Impact of an Information Technology–Enabled Initiative on the Quality of Prostate Multiparametric MRI Reports

Rationale and Objectives: Assess the impact of implementing a structured report template and a computer-aided diagnosis (CAD) tool on the quality of prostate multiparametric MRI (mp-MRI) reports. Materials and Methods: Institutional Review Board approval was obtained for this HIPAA-compliant study performed at an academic medical center. The study cohort included all prostate mp-MRI reports (n=385) finalized 6 months before and after implementation of a structured report template and a CAD tool (collectively the IT tools) integrated into the PACS workstation. Primary outcome measure was quality of prostate mp-MRI reports. An expert panel of our institution’s subspecialty trained abdominal radiologists defined prostate mp-MRI report quality as optimal, satisfactory or unsatisfactory based on documentation of 9 variables. Reports were reviewed to extract the predefined quality variables and determine whether the IT tools were used to create each report. Chi-square and Student’s t-tests were used to compare report quality before and after implementation of IT tools. Results: The overall proportion of optimal or satisfactory reports increased from 29.8% (47/158) to 53.3% (121/227) (p<0.001) after implementing the IT tools. While the proportion of optimal or satisfactory reports increased among reports generated using at least one of the IT tools (47/158=[29.8%] vs. 105/161=[65.2%]; p<0.001), there was no change in quality among reports generated without use of the IT tools (47/158=[29.8%] vs. 16/66=[24.2%]; p=0.404). Conclusion: The use of a structured template and CAD tool improved the quality of prostate mp-MRI reports compared to free-text report format and subjective measurement of contrast enhancement kinetic curve

Biopolítica, Governamentalidade Digital e Tanatopolítica: idosos e a pandemia de covid-19

 Este artigo é um ensaio que aborda a pandemia pelo Covid-19, a partir de uma perspectiva biopolítica e biodigital, assinalando aspectos da precariedade acirrada vivida por idosos frente ao contágio pelo novo coronavírus e os efeitos nefastos deste em suas existências. Busca-se pensar elementos da sociedade de controle e os enquadramentos da política de morte dirigida a este grupo social quanto ao deixar morrer e ao estigma voltado aos idosos como estratégia de gestão da população, no presente. Portanto, visamos analisar práticas sociais que produzem quadros de ausência de proteção, de reconhecimento e expansão da vida de grupos marcados pelo envelhecimento, constituindo-os como um peso e problema para a sociedade contemporânea. Com efeito, utiliza-se a velhice como figura de um viver que não tem valor e não é digno de comoção nem passível de luto durante a gestão da pandemia por Covid-19.Palavras-chave: Idosos. Pandemia de Covid-19. Biopolítica. Biovigilância. Precariedade. Biopolitics, Digital and Tanatopolitical Governance: elderly people and the pandemic of covid-19ABSTRACT This article is an essay that addresses the Covid-19 pandemic, from a biopolitical and biodigital perspective, pointing out aspects of the severe precariousness experienced by the elderly in the face of contagion by the new coronavirus and its harmful effects on their lives. It seeks to think about elements of the control society and the framework of the death policy directed at this social group regarding the letting die and the stigma towards the elderly as a population management strategy, at present. Therefore, we aim to analyze social practices that produce situations of lack of protection, recognition and expansion of the lives of groups marked by aging, constituting them as a weight and problem for contemporary society. Indeed, old age is used as a figure of living that has no value and is not worthy of commotion or mourning during the pandemic management by Covid-19. Keywords: Elderly. Covid-19 Pandemic. Biopolitics. Biovigilance. Precariousness

Assessing Strength of Evidence of Appropriate Use Criteria for Diagnostic Imaging Examinations

Objective For health information technology tools to fully inform evidence-based decisions, recommendations must be reliably assessed for quality and strength of evidence. We aimed to create an annotation framework for grading recommendations regarding appropriate use of diagnostic imaging examinations. Methods The annotation framework was created by an expert panel (clinicians in three medical specialties, medical librarians, and biomedical scientists) who developed a process for achieving consensus in assessing recommendations, and evaluated by measuring agreement in grading the strength of evidence for 120 empirically selected recommendations using the Oxford Levels of Evidence. Results Eighty-two percent of recommendations were assigned to Level 5 (expert opinion). Inter-annotator agreement was 0.70 on initial grading (κ = 0.35, 95% CI, 0.23-0.48). After systematic discussion utilizing the annotation framework, agreement increased significantly to 0.97 (κ = 0.88, 95% CI, 0.77-0.99). Conclusions A novel annotation framework was effective for grading the strength of evidence supporting appropriate use criteria for diagnostic imaging exams

Cuttings of post fire epicormic shoots of Ilex paraguariensis and Cabralea canjerana adult plants

ABSTRACT: The aim of this research was to evaluate the feasibility of rescuing adult plants by cuttings from post-fire epicormic shoots. We evaluated the native tree species erva mate ( Ilex paraguariensis St. Hil.) and canjerana ( Cabralea canjerana Vell. Mart.), which present difficult seedling production and are economically and ecologically important. The plant material used for the preparation of cuttings consisted of shoots from bud differentiation of tissue from the stem collar of the trees. One-bud cuttings of erva mate were treated with 4000 or 8000mg L-1 of indolebutiric acid (IBA) and the checks were not treated with auxins. The cuttings were grown in three different substrates: carbonized rice husks, vermiculite and coarse sand. The experiment was a factorial with a completely random design and five replicates of five cuttings. One-bud cuttings from the basal, intermediate and apical parts of canjerna shoots were treated with 0 or 6000mg L-1 of IBA and planted in commercial substrate and coarse sand (3:2 v/v). The experiment was a factorial with a completely random design and ten replicates of three cuttings. Cuttings from post-fire epicormic shoots can be used for rescuing erva mate and canjerana adult plants. Erva mate cuttings treated with 8000mgL-1 IBA have increased rooting when grown in coarse sand. Canjerana cuttings from the basal part of epicormic shoots have greater survival and rooting than those from intermediate and apical parts