Does Self-Assessed Health Reflect the True Health State?

Self-assessed health (SAH) is a widely used tool to estimate population health. However, the debate continues as to what exactly this ubiquitous measure of social science research means for policy conclusions. This study is aimed at understanding the tenability of the construct of SAH by simultaneously modelling SAH and clinical morbidity. Using data from 17 waves (2001–2017) of the Russian Longitudinal Monitoring Survey, which captures repeated response for SAH and frequently updates information on clinical morbidity, we operationalise a recursive semi-ordered probit model. Our approach allows for the estimation of the distributional effect of clinical morbidity on perceived health. This study establishes the superiority of inferences from the recursive model. We illustrated the model use for examining the endogeneity problem of perceived health for SAH, contributing to population health research and public policy development, in particular, towards the organisation of health systems.

Delayed Surgery after Neoadjuvant Treatment for Rectal Cancer Does Not Lead to Impaired Quality of Life, Worry for Cancer, or Regret

Non operative management of complete clinical responders after neoadjuvant treatment for rectal cancer enjoys an increasing popularity because of the increased functional outcome results. Even a near complete response can evolve in a cCR, and therefore further delaying response assessment is accepted. However, up to 40% of patients will develop a regrowth and will eventually require delayed surgery. It is presently unknown if and to what extent quality of life of these patients is affected, compared to patients who undergo immediate surgery. Between January 2015-May 2020, 200 patients were treated with neoadjuvant therapy of whom 94 received TME surgery. Fifty-one (59%) of 87 alive patients returned the questionnaires: 33 patients who underwent immediate and 18 patients who underwent delayed surgery. Quality of life was measured through the QLQ-C30, QLQ-CR29, and Cancer Worry Scale questionnaires. Regret to participate in repeated response assessment protocol was assessed through the Decision Regret Scale. Exploratory factor analysis (EFA) and a ‘known groups comparison’ was performed to assess QLQ questionnaires validity in this sample. Higher mean physical function scores (89.2 vs. 77.6, p = 0.03) were observed in the immediate surgery group, which lost significance after correction for operation type (p = 0.25). Arousal for men was higher in the delayed surgery group (20.0 vs. 57.1, p = 0.02). There were no differences between surgical groups for the other questionnaire items. Worry for cancer was lower in the delayed surgery group (10.8 vs. 14.0, p = 0.21). Regret was very low (12–16%). EFA reproduced most QLQ C-30 and CR29 subscales with good internal consistency. Quality of life is not impaired in patients undergoing delayed TME surgery after neoadjuvant treatment for rectal cancer. Moreover, there is very low regret and no increase in worry for cancer. Therefore, from a quality of life perspective, this study supports a repeated response assessment strategy after CRTx for rectal carcinoma to identify all complete responders.

Ayrık Denemelerle Öğretim Yapılırken Kullanılan Hata Düzeltmesi Türleri

Öz Gelişimsel yetersizliği olan çocuklara farklı becerilerin öğretiminde yaygın olarak kullanılan ayrık denemelerle öğretim, ipuçlarını kullanarak doğru tepkileri artırmayı amaçlayan, doğru tepkilerin pekiştirilmesini ve yanlış tepkilerin düzeltilmesini içeren etkili bir uygulamadır. Ayrık denemelerle öğretimin temel bileşenlerinden biri, hataları düzelterek ileride bu hataların sergilenmesini azaltmayı amaçlayan hata düzeltmesidir. Hata düzeltmesi, öğretim sırasında çocuğun hata yapmasının hemen ardından, uygulamacının farklı şekillerde çocuğun hatasını düzeltmesidir. Ayrık denemelerle öğretimde hata düzeltmesi, farklı şekillerde gerçekleştirilebilmektedir. Bunlardan bazıları; sözel geribildirim ya da hata ifadesi, kısa süreli mola, doğru tepki için model olma, tek tepki tekrarı/aktif öğrenci tepkisi, çok tepki tekrarı/tekrarlanan tepki, bağımsızlaşana kadar tekrar sunma, deneme tekrarı ve türlerin bir arada kullanımıdır. Derleme biçiminde hazırlanan bu makalenin amacı uygulamacılara, ayrık denemelerle öğretim hakkında kısa bir bilgilendirme yapmak ve bir bileşen olarak hata düzeltmesinin ne olduğunu ve neden önemli olduğunu açıklamaktır. Ayrıca ayrık denemelerle öğretim yaparken sıklıkla kullanılan hata düzeltmesi türlerini tanıtmak, hata düzeltmesi türlerini akış şemaları yoluyla kavramsallaştırmak, hata düzeltmesi türlerinin nasıl kullanılacağını örneklerle anlatmak ve bu hata düzeltmesi türlerini kullanarak gerçekleştirilen araştırmalar konusunda bilgilendirme yapmaktır. Abstract Discrete trial training is an effective intervention commonly used in teaching different skills to children with developmental disabilities. It aims to increase the correct responses using prompts, reinforcements, and error correction strategies. One of the main components of the discrete trial training is error correction, which aims to reduce errors in the future by correcting errors. In error correction, the instructor corrects the child’s error using different strategies immediately after the child makes a mistake during training. There are several types of error correction strategies commonly used in discrete trial training; (a) vocal feedback or error statement, (b) a brief time-out, (c) a model for the correct response, (d) single response repetition/active student response, (e) multi-response repetition/repeated response, (f) re-present until independent, (g) remove and re-present, and (h) the combination of the strategies. The purpose of this study is to provide a brief overview of discrete trial training, to explain the error correction procedures and their importance, to introduce the types of error correction strategies used in discrete trial training, to conceptualize error correction strategies through flowcharts, to explain how to use error correction strategies, and to inform about the error correction literature.

