Influence on screening performance of second reading strategies in two lowvolume programs

BACKGROUND: The European Guidelines specify a minimum of 5,000 screening cases to be read yearly by radiologists carrying out second reading in non-centralized programs. This professional requirement is difficult to reach and/or to implement in regional programs covering a sparse population with a high number of participating radiology units, so that alternative blind double reading strategies must be devised. OBJECTIVE: To evaluate the effect on breast cancer screening performances of two second reading strategies used in non-centralized, low-volume programs. METHODS: Reading performances in two Swiss regional breast cancer screening programs (cantons of Wallis and Vaud), covering female populations, aged 50-69, of about 31'000 and 72'000 inhabitants were computed and compared. Both programs had similar screening regimens and organizations, but differed with respect to second reading. One setting applied a selective strategy whereby only experienced radiologists performed second reading; the other elicited not to restrict second readers on the basis of their individual screening activity. Analysis included some 140,000 mammograms performed between 1999 and 2005. RESULTS: Overall, screening performances improved with increasing total volume of reading, albeit not in a linear fashion. Regardless of setting, radiologists attained a higher level of screening accuracy when performing second rather than first readings, and incident rather than prevalent screening cases. The effect of a selective, small group of second readers appeared to impact favorably on the false-positive rate and other indicators of screening quality. As the learning curve depends on the number of mammograms read, these distinct strategies may bear different outcome in the long run. Implications and practical issues for low-volume programs are discussed.

Variation in performance across Swiss mammography screening programmes: the influence of reading strategy and experience.

[Abstract] Reading volume and mammography screening performance appear positively correlated. Performance was compared across organised Swiss screening programmes, which target relatively small populations. Except for accreditation of 2nd readers radiologists (restrictive vs non-restrictive strategy), Swiss programmes have similar screening regimen/procedures and duration, which maximises comparability. Variation in performance was explored in order to improve mammography practice and optimise screening performance. Indicators of quality and effectiveness were evaluated for about 200,000 screens performed over 4 screening rounds in the 3 longest-standing Swiss cantonal programmes (of Vaud, Geneva and Valais). Interval cancers were identified by linkage with cancer registries records. Most European standards of performance were met with a favourable cancer stage shift. Several performance indicators showed substantial variation across programmes. In subsequent rounds, compared with programmes (Vaud and Geneva) which accredited few 2nd readers to increase their individual reading volume, proportions of in situ lesions and of small cancers (? 1cm) were one third lower and halved, respectively, and the proportion of advanced lesions (stage II+) nearly 50% higher in the programme without a restrictive selection strategy. Discrepancy in second-year proportional incidence of interval cancers appears to be multicausal. Differences in performance could partly be explained by a selective strategy for 2nd readers and a prior experience in service screening, but not by the levels of opportunistic screening and programme attendance. This study provides clues for enhancing mammography screening performance in low-volume Swiss programmes.

School Reading by Grades Second Year

UANL

Extensive reading in the second language classroom.

Desarrolla una actitud positiva hacia la lectura a menudo perdida en el aula de segundo idioma. Los autores proporcionan una base teórica para este enfoque mediante el examen de la naturaleza afectiva y cognitiva de la lectura. También ofrecen sugerencias prácticas para la aplicación de una lectura amplia, incluida su integración en el plan de estudios, el establecimiento de una biblioteca, la selección de material de lectura, y el mantenimiento de registros de evaluación. Contiene una amplia variedad de actividades en la clase para complementar la lectura silenciosa, y un apéndice con una valiosa bibliografía, organizada por niveles, de los mejores libros escritos en inglés para estudiantes de idiomas.

From reader to reading teacher : issues and strategies for second language classrooms.

Se utiliza en cursos de introducción a la enseñanza de la lectura en una segunda lengua y esta dirigido a profesores tanto principiantes, que encuentran información práctica sobre métodos, problemas y estrategias, como experimentados, a los que proporciona métodos más eficaces y un plan de estudios más flexible. El texto analiza la naturaleza de la lectura y las estrategias personales ante ella, así como, los factores que influyen en la lectura en una lengua materna y la realizada en un segundo idioma. Los profesores aprenden a seleccionar las actividades de lectura más apropiadas y a planificar las lecciones más eficaces para sus alumnos.

Practice tests for IGCSE English as a second language : reading and writing book 1.

El libro contiene 4 test prácticos completos con formato de examen para los ejercicios 1 y 2 de la prueba Cambridge IGCSE (International General Certificate of Secondary Education) de inglés como segundo idioma. Los test permiten desarrollar las técnicas de examen de los alumnos familiarizándose con el formato de los ejercicios de lectura y redacción, y con el tipo de temas y textos que pueden encontrar en el examen oficial. El nivel de la prueba es intermedio e intermedio-alto.

Practice tests for IGCSE English as a second language : reading and writing book 1 with key.

El libro contiene 4 test prácticos completos con formato de examen para los ejercicios 1 y 2 de la prueba Cambridge IGCSE (International General Certificate of Secondary Education) de inglés como segundo idioma. Los test permiten desarrollar las técnicas de examen de los alumnos familiarizándose con el formato de los ejercicios de lectura y redacción, y con el tipo de temas y textos que pueden encontrar en el examen oficial. El nivel de la prueba es intermedio e intermedio-alto. Incluye respuestas y redacciones de ejemplo.

Practice tests for IGCSE English as a second language : reading and writing book 2.

