Population-based study reveals new risk-stratification biomarker panel for Barrett's esophagus

BACKGROUND & AIMS: The risk of progression of Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC) is low and difficult to calculate. Accurate tools to determine risk are needed to optimize surveillance and intervention. We assessed the ability of candidate biomarkers to predict which cases of BE will progress to EAC or high-grade dysplasia and identified those that can be measured in formalin-fixed tissues. METHODS: We analyzed data from a nested case-control study performed using the population-based Northern Ireland BE Register (1993-2005). Cases who progressed to EAC (n = 89) or high-grade dysplasia =6 months after diagnosis with BE were matched to controls (nonprogressors, n = 291), for age, sex, and year of BE diagnosis. Established biomarkers (abnormal DNA content, p53, and cyclin A expression) and new biomarkers (levels of sialyl Lewis(a), Lewis(x), and Aspergillus oryzae lectin [AOL] and binding of wheat germ agglutinin) were assessed in paraffin-embedded tissue samples from patients with a first diagnosis of BE. Conditional logistic regression analysis was applied to assess odds of progression for patients with dysplastic and nondysplastic BE, based on biomarker status. RESULTS: Low-grade dysplasia and all biomarkers tested, other than Lewis(x), were associated with risk of EAC or high-grade dysplasia. In backward selection, a panel comprising low-grade dysplasia, abnormal DNA ploidy, and AOL most accurately identified progressors and nonprogressors. The adjusted odds ratio for progression of patients with BE with low-grade dysplasia was 3.74 (95% confidence interval, 2.43-5.79) for each additional biomarker and the risk increased by 2.99 for each additional factor (95% confidence interval, 1.72-5.20) in patients without dysplasia. CONCLUSIONS: Low-grade dysplasia, abnormal DNA ploidy, and AOL can be used to identify patients with BE most likely to develop EAC or high-grade dysplasia.

Occupational choice, socio-economic status and educational attainment: a study of the occupational choices and destinations of young people in the British household panel survey

The article considers young people's occupational choices at the age of 15 in relation to their educational attainment, the occupations of their parents and their actual occupations when they are in their early 20s. It uses data from the British Household Panel Survey over periods of between five and ten years. The young people in the survey are occupationally ambitious: many more aspire to professional, managerial and technical jobs than the likely availability of these occupations. In general ambitions and educational attainment and intentions are well aligned but there are also many instances of misalignment; either people wanting jobs which their educational attainments and intentions will not prepare them for, or people with less ambitious aspirations than their educational performance would justify. Children from more occupationally advantaged families are more ambitious, achieve better educationally and have better occupational outcomes than other children. However, where young people are both ambitious and educationally successful the occupational outcomes are as good for those from disadvantaged as advantaged families. In contrast, where young people are neither ambitious nor educationally successful, the outcomes for those from disadvantaged homes are very much poorer than for other young people. The article suggests that while choice is real it is also heavily constrained for many people. A possible educational implication of the study is that career interventions could be directed at under-ambitious but academically capable young people from disadvantaged backgrounds.

Natural disasters, economic growth and sustainable development in China: an empirical study using provincial panel data

Using a newly developed integrated indicator system with entropy weighting, we analyzed the panel data of 577 recorded disasters in 30 provinces of China from 1985–2011 to identify their links with the subsequent economic growth. Meteorological disasters promote economic growth through human capital instead of physical capital. Geological disasters did not trigger local economic growth from 1999–2011. Generally, natural disasters overall had no significant impact on economic growth from 1985–1998. Thus, human capital reinvestment should be the aim in managing recoveries, and it should be used to regenerate the local economy based on long-term sustainable development.

A computer study of the improvement of PV panel monthly outputs when the panel azimuth is changed thrice daily

The purpose of the calculations was to estimate the most suitable slopes and azimuths for three different positions per day of a solar panel in order to obtain the most possible energy from the PV panel compared with a stationary PV panel. The calculations were made in the computer program PV F-CHART.

Study of the quality of the preparation and performance of educational personnel : external reactor panel reports /

Cover title.

SIPP, the Survey of Income and Program Participation : 2004 panel, wave 1, self-study for field representatives.

Shipping list no.: 2004-0035-P.

José de Escovar at the Chapel of the Souls: Technical and Material Study of a 1603 Panel Painting

This article reports the preliminary results of a technical and material study carried out on a 17th century panel painting located at the Chapel of the Souls in the main church of Vila Nova da Baronia (30 km away from Evora city, in southern Portugal). This painting is attributed to Jose the Escovar, a painter that worked for Evora Archiepiscopate between 1583 and 1622. Jose the Escovar is known by his mural paintings all across the Alentejo region. This is the first time that a panel painting made by this artist was studied. Analytical methods used included in situ technical photography (visible (Vis), raking light (RAK), infrared (IR), and ultraviolet (UV)), optical microscopy of cross sections, scanning electron microscopy with energy dispersive X-ray spectrometry (SEM-EDS), micro Raman spectroscopy, and micro Fourier transform infrared spectroscopy (m-FT-IR). The goal was to ascertain the techniques and colored materials used by Escovar on this painting so that the data can be used in future comparisons with others works attributed to this painter based on stylistic aspects.

Apples, oranges and fruit salad : a Delphi study of the IMC educational mix

Once, we thought that comparing advertising and public relations was a bit like comparing apples and oranges. But with integration the new flavour, many academics are trying to cut and combine and create a fruit salad that will entice their customers and satisfy their stakeholders. While this has produced some culinary triumphs, it has also produced heartburn in equal quantity. This paper seeks the perfect recipe for integrated marketing communication (IMC) education by asking a Delphi panel of IMC champions questions relating to the place of IMC in the university setting; the teaching, research and curriculum development issues and the future for IMC education. The panel draws a chaotic picture of IMC education and identifies some important obstacles to curriculum development. It also predicts a number of key challenges for the future, including turf wars; the lack of faculty experience and enthusiasm to embrace IMC and the desperate need to grow the IMC brand. But perhaps the greatest challenge is how to create a generalist education in a culture of pecialisation that exists both in the university and in the workplace.

A Delphi study to validate an advanced practice nursing tool

Aim This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce.