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The purpose of this comparative analysis study is to compare how students' motivation, emotional stability, and positivity in life are affected by indoor technology-driven activities compared to outdoor play activities. Furthermore, the researchers conducted their study at the St. Michael Institute of Bacoor, using quantitative methods to collect data. They surveyed one hundred and fifty senior high school students aged 18-20. The study used self-made questionnaires with sixty questions divided into three variables: emotional stability, motivation, and positivity in life. The results show no significant difference between the levels of emotional stability, motivation, and positivity in life based on the respondents' preferred activities. This study aims to promote outdoor play activities and a balanced lifestyle with indoor technology-driven activities. It will serve as a basis for suggesting activities that will boost motivation, emotional stability, and positivity in life. [ABSTRACT FROM AUTHOR]

Osmotic demyelination syndrome (ODS) is a rare complication associated with rapid sodium changes, typically encountered in patients with severe hyponatremia. ODS in patients with normonatremia (ODSIN) is less recognized. We describe a patient with MRI‐detected ODSIN following neurotrauma and reviewed the relevant literature. We present a 57‐year‐old female with subdural hematoma following ground‐level fall. Her initial sodium was 140 mEq/L but over 2 days, rose 17 mEq/L, peaking at 157 mEq/L. On exam, unexplainable, unexpected left‐sided hemiplegia with weakness sparing her face were noted; ODS was suspected. MRI revealed central pontine T2 hyperintensity, T1 hypointensity, and FLAIR hyperintensity. Treatment included gradual lowering of sodium with normal saline and free water. She was discharged to a skilled nursing facility (SNF) with sodium 138 mEq/L and upon 4‐year follow‐up had moderate disability and required some assistance to support activities of daily living. Our literature search yielded 23 cases (22 normonatremic; 1 where normonatremia progressed to hypernatremia). Common signs/symptoms were hyperreflexia, dysarthria, and gait disturbance. Common comorbidities were alcoholism, dialysis, and renal disease/failure. Cranial MRI confirmed all cases, frequently revealing central pontine T2 and FLAIR hyperintensity and T1 hypointensity. Our review further characterizes the diverse etiologies, clinical course, and radiographic features of ODSIN. Clinicians should consider this diagnosis when neurological symptoms occur even in the setting of normonatremia. [ABSTRACT FROM AUTHOR]

We are still largely reliant on pesticides for the suppression of arthropod pests which threaten human health and food production, but the recent rise of evolved resistance among important pest species has reduced pesticide efficacy. Despite this, our understanding of strategies that effectively limit the evolution of resistance remains weak. Male‐killing sex ratio distorting microbes (SRDMs), such as Wolbachia and Spiroplasma, are common among arthropod species. Previous theoretical work has suggested that they could limit adaptive potential in two ways: first, because by distorting sex ratios they reduce the effective population size, and second, because infected females produce no male offspring which restricts gene flow. Here we present the results of a novel experiment in which we test the extent by which these two mechanisms limit the adaptive response of arthropods to pesticide. Using a fully factorial design, we manipulated the adult sex ratio of laboratory populations of Drosophila melanogaster, both in the presence and absence of SRDMs, and exposed these populations to six generations of pesticide poisoning. This design allows the effects of SRDMs on sex ratio and their effects on gene flow to be estimated separately. After six generations, individuals from populations with even sex ratios displayed a higher resistance to pesticide relative to individuals from female‐biased populations. By contrast, we found no effect of the presence of SRDMs in host populations on pesticide resistance independent of sex ratio. In addition, males were more susceptible to pesticide than females—this was true of flies from both naïve and previously exposed populations. These findings provide the first empirical proof of concept that sex ratio distortion arising from SRDMs can limit adaptation to pesticides, but cast doubt on the theoretical effect of male‐killers limiting adaptation by disrupting gene flow. [ABSTRACT FROM AUTHOR]

Screening may decrease cancer mortality and treatment costs, but the annual cost of cancer screening in the United States is unknown. This study used national health care survey and cost resources data to estimate the annual medical care cost of cancer screening in the United States in 2021. Visual Abstract. The Annual Cost of Cancer Screening in the United States: Screening may decrease cancer mortality and treatment costs, but the annual cost of cancer screening in the United States is unknown. This study used national health care survey and cost resources data to estimate the annual medical care cost of cancer screening in the United States in 2021. Background: Cancer has substantial health, quality-of-life, and economic impacts. Screening may decrease cancer mortality and treatment costs, but the cost of screening in the United States is unknown. Objective: To estimate the annual cost of initial cancer screening (that is, screening without follow-up costs) in the United States in 2021. Design: Model using national health care survey and cost resources data. Setting: U.S. health care systems and institutions. Participants: People eligible for breast, cervical, colorectal, lung, and prostate cancer screening with available data. Measurements: The number of people screened and associated health care system costs by insurance status in 2021 dollars. Results: Total health care system costs for initial cancer screenings in the United States in 2021 were estimated at $43 billion. Approximately 88.3% of costs were attributable to private insurance; 8.5% to Medicare; and 3.2% to Medicaid, other government programs, and uninsured persons. Screening for colorectal cancer represented approximately 64% of the total cost; screening colonoscopy represented about 55% of the total. Facility costs (amounts paid to facilities where testing occurred) were major drivers of the total estimated costs of screening. Limitations: All data on receipt of cancer screening are based on self-report from national health care surveys. Estimates do not include costs of follow-up for positive or abnormal screening results. Variations in costs based on geography and provider or health care organization are not fully captured. Conclusion: The $43 billion estimated annual cost for initial cancer screening in the United States in 2021 is less than the reported annual cost of cancer treatment in the United States in the first 12 months after diagnosis. Identification of cancer screening costs and their drivers is critical to help inform policy and develop programmatic priorities, particularly for enhancing access to recommended cancer screening services. Primary Funding Source: None. [ABSTRACT FROM AUTHOR]

