British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus

These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.

North Atlantic surface ocean 14C variability between 30 – 40 kyr. BP

The Faroe-Shetland channel is situated in the main path of the inflow of warm North Atlantic surface water to the Nordic seas and further provides an escape route for the cold Norwegian Sea Deep Water. AMS 14C dates of planktonic foraminifera covering Marine Isotope Stage 3 from two cores in the Faroe-Shetland channel will be used to trace past variability of the Atlantic Meridional Overturning Circulation (AMOC). The reservoir age R shows considerable variability ranging between 50 to 2750 14C years. In particular high R values are observed during Heinrich event 4 (H4) with values around 1550 14C years and during the Laschamp magnetic excursion with R values as high as 2700 14C years. The period between Greenland interstadial 8 (GI8) and GI5 show highly variable R values with interstadial R values around 500 – 650 14C years, i.e. slightly higher than ‘normal’, whereas stadials show either significantly higher or lower R values. From GI5 towards the Last Glacial Maximum R values are generally around 1000 14C years or higher. Using magnetic susceptibility, IRD and δ13C and δ18O values measured on the planktic foraminifera species Neogloboquadrina pachyderma, we compare the observed R variability with reconstructed changes in the Atlantic Meridional Overturning Circulation (AMOC). Furthermore a climate model of intermediate complexity (GENIE) including 14C is used as conceptual tool for identifying oceanographic configuration explaining the observed R variability.

Late-Glacial and early Holocene marine 14C reservoir ages off North Iceland (16-9 cal kyr BP)

Tephrochronological age models and 48 14C age determinations on molluscs and foraminifera (planktonic and benthic) are applied for the calculation of marine 14C reservoir age variability during a time period covering the Heinrich event H1 to early Holocene (16–9 cal kyr BP). Our data source consists of four high-resolution marine sediment cores (HM107-04, HM107-05, MD99-2271, MD99-2275) from the North Icelandic shelf. The marine reservoir age (ΔR) is found to be extremely variable, ranging from 385 to 1065 14C years. Extreme ΔR values occur at the end of H1, with values around 1000 14C years (~15 cal kyr BP), probably due to reduced northward flow of well-ventilated subtropical surface waters and a southward expansion of polar waters, as well as an expansion of sea ice limiting air-sea gas exchange. With the onset of the Bølling-Allerød interstadial, the ΔR values decrease towards 0 14C years suggesting a more vigorous North Atlantic Current and an active meridional overturning circulation system. During the Younger Dryas stadial, ΔR values are consistently around 700 14C years suggesting e renewed expansion of polar waters and a weakened meridional overtuning circulation. Interestingly, ΔR values remain high (~200 14C years) at the onset of the Holocene suggesting continued high influence of polar waters. Subsequently, ΔR values rapidly decrease to ~¬ 250 14C years around 11 cal kyr BP, indicating increased air-sea CO2 exchange with the coeval atmosphere. The ΔR values average around 0 14C years from around 10.5 to 9.0 cal kyr BP.

Pleiotropic analysis of cancer risk loci on esophageal adenocarcinoma risk

Background: Several cancer-associated loci identified from genome-wide association studies (GWAS) have been associated with risks of multiple cancer sites, suggesting pleiotropic effects. We investigated whether GWAS-identified risk variants for other common cancers are associated with risk of esophageal adenocarcinoma (EA) or its precursor, Barrett's esophagus. 

Methods: We examined the associations between risks of EA and Barrett's esophagus and 387 SNPs that have been associated with risks of other cancers, by using genotype imputation data on 2,163 control participants and 3,885 (1,501 EA and 2,384 Barrett's esophagus) case patients from the Barrett's and Esophageal Adenocarcinoma Genetic Susceptibility Study, and investigated effect modification by smoking history, body mass index (BMI), and reflux/heartburn. 

Results: After correcting for multiple testing, none of the tested 387 SNPs were statistically significantly associated with risk of EA or Barrett's esophagus. No evidence of effect modification by smoking, BMI, or reflux/heartburn was observed. 

Conclusions: Genetic risk variants for common cancers identified from GWAS appear not to be associated with risks of EA or Barrett's esophagus. 

Impact: To our knowledge, this is the first investigation of pleiotropic genetic associations with risks of EA and Barrett's esophagus.

The role of the humanities in the Bologna idea of a university : learning from the american model?. 'El papel de la humanidad en la idea de Bolonia de una universidad : ¿el aprender del modelo americano?'.

