Breast Cancer Education and Empowerment in Ethiopia: Evaluating Community-Based Cancer Prevention Efforts Using the RE-AIM Framework.

Cancer prevention challenges in Ethiopia include limited community awareness and low uptake of screening, which are in part driven by a lack of culturally and linguistically relevant cancer education appropriate for the diverse indigenous communities of this never-colonized nation. In 2022, a comprehensive multi-media breast cancer (BC) awareness campaign was implemented, featuring local cancer experts and survivors, with community-based screening events in the towns of Adama and Mojo. The RE-AIM framework was used to evaluate and describe its reach, effectiveness, adoption, implementation, and maintenance. Educational pamphlets, videos, social media posts, and interviews were distributed in person and through local and national media networks, reaching tens of millions of people and resulting in 525 individuals screened, with one diagnosis of early-stage cancer. During the free screening events, an interview-administered survey of BC knowledge, attitudes, and screening practices was conducted to inform future cancer education for this population. Among 287 survey respondents, about half correctly identified swelling (46%) or changing nipples/discharge (48.4%) as signs of BC. Maintenance challenges include the lack of a national screening program. Educational resources and a mobile app, translated into the local language, encourage continued patient empowerment to perform breast self-exams. In the absence of established BC prevention programs, "pop-up" mobile screening events can be effective for mobilizing communities to get screened. The paper highlights challenges and lessons gleaned from this community-based BC awareness campaign and screening event to inform future cancer education initiatives in Ethiopia and similar resource-limited settings.

Mismatch-tolerant, alignment-free sequence classification using multiple spaced seeds and multiindex Bloom filters.

Alignment-free classification tools have enabled high-throughput processing of sequencing data in many bioinformatics analysis pipelines primarily due to their computational efficiency. Originally k-mer based, such tools often lack sensitivity when faced with sequencing errors and polymorphisms. In response, some tools have been augmented with spaced seeds, which are capable of tolerating mismatches. However, spaced seeds have seen little practical use in classification because they bring increased computational and memory costs compared to methods that use k-mers. These limitations have also caused the design and length of practical spaced seeds to be constrained, since storing spaced seeds can be costly. To address these challenges, we have designed a probabilistic data structure called a multiindex Bloom Filter (miBF), which can store multiple spaced seed sequences with a low memory cost that remains static regardless of seed length or seed design. We formalize how to minimize the false-positive rate of miBFs when classifying sequences from multiple targets or references. Available within BioBloom Tools, we illustrate the utility of miBF in two use cases: read-binning for targeted assembly, and taxonomic read assignment. In our benchmarks, an analysis pipeline based on miBF shows higher sensitivity and specificity for read-binning than sequence alignment-based methods, also executing in less time. Similarly, for taxonomic classification, miBF enables higher sensitivity than a conventional spaced seed-based approach, while using half the memory and an order of magnitude less computational time.

Afghan women's empowerment and antenatal care utilization: a population-based cross-sectional study.

BACKGROUND: Although antenatal care (ANC) offers a unique opportunity to diagnose and prevent complications by mitigating modifiable risk, 38.2% of women did not complete any ANC visits in Afghanistan in 2015. Women empowerment is associated with increased use of ANC; however, there is no evidence of the effect of women empowerment on ANC in the country. Addressing this gap, we aimed to evaluate the association between women's empowerment and ANC utilization based on the conceptual framework of women's empowerment. METHODS: We analyzed data from the 2015 Afghanistan Demographic and Health Survey for 11,056 women. The association between four domains of women's empowerment, including capability, access to resources, security, and decision-making and power, and at least four ANC visits was analyzed using a multivariable logistic regression. RESULTS: After adjusting for covariates, access to information (AOR 1.38, 95%CI 1.24, 1.54) and decision-making (AOR 1.16, 95%CI 1.08, 1.24) were positively associated with four or more ANC visits. Compared to those without any education, women with primary education (AOR 1.67, 95%CI 1.02, 2.72), secondary education (AOR 2.43, 95%CI 1.25, 4.70), and higher education (AOR 3.03, 95%CI 1.30, 7.07) had higher odds of least four ANC visits. However, asset ownership was negatively associated with ANC visits (AOR 0.72, 95%CI 0.56, 0.92). Variables related to security and literacy were not associated with the minimum ANC visits. CONCLUSIONS: The mixed results of the study highlight the complex natures of women's empowerment, warranting a more nuanced understanding of women's empowerment in the context and future research that capture multidimensionality of women's empowerment. Also, efforts to empower women, particularly those with no education and had less decision-making power and access to health information, could be an effective strategy to enhance ANC use in Afghanistan.

