Interrater Reliability in Toxicity Identification: Limitations of Current Standards.

PurposeThe National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v5.0 is the standard for oncology toxicity encoding and grading, despite limited validation. We assessed interrater reliability (IRR) in multireviewer toxicity identification.Methods and materialsTwo reviewers independently reviewed 100 randomly selected notes for weekly on-treatment visits during radiation therapy from the electronic health record. Discrepancies were adjudicated by a third reviewer for consensus. Term harmonization was performed to account for overlapping symptoms in CTCAE. IRR was assessed based on unweighted and weighted Cohen's kappa coefficients.ResultsBetween reviewers, the unweighted kappa was 0.68 (95% confidence interval, 0.65-0.71) and the weighted kappa was 0.59 (0.22-1.00). IRR was consistent between symptoms noted as present or absent with a kappa of 0.6 (0.66-0.71) and 0.6 (0.65-0.69), respectively.ConclusionsSignificant discordance suggests toxicity identification, particularly retrospectively, is a complex and error-prone task. Strategies to minimize IRR, including training and simplification of the CTCAE criteria, should be considered in trial design and future terminologies

Parallel Five-Cycle Counting Algorithms

Counting the frequency of subgraphs in large networks is a classic research question that reveals the underlying substructures of these networks for important applications. However, subgraph counting is a challenging problem, even for subgraph sizes as small as five, due to the combinatorial explosion in the number of possible occurrences. This paper focuses on the five-cycle, which is an important special case of five-vertex subgraph counting and one of the most difficult to count efficiently. We design two new parallel five-cycle counting algorithms and prove that they are work-efficient and achieve polylogarithmic span. Both algorithms are based on computing low out-degree orientations, which enables the efficient computation of directed two-paths and three-paths, and the algorithms differ in the ways in which they use this orientation to eliminate double-counting. We develop fast multicore implementations of the algorithms and propose a work scheduling optimization to improve their performance. Our experiments on a variety of real-world graphs using a 36-core machine with two-way hyper-threading show that our algorithms achieves 10-46x self-relative speed-up, outperform our serial benchmarks by 10-32x, and outperform the previous state-of-the-art serial algorithm by up to 818x

EDUKASI STANDARD OPERATING PROCEDURE (SOP), KEMASAN, DAN PERIZINAN UMKM KERIPIK ASIH JAWA TIMUR

Sektor Miko, Usaha Kecil dan Menengah (UMKM) memiliki peran penting dalam perekonomian Indonesia. Karena kontribusinya yang besar terhadap perekonomian nasional, tentunya UMKM ini memiliki beberapa permasalahan, terutama pada UMKM Keripik Asih di Jawa Timur yang menjadi sasaran pendampingan. Sifatnya masih tradisional membuat UMKM memerlukan edukasi terkait Standar Operasional Prosedur pangan, pentingnya pengemasan dan pendaftaran izin usaha yang baik sebagai bentuk perlindungan dan kepastian hukum bagi pengusaha UMKM. Mengenai kemasan produk akan berkaitan dengan pentingnya kualitas produk, dan sanitasi produk. Dalam tulisan ini, peneliti ingin memaparkan cara-cara yang dapat dilakukan untuk memajukan UMKM khususnya untuk Keripik Bu Asih. Dalam tulisan ini, peneliti menggunakan pendekatan perawakan dan pendapat ahli yang relevan di UMKM

Local to global policy as a catalyst for change: key messages

Feeding and nourishing a growing and changing global population in the face of rising numbers of chronically hungry people, slow progress on malnutrition, environmental degradation, systemic inequality, and the dire projections of climate change, demands a transformation in global food systems. Policy change at multiple levels is critical for catalysing an inclusive and sustainable transformation in food systems; global and regional policy are transformative only insofar as they are translated into ambitious national action with adequate support, including both public and private investment. Three areas of policy change show potential to be catalytic: 1) reducing emissions and increasing resilience, 2) tackling food loss and waste, and 3) shifting diets to promote nutrition and sustainability. Trade-offs mean a multi-sectoral approach to policymaking is needed, while inequalities in food systems necessitate transparent, inclusive processes and results. Gender inequality, in particular, must be addressed. Transformation demands participation and action from all actors