Resumen tomado de la publicación. Monográfico con el título: El proceso de Bolonia : dinámicas y desafíos de la enseñanza superior en Europa a comienzos de una nueva época

La infancia en la reconstrucción de la familia europea.

Forma parte de un monográfico titulado: Imágenes de la infancia

Experimental evidence for a partially dissociated water bilayer on Ru{0001}

Core-level photoelectron spectra, in excellent agreement with ab initio calculations, confirm that the stable wetting layer of water on Ru{0001} contains O-H and H2O in roughly 3:5 proportion, for OHx coverages between 0.25 and 0.7 ML, and T<170 K. Proton disorder explains why the wetting structure looks to low energy electron diffraction (LEED) to be an ordered p(root3xroot3)R30degrees adlayer, even though approximate to3/8 of its molecules are dissociated. Complete dissociation to atomic oxygen starts near 190 K. Low photon flux in the synchrotron experiments ensured that the diagnosis of the nature of the wetting structure quantified by LEED is free of beam-induced damage.

Mapping evidence gaps in anti-corruption: assessing the state of the operationally relevant evidence on donors' actions and approaches to reducing corruption

This paper charts the current evidence on effectiveness of different anti-corruption reforms, and identifies significant evidence gaps. Despite a substantial amount of literature on corruption, this review found very few studies focusing on anti-corruption reforms, and even fewer that credibly assess issues of effectiveness and impact. The evidence was strong for only two types of interventions: public financial management (PFM) reforms and supreme audit institutions (SAIs). For PFM, the evidence in general showed positive results, whereas the effectiveness was mixed for SAIs. No strong evidence indicates that any of the interventions pursued have been ineffective, but there is fair evidence that anti-corruption authorities, civil service reforms and the use of corruption conditionality in aid allocation decisions in general have not been effective. The paper advocates more operationally-relevant research and rigorous evaluations to build up the missing evidence base, particularly in conflict-afflicted states, in regards to the private sector, and on the interactions and interdependencies between different anti-corruption interventions.

Species-specific responses of Late Quaternary megafauna to climate and humans

Despite decades of research, the roles of climate and humans in driving the dramatic extinctions of large-bodied mammals during the Late Quaternary period remain contentious. Here we use ancient DNA, species distribution models and the human fossil record to elucidate how climate and humans shaped the demographic history of woolly rhinoceros, woolly mammoth, wild horse, reindeer, bison and musk ox. We show that climate has been a major driver of population change over the past 50,000 years. However, each species responds differently to the effects of climatic shifts, habitat redistribution and human encroachment. Although climate change alone can explain the extinction of some species, such as Eurasian musk ox and woolly rhinoceros, a combination of climatic and anthropogenic effects appears to be responsible for the extinction of others, including Eurasian steppe bison and wild horse. We find no genetic signature or any distinctive range dynamics distinguishing extinct from surviving species, emphasizing the challenges associated with predicting future responses of extant mammals to climate and human-mediated habitat change.

Extern Web-service-lösning vid SSAB Tunnplåt i Borlänge- för kommunikation med sina distributions lager

Detta examensarbete har utförts på SSAB- Tunnplåt i Borlänge under vårterminen 2004 och omfattar 10 veckors arbete.SSAB sköter idag sin kommunikation med distributionslagren via fax, telefon eller e-post. Eftersom detta är ett ganska tidskrävande kommunikationssätt, vill SSAB ha en smidigare och snabbare kommunikationslösning. Den lösning som SSAB vill ha är en extern Web-service-lösning för att upprätta en säker kommunikation med sina distributionslager.Parallellt med byggandet av Web-service-lösningen arbetades en förvaltningsmodell fram. Den beskriver hur förvaltningsorganisationen med dess rutiner kan se ut vid implementering av lösningen.För att skapa en säker förbindelse med Web-servicen skall en webbklient användas som i sin tur anropar en COM+ komponent. Detta för att kunna skicka med certifikatet ifrån webbklienten till webbservern där Web-servicen ligger. COM+ komponenten måste få tillgång till en användarprofil när den kommunicerar med Web-servicen. Detta för att kunna upprätta en SSL-förbindelse i det inledande skedet. SSL-förbindelsen skall läggas i den VPN-tunnel som mVPN tillhandahåller via WSSAL.

The stability of AM and FM screenings in different water conditions – with the mottle under consideration

This project was performed at Rochester Institute of Technology to get more understanding and knowledge about AM and FM screenings similarities and differences with considerations of the mottle. By designing a test form conformed to the specific measurements and printing it on Heidelberg's Sunday 2000 press, the project group has evaluated the questions that already existed and the ones that occurred during the project. Hence the first press run left some unexpected phenomenon therefore another press run was performed. Measurements were performed and graphs produced in Excel. The project group evaluated the results and from that able to establish facts and draw conclusions. It has been a great experience for the project group and they have learnt a lot.

