Appropriate Use of Medical Interpreters in the Breast Imaging Clinic.

More than 25 million Americans have limited English-language proficiency (LEP) according to the U.S. Census Bureau. This population experiences challenges accessing health care and is least likely to receive preventive health care, including screening mammogram. In a setting where the breast radiologist does not speak the language of their patient, using certified medical interpreter services is fundamental. Medical interpreter use is associated with improved clinical care and patient satisfaction and can potentially increase adherence to screening mammograms and follow-up in patients with LEP. Title VI of the Civil Rights Act requires interpreter services for patients with LEP who are receiving federal financial assistance. Failure to provide interpretative services when necessary is considered discriminatory and illegal. The use of untrained medical interpreters, including ad hoc interpreters (eg, family, friends, or untrained staff), is associated with more medical errors, violation of confidentiality, and poor health outcomes. Types of medical interpretation services available to address language barriers include in-person interpretation, telephone and video remote interpretation, and qualified bilingual staff. Proper training and certification of medical interpreters is essential to prevent misinterpretations and ensure patient safety. When using an interpreter service, speak to and maintain eye contact with the patient, address the patient directly and seat the interpreter next to or slightly behind the patient, use visual aids whenever possible, and have the patient repeat the information to verify comprehension. Breast radiologists can address disparities in breast cancer screening and treatment by promoting effective communication.

Are change of direction speed and agility different abilities from time and coordinative perspectives?

This study aimed to test whether agility and change of direction speed (COD) are independent capacities using the same movement pattern (1) in terms of the completion time and (2) the entropy. Seventeen semi-professional female football players participated in the study. The agility task consisted of a Y-shaped (45° COD) task with three possible exit options (center, right and left) performed pre-planned or in reaction to the movement of two testers (i.e., blocking exit gates). Players' acceleration was measured using an inertial measurement unit. Entropy was calculated from the acceleration signal and completion time was extracted using a magnet-based timing system. Significantly greater times and lower entropy (p<0.001) were found during agility runs to pre-planned COD runs. Furthermore, weak to moderate correlations were found between COD and agility for both completion time (r = 0.29, p<0.001) and entropy (r = 0.53, p<0.001, r2 = 28.1%). These results highlight that COD speed and agility are independent capacities and skills, and as such, should be tested and trained as distinct, separate qualities. Modifying task constraints including a reactive stimulus (i.e., cognitive factors), is essential for increasing task complexity by altering the biomechanical and coordinative aspects of the action.

Adding mechanical vibration to a half squat with different ballasts and rhythms increases movement variability.

The aim of this study was to determine whether whole body vibration increases movement variability while performing a half squat with different ballasts and rhythms through entropy. A total of 12 male athletes (age: 21.24 ± 2.35 years, height: 176.83 ± 5.80 cm, body mass: 70.63 ± 8.58 kg) performed a half squat with weighted vest, dumbbells and bar with weights suspended with elastic bands, with and without vibration at the squat rhythm of 40 and 60 bpm. Each ballast corresponded to 15% of the body mass. The movement variability was analysed by calculating the sample entropy of the acceleration signal, recorded at the waist using an accelerometer. With vibration, differences were found between weighted vest and dumbbells (t(121) = -8.81, p < 0.001 at 40 bpm; t(121) = -8.18, p < 0.001 at 60 bpm) and between weighted vest and bar at both rhythms (t(121) = -8.96, p < 0.001 at 40 bpm; t(121) = -8.83, p < 0.001 at 60 bpm). Furthermore, a higher sample entropy was obtained at 40 bpm with all ballasts (t(121) = 5.65, p < 0.001 with weighted vest; t(121) = 6.27, p < 0.001 with dumbbells; t(121) = 5.78, p < 0.001 with bar). No differences were found without vibration. These findings reveal that adding mechanical vibration to a half squat produces a non-proportional increase in movement variability, being larger when the ballast is placed on the upper limbs and when performed at a slow rhythm.

Identifying genetically redundant accessions in the world's largest cassava collection.

