Multitarget stool DNA for colorectal cancer screening:A review and commentary on the United States Preventive Services Draft Guidelines

Multitarget stool DNA(mt-sDNA) testing was approved for average risk colorectal cancer(CRC) screening by the United States Food and Drug Administration and thereafter reimbursed for use by the Medicare program(2014).The United States Preventive Services Task Force(USPSTF) October 2015 draft recommendation for CRC screening included mt-s DNA as an "alternative" screening test that "may be useful in select clinical circumstances",despite its very high sensitivity for early stage CRC.The evidence supporting mt-s DNA for routine screening use is robust.The clinical efficacy of mt-s DNA as measured by sensitivity,specificity,life-years gained(LYG),and CRC deaths averted is similar to or exceeds that of the other more specifically recommended screening options included in the draft document,especially those requiring annual testing adherence.In a population with primarily irregular screening participation,tests with the highest point sensitivity and reasonable specificity are more likely to favorably impact CRC related morbidity and mortality than those depending on annual adherence.This paper reviews the evidence supporting mt-s DNA for routine screening and demonstrates,using USPSTF's modeling data,that mt-s DNA at three-year intervals provides significant clinical net benefits and fewer complications per LYG than annual fecal immunochemical testing,high sensitivity guaiac based fecal occult blood testing and 10-year colonoscopy screening.

A Non-Preemptive Priority Queueing System with a Single Server Serving Two Queues M/G/1 and M/D/1 with Optional Server Vacations Based on Exhaustive Service of the Priority Units

We study a vacation queueing system with a single server simultaneously dealing with an M/G/1 and an M/D/1 queue. Two classes of units, priority and non-priority, arrive at the system in two independent Poisson streams. Under a non-preemptive priority rule, the server provides a general service to the priority units and a deterministic service to the non-priority units. We further assume that the server may take a vacation of random length just after serving the last priority unit present in the system. We obtain steady state queue size distribution at a random epoch. Corresponding results for some special cases, including the known results of the M/G/1 and the M/D/1 queues, have been derived.

Target reliability index for serviceability limit state of single piles

The objective is to develop an approach for the determination of the target reliability index for serviceability limit state(SLS) of single piles. This contributes to conducting the SLS reliability-based design(RBD) of piles. Based on a two-parameter,hyperbolic curve-fitting equation describing the load-settlement relation of piles, the SLS model factor is defined. Then, taking into account the uncertainties of load-settlement model, load and bearing capacity of piles, the formula for computing the SLS reliability index(βsls) is obtained using the mean value first order second moment(MVFOSM) method. Meanwhile, the limit state function for conducting the SLS reliability analysis by the Monte Carlo simulation(MCS) method is established. These two methods are finally applied to determine the SLS target reliability index. Herein, the limiting tolerable settlement(slt) is treated as a random variable. For illustration, four load test databases from South Africa are compiled again to conduct reliability analysis and present the recommended target reliability indices. The results indicate that the MVFOSM method overestimates βsls compared to that computed by the MCS method. Besides, both factor of safety(FS) and slt are key factors influencing βsls, so the combination of FS and βsls is welcome to be used for the SLS reliability analysis of piles when slt is determined. For smaller slt, pile types and soils conditions have significant influence on the SLS target reliability indices; for larger slt, slt is the major factor having influence on the SLS target reliability indices. This proves that slt is the most key parameter for the determination of the SLS target reliability index.

