Colorectal Cancer Screening After Sequential Outreach Components in a Demographically Diverse Cohort.

Organized screening outreach can reduce differences in colorectal cancer (CRC) incidence and mortality between demographic subgroups. Outcomes associated with additional outreach, beyond universal outreach, are not well known. To compare CRC screening completion by race and ethnicity, age, and sex after universal automated outreach and additional personalized outreach. This observational cohort study included screening-eligible individuals aged 50 to 75 years assessed during 2019 in a community-based organized CRC screening program within the Kaiser Permanente Northern California (KPNC) integrated health care delivery setting. For KPNC members who are not up to date with screening by colonoscopy, each year the program first uses automated outreach (mailed prescreening notification postcards and fecal immunochemical test [FIT] kits, automated telephone calls, and postcard reminders), followed by personalized components for nonresponders (telephone calls, electronic messaging, and screening offers during office visits). Data analyses were performed between November 2021 and February 2023 and completed on February 5, 2023. Completed CRC screening via colonoscopy, sigmoidoscopy, or FIT. The primary outcome was the proportion of participants completing an FIT or colonoscopy after each component of the screening process. Differences across subgroups were assessed using the χ2 test. This study included 1 046 745 KPNC members. Their mean (SD) age was 61.1 (6.9) years, and more than half (53.2%) were women. A total of 0.4% of members were American Indian or Alaska Native, 18.5% were Asian, 7.2% were Black, 16.2% were Hispanic, 0.8% were Native Hawaiian or Other Pacific Islander, and 56.5% were White. Automated outreach significantly increased screening participation by 31.1%, 38.1%, 29.5%, 31.9%, 31.8%, and 34.5% among these groups, respectively; follow-up personalized outreach further significantly increased participation by absolute additional increases of 12.5%, 12.4%, 13.3%, 14.4%, 14.7%, and 11.2%, respectively (all differences P < .05 compared with White members). Overall screening coverage at the end of the yearly program differed significantly among members who were American Indian or Alaska Native (74.1%), Asian (83.5%), Black (77.7%), Hispanic (76.4%), or Native Hawaiian or Other Pacific Islander (74.4%) compared with White members (82.2%) (all differences P < .05 compared with White members). Screening completion was similar by sex; older members were substantially more likely to be up to date with CRC screening both before and at the end of the screening process. In this cohort study of a CRC screening program, sequential automated and personalized strategies each contributed to substantial increases in screening completion in all demographic groups. These findings suggest that such programs may potentially reduce differences in CRC screening completion across demographic groups

Program Components and Results From an Organized Colorectal Cancer Screening Program Using Annual Fecal Immunochemical Testing.

Programmatic colorectal cancer (CRC) screening increases uptake, but the design and resources utilized for such models are not well known. We characterized program components and participation at each step in a large program that used mailed fecal immunochemical testing (FIT) with opportunistic colonoscopy. Mixed-methods with site visits and retrospective cohort analysis of 51-75-year-old adults during 2017 in the Kaiser Permanente Northern California integrated health system. Among 1,023,415 screening-eligible individuals, 405,963 (40%) were up to date with screening at baseline, and 507,401 of the 617,452 not up-to-date were mailed a FIT kit. Of the entire cohort (n = 1,023,415), 206,481 (20%) completed FIT within 28 days of mailing, another 61,644 (6%) after a robocall at week 4, and 40,438 others (4%) after a mailed reminder letter at week 6. There were over 800,000 medical record screening alerts generated and about 295,000 FIT kits distributed during patient office visits. About 100,000 FIT kits were ordered during direct-to-patient calls by medical assistants and 111,377 people (11%) completed FIT outside of the automated outreach period. Another 13,560 (1.3%) completed a colonoscopy, sigmoidoscopy, or fecal occult blood test unrelated to FIT. Cumulatively, 839,463 (82%) of those eligible were up to date with screening at the end of the year and 12,091 of 14,450 patients (83.7%) with positive FIT had diagnostic colonoscopy. The >82% screening participation achieved in this program resulted from a combination of prior endoscopy (40%), large initial response to mailed FIT kits (20%), followed by smaller responses to automated reminders (10%) and personal contact (12%)

