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INTRODUCTION: The American Joint Committee on Cancer (AJCC) staging system undergoes periodic revisions to maintain contemporary survival outcomes related to stage. Recently, the AJCC has developed a novel, systematic approach incorporating survival data to refine stage groupings. The objective of this study was to demonstrate data‐driven optimization of the version 9 AJCC staging system for anal cancer assessed through a defined validation approach. METHODS: The National Cancer Database was queried for patients diagnosed with anal cancer in 2012 through 2017. Kaplan–Meier methods analyzed 5‐year survival by individual clinical T category, N category, M category, and overall stage. Cox proportional hazards models validated overall survival of the revised TNM stage groupings. RESULTS: Overall, 24,328 cases of anal cancer were included. Evaluation of the 8th edition AJCC stage groups demonstrated a lack of hierarchical prognostic order. Survival at 5 years for stage I was 84.4%, 77.4% for stage IIA, and 63.7% for stage IIB; however, stage IIIA disease demonstrated a 73.0% survival, followed by 58.4% for stage IIIB, 59.9% for stage IIIC, and 22.5% for stage IV (p <.001). Thus, stage IIB was redefined as T1‐2N1M0, whereas Stage IIIA was redefined as T3N0‐1M0. Reevaluation of 5‐year survival based on data‐informed stage groupings now demonstrates hierarchical prognostic order and validated via Cox proportional hazards models. CONCLUSION: The 8th edition AJCC survival data demonstrated a lack of hierarchical prognostic order and informed revised stage groupings in the version 9 AJCC staging system for anal cancer. Thus, a validated data‐driven optimization approach can be implemented for staging revisions across all disease sites moving forward. Evaluation of the 8th edition American Joint Committee on Cancer staging system demonstrated a lack of hierarchical prognostic order for anal cancer. Thus, the version 9 American Joint Committee on Cancer staging system for anal cancer was revised through a validated and data‐driven approach and should similarly be applied across all disease sites moving forward. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to describe college students' (n = 856) gender, year in school and source of tuition funding in relation to their academic motivation. The design was cross-sectional and used cluster sampling. The Academic Motivation Scale was used to measure students' intrinsic and extrinsic motivations as well as amotivation. Three main findings of this study are as follows. First, females reported higher levels of overall motivation as well as intrinsic and extrinsic motivation. Second, both intrinsic and extrinsic motivation declined with years in college. Third, self-funded students appeared lower in academic motivation in general and in extrinsic motivation in particular. (Contains 2 tables.)

Monoaminergic systems are conserved in vertebrates, yet they present variations in neuroanatomy, genetic components and functions across species. MonoAmine Oxidase, or MAO, is the enzyme responsible for monoamine degradation. While mammals possess two genes, MAO‐A and MAO‐B, fish possess one single mao gene. To study the function of MAO and monoamine homeostasis on fish brain development and physiology, here we have generated a mao knockout line in Astyanax mexicanus (surface fish), by CRISPR/Cas9 technology. Homozygote mao knockout larvae died at 13 days post‐fertilization. Through a time‐course analysis, we report that hypothalamic serotonergic neurons undergo fine and dynamic regulation of serotonin level upon loss of mao function, in contrast to those in the raphe, which showed continuously increased serotonin levels – as expected. Dopaminergic neurons were not affected by mao loss‐of‐function. At behavioral level, knockout fry showed a transient decrease in locomotion that followed the variations in the hypothalamus serotonin neuronal levels. Finally, we discovered a drastic effect of mao knockout on brain progenitors proliferation in the telencephalon and hypothalamus, including a reduction in the number of proliferative cells and an increase of the cell cycle length. Altogether, our results show that MAO has multiple and varied effects on Astyanax mexicanus brain development. Mostly, they bring novel support to the idea that serotonergic neurons in the hypothalamus and raphe of the fish brain are different in nature and identity, and they unravel a link between monoaminergic homeostasis and brain growth. [ABSTRACT FROM AUTHOR]

The article focuses on the New Brunswick Pharmacy Assessment Clinic, a pharmacist-led virtual collaborative practice hub for the assessment and prescribing of nirmatrelvir and ritonavir for COVID-19 patients. It discusses the lack of use of collaborative practice agreements (CPAs) in Canada as well as the establishment of health care in New Brunswick in response to the approval of nirmatrelvir and ritonavir for COVID-19 treatment.

PURPOSE: Lung Cancer Master Protocol (Lung-MAP), a public-private partnership, established infrastructure for conducting a biomarker-driven master protocol in molecularly targeted therapies. We compared characteristics of patients enrolled in Lung-MAP with those of patients in advanced non–small-cell lung cancer (NSCLC) trials to examine if master protocols improve trial access. METHODS: We examined patients enrolled in Lung-MAP (2014-2020) according to sociodemographic characteristics. Proportions for characteristics were compared with those for a set of advanced NSCLC trials (2001-2020) and the US advanced NSCLC population using SEER registry data (2014-2018). Characteristics of patients enrolled in Lung-MAP treatment substudies were examined in subgroup analysis. Two-sided tests of proportions at an alpha of.01 were used for all comparisons. RESULTS: A total of 3,556 patients enrolled in Lung-MAP were compared with 2,215 patients enrolled in other NSCLC studies. Patients enrolled in Lung-MAP were more likely to be 65 years and older (57.2% v 46.3%; P <.0001), from rural areas (17.3% v 14.4%; P =.004), and from socioeconomically deprived neighborhoods (42.2% v 36.7%, P <.0001), but less likely to be female (38.6% v 47.2%; P <.0001), Asian (2.8% v 5.1%; P <.0001), or Hispanic (2.4% v 3.8%; P =.003). Among patients younger than 65 years, Lung-MAP enrolled more patients using Medicaid/no insurance (27.6% v 17.8%; P <.0001). Compared with the US advanced NSCLC population, Lung-MAP under represented patients 65 years and older (57.2% v 69.8%; P <.0001), females (38.6% v 46.0%; P <.0001), and racial or ethnic minorities (14.8% v 21.5%; P <.0001). CONCLUSION: Master protocols may improve access to trials using novel therapeutics for older patients and socioeconomically vulnerable patients compared with conventional trials, but specific patient exclusion criteria influenced demographic composition. Further research examining participation barriers for under represented racial or ethnic minorities in precision medicine clinical trials is warranted. Precision medicine master protocols conducted as a public-private partnership may improve trial access for patients. [ABSTRACT FROM AUTHOR]

