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PURPOSE The BILCAP study described a modest benefit for capecitabine as adjuvant therapy for curatively resected biliary tract cancer (BTC), and capecitabine has become the standard of care. We present the long-term data and novel exploratory subgroup analyses. METHODS This randomized, controlled, multicenter, phase III study recruited patients age 18 years or older with histologically confirmed cholangiocarcinoma or muscle-invasive gallbladder cancer after resection with curative intent and an Eastern Cooperative Oncology Group performance status of < 2. Patients were randomly assigned 1:1 to receive oral capecitabine (1,250 mg/m2 twice daily on days 1-14 of a 21-day cycle, for eight cycles) or observation. The primary outcome was overall survival (OS). This study is registered with EudraCT 2005-003318-13. RESULTS Between March 15, 2006, and December 4, 2014, 447 patients were enrolled; 223 patients with BTC resected with curative intent were randomly assigned to the capecitabine group and 224 to the observation group. At the data cutoff of January 21, 2021, the median follow-up for all patients was 106 months (95% CI, 98 to 108). In the intention-to-treat analysis, the median OS was 49.6 months (95% CI, 35.1 to 59.1) in the capecitabine group compared with 36.1 months (95% CI, 29.7 to 44.2) in the observation group (adjusted hazard ratio 0.84; 95% CI, 0.67 to 1.06). In a protocol-specified sensitivity analysis, adjusting for minimization factors, nodal status, grade, and sex, the OS hazard ratio was 0.74 (95% CI, 0.59 to 0.94). We further describe the prognostic impact of R status, grade, nodal status, and sex. CONCLUSION This long-term analysis supports the previous analysis, suggesting that capecitabine can improve OS in patients with resected BTC when used as adjuvant chemotherapy after surgery and should be considered as the standard of care.

This chapter considers some of the challenges of the development of strategy, both for the conventional and ODDE sectors of higher education, with a brief look at the literature since strategic planning was first in vogue in the private sector in the early 1960s. Although the most common approach in higher education, so much so-called strategic planning does little to advance long-term visions and strategies or to differentiate one institution from another. The sudden pivot to online learning and other distance education that the COVID-19 pandemic has forced on conventional (contact) institutions has blurred distinctions between traditional and ODDE universities, thus rendering effective strategy development and implementation more important than ever.This chapter conducts the literature review considering both institutional and system-wide strategy development, underlining their common elements. Then, from the unique vantage point of the South African Institute of Distance Education (Saide), a nongovernmental organization based in Johannesburg but conducting projects throughout South Africa and sub-Saharan Africa, it discusses the challenges for ODDE strategy development in the particular context of COVID-19. The chapter concludes with implications from the analysis for both the conventional and ODDE sectors in higher education in South Africa and elsewhere based, in part, on the lessons learned during the pandemic.

Each year the Kentucky Transportation Center publishes Analysis of Traffic Crash Data in Kentucky, a report that reviews state-level crash data from the previous five years. This report summarizes crash data for 2017 through 2021. In addition to presenting a review of crash data, the report also contains safety performance functions (SPFs) for nine roadway types. Because SPFs were derived using 2017-2021 data, the models predict crashes for a five-year period. Users must adjust the model by adding a coefficient of 1/5 to models to avoid overestimating crashes by a factor of five., KTC-23-04/PT-2-22-00-00-87

SPF-R Online greatly improves and simplifies the SPF development process. Building on the original SPF-R script, the online tool eliminates many of the technical barriers associated with the original process, allowing for a much larger audience to take advantage of SPF-R’s capabilities. Like the original SPF-R script, SPF-R Online lets users quickly explore the effect of roadway network heterogeneity on SPF development, compare CURE plots , and compare goodness-of-fit measures to decide which SPF is most appropriate for a given dataset.

Each year the Kentucky Transportation Center publishes the Traffic Collision Facts report in collaboration with the Commonwealth of Kentucky, Kentucky State Police, and Kentucky Transportation Cabinet. This is the fiscal year 2022 report, which covers collisions reported during calendar year 2021. For the year, 734 fatal crashes, 20,117 nonfatal crashes, and 88,440 property damage only crashes occurred on the state’s roadways. Overall, 109,291 crashes were reported in calendar year 2021, a 8.4 percent increase over calendar year 2020.