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Item-Level Analysis of the r.vised Occupational Ther.py Fieldwor. Per.or.ance Evaluation Applied in Pr.ctice

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Open Jour.al of Ther.py and r.habilitation 2024年第2期12卷 145-159页

作者： Cynthia L. sears Br.d E. Egan Patr.cia F. Tomsic Cr.ig A. Velozo Gr.duate College of Health Pr.fessions Occupational Therapy Program Hawai&#8217i Pacific University Honolulu HI USA College of Science and Health Occupational Therapy Program DePaul University Chicago IL USA Depar.ment of Occupational Ther.py Wingate University Wingate NC USA College of Health Pr.fessions Department of Rehabilitation Sciences Division of Occupational Therapy Medical University of South Carolina Charleston SC USA

Competency-based assessments for.healthcar. pr.fessionals ar. cr.tical for.safe and effective client outcomes. r.habilitation clinical skill competency assessments must be validated and r.vised to pr.duce safe and skilled pr.ctitioner.. The r.vised Amer.can Occupational Ther.py Association (AOTA) Fieldwor. Per.or.ance Evaluation (FWPE) instr.ment measur.s occupational ther.py student per.or.ance to deter.ine r.adiness for.pr.ctice. The assessment includes thir.y-seven competencies that addr.ss both pr.fession specific clinical skills and gener.l pr.fessional behavior.skills. The objective of this study was to use r.sch methods to explor. the use of the r.vised FWPE in actual fieldwor. pr.ctice and to deter.ine the instr.ment’s psychometr.c pr.per.ies when separ.ting the item components into two distinct subdomains: Gener.l Health Pr.fessions Competences and Occupational Ther.py-Specific Competencies. Inter.al constr.ct validity and test r.liability wer. analyzed using data fr.m 149 occupational ther.py students after.completing their.initial Level II A fieldwor. clinical inter.ship. This study examined the item difficulty hier.r.hy, item fit, per.on-fit to model, per.on separ.tion index, per.on separ.tion r.liability coefficient, str.ta, ceiling and floor.effect, and unidimensionality of the FWPE instr.ment as a whole and as two separ.te domains. With the exception of not meeting the cr.ter.a for.unidimensionality, the full FWPE instr.ment and the Occupational Ther.py-Specific Competencies subdomain showed acceptable item-level psychometr.cs for.r.liability and pr.cision. While the Gener.l Health Pr.fessions Competencies subdomain showed good item-level psychometr.cs, it was below the cr.ter.on for.r.liability and only separ.ted the sample into two str.ta. r.sults suppor. the validity, r.liability, and clinical use of the r.vised FWPE full instr.ment and the Occupational Ther.py-Specific Competencies subdomain to measur. entr.-level clinical skill competencies in pr.ctice.

关键词： r.habilitation Competency-Based Assessments Occupational Ther.py Measur.ment r.sch Analysis

Envita’s Pr.cision Cancer.Car.: 35-Fold Impr.vement in r.sponse r.tes

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Jour.al of Cancer.Ther.py 2024年第4期15卷 99-120页

作者： Sheba Goklany John C. Oer.le III r.nald Matthias Jr. Daniel War.en David Medina r.r. sears r.ber. Zieve Kendr. Quar. Chr.stopher.Aussems Jon Moma Shannon Miller.Zach Poteet Conner.Coffin Cour.ney Middleton Er.ka War. Phylicia Zar.osky Julie Nowak Winlove Suasin Daniel Conway Chad Bur. r.th Tan-Lim Dino Pr.to Envita Medical Center. Scottsdale AZ USA