Recent evidence suggests that individuals differ in foraging tactics and this variation is often linked to an individual's behavioural type (BT). Yet, while foraging typically comprises a series of search and handling steps, empirical investigations have rarely considered BT‐dependent effects across multiple stages of the foraging process, particularly in natural settings.In our long‐term sleepy lizard (Tiliqua rugosa) study system, individuals exhibit behavioural consistency in boldness (measured as an individual's willingness to approach a novel food item in the presence of a threat) and aggressiveness (measured as an individual's response to an 'attack' by a conspecific dummy). These BTs are only weakly correlated and have previously been shown to have interactive effects on lizard space use and movement, suggesting that they could also affect lizard foraging performance, particularly in their search behaviour for food.To investigate how lizards' BTs affect their foraging process in the wild, we supplemented food in 123 patches across a 120‐ha study site with three food abundance treatments (high, low and no‐food controls). Patches were replenished twice a week over the species' entire spring activity season and feeding behaviours were quantified with camera traps at these patches. We tracked lizards using GPS to determine their home range (HR) size and repeatedly assayed their aggressiveness and boldness in designated assays.We hypothesised that bolder lizards would be more efficient foragers while aggressive ones would be less attentive to the quality of foraging patches. We found an interactive BT effect on overall foraging performance. Individuals that were both bold and aggressive ate the highest number of food items from the foraging array. Further dissection of the foraging process showed that aggressive lizards in general ate the fewest food items in part because they visited foraging patches less regularly, and because they discriminated less between high and low‐quality patches when revisiting them. Bolder lizards, in contrast, ate more tomatoes because they visited foraging patches more regularly, and ate a higher proportion of the available tomatoes at patches during visits.Our study demonstrates that BTs can interact to affect different search and handling components of the foraging process, leading to within‐population variation in foraging success. Given that individual differences in foraging and movement will influence social and ecological interactions, our results highlight the potential role of BT's in shaping individual fitness strategies and population dynamics. [ABSTRACT FROM AUTHOR]

The use of soil residual herbicides, along with other practices that diversify weed management strategies, have been recommended to improve weed management and deter the progression of herbicide resistance. Although soil characteristics influence recommended application rates for these herbicides, the common practice is to apply a uniform dose of soil residual herbicides across fields with variable soil characteristics. Mapping fields for soil characteristics that dictate the optimal dose of soil residual herbicides could improve the efficiency and effectiveness of these herbicides, as well as improve environmental stewardship. The objectives of this research were to develop and quantify the accuracy of management zone classifications for variable-rate residual herbicide applications using multiple soil data sources and soil sampling intensities. The maps were created from soil data that included (i) Soil Survey Geographic database (SSURGO), (ii) soil samples (SS), (iii) soil samples regressed onto soil electrical conductivity (EC) measurements (SSEC), (iv) soil samples with organic matter (OM) data from SmartFirmer® (SF) sensors (SSSF), and (v) soil samples regressed onto EC measurements plus OM data from SmartFirmer® sensor (SSECSF). A modified Monte Carlo cross validation method was used on ten commercial Indiana fields to generate 36,000 maps across all sources of spatial soil data, sampling density, and three representative herbicides (pyroxasulfone, s-metolachlor, and metribuzin). Maps developed from SSEC data were most frequently ranked with the highest management zone classification accuracy compared to maps developed from SS data. However, SS and SSEC maps concurrently had the highest management zone classification accuracy of 34% among maps developed across all fields, herbicides, and sampling intensities. One soil sample per hectare was the most reliable sampling intensity to generate herbicide application management zones compared to one soil sample for every 2 or 4 hectares. In conclusion, soil sampling with ECa data should be used for defining the management zones for variable-rate (VR) residual herbicide applications. [ABSTRACT FROM AUTHOR]

Models of rocky-coast erosion help us understand the physical phenomena that control coastal morphology and evolution, infer the processes shaping coasts in remote environments, and evaluate risk from natural hazards and future climate change. Existing models, however, are highly complex, are computationally expensive, and depend on many input parameters; this limits our ability to explore planform erosion of rocky coasts over long timescales (thousands to millions of years) and over a range of conditions. In this paper, we present a simplified cellular model of coastline evolution in closed basins through uniform erosion and wave-driven erosion. Uniform erosion is modeled as a constant rate of retreat. Wave erosion is modeled as a function of fetch, the distance over which the wind blows to generate waves, and the angle between the incident wave and the shoreline. This reduced-complexity model can be used to evaluate how a detachment-limited coastal landscape reflects climate, sea-level history, material properties, and the relative influence of different erosional processes. [ABSTRACT FROM AUTHOR]

The paper examines the application of adaptive antennas in wireless communication systems with particular attention to how well they can transmit and receive signals by dynamically adjusting radiation patterns. The review covers a range of artificial intelligence (AI) approaches that have been used to enhance adaptive antenna performance in beamforming, channel estimation, interference mitigation, and spectrum utilization. Besides adaptive antennas' potential to improve wireless communication systems, the paper also discusses their limitations, including computational complexity, interference sensitivity, and the significance of precise channel state information (CSI) estimates. [ABSTRACT FROM AUTHOR]

Lung cancer screening with low-dose computed tomography has been shown to reduce lung cancer mortality. Nevertheless, it may also lead to potential harms, including complications arising from downstream invasive procedures. However, the magnitude of such potential harms in real-world practice remains unknown. The current study evaluated downstream use of invasive procedures and procedural complications after lung cancer screening in 5 diverse U.S. health care systems. Visual Abstract. Downstream Procedures and Complications Associated With Lung Cancer Screening.: Lung cancer screening with low-dose computed tomography has been shown to reduce lung cancer mortality. Nevertheless, it may also lead to potential harms, including complications arising from downstream invasive procedures. However, the magnitude of such potential harms in real-world practice remains unknown. The current study evaluated downstream use of invasive procedures and procedural complications after lung cancer screening in 5 diverse U.S. health care systems. Background: Lung cancer screening (LCS) using low-dose computed tomography (LDCT) reduces lung cancer mortality but can lead to downstream procedures, complications, and other potential harms. Estimates of these events outside NLST (National Lung Screening Trial) have been variable and lacked evaluation by screening result, which allows more direct comparison with trials. Objective: To identify rates of downstream procedures and complications associated with LCS. Design: Retrospective cohort study. Setting: 5 U.S. health care systems. Patients: Individuals who completed a baseline LDCT scan for LCS between 2014 and 2018. Measurements: Outcomes included downstream imaging, invasive diagnostic procedures, and procedural complications. For each, absolute rates were calculated overall and stratified by screening result and by lung cancer detection, and positive and negative predictive values were calculated. Results: Among the 9266 screened patients, 1472 (15.9%) had a baseline LDCT scan showing abnormalities, of whom 140 (9.5%) were diagnosed with lung cancer within 12 months (positive predictive value, 9.5% [95% CI, 8.0% to 11.0%]; negative predictive value, 99.8% [CI, 99.7% to 99.9%]; sensitivity, 92.7% [CI, 88.6% to 96.9%]; specificity, 84.4% [CI, 83.7% to 85.2%]). Absolute rates of downstream imaging and invasive procedures in screened patients were 31.9% and 2.8%, respectively. In patients undergoing invasive procedures after abnormal findings, complication rates were substantially higher than those in NLST (30.6% vs. 17.7% for any complication; 20.6% vs. 9.4% for major complications). Limitation: Assessment of outcomes was retrospective and was based on procedural coding. Conclusion: The results indicate substantially higher rates of downstream procedures and complications associated with LCS in practice than observed in NLST. Diagnostic management likely needs to be assessed and improved to ensure that screening benefits outweigh potential harms. Primary Funding Source: National Cancer Institute and Gordon and Betty Moore Foundation. [ABSTRACT FROM AUTHOR]

