The International Cancer Expert Corps: A Unique Approach for Sustainable Cancer Care in Low and Lower-Middle Income Countries

The growing burden of non-communicable diseases including cancer in low- and lower-middle income countries (LMICs) and in geographic-access limited settings within resource-rich countries requires effective and sustainable solutions. The International Cancer Expert Corps (ICEC) is pioneering a novel global mentorship–partnership model to address workforce capability and capacity within cancer disparities regions built on the requirement for local investment in personnel and infrastructure. Radiation oncology will be a key component given its efficacy for cure even for the advanced stages of disease often encountered and for palliation. The goal for an ICEC Center within these health disparities settings is to develop and retain a high-quality sustainable workforce who can provide the best possible cancer care, conduct research, and become a regional center of excellence. The ICEC Center can also serve as a focal point for economic, social, and healthcare system improvement. ICEC is establishing teams of Experts with expertise to mentor in the broad range of subjects required to establish and sustain cancer care programs. The Hubs are cancer centers or other groups and professional societies in resource-rich settings that will comprise the global infrastructure coordinated by ICEC Central. A transformational tenet of ICEC is that altruistic, human-service activity should be an integral part of a healthcare career. To achieve a critical mass of mentors ICEC is working with three groups: academia, private practice, and senior mentors/retirees. While in-kind support will be important, ICEC seeks support for the career time dedicated to this activity through grants, government support, industry, and philanthropy. Providing care for people with cancer in LMICs has been a recalcitrant problem. The alarming increase in the global burden of cancer in LMICs underscores the urgency and makes this an opportune time fornovel and sustainable solutions to transform cancer care globally

Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (the SToP-BPD study): Statistical analysis plan

Background: Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth with short-term and long-term adverse consequences. Although the glucocorticoid dexamethasone has been proven to be beneficial for the prevention of BPD, there are concerns about an increased risk of adverse neurodevelopmental outcome. Hydrocortisone has been suggested as an alternative therapy. The aim of the Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants (SToP-BPD) trial is to assess the efficacy and safety of postnatal hydrocortisone administration for the reduction of death or BPD in ventilator-dependent preterm infants. Methods/design: The SToP-BPD study is a multicentre, double-blind, placebo-controlled hydrocortisone trial in preterm infants at risk for BPD. After parental informed consent is obtained, ventilator-dependent infants are randomly allocated to hydrocortisone or placebo treatment during a 22-day period. The primary outcome measure is the composite outcome of death or BPD at 36 weeks postmenstrual age. Secondary outcomes are short-term effects on pulmonary condition and long-term neurodevelopmental sequelae assessed at 2 years corrected age. Complications of treatment, other serious adverse events and suspected unexpected serious adverse reactions are reported as safety outcomes. This pre-specified statistical analysis plan was written and submitted without knowledge of the unblinded data

Formal Verification By Reverse Synthesis

Abstract. In this paper we describe Echo, a novel yet practical approach to the formal verification of implementations. Echo splits verification into two major parts. The first part verifies an implementation against a low-level specification. The second uses a technique called reverse synthesis to extract a high-level specification from the low-level specification. The extracted specification is proved to imply the original system specification. Much of Echo is automated, and it reduces the verification burden by distributing it over separate tools and techniques. Reverse synthesis is achieved largely by mechanically applying a variety of semantics-preserving transformations, including complexity-reducing transformations, which can be viewed as optimizing the program for verification rather than for size or speed. We give a detailed example of Echo, verifying an implementation of the Advanced Encryption Standard (AES) against the official specification of AES

Dafny meets the Verification Benchmarks Challenge

A suite of verification benchmarks for software verification tools and techniques, presented at VSTTE 2008 [11], provides an initial catalogue of benchmark challenges for the Verified Software Initiative. This paper presents solutions to these eight benchmarks using the language and verifier Dafny. A Dafny program includes specifications, code, inductive invariants, and termination metrics. Each of the eight programs is fed to the Dafny verifier, which without further user interaction automatically performs the verification in a few seconds

Development and evaluation of a quality assessment instrument for occupational physicians

OBJECTIVES: To develop and apply a method for assessing the quality of the process of occupational health care for individual patients. METHODS: The scientific literature was studied to develop a method to assess the quality of the process of occupational rehabilitation for workers with low back pain. The method was applied to health care and university workers with low back pain who were rehabilitated by their occupational physicians. RESULTS: Assessment of quality of care is regarded as a four step approach. Firstly, guidelines should be developed and implemented. Secondly, indicators for quality and criteria to demarcate good and deviant quality were derived from the guidelines. Thirdly, a method for data collection was chosen. Finally, quality was scored. For occupational rehabilitation, there was some deviance from the guidelines for most cases, especially in continuity of care with a deviant rate of 47%. Other indicators deviated from 1.4%- 17.4%. Occupational physicians agreed on the relevance of the indicators and criteria, but for three indicators they evaluated the criteria as too rigid. They did not agree with their own performance scores in 66% of the deviant cases. CONCLUSION: Assessing the quality of the process of occupational health care with this method is an asset to present methods, but more specific criteria are needed for a more sensitive assessment.