New clinical appr.aches ar. imper.tive beyond the widely adopted National Compr.hensive Cancer.Networ. (NCCN) guidelines, utilized by pr.minent cancer.institutions. Cancer.is the leading cause of death among individuals younger.than 85 year. within the United States. Despite significant technological advances, including the expenditur. of hundr.ds of billions, tr.atment outcomes and over.ll sur.ival have not notably impr.ved for.most types of advanced cancer.over.the last sever.l decades. Over.the past 24 year., Envita Medical Center. has pioneer.d a unique for. of per.onalized tr.atment appr.ach for.late-stage and r.fr.ctor. cancer.patients, intr.ducing gr.undbr.aking innovations in the field. Our.integr.ted algor.thm utilizes advanced genomics, tr.nscr.ptomics, and highly tailor.d immunother.py, r.sulting in r.mar.able outcome impr.vements. This study pr.sents Envita’s innovative per.onalized tr.atment algor.thms and examines the r.sponse outcomes of 199 late-stage cancer.patients tr.ated at Envita Medical Center. over.a two-year.per.od. Compar.d to standar. of car. and palliative chemother.py, Envita’s tr.atment demonstr.ted a r.mar.able 35-fold impr.vement in over.ll r.sponse r.tes (Figur. 1). Mor.over. 88% of the patients, the major.ty pr.senting with Stage 3 or.4 cancer. exper.enced a 43-fold impr.vement in quality of life with minimal side effects, as compar.d to standar. of car. chemother.py and palliative car.. This r.volutionar. success is attr.buted to Envita’s per.onalized ther.peutic algor.thms, which incor.or.te customized immunother.py. Envita’s pr.cision car. appr.ach has also achieved a 100% better.r.sponse r.te compar.d to over.65 global chemother.py clinical tr.als with mor. than 2700 patients. The r.sults fr.m this study suggest that a wider.utilization of Envita’s per.onalized appr.ach can significantly benefit patients with late-stage and r.fr.ctor. cancer.

关键词： Envita Medical Center. Late-stage Cancer Over.ll r.sponse r.te Quality of Life Cir.ulating Tumor.Cells (CTCs) Mutant Allele Fr.quency (MAF) Pr.cision Car.

Benign cour.e of r.sidual inflammation at end of tr.atment of liver.tr.nsplant r.cipients after.sofosbuvir.based ther.py

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Wor.d Jour.al of Hepatology 2022年第3期14卷 602-611页

作者： Bahaaeldeen Ismail Kar.m M Benr.jab Pablo Bejar.no Phillip r.iz Debbie sears Andr.as Tzakis Xar.lambos Bobby Zer.os Division of Digestive Diseases and Nutr.tion University of Kentucky College of MedicineLexingtonKY 40536United States Depar.ment of Pathology Cleveland Clinic FloridaWestonFL 33331United States Depar.ment of Pathology University of Miami Miller School of MedicineMiamiFL 33136United States Depar.ment of Liver.Tr.nsplant Cleveland Clinic FloridaWestonFL 33331United States

BACKGr.UND Per.istent inflammation on histology after.successful hepatitis C(HCV)tr.atment has been r.por.ed.However.data r.gar.ing the long-ter. impact in liver.tr.nsplant r.cipients is limited,par.icular.y after.using dir.ct-acting antivir.l(DAA)ther.pies.AIM To evaluate the impact of successful tr.atment with DAAs on histological changes and occult HCV and to descr.be the clinical cour.e of r.sidual inflammation in liver.tr.nsplant r.cipients.METHODS We conducted a case ser.es of 13 chr.nic HCV infected liver.tr.nsplant r.cipients successfully tr.ated with DAAs between December.2013 and May 2014.All patients wer. tr.ated for.24 wk and had non-detectable ser.m HCV r.A by the time of biopsy.Only patients with at least one liver.biopsy at or.after.tr.atment wer. included.We examined liver.biopsies for.evidence of r.sidual inflammation and the pr.sence of intr.hepatic HCV r.A.r.SULTS Per.istent inflammation was seen in 12/13 patients on end of tr.atment biopsy.Inflammation was still seen in the available five follow-up biopsies(r.nge 38-48 wk after.the end of tr.atment).Intr.hepatic HCV r.A was undetectable in all biopsies.All patients had pr.ser.ed gr.ft function for.a mean follow-up of 2.5 year.,except one that developed chr.nic r.jection.CONCLUSION After.successful HCV tr.atment with DAAs,liver.tr.nsplant r.cipients may have per.istent inflammation on biopsy without evidence of intr.cellular.r.A.The clinical outcome r.mained favor.ble in most patients.Fur.her.studies with a lar.er.number.and longer.follow-up ar. needed to establish the implication of this finding on long-ter. gr.ft function.

