Economic analysis of variable rate management for corn and soybean systems

What is the potential payoff for farmers moving from traditional whole-field management or integrated crop management to precision farming? Using computer models, the investigators sought to analyze how inputs can be applied at optimal rates variably across a field in order to match inputs with crop needs. Over the long term, only modest increases were shown in gross returns from these practices. However, gross returns for individual years can be substantial

Quality grading of painted slates using texture analysis

This paper details the development of an automated vision-based solution for identification of paint and substrate defects on painted slates. The developed vision system consists of two major components. The first component of the system addresses issues including the mechanical implementation and interfacing the inspection system with the sensing and optical equipment. The second component involves the development of an image processing algorithm that is able to identify the visual defects present on the slate surface. The process of imaging the slate proved to be very challenging as the slate surface is darkly coloured and presents depth non-uniformities. Hence, a key issue for this inspection system was to devise an adequate illumination system that was able to accommodate challenges including the slates’ surface depth non-uniformities and vibrations generated by the conveying system. The visual defects are detected using a novel texture analysis solution where the greyscale (tonal characteristics) and texture information are embedded in a composite model. The developed inspection system was tested for robustness and experimental results are presented

The Security imaginary: Explaining military isomorphism

This article proposes the notion of a security imaginary as a heuristic tool for exploring military isomorphism (the phenomenon that weapons and military strategies begin to look the same across the world) at a time when the US model of defence transformation is being adopted by an increasing number of countries. Built on a critical constructivist foundation, the security-imaginary approach is contrasted with rationalist and neo-institutionalist ways of explaining military diffusion and emulation. Merging cultural and constructivist themes, the article offers a ‘strong cultural’ argument to explain why a country would emulate a foreign military model and how this model is constituted in and comes to constitute a society’s security imaginary.Web of Scienc

Opportunities and challenges of applying advanced X-ray spectroscopy to actinide and lanthanide N-donor ligand systems

N-donor ligands such as n-Pr-BTP [2,6-bis­(5,6-di­propyl-1,2,4-triazin-3-yl)­pyridine] preferentially bind trivalent actinides (An$^{3+}$) over trivalent lanthanides (Ln$^{3+}$) in liquid–liquid separation. However, the chemical and physical processes responsible for this selectivity are not yet well understood. Here, an explorative comparative X-ray spectroscopy and computational (L3-edge) study for the An/Ln L$_{3}$-edge and the N K-edge of [An/Ln(n-Pr-BTP) $_{3}$](NO$_{3}$)$_{3}$, [Ln(n-Pr-BTP) $_{3}$](CF$_{3}$SO$_{3}$)$_{3}$ and [Ln(n-Pr-BTP) $_{3}$](ClO$_{4}$)$_{3}$ complexes is presented. High-resolution X-ray absorption near-edge structure (HR-XANES) L$_{3}$-edge data reveal additional features in the pre- and post-edge range of the spectra that are investigated using the quantum chemical codes FEFF and FDMNES. X-ray Raman spectroscopy studies demonstrate the applicability of this novel technique for investigations of liquid samples of partitioning systems at the N K-edge

Randomised controlled trial evidence questions the assumption that pulmonary metastasectomy benefits patients with colorectal cancer

Pulmonary metastasectomy for sarcoma is surgery without proven benefit, and in the light of a randomized controlled trial examining pulmonary metastasectomy in colorectal cancer, it should be questioned

Study protocol for VIdeo assisted thoracoscopic lobectomy versus conventional Open LobEcTomy for lung cancer, a UK multicentre randomised controlled trial with an internal pilot (the VIOLET study)

INTRODUCTION: Lung cancer is a leading cause of cancer deaths worldwide and surgery remains the main treatment for early stage disease. Prior to the introduction of video-assisted thoracoscopic surgery (VATS), lung resection for cancer was undertaken through an open thoracotomy. To date, the evidence base supporting the different surgical approaches is based on non-randomised studies, small randomised trials and is focused mainly on short-term in-hospital outcomes.METHODS AND ANALYSIS: The VIdeo assisted thoracoscopic lobectomy versus conventional Open LobEcTomy for lung cancer study is a UK multicentre parallel group randomised controlled trial (RCT) with blinding of outcome assessors and participants (to hospital discharge) comparing the effectiveness, cost-effectiveness and acceptability of VATS lobectomy versus open lobectomy for treatment of lung cancer. We will test the hypothesis that VATS lobectomy is superior to open lobectomy with respect to self-reported physical function 5 weeks after randomisation (approximately 1 month after surgery). Secondary outcomes include assessment of efficacy (hospital stay, pain, proportion and time to uptake of chemotherapy), measures of safety (adverse health events), oncological outcomes (proportion of patients upstaged to pathologic N2 (pN2) disease and disease-free survival), overall survival and health related quality of life to 1 year. The QuinteT Recruitment Intervention is integrated into the trial to optimise recruitment.ETHICS AND DISSEMINATION: This trial has been approved by the UK (Dulwich) National Research Ethics Service Committee London. Findings will be written-up as methodology papers for conference presentation, and publication in peer-reviewed journals. Many aspects of the feasibility work will inform surgical RCTs in general and these will be reported at methodology meetings. We will also link with lung cancer clinical studies groups. The patient and public involvement group that works with the Respiratory Biomedical Research Unit at the Brompton Hospital will help identify how we can best publicise the findings.TRIAL REGISTRATION NUMBER: ISRCTN13472721.</p

