Management of Barrett's esophagus in the UK: Overtreated and underbiopsied but improved by the introduction of a national randomized trial

OBJECTIVES: To assess the variation in practice of Barrett's esophagus (BE) management in comparison with accepted international guidelines before and after the introduction of a large BE randomized controlled trial (RCT) with protocols including those of tissue sampling.
DESIGN: A validated anonymized questionnaire was sent to 401 senior attending gastroenterologists asking for details of their current management of BE, especially histological sampling. Of the 228 respondents, 57 individuals (each from a different center) were in the first group to enter the ASPirin Esomeprazole (BE) Chemoprevention Trial (AspECT), and we assessed change in practice in these centers.
RESULTS: Ninety percent of specialists did not take adequate biopsies for histological diagnosis. Furthermore, 74% would consider aggressive surgical resection for prevalent cases of high-grade dysplasia in BE as their first-line choice despite the associated perioperative mortality. Ninety-two percent claim their lack of adherence to guidelines is because there is a need for stronger evidence for surveillance and medical interventions. Effect of the AspECT trial: Those clinicians in centers where the AspECT trial has started have improved adherence to ACG guidelines compared with their previous practice (P < 0.05). BE patients now get 18.8% more biopsies compared with previous practice, and 37.7% if the patient is entered into the AspECT trial (P < 0.01).
CONCLUSIONS: This large study indicates both wide variation in practice and poor compliance with guidelines. Because optimal histology is arguably the most important facet of BE management, the improvement in practice in centers taking part in the AspECT trial indicates an additional value of large international RCTs.

Assessing the sensitivity and specificity of fish community indicators to management action

We assessed ten trophodynamic indicators of ecosystem status for their sensitivity and specificity to fishing management using a size-resolved multispecies fish community model. The responses of indicators to fishing depended on effort and the size selectivity (sigmoid or Gaussian) of fishing mortality. The highest specificity against sigmoid (trawl-like) size selection was seen from inverse fishing pressure and the large fish indicator, but for Gaussian size selection, the large species indicator was most specific. Biomass, mean trophic level of the community and of the catch, and fishing in balance had the lowest specificity against both size selectivities. Length-based indicators weighted by biomass, rather than abundance, were more sensitive and specific to fishing pressure. Most indicators showed a greater response to sigmoid than Gaussian size selection. Indicators were generally more sensitive at low levels of effort because of nonlinear sensitivity in trophic cascades to fishing mortality. No single indicator emerged as superior in all respects, so given available data, multiple complementary indicators are recommended for community monitoring in the ecosystem approach to fisheries management.

Regulation of erythropoietin gene expression depends on two different oxygen-sensing mechanisms

Erythropoietin (Epo), a glycoprotein hormone produced principally in the fetal kidney and in the adult liver in response to hypoxia, is the prime regulator of growth and differentiation in erythroid progenitor cells. The regulation of Epo gene expression is not fully understood, but two mechanisms have been proposed. One involves the participation of a heme protein capable of reversible oxygenation and the other depends on the intracellular concentration of reactive oxygen species (ROS), assumed to be a function of pO2. We have investigated the production of Epo in response to three stimuli, hypoxia, cobalt chloride, and the iron chelator desferrioxamine, in Hep3B cells. As expected, hypoxia caused a marked rise in Epo production. When the cells were exposed to the paired stimuli of hypoxia and cobalt no further increase was found. In contrast, chelation of iron under hypoxic conditions markedly enhanced Epo production, suggesting that the two stimuli act by separate pathways. The addition of carbon monoxide inhibited hypoxia-induced Epo production, independent of desferrioxamine concentration. Taken together these data support the concept that pO2 and ROS are sensed independently.

Arsenic in groundwater and its influence on exposure risks through traditionally cooked rice in Prey Vêng Province, Cambodia

Arsenic (As) contamination of communal tubewells in Prey Vêng, Cambodia, has been observed since 2000. Many of these wells exceed the WHO As in drinking water standard of 10 µg/L by a factor of 100. The aim of this study was to assess how cooking water source impacts dietary As intake in a rural community in Prey Vêng. This aim was fulfilled by (1) using geostatistical analysis techniques to examine the extent of As contaminated groundwater in Prey Vêng and identify a suitable study site, (2) conducting an on-site study in two villages to measure As content in cooked rice prepared with water collected from tubewells and locally harvested rainwater, and (3) determining the dietary intake of As from consuming this rice. Geostatistical analysis indicated that high risk tubewells (>50 µg As/L) are concentrated along the Mekong River's east bank. Participants using high risk tubewells are consuming up to 24 times more inorganic As daily than recommended by the previous FAO/WHO provisional tolerable daily intake value (2.1 µg/kgBW/day). However, As content in rice cooked in rainwater was significantly reduced, therefore, it is considered to be a safer and more sustainable option for this region.