El libro contiene cuatro tests prácticos completos con formato de examen para el ejercicio 2 de la prueba Cambridge IGCSE (International General Certificate of Secondary Education) de inglés como segundo idioma. Los tests permiten desarrollar las técnicas de examen de los alumnos familiarizándose con el formato de los ejercicios de lectura, compresión y escritura, y con el tipo de temas que pueden encontrar en el examen oficial. El nivel de la prueba es intermedio e intermedio-alto.

Practice tests for IGCSE English as a second language : reading and writing book 2 with key.

El libro contiene cuatro tests prácticos completos con formato de examen para el ejercicio 2 de la prueba Cambridge IGCSE (International General Certificate of Secondary Education) de inglés como segundo idioma. Los tests permiten desarrollar las técnicas de examen de los alumnos familiarizándose con el formato de los ejercicios de lectura, compresión y redacción, y con el tipo de temas y textos que pueden encontrar en el examen oficial. El nivel de la prueba es intermedio e intermedio-alto. Incluye las respuestas de los tests y redacciones de ejemplo.

Changes in fat, fat-free mass and body water in human normal pregnancy

Measurements of body weight, total body water and total body potassium (40K) were made serially on three occasions during pregnancy and once post partum in 27 normal pregnant women. Skinfold thickness and fat cell diameter were also measured. A model of body composition was formulated to permit the estimation of changes in fat, lean tissue and water content of the maternal body. Total maternal body fat increased during pregnancy, reaching a peak towards the end of the second trimester before diminishing. Serial measurements of fat cell diameter showed poor correlation, whilst total body fat calculated from skinfold thickness correlated well with our estimated values for total body fat in pregnancy.

Processing of regular and irregular past tense morphology in highly proficient second language learners of English: a self-paced reading study

Dual-system models suggest that English past tense morphology involves two processing routes: rule application for regular verbs and memory retrieval for irregular verbs (Pinker, 1999). In second language (L2) processing research, Ullman (2001a) suggested that both verb types are retrieved from memory, but more recently Clahsen and Felser (2006) and Ullman (2004) argued that past tense rule application can be automatised with experience by L2 learners. To address this controversy, we tested highly proficient Greek-English learners with naturalistic or classroom L2 exposure compared to native English speakers in a self-paced reading task involving past tense forms embedded in plausible sentences. Our results suggest that, irrespective to the type of exposure, proficient L2 learners of extended L2 exposure apply rule-based processing.

Monastic and church archaeology

Major advances in church and monastic archaeology are discussed in terms of two distinct waves, ca. 1970–1995 and 1995 to the time of writing (2014). The first wave was influenced by landscape history and processual archaeology; scholarship focused principally on historical, economic, and technological questions and targeted individual sites and monuments for study. The second wave has been informed by postprocessual approaches and considers change and complexity in religious landscapes and perspectives on religious space, embodiment, and agency. In conclusion, this article calls for a more holistic approach to the archaeology of medieval Christian belief, one which moves beyond the focus on institutions and monuments that has characterized monastic and church archaeology and extends archaeological study to include the performative rituals of Christian life and death in the Middle Ages.

Twentieth-century global-mean sea-level rise: is the whole greater than the sum of the parts?

Confidence in projections of global-mean sea level rise (GMSLR) depends on an ability to account for GMSLR during the twentieth century. There are contributions from ocean thermal expansion, mass loss from glaciers and ice sheets, groundwater extraction, and reservoir impoundment. Progress has been made toward solving the “enigma” of twentieth-century GMSLR, which is that the observed GMSLR has previously been found to exceed the sum of estimated contributions, especially for the earlier decades. The authors propose the following: thermal expansion simulated by climate models may previously have been underestimated because of their not including volcanic forcing in their control state; the rate of glacier mass loss was larger than previously estimated and was not smaller in the first half than in the second half of the century; the Greenland ice sheet could have made a positive contribution throughout the century; and groundwater depletion and reservoir impoundment, which are of opposite sign, may have been approximately equal in magnitude. It is possible to reconstruct the time series of GMSLR from the quantified contributions, apart from a constant residual term, which is small enough to be explained as a long-term contribution from the Antarctic ice sheet. The reconstructions account for the observation that the rate of GMSLR was not much larger during the last 50 years than during the twentieth century as a whole, despite the increasing anthropogenic forcing. Semiempirical methods for projecting GMSLR depend on the existence of a relationship between global climate change and the rate of GMSLR, but the implication of the authors' closure of the budget is that such a relationship is weak or absent during the twentieth century.

Search for gravitational radiation from intermediate mass black hole binaries in data from the second LIGO-Virgo joint science run

This paper reports on an unmodeled, all-sky search for gravitational waves from merging intermediate mass black hole binaries (IMBHB). The search was performed on data from the second joint science run of the LIGO and Virgo detectors (July 2009-October 2010) and was sensitive to IMBHBs with a range up to similar to 200 Mpc, averaged over the possible sky positions and inclinations of the binaries with respect to the line of sight. No significant candidate was found. Upper limits on the coalescence-rate density of nonspinning IMBHBs with total masses between 100 and 450 M-circle dot and mass ratios between 0.25 and 1 were placed by combining this analysis with an analogous search performed on data from the first LIGO-Virgo joint science run (November 2005-October 2007). The most stringent limit was set for systems consisting of two 88 M-circle dot black holes and is equal to 0.12 Mpc(-3) Myr(-1) at the 90% confidence level. This paper also presents the first estimate, for the case of an unmodeled analysis, of the impact on the search range of IMBHB spin configurations: the visible volume for IMBHBs with nonspinning components is roughly doubled for a population of IMBHBs with spins aligned with the binary's orbital angular momentum and uniformly distributed in the dimensionless spin parameter up to 0.8, whereas an analogous population with antialigned spins decreases the visible volume by similar to 20%.