Population structure of Pyrenophora teres, the causal agent of net blotch of barley

Spring barley is the most important crop in Finland based on cultivated land area. Net blotch, a disease caused by Pyrenophora teres Drech., is the most damaging disease of barley in Finland. The pressure to improve the economics and efficiency of agriculture has increased the need for more efficient plant protection methods. Development of durable host-plant resistance to net blotch is a promising possibility. However, deployment of disease resistant crops could initiate selection pressure on the pathogen (P. teres) population. The aim of this study was to understand the population biology of P. teres and to estimate the evolutionary potential of P. teres under selective pressure following deployment of resistance genes and application of fungicides. The study included mainly Finnish P. teres isolates. Population samples from Russia and Australia were also included. Using AFLP markers substantial genotypic variation in P. teres populations was identified. Differences among isolates were least within Finnish fields and significantly higher in Krasnodar, Russia. Genetic differentiation was identified among populations from northern Europe and from Australia, and between the two forms P. teres f. teres (PTT, net form of net blotch) and P. teres f. maculata (PTM, spot form of net blotch) in Australia. Differentiation among populations was also identified based on virulence between Finnish and Russian populations, and based on prochloraz (fungicide) tolerance in the Häme region in Finland. Surprisingly only PTT was recovered from Finland and Russia although both forms were earlier equally common in Finland. The reason for the shift in occurrence of forms in Finland remained uncertain. Both forms were found within several fields in Australia. Sexual reproduction of P. teres was supported by recover of both mating types in equal ratio in those areas although the prevalence of sexual mating seems to be less in Finland than in Australia. Population from Krasnodar was an exception since only one mating type was found in there. Based on the substantial high genotypic variation in Krasnodar it was suggested go represent an old P. teres population, whereas the Australian samples were suggested to represent newer populations. In conclusion, P. teres populations are differentiated at several levels. Human assistance in dispersal of P. teres on infected barley seed is obvious and decreases the differentiation among populations. This can increase the plant protection problems caused by this pathogen. P. teres is capable of sexual reproduction in several areas but the prevalence varies. Based on these findings it is apparent that P. teres has the potential to pose more serious problems in barley cultivation if plant protection is neglected. Therefore, good agricultural practices, including crop rotation and the use of healthy seed, are recommended.

Dosage consistency is the key factor in avoiding evolution of resistance to phosphine and population increase in stored-grain pests

BACKGROUND Control of pests in stored grain and the evolution of resistance to pesticides are serious problems worldwide. A stochastic individual-based two-locus model was used to investigate the impact of two important issues, the consistency of pesticide dosage through the storage facility and the immigration rate of the adult pest, on overall population control and avoidance of evolution of resistance to the fumigant phosphine in an important pest of stored grain, the lesser grain borer. RESULTS A very consistent dosage maintained good control for all immigration rates, while an inconsistent dosage failed to maintain control in all cases. At intermediate dosage consistency, immigration rate became a critical factor in whether control was maintained or resistance emerged. CONCLUSION Achieving a consistent fumigant dosage is a key factor in avoiding evolution of resistance to phosphine and maintaining control of populations of stored-grain pests; when the dosage achieved is very inconsistent, there is likely to be a problem regardless of immigration rate. © 2012 Society of Chemical Industry

Eriophyid mites on spotted gums: population and histological damage studies of an emerging pest

A suite of co-occurring eriophyid mite species are significant pests in subtropical Australia, causing severe discolouration, blistering, necrosis and leaf loss to one of the region's most important hardwood species, Corymbia citriodora subsp. variegata (F. Muell.) K. D. Hill & L. A. S. Johnson (Myrtaceae). In this study, we examined mite population dynamics and leaf damage over a 1-year period in a commercial plantation of C. citriodora subsp. variegata. Our aims were to link the incidence and severity of mite damage, and mite numbers, to leaf physical traits (moisture content and specific leaf weight (SLW)); to identify any seasonal changes in leaf surface occupancy (upper vs. lower lamina); and host tree canopy strata (upper, mid or lower canopy). We compared population trends with site rainfall, temperature and humidity. We also examined physical and anatomical changes in leaf tissue in response to mite infestation to characterize the plants' physiological reaction to feeding, and how this might affect photosynthesis. Our main findings included positive correlations with leaf moisture content and mite numbers and with mite numbers and damage severity. Wet and dry leaf mass and SLW were greater for damaged tissue than undamaged tissue. Mites were distributed equally throughout the canopy and on both leaf surfaces. No relationships with climatic factors were found. Damage symptoms occurred equally and were exactly mirrored on both leaf surfaces. Mite infestation increased the overall epidermal thickness and the number and size of epidermal cells and was also associated with a rapid loss of chloroplasts from mesophyll cells beneath damage sites. The integrity of the stomatal complex was severely compromised in damaged tissues. These histological changes suggest that damage by these mites will negatively impact the photosynthetic efficiency of susceptible plantation species.

