Mammographic features and screening outcome in a randomized controlled trial comparing digital breast tomosynthesis and digital mammography

Purpose To compare the distribution of mammographic features among women recalled for further assessment after screening with digital breast tomosynthesis (DBT) versus digital mammography (DM), and to assess associations between features and final outcome of the screening, including immunohistochemical subtypes of the tumour. Methods This randomized controlled trial was performed in Bergen, Norway, and included 28,749 women, of which 1015 were recalled due to mammographic findings. Mammographic features were classified according to a modified BI-RADS-scale. The distribution were compared using 95 % confidence intervals (CI). Results Asymmetry was the most common feature of all recalls, 24.3 % (108/444) for DBT and 38.9 % (222/571) for DM. Spiculated mass was most common for breast cancer after screening with DBT (36.8 %, 35/95, 95 %CI: 27.2−47.4) while calcifications (23.0 %, 20/87, 95 %CI: 14.6−33.2) was the most frequent after DM. Among women screened with DBT, 0.13 % (95 %CI: 0.08−0.21) had benign outcome after recall due to indistinct mass while the percentage was 0.28 % (95 %CI: 0.20−0.38) for DM. The distributions were 0.70 % (95 %CI: 0.57−0.85) versus 1.46 % (95 %CI: 1.27−1.67) for asymmetry and 0.24 % (95 %CI: 0.16−0.33) versus 0.54 % (95 %CI: 0.43−0.68) for obscured mass, among women screened with DBT versus DM, respectively. Spiculated mass was the most common feature among women diagnosed with non-luminal A-like cancer after DBT and after DM. Conclusions Spiculated mass was the dominant feature for breast cancer among women screened with DBT while calcifications was the most frequent feature for DM. Further studies exploring the clinical relevance of mammographic features visible particularly on DBT are warranted.publishedVersio

Salmon lice (Lepeophtheirus salmonis) in the stomach contents of lumpfish (Cyclopterus lumpus) sampled from Norwegian fish farms: Relationship between lice grazing and operational conditions

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Reaching for the low hanging fruits : one health benefits of joint crop-livestock services for small-scale farmers

The benefits of joint health service delivery remain under-explored in One Health. Plant clinics are known to provide; ad hoc; , undocumented advice on animal health and production to farmers. To understand the scope of this activity, 180 plant doctors (extension workers) in Uganda, Kenya, Zambia, Peru and Costa Rica were surveyed and a workshop involving key stakeholders was organized in Uganda. Most (81%) plant doctors regularly received queries from farmers on livestock topics. This shows that the single sectoral approach to service delivery often does not match small-scale farmers' needs. There is growing interest among service providers, ministry officials and researchers to improve integration of farmer services to reduce operational costs and make better use of existing capacities. The workshop supported the proposal for the first 'crop-livestock clinics' to be trialled and evaluated in Uganda. This will inform other countries on the potential of joint services to mixed crop-livestock farming communities

Examining antibiotic use in Kenya: farmers’ knowledge and practices in addressing antibiotic resistance

