The U.S. Preventive Services Task Force (USPSTF) issues evidence-based screening and prevention recommendations, and key to this task is dissemination and implementation of these recommendations. The ...Task Force has recommendations for more than 84 topics; each USPSTF Recommendation Statement includes a letter grade, a topline summary to guide clinician interpretation in practice, and a summary of gaps in evidence to help catalyze clinically relevant research. The USPSTF aims to update existing topics regularly and considers new topics to add each year. Clearly communicating and disseminating each recommendation is a critical task to ensure maximum benefit from use of the recommendations. The primary USPSTF audience is primary care clinicians. Over time, other audiences have become interested in the USPSTF and these entities have broad and diverse needs, necessitating a range of communication platforms and approaches. This includes engagement with and input from topic experts, primary care and federal partners, and the public to help shape the development of the recommendations. It also includes engagement of partners to disseminate USPSTF recommendations to help ensure that the primary care workforce remains up-to-date on USPSTF recommendations. This paper outlines the approaches used by the USPSTF to both solicit input (e.g., public comment periods), as well as to facilitate dissemination of its recommendations to help improve the health of all Americans (e.g., web-based and mobile application tools, journal publications, and annual reports to Congress).
The U.S. Preventive Services Task Force (USPSTF) summarizes the principles and considerations that guide development of its recommendations for diverse U.S. populations. It uses these principles ...through each step in the evidence-based guideline process: developing the research plan, conducting the evidence review, developing the recommendation, and communicating to guideline users. Three recent recommendations provide examples of how the USPSTF has used these principles: the 2015 recommendation on screening for abnormal blood glucose and type 2 diabetes; the 2016 recommendation on screening for breast cancer; and the recommendation on screening for prostate cancer, which is currently in progress. A more comprehensive list of recommendations that includes considerations for specific populations is also provided.
Although the FACED score has demonstrated a great prognostic capacity in bronchiectasis, it does not include the number or severity of exacerbations as a separate variable, which is important in the ...natural history of these patients.
Construction and external validation of a new index, the E-FACED, to evaluate the predictive capacity of exacerbations and mortality.
The new score was constructed on the basis of the complete cohort for the construction of the original FACED score, while the external validation was undertaken with six cohorts from three countries (Brazil, Argentina, and Chile). The main outcome was the number of annual exacerbations/hospitalizations, with all-cause and respiratory-related deaths as the secondary outcomes. A statistical evaluation comprised the relative weight and ideal cut-off point for the number or severity of the exacerbations and was incorporated into the FACED score (E-FACED). The results obtained after the application of FACED and E-FACED were compared in both the cohorts.
A total of 1,470 patients with bronchiectasis (819 from the construction cohorts and 651 from the external validation cohorts) were followed up for 5 years after diagnosis. The best cut-off point was at least two exacerbations in the previous year (two additional points), meaning that the E-FACED has nine points of growing severity. E-FACED presented an excellent prognostic capacity for exacerbations (areas under the receiver operating characteristic curve: 0.82 for at least two exacerbations in 1 year and 0.87 for at least one hospitalization in 1 year) that was statistically better than that of the FACED score (0.72 and 0.78,
<0.05, respectively). The predictive capacities for all-cause and respiratory mortality were 0.87 and 0.86, respectively, with both being similar to those of the FACED.
E-FACED score significantly increases the FACED capacity to predict future yearly exacerbations while maintaining the score's simplicity and prognostic capacity for death.
A Ni-based pyrazolate MOF (NiBDP) is studied for SO2 adsorption under static conditions, demonstrating a high SO2 uptake of 8.48 mmol g−1 at 298 K and 1 bar while maintaining a high chemical ...stability. The influence of Ni(ii) coordinatively unsaturated metal sites and coordinated water on the SO2 adsorption performance of this MOF is investigated by using a combination of experimental techniques, including FTIR and in situ DRIFTS measurements, along with Density Functional Theory calculations. The pore-filling of the SO2 adsorbates within the material, at the molecular level, is further unravelled through grand Canonical Monte Carlo simulations employing a newly DFT-derived accurate set of force field parameters.
The analysis of current and future cosmological surveys of Type Ia supernovae (SNe Ia) at high redshift depends on the accuratephotometric classification of the SN events detected. Generating ...realistic simulations of photometric SN surveys constitutes anessential step for training and testing photometric classification algorithms, and for correcting biases introduced by selectioneffects and contamination arising from core-collapse SNe in the photometric SN Ia samples. We use published SN time-seriesspectrophotometric templates, rates, luminosity functions, and empirical relationships between SNe and their host galaxies toconstruct a framework for simulating photometric SN surveys. We present this framework in the context of the Dark EnergySurvey (DES) 5-yr photometric SN sample, comparing our simulations of DES with the observed DES transient populations.We demonstrate excellent agreement in many distributions, including Hubble residuals, between our simulations and data.We estimate the core collapse fraction expected in the DES SN sample after selection requirements are applied and beforephotometric classification. After testing different modelling choices and astrophysical assumptions underlying our simulation,we find that the predicted contamination varies from 7.2 to 11.7 per cent, with an average of 8.8 per cent and an r.m.s. of 1.1 percent. Our simulations are the first to reproduce the observed photometric SN and host galaxy properties in high-redshift surveyswithout fine-tuning the input parameters. The simulation methods presented here will be a critical component of the cosmologyanalysis of the DES photometric SN Ia sample: correcting for biases arising from contamination, and evaluating the associatedsystematic uncertainty.