Induction of riboflavin-carrier protein in the immature male rat by estrogen: kinetic and hormonal specificity

The kinetics of estrogen-induced accumulation of riboflavin-carrier protein in the plasma was investigated in immature male rats using a specific and sensitive homologous radio-immunoassay procedure developed for this purpose. Following a single injection of the steroid hormone, plasma riboflavin-carrier protein levels increased markedly after an initial lag period of approximately 24 h, reaching peak levels around 96 h and declining thereafter. A 1.5 fold amplification of the inductive response was evident on secondary stimulation with the hormone. The magnitude of the response was dependent on hormonal dose, whereas the initial lag phase and the time of peak riboflavin-carrier protein induction were unaltered within the range of the steroid doses (0.1–10 mg/ kg body wt.) tested. Simultaneous administration of progesterone did not affect either the kinetics or the maximum level of the protein induced. The hormonal specificity of this induction was further adduced by the effect of administration of antiestrogens viz., En and Zu chlomiphene citrates, which effectively curtailed hormonal induction of the protein. That the induction involvedde novo-protein synthesis was evident from the complete inhibition obtained upon administration of cycloheximide. Passive immunoneutralization of endogenous riboflavin-carrier protein with antiserum to the homologous protein terminated pregnancy in rats confirming the earlier results with antiserum to chicken riboflavin-carrier protein.

Can competition with pasture be used to manipulate bellyache bush (Jatropha gossypiifolia L.) population biology?

Bellyache bush (Jatropha gossypiifolia L.) is an invasive weed that poses economic and environmental problems in northern Australia. Competition between pasture and bellyache bush was examined in North Queensland using combinations of five pasture treatments (uncut (control); cut as low, medium, and high pasture; and no pasture) and four bellyache bush densities (0, 2, 6 and 12plantsm(-2)) in a buffel grass (Cenchrus ciliaris L.) dominated pasture. The pasture treatments were applied approximately once per year but no treatments were applied directly to the bellyache bush plants. Measurements of bellyache bush flowering, seed formation, and mortality were undertaken over a 9-year period, along with monitoring the pasture basal cover and plant species diversity. Maximum flowering rates of bellyache bush occurred after 9 years (97%) in plots containing no pasture, with the lowest rates of 9% in uncut control plots. Earliest flowering (322 days after planting) and seed formation (411 days) also occurred in plots with no pasture compared with all other pasture treatments (range 1314-1393 days for seed formation to occur). No seeds were produced in uncut plots. At the end of 9 years, mortality rates of bellyache bush plants initially planted averaged 73% for treatments with some pasture compared with 55% under the no-pasture treatment. The percentage of herbaceous plant basal cover in uncut plots was increased 5-fold after 9 years, much greater than the average 2% increase recorded across the low, medium, and high pasture treatments. The number of herbaceous species in uncut plots remained largely unchanged, whereas there was an average reduction of 46% in the cut pasture treatments. Buffel grass remained the species with the greatest basal cover across all cut pasture treatments, followed by sabi grass (Urochloa mosambicensis (Hack.) Dandy) and then red Natal grass (Melinis repens (Willd.) Ziska). These results suggest that grazing strategies that maintain a healthy and competitive pasture layer may contribute to reducing the rate of spread of bellyache bush and complement traditional control techniques such as the use of herbicides.