Models of rocky coast erosion help us understand the physical phenomena that control coastal morphology and evolution, infer the processes shaping coasts in remote environments, and evaluate risk from natural hazards and future climate change. Existing models, however, are highly complex, computationally expensive, and depend on many input parameters; this limits our ability to explore planform erosion of rocky coasts over long timescales (100s to 100,000s years) and a range of conditions. In this paper, we present a simplified cellular model of coastline evolution through uniform erosion and wave-driven erosion. Uniform erosion is modeled as a constant rate of retreat. Wave erosion is modeled as a function of fetch, the distance over which the wind blows to generate waves, and the angle between the incident wave and the shoreline. This reduced complexity model can be used to evaluate how a detachment-limited coastal landscape reflects climate, sea level history, material properties, and the relative influence of different erosional processes. [ABSTRACT FROM AUTHOR]

Alluvial rivers are conveyor belts of fluid and sediment that provide a record of upstream climate and erosion on Earth, Titan, and Mars. However, many of Earth’s rivers remain unsurveyed, Titan’s rivers are not well resolved by current spacecraft data, and Mars’ rivers are no longer active, hindering reconstructions of planetary surface conditions. To overcome these problems, we use dimensionless hydraulic geometry relations—scaling laws that relate river channel dimensions to flow and sediment transport rates—to calculate in-channel conditions using only remote sensing measurements of channel width and slope. On Earth, this offers a way to predict flow and sediment flux in rivers that lack field measurements and shows that the distinct dynamics of bedload-dominated, suspended load-dominated, and bedrock rivers give rise to distinct channel characteristics. On Mars, this approach not only predicts grain sizes at Gale Crater and Jezero Crater that overlap with those measured by the Curiosity and Perseverance rovers, it enables reconstructions of past flow conditions that are consistent with proposed long-lived hydrologic activity at both craters. On Titan, our predicted sediment fluxes to the coast of Ontario Lacus could build the lake’s river delta in as little as ~1,000 y, and our scaling relationships suggest that Titan’s rivers may be wider, slope more gently, and transport sediment at lower flows than rivers on Earth or Mars. Our approach provides a template for predicting channel properties remotely for alluvial rivers across Earth, along with interpreting spacecraft observations of rivers on Titan and Mars. [ABSTRACT FROM AUTHOR]

Lung cancer screening (LCS) with low-dose CT (LDCT) imaging was recommended in 2013, making approximately 8 million Americans eligible for LCS. The demographic characteristics and outcomes of individuals screened in the United States have not been reported at the population level. What are the outcomes among people screened and entered in the American College of Radiology's Lung Cancer Screening Registry compared with those of trial participants? This was a cohort study of individuals undergoing baseline LDCT imaging for LCS between 2015 and 2019. Predictors of adherence to annual screening were computed. LDCT scan interpretations by Lung Imaging Reporting and Data System (Lung-RADS) score, cancer detection rates (CDRs), and stage at diagnosis were compared with National Lung Cancer Screening Trial data. Adherence was 22.3%, and predictors of poor adherence included current smoking status and Hispanic or Black race. On baseline screening, 83% of patients showed negative results and 17% showed positive screening results. The overall CDR was 0.56%. The percentage of people with cancer detected at baseline was higher in the positive Lung-RADS categories at 0.4% for Lung-RADS category 3, 2.6% for Lung-RADS category 4A, 11.1% for Lung-RADS category 4B, and 19.9% for Lung-RADS category 4X. The cancer stage distribution was similar to that observed in the National Lung Cancer Screening Trial, with 53.5% of patients receiving a diagnosis of stage I cancer and 14.3% with stage IV cancer. Underreporting into the registry may have occurred. This study revealed both the positive aspects of CT scan screening for lung cancer and the challenges that remain. Findings on CT imaging were correlated accurately with lung cancer detection using the Lung-RADS system. A significant stage shift toward early-stage lung cancer was present. Adherence to LCS was poor and likely contributes to the lower than expected cancer detection rate, all of which will impact the outcomes of patients undergoing screening for lung cancer. [Display omitted] [ABSTRACT FROM AUTHOR]

As the Covid-19 greatly affected the libraries, so too did the librarians' attempts to reach the library users through online and remote services. These emergency reforms have offered an unexpected opportunity to reevaluate and re-imagine current service models in order to improve the library's user experience. This study looks into the awareness of online library services and the frequency of utilization of online resources among education students during the COVID 19 Pandemic. Descriptive in nature, the study utilized an online survey which was accomplished by 70 students of the College of Education. Findings revealed that respondents are fully aware of the online library services and they frequently utilize the library's online resources regardless of their gender, program, and year level. Findings also showed that the higher the level of respondents' awareness on online library services, the more frequent they utilize the online resources. As a whole, the results imply that libraries need to ensure the sustainability of their online resources and services by providing user education and supporting the users to cope-up with the changing information environment so that optimum use of information resources becomes possible during and after the pandemic. [ABSTRACT FROM AUTHOR]

Background: Lung cancer screening (LCS) with low-dose computed tomography (LDCT) was recommended by the U.S. Preventive Services Task Force (USPSTF) in 2013, making approximately 8 million Americans eligible for screening. The demographic characteristics and adherence of persons screened in the United States have not been reported at the population level.Objective: To define sociodemographic characteristics and adherence among persons screened and entered into the American College of Radiology's Lung Cancer Screening Registry (LCSR).Design: Cohort study.Setting: United States, 2015 to 2019.Participants: Persons receiving a baseline LDCT for LCS from 3625 facilities reporting to the LCSR.Measurements: Age, sex, and smoking status distributions (percentages) were computed among persons who were screened and among respondents in the 2015 National Health Interview Survey (NHIS) who were eligible for screening. The prevalence between the LCSR and the NHIS was compared with prevalence ratios (PRs) and 95% CIs. Adherence to annual screening was defined as having a follow-up test within 11 to 15 months of an initial LDCT.Results: Among 1 159 092 persons who were screened, 90.8% (n = 1 052 591) met the USPSTF eligibility criteria. Compared with adults from the NHIS who met the criteria (n = 1257), screening recipients in the LCSR were older (34.7% vs. 44.8% were aged 65 to 74 years; PR, 1.29 [95% CI, 1.20 to 1.39]), more likely to be female (41.8% vs. 48.1%; PR, 1.15 [CI, 1.08 to 1.23]), and more likely to currently smoke (52.3% vs. 61.4%; PR, 1.17 [CI, 1.11 to 1.23]). Only 22.3% had a repeated annual LDCT. If follow-up was extended to 24 months and more than 24 months, 34.3% and 40.3% were adherent, respectively.Limitations: Underreporting of LCS and missing data may skew demographic characteristics of persons reported to be screened. Underreporting of adherence may result in underestimates of follow-up.Conclusion: Approximately 91% of persons who had LCS met USPSTF eligibility criteria. In addition to continuing to target all eligible adults, men, those who formerly smoked, and younger eligible patients may be less likely to be screened. Adherence to annual follow-up screening was poor, potentially limiting screening effectiveness.Primary Funding Source: None. [ABSTRACT FROM AUTHOR]