Crop diversity conserved in genebanks facilitates the development of superior varieties, improving yields, nutrition, adaptation to climate change and resilience against pests and diseases. Cassava (Manihot esculenta) plays a vital role in providing carbohydrates to approximately 500 million people in Africa and other continents. The International Center for Tropical Agriculture (CIAT) conserves the largest global cassava collection, housing 5,963 accessions of cultivated cassava and wild relatives within its genebank. Efficient genebank management requires identifying and eliminating genetic redundancy within collections. In this study, we optimized the identification of genetic redundancy in CIAT's cassava genebank, applying empirical distance thresholds, and using two types of molecular markers (single-nucleotide polymorphism (SNP) and SilicoDArT) on 5,302 Manihot esculenta accessions. A series of quality filters were applied to select the most informative and high-quality markers and to exclude low-quality DNA samples. The analysis identified a total of 2,518 and 2,526 (47 percent) distinct genotypes represented by 1 to 87 accessions each, using SNP or SilicoDArT markers, respectively. A total of 2,776 (SNP) and 2,785 (SilicoDArT) accessions were part of accession clusters with up to 87 accessions. Comparing passport and historical characterization data, such as pulp color and leaf characteristic, we reviewed clusters of genetically redundant accessions. This study provides valuable guidance to genebank curators in defining minimum genetic-distance thresholds to assess redundancy within collections. It aids in identifying a subset of genetically distinct accessions, prioritizing collection management activities such as cryopreservation and provides insights for follow-up studies in the field, potentially leading to removal of duplicate accessions.

Culturally Competent Care in the Breast Imaging Clinic: Hispanic/Latino Patients.

Hispanic/Latino people represent 19% of the U.S. population, and this proportion is expected to increase to 26% by 2050. Hispanic/Latino people comprise a diverse ethnic group that includes individuals from all races, religions, languages, cultural identities, and nationalities. Barriers to health care that have created significant disparities in this community include language, low socioeconomic status, and inability to afford health insurance. Health coverage for Hispanic/Latino people has been a longstanding problem in the U.S., stopping many of these patients from seeking preventive care such as screening mammography. Breast cancer is the most common cancer among Hispanic/Latino women in the U.S. and the leading cause of cancer death in this group. Five-year breast cancer survival in Hispanic/Latino women is slightly lower than that in non-Hispanic White women. Some of the factors that account for the ethnic disparities in breast cancer include lower levels of adherence to screening mammography of Hispanic/Latino women as a consequence of inadequate insurance coverage, language barriers, lack of transportation, being unable to leave work, and lack of childcare. By promoting a culturally sensitive clinical environment, breast radiologists can increase patient engagement, utilization of preventive services, treatment adherence rates, and overall health status.

Axillary lymph node "bubbly" calcifications and body tattoo: A case series and proposed algorithm to minimize lymph node biopsies.

The presence of mammographically evident hyperdense foci within axillary lymph nodes elicits concern for calcium deposits, which in turn have a wide differential diagnosis including both benign and malignant entities. Tissue sampling, most commonly by way of image-guided core needle biopsy, is needed in many cases when a definite etiology cannot be clinically established. In this case series we present history, imaging findings, and pathology results (or long term follow-up stability as biopsy surrogate) of several women with body tattoos who at mammography were noted to have a characteristic pattern of "bubbly" pseudo-calcifications within axillary lymph nodes, and absence of other mammographic, sonographic and clinical abnormalities.

Kikuchi-Fujimoto-like lymphadenopathy following COVID-19 vaccine: diagnosis and management.

A woman in her mid 40s presented for breast imaging after 1 week of painful and enlarged right axillary lymphadenopathy. She denied history of fever, weight loss, night sweats fatigue, cat scratch or other trauma. She received the second dose of Pfizer COVID-19 vaccine 3 months previously on the contralateral arm. A mammogram demonstrated a single, asymmetric, large and dense right axillary lymph node. Ultrasound confirmed a 2.5 cm lymph node with cortical thickening of 0.6 cm. Ultrasound-guided core biopsy showed necrotising lymphadenitis with associated aggregates of histiocytes and plasmacytoid dendritic cells. Potential causes of necrotising adenitis including Bartonella, tuberculosis, Epstein-Barr Virus, herpes simplex virus, systemic lupus erythematosus and lymphoma were excluded. In the absence of any identifiable infectious or autoimmune causes, and given the temporal relatedness with vaccine administration, it was determined that the Kikuchi-Fujimoto-like necrotising lymphadenitis was likely secondary to the COVID-19 vaccine. To date, there has been no casual association made between the COVID-19 vaccine and KFD necrotising lymphadenitis.

Genome Analysis and Pathobiology of Cassava-Infecting Torradoviruses Containing a Putative Maf/HAM1 Pyrophosphatase Domain.