Mapping Quantitative Trait Loci for Partial Resistance to Powdery Mildew in an Australian Barley Population

Genomic regions influencing resistance to powdery mildew [Blumeria graminis (DC.) E.O. Speer f. sp. hordei Em. Marchal] were detected in a doubled haploid (DH) barley (Hordeum vulgare L.) population derived from a cross between the breeding line ND24260 and cultivar Flagship when evaluated across four field environments in Australia and Uruguay. Significant quantitative trait loci (OIL) for resistance to B. graminis were detected on six of the seven chromosomes (1H, 2H, 3H, 4H, 5H, and 7H). A QTL with large effect donated by ND24260 mapped to the short arm of chromosome 1H (1 HS) conferring near immunity to B. graminis in Australia but was ineffective in Uruguay. Three OIL donated by Flagship contributed partial resistance to B. graminis and were detected in at least two environments. These OIL were mapped to chromosomes 3H, 4H, and 5H (5HS) accounting for up to 18.6, 3.4, and 8.8% phenotypic variation, respectively. The 5HS QTL contributed partial resistance to B. graminis in all field environments in both Australia and Uruguay and aligned with the genomic region of Rph20, a gene conferring adult plant resistance (APR) to leaf rust (Puccinia hordei Otth), which is found in some cultivars having Vada' or 'Emir' in their parentage. Selection for favorable marker haplotypes within the 3H, 4H, and 5H QTL regions can be performed even in the presence of single (major) gene resistance. Pyramiding such QTL may provide an effective and potentially durable form of resistance to B. graminis.

Eriophyid mites on spotted gums: population and histological damage studies of an emerging pest

A suite of co-occurring eriophyid mite species are significant pests in subtropical Australia, causing severe discolouration, blistering, necrosis and leaf loss to one of the region's most important hardwood species, Corymbia citriodora subsp. variegata (F. Muell.) K. D. Hill & L. A. S. Johnson (Myrtaceae). In this study, we examined mite population dynamics and leaf damage over a 1-year period in a commercial plantation of C. citriodora subsp. variegata. Our aims were to link the incidence and severity of mite damage, and mite numbers, to leaf physical traits (moisture content and specific leaf weight (SLW)); to identify any seasonal changes in leaf surface occupancy (upper vs. lower lamina); and host tree canopy strata (upper, mid or lower canopy). We compared population trends with site rainfall, temperature and humidity. We also examined physical and anatomical changes in leaf tissue in response to mite infestation to characterize the plants' physiological reaction to feeding, and how this might affect photosynthesis. Our main findings included positive correlations with leaf moisture content and mite numbers and with mite numbers and damage severity. Wet and dry leaf mass and SLW were greater for damaged tissue than undamaged tissue. Mites were distributed equally throughout the canopy and on both leaf surfaces. No relationships with climatic factors were found. Damage symptoms occurred equally and were exactly mirrored on both leaf surfaces. Mite infestation increased the overall epidermal thickness and the number and size of epidermal cells and was also associated with a rapid loss of chloroplasts from mesophyll cells beneath damage sites. The integrity of the stomatal complex was severely compromised in damaged tissues. These histological changes suggest that damage by these mites will negatively impact the photosynthetic efficiency of susceptible plantation species.

Population dynamics of house mice in Queensland grain-growing areas

Context. Irregular plagues of house mice cause high production losses in grain crops in Australia. If plagues can be forecast through broad-scale monitoring or model-based prediction, then mice can be proactively controlled by poison baiting. Aims. To predict mouse plagues in grain crops in Queensland and assess the value of broad-scale monitoring. Methods. Regular trapping of mice at the same sites on the Darling Downs in southern Queensland has been undertaken since 1974. This provides an index of abundance over time that can be related to rainfall, crop yield, winter temperature and past mouse abundance. Other sites have been trapped over a shorter time period elsewhere on the Darling Downs and in central Queensland, allowing a comparison of mouse population dynamics and cross-validation of models predicting mouse abundance. Key results. On the regularly trapped 32-km transect on the Darling Downs, damaging mouse densities occur in 50% of years and a plague in 25% of years, with no detectable increase in mean monthly mouse abundance over the past 35 years. High mouse abundance on this transect is not consistently matched by high abundance in the broader area. Annual maximum mouse abundance in autumn–winter can be predicted (R2 = 57%) from spring mouse abundance and autumn–winter rainfall in the previous year. In central Queensland, mouse dynamics contrast with those on the Darling Downs and lack the distinct annual cycle, with peak abundance occurring in any month outside early spring.Onaverage, damaging mouse densities occur in 1 in 3 years and a plague occurs in 1 in 7 years. The dynamics of mouse populations on two transects ~70 km apart were rarely synchronous. Autumn–winter rainfall can indicate mouse abundance in some seasons (R2 = ~52%). Conclusion. Early warning of mouse plague formation in Queensland grain crops from regional models should trigger farm-based monitoring. This can be incorporated with rainfall into a simple model predicting future abundance that will determine any need for mouse control. Implications. A model-based warning of a possible mouse plague can highlight the need for local monitoring of mouse activity, which in turn could trigger poison baiting to prevent further mouse build-up.