Coagulation of dissolved organic matter in surface water by novel titanium (III) chloride: Mechanistic surface chemical and spectroscopic characterisation

Problems caused by residual organics in treated water include the formation of disinfection by-products (DBP) following reaction with chlorine and being a substrate for microbial regrowth in the drinking water distribution system. Dissolved organic matter (DOM) can only be partially removed by conventional treatment process i.e. coagulation by Al- and Fe-based salts. In the present study, the performance of titanium trichloride (TiCl3) as a coagulant for surface water treatment was studied and compared with conventionally used aluminum sulfate (alum). Jar test experiments were performed at various coagulant doses and pH levels to determine the optimum conditions based on removal efficiencies of dissolved organic carbon (DOC). The zeta potential values were analysed for assessing the destabilisation mechanism of DOM flocs. The TiCl3 showed a significantly higher capacity for DOC removal at pH around 3 at which charge neutralization was found to be the dominant mechanism for the floc formation. This was further evident from the relatively larger floc sizes obtained with TiCl3 treatment. However, destabilization of Ti-flocs occurred at pH 4.5 through an adsorption-enmeshment mechanism due to a highly negative zeta potential. Additionally, fluorescence spectroscopic analyses showed that TiCl3 was more efficient than alum in removing humic compounds. A two-stage treatment process by alum and TiCl3, either as the same chemical or both showed better performance than a single dose treatment. The results indicate that TiCl3 could be an effective alternative coagulant for the treatment of waters, particularly those of low alkalinity and high DOC concentration and low pH wastewaters for removal of hydrophobic compounds and particulate matter

Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection: A Community-Based Cohort Study.

The fecal immunochemical test (FIT) is commonly used for colorectal cancer (CRC) screening. Despite demographic variations in stool hemoglobin concentrations, few data exist regarding optimal positivity thresholds by age and sex. To identify programmatic (multitest) FIT performance characteristics and optimal FIT quantitative hemoglobin positivity thresholds in a large, population-based, screening program. Retrospective cohort study. Kaiser Permanente Northern and Southern California. Adults aged 50 to 75 years who were eligible for screening and had baseline quantitative FIT results (2013 to 2014) and 2 years of follow-up. Nearly two thirds (411 241) had FIT screening in the previous 2 years. FIT programmatic sensitivity for CRC and number of positive test results per cancer case detected, overall and by age and sex. Of 640 859 persons who completed a baseline FIT and were followed for 2 years, 481 817 (75%) had at least 1 additional FIT and 1245 (0.19%) received a CRC diagnosis. Cancer detection (programmatic sensitivity) increased at lower positivity thresholds, from 822 in 1245 (66.0%) at 30 µg/g to 925 (74.3%) at 20 µg/g and 987 (79.3%) at 10 µg/g; the number of positive test results per cancer case detected increased from 43 at 30 µg/g to 52 at 20 µg/g and 85 at 10 µg/g. Reducing the positivity threshold from 20 to 15 µg/g would detect 3% more cancer cases and require 23% more colonoscopies. At the conventional FIT threshold of 20 µg/g, programmatic sensitivity decreased with increasing age (79.0%, 73.4%, and 68.9% for ages 50 to 59, 60 to 69, and 70 to 75 years, respectively; P = 0.009) and was higher in men than women (77.0% vs. 70.6%; P = 0.011). Information on advanced adenoma was lacking. Increased cancer detection at lower positivity thresholds is counterbalanced by substantial increases in positive tests. Tailored thresholds may provide screening benefits that are more equal among different demographic groups, depending on local resources. National Cancer Institute

Degree of entanglement for two qubits

In this paper, we present a measure to quantify the degree of entanglement for two qubits in a pure state.Comment: 5 page

