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Frequency and survival of delayed breast cancer diagnosis in women participating at screening mammography in the Netherlands:a population-based study
No full textBackground Although breast cancer screening programmes aim to enable early breast cancer detection, diagnostic delays still occur among participants. Limited information is available on the frequency and survival of women with a delay in breast cancer diagnosis within the screening population. We determined the frequency of various types of delay in breast cancer diagnosis at screening mammography and specified the tumour characteristics, surgical therapy and survival rates of women with these delayed diagnoses, as well as variations in their proportions over time. Methods We included 901,133 screening examinations obtained in the southern Netherlands between 1999 and 2019. Screening mammograms of women with interval cancers (ICs) and breast cancers detected at subsequent screening were reviewed to determine whether the cancer had been missed. Findings Of the 7129 women with breast cancers, 5419 (76.0%) were diagnosed without delay after recall and 1101 (15.4%) had a true IC (i.e., not detectable at the previous screen). In total, 1601 women experienced a delay in breast cancer diagnosis, comprising the following three study groups: (i) recalled women with a delay in diagnostic work-up (n = 264), (ii) recalled women with screen-detected cancers (SDCs) at subsequent screening and without a delay in diagnostic work-up, that had been missed at the previous screening round (n = 992), and (iii) women with ICs missed at the latest screening round (n = 345). Overall, 26.6% of cancers were associated with a delay (1601/6028), primarily due to SDCs missed at the previous screen (62.0%, 992/1601), followed by missed ICs (21.5%, 345/1601) and misdiagnosis after recall (16.5%, 264/1601). Compared to SDCs missed at the previous screen and misdiagnosis after recall, missed ICs demonstrated the poorest tumour characteristics, highest mastectomy rate (42.6% vs 20.1% and 19.3%, p < 0.0001) and poorest overall survival (5-year rate 86.9% vs 93.8% and 93.8%, p = 0.0017). Temporal trends in tumour characteristics were mainly observed in SDCs missed at the previous screen. Interpretation Delayed breast cancer diagnosis at screening mammography or after recall remains a serious point of concern. Most delays are related to SDCs missed at a previous screen, whereas missed ICs show the worst survival. Funding This research did not receive any funding. Copyright (c) 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Health 2026;61: Published https://doi.org/10. 1016/j.lanepe.2025. 10152
Empathy and Offending, a Study About the Role of Cognitive and Affective Empathy in Sexual Violence
No full textEmpathy deficits are common among offenders, including those with sexual offenses. While empathy is not a major risk factor for sexual offending, it is linked to other risk factors like offense-supportive attitudes and hostility. Research often fails to differentiate between cognitive (understanding emotions) and affective (emotional resonance) empathy, hindering identification of specific empathy impairments in offenders. This study examines cognitive and affective empathy in Dutch males with sexual offenses (N = 33), violent offenses (N = 30), and the general population (N = 91). Using the Interpersonal Reactivity Index (IRI) and considering impulsivity as a covariate, the study found that sexual offenders had higher levels of both cognitive and affective empathy compared to violent offenders. However, only affective empathy differed significantly from the general population, with sexual offenders showing higher levels. The study suggests nuanced empathy deficits in sexual offenders, though self-reporting may have influenced results.</p
Event-based optical flow on neuromorphic processor:ANN vs. SNN comparison based on activation sparsification
No full textSpiking neural networks (SNNs) for event-based optical flow are claimed to be computationally more efficient than their artificial neural networks (ANNs) counterparts, but a fair comparison is missing in the literature. In this work, we propose an event-based optical flow solution based on activation sparsification and a neuromorphic processor, SENECA. SENECA has an event-driven processing mechanism that can exploit the sparsity in ANN activations and SNN spikes to accelerate the inference of both types of neural networks. The ANN and the SNN for comparison have similar low activation/spike density (~5%) thanks to our novel sparsification-aware training. In the hardware-in-loop experiments designed to deduce the average time and energy consumption, the SNN consumes 44.9ms and 927.0µJ, which are 62.5% and 75.2% of the ANN's consumption, respectively. We find that SNN's higher efficiency is attributed to its lower pixel-wise spike density (43.5% vs. 66.5%) that requires fewer memory access operations for neuron states
To NER or Not to NER? A Case Study of Low-Resource Deontic Modalities in EU Legislation