ABySS 2.0: resource-efficient assembly of large genomes using a Bloom filter.

The assembly of DNA sequences de novo is fundamental to genomics research. It is the first of many steps toward elucidating and characterizing whole genomes. Downstream applications, including analysis of genomic variation between species, between or within individuals critically depend on robustly assembled sequences. In the span of a single decade, the sequence throughput of leading DNA sequencing instruments has increased drastically, and coupled with established and planned large-scale, personalized medicine initiatives to sequence genomes in the thousands and even millions, the development of efficient, scalable and accurate bioinformatics tools for producing high-quality reference draft genomes is timely. With ABySS 1.0, we originally showed that assembling the human genome using short 50-bp sequencing reads was possible by aggregating the half terabyte of compute memory needed over several computers using a standardized message-passing system (MPI). We present here its redesign, which departs from MPI and instead implements algorithms that employ a Bloom filter, a probabilistic data structure, to represent a de Bruijn graph and reduce memory requirements. We benchmarked ABySS 2.0 human genome assembly using a Genome in a Bottle data set of 250-bp Illumina paired-end and 6-kbp mate-pair libraries from a single individual. Our assembly yielded a NG50 (NGA50) scaffold contiguity of 3.5 (3.0) Mbp using <35 GB of RAM. This is a modest memory requirement by today's standards and is often available on a single computer. We also investigate the use of BioNano Genomics and 10x Genomics' Chromium data to further improve the scaffold NG50 (NGA50) of this assembly to 42 (15) Mbp.

Molecular Imaging of Fluorinated Probes for Tau Protein and Amyloid-ß Detection.

Alzheimer's disease (AD) is the most common form of dementia and results in progressive neurodegeneration. The incidence rate of AD is increasing, creating a major public health issue. AD is characterized by neurofibrillary tangles (NFTs) composed of hyperphosphorylated tau protein and senile plaques composed of amyloid-ß (Aß). Currently, a definitive diagnosis of AD is accomplished post-mortem. Thus, the use of molecular probes that are able to selectively bind to NFTs or Aß can be valuable tools for the accurate and early diagnosis of AD. The aim of this review is to summarize and highlight fluorinated molecular probes that can be used for molecular imaging to detect either NFTs or Aß. Specifically, fluorinated molecular probes used in conjunction with 19F MRI, PET, and fluorescence imaging will be explored.

ARCS: scaffolding genome drafts with linked reads.

Motivation: Sequencing of human genomes is now routine, and assembly of shotgun reads is increasingly feasible. However, assemblies often fail to inform about chromosome-scale structure due to a lack of linkage information over long stretches of DNA-a shortcoming that is being addressed by new sequencing protocols, such as the GemCode and Chromium linked reads from 10 × Genomics. Results: Here, we present ARCS, an application that utilizes the barcoding information contained in linked reads to further organize draft genomes into highly contiguous assemblies. We show how the contiguity of an ABySS H.sapiens genome assembly can be increased over six-fold, using moderate coverage (25-fold) Chromium data. We expect ARCS to have broad utility in harnessing the barcoding information contained in linked read data for connecting high-quality sequences in genome assembly drafts. Availability and implementation: https://github.com/bcgsc/ARCS/. Contact: rwarren@bcgsc.ca. Supplementary information: Supplementary data are available at Bioinformatics online.