Background: Cancer screening should be recommended only when the balance between benefits and harms is favorable. This review evaluated how U.S. cancer screening guidelines reported harms, within and across organ-specific processes to screen for cancer.Objective: To describe current reporting practices and identify opportunities for improvement.Design: Review of guidelines.Setting: United States.Patients: Patients eligible for screening for breast, cervical, colorectal, lung, or prostate cancer according to U.S. guidelines.Measurements: Information was abstracted on reporting of patient-level harms associated with screening, diagnostic follow-up, and treatment. The authors classified harms reporting as not mentioned, conceptual, qualitative, or quantitative and noted whether literature was cited when harms were described. Frequency of harms reporting was summarized by organ type.Results: Harms reporting was inconsistent across organ types and at each step of the cancer screening process. Guidelines did not report all harms for any specific organ type or for any category of harm across organ types. The most complete harms reporting was for prostate cancer screening guidelines and the least complete for colorectal cancer screening guidelines. Conceptualization of harms and use of quantitative evidence also differed by organ type.Limitations: This review considers only patient-level harms. The authors did not verify accuracy of harms information presented in the guidelines.Conclusion: The review identified opportunities for improving conceptualization, assessment, and reporting of screening process-related harms in guidelines. Future work should consider nuances associated with each organ-specific process to screen for cancer, including which harms are most salient and where evidence gaps exist, and explicitly explore how to optimally weigh available evidence in determining net screening benefit. Improved harms reporting could aid informed decision making, ultimately improving cancer screening delivery.Primary Funding Source: National Cancer Institute. [ABSTRACT FROM AUTHOR]

Purpose: To determine whether military men report different prostate-specific antigen (PSA) screening rates than civilian men and if shared decision-making (SDM) is associated with PSA screening. Methods: We used data from the 2018 Behavioral Risk Factor Surveillance System and included 101,901 men (26,363 military and 75,538 civilian men) in the analysis conducted in 2021. We conducted binomial logistic regression analyses to determine covariate-adjusted associations between military status and receiving a PSA test in the last 2 years. We then added patient reports of SDM to the model. Finally, we looked at the joint effects of military status and SDM on the receipt of a PSA test in the last 2 years. Results: Military men had 1.1 times the odds of PSA testing compared to civilian men (95% CI 1.1, 1.2) after adjusting for SDM and sociodemographic and health covariates. When examining the joint effect of military status and SDM, military and civilian men had over three times the odds of receiving a PSA test in the last 2 years if they had reported SDM (OR 3.5 and OR 3.4, respectively) compared to civilian men who did not experience SDM. Conclusion: Military men are slightly more likely to report receiving a PSA test in the last 2 years compared to civilian men. Additionally, results show SDM plays a role in the receipt of a PSA test in both populations. These findings can serve as a foundation for tailored interventions to promote appropriate SDM for PSA screening in civilian, active duty, and veteran healthcare systems. [ABSTRACT FROM AUTHOR]

Improvements in cancer care delivery have the potential to reduce morbidity and mortality from cancer, however, challenges to delivery of recommended care limit progress. These challenges include growing demands for care, increasing treatment complexity, inadequate care coordination, dramatic increases in costs, persistent disparities in care, and insufficient use of evidence-based guidelines. Recognizing the important role of research in understanding and addressing these challenges, the National Cancer Institute created the Healthcare Delivery Research Program (HDRP) in 2015 as a catalyst for expanding work in this area. Health-care delivery research is a multidisciplinary effort which recognizes that care delivery occurs in a multilevel system encompassing individuals, health-care systems, and communities. HDRP staff use a range of activities to fulfill the program's mission of advancing innovative research to improve delivery of care across the cancer control continuum. In addition to developing funding opportunities, HDRP staff; support and facilitate the use of research infrastructure for conducting health-care delivery research; oversee publicly available data that can be used to evaluate patterns, costs, and patient experiences of care; contribute to development and dissemination of standardized health measurement tools for public use; and support professional development and training to build capacity within the field and grow the workforce. As HDRP enters its sixth year, we appreciate the opportunity to reflect on the program's progress in advancing the science of health-care delivery. At the same time, we recognize the need for the program to evolve and develop additional resources and opportunities to address new and emerging challenges. [ABSTRACT FROM AUTHOR]

We make some beginning observations about the category 피q of equivalence relations on the set of natural numbers, where a morphism between two equivalence relations R and S is a mapping from the set of R-equivalence classes to that of S-equivalence classes, which is induced by a computable function. We also consider some full subcategories of 피q, such as the category E q Σ 1 0 of computably enumerable equivalence relations (called ceers), the category E q Π 1 0 of co-computably enumerable equivalence relations, and the category 피q(Dark*) whose objects are the so-called dark ceers plus the ceers with finitely many equivalence classes. Although in all these categories the monomorphisms coincide with the injective morphisms, we show that in E q Σ 1 0 the epimorphisms coincide with the onto morphisms, but in E q Π 1 0 there are epimorphisms that are not onto. Moreover, 피q, E q Σ 1 0 , and 피q(Dark*) are closed under finite products, binary coproducts, and coequalizers, but we give an example of two morphisms in E q Π 1 0 whose coequalizer in 피q is not an object of E q Π 1 0. [ABSTRACT FROM AUTHOR]

