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.     

朝阳民间刺绣：遗留在深山的“珍珠”

一项项民间技艺如一颗颗美丽的珍珠,散落在乡野间的每个角落,经过岁月的打磨,散发出温润的光泽.而作为非遗工作者,就是那些采撷珠宝的人,要将它们一一串联,使其绽放更为动人的夺目光彩.2013年的初夏,我和同事们来到朝阳,找寻那颗遗留在深山里的珍珠——朝阳民间刺绣.     

中国城镇新增住房需求规模的测算与分析

本文围绕城镇家庭户自然增长、城镇家庭户机械增长和城镇存量住房拆除三项需求来源,设计了基于人口普查等公开统计数据定量测算城镇新增住房需求规模的系统性方法,对2001—2010年和2011—2015年间全国和各省份城镇新增住房需求规模进行测算与分析。在此期间新增住房供需关系经历了从基本均衡向供过于求的变化,同时存量住房拆除引致的被动需求取代城镇家庭户自然增长和机械增长引致的主动需求,成为新增住房需求的最主要来源。东、中、西部省份在新增需求规模、新增供需比、需求结构等方面表现出明显差异。本文还进一步对2021—2030年的发展趋 势进行了定量预测。由于三项需求来源均趋于下降,2021—2025年和2026—2030年间全国年均城镇新增住房需求规模预计将较2011—2015年间分别下降33%和53%。本文设计的城镇新增住房需求规模测算方法和预测思路能够为各级政府“十四五”住房发展规划编制、房地产企业战略制定等提供参考。     

区块链技术嵌入医联体信息化建设:内在逻辑与现实挑战

信息化建设是医联体建设的重要内容和重点领域。现阶段的医联体信息化建设存在着医疗信息数据难共享、医疗隐私数据易泄露、医疗数据质量难改观等问题。文章通过梳理区块链的技术原理，发现区块链技术同医联体信息化建设有着高度的契合性并能以智能化的应对方式密切医患互动关系、保障数据高效共享、加强数据安全治理以及提升数据准确性、一致性、时效性和规整性，因此，区块链技术嵌入医联体信息化建设具有可行性。但区块链技术应用于医联体信息化建设在技术、理念、监管等方面还存在诸多挑战，未来仍需提升技术应用手段、转变医方观念体系、健全法规监管模式。     

Utilizing social media for social work: insights from clients in online youth services

ABSTRACT

This study explored and conceptualised service users’ experiences in online outreach projects supported by the Hong Kong SAR government. Fifteen active users were interviewed. The study used thematic analysis to explore service users’ experiences that might not have been possible without technology. Participant utterances were non-mutually-exclusively tagged with a specific theme. Each utterance reflected an aspect of user experience which combined a technical component with a service-need component. Six themes were identified, including: (i) Personalised newsfeeds help identify service information and news, (ii) Online status indicators improve service accessibility, (iii) Online communications enable a disinhibition effect, (iv) Asynchronous communications facilitate continual feedback loops, (v) Incomplete communicative modalities may cause misunderstanding and (vi) Asynchronous communication may disrupt conversations. The findings reveal that there are middle-level concepts between broad social work concepts and ever-changing technology. Implications for research and practice are discussed.     

Causal structure among US corn futures and regional cash prices in the time and frequency domain

This study investigates causal structure among daily Chicago Board of Trade corn futures prices and seven regional cash series from Iowa, Illinois, Indiana, Ohio, Minnesota, Nebraska, and Kansas for January 2006–March 2011. Their wavelet transformed series are further analyzed for causal relationships at different time scales. Empirical results indicate no causality among states or between the futures and a cash series for time scales shorter than one month. As scales increase but do not exceed a year, bidirectional causal flows are determined among all prices. The information leadership role of the futures against a cash price is identified for the scale longer than one year and raw series, at which no interstate causality is found.     

Statistical considerations in clinical trial design with event-free survival as the primary efficacy endpoint

In late-phase confirmatory clinical trials in the oncology field, time-to-event (TTE) endpoints are commonly used as primary endpoints for establishing the efficacy of investigational therapies. Among these TTE endpoints, overall survival (OS) is always considered as the gold standard. However, OS data can take years to mature, and its use for measurement of efficacy can be confounded by the use of post-treatment rescue therapies or supportive care. Therefore, to accelerate the development process and better characterize the treatment effect of new investigational therapies, other TTE endpoints such as progression-free survival and event-free survival (EFS) are applied as primary efficacy endpoints in some confirmatory trials, either as a surrogate for OS or as a direct measure of clinical benefits. For evaluating novel treatments for acute myeloid leukemia, EFS has been gradually recognized as a direct measure of clinical benefits. However, the application of an EFS endpoint is still controversial mainly due to the debate surrounding definition of treatment failure (TF) events. In this article, we investigate the EFS endpoint with the most conservative definition for the timing of TF, which is Day 1 since randomization. Specifically, the corresponding non-proportional hazard pattern of the EFS endpoint is investigated with both analytical and numerical approaches.     

Economic Stress, Quality of Life, and Mortality for the Oldest-Old in China

China??s oldest old population is estimated to quadruple by 2050. Yet, poverty rate for the oldest old has been the highest among all age groups in China. This paper investigates the relationship between economic stress, quality of life, and mortality among the oldest-old in China. Both objective economic hardships and perceived economic strain are examined. We base our investigation on data drawn from the Chinese Longitudinal Healthy Longevity Survey conducted between 2000 and 2005. Our sample includes 10,972 men and women between the ages of 80 and 105 in 2000. The data show that about 16% of these oldest-old lived under economic stress in 2000. The risk factors that make one vulnerable to economic stress include age, being male, being widowed or never married, being a minority member, having no education, having no living children, and not having children as main source of income, and having no pension. Economic stress is negatively associated with indicators of quality of life, such as the quality of medical care and mental well-being. The poor quality of life contributes to the higher mortality rate for the oldest old who are under economic stress. Results also show that perceived economic strain increases the risk of mortality by 42% in rural areas, even after controlling for basic demographic characteristics, life style factors, and major health events.?For the rural oldest-old, having children as a main source of income and having access to pension alleviates the negative impact of economic hardship on mortality hazard by 23 and 66% respectively. However, in urban areas, economic stress has no direct impact on the hazard of mortality.