Tigmint: correcting assembly errors using linked reads from large molecules.

BACKGROUND: Genome sequencing yields the sequence of many short snippets of DNA (reads) from a genome. Genome assembly attempts to reconstruct the original genome from which these reads were derived. This task is difficult due to gaps and errors in the sequencing data, repetitive sequence in the underlying genome, and heterozygosity. As a result, assembly errors are common. In the absence of a reference genome, these misassemblies may be identified by comparing the sequencing data to the assembly and looking for discrepancies between the two. Once identified, these misassemblies may be corrected, improving the quality of the assembled sequence. Although tools exist to identify and correct misassemblies using Illumina paired-end and mate-pair sequencing, no such tool yet exists that makes use of the long distance information of the large molecules provided by linked reads, such as those offered by the 10x Genomics Chromium platform. We have developed the tool Tigmint to address this gap. RESULTS: To demonstrate the effectiveness of Tigmint, we applied it to assemblies of a human genome using short reads assembled with ABySS 2.0 and other assemblers. Tigmint reduced the number of misassemblies identified by QUAST in the ABySS assembly by 216 (27%). While scaffolding with ARCS alone more than doubled the scaffold NGA50 of the assembly from 3 to 8 Mbp, the combination of Tigmint and ARCS improved the scaffold NGA50 of the assembly over five-fold to 16.4 Mbp. This notable improvement in contiguity highlights the utility of assembly correction in refining assemblies. We demonstrate the utility of Tigmint in correcting the assemblies of multiple tools, as well as in using Chromium reads to correct and scaffold assemblies of long single-molecule sequencing. CONCLUSIONS: Scaffolding an assembly that has been corrected with Tigmint yields a final assembly that is both more correct and substantially more contiguous than an assembly that has not been corrected. Using single-molecule sequencing in combination with linked reads enables a genome sequence assembly that achieves both a high sequence contiguity as well as high scaffold contiguity, a feat not currently achievable with either technology alone.

Implementation, utilization and influence of a community-based participatory nutrition promotion programme in rural Ethiopia: programme impact pathway analysis.

OBJECTIVE: A community-based participatory nutrition promotion (CPNP) programme, involving a 2-week group nutrition session, attempted to improve child feeding and hygiene. The implementation, utilization and influence of the CPNP programme were examined by programme impact pathway (PIP) analysis. DESIGN: Five CPNP programme components were evaluated: (i) degree of implementation; (ii) participants' perception of the nutrition sessions; (iii) participants' message recall; (iv) utilization of feeding and hygiene practices at early programme stage; and (v) participants' engagement in other programmes. SETTING: Habro and Melka Bello districts, Ethiopia. SUBJECTS: Records of 372 nutrition sessions, as part of a cluster-randomized trial, among mothers (n 876 in intervention area, n 914 in control area) from a household survey and CPNP participants (n 197) from a recall survey. RESULTS: Overall, most activities related to nutrition sessions were successfully operated with high fidelity (>90 %), but a few elements of the protocol were only moderately achieved. The recall survey among participants showed a positive perception of the sessions (~90 %) and a moderate level of message recall (~65 %). The household survey found that the CPNP participants had higher minimum dietary diversity at the early stage (34·0 v. 19·9 %, P=0·01) and a higher involvement in the Essential Nutrition Action (ENA) programme over a year of follow-up (28·2 v. 18·3 %; P<0·0001) compared with non-participants within the intervention area. CONCLUSIONS: Our PIP analysis suggests that CPNP was feasibly implemented, promoted a sustained utilization of proper feeding behaviours, and enhanced participation in the existing ENA programme. These findings provide a possible explanation to understanding CPNP's effectiveness.

Advancement of female representation within ophthalmology in Canada: an assessment of representation at the Canadian Ophthalmology Society annual meeting.

