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This study investigates the impact of primary care utilisation of a symptom-based head and neck cancer risk calculator (Head and Neck Cancer Risk Calculator version 2) in the post-coronavirus disease 2019 period on the number of primary care referrals and cancer diagnoses.
The number of referrals from April 2019 to August 2019 and from April 2020 to July 2020 (pre-calculator) was compared with the number from the period January 2021 to August 2022 (post-calculator) using the chi-square test. The patients’ characteristics, referral urgency, triage outcome, Head and Neck Cancer Risk Calculator version 2 score and cancer diagnosis were recorded.
In total, 1110 referrals from the pre-calculator period were compared with 1559 from the post-calculator period. Patient characteristics were comparable for both cohorts. More patients were referred on the cancer pathway in the post-calculator cohort (pre-calculator patients 51.1 per cent vs post-calculator 64.0 per cent). The cancer diagnosis rate increased from 2.7 per cent in the pre-calculator cohort to 3.3 per cent in the post-calculator cohort. A lower rate of cancer diagnosis in the non-cancer pathway occurred in the cohort managed using the Head and Neck Cancer Risk Calculator version 2 (10 per cent vs 23 per cent, p = 0.10).
Head and Neck Cancer Risk Calculator version 2 demonstrated high sensitivity in cancer diagnosis. Further studies are required to improve the predictive strength of the calculator.
We describe the glacial geomorphology and initial geochronology of two ice-free valley systems within the Neptune Range of the Pensacola Mountains, Antarctica. These valleys are characterized by landforms associated with formerly more expanded ice sheet(s) that were at least 200 m thicker than at present. The most conspicuous features are areas of supraglacial debris, discrete debris accumulations separated from modern-day ice and curvilinear ridges and mounds. The landsystem bears similarities to debris-rich cold-based glacial landsystems described elsewhere in Antarctica and the Arctic where buried ice is prevalent. Geochronological data demonstrate multiple phases of ice expansion. The oldest, occurring > 3 Ma, overtopped much of the landscape. Subsequent, less expansive advances into the valleys occurred > 2 Ma and > ~1 Ma. An expansion of some local glaciers occurred < 250 ka. This sequence of glacial stages is similar to that described from the northernmost massif of the Pensacola Mountains (Dufek Massif), suggesting that it represents a regional signal of ice-sheet evolution over the Plio-Pleistocene. The geomorphological record and its evolution over millions of years makes the Neptune Range valleys an area worthy of future research and we highlight potential avenues for this.
In this paper we report on a visual world eye-tracking experiment that investigated the differing abilities of adults and children to use referential scene information during reanalysis to overcome lexical biases during sentence processing. The results showed that adults incorporated aspects of the referential scene into their parse as soon as it became apparent that a test sentence was syntactically ambiguous, suggesting they considered the two alternative analyses in parallel. In contrast, the children appeared not to reanalyze their initial analysis, even over shorter distances than have been investigated in prior research. We argue that this reflects the children's over-reliance on bottom-up, lexical cues to interpretation. The implications for the development of parsing routines are discussed.
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