Appropriateness of fecal immunochemical testing utilization for colorectal cancer screening at an academic center.

Fecal immunochemical testing (FIT) has become the most utilized test for colorectal cancer (CRC) screening. This retrospective quality assurance report analyzed data for 411 patients from one academic center in Central New York who underwent FIT between September 2015 and September 2016. All 67 positive tests and 344 of 952 negative tests were analyzed. Subjects from the FIT-negative "control group" were chosen at random. The mean age was 67 years and the male/female distribution was 391/20, with differences between the FIT-positive and -negative groups. FIT was inappropriately used in 210 (51%) of the 411 patients. The most common reasons for inappropriate FIT use were a documented refusal of colonoscopy (39.60% of inappropriate use), FIT occurring within the recommended surveillance interval from previous colonoscopy (27.98%), and a Charlson Co-Morbidity Index score ≥5 (22.87%). Other reasons were a history of adenoma (9.25%), family history of CRC/high-risk adenoma <60 years of age (5.84%), active/overt gastrointestinal bleed (4.87%), history of CRC (1.46%), and history of inflammatory bowel disease (1.46%). The results of this study show that FIT is being utilized inappropriately about 50% of the time.

Experimental study of granular flows in a rough annular shear cell.

The study of granular flows in physics has always been important because of their recurring presence in nature and industry. However, the nonlinear and multiphase behavior exhibited by these particulate systems makes them hard to model and predict. Several experiments were conducted in the past to gain insight into granular flows. The current experimental work furthers this insight and specifically attempts to understand the effect of rough surfaces on granular flows, namely, their local flow behavior. Understanding this interaction can have implications on industrial-scale granular problems. In this work, a granular shear cell, a two-dimensional annular shear cell, was developed to conduct shear experiments where roughness is imposed on the driving surface and experimentally quantified. A digital particle tracking velocimetry data retrieval scheme was developed to extract solid fraction, velocity, and granular temperature data from the experiments as a function of the roughness factor and wheel rotation rate. In general, the steady-state results show the two distinct regions as expected-a high-velocity and dilute-gas-like kinetic region near the moving wall and a high-solid-fraction liquid-like frictional flow regime away from the moving wall. Parametric studies conducted show that the normalized slip near the moving wall decreases with increasing wall roughness and decreasing wall rotation rate. Slip is an important parameter which can be easily interpreted as momentum transfer or traction performance in granular systems related to wheel-terrain interaction, agricultural processing, and most notably granular lubrication.