Still waiting for predictive biomarkers in Barrett's oesophagus

Barrett's oesophagus is important as a precursor of oesophageal adenocarcinoma via a metaplasia-dysplasia-carcinoma sequence. It is often detected on upper gastrointestinal endoscopy. In the absence of glandular dysplasia the risk of progression to cancer is low but ascertainment of dysplasia is not always straightforward. Sparse mucosal sampling may miss dysplasia, or reactive changes may be overinterpreted due to inter and intraobserver variation. Low-grade and even high-grade dysplasia do not necessarily progress, provided prevalent cancer has been rigorously excluded. This indeterminacy motivates an ongoing search for clinically useful predictive biomarkers. Although many genetic and epigenetic abnormalities have been associated with neoplastic progression in Barrett's mucosa no molecular tests have as yet been accepted into routine pathology practice. Challenges of assay definition remain and many marker studies lack statistical power or have other methodological flaws. Even where strong evidence of clinically relevant predictive value does exist (in the case of ploidy analysis by flow or image cytometry) adoption has been minimal, likely reflecting technological and possible reimbursement obstacles. Well designed multicentre studies are likely to be required to translate improved knowledge of Barrett's carcinogenesis into clinically significant progress on predictive testing, and will require a degree of cooperation not so far widely seen in the field

Improvement of parenteral nutrition-associated cholestasis in an adult using fish oil-based parenteral nutrition

Parenteral nutrition-associated cholestasis (PNAC) is a severe complication of parenteral nutrition. Standard feed preparations contain soybean and olive oil that are rich in ω-6 polyunsaturated fats, and which studies suggest can be hepatotoxic. Preparations containing fish oil, rich in ω-3 polyunsaturated fats, may be hepatoprotective and have been used in the critical care setting as immunotherapy. A case demonstrating dramatic improvement in liver function and overall clinical condition in an adult with PNAC and intestinal failure within 8 weeks of changing to a fish oil-based parenteral feed is reported. As far as is known, this is the first report of an adult patient whose parenteral nutrition-associated liver disease resolved after a parenteral nutrition lipid emulsion was changed to the fish oil-containing emulsion, SMOFlipid

Dataset: BioTIME: A database of biodiversity time series for the Anthropocene

The BioTIME database contains raw data on species identities and abundances in ecological assemblages through time. The database consists of 11 tables; one raw data table plus ten related meta data tables. For further information please see our associated data paper. This data consists of several elements: BioTIMESQL_02_04_2018.sql - an SQL file for the full public version of BioTIME which can be imported into any mySQL database. BioTIMEQuery_02_04_2018.csv - data file, although too large to view in Excel, this can be read into several software applications such as R or various database packages. BioTIMEMetadata_02_04_2018.csv - file containing the meta data for all studies. BioTIMECitations_02_04_2018.csv - file containing the citation list for all studies. BioTIMECitations_02_04_2018.xlsx - file containing the citation list for all studies (some special characters are not supported in the csv format). BioTIMEInteractions_02_04_2018.Rmd - an r markdown page providing a brief overview of how to interact with the database and associated .csv files (this will not work until field paths and database connections have been added/updated)