Background: Antibiotics hold the promise of mitigating the spread of livestock diseases while enhancing productivity. However, there is global concerns surrounding the improper handling and administration of antibiotics, which has led to an alarming rise in antimicrobial resistance (AMR). Kenya is currently listed as an AMR hotspot. This study assesses farmers’ knowledge and practices on antibiotics in livestock production, knowledge on AMR as well as factors influencing farmers’ knowledge of antibiotic safety and resistance, and antibiotics use. Methods: A across-sectional, quantitative survey was employed with 319 farming households in five counties in Kenya. Multivariate regression analysis was used to identify explanatory factors. Results: About 80% of households use antibiotics in their livestock, and 58% administer the antibiotics themselves. The vast majority of farmers buy antibiotics without a prescription. Antibiotics are used for both therapeutic and non-therapeutic purposes, the latter mainly in form of growth promoters and feed enhancers in poultry. The withdrawal periods reported by farmers are shorter than the officially recommended periods. Although the majority of farmers reported risky antibiotic practices, most (76%) were well aware of bacterial AMR. Nineteen of 21 knowledge statements on AMR and safe use of antibiotics were answered correctly by 55–89% of respondents, indicating considerable farmer knowledge on different aspects of antibiotics risk, while certain knowledge gaps remain. Number of livestock owned was the factor most positively influencing farmers’ knowledge on AMR and safe use. Conclusion: Kenya has made notable progress towards creating knowledge and awareness of farming communities on the risks and requirements associated with antibiotic use in livestock. Nonetheless, farmers’ antibiotics practices continue to constitute considerable risk of further AMR development. This shows that knowledge is not enough to ensure fundamental behavioral change. There needs to be an enabling environment driven by (1) effective policy interventions and enforcement to ensure compliance with set guidelines for antibiotic use; (2) research on and deployment of alternatives, such as probiotics, vaccinations and disease prevention measures, (3) continued public awareness raising and education using multiple channels to reach farmers and, (4) strengthened cross-sector, multi-stakeholder collaboration to address the multi-dimensional complexities of AMR

Sequence variants with large effects on cardiac electrophysiology and disease.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadFeatures of the QRS complex of the electrocardiogram, reflecting ventricular depolarisation, associate with various physiologic functions and several pathologic conditions. We test 32.5 million variants for association with ten measures of the QRS complex in 12 leads, using 405,732 electrocardiograms from 81,192 Icelanders. We identify 190 associations at 130 loci, the majority of which have not been reported before, including associations with 21 rare or low-frequency coding variants. Assessment of genes expressed in the heart yields an additional 13 rare QRS coding variants at 12 loci. We find 51 unreported associations between the QRS variants and echocardiographic traits and cardiovascular diseases, including atrial fibrillation, complete AV block, heart failure and supraventricular tachycardia. We demonstrate the advantage of in-depth analysis of the QRS complex in conjunction with other cardiovascular phenotypes to enhance our understanding of the genetic basis of myocardial mass, cardiac conduction and disease

Genetic variability in the absorption of dietary sterols affects the risk of coronary artery disease.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadAims: To explore whether variability in dietary cholesterol and phytosterol absorption impacts the risk of coronary artery disease (CAD) using as instruments sequence variants in the ABCG5/8 genes, key regulators of intestinal absorption of dietary sterols. Methods and results: We examined the effects of ABCG5/8 variants on non-high-density lipoprotein (non-HDL) cholesterol (N up to 610 532) and phytosterol levels (N = 3039) and the risk of CAD in Iceland, Denmark, and the UK Biobank (105 490 cases and 844 025 controls). We used genetic scores for non-HDL cholesterol to determine whether ABCG5/8 variants confer greater risk of CAD than predicted by their effect on non-HDL cholesterol. We identified nine rare ABCG5/8 coding variants with substantial impact on non-HDL cholesterol. Carriers have elevated phytosterol levels and are at increased risk of CAD. Consistent with impact on ABCG5/8 transporter function in hepatocytes, eight rare ABCG5/8 variants associate with gallstones. A genetic score of ABCG5/8 variants predicting 1 mmol/L increase in non-HDL cholesterol associates with two-fold increase in CAD risk [odds ratio (OR) = 2.01, 95% confidence interval (CI) 1.75-2.31, P = 9.8 × 10-23] compared with a 54% increase in CAD risk (OR = 1.54, 95% CI 1.49-1.59, P = 1.1 × 10-154) associated with a score of other non-HDL cholesterol variants predicting the same increase in non-HDL cholesterol (P for difference in effects = 2.4 × 10-4). Conclusions: Genetic variation in cholesterol absorption affects levels of circulating non-HDL cholesterol and risk of CAD. Our results indicate that both dietary cholesterol and phytosterols contribute directly to atherogenesis. Keywords: ABCG5/8; Absorption; Dietary cholesterol; Genetics; Phytosterols.Novo Nordisk Foundation University College London Hospital National Institute for Health Research Biomedical Research Centr