OBJECTIVE: Females in ophthalmology represent a small proportion of senior positions. Participation in academic endeavours (e.g., involvement at conferences) plays a crucial role in promoting a physician's career. This study evaluates the representation of females from 2003 to 2021 at the Canadian Ophthalmology Society (COS) annual meeting. DESIGN: Retrospective cross-sectional study. METHODS: Data were extracted for the following and classified according to gender (female or male): oral presentations, free workshops, skills transfer courses, committee members, moderators, keynote speakers, and panelists. Percentages of gender were calculated and trended per category and in aggregate. RESULTS: The total percentage of females in any conference position demonstrated a positive trend. Over 18 years, there was an 18.2% increase in females (24.9%-43.1%). Excluding duplicates, only a 12.7% increase (27.4%-40.1%) was found. An increase in representation among all categories was observed, most significantly in female committee members (14.3%-50.0%). Female keynote speakers continue to be the most underrepresented category (8.33%-35.0%). CONCLUSIONS: While underrepresented, females continue to trend upward in participation at COS meetings. Continuous analysis of females participating in academic positions such as at COS meetings will aid in limiting gender disparities in ophthalmology.

"Nobody does checkups back there": A qualitative study of refugees' healthcare needs in the United States from stakeholders' perspectives.

The number of refugees globally grew to 35.3 million in 2022, and many refugees are exposed to various health risks along their migration journey. As a result, they may arrive in host communities with numerous health issues, including communicable diseases and chronic and mental health conditions. Navigating the healthcare system in a host country proves to be a significant challenge for them, leading to delayed care. This qualitative study explored the convolute healthcare needs of refugees in the United States by soliciting insights from stakeholders involved in refugee resettlement and healthcare. In-depth interviews were conducted with fifteen stakeholders who work closely with refugees, including healthcare providers, cultural/clinical health navigators supporting refugees, staff from refugee resettlement agencies and governmental entities, and researchers studying refugee health. Following informed consent, interviews were audio-recorded, transcribed verbatim, and imported into MAXQDA 2022 (VERBI Software) for thematic analysis. The results revealed key themes, including the heterogeneity of refugee populations, limited awareness of preventive healthcare, high prevalence and suboptimal management of chronic conditions, complexity of the healthcare system, lack of follow-up, and language barriers. Further research is warranted concerning the long-term health of refugee populations in the United States. Additionally, more tailored programs involving peer educators are recommended to support refugee communities in navigating the complex healthcare system in the host country.

Reading Speed Using the International Reading Speed Texts in a Normal Canadian Cohort.

Background The International Reading Speed Texts (IReST) are commonly used to measure reading speed, which may be affected in many eye conditions. They were originally tested in a younger British population. Our study evaluates IReST in a normal Canadian population. Methodology A normal Canadian cohort in Ontario was prospectively recruited with age >14 years, education >9 years, English as the primary language, and best-corrected visual acuity >20/25 distance and >N8 near in each eye. Participants with eye conditions and neurological/cognitive problems were excluded. Each participant consecutively read two IReST passages (passages 1 and 8). Reading speed in words per minute (WPM) was calculated. One-sample t-test was used to compare our cohort to published IReST standards. Results A total of 112 participants were included (35 male, 77 female). The mean age was 40 ± 17 years (14-18 years: 12; 18-35 years: 34; 35-60 years: 53; 60-75 years: 13). The mean reading speed for passage 1 was 211 ± 33 WPM compared to the published IReST standard of 236 ± 29 WPM (p < 0.0001). The mean reading speed for passage 8 was 218 ± 34 WPM compared to the IReST standard of 237 ± 24 WPM (p < 0.0001). Thus, our cohort read slower for both passages compared to IReST standards. The mean reading speed for passages 1 and 8 was the highest for the 14-18-year (231 and 239, respectively) and the lowest for the 60-75-year group (195 and 192, respectively). Conclusions Normal older populations have slower reading compared to younger populations. The slower reading in our cohort may also be because the passages were in British rather than in Canadian English. It is important that the IReST is evaluated in different populations to ensure reliable comparison standards for future research.