Coastal cliff erosion is alongshore-variable and episodic, with retreat rates that depend upon sediment as either tools of abrasion or protective cover. However, the feedbacks between coastal cliff planform morphology, retreat rate, and sediment cover are poorly quantified. This study investigates Sargent Beach, Texas, USA, at the annual to interannual scale to explore (1) the relationship between temporal and spatial variability in cliff retreat rate, roughness, and sinuosity and (2) the response of retreat rate and roughness to changes in sand and shell hash cover of the underlying mud substrate as well as the impact of major storms using field measurements of sediment cover, erosion, and aerial images to measure shore platform morphology and retreat. A storm event in 2009 increased the planform roughness and sinuosity of the coastal cliff at Sargent Beach. Following the storm, aerial-image-derived shorelines with annual resolution show a decrease in average alongshore erosion rates from 12 to 4 myr-1 , coincident with a decrease in shoreline roughness and sinuosity (smoothing). Like the previous storm, a storm event in 2017 increased the planform roughness and sinuosity of the cliff. Over shorter timescales, monthly retreat of the sea cliff occurred only when the platform was sparsely covered with sediment cover on the shore platform, indicating that the tools and cover effects can significantly affect short-term erosion rates. The timescale to return to a smooth shoreline following a storm or roughening event, given a steady-state erosion rate, is approximately 24 years, with the long-term rate suggesting a maximum of ∼107 years until Sargent Beach breaches, compromising the Gulf Intracoastal Waterway (GIWW) under current conditions and assuming no future storms or intervention. The observed retreat rate varies, both spatially and temporally, with cliff face morphology, demonstrating the importance of multi-scale measurements and analysis for interpretation of coastal processes and patterns of cliff retreat. [ABSTRACT FROM AUTHOR]

Classifying images using supervised machine learning (ML) relies on labeled training data—classes or text descriptions, for example, associated with each image. Data‐driven models are only as good as the data used for training, and this points to the importance of high‐quality labeled data for developing a ML model that has predictive skill. Labeling data is typically a time‐consuming, manual process. Here, we investigate the process of labeling data, with a specific focus on coastal aerial imagery captured in the wake of hurricanes that affected the Atlantic and Gulf Coasts of the United States. The imagery data set is a rich observational record of storm impacts and coastal change, but the imagery requires labeling to render that information accessible. We created an online interface that served labelers a stream of images and a fixed set of questions. A total of 1,600 images were labeled by at least two or as many as seven coastal scientists. We used the resulting data set to investigate interrater agreement: the extent to which labelers labeled each image similarly. Interrater agreement scores, assessed with percent agreement and Krippendorff's alpha, are higher when the questions posed to labelers are relatively simple, when the labelers are provided with a user manual, and when images are smaller. Experiments in interrater agreement point toward the benefit of multiple labelers for understanding the uncertainty in labeling data for machine learning research. Plain Language Summary: After hurricanes and storms, pictures taken from a plane can be used to observe how the coast was impacted. A single flight might take thousands of pictures. If a computer could automatically analyze the pictures, then a person would not need to look at them one‐by‐one. To teach a computer to analyze images, we need many pictures and many labels that describe what is visible in each picture. But where do we get those labels? Typically, a coastal scientist labels the pictures by sorting them into folders or typing codes into a spreadsheet. But does every coastal scientist label pictures the same way? Some labeling questions are easy to answer, and scientists mostly agree ("Is this image all water?"). Other labeling questions are harder to answer, and cause disagreement ("Was there damage to buildings?"). This paper is about how well scientists agree when labeling the same pictures, and how we can improve agreement among scientists. We try some experiments and offer a few ideas on how to improve agreement. We suggest writing very clear questions, using smaller images, and having a comprehensive manual. It turns out that having a manual with examples—and reading the manual!—really helps. Key Points: We measure agreement among coastal scientists labeling the same sets of poststorm imagesCoastal scientists agree more when rating landforms, less when labeling inferred processesIterating on questions, providing documentation, and using smaller image sizes all increase agreement [ABSTRACT FROM AUTHOR]

The success of fecal occult blood‐based colorectal cancer screening programs is dependent on repeating screening at short intervals (ie, every 1‐2 years). We conducted a literature review to assess measures that have been used to assess longitudinal adherence to fecal‐based screening. Among 46 citations identified and included in this review, six broad classifications of longitudinal adherence were identified: (a) stratified single‐round attendance, (b) all possible adherence permutations, (c) consistent/inconsistent/never attendance, (d) number of times attended, (e) program adherence and (f) proportion of time covered. Advantages and disadvantages of these measures are described, and recommendations on which measures to use based on data availability and scientific question are also given. Stratified single round attendance is particularly useful for describing the yield of screening, while programmatic adherence measures are best suited to evaluating screening efficacy. We recommend that screening programs collect detailed longitudinal, individual‐level data, not only for the screening tests themselves but additionally for diagnostic follow‐up and surveillance exams, to allow for maximum flexibility in reporting adherence patterns using the measure of choice. What's new? Fecal‐based screening for colorectal cancer requires testing at short intervals, usually every one to two years. Consequently, screening program effectiveness is dependent on adherence to repeat screening. Here, the authors describe a literature review aimed at identifying measures to assess adherence to fecal‐based screening over time. In total, six broad categories of measures of longitudinal adherence were identified. Categories varied in amount of individual‐level data required for calculation and in suitability to address specific scientific questions. The authors further provide recommendations for choice of measure to assess longitudinal adherence. [ABSTRACT FROM AUTHOR]

Objective: To examine whether receiving a fecal occult blood test after a negative sigmoidoscopy reduced mortality from colorectal cancer. Methods: We used a nested case-control design with incidence-density matching in historical cohorts of 1,877,740 50-90-year-old persons during 2006-2012, in an integrated health-system setting. We selected 1758 average risk patients who died from colorectal cancer and 3503 matched colorectal cancer-free persons. Colorectal cancer-specific death was ascertained from cancer and mortality registries. Screening histories were determined from electronic and chart-audit clinical data in the 5- to 10-year period prior to the reference date. We evaluated receipt of subsequent fecal occult blood test within five years of the reference date among patients with negative sigmoidoscopy two to six years before the reference date. Results: Of the 5261 patients, 831 patients (204 colorectal cancer deaths/627 controls) had either negative sigmoidoscopy only (n = 592) or negative sigmoidoscopy with subsequent screening fecal occult blood test (n = 239). Fifty-six (27.5%) of the 204 patients dying of colorectal cancer and 183 (29.2%) of the 627 colorectal cancer-free patients received fecal occult blood test following a negative sigmoidoscopy. Conditional regressions found no significant association between fecal occult blood test receipt and colorectal cancer death risk, overall (adjusted odds ratio = 0.93, confidence interval: 0.65-1.33), or for right (odds ratio = 1.02, confidence interval: 0.65-1.60) or left-colon/rectum (odds ratio = 0.77, confidence interval: 0.39-1.52) cancers. Similar results were obtained in sensitivity analyses with alternative exposure ascertainment windows or timing of fecal occult blood test. Conclusions: Our results suggest that receipt of at least one fecal occult blood test during the several years after a negative sigmoidoscopy did not substantially reduce mortality from colorectal cancer. [ABSTRACT FROM AUTHOR]