Flexible and Optical Fiber Sensors Composited by Graphene and PDMS for Motion Detection

A stretchable optical sensor can quantify the strain generated by human movement, which has been widely studied in the development of health monitoring systems, human–machine interfaces and wearable devices. This paper reports a graphene-added polydimethylsiloxane (PDMS) fiber, which has high tensile properties and good light transmittance suitable for detecting human movement. When the graphene-added PDMS fiber is stretched, the concentration of graphene per unit volume is constant, and the sensor uses the optical loss of the beam through the graphene PDMS fiber to detect the tensile strain. The fiber has excellent strain-sensing performance, outstanding sensitivity, a tensile property of 150%, and an excellent waterproofing performance. The linear response and repeated response in large dynamic range could reach 100% stability. The results show that the sensor can be used to detect human motion detection. These excellent properties indicate that the fiber has potential applications in wearable devices, soft robots and electronic skin.

Adoptive Immunotherapy of p53-Mutated B-CLL with a Trifunctional Antibody (Anti-CD3 x Anti-CD20) and Allogeneic Donor Lymphocyte Transfusion.

In most cases CLL patients with p53 aberrations are refractory to standard treatment approaches, even to allogeneic stem cell transplantation (ASCT). Here we report 3 patients with relapse after ASCT that were treated with the combination of the trifunctional antibody Bi20 and donor lymphocyte transfusions (DLT). The Bi20 antibody is trifunctional, it binds to CD20 and CD3 and activates phagocytosis of the leukemia cell by accessory cells via the Fc part. Bi20 was applied in escalating doses from 10 μg up to 640 μg and followed by DLT (1 x 107/kg body weight). Patient 2 and 3 received repeated courses of antibody and DLT. In all cases we observed a prompt, dose-dependent decrease of B-CLL cells in the peripheral blood, which already started hours after application of the antibody infusion. Furthermore, in all cases the reduction of the enlarged lymph nodes and spleen went along with a significant improvement of the clinical symptoms like night sweat. Clinically, side effects were restricted to fever, chills and bone pain that could be easily controlled. These effects peaked at a concentration of 80 μg and did not increase or even decreased at higher concentrations. The cytokine profile was characterized by a transient increase of IL-6, IL-12 and IL-10. With respect to the transaminases, only a transient and modest increase of γGT was observed. HAMAs (human anti mouse antibodies) were not detectable; the absence allowed repeated transfusions of the trifunctional antibodies. Moreover, graft-versus-host disease (GVHD) was not observed. Unfortunately relapse of the disease occurred in all cases. In two cases repeated application of Bi20 and T-cells induced a repeated response. The overall survival was 47, 151 and 196 days. Bi20 can induce a prompt anti tumor response in B-CLL patients with a p53 mutation. The toxicity of treatment is not severe. However the response is of short duration and further studies are necessary to improve the outcome of patients by e.g. optimizing the application schedule.

Inhalation of adenosine 5'-monophosphate increases methacholine airway responsiveness

Airway hyperresponsiveness is a characteristic feature in asthmatic subjects, but the mechanism of the hyperresponsiveness is not known. The purpose of this study was to investigate whether methacholine airway responsiveness was increased 24 h after inhalation of adenosine 5′-monophosphate (AMP). Ten atopic asthmatic subjects and six atopic normal subjects were studied on 4 study days. On the 1st day, a methacholine inhalation test was performed, followed within 48 h by an AMP inhalation test. Seven days later the second AMP test was performed, and 24 h later the methacholine inhalation test was repeated. Response was measured using partial flow-volume curves, and the concentration required to cause a 40% fall in the partial flow-volume curve (PC40) was calculated. The geometric mean methacholine PC40 fell from 1.36 mg/ml on day 1 (before AMP inhalation) to 0.71 mg/ml on day 4 (24 h after AMP inhalation, P less than 0.01). There was no change in the mean PC40 for adenosine on the 2 study days (5.82 and 7.06 mg/ml, P greater than 0.1). These findings suggest that adenosine release may contribute to the increase in airway responsiveness after allergen challenge.