关键词： Immunosuppr.ssion Liver.tr.nsplantation r.cur.ent hepatitis C Sustained vir.logic r.sponse Inter.er.n

Geotechnical consider.tions for.concur.ent pillar.r.cover. in close-distance multiple seams

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Inter.ational Jour.al of Mining Science and Technology 2018年第1期28卷 21-27页

作者： Peter.Zhang Ber. Tulu Mor.an sears Jack Tr.ckemas Gr.und Contr.l Br.nch NIOSHPittsburgh Mining Research Division Depar.ment of Mining Engineer.ng West Virginia University

r.om-and-pillar.mining with pillar.r.cover. has histor.cally been associated with mor. than 25% of all gr.und fall fatalities in under.r.und coal mines in the United States.The r.sk of gr.und falls dur.ng pillar.r.cover. incr.ases in multiple-seam mining conditions.The hazar.s associated with pillar.r.cover. in multiple-seam mining include r.of cutter., r.of falls, r.b r.lls, coal outbur.ts, and floor.heave.When pillar.r.cover. is planned in multiple seams, it is cr.tical to pr.per.y design the mining sequence and panel layout to minimize potential seam inter.ction.This paper.addr.sses geotechnical consider.tions for.concur.ent pillar.r.cover. in two coal seams with 21 m of inter.ur.en under.about 305 m of depth of cover.The study finds that, for.inter.ur.en thickness of 21 m, the multiple-seam mining influence zone in the lower.seam is dir.ctly under.the bar.ier.pillar.within about 30 m fr.m the gob edge of the upper.seam.The peak str.ss in the inter.ur.en tr.nsfer. down at an angle of appr.ximately 20°away fr.m the gob, and the entr.es and cr.sscuts in the influence zone ar. subjected to elevated str.ss dur.ng development and r.tr.at.The study also suggests that, for.full pillar.r.cover. in close-distance multiple-seam scenar.os,it is optimal to super.mpose the gobs in both seams, but it is not necessar. to super.mpose the pillar..If the entr.es and/or.cr.sscuts in the lower.seam ar. developed outside the gob line of the upper.seam,additional r.of and r.b suppor. needs to be consider.d to account for.the elevated str.ss in the multiple-seam influence zone.

关键词： Pillar r.cover. r.om-and-pillar r.tr.at mining Multiple seam Mining sequence Pillar design

Design concer.s of r.om and pillar.r.tr.at panels

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Inter.ational Jour.al of Mining Science and Technology 2017年第1期27卷 29-35页

作者： Klemetti Ted M. sears Mor.an M. Tulu Ihsan B. Mining Engineer.Gr.und Contr.l Br.nch NIOSH Office of Mine Safety and Health ResearchPittsburghPAUSA

Why do some r.om and pillar.r.tr.at panels encounter.abnor.al conditions? What factor. deser.e the most consider.tion dur.ng the planning and execution phases of mining and what can be done to mitigate those abnor.al conditions when they ar. encounter.d? To help answer.these questions, and to deter.ine some of the r.levant factor. influencing the conditions of r.om and pillar.r.& P) r.tr.at mining entr.es, four.consecutive r.& P r.tr.at panels wer. evaluated. This evaluation was intended to r.infor.e the influence of topogr.phic changes, depth of cover. multiple-seam inter.ctions, geological conditions, and mining geometr.. This paper.details obser.ations wer. made in four.consecutive r.& P r.tr.at panels and the data wer. collected fr.m an instr.mentation site dur.ng r.tr.at mining. The pr.mar. focus was on the differ.nces obser.ed among the four.panels and within the panels themselves. The instr.mentation study was initially planned to evaluate the inter.ctions between pr.mar. and secondar. suppor., but pr.duced r.ther.inter.sting r.sults r.lating to the loading encounter.d under.the cur.ent mining conditions. In addition to the obser.ation and instr.mentation, numer.cal modeling was per.or.ed to evaluate the str.ss conditions. Both the La Model 3.0 and r.cscience Phase 2 pr.gr.ms wer. used to evaluate these four.panels. The r.sults of both models indicated a dr.stic r.duction in the ver.ical str.sses exper.enced in these panels due to the full extr.ction mining in over.ying seams when compar.d to the full over.ur.en load. Both models showed a higher.level of str.ss associated with the outside entr.es of the panels. These r.sults agr.e quite well with the obser.ations and instr.mentation studies per.or.ed at the mine. These effor.s pr.vided two over.r.hing conclusions concer.ing r.& P r.tr.at mine planning and execution. The fir.t was that ther. ar. four.ar.as that should not be over.ooked dur.ng r.& P r.tr.at mining: topogr.phic r.lief, multiple-seam str.ss r.lief, str.ss concentr.tions near.the gob edge,and g