Base excision repair (BER) pathway involves repair of damaged DNA caused by spontaneous decay of DNA, reactive oxygen species, and ionizing radiation. Polymorphisms of genes involved in the pathway have been reported to be associated with cancer risk. In this study, the association of BER gene polymorphisms with breast cancer risk in Filipino women was assessed. The polymorphisms studied included X-ray repair cross-complementing group 1 (XRCC1, Arg399Gln), 8-oxoguanine DNA glycosylase (OGG1, Ser326Cys), and apurinic/apyrimidinic endonuclease 1 (APE1, Asp148Glu; -141T/G). A total of 186 participants (93 breast cancer cases and 93 breast cancer-free control) were recruited for the study. The genotyping of samples was performed using polymerase chain reaction with confronting two-pair primers (PCR-CTPP). The association of polymorphisms of BER genes with breast cancer risk and gene-environment interaction was determined using the unconditional logistic regression model. Distributions of OGG1 and APE1 genotypes were in Hardy-Weinberg equilibrium (HWE); however, XRCC1 genotype distribution deviated from HWE and was not further analyzed. The analysis showed that OGG1 Ser326Cys, APE1 Asp148Glu, and APE1 -141T/G had no significant association with breast cancer risk. Also, there is no significant interaction between the three BER gene variants and family history of cancer. Lastly, no significant increased risk was observed when the combined effects of risk alleles of the three BER gene variants were determined. In conclusion, the study suggests that OGG1 Ser326Cys, APE1 Asp148Glu, and APE1 -141T/G are not good indicators of breast cancer risk in Filipino women. [ABSTRACT FROM AUTHOR]

Importance: The US Preventive Services Task Force (USPSTF) is updating its 2016 colorectal cancer screening recommendations.Objective: To provide updated model-based estimates of the benefits, burden, and harms of colorectal cancer screening strategies and to identify strategies that may provide an efficient balance of life-years gained (LYG) from screening and colonoscopy burden to inform the USPSTF.Design, Setting, and Participants: Comparative modeling study using 3 microsimulation models of colorectal cancer screening in a hypothetical cohort of 40-year-old US individuals at average risk of colorectal cancer.Exposures: Screening from ages 45, 50, or 55 years to ages 70, 75, 80, or 85 years with fecal immunochemical testing (FIT), multitarget stool DNA testing, flexible sigmoidoscopy alone or with FIT, computed tomography colonography, or colonoscopy. All persons with an abnormal noncolonoscopy screening test result were assumed to undergo follow-up colonoscopy. Screening intervals varied by test. Full adherence with all procedures was assumed.Main Outcome and Measures: Estimated LYG relative to no screening (benefit), lifetime number of colonoscopies (burden), number of complications from screening (harms), and balance of incremental burden and benefit (efficiency ratios). Efficient strategies were those estimated to require fewer additional colonoscopies per additional LYG relative to other strategies.Results: Estimated LYG from screening strategies ranged from 171 to 381 per 1000 40-year-olds. Lifetime colonoscopy burden ranged from 624 to 6817 per 1000 individuals, and screening complications ranged from 5 to 22 per 1000 individuals. Among the 49 strategies that were efficient options with all 3 models, 41 specified screening beginning at age 45. No single age to end screening was predominant among the efficient strategies, although the additional LYG from continuing screening after age 75 were generally small. With the exception of a 5-year interval for computed tomography colonography, no screening interval predominated among the efficient strategies for each modality. Among the strategies highlighted in the 2016 USPSTF recommendation, lowering the age to begin screening from 50 to 45 years was estimated to result in 22 to 27 additional LYG, 161 to 784 additional colonoscopies, and 0.1 to 2 additional complications per 1000 persons (ranges are across screening strategies, based on mean estimates across models). Assuming full adherence, screening outcomes and efficient strategies were similar by sex and race and across 3 scenarios for population risk of colorectal cancer.Conclusions and Relevance: This microsimulation modeling analysis suggests that screening for colorectal cancer with stool tests, endoscopic tests, or computed tomography colonography starting at age 45 years provides an efficient balance of colonoscopy burden and life-years gained. [ABSTRACT FROM AUTHOR]

The article examines the updated breast, colorectal and cervical cancer screening test receipt per U.S. Preventive Services Task Force (USPSTF) recommendations based on 2018 National Health Interview Survey (NHIS) data. Topics include the conducted tests like mammography, Pap test with human papillomavirus (HPV) test, and home blood stool or fecal immunochemical test (FIT), and the factors linked to lower test receipt like public health insurance coverage.

Background: Cancer screening is a complex process encompassing risk assessment, the initial screening examination, diagnostic evaluation, and treatment of cancer precursors or early cancers. Metrics that enable comparisons across different screening targets are needed. We present population-based screening metrics for breast, cervical, and colorectal cancers for nine sites participating in the Population-based Research Optimizing Screening through Personalized Regimens consortium.Methods: We describe how selected metrics map to a trans-organ conceptual model of the screening process. For each cancer type, we calculated calendar year 2013 metrics for the screen-eligible target population (breast: ages 40-74 years; cervical: ages 21-64 years; colorectal: ages 50-75 years). Metrics for screening participation, timely diagnostic evaluation, and diagnosed cancers in the screened and total populations are presented for the total eligible population and stratified by age group and cancer type.Results: The overall screening-eligible populations in 2013 were 305 568 participants for breast, 3 160 128 for cervical, and 2 363 922 for colorectal cancer screening. Being up-to-date for testing was common for all three cancer types: breast (63.5%), cervical (84.6%), and colorectal (77.5%). The percentage of abnormal screens ranged from 10.7% for breast, 4.4% for cervical, and 4.5% for colorectal cancer screening. Abnormal breast screens were followed up diagnostically in almost all (96.8%) cases, and cervical and colorectal were similar (76.2% and 76.3%, respectively). Cancer rates per 1000 screens were 5.66, 0.17, and 1.46 for breast, cervical, and colorectal cancer, respectively.Conclusions: Comprehensive assessment of metrics by the Population-based Research Optimizing Screening through Personalized Regimens consortium enabled systematic identification of screening process steps in need of improvement. We encourage widespread use of common metrics to allow interventions to be tested across cancer types and health-care settings. [ABSTRACT FROM AUTHOR]

