Modeling the Adenoma and Serrated Pathway to Colorectal CAncer (ASCCA)

Several colorectal cancer (CRC) screening models have been developed describing the progression of adenomas to CRC. Currently, there is increasing evidence that serrated lesions can also develop into CRC. It is not clear whether screening tests have the same test characteristics for serrated lesions as for adenomas, but lower sensitivities have been suggested. Models that ignore this type of colorectal lesions may provide overly optimistic predictions of the screen‐induced reduction in CRC incidence. To address this issue, we have developed the Adenoma and Serrated pathway to Colorectal CAncer (ASCCA) model that includes the adenoma‐carcinoma pathway and the serrated pathway to CRC as well as characteristics of colorectal lesions. The model structure and the calibration procedure are described in detail. Calibration resulted in 19 parameter sets for the adenoma‐carcinoma pathway and 13 for the serrated pathway that match the age‐ and sex‐specific adenoma and serrated lesion prevalence in the COlonoscopy versus COlonography Screening (COCOS) trial, Dutch CRC incidence and mortality rates, and a number of other intermediate outcomes concerning characteristics of colorectal lesions. As an example, we simulated outcomes for a biennial fecal immunochemical test screening program and a hypothetical one‐time colonoscopy screening program. Inclusion of the serrated pathway influenced the predicted effectiveness of screening when serrated lesions are associated with lower screening test sensitivity or when they are not removed. To our knowledge, this is the first model that explicitly includes the serrated pathway and characteristics of colorectal lesions. It is suitable for the evaluation of the (cost)effectiveness of potential screening strategies for CRC.     

Impact of an Overt Response System on Staff Performance and Maintenance of Computer-Based Instruction

Interactive Computer Based Instruction (CBI) systems involve teaching strategies to facilitate greater response opportunities during training in an effort to improve learner performance. The current study investigated the effect of online staff training videos with and without overt response requirements on posttest and maintenance test scores across six block-randomized instructional modules for four employees of a university located in the southeastern region of the United States. The overt response consisted of multiple-choice questions administered throughout select teaching modules using an alternating treatment design. Findings suggest that learning occurred as a result of the CBI training; however, the effectiveness of the overt response system varied across individuals, with no discernible differentiation between learning gains associated with response requirements. Other areas of research for expanding the efficacy of CBI and overt response systems are highlighted.     

Amassing rural power in the fight against fracking in Maryland: A report from the field

ABSTRACT

Social workers can mobilize vulnerable populations to shape policy decisions about industrial practices that could have adverse impacts on their wellbeing. One such practice is hydraulic fracturing or “fracking” to extract oil and natural gas from shale rock deposits. There is scant social work literature on mobilizing opposition to fracking despite a proliferation of literature from other disciplines. This article documents the campaign in Maryland that led to the adoption of the first legislative ban on fracking in a U.S. state with shale gas reserves, using social movement theory to identify factors that led to this successful outcome.     

Acceptance of automation manufacturing technology in China: an examination of perceived norm and organizational efficacy

Abstract

With a shift to more automation technology, social acceptance of technology plays an important role in the manufacturing sector. To what extent this occurs, and affects the adoption of technology, has been less researched, but is important in deciding how such technology is introduced, and the nature of the shift from labour-intensive manufacturing to automation. This research applies the revised technology acceptance model (TAM) to examine the impact of social and individual antecedents on the acceptance of automation manufacturing technology. Survey data are collected from 258 Chinese manufacturers. Results suggest that perceived norms significantly affect organizational intention to use automation manufacturing technology both directly and via perceived usefulness; organizational efficacy explains the intention to use via mediating effect of perceived usefulness and perceived ease of use. This research is one of the first extending and applying TAM from individuals to organizations.     

Humility,Forgiveness, and Emerging Adult Female Romantic Relationships

Among a sample of emerging adult females (N = 152) we empirically examined the role of humility and forgiveness in romantic relationships. We specifically tested a model linking perceived humility to relationship satisfaction with self‐forgiveness and partner‐forgiveness. Participants in a romantic relationship completed measures of self‐reported humility, self‐forgiveness, partner‐forgiveness, and relationship satisfaction. Serial mediation analyses were conducted using path analysis to test the following sequence, humility self‐forgiveness partner‐forgiveness relationship satisfaction. Findings indicate that humility was related to relationship satisfaction via a serially mediated path of self‐forgiveness and partner‐forgiveness, which was not reducible to impression management. We consider implications for research and clinical practice.     

Human Health Risk Assessment of Penicillin/Aminopenicillin Resistance in Enterococci Due to Penicillin Use in Food Animals

Penicillin and ampicillin drugs are approved for use in food animals in the United States to treat, control, and prevent diseases, and penicillin is approved for use to improve growth rates in pigs and poultry. This article considers the possibility that such uses might increase the incidence of ampicillin-resistant Enterococcus faecium (AREF) of animal origin in human infections, leading to increased hospitalization and mortality due to reduced response to ampicillin or penicillin. We assess the risks from continued use of penicillin-based drugs in food animals in the United States, using several assumptions to overcome current scientific uncertainties and data gaps. Multiplying the total at-risk population of intensive care unit (ICU) patients by a series of estimated factors suggests that not more than 0.04 excess mortalities per year (under conservative assumptions) to 0.14 excess mortalities per year (under very conservative assumptions) might be prevented in the whole U.S. population if current use of penicillin drugs in food animals were discontinued and if this successfully reduced the prevalence of AREF infections among ICU patients. These calculations suggest that current penicillin usage in food animals in the United States presents very low (possibly zero) human health risks.     

情感与欲望之间——论"花儿"情歌的基本文化特征

“花儿”情歌的内容,始终游走于情感与欲望之间。本文以此为出发点,简要分析和阐述“花儿”情歌的基本特征。     

Coherence principles in interval‐based dose finding

This paper studies the notion of coherence in interval‐based dose‐finding methods. An incoherent decision is either (a) a recommendation to escalate the dose following an observed dose‐limiting toxicity or (b) a recommendation to deescalate the dose following a non–dose‐limiting toxicity. In a simulated example, we illustrate that the Bayesian optimal interval method and the Keyboard method are not coherent. We generated dose‐limiting toxicity outcomes under an assumed set of true probabilities for a trial of n=36 patients in cohorts of size 1, and we counted the number of incoherent dosing decisions that were made throughout this simulated trial. Each of the methods studied resulted in 13/36 (36%) incoherent decisions in the simulated trial. Additionally, for two different target dose‐limiting toxicity rates, 20% and 30%, and a sample size of n=30 patients, we randomly generated 100 dose‐toxicity curves and tabulated the number of incoherent decisions made by each method in 1000 simulated trials under each curve. For each method studied, the probability of incurring at least one incoherent decision during the conduct of a single trial is greater than 75%. Coherency is an important principle in the conduct of dose‐finding trials. Interval‐based methods violate this principle for cohorts of size 1 and require additional modifications to overcome this shortcoming. Researchers need to take a closer look at the dose assignment behavior of interval‐based methods when using them to plan dose‐finding studies.