Contracts in the payments for ecosystem services: the case of bio-prospecting

We examine the economics of royalties in bioprospecting contracts between a pharmaceutical and genetic resource supplier (local), with an eye to understanding the relative advantages of indexing royalty payments to gross revenue or net revenue. We show a risk-averse f irm facing only production or only cost risks will index royalties to net revenue. When facing both types of risk, the choice of royalty type depends on the relative magnitudes of the pro-duction and cost risk. In each case, the risk-averse f irm chooses the royalty-type that shifts as much risk as possible to the local. When the local is risk neutral, the pharmaceutical's and local's preferences are compatible. If the local is risk averse and there is only one type of risk, it will prefer a gross revenue royalty, and shift as much risk as pos-sible to the fi rm: here the local and fi rm preferences are compatible only if the fi rm is risk-neutral. Lastly, we show if the f irm sets the terms of the contract, and both agents are risk averse, the f irm will not likely volunteer to imple-ment the socially optimal royalty arrangement as it prefers to shift as much risk to the local, who now also prefers a more certain return. This last outcome is at the heart of the benef it sharing discussion and suggests if risk sharing and equity are a concern in benef it sharing, then the choice of royalty type can be an important part of negotiations between pharmaceuticals and locals for the phytochemical from nature for new drug discovery.

Effects of USPSTF guidelines on patterns of screening and treatment outcomes for prostate cancer

The updated United States Preventive Services Task Force(USPSTF) for prostate cancer in 2012 recommends against prostate-specific antigen(PSA) based screening for men of all ages. Prostate cancer is the second most common and second most deadly cancer in American men. PSA screening for prostate cancer has been present since 1994 leading to an over diagnosis and over treatment of low volume disease. There is an overall agreement of men towards the guidelines but even with the understanding of the USPSTF, these men tend to follow more personal beliefs that have been influenced by their knowledge of the disease process and physician influence. Physicians also followed the directions of the patients and opted not to change their current practice of PSA screening despite the new guidelines. Time, legal, and ethical issues were some of the barriers that physicians faced in tailoring their practice towards screening. The importance of informed consent is highlighted by both the patients and the physicians and clearly more effective when the patient was pre-informed of the disease processand prompted the physicians to initiate conversation of informed screening. Younger patients were inclined towards aggressive treatment and older patients opted towards watchful waiting both with emphasis on the importance of evidence-based information provided by the physician. Decision aids were useful in making informed decisions and could be used to educate patients on screening purposes and treatment options. However, even with well-created decision aids and physician influence, patients' own belief system played a major part in healthcare decision making in either screening or treatment for prostate cancer.

Islay3D—A Programming Environment for Authoring Interactive 3D Animations in Terms of State-Transition Diagram

An educational programming language is a programming language that is designed primarily as a learning instrument and not so much as a tool for writing programs for production. Three-dimensional (3D) interactive animations provide an effective means to engage the attention of the audience to learn programming language. Traditionally, creating 3D games had been difficult as it requires specialized programming skills. However, it had been proven that the state-transition diagram, which is the most fundamental principle for automata, is intuitively so comprehensive that even children can create programs for interactive animations and video games in the two-dimensional world. Islay3D is a programming environment for authoring interactive 3D animations based on this concept. In this paper, the Islay3D animation language is introduced, where a character is modeled as an object, and its behavior is defined in term of a set of state-transition diagrams. The interpretation of the state-transition diagrams to JavaScript is also presented. Finally, the web-based programming environment is introduced. With the web-based platform, the public will be able express their creativity in creating interactive 3D animations and video games easily from within their browser.

Vehicle Fleet Management Practices and Service Delivery in State Owned Enterprises in Zimbabwe

The main objective of the study was to examine the influence of vehicle fleet management practices on service delivery in State-Owned Enterprises (SOEs) in Zimbabwe. The study adopted a pragmatism research philosophy together with a mixed method research paradigm. In addition, structured questionnaires were distributed to 344 respondents drawn from 86 SOEs. Stratified and purposive sampling was used. Descriptive statistics were calculated using Statistical Package for the Social Science (SPSS) version 20. Exploratory factor analysis (EFA) was done on all items of the study while research hypotheses were tested using Structural Equation Modelling (SEM) in AMOS version 21. The study concluded that vehicle maintenance, fuel management, driver management and vehicle replacement positively influence service delivery. In addition, the study also established that Information and Communication Technologies (ICTs) moderate the influence of vehicle fleet management practices on service delivery. The study recommended that there is need for regular driver training and vehicle programs encompassing electronic spares tracking.

