The impact of focused training on abnormality detection and provision of accurate preliminary clinical evaluation in newly qualified radiographers

Introduction: Preliminary clinical evaluation (PCE) can be a useful initial assessment of traumatic abnormalities by frontline radiographers; new graduates are expected to have the skills and knowledge required to provide this initial interpretation. This study evaluates the abnormality detection performance and accuracy of PCE commenting in newly qualified radiographers. Method: Four newly qualified radiographers completed a fracture/dislocation detection task consisting of 58 cases, including providing a PCE for each suspicious area. Following this, an 8-week training program was completed to improve competence in recognizing abnormalities and providing an accurate PCE. Equally weighted jackknife alternative free-response receiver operating characteristic (wJAFROC) analysis was performed; a difference between pre- and post-training would be considered significant at a test alpha of less than 0.05. Results: Fracture/dislocation detection was significantly better in the post-training evaluation for fixed observers and random cases (F (1,57) = 4.48, p = 0.0387). The reader averaged wJAFROC FOM and 95% CIs for pre- and post-training were 0.619 (0.516, 0.737) and 0.703 (0.622, 0.852). A paired t-test demonstrated a significant difference in PCE scores in favour of the post-training evaluation p = 0.0006. This small cohort demonstrated difficulty in recognising undisplaced fractures and buckle fractures. Conclusion: An 8-week training program had a positive impact on participants’ ability to localise and accurately describe fractures. Implementation of abnormality detection training should be considered during preceptorship periods. Due to the small sample size, it is inappropriate to suggest these findings are representative of all graduate radiographers

Constraints imposed by non-functional protein–protein interactions on gene expression and proteome size

Crowded intracellular environments present a challenge for proteins to form functional specific complexes while reducing non-functional interactions with promiscuous non-functional partners. Here we show how the need to minimize the waste of resources to non-functional interactions limits the proteome diversity and the average concentration of co-expressed and co-localized proteins. Using the results of high-throughput Yeast 2-Hybrid experiments, we estimate the characteristic strength of non-functional protein–protein interactions. By combining these data with the strengths of specific interactions, we assess the fraction of time proteins spend tied up in non-functional interactions as a function of their overall concentration. This allows us to sketch the phase diagram for baker's yeast cells using the experimentally measured concentrations and subcellular localization of their proteins. The positions of yeast compartments on the phase diagram are consistent with our hypothesis that the yeast proteome has evolved to operate closely to the upper limit of its size, whereas keeping individual protein concentrations sufficiently low to reduce non-functional interactions. These findings have implication for conceptual understanding of intracellular compartmentalization, multicellularity and differentiation

Radiographer abnormality flagging systems in the UK – A preliminary updated assessment of practice

Introduction Radiographer abnormality flagging systems have been in use in the UK for over 30 years, with the guidance of the Society and College of Radiographers indicated that the preliminary clinical evaluation (PCE), or comment, be the preferred system of choice. This study aimed to provide an updated assessment of current practice based upon a previous 2008 study. Methods A cross-sectional online survey was disseminated via Twitter and aimed at departmental and reporting leads. It requested information on the types of flagging and reporting systems operated, scope of the systems employed, required education of participants, and the role of audit. Results Responses were received from 31 Trusts within the UK. Red dot systems were employed in 90% (n = 28) of sites, with 26% (n = 8) undertaking PCE. Skeletal radiographs were most commonly reviewed (90%; n = 28) followed by chest (58%; n = 18) and abdomen (32%; n = 10). Only 13% (n = 4) sites indicated if the image was normal but 71% (n = 22) allowed the radiographer to indicate if they were unsure. There was marked variation in the educational requirements and use of audit. Conclusion Compared to 2008 there appears to be quite minimal change in practices in the UK. There does appear to be some increase in the use of flagging systems generally and a higher proportion of PCE systems in comparison to red dot but the use of education and audit does not necessarily show much development in the past 15 years. Implications for practice Significant conclusions cannot be drawn due to limited sample size, however, it may support further study and consideration in relation to implementation and potentially standardisation of abnormality detection systems may be justified