Climate variability has increased demand for research on how management practices impact crop growth. Past research suggests increased root cortical aerenchyma tissue may increase corn's tolerance to abiotic stress, and it is possible seed treatments may affect its formation. In 2019, an open-air pot study was conducted in central Ohio to assess how a commercial seed treatment (Poncho 1250 + VOTiVO) would impact early season above- and belowground growth of corn (Zea mays L.). Two recombinant inbred lines and two commercial hybrids were selected, with each corn accession treated with clothianidin + Bacillus firmus I-1582 (Poncho 1250 + VOTiVO) or untreated prior to planting. Seed treatment had a positive effect on growth stage, plant height, and root surface area at termination. Root porosity was unaffected by seed treatment aside from one commercial hybrid where porosity decreased with seed treatment. Application of Poncho 1250 + VOTiVO improved early season growth of seedlings, but more research is needed to understand its impact on yield and improving crop tolerance to early season abiotic stresses. [ABSTRACT FROM AUTHOR]

Background: Flexible sigmoidoscopy and colonoscopy are both recommended colorectal cancer screening options, but their relative effectiveness needs clarification. The aim of this study was to compare the effectiveness of colonoscopy and flexible sigmoidoscopy for reduction of colorectal cancer incidence. Methods: We conducted a case-control study within the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Cases were subjects age 70–85 years in the SEER-Medicare database diagnosed with CRC during 2004–2013. Up to 3 controls were matched to each case by birth year, sex, race, and SEER region. Receipt of screening colonoscopy or flexible sigmoidoscopy was ascertained from Medicare claims. Conditional logistic regression models were developed to estimate the odds ratios (ORs) and 95% confidence intervals (CI) for a history of screening in cases vs. controls. We conducted secondary analyses by sex, race, endoscopist characteristics, and with varying timing and duration of the look-back period. Results: Receipt of screening colonoscopy and sigmoidoscopy was associated with a 59% (OR 0.41, 95%CI 0.39, 0.43) and 22% reduction (OR 0.78, 95%CI 0.67, 0.92) in colorectal cancer incidence, respectively. Colonoscopy was associated with greater reduction in the distal colorectal cancer incidence (OR 0.22, 95%CI 0.20, 0.24) than proximal colorectal cancer incidence (OR 0.62, 95%CI 0.59, 0.66). Sigmoidoscopy was associated with a 52% reduction in distal colorectal cancer incidence (OR 0.48, 95%CI 0.37, 0.63), but with no reduction in proximal colorectal cancer incidence. These associations were stronger in men than in women. No differences by race or endoscopist characteristics were observed. Conclusion: Both screening colonoscopy and sigmoidoscopy were associated with reductions in overall colorectal cancer incidence, with a greater magnitude of reduction observed with colonoscopy. [ABSTRACT FROM AUTHOR]

Purpose: Colonoscopy and flexible sigmoidoscopy are both recommended colorectal cancer (CRC) screening strategies, but their relative effectiveness is unclear. We sought to evaluate the ability of each of these two modalities to reduce CRC mortality. Methods: We conducted a case-control study using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Cases were persons aged 70–85 years who died of CRC and were matched to up to three non-CRC controls. Receipt of endoscopy was ascertained from Medicare claims and endoscopy indication assigned using a validated algorithm. Conditional logistic regression models were developed to estimate the association between screening colonoscopy or sigmoidoscopy and CRC mortality. We conducted secondary analyses by race, sex, and endoscopist characteristics, and with varying duration of the look-back period. Results: In the initial analysis using all available look-back years, screening flexible sigmoidoscopy was associated with a 35% reduction in CRC mortality (OR 0.65, 95% CI 0.48, 0.89), while screening colonoscopy was associated with a 74% reduction (OR 0.26, 95% CI 0.23, 0.30). Sigmoidoscopy was not associated with any reduction in proximal CRC mortality. The association between colonoscopy and reduced CRC mortality was stronger in the distal than the proximal colon. Results were similar in analyses using a 5-year look-back period. Conclusions: Screening colonoscopy was associated with greater reductions in CRC mortality than screening sigmoidoscopy, and with a greater reduction in the distal than the proximal colon. These results provide additional information on the relative benefits of screening for CRC with sigmoidoscopy and colonoscopy. [ABSTRACT FROM AUTHOR]

Case-control studies evaluating a screening test's efficacy in reducing cancer mortality require accurate classification of test indication to obtain a valid result. However, for analogous studies of cancer incidence, determination of test indication is not as critical because, to define exposure, we need consider only tests that can identify precursor lesions whose treatment might prevent cancer, not tests leading to cancer diagnosis. This study utilizes US Surveillance, Epidemiology, and End Results (SEER)-Medicare data, which do not include information about colonoscopy indication, to evaluate the efficacy of colonoscopy in preventing colorectal cancer (CRC) incidence. Cases were Medicare enrollees diagnosed with CRC between 1996 and 2013; up to 3 controls were matched to each case. Colonoscopy receipt prior to presumed onset of occult cancer was associated with an approximately 60% reduction in CRC incidence (odds ratio = 0.41, 95% confidence interval: 0.40, 0.42). The association was robust to differing exposure windows and estimates of occult cancer duration and is similar to those from CRC incidence studies in which exam indication was available. Our results suggest that, when it is impractical/impossible to determine whether tests were conducted for screening, the efficacy of a test in preventing cancer incidence can still be estimated using a case-control study design. [ABSTRACT FROM AUTHOR]

The National Lung Screening Trial (NLST) reported substantial reduction in lung cancer mortality among high-risk individuals screened annually with low-dose helical computed tomography (LDCT). As a result, the US Preventive Services Task Force issued a B recommendation for annual LDCT in high-risk individuals, which requires private insurers to cover it without cost-sharing. The Medicare program also covers LDCT for high-risk beneficiaries without cost-sharing. However, the NLST findings may not be generalizable to the community setting because of differences in patients, providers, and practices participating in the NLST. Thus, examining uptake of LDCT screening in community practice is critical, as is evaluating the immediate and downstream outcomes of screening, including false-positive scans, follow-up examinations and adverse events, costs, stage of disease at diagnosis, and survival. This commentary presents an overview of the landscape of the data resources currently available to evaluate the uptake, outcomes, and costs of LDCT screening in the United States. We describe the strengths and limitations of existing data sources, including administrative databases, surveys, and registries. Thereafter, we provide recommendations for improving the data infrastructure pertaining to three overarching research areas: receipt of guideline-consistent screening and follow-up, weighing benefits and harms of screening, and costs of screening. [ABSTRACT FROM AUTHOR]

