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The AI-informed management strategy achieved sensitivity and specificity of 91% and 96%, respectively. Average sensitivity and specificity of six radiologists using Lung-RADS only was 91% and 66%, respectively. Using the AI-informed management strategy, 41 (0.2%) category 1 or 2 classifications were upgraded to category 3, and 5,750 (30%) category 3 or higher classifications were downgraded to category 2. Minimum net cost savings using the AI-informed management strategy was estimated to be $72 per patient screened.
Using an AI risk score combined with Lung-RADS at baseline lung cancer screening may result in fewer follow-up investigations and substantial cost savings.
Using an AI risk score combined with Lung-RADS at baseline lung cancer screening may result in fewer follow-up investigations and substantial cost savings.
To examine whether radiologists' mammogram reading performance varies according to how long they have been awake ("hours awake") and the number of hours they slept ("hours slept") the night before a reading session.
Retrospective data were retrieved from the BreastScreen Reader Assessment Strategy database. Malignancy-enriched mammographic readings were performed by 133 radiologists. Information on their hours awake and hours slept was collected. Analysis of covariance was performed to determine whether these two variables influenced radiologists' sensitivity, specificity, lesion sensitivity, receiver operating characteristic (ROC) curve, and jackknife alternative free-response ROC. Radiologists were divided into a more experienced and a less experienced groups (based on reading ≥2,000 and <2,000 mammogram readings per year, respectively).
The hours awake significantly influenced less experienced radiologists' lesion sensitivity (F
= 2.51; P= .03). Those awake for <2 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P= .01), and those awake for 4 to 6 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P= .002) and 10 to 12 hours (P= .02). The hours slept also influenced the ROC values of less experienced radiologists (F
= 4.96; P= .02). Radiologists with up to 6 hours of sleep had a significantly lower value (0.72) than those who had slept more than 6 hours (0.77). No statistically significant findings were noted for more experienced radiologists.
Inexperienced radiologists' performance may be influenced by the hours awake and hours slept before reading sessions.
Inexperienced radiologists' performance may be influenced by the hours awake and hours slept before reading sessions.
Assess diagnostic radiology examination utilization and associated social determinants of health during the early stages of reopening after state-mandated shutdown of nonurgent services because of coronavirus disease 2019 (COVID-19).
This institutional review board-approved, retrospective study assessed all patients with diagnostic radiology examinations performed at an academic medical center with eight affiliated outpatient facilities before (January 1, 2020, to March 8, 2020) and after (June 7, 2020, to July 15, 2020) the COVID-19 shutdown. Examinations during the shut down (March 9, 2020, to June 6, 2020) were excluded. Patient-specific factors (eg, race, ethnicity), imaging modalities, and care settings were extracted from the Research Data Warehouse. Primary outcome was the number of diagnostic radiology examinations per day compared pre- and post-COVID-19 shutdown. Univariate analysis and multivariable logistic regression determined features associated with completing an examination.
Despite resureceive necessary diagnostic radiology examinations, potentially leading to compromised patient safety and quality of care.
The COVID-19 pandemic has exacerbated known pre-existing inequities in diagnostic radiology utilization. Resources should be allocated to address subgroups of patients who may be less likely to receive necessary diagnostic radiology examinations, potentially leading to compromised patient safety and quality of care.Many genes are regulated by multiple enhancers that often simultaneously activate their target gene. However, how individual enhancers collaborate to activate transcription is not well understood. Here, we dissect the functions and interdependencies of five enhancer elements that together activate Fgf5 expression during exit from naive murine pluripotency. Four intergenic elements form a super-enhancer, and most of the elements contribute to Fgf5 induction at distinct time points. A fifth, poised enhancer located in the first intron contributes to Fgf5 expression at every time point by amplifying overall Fgf5 expression levels. Despite low individual enhancer activity, together these elements strongly induce Fgf5 expression in a super-additive fashion that involves strong accumulation of RNA polymerase II at the intronic enhancer. Finally, we observe a strong anti-correlation between RNA polymerase II levels at enhancers and their distance to the closest promoter, and we identify candidate elements with properties similar to the intronic enhancer.
Haematopoietic stem-cell transplantation (HSCT) recipients are considered at high risk of poor outcomes after COVID-19 on the basis of their immunosuppressed status, but data from large studies in HSCT recipients are lacking. This study describes the characteristics and outcomes of HSCT recipients after developing COVID-19.
In response to the pandemic, the Center for International Blood and Marrow Transplant Research (CIBMTR) implemented a special form for COVID-19-related data capture on March 27, 2020. Shield-1 order All patients-irrespective of age, diagnosis, donor type, graft source, or conditioning regimens-were included in the analysis with data cutoff of Aug 12, 2020. The main outcome was overall survival 30 days after a COVID-19 diagnosis. Overall survival probabilities were calculated using Kaplan-Meier estimator. Factors associated with mortality after COVID-19 diagnosis were examined using Cox proportional hazard models.
318 HSCT recipients diagnosed with COVID-19 were reported to the CIBMTR. The median time from HSCT to COVID-19 diagnosis was 17 months (IQR 8-46) for allogeneic HSCT recipients and 23 months (8-51) for autologous HSCT recipients.
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