A scoping review of maternal health among resettled refugee women in the United States.

Background: Globally, refugee women continue to face higher maternity-related risks from preventable complications during pregnancy and childbirth, partly due to high health care costs, unfamiliarity with the healthcare system, language barriers, and discrimination. Nevertheless, there is still a paucity of literature that evaluates the available evidence in the US. This scoping review delineated the body of literature on maternal health among refugee women resettled in the US in order to identify knowledge gaps in the literature and highlight future research priorities and directions for maternal health promotion. Methods: Electronic databases were searched in PubMed, CINAHL, PsycINFO, and EMBASE from inception through July 2021. We included all peer-reviewed study designs; qualitative, quantitative, and mixed method if they reported on refugee women's perinatal health experiences and outcomes in the US. Results: A total of 2,288 records were identified, with 29 articles meeting the inclusion criteria. Refugee women tend to initiate prenatal care late and have fewer prenatal care visits compared to women born in the US. Some of them were reluctant to get obstetric interventions such as labor induction and cesarean delivery. Despite numerous risk factors, refugee women had generally better maternal health outcomes. Studies have also highlighted the importance of health care providers' cultural competency and sensitivity, as well as the potential role of community health workers as a bridge between refugee women and health care providers. Conclusions: The scoping review emphasizes the need for early prenatal care initiation and more frequent prenatal care visits among refugee women. Furthermore, more needs to be done to mitigate resistance to obstetric interventions and mistrust. The mechanism by which healthy migrant effects occur could be better understood, allowing protective factors to be maintained throughout the resettlement and acculturation process. The scoping review identifies critical gaps in the literature, such as the underrepresentation of different ethnic groups of refugee women in refugee maternal studies in the US. Since this invisibility may indicate unspoken and unaddressed needs, more attention should be paid to underrepresented and understudied groups of refugee women in order to achieve health equity for all.

Survival Outcomes of Ewing Sarcoma and Rhabdomyosarcoma by High- versus Low-Volume Cancer Centres in British Columbia, Canada.

Due to the rarity and complexity of treatment for Ewing sarcoma and rhabdomyosarcoma, studies demonstrate improved patient outcomes when managed by a multidisciplinary team at high-volume centres (HVCs). Our study explores the difference in outcomes of Ewing sarcoma and rhabdomyosarcoma patients based on the centre of initial consultation in British Columbia, Canada. This retrospective study assessed adults diagnosed with Ewing sarcoma and rhabdomyosarcoma between 1 January 2000 and 31 December 2020 undergoing curative intent therapy in one of five cancer centres across the province. Seventy-seven patients were included, 46 seen at HVCs and 31 at low-volume centres (LVCs). Patients at HVCs were younger (32.1 vs. 40.8 years, p = 0.020) and more likely to receive curative intent radiation (88% vs. 67%, p = 0.047). The time from diagnosis to first chemotherapy was 24 days shorter at HVCs (26 vs. 50 days, p = 0.120). There was no significant difference in overall survival by treatment centre (HR 0.850, 95% CI 0.448-1.614). Variations in care exist amongst patients treated at HVCs vs. LVCs, which may reflect differences in access to resources, clinical specialists, and varying practice patterns across centres. This study can be used to inform decisions regarding triaging and centralization of Ewing sarcoma and rhabdomyosarcoma patient treatment.

Qualitative research on maternal care access among Arabic-speaking refugee women in the USA: study protocol.