Next generation sequencing has been used to identify and characterize the full genome sequence of a cassava-infecting torradovirus, revealing the presence of a Maf/HAM1 domain downstream of the RNA-dependent RNA-polymerase (RdRp) domain in RNA1 in all isolates sequenced. A similar domain is also found in unrelated potyvirids infecting Euphorbiaceae hosts in the Americas and cassava in Africa. Even though cassava torrado-like virus (CsTLV) could not be mechanically transmitted to a series of herbaceous hosts, it can be efficiently transmitted by bud graft-inoculation to different cassava landraces. Our bioassays show that CsTLV has a narrow host range. Crystal-like structures of isometric virus-like particles were observed in cells of plants with single infection by CsTLV, and consistently induced chlorotic leaf spots and affected root yields significantly. Moreover, CsTLV infection induces changes in the accumulation of total sugars in storage roots. Field surveys indicated the presence of CsTLV in the main cassava growing regions of Colombia, and the occurrence of two different cassava-infecting torradovirus species. Profiles of small RNAs of 21 to 24 nucleotides in length, derived from CsTLV RNAs targeted by cassava RNA silencing defense mechanisms, are also reported.

Assessing the Reliability and Validity of Agility Testing in Team Sports: A Systematic Review.

ABSTRACT: Yepes, MM, Feliu, GM, Bishop, C, and Gonzalo-Skok, O. Assessing the reliability and validity of agility testing in team sports: A systematic review. J Strength Cond Res 36(7): 2035-2049, 2022-The aims of this systematic review were to (a) examine the reliability of the reactive agility tests and (b) analyze the discriminatory validity of the agility tests. A literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We explored PubMed, SPORTDiscus, and Cochrane Plus databases looking for articles about agility in team sports. After filtering for article relevance, only 42 studies met the inclusion criteria; 37 of which assessed the reliability of agility tests and 22 assessing their validity. Reliability showed a high intraclass correlation coefficient (ICC) in almost all studies (range 0.79-0.99) with the exception of 2 studies. In addition, other studies also assessed the reliability of decision time (ICC = 0.95), movement time (ICC = 0.92), and decision accuracy (ICC = 0.74-0.93), all of which exhibited acceptable reliability. Furthermore, these data show high discriminatory validity, with higher performance level players being faster than lower performance level players (mean = 6.4%, range = 2.1-25.3%), with a faster decision time (mean = 23.2%, range = 10.2-48.0%) with the exception of 1 study, and better decision accuracy (mean = 9.3%, range = 2.5-21.0%). Thus, it can be concluded that reactive agility tests show good reliability and discriminatory validity. However, most agility tests occur in simple contexts whereby only 2 possible responses are possible. Therefore, future research should consider creating more specific and complex environments that challenge the cognitive process of high-level athletes.

Perception of Breast Density Information Among Women in Miami, FL: a Qualitative Study.

The US Food and Drug Administration has proposed requiring that all women undergoing mammography receive written information about their breast density. Past research suggests many women may misperceive the meaning of breast density. Additionally, women with dense breasts may not understand the risks and benefits of pursuing additional imaging studies. The goal of this study was to explore women's beliefs about breast density and their preferences for how this information is conveyed. Women with increased breast density detected on mammography at a university-based breast imaging center in South Florida were recruited for a series of focus groups. Twenty-five women participated, ranging in age from 42 to 65 years. Nine women (36%) self-identified as Hispanic/Latina, eight (32%) as Black, four (16%) as White, three (12%) as Asian, and one as "other." Four focus groups were conducted in English and one in Spanish by professional moderators using a semi-structured format. A constant comparative method was used to identify common themes using a general inductive approach. Areas explored included understanding of the term breast density; personal reaction to being informed of dense breasts; questions about breast density; understanding of supplemental screening; and preferences for how to convey breast density information. Subthemes identified included a misperception that breast density is palpable; a feeling of fear on learning of increased breast density results; a concern about what causes increased breast density and whether it can be reversed; a desire to proceed with supplemental ultrasound imaging; and a preference for simple messages explaining the concept of breast density in multiple formats including video. Participants voiced the incorrect belief that caffeine intake could increase breast density and stated that they wanted to know specific details about their personal results. There is a need for better tools to communicate breast density in a way that allays anxiety while enabling women to make fully informed decisions about their breast health. Clinicians and cancer educators should be aware of misperceptions women may have about breast density. Policymakers should keep in mind potential public confusion about this complex topic when crafting density notification rules.

The Challenge of Digital Breast Tomosynthesis-Detected Architectural Distortion of the Breast: Inter-reader Variability and Imaging Characteristics That May Improve Positive Predictive Value.