Monitoring exposure to polycyclic aromatic hydrocarbons in an Australian population using pooled urine samples

Integrated exposure to polycyclic aromatic hydrocarbons (PAHs) can be assessed through monitoring of urinary mono-hydroxylated PAHs (OH-PAHs). The aim of this study was to provide the first assessment of exposure to PAHs in a large sample of the population in Queensland, Australia including exposure to infant (0-4. years). De-identified urine specimens, obtained from a pathology laboratory, were stratified by age and sex, and pooled (n. =. 24 pools of 100) and OH-PAHs were measured by gas chromatography-isotope dilution-tandem mass spectrometry. Geometric mean (GM) concentrations ranged from 30. ng/L (4-hydroxyphenanthrene) to 9221. ng/L (1-naphthol). GM of 1-hydroxypyrene, the most commonly used PAH exposure biomarker, was 142. ng/L. The concentrations of OH-PAHs found in this study are consistent with those in developed countries and lower than those in developing countries. We observed no association between sex and OH-PAH concentrations. However, we observed lower urinary concentrations of all OH-PAHs in samples from infants (0-4. years), children (5-14. years) and the elderly (>. 60. year old) compared with samples from other age groups (15-29, 30-44 and 45-59. years) which may be attributed to age-dependent behaviour-specific exposure sources.

Evaluation of ELISA coupled with Western blot as a surveillance tool for Trichinella infection in wild boar (Sus scrofa)

Trichinella surveillance in wildlife relies on muscle digestion of large samples which are logistically difficult to store and transport in remote and tropical regions as well as labour-intensive to process. Serological methods such as enzyme-linked immunosorbent assays (ELISAs) offer rapid, cost-effective alternatives for surveillance but should be paired with additional tests because of the high false-positive rates encountered in wildlife. We investigated the utility of ELISAs coupled with Western blot (WB) in providing evidence of Trichinella exposure or infection in wild boar. Serum samples were collected from 673 wild boar from a high- and low-risk region for Trichinella introduction within mainland Australia, which is considered Trichinella-free. Sera were examined using both an 'in-house' and a commercially available indirect-ELISA that used excretory secretory (E/S) antigens. Cut-off values for positive results were determined using sera from the low-risk population. All wild boar from the high-risk region (352) and 139/321 (43.3%) of the wild boar from the low-risk region were tested by artificial digestion. Testing by Western blot using E/S antigens, and a Trichinella-specific real-time PCR was also carried out on all ELISA-positive samples. The two ELISAs correctly classified all positive controls as well as one naturally infected wild boar from Gabba Island in the Torres Strait. In both the high- and low-risk populations, the ELISA results showed substantial agreement (k-value = 0.66) that increased to very good (k-value = 0.82) when WB-positive only samples were compared. The results of testing sera collected from the Australian mainland showed the Trichinella seroprevalence was 3.5% (95% C.I. 0.0-8.0) and 2.3% (95% C.I. 0.0-5.6) using the in-house and commercial ELISA coupled with WB respectively. These estimates were significantly higher (P < 0.05) than the artificial digestion estimate of 0.0% (95% C.I. 0.0-1.1). Real-time PCR testing of muscle from seropositive animals did not detect Trichinella DNA in any mainland animals, but did reveal the presence of a second larvae-positive wild boar on Gabba Island, supporting its utility as an alternative, highly sensitive method in muscle examination. The serology results suggest Australian wildlife may have been exposed to Trichinella parasites. However, because of the possibility of non-specific reactions with other parasitic infections, more work using well-defined cohorts of positive and negative samples is required. Even if the specificity of the ELISAs is proven to be low, their ability to correctly classify the small number of true positive sera in this study indicates utility in screening wild boar populations for reactive sera which can be followed up with additional testing. (C) 2013 Elsevier B.V. All rights reserved.