Little is known about the effect of evolving risk‐based cervical cancer screening and management guidelines on United States (US) clinical practice and patient outcomes. We describe the National Cancer Institute's Population‐based Research Optimizing Screening through Personalized Regimens (PROSPR I) consortium, methods and baseline findings from its cervical sites: Kaiser Permanente Washington, Kaiser Permanente Northern California, Kaiser Permanente Southern California, Parkland Health & Hospital System/University of Texas Southwestern (Parkland‐UTSW) and New Mexico HPV Pap Registry housed by University of New Mexico (UNM‐NMHPVPR). Across these diverse healthcare settings, we collected data on human papillomavirus (HPV) vaccinations, screening tests/results, diagnostic and treatment procedures/results and cancer diagnoses on nearly 4.7 million women aged 18–89 years from 2010 to 2014. We calculated baseline (2012 for UNM‐NMHPVPR; 2010 for other sites) frequencies for sociodemographics, cervical cancer risk factors and key screening process measures for each site's cohort. Healthcare delivery settings, cervical cancer screening strategy, race/ethnicity and insurance status varied among sites. The proportion of women receiving a Pap test during the baseline year was similar across sites (26.1–36.1%). Most high‐risk HPV tests were performed either reflexively or as cotests, and utilization pattern varied by site. Prevalence of colposcopy or biopsy was higher at Parkland‐UTSW (3.6%) than other sites (1.3–1.4%). Incident cervical cancer was rare. HPV vaccination among age‐eligible women not already immunized was modest across sites (0.1–7.2%). Cervical PROSPR I makes available high‐quality, multilevel, longitudinal screening process data from a large and diverse cohort of women to evaluate and improve the effectiveness of US cervical cancer screening delivery. What's new? Cervical cancer screening in the United States has undergone substantial change. In 2011, to assess the impact of that change, the U.S. National Cancer Institute initiated Population‐based Research Optimizing Screening through Personalized Regimens (PROSPR I). The present report describes the rationale and methods of PROSPR 1 as they pertain specifically to cervical cancer screening. Baseline assessment of data gathered from participating PROSPR 1 research centers reveals diversity in center organization and cohort demographics. Sites were similar with regard to the proportion of women receiving Pap tests but varied in their utilization of tests for high‐risk human papillomavirus infection. [ABSTRACT FROM AUTHOR]

Expanding research capacity of large research networks within health care delivery systems requires strategically training both embedded and external investigators in necessary skills for this purpose. Researchers new to these settings frequently lack the skills and specialized knowledge conducive to multi-site and multi-disciplinary research set in delivery systems. This report describes the goals and components of the Cancer Research Network (CRN) Scholars Program, a 26-month training program developed to increase the capacity for cancer research conducted within the network's participating sites, its progression from training embedded investigators to a mix of internal and external investigators, and the content evolution of the training program. The CRN Scholars program was launched in 2007 to assist junior investigators from member sites develop independent and sustainable research programs within the CRN. Resulting from CRN's increased emphasis on promoting external collaborations, the 2013 Scholars program began recruiting junior investigators from external institutions committed to conducting delivery system science. Based on involvement of this broader population and feedback from prior Scholar cohorts, the program has honed its focus on specific opportunities and issues encountered in conducting cancer research within health care delivery systems. Efficiency and effectiveness of working within networks is accelerated by strategic and mentored navigation of these networks. Investing in training programs specific to these settings provides the opportunity to improve multi-disciplinary and multi-institutional collaboration, particularly for early-stage investigators. Aspects of the CRN Scholars Program may help inform others considering developing similar programs to expand delivery system research or within large, multi-disciplinary research networks. [ABSTRACT FROM AUTHOR]

The structural and electronic properties of ultrathin insulator Al2O3 films on CoAl(100) have been studied using a combination of scanning tunneling spectroscopy and microscopy. The analysis of the differential conductance yields a band gap of 2.6–2.9 eV for amorphous Al2O3. In the case of a well-ordered alumina film, the band gap is increased to 4.5 eV. On each of the oxide phases, the barrier height is to a large extent independent of local variations such as the surface corrugations or oxide steps. [ABSTRACT FROM AUTHOR]

Background: Despite the importance of characterizing colonoscopy indication for quality monitoring and cancer screening program evaluation, there is no standard approach to documenting colonoscopy indication in medical records. Methods: We applied two algorithms in three health care systems to assign colonoscopy indication to persons 50-89 years old who received a colonoscopy during 2010-2013. Both algorithms used standard procedure, diagnostic, and laboratory codes. One algorithm, the KPNC algorithm, used a hierarchical approach to classify exam indication into: diagnostic, surveillance, or screening; whereas the other, the SEARCH algorithm, used a logistic regression-based algorithm to provide the probability that colonoscopy was performed for screening. Gold standard assessment of indication was from medical records abstraction. Results: There were 1,796 colonoscopy exams included in analyses; age and racial/ethnic distributions of participants differed across health care systems. The KPNC algorithm's sensitivities and specificities for screening indication ranged from 0.78-0.82 and 0.78-0.91, respectively; sensitivities and specificities for diagnostic indication ranged from 0.78-0.89 and 0.74-0.82, respectively. The KPNC algorithm had poor sensitivities (ranging from 0.11-0.67) and high specificities for surveillance exams. The Area Under the Curve (AUC) of the SEARCH algorithm for screening indication ranged from 0.76-0.84 across health care systems. For screening indication, the KPNC algorithm obtained higher specificities than the SEARCH algorithm at the same sensitivity. Conclusion: Despite standardized implementation of these indication algorithms across three health care systems, the capture of colonoscopy indication data was imperfect. Thus, we recommend that standard, systematic documentation of colonoscopy indication should be added to medical records to ensure efficient and accurate data capture. [ABSTRACT FROM AUTHOR]

The Cancer Research Network (CRN) is a consortium of 12 research groups, each affiliated with a nonprofit integrated health care delivery system, that was first funded in 1998. The overall goal of the CRN is to support and facilitate collaborative cancer research within its component delivery systems. This paper describes the CRN's 20-year experience and evolution. The network combined its members' scientific capabilities and data resources to create an infrastructure that has ultimately supported over 275 projects. Insights about the strengths and limitations of electronic health data for research, approaches to optimizing multidisciplinary collaboration, and the role of a health services research infrastructure to complement traditional clinical trials and large observational datasets are described, along with recommendations for other research consortia. [ABSTRACT FROM AUTHOR]

We report a study of demagnetization protocols for frustrated arrays of interacting single-domain permalloy nanomagnets by rotating the arrays in a changing magnetic field. The most effective demagnetization is achieved by not only stepping the field strength down while the sample is rotating, but also by combining each field step with alternation in the field direction. By contrast, linearly decreasing the field strength or stepping the field down without alternating the field direction leaves the arrays with a larger remanent magnetic moment. These results suggest that nonmonotonic variations in field magnitude around and below the coercive field are important for the demagnetization process. [ABSTRACT FROM AUTHOR]