The Reform on “Separation of Operation Permits and Business Licenses” Is Implementing Nationwide

On 10 October 2018, the State Council issued a noticed on the reform of “Separation of Operation Permits and Business Licenses”, which pointed out that from 10 November 2018, the first batch of 106 administrative examination and approval items involved with enterprises around the country will be reformed respectively to one of the 4 ways in: 1) direct cancellation of approval; 2) record-keeping instead of approval; 3) implement informed commitment; or 4) optimization of market access services.

Tide will open 2,000 laundries in the United States by 2020

Tide,a subsidiary of P&G,recently announced that it would officially develop its laundry business.By 2020,Tide will open 2,000 laundries in the United States to provide all-round&on-demand laundry service.

State estimation of connected vehicles using a nonlinear ensemble filter

The concept of connected vehicles is with great potentials for enhancing the road transportation systems in the future. To support the functions and applications under the connected vehicles frame, the estimation of dynamic states of the vehicles under the cooperative environments is a fundamental issue. By integrating multiple sensors, localization modules in OBUs(on-board units) require effective estimation solutions to cope with various operation conditions. Based on the filtering estimation framework for sensor fusion, an ensemble Kalman filter(En KF) is introduced to estimate the vehicle's state with observations from navigation satellites and neighborhood vehicles, and the original En KF solution is improved by using the cubature transformation to fulfill the requirements of the nonlinearity approximation capability, where the conventional ensemble analysis operation in En KF is modified to enhance the estimation performance without increasing the computational burden significantly. Simulation results from a nonlinear case and the cooperative vehicle localization scenario illustrate the capability of the proposed filter, which is crucial to realize the active safety of connected vehicles in future intelligent transportation.

Scheduling Algorithm with Quality of Service Support in IEEE 802.16 Networks

The MAC layer in IEEE802.16 is designed to differentiate service among traffic categories with different multimedia requirements.In this paper,a scheduling algorithm at MAC layer for multiple connections with diverse QoS requirements is proposed.As for this algorithm,each connection is assigned a priority,which is updated dynamically based on its service status concluding queue characteristic and channel state.A connection with the highest priority is scheduled each time.Analytical model is developed by assuming a Finite State Markov Chain(FSMC)channel model.Simulation results show that the proposed scheduling algorithm can improve the performance of mean waiting time and throughput in broadband wireless networks.

Echo-state-network classification based multi-services awareness in high-speed optical passive networks

With the challenge of great growing of services diversity,service-oriented supporting ability is required by current high-speed passive optical network( PON). Aimed at enhancing the quality of service( Qo S) brought by diversified-services,this study proposes an echo state network( ESN)based multi-service awareness mechanism in 10-Gigabite ethernet passive optical network( 10GEPON). In the proposed approach,distributed architecture is adopted to realize this ESN based multi-service awareness. According to the network architecture of 10G-EPON,where a main ESN is running in OLT and a number of ESN agents works in ONUs. The main-ESN plays the main function of service-awareness from the total view of various kinds of services in 10G-EPON system,by full ESN training. Then,the reservoir information of well-trained ESN in OLT will be broadcasted to all ONUs and those ESN agents working in ONUs are allowed to conduct independent service-awareness function. Thus,resources allocation and transport policy are both determined only in ONUs. Simulation results show that the proposed mechanism is able to better support the ability of multiple services.