Modelling and characterization of ultrasonic consolidation process of Aluminium alloys

Ultrasonic consolidation process is a rapid manufacturing process used to join thin layers of metal at low temperatures and low energy consumption. In this work, finite element method has been used to simulate the ultrasonic consolidation of Aluminium alloys 6061 (AA-6061) and 3003 (AA-3003). A thermomechanical material model has been developed in the framework of continuum cyclic plasticity theory which takes into account both volume (acoustic softening) and surface (thermal softening due to friction) effects. A friction model based on experimental studies has been developed, which takes into account the dependence of coefficient of friction upon contact pressure, amount of slip, temperature and number of cycles. Using the developed material and friction model ultrasonic consolidation (UC) process has been simulated for various combinations of process parameters involved. Experimental observations are explained on the basis of the results obtained in the present study. The current research provides the opportunity to explain the differences of the behaviour of AA-6061 and AA-3003 during the ultrasonic consolidation process. Finally, trends of the experimentally measured fracture energies of the bonded specimen are compared to the predicted friction work at the weld interface resulted from the simulation at similar process condition. Similarity of the trends indicates the validity of the developed model in its predictive capability of the process. © 2008 Materials Research Society.

The SEMAINE corpus of emotionally coloured character interactions

We have recorded a new corpus of emotionally coloured conversations. Users were recorded while holding conversations with an operator who adopts in sequence four roles designed to evoke emotional reactions. The operator and the user are seated in separate rooms; they see each other through teleprompter screens, and hear each other through speakers. To allow high quality recording, they are recorded by five high-resolution, high framerate cameras, and by four microphones. All sensor information is recorded synchronously, with an accuracy of 25 μs. In total, we have recorded 20 participants, for a total of 100 character conversational and 50 non-conversational recordings of approximately 5 minutes each. All recorded conversations have been fully transcribed and annotated for five affective dimensions and partially annotated for 27 other dimensions. The corpus has been made available to the scientific community through a web-accessible database.

The challenge and response to global tourism in the post-modern era: the commodification, reconfiguration and mutual transformation of Habana Vieja, Cuba

There is a growing literature on the symbolic and cultural meanings of tourism and the ways in which cities are increasingly competing for tourists through the promotion of cultural assets and different forms of spectacle in the `tourist bubble'. To date, research on the role and impact of tourism in cities has largely been confined to those in Western, post-industrial economies. This paper examines the growth of cultural tourism in the central area of Havana, Cuba, and explores the range of unique, devolved, state-owned enterprises that are attempting to use tourism as a funding mechanism to achieve improvements in the social and cultural fabric of the city for the benefit of residents. The paper concludes with an assessment of the implications of this example for our understanding of how the pressures for restructuring and commodification can be moderated at the city level. Copyright 2008 SAGE Publications. All rights reserved. Not for commercial use or unauthorized distribution.

STAT5 in Cancer and Immunity

Signal transducers and activators of transcription 5 (STAT5a and STAT5b) are highly homologous proteins that are encoded by 2 separate genes and are activated by Janus-activated kinases (JAK) downstream of cytokine receptors. STAT5 proteins are activated by a wide variety of hematopoietic and nonhematopoietic cytokines and growth factors, all of which use the JAK-STAT signalling pathway as their main mode of signal transduction. STAT5 proteins critically regulate vital cellular functions such as proliferation, differentiation, and survival. The physiological importance of STAT5 proteins is underscored by the plethora of primary human tumors that have aberrant constitutive activation of these proteins, which significantly contributes to tumor cell survival and malignant progression of disease. STAT5 plays an important role in the maintenance of normal immune function and homeostasis, both of which are regulated by specific members of IL-2 family of cytokines, which share a common gamma chain (γc) in their receptor complex. STAT5 critically mediates the biological actions of members of the γc family of cytokines in the immune system. Essentially, STAT5 plays a critical role in the function and development of Tregs, and consistently activated STAT5 is associated with a suppression in antitumor immunity and an increase in proliferation, invasion, and survival of tumor cells. Thus, therapeutic targeting of STAT5 is promising in cancer.

