Living on thin abstractions: more power/economic knowledge

Debates over the role of knowledge and know-how as key economic assets in the contemporary economy, although far from new, are now increasingly couched in terms of a new-found economic immateriality which allows for their costless reproduction and widespread geographical dissemination. In the rush to tie down and reproduce economic know-how in abstract codifiable form, it has become almost baffling to argue that our stock of economic knowledge may rest upon affects as much as analysis, expressive symbolism as much as abstract symbolism. This paper is an attempt to think through how such 'elusive' economic knowledges may be grasped, yet neither formalized nor codified in abstract terms. It is also a plea to consider the geography of economic knowledge outside of the tacit - explicit distinction

Machine Learning for Health: Algorithm Auditing & Quality Control

Developers proposing new machine learning for health (ML4H) tools often pledge to match or even surpass the performance of existing tools, yet the reality is usually more complicated. Reliable deployment of ML4H to the real world is challenging as examples from diabetic retinopathy or Covid-19 screening show. We envision an integrated framework of algorithm auditing and quality control that provides a path towards the effective and reliable application of ML systems in healthcare. In this editorial, we give a summary of ongoing work towards that vision and announce a call for participation to the special issue Machine Learning for Health: Algorithm Auditing & Quality Control in this journal to advance the practice of ML4H auditing

Human factors review for Severe Accident Sequence Analysis (SASA)

The paper will discuss work being conducted during this human factors review including: (1) support of the Severe Accident Sequence Analysis (SASA) Program based on an assessment of operator actions, and (2) development of a descriptive model of operator severe accident management. Research by SASA analysts on the Browns Ferry Unit One (BF1) anticipated transient without scram (ATWS) was supported through a concurrent assessment of operator performance to demonstrate contributions to SASA analyses from human factors data and methods. A descriptive model was developed called the Function Oriented Accident Management (FOAM) model, which serves as a structure for bridging human factors, operations, and engineering expertise and which is useful for identifying needs/deficiencies in the area of accident management. The assessment of human factors issues related to ATWS required extensive coordination with SASA analysts. The analysis was consolidated primarily to six operator actions identified in the Emergency Procedure Guidelines (EPGs) as being the most critical to the accident sequence. These actions were assessed through simulator exercises, qualitative reviews, and quantitative human reliability analyses. The FOAM descriptive model assumes as a starting point that multiple operator/system failures exceed the scope of procedures and necessitates a knowledge-based emergency response by the operators. The FOAM model provides a functionally-oriented structure for assembling human factors, operations, and engineering data and expertise into operator guidance for unconventional emergency responses to mitigate severe accident progression and avoid/minimize core degradation. Operators must also respond to potential radiological release beyond plant protective barriers. Research needs in accident management and potential uses of the FOAM model are described. 11 references, 1 figure

Cost-effectiveness of the Hall Technique in a randomized trial

Clinical and patient-reported outcomes were reported for carious primary molars treated with the Hall technique (HT) as compared with conventional carious tissue removal and restorations (i.e., conventional restoration [CR]) in a 5-y randomized controlled practice-based trial in Scotland. We interrogated this data set further to investigate the cost-effectiveness of HT versus CR. A total of 132 children who had 2 matched occlusal/occlusal-proximal carious lesions in primary molars (n = 264 teeth) were randomly allocated to HT or CR, provided by 17 general dental practitioners. Molars were followed up for a mean 5 y. A societal perspective was taken for the economic analysis. Direct dental treatment costs were estimated from a Scottish NHS perspective (an NHS England perspective was taken for a sensitivity analysis). Initial, maintenance, and retreatment costs, including rerestorations, endodontic treatments, and extractions, were estimated with fee items. Indirect/opportunity costs were estimated with time and travel costs from a UK perspective. The primary outcome was tooth survival. Secondary outcomes included 1) not having pain or needing endodontic treatments/extractions and 2) not needing rerestorations. Cost-effectiveness and acceptability were estimated from bootstrapped samples. Significantly more molars in HT survived (99%, 95% CI: 98% to 100%) than in CR (92%; 87% to 97%). Also, the proportion of molars retained without pain or requiring endodontic treatment/extraction was significantly higher in HT than CR. In the base case analysis (NHS Scotland perspective), cumulative direct dental treatment costs (Great British pound [GBP]) of HT were 24 GBP (95% CI: 23 to 25); costs for CR were 29 (17 to 46). From an NHS England perspective, the cost advantage of HT (29 GBP; 95% CI: 25 to 34) over CR (107; 86 to 127) was more pronounced. Indirect/opportunity costs were significantly lower for HT (8 GBP; 95% CI: 7 to 9) than CR (19; 16 to 23). Total cumulative costs were significantly lower for HT (32 GBP; 95% CI: 31 to 34) than CR (49; 34 to 69). Based on a long-term practice-based trial, HT was more cost-effective than CR with HT retained for longer and experiencing less complications at lower costs

Therapy of renal cell carcinoma. 1. Hormonal therapy

腎細胞癌の35例に対して全例に根治的腎摘除術を施行後, 黄体ホルモンを主体とした集学的治療をおこなった.その臨床成績について文献的考察を含めて統計学的観察をおこなった.腎細胞癌の35例にゲスターゲン療法をおこなった.そのうち32例にchlormadinone acetate (CMA)を, 他の3例にMedroxyprogesterone acetate (MPA)を使用した.CMAを投与した32例に対してprophylactic groupとadvanced groupの2群に分けて統計学的観察をおこなった.prophylactic groupに関してCMA投与群はcontrolと比較して再発率, 生存率ともに有意差はなく, 予防的効果はほとんど認められなかった.advanced groupにおいて有効率は11例中CRの1例であり9%であった.Progesterone療法の副作用に関しては長期投与例において, ほぼ全例に体重増加があり, 治療後3ヵ月で肝機能障害が出現し投与を中止した1例, またインポテンツ, 閉経後の不正性器出血で投与を延期した男女おのおの1例以外はとくに重篤な副作用は生じなかったSixty eight patients with renal cell carcinoma were treated at our University in 1968 approximately 1983. The prognosis of these patients was studied retrospectively. Sixty six patients had also been receiving treatment with chemotherapy or radiotherapy except 3 cases after radical nephrectomy. Thirty five of the patients with Stage I approximately N renal cell carcinoma were treated with hormonal therapy using chlormadinone acetate (CMA) or medroxyprogesterone acetate (MPA). CMA was used prophylactically in 21 patients with Stage I approximately IIIA renal cell carcinoma and who had undergone radical nephrectomy. Metastasis was noted in 3 cases in this prophylactic CMA group (21 cases) and 4 cases in the control group (19 cases). No significant difference between these two groups was observed statistically. In the advanced group with Stage IIIC-IV renal cell carcinoma (11 cases), only one case with a complete response was noted after CMA combination therapy