Establishing Standardized Terminology for Digital Image Analysis: A Pilot Study.

PURPOSE: To point out the need for standardized terminology for digital image analysis and to collect data by surveying radiologic technology professionals for a more comprehensive, national-breadth study. METHODS: A mixed-method pilot study was conducted, in which a survey was emailed to 4 Joint Review Committee on Education in Radiologic Technology-accredited radiography programs in July and August 2019. Eight educators and 28 radiologic technologists responded, and acceptance was evaluated on 3 of the proposed terms: signal, signal value, and signal variance (later changed to signal differences). Quantitative data results were analyzed in Microsoft Forms and percentage of acceptance rates calculated. Respondents who did not accept the proposed terms were asked to provide reasoning in open-ended responses, which were analyzed using manual coding and categorization. RESULTS: The term signal received an 88% acceptance rate among educators and a 96% rate among radiographers. Signal value was accepted by 88% of educators and 79% of radiographers. The lowest acceptance rate was for the term signal variance (educators, 63%; radiographers, 79%). Open-ended responses were categorized into themes revealing respondent concerns about the use of signal value, which might result in forgetting about radiation dose (4 respondents) and how signal value relates to image receptor exposure and exposure indicator value (2 respondents). Concerns about signal variance involved contrast being easier to understand because it is visible (2 respondents), confusion with the usage of the proposed term (2 respondents), and preference for contrast because of its current use (2 respondents). DISCUSSION: Recent history indicates confusion regarding which terms effectively describe the new image quality factors that dictate proper use of digital radiography. The proposed terms evaluated in this pilot study received a mean acceptance rate of 83.5%, suggesting understanding of terms related to digital image analysis from participating educators and radiographers. CONCLUSION: The findings of this pilot study indicate a need to standardize terminology related to digital image quality factors. However, these preliminary results should be interpreted with caution because of the low response rate. Readers can participate in helping to establish a universal language for digital image analysis by scanning the quick response (QR) code or clicking the link at the end of the article and completing the survey.

Phage therapy reduces Campylobacter jejuni colonization in broilers.

The effect of phage therapy in the control of Campylobacter jejuni colonization in young broilers, either as a preventive or a therapeutic measure, was tested. A prevention group was infected with C. jejuni at day 4 of a 10-day phage treatment. A therapeutic group was phage treated for 6 days, starting 5 days after C. jejuni colonization of the broilers had been established. Treatment was monitored by enumerating Campylobacter colony forming units (CFU) and phage plaque forming units (PFU) from caecal content. Counts were compared with control birds not receiving phage therapy. A clear 3 log decline in C. jejuni counts was initially observed in the therapeutic group, however, after 5 days bacterial counts stabilized at a level 1 log lower than that of the control group. Colonization of C. jejuni in the prevention group was delayed by the treatment and after an initial 2 log reduction, colonization stabilized within a week at levels comparable to the therapeutic group. The CFU and PFU counts displayed opposing highs and lows over time, indicative of alternating shifts in amplification of bacteria and phages. There were no adverse health effects from the phage treatment. Two different phages were combined as therapeutic treatment of Campylobacter positive chickens challenged at the age approaching broiler harvest. This again resulted in a significant decrease in Campylobacter colonization. We conclude that phage treatment is a promising alternative for reducing C. jejuni colonization in broilers.

Domestic violence compared to other health risks: a survey of physicians' beliefs and behaviors.

BACKGROUND: Physicians routinely confront patient risk behaviors once considered private, including tobacco use, alcohol abuse, and HIV/STD-risk behavior. We compared physicians' behaviors and beliefs on screening and intervention for domestic violence with each other risk. METHODS: Survey of nationwide, random sample of 610 primary care physicians from the American Medical Association Physician Masterfile. RESULTS: Fewer primary care physicians screened for domestic violence than for other risks (p <0.001); once domestic violence was identified, however, physicians intervened with equal or greater frequency than for other risks. Fewer believed that they knew how to screen or intervene for domestic violence compared with other risks, and significantly fewer believed that domestic violence interventions were successful compared with interventions for tobacco and HIV/STD risks (Bonferroni adjusted p<0.001). CONCLUSIONS: Lower domestic violence screening rates may reflect physicians' beliefs that they do not know how to screen or intervene, and that interventions are less successful for domestic violence than for other risks. We may improve screening rates by educating physicians that a simplified role, as for other risks, can be effective for domestic violence.

Bacteriophage therapy rescues mice bacteremic from a clinical isolate of vancomycin-resistant Enterococcus faecium.

Colonization of the gastrointestinal tract with vancomycin-resistant Enterococcus faecium (VRE) has become endemic in many hospitals and nursing homes in the United States. Such colonization predisposes the individual to VRE bacteremia and/or endocarditis, and immunocompromised patients are at particular risk for these conditions. The emergence of antibiotic-resistant bacterial strains requires the exploration of alternative antibacterial therapies, which led our group to study the ability of bacterial viruses (bacteriophages, or phages) to rescue mice with VRE bacteremia. The phage strain used in this study has lytic activity against a wide range of clinical isolates of VRE. One of these VRE strains was used to induce bacteremia in mice by intraperitoneal (i.p.) injection of 10(9) CFU. The resulting bacteremia was fatal within 48 h. A single i.p. injection of 3 x 10(8) PFU of the phage strain, administered 45 min after the bacterial challenge, was sufficient to rescue 100% of the animals. Even when treatment was delayed to the point where all animals were moribund, approximately 50% of them were rescued by a single injection of this phage preparation. The ability of this phage to rescue bacteremic mice was demonstrated to be due to the functional capabilities of the phage and not to a nonspecific immune effect. The rescue of bacteremic mice could be effected only by phage strains able to grow in vitro on the bacterial host used to infect the animals, and when such strains are heat inactivated they lose their ability to rescue the infected mice.