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* Context.--Recent data support that low-risk submucosally invasive (pT1) colonic adenocarcinomas (ie, completely resected tumors that lack high-grade morphology, tumor budding, and lymphovascular invasion) are considered cured via endoscopic resection, provided that the submucosal invasion is less than 1000 [micro]m. Hence, the pathologists' assessment of depth of submucosal invasion may guide further management (ie, surveillance versus colectomy). Objective.--To assess interobserver concordance among gastrointestinal pathologists in measuring submucosal depth of invasion in colonic endoscopic resections. Design.--Six gastrointestinal pathologists from 5 academic centers independently measured the greatest depth of submucosal invasion in micrometers on 52 hematoxylineosin-stained slides from colonic endoscopic specimens with pT1 adenocarcinomas, per published guidelines (round 1 scoring). Two separate measurements (round 2 scoring) were subsequently performed by each pathologist following a consensus meeting, (1) from the surface of the lesion and (2) from the muscularis mucosae, and pathologists were asked to choose their (3) 'real-life (best)' assessment between the first 2 measurements. Interobserver agreement was assessed by the intraclass correlation coefficient (ICC) and Cohen [kappa] statistics. Results.--Round 1 had poor ICC (0.43; 95% CI, 0.31-0.56). Round 2 agreement was good when measuring from the surface (ICC = 0.83; 95% CI, 0.76-0.88) but moderate (ICC = 0.59; 95% CI, 0.47-0.70) when measuring from the muscularis mucosae and became poor (ICC = 0.49; 95% CI, 0.36-0.61) for the best-assessment measurement. Conclusions.--Our findings indicate that clearer and reproducible guidelines are needed if clinical colleagues are to base important management decisions on pathologists' estimate of the depth of submucosal invasion in colonic endoscopic resections. doi: 10.5858/arpa.2021-0598-OA, Widespread screening colonoscopy procedures and advances in definitive endoscopic therapy call for precise and reproducible criteria for the evaluation of superficially invasive colorectal adenocarcinoma (CRC) in endoscopic resections. Submucosa-invasive CRC [...]

Allosteric regulation of protein function is widespread in biology, but is challenging for de novo protein design as it requires the explicit design of multiple states with comparable free energies. Here we explore the possibility of designing switchable protein systems de novo, through the modulation of competing inter- and intramolecular interactions. We design a static, five-helix 'cage' with a single interface that can interact either intramolecularly with a terminal 'latch' helix or intermolecularly with a peptide 'key'. Encoded on the latch are functional motifs for binding, degradation or nuclear export that function only when the key displaces the latch from the cage. We describe orthogonal cage-key systems that function in vitro, in yeast and in mammalian cells with up to 40-fold activation of function by key. The ability to design switchable protein functions that are controlled by induced conformational change is a milestone for de novo protein design, and opens up new avenues for synthetic biology and cell engineering.

Objective: To develop and explore the validity characteristics of a new measure of organizational culture in public child welfare agencies. Method: Multiple validation methods were used, including expert judgment and criterion-related validity procedures using a statewide sample of 1,033 child welfare caseworkers, supervisors, and administrators. Results: Principal components analyses identified seven measurement dimensions positively correlated with a criterion measure of intent to remain employed in child welfare. Regression analyses showed that four measurement dimensions accounted for 26% of the variation in the criterion measure. Conclusions: The validity evidence for this new measure supports its use in a variety of ways in child welfare practice and in continued research on organizational culture and in child welfare workforce and child outcomes research. (Contains 3 tables.)

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.childyouth.2006.07.005 Byline: Alberta J. Ellett (a), Jacquelyn I. Ellis (a), Tonya M. Westbrook (b), Denise' Dews (c) Keywords: Child welfare; Employee retention; Turnover; Qualitative study Abstract: A statewide qualitative study of personal and organizational factors contributing to employees' decisions to either remain or leave employment in child welfare is described. Of particular interest was identifying factors related to employee retention. Professional staff (n =369) in a state public child welfare agency, representing all levels of the agency and regions of the state, participated in 58 focus group interviews comprising some 1200 person hours of data collection. Core findings of the results are presented and discussed in view of information from other recent child welfare workforce studies. Recommendations and implications of the results for policy and practice are described. Author Affiliation: (a) School of Social Work, University of Georgia, Athens, GA 30602, United States (b) School of Social Work, East Carolina University, United States (c) School of Social Work, Appalachian State University, United States Article History: Received 3 April 2006; Revised 22 May 2006; Accepted 19 July 2006

This study expands understanding of personal and organizational factors related to retention among public child welfare workers and supervisors from the personal experiences of highly competent, long-term employees, following the original terminology used by Ellett and Ellett (1997), we termed the committed survivors. A series of focus group interviews was completed with child welfare employees in urban, suburban, and rural settings. The results of the study are described in six sections: (a) Engagement and Involvement of Participants; (b) Reminiscence: Organizational; (c) Reminiscence: Societal; (d) Personal Characteristics; (e) Core Themes; and (f) Group Differences. Implications of the findings for local administrators, supervisors and higher-level administrators to enhance employee retention, and for social work educators are discussed, doi: 10.1300/J147v30n04_04 KEYWORDS. Employee/staff retention, child welfare workforce, professional commitment, child protective services

Aims: Emerging data support that submucosa-invasive (pT1b) esophageal adenocarcinomas are cured via endoscopic resection, provided that invasion measures =500 lm, they lack other histological features predictive of nodal metastasis and have negative margins. Hence, pathologists' measurement of the depth of submucosal invasion in endoscopic resections may dictate further management (i.e. endoscopic follow-up versus oesophagectomy). In this study, we assessed the interobserver agreement in measuring the depth of submucosal invasion in oesophageal endoscopic resections. Methods and results: Six subspecialised gastrointestinal (GI) pathologists from five academic centres independently measured the depth of submucosal invasion in lm from the deepest muscularis mucosae on 37 oesophageal endoscopic resection slides (round 1 scoring). A consensus meeting with a systematic approach for measuring and discussion of pitfalls was undertaken and remeasuring (round 2 scoring) was conducted. Interobserver agreement was assessed by the intraclass correlation coefficient (ICC) and Cohen's kappa statistics. A lack of agreement was seen among the six reviewers with a poor ICC for both rounds: 1 [0.40, 95% confidence interval (CI) = 0.26-0.56] and 2 (0.49, 95% CI = 0.34-0.63). When measurements were categorised as < or >500 lm, the overall agreement among the six reviewers was only fair for both rounds: 1 (kappa = 0.37, 95% CI = 0.22-0.53) and 2 (kappa = 0.29, 95% CI = 0.12-0.46). Conclusions: Our study shows a lack of agreement among gastrointestinal pathologists in measuring the depth of submucosal invasion in oesophageal endoscopic resections despite formulating a consensus approach for scoring. If important management decisions continue to be based upon this parameter, more reproducible and concrete guidelines are needed. [ABSTRACT FROM AUTHOR]