OBJECTIVE: To compare readers' performances when detecting architectural distortion (AD) on digital breast tomosynthesis (DBT). To determine the risk of malignancy of DBT with synthetic mammogram (SM)-detected AD and evaluate imaging features that are associated with malignancy risk. METHODS: This IRB-approved retrospective review included all cases of DBT-detected AD that were recommended for biopsy from October 2013 to July 2019. Cases were reviewed by three breast radiologists and the overall agreement between radiologists was calculated. Medical records were reviewed for pathological outcomes and imaging findings. Statistical analyses used were Cohen's kappa and its 95% confidence interval, and one-way analysis of variance. RESULTS: A total of 172 lesions were included. The overall agreement for the presence of AD in our study was fair (0.253). The majority (20/36, 55.5%) of the malignant ADs were associated with asymmetries (13/36, 36.1%), calcifications (4/36, 11.1%), or both (3/36, 8.3%), compared to nonmalignant ADs (40/136, 31.0%; P = 0.038). The positive predictive value (PPV) of DBT with SM-detected AD for malignancy was 21.8% (36/165), 18.8% (18/96) for DBT-detected AD, and 26.0% (18/69) for SM-detected AD, although the difference was not statistically significant (P = 0.258). A breast MRI correlate was identified for all malignant AD lesions (17/17, 100.0%; P = 0.004). CONCLUSION: The detection of AD remains a challenging task for radiologists, with moderate-to-fair interobserver agreement. With a PPV for malignancy of 21.8%, percutaneous biopsy and subsequent pathology-imaging correlation are necessary for AD to exclude the possibility of malignancy.

Validity of a Magnet-Based Timing System Using the Magnetometer Built into an IMU.

Inertial measurement units (IMUs) represent a technology that is booming in sports right now. The aim of this study was to evaluate the validity of a new application on the use of these wearable sensors, specifically to evaluate a magnet-based timing system (M-BTS) for timing short-duration sports actions using the magnetometer built into an IMU in different sporting contexts. Forty-eight athletes (22.7 ± 3.3 years, 72.2 ± 10.3 kg, 176.9 ± 8.5 cm) and eight skiers (17.4 ± 0.8 years, 176.4 ± 4.9 cm, 67.7 ± 2.0 kg) performed a 60-m linear sprint running test and a ski slalom, respectively. The M-BTS consisted of placing several magnets along the course in both contexts. The magnetometer built into the IMU detected the peak-shaped magnetic field when passing near the magnets at a certain speed. The time between peaks was calculated. The system was validated with photocells. The 95% error intervals for the total times were less than 0.077 s for the running test and 0.050 s for the ski slalom. With the M-BTS, future studies could select and cut the signals belonging to the other sensors that are integrated in the IMU, such as the accelerometer and the gyroscope.

Breast Implant-Associated Anaplastic Large Cell lymphoma: Brief overview of current data and imaging findings.

In 2016, the World Health Organization added Breast Implant-Associated Anaplastic Large Cell lymphoma as a provisionally recognized lymphoma to the family of existing Anaplastic Large Cell lymphomas. Current estimates of the lifetime risk of the disease in women with textured breast implants range from 1:1,000 to 1:30,000. The mean interval from implant placement to diagnosis is 10.7 ± 4.6 years and the most common clinical symptom at presentation is breast swelling. A high level of clinical suspicion is recommended in patients presenting with breast symptoms and/or peri-implant fluid collection occurring more than 1 year after breast implant placement. Ultrasound is the imaging modality of choice, with a high sensitivity for peri-implant fluid and a high specificity for peri-implant mass. When ultrasound is inconclusive, breast MRI is indicated. As of today, all confirmed cases have tested positive for CD30 immunohistochemistry and the disease has shown to have an excellent prognosis when it is diagnosed earlier (localized disease), and when complete surgery, consisting of explantation, capsulectomy, and removal of any associated capsule mass, is performed. This overview summarizes the available epidemiological and clinical data of Breast Implant-Associated Anaplastic Large Cell lymphoma, with an emphasis on imaging features.

Ductal and lobular carcinoma in situ arising within an enlarging biopsy proven fibroadenoma.

