Minimally invasive esophageal sponge cytology sampling is feasible in a Tanzanian community setting.

Esophageal sponge cytology is an endoscopy alternative well accepted by patients with extensive data for accuracy in the context of adenocarcinoma. Few studies have assessed its feasibility in asymptomatic community members, and fewer still in East Africa, where esophageal squamous cell carcinoma (ESCC) rates are high. We aimed to assess the feasibility of a capsule-based diagnosis of esophageal squamous dysplasia (ESD), an ESCC precursor, which may benefit epidemiological and early detection research. We collected Cytosponge collections in 102 asymptomatic adults from Kilimanjaro, Tanzania. Uptake, acceptability and safety were assessed. Participants scored acceptability immediately following the procedure and 7 days later on a scale of 0 (least) to 10 (most acceptable). Slides from paraffin-embedded cell clots were read by two pathologists for ESD and other pathologies. All participants (52 men, 50 women, aged 30-77) swallowed the device at first attempt, 100 (98%) of which gave slides of adequate cellularity. Acceptability scores were 10 (53%), 9 (24%), 8 (21%), 7 (2%) and 6 (1%), with no differences by age, sex or time of asking. Cytological findings were esophageal inflammation (4%), atypical squamous cells of uncertain significance (1%), low-grade dysplasia (1%), gastritis (22%) and suspected intestinal metaplasia (6%). Setting-specific logistical and ethical considerations of study implementation are discussed. We demonstrate the safety, acceptability and feasibility of Cytosponge sampling in this setting, paving the way for innovative etiology and early-detection research. Targeted sampling strategies and biomarker development will underpin the success of such initiatives. The study protocol is registered on ClinicalTrials.gov (NCT04090554)

Platelets as autonomous drones for hemostatic and immune surveillance

Platelets participate in many important physiological processes, including hemostasis and immunity. However, despite their broad participation in these evolutionarily critical roles, the anucleate platelet is uniquely mammalian. In contrast with the large nucleated equivalents in lower vertebrates, we find that the design template for the evolutionary specialization of platelets shares remarkable similarities with human-engineered unmanned aerial vehicles in terms of overall autonomy, maneuverability, and expendability. Here, we review evidence illustrating how platelets are uniquely suited for surveillance and the manner in which they consequently provide various types of support to other cell types.J.L. Li is supported by Agency for Science, Technology and Research funding. A. Zarbock is supported by Deutsche Forschungsgemeinschaft (ZA428/13-1 and INST211/604-2 A05). A. Hidalgo is supported by Plan Estatal de Investigación Científica y Técnica y de Innovación 2013–2016 (SAF2015-65607-R and PCIN-2014-103), Programa Estatal de I+D+i Orientada a los Retos de la Sociedad Retos Investigación I+D+i from MECI, and cofunding from Fondo Europeo de Desarrollo Regional. Centro Nacional de Investigaciones Cardiovasculares Carlos III is supported by the MECI and the Pro CNIC Foundation and is a Severo Ochoa Center of Excellence (MECI award SEV-2015-0505).S

Lot Sizing in Cyclic Scheduling

Lot Sizing in Cyclic Schedulin

Knowledge transfer and innovation among attractions

This study examines knowledge transfers amongst attractions in Cornwall, England, paying attention to the significance of spatial clustering and product similarity. It is based on in-depth interviews with tourist attraction managers and key informants in two contrasting spatial clusters. The findings demonstrate that spatial proximity, product similarity and market similarity generally facilitate knowledge transfers and innovation spillovers, at the local and the regional scales. They also show that the influences of product similarity and spatial proximity are closely related, although this is scale specific. The paper makes a contribution to the literature by studying knowledge transfer and innovations in the relatively neglected attractions sector, exploring the sources, mechanisms, and outcomes of knowledge transfer, and providing insights into the complexities of product similarity and spatial proximity/clustering