Massachusetts Health Passport Project Evaluation Final Report

Adapted from the Executive Summary: The Massachusetts Health Passport Project (MHPP) began in April 2004, as a pilot program of the Juvenile Rights Advocacy Project at Boston College Law School under the direction of Francine Sherman, Esq. The program was originally called the Girls’ Health Passport Project (GHPP) and was designed to address the unmet health needs and gaps in health care services for girls committed to the Massachusetts Department of Youth Services (DYS) and re-entering their communities from DYS assessment and treatment facilities. An advisory board of health, juvenile justice, philanthropy, and evaluation professionals assisted the program in its early development

Predictors of amounts of child and adolescent mental health service use

The aim of this study was to build evidence about how to tailor services to meet the individual needs of young people by identifying predictors of amounts of child and adolescent mental health service use. We conducted a secondary analysis of a large administrative dataset from services in England was conducted using the Mental Health Services Data Set (years 2016-17 and 2017-18). The final sample included N = 27,362 episodes of care (periods of service use consisting of at least two attended care contacts and less than 180 days between care contacts) from 39 services. There were 50-10,855 episodes per service. The descriptive statistics for episodes of care were: Mage = 13 years, SDage = 4.71, range = 0-25 years; 13,785 or 50% male. Overall, there were high levels of heterogeneity in number of care contacts within episodes of care: M = 11.12, SD = 28.28, range = 2-1529. Certain characteristics predicted differential patterns of service use. For example, young people with substance use (beta = 6.29, 95% CI = 5.06-7.53) or eating disorders (beta = 4.30, 95% CI = 3.29-5.30) were particularly more likely to have higher levels of service use. To build on this, evidence is needed about predictors of child and adolescent mental health treatment outcome and whether the same characteristics predict levels of improvement as well as levels of service use

Comparison of novel mechanical cervical dislocation and a modified captive bolt for on-farm killing of poultry on behavioural reflex responses and anatomical pathology

An alternative emergency method for killing poultry on-farm is required following European legislation changes (EU 1099/2009), which heavily restricts the use of manual cervical dislocation. This study investigated the kill efficacy of two mechanical methods that conform to the new legislation: (i) a novel mechanical cervical dislocation device; and (ii) a modified captive-bolt device (Rabbit Zinger™) and manual cervical dislocation (the control). Killing treatments were applied to broilers and layers at two stages of production (broilers: 2–3 and 5 weeks of age; layers: 12–13 and 58–62 weeks), with a total of 180 birds. Latency to abolition of cranial and behavioural reflexes, as well as post mortem analysis of the physiological damage produced, were used to estimate time to unconsciousness and assess kill efficacy. The novel mechanical cervical dislocation device was reliable and a practical method for killing poultry on-farm (100% kill success), with the majority of cranial reflexes showing no significant differences between interval mean durations across killing methods (eg nictitating membrane [mean = 0.7–3.3 s], and rhythmic breathing [mean = 0.0–0.3 s]), however for jaw tone and pupillary reflex, the modified Rabbit Zinger™ had significantly shorter interval mean durations compared to the control and mechanical cervical dislocation device (mean differences: jaw tone = ∼8 s; pupillary = ∼38 s). The novel mechanical cervical dislocation device resulted in consistent anatomical damage to the birds (eg high dislocation of the neck and severing of the spinal cord) compared to the manual method, despite both having 100% success rate, while the modified Rabbit Zinger™ was difficult to operate and resulted in varied anatomical damage. The novel mechanical cervical dislocation device showed promise as a replacement kill method on-farm for poultry