The diagnosis via core needle biopsy of concurrent ductal carcinoma in situ and lobular carcinoma in situ within an enlarging previously biopsied benign fibroadenoma in women in their 40s is rare. Several case reports have described the occurrence of malignant changes within fibroadenomas, usually as an incidental finding following excision, and few reports have documented the transition of a fibroadenoma to malignancy. The current case report emphasises the importance of re-biopsying enlarging fibroadenomas, even with otherwise maintained benign appearing features on imaging, in women in their 40s, in order to exclude the possibility of malignancy.

Breast Arterial Calcifications on Mammography: A Survey of Practicing Radiologists.

OBJECTIVE: To explore current practice patterns of reporting and issuing recommendations based on the presence of breast arterial calcifications on mammography and existing knowledge of their prevalence and associated factors. METHODS: An online anonymous 19-question survey was distributed to 2583 practicing radiologists who were members of the Society of Breast Imaging. Questions covered demographics, breast imaging training, practice type, and knowledge regarding the epidemiology and potential clinical significance of breast arterial calcifications detected on mammograms. Differences between groups were calculated using the chi-square test or Fisher exact test. An α level of 0.05 was used to determine statistical significance. RESULTS: Response rate was 22% (364/1662). The median age of respondents was 51 years (range: 29-76) and most were female (248/323, 77%). The most prevalent characteristics among respondents were as follows: 69% (223/323) had completed a breast imaging fellowship, 55% (179/323) were in private practice, 49% (158/323) practiced dedicated breast imaging, and 38% (124/323) had been in practice for more than 20 years. The prevalence of breast arterial calcifications was correctly estimated to be 1%-30% by 39% (125/323) of respondents. Most respondents correctly recognized the growing evidence of an association between breast arterial calcifications and coronary artery disease (275/323, 85%). However, only 15% (48/323) always reported the presence of these calcifications, and of those who report them at any time, only 0.7% (2/274) always issued recommendations. CONCLUSION: There are differences in both knowledge of the epidemiology of breast arterial calcifications and practices around their reporting amongst breast radiologists.

Global Cropland Connectivity: A Risk Factor for Invasion and Saturation by Emerging Pathogens and Pests.

The geographic pattern of cropland is an important risk factor for invasion and saturation by crop-specific pathogens and arthropods. Understanding cropland networks supports smart pest sampling and mitigation strategies. We evaluate global networks of cropland connectivity for key vegetatively propagated crops (banana and plantain, cassava, potato, sweet potato, and yam) important for food security in the tropics. For each crop, potential movement between geographic location pairs was evaluated using a gravity model, with associated uncertainty quantification. The highly linked hub and bridge locations in cropland connectivity risk maps are likely priorities for surveillance and management, and for tracing intraregion movement of pathogens and pests. Important locations are identified beyond those locations that simply have high crop density. Cropland connectivity risk maps provide a new risk component for integration with other factors-such as climatic suitability, genetic resistance, and global trade routes-to inform pest risk assessment and mitigation.

Frontline brentuximab vedotin in breast implant-associated anaplastic large-cell lymphoma.

We report a woman who developed BIA-ALCL 9 years after saline implant placement. The lymphoma manifested as a mass lesion associated with axillary lymphadenopathy. She was successfully treated with brentuximab vedotin with minimal toxicity. Brentuximab vedotin may be a promising frontline therapeutic modality for patients with BIA-ALCL.

Complete Genome Sequence of Rice hoja blanca tenuivirus Isolated from a Susceptible Rice Cultivar in Colombia.

We describe here the complete genome of Rice hoja blanca tenuivirus The sequenced isolate was obtained by insect vector transmission from a symptomatic rice sample grown in Colombia. Sequence data from the four RNA components were obtained by deep sequencing (Illumina), and infections were confirmed by enzyme-linked immunosorbent assay and Sanger sequencing.

ACR Appropriateness Criteria® Breast Cancer Screening.

Breast cancer screening recommendations are based on risk factors. For average-risk women, screening mammography and/or digital breast tomosynthesis is recommended beginning at age 40. Ultrasound (US) may be useful as an adjunct to mammography for incremental cancer detection in women with dense breasts, but the balance between increased cancer detection and the increased risk of a false-positive examination should be considered in the decision. For intermediate-risk women, US or MRI may be indicated as an adjunct to mammography depending upon specific risk factors. For women at high risk due to prior mantle radiation between the ages of 10 to 30, mammography is recommended starting 8 years after radiation therapy but not before age 25. For women with a genetic predisposition, annual screening mammography is recommended beginning 10 years earlier than the affected relative at the time of diagnosis but not before age 30. Annual screening MRI is recommended in high-risk women as an adjunct to mammography. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.