OBJECTIVE. Appropriate radiologic interpretation of screening CT can minimize unnecessary workup and intervention. This is particularly challenging in the baseline round. We report on the quality assurance process we developed for the International Early Lung Cancer Action Program. MATERIALS AND METHODS. After initial training at the coordinating center, radiologists at 10 participating institutions and at the center independently interpreted the first 100 baseline screenings. The radiologist at the institutions had access to the center interpretations before issuing the final reports. After the first 100 screenings, the interpretations were jointly discussed. This report summarizes the results of the initial 100 dual interpretations at the 10 institutions. RESULTS. The final institution interpretations agreed with the center in 895 of the 1000 interpretations. Compared with the center, the frequency of positive results was higher at eight of the 10 institutions. The most frequent reason of discrepant interpretations was not following the protocol (n = 55) and the least frequent was not identifying a nodule (n = 3). CONCLUSION. The quality assurance process helped focus educational programs and provided an excellent vehicle for review of the protocol with participating physicians. It also suggests that the rate of positive results can be reduced by such measures.
To report the results of low-dose computed tomography (LDCT) screening for early lung cancer in 4 690 asymptomatic participants at the Cancer Hospital, Chinese Academy of Medical Sciences between July 2007 and June 2012.
Systematic reviews are utilized in evidence-based medicine and are increasingly being used to help guide standards, guidelines, and clinical practice. The National Lung Screening Trial results prompted such a review of lung cancer screening literature. The review was endorsed by five major medical societies. We aimed at assessing its accuracy. Two independent groups of two reviewers reviewed the systematic review, including its source literature. Errors were placed into three major categories and tabulated: (i) selection of studies, (ii) misrepresentation of published reports, and (iii) errors in calculation and rounding. A total of 151 errors were found. There were 13 errors in selection of studies, 124 errors due to misrepresentation of published reports, and 14 errors in calculations and rounding. The extent of these errors raises concern about the credibility of the conclusions of the recent lung cancer screening systematic review. A process that allows for a thorough checking of data included in systematic reviews should be established.
Water desalination becomes an increasingly important approach for clean water supply to meet the rapidly growing demand of population boost, industrialization, and urbanization. The main challenge in current desalination technologies lies in the reduction of energy consumption and economic costs. Here, we propose to use charged nanopores drilled in a graphene sheet as ion exchange membranes to promote the efficiency and capacity of desalination systems. Using molecular dynamics simulations, we investigate the selective ion transport behavior of electric-field-driven KCl electrolyte solution through charge modified graphene nanopores. Our results reveal that the presence of negative charges at the edge of graphene nanopore can remarkably impede the passage of Cl(-) while enhance the transport of K(+), which is an indication of ion selectivity for electrolytes. We further demonstrate that this selectivity is dependent on the pore size and total charge number assigned at the nanopore edge. By adjusting the nanopore diameter and electric charge on the graphene nanopore, a nearly complete rejection of Cl(-) can be realized. The electrical resistance of nanoporous graphene, which is a key parameter to evaluate the performance of ion exchange membranes, is found two orders of magnitude lower than commercially used membranes. Our results thus suggest that graphene nanopores are promising candidates to be used in electrodialysis technology for water desalinations with a high permselectivity.
The irradiation effects in graphene supported by SiO(2) substrate including defect production and implantation efficiency are investigated using the molecular dynamics (MD) method with empirical potentials. We show that the irradiation damage in supported graphene comes from two aspects: the direct damage induced by the incident ions and the indirect damage resulting from backscattered particles and sputtered atoms from the substrate. In contrast with the damage in suspended graphene, we find that the indirect damage is dominant in supported graphene at high energies. As a result, enhanced irradiation damage in supported graphene is observed when the incident energy is above 5 keV for Ar and 3 keV for Si. The direct damage probability at all energies, even the total damage probability at low energies, in supported graphene is always much lower than that in suspended graphene because of the higher threshold displacement energy of carbon atoms. In addition, we demonstrate the striking finding that it is possible to dope graphene with sputtered atoms from the substrate and the implantation probability is considerable at optimal energies. Our results indicate that the substrate is an important factor in the process of ion-irradiation-assisted engineering of the properties of graphene.
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