Implications of methoprene resistance for managing Rhyzopertha dominica (F.) in stored grain

Commercial formulations of methoprene have been used in a number of countries such as Australia and the USA to provide long-term protection to grain from a range of storage pests. The level of resistance in Rhyzopertha dominica (F.), the lesser grain borer, was investigated in laboratory experiments by direct exposure of adults on treated wheat. Adults of a reference homozygous resistant strain of R.dominica were exposed to treatments of 0, 2, 3, 5, 10, 20 and 40kg-1 of s-methoprene for 7 days. Mortality and progeny production were dose dependent with 98.7% mortality and complete progeny suppression at 40mgkg-1, which is 67 times the registered rate at which s-methoprene is applied as a grain protectant in Australia (0.6mgkg-1) and eight times the rate which has been used in the USA (5mgkg-1). This strain was also tested by adding adults to wheat treated at 0, 1, 3, 10 and 30mgkg-1 and determining the number of adults (progeny plus original parental adults) after 6, 8, 10 or 12 weeks of continuous exposure. The effect of s-methoprene was consistent regardless of the number of weeks of continuous exposure and average population suppression was 99.5% at 30mgkg-1. Screening of 162 field samples collected from southeast Australia in 2009 showed that 93% of samples reproduced when exposed to wheat treated with the Australian registered rate of 0.6mgkg-1. When four unselected resistant field samples from this region were tested, progeny production but not mortality was dose dependent, and all four samples produced live progeny at the highest dose of 30mgkg-1. Our results show that methoprene resistance is a serious threat to the management of R.dominica, and that strategies need to be developed to minimise the further development and spread of resistance. © 2013.

QTLs for water absorption and flour yield identified in the doubled haploid wheat population Lang/QT8766

Two key quality traits in milling wheat are flour yield (FY) and water absorption (WA). Ideally, breeders would prefer to use markers to select promising lines rather than time consuming rheology tests. In this study, we measured FY and WA on a wheat mapping population (Lang/QT8766) of 162 individuals grown in two replicated field experiments at three locations over 2 years. We also carried out near infrared reflectance spectroscopy (NIRS) predictions on the grain for these traits to see if NIRS phenotypic data could provide useful mapping results when compared to the reference phenotypic data. Several common QTLs were identified for FY and WA by both sets of data. The QTL on chromosome 4D was a consistently recurring QTL region for both traits. The QTL on chromosome 2A was positively linked to protein content which was supported by genetic correlation data. The results also indicated it was possible to obtain useful phenotypic data for mapping FY and WA using NIRS data. This would save time and costs as NIRS is quicker and cheaper than current rheology methods.

Population Expansion and Genetic Structure in Carcharhinus brevipinna in the Southern Indo-Pacific

Background:Quantifying genetic diversity and metapopulation structure provides insights into the evolutionary history of a species and helps develop appropriate management strategies. We provide the first assessment of genetic structure in spinner sharks (Carcharhinus brevipinna), a large cosmopolitan carcharhinid, sampled from eastern and northern Australia and South Africa. Methods and Findings:Sequencing of the mitochondrial DNA NADH dehydrogenase subunit 4 gene for 430 individuals revealed 37 haplotypes and moderately high haplotype diversity (h = 0.6770 ±0.025). While two metrics of genetic divergence (ΦST and FST) revealed somewhat different results, subdivision was detected between South Africa and all Australian locations (pairwise ΦST, range 0.02717–0.03508, p values ≤ 0.0013; pairwise FST South Africa vs New South Wales = 0.04056, p = 0.0008). Evidence for fine-scale genetic structuring was also detected along Australia’s east coast (pairwise ΦST = 0.01328, p < 0.015), and between south-eastern and northern locations (pairwise ΦST = 0.00669, p < 0.04).Conclusions: The Indian Ocean represents a robust barrier to contemporary gene flow in C. brevipinna between Australia and South Africa. Gene flow also appears restricted along a continuous continental margin in this species, with data tentatively suggesting the delineation of two management units within Australian waters. Further sampling, however, is required for a more robust evaluation of the latter finding. Evidence indicates that all sampled populations were shaped by a substantial demographic expansion event, with the resultant high genetic diversity being cause for optimism when considering conservation of this commercially-targeted species in the southern Indo-Pacific.

