In a group of patients at high risk for colorectal neoplasia, virtual and conventional colonoscopy had similar efficacy for the detection of polyps that were 6 mm or more in diameter.
Intelligent Personal Assistants (IPAs) are widely available on devices such as smartphones. However, most people do not use them regularly. Previous research has studied the experiences of frequent IPA users. Using qualitative methods we explore the experience of infrequent users: people who have tried IPAs, but choose not to use them regularly. Unsurprisingly infrequent users share some of the experiences of frequent users, e.g. frustration at limitations on fully hands-free interaction. Significant points of contrast and previously unidentified concerns also emerge. Cultural norms and social embarrassment take on added significance for infrequent users. Humanness of IPAs sparked comparisons with human assistants, juxtaposing their limitations. Most importantly, significant concerns emerged around privacy, monetization, data permanency and transparency. Drawing on these findings we discuss key challenges, including: designing for interruptability; reconsideration of the human metaphor; issues of trust and data ownership. Addressing these challenges may lead to more widespread IPA use.
Rationale: The presence of inflammatory cells on bronchoalveolar lavage is often used to predict disease activity and the need for therapy in systemic sclerosis-associated interstitial lung disease. Objectives: To evaluate whether lavage cellularity identifies distinct subsets of disease and/or predicts cyclophosphamide responsiveness. Methods: Patients underwent baseline lavage and/or high-resolution computed tomography as part of a randomized placebo-controlled trial of cyclophosphamide versus placebo (Scleroderma Lung Study) to determine the effect of therapy on forced vital capacity. Patients with 3% or greater polymorphonuclear and/or 2% or greater eosinophilic leukocytes on lavage and/or ground-glass opacification on computed tomography were eligible for enrollment. Measurements and Main Results: Lavage was performed in 201 individuals, including 141 of the 158 randomized patients. Abnormal cellularity was present in 101 of these cases (71.6%) and defined a population with a higher percentage of men (P 5 0.04), more severe lung function, including a worse forced vital capacity (P 5 0.003), worse total lung capacity (P 5 0.005) and diffusing capacity of the lung for carbon monoxide (P 5 0.004), more extensive ground-glass opacity (P 5 0.005), and more extensive fibrosis in the right middle lobe (P 5 0.005). Despite these relationships, the presence or absence of an abnormal cell differential was not an independent predictor of disease progression or response to cyclophosphamide at 1 year (P 5 not significant). Conclusions: The presence of an abnormal lavage in the Scleroderma Lung Study defined patients with more advanced interstitial lung disease but added no additional value to physiologic and computed tomography findings as a predictor of progression or treatment response. Clinical trial registered with www.clinicaltrials.gov (NCT 000004563).
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