BOB CAT: a Large-Scale Review and Delphi Consensus for Management of Barrett’s Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia

OBJECTIVES: Barrett’s esophagus (BE) is a common premalignant lesion for which surveillance is recommended. This strategy is limited by considerable variations in clinical practice. We conducted an international, multidisciplinary, systematic search and evidence-based review of BE and provided consensus recommendations for clinical use in patients with nondysplastic, indefinite, and low-grade dysplasia (LGD). METHODS: We defined the scope, proposed statements, and searched electronic databases, yielding 20,558 publications that were screened, selected online, and formed the evidence base. We used a Delphi consensus process, with an 80% agreement threshold, using GRADE (Grading of Recommendations Assessment, Development and Evaluation) to categorize the quality of evidence and strength of recommendations. RESULTS: In total, 80% of respondents agreed with 55 of 127 statements in the final voting rounds. Population endoscopic screening is not recommended and screening should target only very high-risk cases of males aged over 60 years with chronic uncontrolled reflux. A new international definition of BE was agreed upon. For any degree of dysplasia, at least two specialist gastrointestinal (GI) pathologists are required. Risk factors for cancer include male gender, length of BE, and central obesity. Endoscopic resection should be used for visible, nodular areas. Surveillance is not recommended for <5 years of life expectancy. Management strategies for indefinite dysplasia (IND) and LGD were identified, including a de-escalation strategy for lower-risk patients and escalation to intervention with follow-up for higher-risk patients. CONCLUSIONS: In this uniquely large consensus process in gastroenterology, we made key clinical recommendations for the escalation/de-escalation of BE in clinical practice. We made strong recommendations for the prioritization of future research.

Signal Reception Characteristics in the Proximity of Alice and Bob for Secure Indoor Peer-to-Peer Communications At 2.45 GHz

Mutual variation of the received signal which occurs as a consequence of the channel reciprocity property has recently been proposed as a viable method for secret key generation. However, this cannot be strictly maintained in practice as the property is applicable only in the absence of interference. To ensure the propagation defined key remains secret, one requirement is that there remain high degrees of uncertainty between the legitimate users channel response and that of any eavesdropper's. In this paper, we investigate whether such de-correlation occurs for an indoor point-to-point link at 2.45 GHz. This is achieved by computing the localized correlation coefficient between the simultaneous channel response measured by the legitimate users and that of multiple distributed eavesdroppers for static and dynamic scenarios.

Bob Williams secrétaire de la fédération des transports anglais fait un discours près de Nijni-Novgorod : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 60069

Letter - Donald Ziraldo to Bob Welch, 1974

A letter from Donald Ziraldo to Bob Welch (M.P.P. for Lincoln) discussing the permit attained from the LCBO to produce wine. The letter is dated 9 September 1974.

Letter - Bob Rae to Donald Ziraldo, 1995

A letter from Bob Rae, leader of the NDP, to Donald Ziraldo, discussing the book Anatomy of a Winery. Rae thanks Ziraldo and goes on to mention the significant role Inniskillin Winery has played in making the Ontario Wine industry so successful. Rae also mentions the partnership of the NDP with the industry in order to do "restructuring" and "become internationally competitive." 21 September, 1995

Wrestling Card - Bob Wagner

The wrestler's name is Bob Wagner and the number stamped on the reverse is faded. There is a handwritten number RA9972.

Bob and Jane go to Argentina: The Ethics of Cross-Border Care

Étude de cas / Case study

Dylan Walsh - dance : art, mourning, archive.

Cet essai envisage le deuil du point de vue d’un homme endeuillé. Sur la base de ma propre expérience de deuil, j’ai questionné les théories freudiennes sur le sujet. Face aux théories derridiennes sur l’archive, je me positionne non pas comme un archiviste professionnel mais comme une personne endeuillée trouvée engagée dans un processus d’archivage. Au regard de la psychanalyse et de l’archive, ce texte n’entend ni ne prétend avancer de nouvelles théories sans prendre en compte leurs histoires respectives. Ce texte propose une étude comparée pour une tentative de définitions à la lumière d’une expérience personnelle. Ces questions seront finalement mises à l’épreuve dans le monument performatif audio-visuel Dylan Walsh – dance.

Bob, the hedgehog

Obtuvo la tercera menci??n de la modalidad A en el XII Certamen de Materiales Curriculares de 2004, organizado por la Consejer??a de Educaci??n de la Comunidad de Madrid