Comparing open and minimally invasive surgical procedures for oesophagectomy in the treatment of cancer: the ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) feasibility study and pilot trial

Localised oesophageal cancer can be curatively treated with surgery (oesophagectomy) but the procedure is complex with a risk of complications, negative effects on quality of life and a recovery period of 6-9 months. Minimal-access surgery may accelerate recovery.The ROMIO (Randomised Oesophagectomy: Minimally Invasive or Open) study aimed to establish the feasibility of, and methodology for, a definitive trial comparing minimally invasive and open surgery for oesophagectomy. Objectives were to quantify the number of eligible patients in a pilot trial; develop surgical manuals as the basis for quality assurance; standardise pathological processing; establish a method to blind patients to their allocation in the first week post surgery; identify measures of postsurgical outcome of importance to patients and clinicians; and establish the main cost differences between the surgical approaches.Pilot parallel three-arm randomised controlled trial nested within feasibility work.Two UK NHS departments of upper gastrointestinal surgery.Patients aged ≥ 18 years with histopathological evidence of oesophageal or oesophagogastric junctional adenocarcinoma, squamous cell cancer or high-grade dysplasia, referred for oesophagectomy or oesophagectomy following neoadjuvant chemo(radio)therapy.Oesophagectomy, with patients randomised to open surgery, a hybrid open chest and minimally invasive abdomen or totally minimally invasive access.The primary outcome measure for the pilot trial was the number of patients recruited per month, with the main trial considered feasible if at least 2.5 patients per month were recruited.During 21 months of recruitment, 263 patients were assessed for eligibility; of these, 135 (51%) were found to be eligible and 104 (77%) agreed to participate, an average of five patients per month. In total, 41 patients were allocated to open surgery, 43 to the hybrid procedure and 20 to totally minimally invasive surgery. Recruitment is continuing, allowing a seamless transition into the definitive trial. Consequently, the database is unlocked at the time of writing and data presented here are for patients recruited by 31 August 2014. Random allocation achieved a good balance between the arms of the study, which, as a high proportion of patients underwent their allocated surgery (69/79, 87%), ensured a fair comparison between the interventions. Dressing patients with large bandages, covering all possible incisions, was successful in keeping patients blind while pain was assessed during the first week post surgery. Postsurgical length of stay and risk of adverse events were within the typical range for this group of patients, with one death occurring within 30 days among 76 patients. There were good completion rates for the assessment of pain at 6 days post surgery (88%) and of the patient-reported outcomes at 6 weeks post randomisation (74%).Rapid recruitment to the pilot trial and the successful refinement of methodology indicated the feasibility of a definitive trial comparing different approaches to oesophagectomy. Although we have shown a full trial of open compared with minimally invasive oesophagectomy to be feasible, this is necessarily based on our findings from the two clinical centres that we could include in this small preliminary study.Current Controlled Trials ISRCTN59036820.This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 48. See the NIHR Journals Library website for further project information

Search for antiproton decay at the Fermilab Antiproton Accumulator

A search for antiproton decay has been made at the Fermilab Antiproton Accumulator. Limits are placed on thirteen antiproton decay modes. The results include the first explicit experimental limits on the muonic decay modes of the antiproton, and the first limits on the decay modes e- gamma gamma, and e- omega. The most stringent limit is for the decay mode pbar-> e- gamma. At 90% C.L. we find that tau/B(pbar-> e- gamma) > 7 x 10^5 yr. The most stringent limit for decay modes with a muon in the final state is for the decay pbar-> mu- gamma. At 90% C.L. we find that tau/B(pbar-> mu- gamma) > 5 x 10^4 yr.Comment: 20 pages, 8 figures. Submitted to Phys. Rev. D. Final results on 13 channels (was 15) are presente

Access to CAMAC from VxWorks and UNIX in DART

As part of the DART Project the authors have developed a package of software for CAMAC access from UNIX and VxWorks platforms, with support for several hardware interfaces. They report on developments for the CES CBD8210 VME to parallel CAMAC, the Hytec VSD2992 VME to serial CAMAC and Jorway 411S SCSI to parallel and serial CAMAC branch drivers, and give a summary of the timings obtained

Source characteristics of volatile organic compounds during high ozone episodes in Hong Kong, Southern China