För många val - För lite gjort? : En fallstudie i datorbaserad musikproduktion

Denna uppsats syftar till att redogöra för hur musikproducenter betraktar och hanterar det utbud av musikproduktionsrelaterad programvara som finns tillgängligt idag, samt att öka kunskapen om hur detta utbud kan inverka på musikalisk produktivitet. Föremål för den undersökning jag gjort är fem studenter på Medieproduktionsprogrammet vid Högskolan Dalarna. Undersökningen har genomförts i form av strukturerade kvalitativa intervjuer. Med utgång från denna empiri har en verbal analys gjorts av resultaten. Från resultatet kan utläsas att mängden tillgänglig programvara, och dess inneboende möjligheter, har gjort ramarna för vad man kan och inte kan göra i sitt musikproducerande diffusa. Tidigare har tekniska begränsningar utgjort ramar för vad som är genomförbart, idag är det i högre grad upp till människan själv att sätta begränsningar. En slutsats jag drar utifrån undersökningen är att de intervjuade kan uppleva detta ansvar för sina egna förutsättningar som hämmande för den musikaliska produktiviteten.

Evaluating Projects in a Dynamic Economy: Some New Envelope Results

This paper is concerned with the modern theory of social cost-benefit analysis in a dynamic economy. The theory emphasizes the role of a comprehensive, forward-looking, dynamic welfare index within the period of the project rather than that of a project's long-term consequences. However, what constitutes such a welfare index remains controversial in the recent literature. In this paper, we attempt to shed light on the issue by deriving three equivalent cost-benefit rules for evaluating a small project. In particular, we show that the direct change in net national product (NNP) qualifies as a convenient welfare index without involving any other induced side effects. The project evaluation criterion thus becomes the present discounted value of the direct changes in NNP over the project period. We also illustrate the application of this theory in a few stylized examples.

Tillit och misstro till molntjänster : Identifiering av vilka kriterier som skapar tillit till molntjänster

Cloud computing innebär att datorkraft och IT-resurser i form av servrar, lagring och lokala nätverk görs tillgängliga via internet, cloud computing har ökat snabbt i användning de senaste åren. Möjligheterna med molntjänster har lett till nya utmaningar avseende tillit till molntjänster genom att öppna för helt nya förhållanden mellan leverantör och kund. I dagsläget så är tillit till molntjänsterna ett stort problem för kunder såsom mikroföretag samt små och medelstora företag. Vårt examensarbete syftar till att beskriva mikroföretags samt små och medelstora företags tillit och misstro till molntjänster, samt identifiera vilka kriterier som bidrar till detta. Resultatet visar att det är svårt att tydligt definiera tillit och misstro hos företag, då deras situationer och verksamheter skiljer sig. Tack vare vår litteraturstudie i kombination med våra intervjuer har vi skapat oss en bra bild av vilka kriterier som bidrar med tillit och misstro till molntjänster. Baserat på vårt arbete har vi sammanställt en konceptuell modell som beskriver tillit och misstro till molntjänster.

Följsamhet till råd om egenvård hos patienter med diabetes typ 2 : En litteraturöversikt

Bakgrund: Diabetes typ 2 är en endokrin sjukdom och ett globalt hälsoproblem, där antalet insjuknande personer ökar kraftigt. Behandlingen vid diabetes typ 2 utgörs till största del av egenvård vilket ställer stora krav på patienten och på sjukvården. En bristande följsamhet till råd om egenvård kan leda till sämre hälsa för patienten och ökade kostnader för samhället. Syfte: Syftet med denna litteraturöversikt var att beskriva vilka faktorer som påverkar följsamheten till råd om egenvård hos patienter med diabetes typ 2. Metod: En litteraturöversikt baserad på 15 vetenskapliga artiklar där både kvalitativa och kvantitativa artiklar har granskats. Databaserna CINAHL och PubMed har använts. Resultat: Faktorer som påverkade följsamheten till råd om egenvård identifierades och resulterade i fem huvudkategorier: Information; Kunskap; Socialt stöd; Teknologiskt stöd och Livssituation. Dessa faktorer framkom som viktiga för en god följsamhet till råd om egenvård. Slutsats: Det är av stor betydelse att försöka identifiera varje individs olika förutsättningar, för att på så sätt ha möjlighet att anpassa både information, utbildning och egenvårdsplanering utifrån individen.