BACKGROUND: Refugees tend to have greater health needs and pre-existing medical conditions due to poor living conditions, lack of health services, exposure to a variety of risk factors, and a high level of stress and trauma prior to entry to a host country. Notwithstanding distinctive needs and inherent conditions, there is a paucity of literature on refugee maternal health, especially for Arabic-speaking refugee women resettled in the USA. METHODS AND ANALYSIS: The paper delineates a qualitative study protocol to explore the experiences of Arabic-speaking refugee women in the USA when accessing maternal care. Informed by social cognitive theory, the study will employ two qualitative research methods; in-depth interviews and 'go-along' interviews with Arabic-speaking refugee women. Go-along interview will be used to elicit spatial experiences in situ to explore perceptions of environments among study participants and environmental and structural barriers. 20 refugee women who meet the inclusion criteria will be recruited through snowball sampling with support from community partners. Two researchers will code the transcription and fieldnotes using MAXQDA 2020 (VERBI Software, 2019). The analysis will involve deductive content analysis using a structured categorisation matrix based on the theory while also incorporating inductive codes that may emerge through the process. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Human Subjects Protection Programme at the University of Arizona (IRB 2104716241). The study results will be condensed in a summary report, which will be shared with community partners, including refugee resettlement agencies and relevant staff at the state department. Also, community feedback will be garnered from the dissemination workshops to inform community discussions for actions and an intervention to address the identified needs.

Formative Qualitative Research: Design Considerations for a Self-Directed Lifestyle Intervention for Type-2 Diabetes Patients Using Human-Centered Design Principles in Benin.

Given the burgeoning prevalence of Type-2 Diabetes (T2D) in Benin and other sub-Saharan countries, tailored diabetes self-management interventions are urgently needed. Human-centered designs can be useful for identifying beneficiaries' needs while keeping in mind feasibility and viability in a given context. Therefore, this study examined the acceptability and community perceptions of a self-directed lifestyle program for T2D patients in Cotonou, southern Benin. Data were collected using focus group discussions (FDGs) with T2D patients (n = 3; 32 participants), academic partners (n = 2; 16 participants), and community partners (n = 2; 12 participants). All FDG sessions were audio-recorded, transcribed from French into English verbatim, and analyzed using MAXQDA 2020. Most participants found the program to be useful and feasible. However, they preferred pictorial brochures as training materials and suggested community health workers as facilitators, assisted by clinicians or dietitians. They recommended community-based delivery mechanisms and mobile applications like WhatsApp to enhance patient adherence. Participants' characteristics, tangible health benefits, incentives, and simple curriculums were cited as critical to program feasibility, effectiveness, and acceptability. This study provides a deeper understanding of potential diabetes self-management participants' needs and concerns. Moreover, it highlights the need to consider key stakeholders' needs and voices for effective intervention.

Caught in the net: Characterizing how testicular cancer patients use the internet as an information source.

INTRODUCTION: Over 70% of Canadians who use the internet search for healthcare information online. This is especially true regarding the young adult population. Testicular cancer is the most commonly diagnosed cancer in men aged 15-29. This study characterizes how testicular cancer patients access healthcare information online, and how this influences their clinical encounters and treatment decisions. METHODS: From June 2018 to January 2019, a survey consisting of 24 open- and close-ended questions was distributed to testicular cancer patients at a tertiary cancer center. Survey results were evaluated using mixed methods analysis. RESULTS: Fifty-nine surveys were distributed and 44 responses were received. All respondents used the internet regularly and 82% used the internet as a source of information regarding their cancer. The majority followed top hits from Google when selecting websites to view. Frequent topics searched included treatment details and survivorship concerns. Eighty-nine percent of users found online information easy to understand and 94% found it increased their understanding. For 47% of users, the internet did not influence their clinical consultation nor their treatment decision (53%). CONCLUSIONS: Most testicular cancer patients in this study are regular internet users and use the internet to search for testicular cancer information. Healthcare providers should recognize this, and can play important roles in discussing online findings with patients to assess their background knowledge and expectations, as well as providing guidance on selecting credible online resources. The results of this study can be used to improve patient-physician communication and education.

Cultural Considerations for the Adaptation of a Diabetes Self-Management Education Program in Cotonou, Benin: Lessons Learned from a Qualitative Study.