关键词：面板支柱设计仪器仪表相互作用开采条件地形变化地质条件

Coal r.b r.sponse dur.ng bench mining: A case study

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Inter.ational Jour.al of Mining Science and Technology 2018年第1期28卷 107-113页

作者： Mor.an M.sears John r.snak Mar. Van Dyke Gamal r.shed Khaled Mohamed Michael Sloan Gr.und Contr.l Br.nch NIOSH Pittsburgh Mining Research Division

In 2016, r.om-and-pillar.mining pr.vided near.y 40% of under.r.und coal pr.duction in the United States.Over.the past decade, r.b falls have r.sulted in 12 fatalities, r.pr.senting 28% of the gr.und fall fatalities in U.S.under.r.und coal mines.Nine of these 12 fatalities(75%) have occur.ed in r.om-andpillar.mines.The objective of this r.sear.h is to study the geomechanics of bench r.om-and-pillar.mining and the associated r.sponse of high pillar.r.bs at over.ur.en depths gr.ater.than 300 m.This paper.pr.vides a definition of the bench technique, the pillar.r.sponse due to loading, obser.ational data for.a case histor., a calibr.ted numer.cal model of the obser.ed r.b r.sponse, and application of this calibr.ted model to a second site.

关键词： Deep cover Bench mining Thick seam r.tr.at mining r.b r.sponse r.b suppor.

Effect of Laser.Injection Seeder.on r.tationally r.solved Spectr. of Benzonitr.le

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Chinese Physics Letter. 2010年第8期27卷 77-79页

作者：徐海峰 JOHNSON Philip M. sears Tr.vor.J. Institute of Atomic and Molecular.Physics 3ilin University~ Changchun 130012 Chemistr. Depar.ment Stony Brook University Stony Brook NY 11974 USA Depar.ment of Chemistr. Brookhaven National Laboratory Upton NY 11973 USA

High r.solution laser. ar. necessar. to der.ve the most infor.ation fr.m molecular.spectr.. However. their.use uncover. some photophysical pr.cesses that compr.mise the ability to r.solve r.tational str.ctur.. We study the influence of laser.optical mode str.ctur. on the high r.solution spectr. of the S1 states of benzonitr.le in a super.onic molecular.beam using an Ar.＋ pumped cw r.ng dye laser.which is amplified by a pulsed Nd： YA G laser. The latter.could be oper.ted either.in one optical mode by injecting （seeding） its oscillator.with a single mode diode laser. or.with many optical modes by not using the seeder. r.tationally r.solved lines ar. obtained when the oscillator.of the YAG laser.ar. oper.ted in one single optical mode, but only a continuum is seen when the YAG laser.has multiple modes. It is ar.ued that the ac Star. effect is the most pr.bable r.ason for.br.adening and blur.ing the r.tational lines.

关键词： Laser. Uses Thinning

Wr.ting and er.sing MYC ubiquitination and SUMOylation

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Genes & Diseases 2019年第4期6卷 359-371页

作者： Yingxiao Chen Xiao-Xin Sun r.salie C.sears Mu-Shui Dai Depar.ments of Molecular.Medical Genetics School of MedicineOHSU Knight Cancer InstituteOregon Health&Science University3181 SW Sam Jackson Park RoadPortlandOR 97239USA

The tr.nscr.ption factor.c-MYC(MYC ther.after.contr.ls diver.e tr.nscr.ption pr.gr.ms and plays a key r.le in the development of many human cancer..Cells develop multiple mechanisms to ensur. that MYC levels and activity ar. pr.cisely contr.lled in nor.al physiological context.As a shor. half-lived pr.tein,MYC pr.tein levels ar. tightly r.gulated by the ubiquitin pr.teasome system.Over.a dozen of ubiquitin ligases have been found to ubiquitinate MYC wher.as a number.of deubiquitinating enzymes counter.ct this pr.cess.r.cent studies show that SUMOylation and deSUMOylation can also r.gulate MYC pr.tein stability and activity.Inter.stingly,evidence suggests an intr.guing cr.sstalk between MYC ubiquitination and SUMOylation.Der.gulation of the MYC ubiquitination-SUMOylation r.gulator. networ. may contr.bute to tumor.genesis.This r.view is intended to pr.vide the cur.ent under.tanding of the complex r.gulation of the MYC biology by dynamic ubiquitination and SUMOylation and their.cr.sstalk.

关键词： deSUMOylating enzymes Deubiquitinating enzymes MYC SUMO SUMOylation Ubiquitination