings suggest that, whilst hospital admission can act as a catalyst, encouraging individuals to reflect on their alcohol consumption through ABI may consolidate this, turning this reflective moment into action. Sustainability may be enhanced by the presence of a ‘significant other’ who encourages and experiences benefit. In addition having a purpose or structure with activities linked to employment and/or social and leisure pursuits offers the potential to enhance and sustain reduced alcohol consumption. Trial registration: Trial registration number TRN NCT00982306 September 22nd 200

Transition models of care for type 1 diabetes : a systematic review

Background: Managing the care regimen for Type 1 Diabetes is challenging for emerging adults, as they take on greater responsibility for self-management. A diverse range of models of care have been implemented to improve safety and quality of care during transition between paediatric and adult services. However, evidence about acceptability and effectiveness of these is limited. Our aim was to synthesise the evidence for transition models and their components, examine the health related and psychosocial outcomes, and to identify determinants associated with the implementation of person-centred models of transition care. Method: We searched Medline, CINAHL, EMBASE and Scopus. Peer reviewed empirical studies that focused on T1D models of care published from 2010 to 2021 in English, reporting experimental, qualitative, mixed methods, and observational studies were included. Results: Fourteen studies reported on health and psychosocial outcomes, and engagement with healthcare. Three key models of care emerged: structured transition education programs (6 studies), multidisciplinary team transition support (5 studies) and telehealth/virtual care (3 studies). Compared with usual practice, three of the six structured transition education programs led to improvements in maintenance of glycaemic control, psychological well-being, and engagement with health services. Four MDT transition care models reported improved health outcomes, and improved engagement with health services, however, three studies reported no benefit. Reduced diabetes related stress and increased patient satisfaction were reported by two studies, but three reported no benefit. Telehealth and virtual group appointments improved adherence to self-management and reduced diabetes distress but did not change health outcomes. Conclusions: Although some health and psychosocial benefits are reported, the results were mixed. No studies reported on T1D transition model implementation outcomes such as acceptability, adoption, and appropriateness among clinicians or managers implementing these models. This gap needs to be addressed to support future adoption of successful models

A Framework to Manage the Complex Organisation of Collaborating: Its Application to Autonomous Systems

In this paper we present an analysis of the complexities of large group collaboration and its application to develop detailed requirements for collaboration schema for Autonomous Systems (AS). These requirements flow from our development of a framework for collaboration that provides a basis for designing, supporting and managing complex collaborative systems that can be applied and tested in various real world settings. We present the concepts of "collaborative flow" and "working as one" as descriptive expressions of what good collaborative teamwork can be in such scenarios. The paper considers the application of the framework within different scenarios and discuses the utility of the framework in modelling and supporting collaboration in complex organisational structures

Breadwinners and Homemakers: Migration and Changing Conjugal Expectations in Rural Bangladesh

The literature on marriage norms and aspirations across societies largely sees the institution as static – a tool for the assertion of masculinities and subordination of women. The changing meanings of marriage and conjugality in the contemporary context of globalisation have received scant attention. Based on research in rural Bangladesh, this article questions the usefulness of notions of autonomy and dependence in understanding conjugal relations and expectations in a context of widespread migration for extended periods, especially to overseas destinations, where mutuality is crucial for social reproduction, though in clearly genderdemarcated domains

Never the twain shall meet: a critical appraisal of the combination of discourse and psychoanalytic theory in studies of men and masculinity

In recent years there has been a number of attempts by different researchers to study men and masculinity using a combination of discourse theory and psychoanalysis. The main reason for this development is the sense that, on its own, discourse theory provides an incomplete account of masculine subjectivity. Psychoanalysis is thought to be able to fill those gaps. In this paper I want to begin by reviewing these arguments. I will provide an outline of the alleged deficiencies in discursive approaches to men and masculinity before going on to examine some of the work that has attempted the above synthesis. What I aim to show is that, for a number of reasons, such attempts are bound to fail. Instead, I will argue that better progress can be made in studies of masculinity by remaining within the theoretical boundaries of Discursive Psychology

Electron-based crystalline undulator

We discuss the features of a crystalline undulator of the novel type based on the effect of a planar channeling of ultra-relativistic electrons in a periodically bent crystals. It is demonstrated that an electron-based undulator is feasible in the tens of GeV range of the beam energies, which is noticeably higher than the energy interval allowed in a positron-based undulator. Numerical analysis of the main parameters of the undulator as well as the characteristics of the emitted undulator radiation is carried out for 20 and 50 GeV electrons channeling in diamond and silicon crystals along the (111) crystallographic planes.Comment: 16 pages, 8 figures, Latex, IOP styl