Systematic review of the psychological consequences of false-positive screening mammograms

- Background In the UK, women aged 50–73 years are invited for screening by mammography every 3 years. In 2009–10, more than 2.24 million women in this age group in England were invited to take part in the programme, of whom 73% attended a screening clinic. Of these, 64,104 women were recalled for assessment. Of those recalled, 81% did not have breast cancer; these women are described as having a false-positive mammogram. - Objective The aim of this systematic review was to identify the psychological impact on women of false-positive screening mammograms and any evidence for the effectiveness of interventions designed to reduce this impact. We were also looking for evidence of effects in subgroups of women. - Data sources MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, Health Management Information Consortium, Cochrane Central Register for Controlled Trials, Cochrane Database of Systematic Reviews, Centre for Reviews and Dissemination (CRD) Database of Abstracts of Reviews of Effects, CRD Health Technology Assessment (HTA), Cochrane Methodology, Web of Science, Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index-Science, Conference Proceeding Citation Index-Social Science and Humanities, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, the International Bibliography of the Social Sciences, the British Library's Electronic Table of Contents and others. Initial searches were carried out between 8 October 2010 and 25 January 2011. Update searches were carried out on 26 October 2011 and 23 March 2012. - Review methods Based on the inclusion criteria, titles and abstracts were screened independently by two reviewers. Retrieved papers were reviewed and selected using the same independent process. Data were extracted by one reviewer and checked by another. Each included study was assessed for risk of bias. - Results Eleven studies were found from 4423 titles and abstracts. Studies that used disease-specific measures found a negative psychological impact lasting up to 3 years. Distress increased with the level of invasiveness of the assessment procedure. Studies using instruments designed to detect clinical levels of morbidity did not find this effect. Women with false-positive mammograms were less likely to return for the next round of screening [relative risk (RR) 0.97; 95% confidence interval (CI) 0.96 to 0.98] than those with normal mammograms, were more likely to have interval cancer [odds ratio (OR) 3.19 (95% CI 2.34 to 4.35)] and were more likely to have cancer detected at the next screening round [OR 2.15 (95% CI 1.55 to 2.98)]. - Limitations This study was limited to UK research and by the robustness of the included studies, which frequently failed to report quality indicators, for example failure to consider the risk of bias or confounding, or failure to report participants' demographic characteristics. - Conclusions We conclude that the experience of having a false-positive screening mammogram can cause breast cancer-specific psychological distress that may endure for up to 3 years, and reduce the likelihood that women will return for their next round of mammography screening. These results should be treated cautiously owing to inherent weakness of observational designs and weaknesses in reporting. Future research should include a qualitative interview study and observational studies that compare generic and disease-specific measures, collect demographic data and include women from different social and ethnic groups.

Psychological consequences of false-positive screening mammograms in the UK

- Objectives To identify the psychological effects of false-positive screening mammograms in the UK. - Methods Systematic review of all controlled studies and qualitative studies of women with a false-positive screening mammogram. The control group participants had normal mammograms. All psychological outcomes including returning for routine screening were permitted. All studies had a narrative synthesis. - Results The searches returned seven includable studies (7/4423). Heterogeneity was such that meta-analysis was not possible. Studies using disease-specific measures found that, compared to normal results, there could be enduring psychological distress that lasted up to 3 years; the level of distress was related to the degree of invasiveness of the assessment. At 3 years the relative risks were, further mammography, 1.28 (95% CI 0.82 to 2.00), fine needle aspiration 1.80 (95% CI 1.17 to 2.77), biopsy 2.07 (95% CI 1.22 to 3.52) and early recall 1.82 (95% CI 1.22 to 2.72). Studies that used generic measures of anxiety and depression found no such impact up to 3 months after screening. Evidence suggests that women with false-positive mammograms have an increased likelihood of failing to reattend for routine screening, relative risk 0.97 (95% CI 0.96 to 0.98) compared with women with normal mammograms. - Conclusions Having a false-positive screening mammogram can cause breast cancer-specific distress for up to 3 years. The degree of distress is related to the invasiveness of the assessment. Women with false-positive mammograms are less likely to return for routine assessment than those with normal ones.