No full textDeontic modality (obligation, permission, prohibition) in legal documents can convey critical information, and identification of deontic modalities is often performed using Natural Language Processing (NLP) techniques as a 'Deontic Modality Classification' (DMC) text classification task. As deontic modalities in legal text are not mutually exclusive, a key challenge with DMC is that it classifies the provided text into a single modality while in reality it might have multiple deontic modalities. To address this, this study analyzes the feasibility of performing deontic modality identification as a Named Entity Recognition (NER) task over DMC task approaches in a low-resource data setting with EU legislation. Low-resource NLP approaches can offer solutions to tackle the problem of scarce data. In this paper, we use a rule-based approach with modal verbs and a Decision Tree classifier for DMC task. For NER, we utilize Conditional Random Fields (CRFs) in a low-resource setting and report on the reliability and precision for identification of deontic modality. Our experiments reveal that simpler models, like decision trees, out perform larger models in the low-resource setting of DMC obtaining macro-F1 score of 0.83. For the NER task, the CRF models show consistent performance for 'obligation' labels with an F1-score of 0.51 but have wavering results for other classes with a max F1-score of 0.26 for 'permission', and 0.08 for 'prohibition'
Neural and Behavioral Markers of Negative Symptoms and Cognitive Impairment in Patients with Psychosis
No full textNegative and cognitive symptoms impair functioning in patients with psychotic illnesses [i.e., schizophrenia spectrum disorders (SZ) and bipolar I disorder with psychotic features (BD)]. Disruptions in mesocorticolimbic circuitry are hypothesized to underpin negative symptoms and cognitive impairment in patients with psychosis and may also facilitate reward-motivational deficits. In male and female patients with psychosis (N = 44) and healthy controls (HC = 27), we used neuroimaging to define gray matter morphology and white matter microstructure. We examined negative symptom severity with the Clinical Assessment Interview for Negative Symptoms (CAINS), effort allocation during reward processing with the Effort Expenditure for Rewards Task (EEfRT), and cognitive performance with the MATRICS cognitive consensus battery (MCCB). Reduced nucleus accumbens volumes in patients with psychosis were associated with higher CAINS total and motivation and pleasure subscale scores as well as lower effort expenditure for medium (50%) and high (88%) reward probability conditions during EEfRT. The fornix showed reduced fractional anisotropy in patients with psychosis. Negative associations were present between CAINS motivation and pleasure subscores and MCCB composite and subscale scores. Lower gray matter volume in cerebellar Lobule IV corresponded with impaired effort allocation during medium and high reward probability conditions and lower cognitive performance. However, Lobule IV was not correlated with CAINS scores. While nucleus accumbens volume may serve as a marker of negative symptoms in psychotic illnesses, cerebellar Lobule IV morphology may inform on cognitive impairment in patients with SZ and BD. The nucleus accumbens and Lobule IV may each contribute to reduced effort allocation during reward processing.</p
Ablation of cavo-tricuspid isthmus dependent atrial flutter using a focal monopolar pulsed-field ablation catheter:Feasibility, periprocedural coronary spasms and conduction disorders
No full textBackground: Pulsed-field ablation for the treatment of cavotricuspid isthmus (CTI)–dependent atrial flutter has been associated with coronary spasms (CS) and atrioventricular conduction disorders (CD). Objectives: The purpose of this study was to evaluate the feasibility of CTI ablation using a monopolar focal pulsed-field ablation (F-PFA) catheter and to assess the risk of CS and CD during and after the procedure. Methods: We prospectively enrolled patients with atrial flutter treated with an F-PFA system (CardioFocus, Marlborough, MA) or by focal radiofrequency ablation (RFA) using contact force–sensing catheters integrated into electroanatomic mapping systems. Intravenous nitroglycerin was administered prior to F-PFA. Feasibility and safety with a focus on CS or CD were assessed. In a subgroup of patients, the course of the right coronary artery and the His position were determined. Results: In total, 82 patients underwent CTI ablation with F-PFA (mean age 66 ± 8 years; 15 (18%) being female; CHA 2DS 2-VA score 1.6 ± 1.3) and 27 patients underwent CTI ablation with RFA (mean age 63 ± 9 years; 4 (23%) being female; CHA 2DS 2-VA score 2 ± 1.3). For F-PFA, the rate of first-pass block was higher (93% vs 55%) and the median (interquartile range) procedure times were shorter (7 [5–11] minutes vs 17 [15–19] minutes) than for RFA. In the F-PFA group, 4 patients (5%) had transient ST-segment elevation and 2 patients (2%) had transient complete atrioventricular block during ablation. There was a small but significant prolongation of the PQ interval after CTI ablation in the F-PFA group. Conclusion: CTI ablation using F-PFA is feasible, but operators should be aware of rare but critical CD and CS during the procedure, even when preventive measures such as nitroglycerin administration are used.</p
The Moderating Role of Dementia-Related Fear in the Relationship Between Perceived Cognitive Decline and Motivation for Dementia Risk Reduction Behaviors in Community-Dwelling Middle-Aged and Older Adults
No full textOBJECTIVE: With the increasing incidence of dementia, lifestyle interventions are key for long-term risk reduction. Understanding the psychological factors affecting lifestyle change motivation is crucial to developing effective policy strategies for dementia risk reduction. This study explores the moderating role of dementia-related fear on the relationship between perceived cognitive decline and engagement in dementia risk reduction behaviors. METHODS: A cross-sectional study was conducted among 200 Chinese community-dwelling middle-aged and older adults. Hierarchical regression and simple slope analysis were used to assess the moderating effect of dementia-related fear on the relationship between perceived cognitive decline and motivation to engage in dementia risk reduction behaviors. RESULTS: A significant correlation was found between perceived cognitive decline and increased motivation to engage in dementia risk reduction behaviors (r = 0.44). Dementia-related fear acted as a significant moderator; motivation was positively associated with low to moderate levels of fear, whereas this association diminished and became non-significant at higher levels of fear. CONCLUSIONS: The findings suggest that while lower levels of dementia-related fear may be linked to increased motivation for engaging in risk reduction behaviors, elevated levels of fear do not appear to support such engagement. Rather than emphasizing the negative impacts of dementia, public health strategies should empower individuals with actionable messages to engage in dementia risk reduction behaviors
