Do airway metallic stents for benign lesions confer too costly a benefit?

<p>Abstract</p> <p>Background</p> <p>The use of self-expanding metallic stents (SEMAS) in the treatment benign airway obstruction is controversial.</p> <p>Methods</p> <p>To evaluate the safety and efficacy of SEMAS for this indication, we conducted a 10-year retrospective review at our tertiary medical centre.</p> <p>Results</p> <p>Using flexible bronchoscopy, 82 SEMAS (67% Ultraflex, 33% Wallstent) were placed in 35 patients with inoperable lesions, many with significant medical comorbidities (88%). 68% of stents were tracheal, and 83% of patients showed immediate symptomatic improvement. Reversible complications developed in 9% of patients within 24 hrs of stent placement. Late complications (>24 hrs) occurred in 77% of patients, of which 37% were clinically significant or required an interventional procedure. These were mainly due to stent migration (12.2%), fracture (19.5%), or obstructive granulomas (24.4%). The overall granuloma rate of 57% was higher at tracheal sites (59%) than bronchial ones (34%), but not significantly different between Ultraflex and Wallstents. Nevertheless, Wallstents were associated with higher rates of bleeding (5% vs. 30%, p = 0.005) and migration (7% vs. 26%, p = 0.026). Of 10 SEMAS removed using flexible bronchoscopy, only one was associated with incomplete removal of fractured stent wire. Median survival was 3.6 ± 2.7 years.</p> <p>Conclusion</p> <p>Ill patients with inoperable lesions may be considered for treatment with SEMAS.</p

A pulse of mid-Pleistocene rift volcanism in Ethiopia at the dawn of modern humans

The Ethiopian Rift Valley hosts the longest record of human co-existence with volcanoes on Earth, however, current understanding of the magnitude and timing of large explosive eruptions in this region is poor. Detailed records of volcanism are essential for interpreting the palaeoenvironments occupied by our hominin ancestors; and also for evaluating the volcanic hazards posed to the 10 million people currently living within this active rift zone. Here we use new geochronological evidence to suggest that a 200 km-long segment of rift experienced a major pulse of explosive volcanic activity between 320 and 170 ka. During this period, at least four distinct volcanic centres underwent large-volume (&gt;10 km3) caldera-forming eruptions, and eruptive fluxes were elevated five times above the average eruption rate for the past 700 ka. We propose that such pulses of episodic silicic volcanism would have drastically remodelled landscapes and ecosystems occupied by early hominin populations

Adult Cognitive and Non-cognitive Skills: An Overview of Existing PIAAC Data

As of summer 2019, more than 60 PIAAC datasets from participating countries worldwide were available for research purposes. These datasets can be differentiated, for example, in terms of their accessibility, the extent of the information provided, the population group in focus, and the design of the underlying study. PIAAC Public Use Files, for instance, are freely available and are therefore highly anonymised, whereas PIAAC Scientific Use Files are available only for scientific research purposes and provide access to more detailed variables. The majority of the PIAAC data are available as public use files, but some participating countries (e.g. Germany and the United States) have also made several scientific use files or other extended file versions available to the research community. Some of the available PIAAC datasets focus on specific population groups - for example, the incarcerated adult population in the United States. Regarding the design of the underlying studies, most available datasets are cross-sectional, but some longitudinal data already exist (e.g. PIAAC-L in Germany). The present chapter provides an overview of the structure, accessibility, and use of the PIAAC datasets available worldwide

Spectroscopic Results from the Life in the Atacama (LITA) Project 2004 Field Season

Introduction: The Life in the Atacama (LITA) project includes rover field tests designed to look for life in the arid environment of the Atacama Desert (Chile). Field instruments were chosen to help remote observers identify potential habitats and the presence of life in these habitats, and included two spectrometers for help in identifying the mineralogy of the field sites. Two field trials were undertaken during the 2004 field season. The remote science team had no prior knowledge of the local geology, and relied entirely on orbital images and rover-acquired data to make interpretations. Each field trial lasted approximately one week: the sites for these trials were in different locations, and are designated "Site B" and "Site C.