The article discusses the findings of a study to evaluate and update the 2012 recommendations by the U.S. Preventive Services Task Force (USPSTF) on screening for cervical cancer, which revealed that ...the USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years, and recommends screening every 3 years alone with cervical cytology along, every 5 years with hrHPV testing alone, or every 5 years with hrHPV testing in combination with cytology (contesting) in women aged 30-65 years. The need to make the tools available to the populations that bear the greatest disease burden from cervical cancer such as poor women, women from communities of color, and other women with compromised access to timely and effective care is highlighted.
In 2011, the American Cancer Society, the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology updated screening guidelines for the early detection ...of cervical cancer and its precursors. Recommended screening strategies were cytology or cotesting (cytology in combination with high-risk human papillomavirus hrHPV testing). These guidelines also addressed the use of hrHPV testing alone as a primary screening approach, which was not recommended for use at that time. There is now a growing body of evidence for screening with primary hrHPV testing, including a prospective U.S.-based registration study. Thirteen experts, including representatives from the Society of Gynecologic Oncology, the American Society for Colposcopy and Cervical Pathology, the American College of Obstetricians and Gynecologists, the American Cancer Society, the American Society of Cytopathology, the College of American Pathologists, and the American Society for Clinical Pathology, convened to provide interim guidance for primary hrHPV screening. This guidance panel was specifically triggered by an application to the U.S. Food and Drug Administration (FDA) for a currently marketed HPV test to be labeled for the additional indication of primary cervical cancer screening. Guidance was based on literature review and review of data from the FDA registration study, supplemented by expert opinion. This document aims to provide information for health care providers who are interested in primary hrHPV testing and an overview of the potential advantages and disadvantages of this strategy for screening as well as to highlight areas in need of further investigation.
ABSTRACT
Quantifying tensions – inconsistencies amongst measurements of cosmological parameters by different experiments – has emerged as a crucial part of modern cosmological data analysis. ...Statistically significant tensions between two experiments or cosmological probes may indicate new physics extending beyond the standard cosmological model and need to be promptly identified. We apply several tension estimators proposed in the literature to the dark energy survey (DES) large-scale structure measurement and Planck cosmic microwave background data. We first evaluate the responsiveness of these metrics to an input tension artificially introduced between the two, using synthetic DES data. We then apply the metrics to the comparison of Planck and actual DES Year 1 data. We find that the parameter differences, Eigentension, and Suspiciousness metrics all yield similar results on both simulated and real data, while the Bayes ratio is inconsistent with the rest due to its dependence on the prior volume. Using these metrics, we calculate the tension between DES Year 1 3 × 2pt and Planck, finding the surveys to be in ∼2.3σ tension under the ΛCDM paradigm. This suite of metrics provides a toolset for robustly testing tensions in the DES Year 3 data and beyond.
Ruxolitinib, a potent Janus kinase 1/2 inhibitor, resulted in rapid and durable improvements in splenomegaly and disease-related symptoms in the 2 phase III COMFORT studies. In addition, ruxolitinib ...was associated with prolonged survival compared with placebo (COMFORT-I) and best available therapy (COMFORT-II). We present a pooled analysis of overall survival in the COMFORT studies using an intent-to-treat analysis and an analysis correcting for crossover in the control arms. Overall, 301 patients received ruxolitinib (COMFORT-I, n=155; COMFORT-II, n=146) and 227 patients received placebo (n=154) or best available therapy (n=73). After a median three years of follow up, intent-to-treat analysis showed that patients who received ruxolitinib had prolonged survival compared with patients who received placebo or best available therapy hazard ratio=0.65; 95% confidence interval (95%CI): 0.46-0.90; P=0.01; the crossover-corrected hazard ratio was 0.29 (95%CI: 0.13-0.63). Both patients with intermediate-2- or high-risk disease showed prolonged survival, and patients with high-risk disease in the ruxolitinib group had survival similar to that of patients with intermediate-2-risk disease in the control group. The Kaplan-Meier estimate of overall survival at week 144 was 78% in the ruxolitinib arm, 61% in the intent-to-treat control arm, and 31% in the crossover-adjusted control arm. While larger spleen size at baseline was prognostic for shortened survival, reductions in spleen size with ruxolitinib treatment correlated with longer survival. These findings are consistent with previous reports and support that ruxolitinib offers a survival benefit for patients with myelofibrosis compared with conventional therapies. (clinicaltrials.gov identifiers: COMFORT-I, NCT00952289; COMFORT-II, NCT00934544).
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