Phenotype-environment matching in sand fleas

This is the final version of the article. Available from the publisher via the DOI in this record.Camouflage is perhaps the most widespread anti-predator strategy in nature, found in numerous animal groups. A long-standing prediction is that individuals should have camouflage tuned to the visual backgrounds where they live. However, while several studies have demonstrated phenotype-environment associations, few have directly shown that this confers an improvement in camouflage, particularly with respect to predator vision. Here, we show that an intertidal crustacean, the sand flea (Hippa testudinaria), has coloration tuned to the different substrates on which it occurs when viewed by potential avian predators. Individual sand fleas from a small, oceanic island (Ascension) matched the colour and luminance of their own beaches more closely than neighbouring beaches to a model of avian vision. Based on past work, this phenotype-environment matching is likely to be driven through ontogenetic changes rather than genetic adaptation. Our work provides some of the first direct evidence that animal coloration is tuned to provide camouflage to prospective predators against a range of visual backgrounds, in a population of animals occurring over a small geographical range.M.S., A.E.L. and J.T.: Biotechnology and Biological Sciences Research Council (BB/G022887/1). Fieldwork was funded by the Darwin Initiative (Project no. 19-026)

A 180 ka record of environmental change at Erdut (Croatia): a new chronology for the loess–palaeosol sequence and its implications for environmental interpretation

While there are numerous thick loess–palaeosol sequences preserved across the Carpathian Basin, well dated sites that provide terrestrial palaeoenvironmental records extending beyond last glacial–interglacial cycle are scarce. Robust chronologies are essential for correlations of loess with other long‐term Quaternary records and to further understanding of the palaeoenvironment and climate of this important region beyond the last 125 ka. Here a new geochronology based on 13 post‐infrared infrared stimulated luminescence ages focused on the lower part of the loess–palaeosol sequence at Erdut is presented. The results show that the lower part of the Erdut profile spans the penultimate glacial cycle (MIS 7 to MIS 5). The considerable sediments overlaying the investigated part of the profile suggest that this section spans two glacial cycles, rather than the previously suggested one. The most likely source of the discrepancy is the use of uncorrected infrared stimulated luminescence signal, which can cause age underestimation if not accounted for. This study demonstrates the need to revisit sites such as Erdut, re‐date them using updated measurement protocols, and update existing palaeoenvironmental interpretations

Desmoplastic Small Round Cell Tumour of Childhood: A Report of Four Cases Demonstrating Wider Clinical Features and Variable Outcome

Purpose. Four further cases of desmoplastic small round cell tumour with multi phenotypic differentiation are described

The acoustic space of pain: cries as indicators of distress recovering dynamics in preverbal infants

Crying is a vital built-in survival mechanism for the Human baby. Yet both the information carried by cries and the factors driving the perception and reaction of adult listeners remain under-investigated. Here, we contrasted the relevance of psychoacoustic vs. acoustic evaluation for the assessment of distress levels in babies' cries recorded during baths and during an immunization event. Parents asked to rate the level of distress experienced by babies from listening to their cries attributed lower pain ratings to mild discomfort (bath) than to distress (vaccination) cries but failed to discriminate between different putative levels of pain experienced during different vaccination sequences. In contrast, vocal "roughness", a composite acoustic factor characterising the level of aperiodicity of the cries, not only differed between mild discomfort and distress cries but also between the levels of pain experienced during the different vaccination sequences. These observations suggest that acoustic analyses are more powerful than psychoacoustic evaluations for discriminating distress levels in babies’ cries, and opens the way for the design of a tool based on the acoustics of cries for assessing and monitoring pain levels in preverbal infants

Rossby wave dynamics of the North Pacific extra-tropical response to El Niño: importance of the basic state in coupled GCMs

The extra-tropical response to El Nino in a "low" horizontal resolution coupled climate model, typical of the Intergovernmental Panel on Climate Change fourth assessment report simulations, is shown to have serious systematic errors. A high resolution configuration of the same model has a much improved response that is similar to observations. The errors in the low resolution model are traced to an incorrect representation of the atmospheric teleconnection mechanism that controls the extra-tropical sea surface temperatures (SSTs) during El Nino. This is due to an unrealistic atmospheric mean state, which changes the propagation characteristics of Rossby waves. These erroneous upper tropospheric circulation anomalies then induce erroneous surface circulation features over the North Pacific. The associated surface wind speed and direction errors create erroneous surface flux and upwelling anomalies which finally lead to the incorrect extra-tropical SST response to El Nino in the low resolution model. This highlights the sensitivity of the climate response to a single link in a chain of complex climatic processes. The correct representation of these processes in the high resolution model indicates the importance of horizontal resolution in resolving such processes