Defining growth in small pulmonary nodules using volumetry: results from a “coffee-break” CT study and implications for current nodule management guidelines

Objectives An increase in lung nodule volume on serial CT may represent true growth or measurement variation. In nodule guidelines, a 25% increase in nodule volume is frequently used to determine that growth has occurred; this is based on previous same-day, test–retest (coffee-break) studies examining metastatic nodules. Whether results from prior studies apply to small non-metastatic nodules is unknown. This study aimed to establish the interscan variability in the volumetric measurements of small-sized non-metastatic nodules. Methods Institutional review board approval was obtained for this study. Between March 2019 and January 2021, 45 adults (25 males; mean age 65 years, range 37–84 years) with previously identified pulmonary nodules (30–150 mm3) requiring surveillance, without a known primary tumour, underwent two same-day CT scans. Non-calcified solid nodules were measured using commercial volumetry software, and interscan variability of volume measurements was assessed using a Bland–Altman method and limits of agreement. Results One hundred nodules (range 28–170 mm3; mean 81.1 mm3) were analysed. The lower and upper limits of agreement for the absolute volume difference between the two scans were − 14.2 mm3 and 12.0 mm3 respectively (mean difference 1.09 mm3, range − 33–12 mm3). The lower and upper limits of agreement for relative volume difference were − 16.4% and 14.6% respectively (mean difference 0.90%, range − 24.1–32.8%). Conclusions The interscan volume variability in this cohort of small non-metastatic nodules was smaller than that in previous studies involving lung metastases of varying sizes. An increase of 15% in nodule volume on sequential CT may represent true growth, and closer surveillance of these nodules may be warranted. Key Points • In current pulmonary nodule management guidelines, a threshold of 25% increase in volume is required to determine that true growth of a pulmonary nodule has occurred. • This test–retest (coffee break) study has demonstrated that a smaller threshold of 15% increase in volume may represent true growth in small non-metastatic nodules. • Closer surveillance of some small nodules growing 15–25% over a short interval may be appropriate.

Assessing Without Words: Verbally Incomplete Utterances in Complaints

This study investigates the use of verbally incomplete utterances in French-language complaints about third parties or situations. In these cases, a speaker initiates a turn with verbal means but stops talking before reaching lexico-syntactic completion. The utterance becomes recognizable as an expression of negative stance or as a precise negative assessment by virtue of the linguistic formatting of the turn-initiation, its position within the larger interactional context, and the speaker’s accompanying bodily-visual displays and vocalizations. Data consist of video-recorded coffee-break conversations among first and second language speakers of French. Using multimodal Conversation Analysis, the analysis documents recurrent linguistic formats of the verbally incomplete utterances and examines the interactional deployment of the utterances in two distinct sequential contexts: (1) in the initiation of complaints, and (2) at the end of complaint tellings or reports. In the first of these, the action of leaving a turn verbally incomplete and expressing stance with bodily-visual means allows the speaker to prepare the grounds for the complaint by foreshadowing the negative valence of the upcoming talk. In the latter case, the verbally incomplete utterance and accompanying vocal and/or embodied conduct are deployed as a summary assessment or upshot of the complaint which shows, rather than merely describes, the complaint-worthiness of the situation. In both cases, the utterances work to enhance the chances for the speaker to obtain affiliative responses from coparticipants. While prior studies on verbally incomplete utterances have suggested that such utterances may be specifically suitable for subtly dealing with delicate actions, in this study the utterances are sometimes produced as part of multimodal ‘extreme-case expressions’ that convey negative stance in a high-grade manner. The findings contribute to a better understanding of interactional uses of verbally incomplete utterances and of the multimodal nature of negative assessments. The study thereby furthers our understanding of how grammar and the body interface as resources for the accomplishment of context-specific actions and the organization of social interaction.