Background: Type 2 diabetes (T2D) poses a disproportionate burden on Benin, West Africa. However, no diabetes intervention has yet been developed for Benin's contexts. This study aimed to explore specific cultural beliefs, attitudes, behaviors, and environmental factors to help adapt a diabetes self-management program to patients with T2D from Cotonou, in southern Benin. Methods: Qualitative data were collected through focus group discussions (FDGs) involving 32 patients with T2D, 16 academic partners, and 12 community partners. The FDGs were audio-recorded, transcribed verbatim from French to English, and then analyzed thematically with MAXQDA 2020. Results: Healthy food was challenging to obtain due to costs, seasonality, and distance from markets. Other issues discussed were fruits and vegetables as commodities for the poor, perceptions and stigmas surrounding the disease, and the financial burden of medical equipment and treatment. Information about local food selections and recipes as well as social support, particularly for physical activity, were identified, among other needs. When adapting the curriculum, gender dynamics and spirituality were suggested. Conclusions: The study demonstrates the need for culturally sensitive interventions and a motivation-based approach to health (spiritual and emotional support). It also lays the groundwork for addressing T2D contextually in Benin and similar sub-Saharan African countries.

Gender Disparity in Chest Radiology in North America.

PURPOSE: In the current cultural climate, gender disparity is a topical and contentious issue. In academic medicine, there is an underrepresentation of female faculty in leadership positions with lower research output and fewer grant awards. We study the gender differences in faculty rank, leadership positions, and research output among chest radiologists in North America. MATERIALS AND METHODS: A list of clinical faculty at radiology programs in North America was obtained using the FREIDA database and program websites. Demographic information and data pertaining to academic rank, peer-reviewed publications, and research productivity of each chest radiologist was obtained from Doximity and SCOPUS databases. RESULTS: Four hundred ten (281 male:129 female) academic chest radiologists were included. Females were underrepresented at senior faculty level accounting for 18.8% (n = 21) of full, 29.2% (n = 21) of associate and 40.7% (n = 61) of assistant professors. 23.1% (n = 14) of department chiefs were women. Women were more likely to occupy a faculty position in chest radiology in Canada than in US (P < 0.05). The median H-index, and numbers of publications and citations were lower for females than male faculty (P < 0.05). Male faculty had more years of experience - median of 19 years, 16.5 years for females (P < 0.05). CONCLUSIONS: Gender disparity exists in chest radiology with similar male predominance in terms of senior faculty rank, leadership roles, and research productivity to other medical specialties. The observed deficiency of research and scholarly output among female chest radiologists and the paucity of aspirational female radiologists in senior academic/leadership positions are factors which perpetuate this gender disparity and contribute to persistence of the gender pay gap.

A fountain of knowledge? The quality of online resources for testicular cancer patients.

INTRODUCTION: Testicular cancer is the most common solid malignancy diagnosed in young men aged 15-29. This population is also the age group that searches most actively for health information online. This study systematically evaluates the quality of websites available to patients with testicular cancer. METHODS: The term "testicular cancer" was inputted into the search engines Google, Dogpile, and Yippy. The top 100 websites intended for patient education were compiled. A validated structural rating tool was used to evaluate the websites with respect to attribution, currency, disclosure, interactivity, readability, and content. RESULTS: Less than half of the websites (44) disclosed authorship. Sixty-one websites provided a last modified date, and of those, 46 were updated in the last two years. The average readability level was 11.01 using the Flesh-Kincaid grade level system. The most accurate topic was treatment, with 82 websites being completely accurate and containing all required information. The least accurate topic was prognosis, with 27 being completely accurate. CONCLUSIONS: These results show that authorship and currency are lacking in many online testicular resources, making it difficult for patients to validate the reliability of information. The high average readability of testicular cancer websites can affect comprehension. Topics such as prognosis were incompletely covered although represent an area for which patients often seek more information. These results can be used to counsel patients on the strength and weaknesses of online testicular cancer resources.