International audienceMeasurements of Volatile Organic Compounds (VOC) are analyzed to characterize the sources impacting the Hong Kong area. The ratios of different VOC species, m,p-xylenes-to-ethylbenzene, C6H14-to-toluene and p-xylene-to-total xylenes are used for diagnostic analyses. Photochemical age analysis shows that the sources of reactive aromatics, the most important contributor to the photochemical reactivity, do not appear to be preferentially located in downtown Hong Kong. In addition, they do not appear to be dominated by mobile emissions based on the analyses of speciated VOC data from an earlier study, but related to industrial, waterfront, and fuel-storage activities. The ratios, p-xylene-to-total xylenes and dSO2/dNOy, suggest that the anomalously high pollutant concentrations in western Hong Kong in the early morning hours of two episode days appear to have come from transport of urban-type emissions. Comparison of observed ambient ratios of selected VOC and their ratios in the speciated VOC emission inventories for Hong Kong and adjacent Pearl River Delta (PRD) Region give mixed results. The observed ratio C6H14-to-toluene is consistent with the speciated version of the VOC emission inventory. The ratios of selected alkanes are not. This may be caused by the inaccuracies in the inventory and/or the speciation method

The cAMP Signaling pathway and direct protein kinase a phosphorylation regulate polycystin-2 (TRPP2) Channel Function

Polycystin-2 (PC2) is aTRP-type, Ca2+-permeable non-selective cation channel that plays an important role in Ca2+ signaling in renal and non-renal cells. The effect(s) of the cAMP pathway and kinase mediated phosphorylation of PC2 seem to be relevant to PC2 trafficking and its interaction with polycystin-1. However, the role of PC2 phosphorylation in channel function is still poorly defined. Here we reconstituted apical membranes of term human syncytiotrophoblast (hST), containing endogenous PC2 (PC2hst), and in vitro translated channel protein (PC2iv). Addition of the catalytic subunit of PKA increased by 566% the spontaneous PC2hst channel activity in the presence of ATP. Interestingly, 8-Br-cAMP also stimulated spontaneous PC2hst channel activity in the absence of the exogenous kinase. Either stimulation was inhibited by addition of alkaline phosphatase, which in turn, was reversed by the phosphatase inhibitor vanadate. Neither maneuver modified the single channel conductance but instead increased channel mean open time. PKA directly phosphorylated PC2, which increased the mean open time but not the single channel conductance of the channel. PKA phosphorylation did not modify either R742X truncated or S829A-mutant PC2iv channel function. The data indicate that the cAMP pathway regulates PC2-mediated cation transport in the hST. The relevant PKA site for PC2 channel regulation centers on a single residue serine 829, in the carboxyl terminus.Fil: Cantero, Maria del Rocio. Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Biofísica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Velázquez, Irina Florencia. Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Biofísica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Streets, Andrew J.. University of Sheffield Medical School; Reino UnidoFil: Ong, Albert C. M.. University of Sheffield Medical School; Reino UnidoFil: Cantiello, Horacio Fabio. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Odontología. Cátedra de Biofísica; Argentin

IPEP: The integrated performance evaluation program for the Department of Energy`s Office of Environmental Management

The quality of the analytical data being provided to DOE`s Office of Environmental Management (EM) for environmental restoration activities and the extent to which these data meet the data quality objectives are critical in the decision-making process. One of several quality metrics that can be used in evaluating a laboratory is its performance in performance evaluation (PE) programs. In support of DOE`s environmental restoration and waste management efforts, EM has been charged with developing and implementing a program to assess the performance of participating laboratories. Argonne National Laboratory (ANL) and DOE`s Environmental Measurements Laboratory (EML) and Radiological and Environmental Sciences Laboratory (RESL) have been collaborating on the development and implementation of a comprehensive Integrated Performance Evaluation Program (IPEP) for DOE-wide implementation. The IPEP will use results from existing inorganic, organic, and radiological PE programs when these are available and appropriate for the analytes and matrices being determined for DOE`s EM activities. Existing programs include the U.S. Environmental Protection Agency`s (EPA`s) Contract Laboratory Program (CLP), the Water Supply (WS) and Water Pollution (WP) PE studies for inorganic and organic analytes, and DOE`s Quality Assessment Program (QAP) for radiological analytes. In addition, DOE has begun the development of the Mixed Analyte Performance Evaluation Program (MAPEP) to address the needs of the DOE Complex. These PE programs provide a spectrum of matrices and analytes covering the various inorganic, organic, and low-level radiologic categories found in routine environmental and waste samples. These PE programs already provide some assessment of laboratory performance; IPEP will expand these assessments by evaluating historical performance, as well as results from multiple PE programs, thereby providing an enhanced usage of the PE program information

Search for muonic decays of the antiproton at the Fermilab Antiproton Accumulator

