Six weeks of home enteral nutrition versus standard care after esophagectomy or total gastrectomy for cancer: study protocol for a randomized controlled trial

Background: Each year approximately 3000 patients in the United Kingdom undergo surgery for esophagogastric cancer. Jejunostomy feeding tubes, placed at the time of surgery for early postoperative nutrition, have been shown to have a positive impact on clinical outcomes in the short term. Whether feeding out of hospital is of benefit is unknown. Local experience has identified that between 15 and 20% of patients required ‘rescue’ jejunostomy feeding for nutritional problems and weight loss while at home. This weight loss and poor nutrition may contribute to the detrimental effect on the overall quality of life (QoL) reported in these patients. Methods/Design: This randomized pilot and feasibility study will provide preliminary information on the routine use of jejunostomy feeding after hospital discharge in terms of clinical benefits and QoL. Sixty participants undergoing esophagectomy or total gastrectomy will be randomized to receive either a planned program of six weeks of home jejunostomy feeding after discharge from hospital (intervention) or treatment-as-usual (control). The intention of this study is to inform a multi-centre randomized controlled trial. The primary outcome measures will be recruitment and retention rates at six weeks and six months. Secondary outcome measures will include disease specific and general QoL measures, nutritional parameters, total and oral nutritional intake, hospital readmission rates, and estimates of healthcare costs. Up to 20 participants will also be enrolled in a qualitative sub-study that will explore participants’ and carers’ experiences of home tube feeding. The results will be disseminated by presentation at surgical, gastroenterological and dietetic meetings and publication in appropriate peer review journals. A patient-friendly lay summary will be made available on the University of Leicester and the University Hospitals of Leicester NHS Trust websites. The study has full ethical and institutional approval and started recruitment in July 2012. Trial registration: UKClinical Research Network ID #12447 (Main study); UKCRN ID#13361 (Qualitative sub study); ClinicalTrials.gov #NCT01870817 (First registered 28 May 2013

How to formulate rates to assess operational effectiveness of military aircraft - an introduction

The paper has been intended to deliver a brief introduction to the forecast on the potential military advantages for some selected aircraft using data from the TURAWA and SAMANTA computer-based systems for tracking aircraft operation and maintenance. The term "operational effectiveness" of a military aircraft may be read as a sum of effects gained from particular sorties by this aircraft. In the simplest case, the operational effectiveness is nothing more but the number of destroyed hostile targets. The number of destroyed hostile targets is a random variable. With account taken of hostile counteractions and unreliability of engineered systems, the number of possible sorties by one aircraft is also a random variable. Therefore, the assessment of predicted operational effects gained by the aircraft may result from, either: a single operational (combat) flight (sortie) by one aircraft or flights (sorties) within some assumed time interval (time of an air mission), or the aircraft's total lifetime (service life). Findings of the study may find their application in an attempt to use the data collected in the TURAWA and SAMANTA systems to construct rates of aircraft effectiveness in the forms of: expected value of effects gained from a single sortie, expected value of effects gained from some assumed time interval (flying time), expected value of effects gained throughout the aircraft’s service life. All the relationships gained may then be applied to forecast the effectiveness of operating some selected types of aircraft using data collected throughout the service, and verified under field conditions while performing exercises

Trophic state of three lowland reservoirs from se Poland

W pracy poddano ocenie stan troficzny trzech niestratyfikowanych, reolimnicznych zbiorników zaporowych zlokalizowanych na pierwszorzędowych dopływach Wisły, w rejonie Polski południowo-wschodniej: zbiornika Wilcza Wola na Łęgu, Chańcza na Czarnej Staszowskiej oraz Nielisz na Wieprzu. W badaniach wykorzystano dostępne w literaturze kryteria pozwalające ustalać stan troficzny na podstawie stężeń związków azotu, fosforu i chl a w wodach, oraz zintegrowane indeksy troficzności, gdzie stan wód wynika ze dostępności substratów oraz zawartości produktów fotosyntezy. Na tej podstawie zbiorniki Wilcza Wola i Nielisz zakwalifikowane zostały do grupy eutroficznych/hipertroficznych, zaś zbiornik Chańcza do mezotroficznych/eutroficznych. Stwierdzono także, że wykorzystane kryteria i indeksy są przydatne do tego typu analiz.The study assesses the trophic state of three unstratified, reolimnic reservoirs located on tributaries of the Vistula in the SE Poland: Wilcza Wola on the Łęg river, Chańcza on the Czarna Staszowska river and Nielisz on the Wieprz river. For the trophic state identification were used both the literature criteria based on the concentrations of nitrogen and phosphorus in the water, and integrated trophic state indexes (TSI). TSI shows the trophic state of water due to the availability of substrates and the content of the products of photosynthesis. On this basis, Wilcza Wola and Nielisz reservoirs were qualified for group of eutrophic /hypertrophic, while Chańcza reservoir to mesotrophic/eutrophic. It was also stated that the criteria and indices used are suitable for this type of analysis

An algorithm for swarm robot to avoid multiple dynamic obstacles and to catch the moving target

This paper presents a method for swarm robot to catch the moving target and to avoid multiple dynamic obstacles in the unknown environment. An imaginary map is built, including the highest mountain, some small hills, and a lowest lying land, respectively corresponding to the starting position of the robot, the detected obstacles, and the target. The robot is considered as a flow of water flowing from high to low. The flow of water is the robot trajectory that is divided into a set of points created by an algorithm called Self-organizing migrating algorithm. Simulation results are also presented to show that the obstacle avoidance and catching target task can be reached using this method. © Springer Nature Switzerland AG 2019.VSB-Technical University of Ostrava [SGS 2019/137]; Ministry of Education, Youth and Sports of the Czech RepublicMinistry of Education, Youth & Sports - Czech Republic [LO1303 (MSMT-7778/2014)]; European Regional Development Fund under the Project CEBIA-Tech [CZ.1.05/2.1.00/03.0089

MicroRNA and mRNA Features of Malignant Pleural Mesothelioma and Benign Asbestos-Related Pleural Effusion

Introduction. We investigated the expression of microRNAs and mRNAs in pleural tissues from patients with either malignant pleural mesothelioma or benign asbestos-related pleural effusion. Methods. Fresh frozen tissues from a total of 18 malignant pleural mesothelioma and 6 benign asbestos-related pleural effusion patients were studied. Expression profiling of mRNA and microRNA was performed using standard protocols. Results. We discovered significant upregulation of multiple microRNAs in malignant pleural mesothelioma compared to benign asbestos-related pleural effusion. Hsa-miR-484, hsa-miR-320, hsa-let-7a, and hsa-miR-125a-5p were able to discriminate malignant from benign disease. Dynamically regulated mRNAs were also identified. MET was the most highly overexpressed gene in malignant pleural mesothelioma compared to benign asbestos-related pleural effusion. Integrated analyses examining microRNA-mRNA interactions suggested multiple altered targets within the Notch signaling pathway. Conclusions. Specific microRNAs and mRNAs may have diagnostic utility in differentiating patients with malignant pleural mesothelioma from benign asbestos-related pleural effusion. These studies may be particularly helpful in patients who reside in a region with a high incidence of mesothelioma