Large diversity in AMOC internal variability across NEMO-based climate models

We characterise, and explore the drivers of, differences in the internal variability of the atlantic meridional overturning circulation (AMOC) across five NEMO-based CMIP6 class climate models. While the variability of AMOC variability is dominated by its lower dense limb in all models, there is large diversity in the timescale, multidecadal variability, and latitudinal coherence of AMOC across models. In particular, the UK models have much weaker AMOC multidecadal variability and latitudinal coherence. The model diversity is associated with differences in salinity-governed surface density variations which drive high-density water mass transformation (WMT) in the Greenland–Iceland–Norwegian Seas (GIN) and the Arctic. Specifically, GIN Seas WMT shows large multidecadal variability which has a major impact on AMOC variability in non-UK models. In contrast, the smaller variability in GIN Seas WMT in the UK models has limited impact on the lower latitude AMOC via the Denmark strait overflow mass transport. This leads to a latitudinally less coherent and weaker multidecadal variability of the AMOC lower limb. Such differences between UK and non-UK models are related to differences in model mean states and densification processes in the Arctic and GIN Seas. Consequently, we recommend further in-depth studies to better understand and constrain processes driving salinity changes in the Arctic and GIN Seas for more reliable representation of the AMOC in climate models

Lanthanide doping induced electrochemical enhancement of Na(2)Ti(3)O(7) anodes for sodium-ion batteries

Na₂Ti₃O₇ is considered as a promising anode material for sodium ion batteries (SIBs) due to its excellent high-rate performance compared with hard carbons. However, the electrochemical performance of Na₂Ti₃O₇ is heavily limited by its low electrical conductivity. In this study, we synthesized a series of lanthanide (Ln = La, Ce, Nd, Sm, Gd, Er, and Yb) doped microsized Na₂Ti₃O₇ anode materials and systematically studied the electrochemical performance. Compared with pristine Na₂Ti₃O₇, all the doped samples show superior electrochemical performance. Especially, the Yb³⁺ doped sample not only delivers a high reversible capacity of 89.4 mA h g⁻¹ at 30C, but also maintains 71.6 mA h g⁻¹ at 5C after 1600 cycles, nearly twice that of pristine Na₂Ti₃O₇. It is found for the first time that the enhancement in doped samples is attributed to the introduction of lanthanides which induces lattice distortion and oxygen vacancies.Jiale Xia, Hongyang Zhao, Wei Kong Pang, Zongyou Yin, Bo Zhou, Gang He, Zaiping Guo and Yaping D

State transfer in dissipative and dephasing environments

By diagonalization of a generalized superoperator for solving the master equation, we investigated effects of dissipative and dephasing environments on quantum state transfer, as well as entanglement distribution and creation in spin networks. Our results revealed that under the condition of the same decoherence rate $\gamma$, the detrimental effects of the dissipative environment are more severe than that of the dephasing environment. Beside this, the critical time $t_c$ at which the transfer fidelity and the concurrence attain their maxima arrives at the asymptotic value $t_0=\pi/2\lambda$ quickly as the spin chain length $N$ increases. The transfer fidelity of an excitation at time $t_0$ is independent of $N$ when the system subjects to dissipative environment, while it decreases as $N$ increases when the system subjects to dephasing environment. The average fidelity displays three different patterns corresponding to $N=4r+1$, $N=4r-1$ and $N=2r$. For each pattern, the average fidelity at time $t_0$ is independent of $r$ when the system subjects to dissipative environment, and decreases as $r$ increases when the system subjects to dephasing environment. The maximum concurrence also decreases as $N$ increases, and when $N\rightarrow\infty$, it arrives at an asymptotic value determined by the decoherence rate $\gamma$ and the structure of the spin network.Comment: 12 pages, 6 figure

Quantum error rejection code with spontaneous parametric conversion

We propose a linear optics scheme with SPDC process to test the fault tolerance property of quantum error correction code. To transmit an unknown qubit robustly through the noisy channel, one may first encode it into a certain quantum error correction code and then transmit it. The remote party decodes it and stores it. Sending a qubit in such a way can significantly reduces the error rate compared with directly sending the qubit itself. Here we show how to realize such a scheme by linear optics.Comment: To appear in Phys. Rev. A. 18 pages, 2 figure, minor erros corrected and more explanations added to increase the readabilit