Assessment of psychosocial adjustment and reduced initiative in children with myotonic dystrophy type 1:a pilot study on the reliability and clinical utility of a short parent-report questionnaire
No full textWe describe the reliability and clinical utility of the personal adjustment and role skills scale III (PARS-III) for screening of psychosocial adjustment in children with myotonic dystrophy type 1 (DM1). Data of 36 pediatric DM1 patients were included from the Dutch MYODRAFT patient registry. Reliability was assessed using Cronbach's alpha. Associations between PARS-III scores and estimates of brain-related comorbidity and parent-reported physical disease burden were explored as possible factors affecting psychosocial adjustment. PARS-III data of children with DM1 in this study were compared to PARS-III data from children with Duchenne muscular dystrophy in order to describe specificity to the pediatric DM1 population. The PARS-III showed adequate internal consistency. PARS-III total scores correlated with parent-reported symptoms of autism spectrum disorder and attention deficit/hyperactivity disorder and parent-reported physical disease burden. No statistically significant associations were found with intelligence. Parents reported most problems in reduced social activity and reduced initiative. Reduced initiative was not associated with attention deficit/hyperactivity disorder, autism spectrum disorder or reported physical disease burden. Parents of children with DM1 reported more problems in initiative compared to parents of children with Duchenne muscular dystrophy. We conclude that the PARS-III is a reliable instrument for screening psychosocial adjustment in general and deficits in initiative in particular. More research is needed on this clinically relevant symptom as a possible brain-related comorbidity of children with DM1
DTW-Align: Bridging the Modality Gap in End-to-End Speech Translation with Dynamic Time Warping Alignment
No full textEnd-to-End Speech Translation (E2E-ST) is the task of translating source speech directly into target text bypassing the intermediate transcription step. The representation discrepancy between the speech and text modalities has motivated research on what is known as bridging the modality gap. State-of-the-art methods addressed this by aligning speech and text representations on the word or token level. Unfortunately, this requires an alignment tool that is not available for all languages. Although this issue has been addressed by aligning speech and text embeddings using nearest-neighbor similarity search, it does not lead to accurate alignments. In this work, we adapt Dynamic Time Warping (DTW) for aligning speech and text embeddings during training. Our experiments demonstrate the effectiveness of our method in bridging the modality gap in E2E-ST. Compared to previous work, our method produces more accurate alignments and achieves comparable E2E-ST results while being significantly faster. Furthermore, our method outperforms previous work in low resource settings on 5 out of 6 language directions
UCI Sports Nutrition Project:Nutritional Periodization
No full textThe fundamental goal of nutrition for training is to provide the required energy and substrate to sustain the target training volume and intensity that is necessary to induce desired physiological adaptations. However, aside from fueling and recovery, it is now recognized that nutrient availability also modulates the activation of cell signaling pathways that regulate adaptations associated with both endurance and strength training. Such developments are the guiding principles underpinning "nutritional periodization" wherein energy, macronutrient, and micronutrient availability are deliberately manipulated across the microcycle, mesocycle, and macrocycle with the strategic goal to promote training adaptations, support recovery, manipulate body composition, and optimize competition performance. In addition to total "daily" nutrient intake, the elite athlete must, therefore, adjust their energy and carbohydrate intake in a meal-by-meal and day-by-day manner (i.e., carbohydrate periodization) in accordance with the energetic demands and training objectives of each specific training session. In addition to fueling (and refueling) for the work required, daily protein intake should at least be 1.6-2.1 g<middle dot>kg-1<middle dot>day-1 not only to account for amino acid oxidation during exercise but also, importantly, to promote tissue remodeling, notably skeletal muscle. Emerging evidence also supports the rationale for nutraceuticals to promote recovery and sleep, though the potential effect of such compounds in blunting training adaptation should also be considered. Taken together, it is increasingly clear that nutrition is a critical enabler to successful training outcomes, and as such, the sport nutritionist should be considered an integral member of an athlete's coaching and performance support team