Behind video lectures in a MOOC

The year 2012 was the “boom year” in MOOC and all its outstanding growth until now, made us move forward in designing the first MOOC in our Institution (and the third in our country, Portugal). Most MOOC are video lectured based and the learning analytic process to these ones is just taking its first steps. Designing a video-lecture seems, at a first glance, very easy: one can just record a live lesson or lecture and turn it, directly, into a video-lecture (even here one may experience some “sound” and “camera” problems); but developing some engaging, appealing video-lecture, that motivates students to embrace knowledge and that really contributes to the teaching/learning process, it is not an easy task. Therefore questions like: “What kind of information can induce knowledge construction, in a video-lecture?”, “How can a professor interact in a video-lecture when he is not really there?”, “What are the video-lectures attributes that contribute the most to viewer’s engagement?”, “What seems to be the maximum “time-resistance” of a viewer?”, and many others, raised in our minds when designing video-lectures to a Mathematics MOOC from the scratch. We believe this technological resource can be a powerful tool to enhance students' learning process. Students that were born in digital/image era, respond and react slightly different to outside stimulus, than their teachers/professors ever did or do. In this article we will describe just how we have tried to overcome some of the difficulties and challenges we tackled when producing our own video-math-lectures and in what way, we feel, videos can contribute to the teaching and learning process at higher education level.

The development and implementation of math projects in a HEI: expectations, objectives, experiences and analysis

An overwhelming problem in Math Curriculums in Higher Education Institutions (HEI), we are daily facing in the last decade, is the substantial differences in Math background of our students. When you try to transmit, engage and teach subjects/contents that your “audience” is unable to respond to and/or even understand what we are trying to convey, it is somehow frustrating. In this sense, the Math projects and other didactic strategies, developed through Learning Management System Moodle, which include an array of activities that combine higher order thinking skills with math subjects and technology, for students of HE, appear as remedial but important, proactive and innovative measures in order to face and try to overcome these considerable problems. In this paper we will present some of these strategies, developed in some organic units of the Polytechnic Institute of Porto (IPP). But, how “fruitful” are the endless number of hours teachers spent in developing and implementing these platforms? Do students react to them as we would expect? Do they embrace this opportunity to overcome their difficulties? How do they use/interact individually with LMS platforms? Can this environment that provides the teacher with many interesting tools to improve the teaching – learning process, encourages students to reinforce their abilities and knowledge? In what way do they use each available material – videos, interactive tasks, texts, among others? What is the best way to assess student’s performance in these online learning environments? Learning Analytics tools provides us a huge amount of data, but how can we extract “good” and helpful information from them? These and many other questions still remain unanswered but we look forward to get some help in, at least, “get some drafts” for them because we feel that this “learning analysis”, that tackles the path from the objectives to the actual results, is perhaps the only way we have to move forward in the “best” learning and teaching direction.

Viva@Matemática project: a different way to see math

Viva@Mat is a project developed by four Math teachers from the School of Industrial Studies and Management (ESEIG) that was born with the fundamental objective of engaging ESEIG students with different math backgrounds in Math challenging activities. Some of these activities were transformed into real palpable materials and others into small interactive ones, being the great majority of them proposed by ESEIG’ students themselves. This small project rapidly grew into something we didn’t expect – it did flow over the walls of our institution to the general involving community – specifically to pre-university schools through the Viva@Math Exhibits – Orange, Blue and Green (the fourth, the Purple one is still in development). Nowadays, Viva@Math Exhibits – the public face of the Project – are itinerant and have been travelling between several, and different institutions (pre-university schools, preparatory schools, libraries, among others), around ESEIG and IPP area of influence and having registered visitors/participants of all ages. In this article we will describe the Viva@Math Project, its different activities that are categorized in some “great groups” like Numerical Trivia, Logic Activities and Mental Calculation, Puzzles, Geometric Curiosities, Magic Tricks, among others, designed to challenge students to use the underlying logical-mathematical reasoning to any ordinary and everyday activity. We will give specific and concrete examples of some of the activities developed and, also, reproduce of the general stimulating feedback the Project receives from the enrolled “actors” (teachers, students and their relatives, institutions, among others). We feel that this Project has become a small “bridge” between the pre-university schools and Higher Education Institutions (HEI), in trying to shorten the “gap” between the institutions of different levels of education and bring them to work together.