Multimodality local consolidative treatment versus conventional care of advanced lung cancer after first-line systemic anti-cancer treatment: study protocol for the RAMON multicentre randomised controlled trial with an internal pilot

Introduction Lung cancer is the most common cause of cancer death worldwide and most patients present with extensive disease. One-year survival is improving but remains low (37%) despite novel systemic anti-cancer treatments forming the current standard of care. Although new therapies improve survival, most patients have residual disease after treatment, and little is known on how best to manage it. Therefore, residual disease management varies across the UK, with some patients receiving only maintenance systemic anti-cancer treatment while others receive local consolidative treatment (LCT), alongside maintenance systemic anti-cancer treatment. LCT can be a combination of surgery, radiotherapy and/or ablation to remove all remaining cancer within the lung and throughout the body. This is intensive, expensive and impacts quality of life, but we do not know if it results in better survival, nor the extent of impact on quality of life and what the cost might be for healthcare providers. The RAMON study (RAdical Management Of Advanced Non-small cell lung cancer) will evaluate the acceptability, effectiveness and cost-effectiveness of LCT versus no LCT after first-line systemic treatment for advanced lung cancer. Methods and analysis RAMON is a pragmatic open multicentre, parallel group, superiority randomised controlled trial. We aim to recruit 244 patients aged 18 years and over with advanced non-small-cell lung cancer from 40 UK NHS hospitals. Participants will be randomised in a 1:1 ratio to receive LCT alongside maintenance treatment, or maintenance treatment alone. LCT will be tailored to each patient’s specific disease sites. Participants will be followed up for a minimum of 2 years. The primary outcome is overall survival from randomisation. Ethics and dissemination The West of Scotland Research Ethics Committee (22/WS/0121) gave ethical approval in August 2022 and the Health Research Authority in September 2022. Participants will provide written informed consent before participating in the study. Findings will be presented at international meetings, in peer-reviewed publications, through patient organisations and notifications to patients. Trial registration number ISRCTN11613852

Variability in COVID-19 in-hospital mortality rates between national health service trusts and regions in England: A national observational study for the Getting It Right First Time Programme

Background A key first step in optimising COVID-19 patient outcomes during future case-surges is to learn from the experience within individual hospitals during the early stages of the pandemic. The aim of this study was to investigate the extent of variation in COVID-19 outcomes between National Health Service (NHS) hospital trusts and regions in England using data from March–July 2020. Methods This was a retrospective observational study using the Hospital Episode Statistics administrative dataset. Patients aged ≥ 18 years who had a diagnosis of COVID-19 during a hospital stay in England that was completed between March 1st and July 31st, 2020 were included. In-hospital mortality was the primary outcome of interest. In secondary analysis, critical care admission, length of stay and mortality within 30 days of discharge were also investigated. Multilevel logistic regression was used to adjust for covariates. Findings There were 86,356 patients with a confirmed diagnosis of COVID-19 included in the study, of whom 22,944 (26.6%) died in hospital with COVID-19 as the primary cause of death. After adjusting for covariates, the extent of the variation in-hospital mortality rates between hospital trusts and regions was relatively modest. Trusts with the largest baseline number of beds and a greater proportion of patients admitted to critical care had the lowest in-hospital mortality rates. Interpretation There is little evidence of clustering of deaths within hospital trusts. There may be opportunities to learn from the experience of individual trusts to help prepare hospitals for future case-surges

Gabapentin for pain management following major surgery: a placebo controlled, double blind, randomized clinical trial (The GAP Study)

Background:  Gabapentin is an anticonvulsant medication with approval for use in neuropathic pain and epileptic disorders. It is frequently added to multimodal analgesic regimens during and after surgery to reduce opioid use while controlling pain effectively. There is little evidence to show its effectiveness in major surgery. Methods:  In this multicenter, double blinded, randomized controlled trial, adults undergoing major cardiac, thoracic or abdominal surgery were randomized to receive either gabapentin (600mg before surgery, 300mg twice daily for 2 days after surgery) or placebo. The primary outcome was length of hospital stay. Secondary outcomes included acute and chronic pain, total opioid use, adverse health events and health related quality of life. Patients were followed up daily in-hospital until discharge and then at 4-weeks and 4 months after surgery. Results:  1196 participants were randomized (500 underwent cardiac, 346 thoracic and 350 abdominal surgery); 596 were allocated to placebo and 600 were allocated to gabapentin. Median length of hospital stay was similar in the two groups (gabapentin 5.94 (IQR 4.08-8.04) days, placebo 6.15 (IQR 4.22 – 8.97) days; hazard ratio 1.07, 95%CI 0.95-1.20, p=0.26). Overall, 384 participants experienced one or more serious adverse events (gabapentin 189/596, 31.7%; placebo 195/599, 32.6%), with some variation across surgical specialties. Conclusions:  Among patients undergoing major cardiac, thoracic and abdominal surgery, adding gabapentin to multimodal analgesic regimes did not alter the length of hospital stay, or the number of serious adverse events