Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

Background: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications. The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Methods/design. Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma 3 cm, located between 115 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane i

Chromophore switch from 11-cis-dehydroretinal (A2) to 11-cis-retinal (A1) decreases dark noise in salamander red rods

Dark noise, light-induced noise and responses to brief flashes of light were recorded in the membrane current of isolated rods from larval tiger salamander retina before and after bleaching most of the native visual pigment, which mainly has the 11-cis-3,4-dehydroretinal (A2) chromophore, and regenerating with the 11-cis-retinal (A1) chromophore in the same isolated rods. The purpose was to test the hypothesis that blue-shifting the pigment by switching from A2 to A1 will decrease the rate of spontaneous thermal activations and thus intrinsic light-like noise in the rod. Complete recordings were obtained in five cells (21◦C). Based on the wavelength of maximum absorbance, λmax,A1 =502 nm and λmax,A2 =528 nm, the average A2 : A1 ratio determined from rod spectral sensitivities and absorbances was ∼0.74 : 0.26 in the native state and ∼0.09 : 0.91 in the final state. In the native (A2) state, the single-quantum response (SQR) had an amplitude of 0.41±0.03 pA and an integration time of 3.16±0.15 s (mean±S.E.M.). The low-frequency branch of the dark noise power spectrum was consistent with discrete SQR-like events occurring at a rate of 0.238±0.026 rod−1 s−1. The corresponding values in the final state were 0.57±0.07 pA (SQR amplitude), 3.47±0.26 s (SQR integration time), and 0.030±0.006 rod−1 s−1 (rate of dark events). Thus the rate of dark events per rod and the fraction of A2 pigment both changed by ca 8-fold between the native and final states, indicating that the dark events originated mainly in A2 molecules even in the final state. By extrapolating the linear relation between event rates and A2 fraction to 0% A2 (100% A1) and 100% A2 (0% A1), we estimated that the A1 pigment is at least 36 times more stable than the A2 pigment. The noise component attributed to discrete dark events accounted for 73% of the total dark current variance in the native (A2) state and 46% in the final state. The power spectrum of the remaining ‘continuous’ noise component did not differ between the two states. The smaller and faster SQR in the native (A2) state is consistent with the idea that the rod behaves as if light-adapted by dark events that occur at a rate of nearly one per integration time. Both the decreased level of dark noise and the increased SQR amplitude must significantly improve the reliability of photon detection in dim light in the presence of the A1 chromophore compared to the native (A2) state in salamander rods

EFFECTS OF VISUAL SCANNING AND CLASSIFICATION TRAINING ON PIAGETIAN TASKS

The purpose of this study was to determine whether instruction in specific aspects of classification tasks, or in systematic visual scanning, would have more facilitating effects on the attainment of classification operations of kindergarteners and second graders.^ The independent variables in this study were: a Classification Training Unit, a Systematic Scanning Training Unit, and Age.^ The dependent variable was achivement on classification tasks as measured by the Classification Test with Subquestions.^ Using a stratified random sampling technique to control for grade and sex, 40 subjects were selected from 73 kindergarteners and 105 second graders enrolled in a public elementary school in an inner-city community of New York City, and assigned to two experimental groups.^ Training conditions for both treatments consisted of six half-hour sessions of individualized instruction designed to meet that treatment\u27s objective, respectively, mastery of either classification skills or systematic scanning.^ The results indicated: (1) For the posttest data, (a) the Classification Group scored significantly higher than the Scanning Group; (b) the 7-8-year-old group scored significantly higher than the 5-6-year-old group; and (c) there was no significant interaction between type of training and age. (2) For the retention test data, (a) there was no significant difference as a function of treatment; (b) the 7-8-year-old group scored significantly higher than the 5-6-year-old group; and (c) there was no significant interaction between type of training and age.^ Correlation matrices were analyzed to determine significant classification-scanning relationships. Those relationships that reached the .05 level of significance for both groups were: (a) class intersection and horizontal scanning, and (b) class inclusion and horizontal scanning.^ The conclusions were: (1) Training in scanning was as effective as direct training in classification for classification performance. (2) Both treatments were similarly effective for subjects at both age levels. (3) The prerequisite skill of scanning was determined as more appropriate because it can be generalized to a larger repertoire of academic tasks.

Effect of Visual Scanning and Classification Training on Piagetian Tasks

Abstract not availabl

2008 Energy Balance for the Corn-Ethanol Industry

The Agricultural Resource Management Survey of corn growers for the year 2005 and the 2008 survey of dry mill ethanol plants are used to estimate the net energy balance of corn ethanol. This report measures all conventional fossil fuel energy used in the production of 1 gallon of corn ethanol. The ratio is about 2.3 BTU of ethanol for 1 BTU of energy inputs, when a portion of total energy input is allocated to byproduct and fossil fuel is used for processing energy. The ratio is somewhat higher for some firms that are partially substituting biomass energy in processing energy

2008 Energy Balance for the Corn-Ethanol Industry

The Agricultural Resource Management Survey of corn growers for the year 2005 and the 2008 survey of dry mill ethanol plants are used to estimate the net energy balance of corn ethanol. This report measures all conventional fossil fuel energy used in the production of 1 gallon of corn ethanol. The ratio is about 2.3 BTU of ethanol for 1 BTU of energy inputs, when a portion of total energy input is allocated to byproduct and fossil fuel is used for processing energy. The ratio is somewhat higher for some firms that are partially substituting biomass energy in processing energy.</p