Background Screening for viral infection in cancer patients is inconsistent. A mechanism to readily identify cancer patients at increased risk of existing or prior viral infection could enhance screening efforts while reducing costs. Methods We identified factors associated with increased risk of past or chronic hepatitis virus B, hepatitis virus C, or HIV infection before initiation of systemic cancer therapy. Data were from a multicenter prospective cohort study of 3051 patients with newly diagnosed cancer (SWOG-S1204) enrolled between 2013 and 2017. Patients completed a survey with questions pertaining to personal history and behavioral, socioeconomic, and demographic risk factors for viral hepatitis or HIV. We derived a risk model to predict the presence of viral infection in a random set of 60% of participants using best subset selection. The derived model was validated in the remaining 40% of participants. Logistic regression was used. Results A model with 7 risk factors was identified, and a risk score with 4 levels was constructed. In the validation cohort, each increase in risk level was associated with a nearly threefold increased risk of viral positivity (odds ratio = 2.85, 95% confidence interval = 2.26 to 3.60, P  < .001). Consistent findings were observed for individual viruses. Participants in the highest risk group (with > 3 risk factors), comprised of 13.4% of participants, were 18 times more likely to be viral positive compared with participants with no risk factors (odds ratio = 18.18, 95% confidence interval = 8.00 to 41.3, P  < .001). Conclusions A risk-stratified screening approach using a limited set of questions could serve as an effective strategy to streamline screening for individuals at increased risk of viral infection. [ABSTRACT FROM AUTHOR]

Cutscores for reading and math (general outcome measures) to predict passage on New York state-mandated assessments were created by using a freely available Excel workbook. The authors used linear regression to create the cutscores and diagnostic indicators were provided. A rationale and procedure for using this method is outlined. This method allows practitioners to model alternative cutscores and observe effects on correct and incorrect classification of students as passing or failing a high-stakes test. This method of determining cutscores allows school personnel to create defensible and appropriate cutscores on the basis of resources available at the local level. (Contains 6 tables and 2 notes.)

In order to gain a better understanding of the ways in which an instructor could enhance an on-line learning experience, we surveyed 96 students enrolled in on-line Health Promotion and Wellness courses. Almost all respondents felt that sending e-mailed reminders and posting announcements on the course was very important or important for enhancing the on-line learning experience. There was a mixed response in the ratings for how important it was for an on-line instructor to host on-line office hours and the weakest ratings were for rating importance of having asynchronous time with an on-line instructor. Not surprisingly, most students used the library for research purposes less often or as often for their on-line courses than for their face-to-face courses. However, the majority of students used the Internet for resources more often or as often. Interestingly, half of the respondents felt that they interacted more with classmates in their on-line course. The amount of time spent preparing assignments in a face-to-face versus an on-line course was split. (Contains 2 tables.)

There is a paucity of research concerning the opinions and roles of Department Chairs pertaining to computer use, yet these individuals are in a key position to influence the curricula. The purpose of this survey was to improve understandings about Department Chairs' opinions and reported practices concerning computer applications in their undergraduate professional preparation programs. The target population for the study was all of the Department Chairs of undergraduate health education or related programs in the United States. The sampling frame was conducted by using the list maintained by the American Alliance of Health, Physical Education, Recreation and Dance (AAHPERD). The design for this study was cross sectional. All data represent chairpersons' reports on a single survey instrument. (Contains 5 tables.)

Through a joint research committee sponsored by the Association for Play Therapy (APT) and the American Counseling Association (ACA), The National Play Therapy in Counseling Practices Project conducted the first phase of investigation. Findings offered a snapshot of mental health providers of play therapy, regarding the nature of who they are and what they do. In terms of training, play modalities, theoretical orientation, and employment setting, comparisons were made based on membership of participants in ACA or APT. Further research was suggested to examine the effectiveness of play therapy with specific therapeutic issues.

In this brief article, a case example is provided that illustrates potential program-evaluation procedures for examining the outcomes of children served in different models of special education. Specifically, the goal of this project was to evaluate the academic outcomes of children served in self-contained versus inclusive models of special education programming in a midsize urban school district in Upstate New York. For this evaluation, similar student groupings were formed for analysis by controlling for age, years in placement, significant behavioral problems, and IQ. In this example, reading achievement was significantly higher for students participating in inclusive classrooms on both group and individual measures. No significant difference existed on measures of math achievement. Results indicated that within this school district, students who were educated in inclusive settings achieved at a rate that is comparable to or better than those educated in self-contained settings. Implications for other districts interested in engaging in similar program evaluations are discussed.