“互联网+居家护理”在志愿护理服务中的应用效果

目的探讨"互联网+居家护理"在志愿护理服务中的应用效果。方法选取2020年12月至2021年12月"党群服务365平台"82例需要服务人群作为研究对象,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组实施常规医疗服务,观察组实施"互联网+居家护理"服务,两组均持续护理12个月。比较两组的医院看病次数、医疗花费情况、日常生活能力、精神状态、照护者照护技能水平以及生活满意度。结果观察组医院看病次数、医疗花费情况均少于对照组,差异有统计学意义(P<0.05);观察组护理后日常生活活动能力量表(ADL)评分低于对照组,简易精神状态检查量表(MMSE)评分、照护技能水平评分均高于对照组,差异有统计学意义(P<0.05);观察组护理后生活满意度调查表(LSR)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论通过互联网平台,护理志愿者对服务人群进行居家护理,能够改善服务人群的精神状态,促使其保持身心健康,提高生活自理能力,还能提高照护者的护理技能,一定程度上减少看病次数和医疗花费,从而提升服务人员满意度。

美国电子资源相关标准规范研究

近年来,数字阅读在全民阅读中所占的比重越来越大,图书馆提供更加丰富的数字资源服务已是大势所趋。然而,我国公共数字文化建设还存在平台、管理、资源方面互联互通程度不高等问题,要建设优质的电子资源管理平台,需要完善的标准作为支撑。文章通过调研电子资源相关标准较为完备的美国,以《电子资源管理系统未来标准需求白皮书》为主要参考依据,将世界先行执行组织作为标杆,对白皮书发布后重要标准的变化进行分析,为完善我国相关标准规范提供借鉴,同时为电子资源产业行业的健康发展提供支持。

美英日国家图书馆智库服务研究

国家图书馆智库作为国家发展和治理的重要支撑,其建设和发展应受到关注和重视。文章从机构概况、服务内容、服务成果三方面,详细介绍并对比了美国国会图书馆、英国下议院图书馆和日本国立国会图书馆的智库情况,并从人才队伍、组织结构、研究领域以及平台建设等方面,对我国国家图书馆智库建设和服务提出建议。

国家统筹能力的数字化建构——基于政务服务“跨省通办”的考察

社会流动性的增强及异地办事诉求的剧增,亟需国家统筹推进全域性政务服务“跨省通办”。在数字政府建设中,业务导向的“竖井化”和地方导向的“属地化”,成为国家统筹推进跨域治理的关键难题,具体表现为治理界面的分散化、创新扩散的局域化和层级治理的阻滞性。考察我国政务服务“跨省通办”的发展历程可以发现:政务服务一体化平台的开放嵌入性,为治理界面分散化的跨界整合提供了技术架构;区域协作体嵌入一体化平台,为跨域治理创新局域化的串联式扩散提供了组织网络;高频事项清单的渐进调适,为层级治理阻滞性的敏捷迭代提供了制度基础。政务服务一体化平台赋能国家跨域治理和层级互动,为理解国家统筹能力的数字建构提供观察窗口,构成理解数字时代国家能力转型的重要维度。

美国中小学服务性学习要素分析、实施策略与启示

我国2022年新版义务教育课程方案倡导学生参与社会实践,在发现并解决真实问题中培养核心素养,这一理念与服务性学习不谋而合。美国的中小学服务性学习已有上百年的历史,涉及多个角色职能、典型特征和基本类型等要素,在具体实施中采取明晰育人目标、整合学习内容、明确实施流程和开展多元效果评价等策略,学区与校外主体的合作方式和流程也保障了服务性学习的良好运行。文章基于对美国服务性学习的梳理与分析,对我国跨学科主题学习活动、综合实践活动的设计与实施提出了建议。

WTO后的上海养老机构

目的 探讨在中国加入 WTO之后 ,上海养老机构今后面对的困难情况预测和解决办法。方法 根据知情同意原则所做的问卷素材、对业务主管部门做的调查材料 ,对照 WTO的有关服务贸易的文献资料 ,对市场资源、入世、养老机构现状做分析。结果 中国加入 WTO将对上海养老机构造成较大影响。结论 对政府、养老机构及入住者对入世所带来的影响提出建议。对于市场准入、“以房养房”、养老机构的经营模式、幼稚产业等看法希望引起社会关注与讨论。