Expression of the alpha 1b-adrenergic receptor and G protein subunits in mammalian cell lines using the Semliki Forest virus expression system.

Semliki Forest virus (SFV) vectors have been efficiently used for rapid high level expression of several G protein-coupled receptors. Here we describe the use of SFV vectors to express the alpha 1b-adrenergic receptor (AR) alone or in the presence of the G protein alpha q and/or beta 2 and gamma 2 subunits. Infection of baby hamster kidney (BHK) cells with recombinant SFV-alpha 1b-AR particles resulted in high specific binding activity of the alpha 1b-AR (24 pmol receptor/mg protein). Time-course studies indicated that the highest level of receptor expression was obtained 30 hours post-infection. The stimulation of BHK cells, with epinephrine led to a 5-fold increase in inositol phosphate (IP) accumulation, confirming the functional coupling of the receptor to G protein-mediated activation of phospholipase C. The SFV expression system represents a rapid and reproducible system to study the pharmacological properties and interactions of G protein coupled receptors and of G protein subunits.

Variaciones en la intensidad del desove de la sardina Sardinops sagax sagax (J) en la costa peruana en los años 1966-1973

Un marcado incremento den la extensión y densidad de las áreas de desove de la "sardina" en 1972 con respecto al los años anteriores así como el aumento considerable de las capturas comerciales de esta especie, nos indujo a efectuar un estudio de las variaciones del desove con el fin de analizar las fluctuaciones, como parte del Programa de Ictioplancton que desarrolla el Instituto del Mar del Perú (IMARPE). Con el propósito anterior hemos analizado un total de 3,389 muestras de zooplancton colectadas en 29 cruceros, desde febrero de 1966 hasta enero de 1973. Las muestras fueron colectadas a lo largo del litoral peruano, de 03°16 ' a 20°52 ' Latitud Sur y hasta una distancia máxima de 350 millas de la costa. Se describe el huevo de "sardina", en la diferentes fases de desarrollo y larva hasta la longitud de 16.6 mm. El huevo de "sardina" es característico por la presencia de una sola gota oleosa y amplio espacio perivitelínico y mide de 1.12 a 1.94 mm. La larva es diferenciable por las proporciones del cuerpo, especialmente, boca-ano en longitud estándar y posición de aletas dorsal y anal. Las temperaturas superficiales en las que fueron hallados los huevos, fluctúan entre 15.4 a 27.2 °C, y las más adecuadas para el desove de esta especie variaron entre 19 y 22 °C, y salinidades entre 35 y 35.26%, a juzgar por el hallazgo de las mejores y más frecuentes concentraciones de huevos en estos niveles.

Treatment of genital mycoplasma in colonized pregnant women in late pregnancy is associated with a lower rate of premature labour and neonatal complications.

Mycoplasma hominis and Ureaplasma spp. may colonize the human genital tract and have been associated with adverse pregnancy outcomes such as preterm labour and preterm premature rupture of membranes. However, as these bacteria can reside in the normal vaginal flora, there are controversies regarding their true role during pregnancy and so the need to treat these organisms. We therefore conducted a retrospective analysis to evaluate the treatment of genital mycoplasma in 5377 pregnant patients showing symptoms of potential obstetric complications at 25-37 weeks of gestation. Women presenting with symptoms were routinely screened by culture for the presence of these bacteria and treated with clindamycin when positive. Compared with uninfected untreated patients, women treated for genital mycoplasma demonstrated lower rates of premature labour. Indeed preterm birth rates were, respectively, 40.9% and 37.7% in women colonized with Ureaplasma spp. and M. hominis, compared with 44.1% in uncolonized women (Ureaplasma spp., p 0.024; M. hominis, p 0.001). Moreover, a reduction of neonatal complications rates was observed, with 10.9% of newborns developing respiratory diseases in case of Ureaplasma spp. colonization and 5.9% in the presence of M. hominis, compared with 12.8% in the absence of those bacteria (Ureaplasma spp., p 0.050; M. hominis, p <0.001). Microbiological screening of Ureaplasma spp. and/or M. hominis and pre-emptive antibiotic therapy of symptomatic pregnant women in late pregnancy might represent a beneficial strategy to reduce premature labour and neonatal complications.