A search for antiproton decay has been made at the Fermilab Antiproton Accumulator. Limits are placed on six antiproton decay modes which contain a final-state muon. At the 90% C.L. we find that tau/B(mu gamma) > 5.0 x 10^4 yr, tau/B(mu pi0) > 4.8 x 10^4 yr, tau/B(mu eta) > 7.9 x 10^3 yr, tau/B(mu gamma gamma) > 2.3 x 10^4 yr, tau/B(mu K0S > 4.3 x 10^3 yr, and tau/B(mu K0L) > 6.5 x 10^3 yr.Comment: 8 pages + 3 Postscript figure

Multi-scale modeling study of the source contributions to near-surface ozone and sulfur oxides levels over California during the ARCTAS-CARB period

Chronic high surface ozone (O_3) levels and the increasing sulfur oxides (SO_x = SO_2 + SO_4) ambient concentrations over South Coast (SC) and other areas of California (CA) are affected by both local emissions and long-range transport. In this paper, multi-scale tracer, full-chemistry and adjoint simulations using the STEM atmospheric chemistry model are conducted to assess the contribution of local emission sourcesto SC O_3 and to evaluate the impacts of transported sulfur and local emissions on the SC sulfur budgetduring the ARCTAS-CARB experiment period in 2008. Sensitivity simulations quantify contributions of biogenic and fire emissions to SC O_3 levels. California biogenic and fire emissions contribute 3–4 ppb to near-surface O_3 over SC, with larger contributions to other regions in CA. During a long-range transport event from Asia starting from 22 June, high SO_x levels (up to ~0.7 ppb of SO_2 and ~1.3 ppb of SO_4) is observed above ~6 km, but they did not affect CA surface air quality. The elevated SO_x observed at 1–4 km is estimated to enhance surface SO_x over SC by ~0.25 ppb (upper limit) on ~24 June. The near-surface SO_x levels over SC during the flight week are attributed mostly to local emissions. Two anthropogenic SO_x emission inventories (EIs) from the California Air Resources Board (CARB) and the US Environmental Protection Agency (EPA) are compared and applied in 60 km and 12 km chemical transport simulations, and the results are compared withobservations. The CARB EI shows improvements over the National Emission Inventory (NEI) by EPA, but generally underestimates surface SC SO_x by about a factor of two. Adjoint sensitivity analysis indicated that SO_2 levels at 00:00 UTC (17:00 local time) at six SC surface sites were influenced by previous day maritime emissions over the ocean, the terrestrial emissions over nearby urban areas, and by transported SO_2 from the north through both terrestrial and maritime areas. Overall maritime emissions contribute 10–70% of SO2 and 20–60% fine SO_4 on-shore and over the most terrestrial areas, with contributions decreasing with in-land distance from the coast. Maritime emissions also modify the photochemical environment, shifting O_3 production over coastal SC to more VOC-limited conditions. These suggest an important role for shipping emission controls in reducing fine particle and O_3 concentrations in SC

Carbonyl sulfide and carbon disulfide: Large-scale distributions over the western Pacific and emissions from Asia during TRACE-P

An extensive set of carbonyl sulfide (OCS) and carbon disulfide (CS2) observations were made as part of the NASA Transport and Chemical Evolution over the Pacific (TRACE-P) project, which took place in the early spring 2001. TRACE-P sampling focused on the western Pacific region but in total included the geographic region 110°E to 290°E longitude, 5°N to 50°N latitude, and 0–12 km altitude. Substantial OCS and CS2 enhancements were observed for a great many air masses of Chinese and Japanese origin during TRACE-P. Over the western Pacific, mean mixing ratios of long-lived OCS and shorter-lived CS2 showed a gradual decrease by about 10% and a factor of 5–10, respectively, from the surface to 8–10 km altitude, presumably because land-based sources dominated their distribution during February through April 2001. The highest mean OCS and CS2levels (580 and 20 pptv, respectively, based on 2.5° × 2.5° latitude bins) were observed below 2 km near the coast of Asia, at latitudes between 25°N and 35°N, where urban Asian outflow was strongest. Ratios of OCS versus CO for continental SE Asia were much lower compared to Chinese and Japanese signatures and were strongly associated with biomass burning/biofuel emissions. We present a new inventory of anthropogenic Asian emissions (including biomass burning) for OCS and CS2 and compare it to emission estimates based on regional relationships of OCS and CS2 to CO and CO2. The OCS and CS2 results for the two methods compare well for continental SE Asia and Japan plus Korea and also for Chinese CS2 emissions. However, it appears that the inventory underestimates Chinese emissions of OCS by about 30–100%. This difference may be related to the fact that we did not include natural sources such as wetland emissions in our inventory, although the contributions from such sources are believed to be at a seasonal low during the study period. Uncertainties in OCS emissions from Chinese coal burning, which are poorly characterized, likely contribute to the discrepancy