2.ª TERTÚLIA NADA SOBRE NÓS SEM NÓS:

Este trabalho tem como tema discutir a acessibilidade, em uma perspectiva inclusiva, para eventos com pessoas com deficiência, dando principal atenção para o momento de pausa para lanche, o coffee break, proveniente da 2ª Tertúlia Nada Sobre Nós Sem Nós, evento promovido pelo grupo de pesquisa e extensão INCLUSIVE. O evento foi realizado na Universidade Federal do Pampa. O objetivo da investigação é discutir sobre inclusão e acessibilidade pelo viés de uma das ações ou atividades realizadas no evento, o coffee break. A justificativa é o fato do evento é protagonizado por pessoas com deficiência dentro do movimento Nada Sobre Nós Sem Nós, em razão disso é necessário pensar todos os momentos do evento em uma perspectiva inclusiva, inclusive o intervalo para a alimentação. Para coleta de dados, utilizamos o Google Forms e o Whatsapp. A análise foi realizada através da Análise de Conteúdo (BARDIN, 2009). Os resultados revelaram que ocorreu acessibilidade durante o evento no coffee break. Compreendemos que “fazer inclusão” é, antes de qualquer coisa, se rever e fazer o processo de olhar para dentro de nós, tentando identificar em que medida nós reforçamos muitas vezes os estereótipos e os paradigmas, que minimizam as pessoas com deficiência.

Kopi bagi Kita

Tradisi minum kopi biasa dilakukan masyarakat setiap pagi. Sebagian menambahkannya pada malam hari ketika begadang atau tugas ronda. Namun, sekarang kopi tak lagi sekadar tradisi, tetapi menjadi rutin, atau kebutuhan sehari-hari, menjadi teman aktivitas sejak pagi hingga dini hari. Bahkan, hampir umum di setiap penyelenggaraan acara formal, juga informal, yang dilaksanakan pihak pemerintah ataupun swasta, selalu menyelipkan satu acara khusus: coffee break.

MANAJEMEN SUMBER DAYA MANUSIA (Tinjauan Strategis Berbasis Kompetensi)

Puji syukur kehadirat Allah SWT, atas berkat dan rahmat-Nya penulis dapat menyelesaikan buku yang berjudul Manajemen Sumber Daya Manusia (Tinjauan Strategis Berbasis Kompetensi). Adapun dasar pemikiran dari penulisan buku ini dikarenakan keprihatinan penulis yang menilai bahwa buku-buku MSDM yang telah banyak beredar saat ini dan yang sering digunakan sebagai referensi pustaka perkuliahan masih menawarkan materi yang sama, yaitu hanya sebatas pada kajian-kajian teori deskriptif yang membutuhkan penjelasan praktik lebih lanjut.Meskipun telah terdapat berbagai keluaran buku referensi lainnya yang menjelaskan praktik MSDM, namun jumlahnya masih sangat sedikit. Untuk itu, kehadiran buku ini adalah sebagai alternatif dan pelengkap dari berbagai kajian pada buku-buku MSDM yang umumnya sudah ada. Selain membahas kajian MSDM secara umum, pembaca akan dibawa kepada tingkat pemahaman yang lebih komprehensif melalui berbagai kajian praktik, metode, dan strategi yang digunakan di dunia MSDM berbasis kompetensi. Sehingga baik perusahaan maupun para karyawannya mampu menghasilkan nilai tambah (value added) agar dapat mencapai keunggulan daya saing (gaining a competitive advantage).Selain pembahasan materi, dalam buku ini juga terdapat dua sesi menarik, yaitu sesi “Coffee Break” dan sesi “Brainstorming”. Sesi coffee break menghadirkan berbagai artikel pemberitaan terkait dengan permasalahan yang terjadi di dunia kerja (MSDM) yang disesuaikan dengan pembahasan materi pada masing-masing bab. Kemudian pada sesi brainstorming, pembaca diarahkan untuk dapat menganalisis, mengidentifikasi, dan memecahkan berbagai persoalan yang terkait pada setiap materi pembahasan. Tujuan dari sesi brainstorming adalah untuk meningkatkan pemahaman dan kemampuan pembaca, bukan hanya sekedar teori, namun juga praktik dan penerapan dari berbagai metode yang telah dipelajari.Dalam penyusunan buku ini, tentu masih terdapat beberapa kekurangan di dalamnya. Untuk itu penulis sangat terbuka menerima masukan yang bersifat membangun demi perbaikan dan kesempurnaan pada edisi dan penulisan buku berikutnya.