ASN guidelines on P values.

Letter to the Editor - No Abstract available

Evaluation of parenteral nutrition use in patients undergoing major upper gastro-intestinal surgery

Abstract Background After major upper gastro-intestinal surgery, enteral feeding is often hampered. There is still no consensus on which route of nutrition is preferable in patients undergoing this type of surgery. Current ESPEN guidelines recommend parenteral nutrition in undernourished patients, if caloric requirements cannot be met orally/enterally within 7 days and enteral nutrition is contraindicated. Objective The current practice of systematic parenteral nutrition at the thoracic surgery ward of the University Hospitals Leuven was evaluated based on the ESPEN guidelines. Method This prospective observational study included patients undergoing upper gastro-intestinal surgery and receiving postoperative parenteral nutrition. Parenteral nutrition use was considered appropriate when patients were undernourished and unable to obtain adequate caloric requirements by oral or enteral feeding within 7 days. Results Twenty-five out of 35 patients were nutritionally at risk. In 9 of 25 patients, the indication for parenteral nutrition was considered justified. As the intestinal tract below the anastomosis site remains accessible in the total studied population, enteral nutrition might be an option. Unfortunately, an appropriate jejunostomy tube was not available at our institution. Conclusion In accordance to the ESPEN guidelines, enteral nutrition can replace parenteral nutrition in most thoracic surgery patients, but only if an appropriate enteral access is available

Rhotics.New Data and Perspectives

This book provides an insight into the patterns of variation and change of rhotics in different languages and from a variety of perspectives. It sheds light on the phonetics, the phonology, the socio-linguistics and the acquisition of /r/-sounds in languages as diverse as Dutch, English, French, German, Greek, Hebrew, Italian, Kuikuro, Malayalam, Romanian, Slovak, Tyrolean and Washili Shingazidja thus contributing to the discussion on the unity and uniqueness of this group of sounds

A scientific transition to support the 21st century dietary transition

Background Eating habits must change substantially in order to address the urgent societal challenges of personal, public and planetary health. Research surrounding various facets of the dietary transition remains siloed, hindering breakthroughs. Scope and approach We argue the scientific case for transdisciplinary research centered around the transition to healthy, sustainable, and acceptable diets. This transition requires tackling the broad societal challenges of engaging consumers in the diet transition, improving nutritional health and achieving environmental sustainability of foods and food systems. Key findings The crucial synergies and trade-offs from addressing single challenges in isolation are discussed, as well as obstacles when considering the collaboration between the multiple scientific disciplines concerned with the dietary transition. Currently, interactions between these challenges remain understudied and/or ambiguous, in part due to a lack of interoperable data and standards. Intersectional research entry points acting at the intersection of the three challenges are explored: food taste and texture reformulation, food pricing strategies and food literacy. The implementation of such cross-cutting interventions urgently requires both the generation of new data and exploitation of the breadth of existing data. Researchers must therefore be facilitated to find, access and use interoperable data to model and measure food intake and all its determinants. Conclusions The dietary transition requires underpinning by a research infrastructure that supports access to transdisciplinary data, facilities and research tools, alongside training and capacity building. Filling these unmet data, tools and training needs is the first step towards delivering breakthrough innovations to foods and food environments, mobilizing consumers to engage in the dietary transition

Evidence that breast cancer risk at the 2q35 locus is mediated through IGFBP5 regulation.

GWAS have identified a breast cancer susceptibility locus on 2q35. Here we report the fine mapping of this locus using data from 101,943 subjects from 50 case-control studies. We genotype 276 SNPs using the 'iCOGS' genotyping array and impute genotypes for a further 1,284 using 1000 Genomes Project data. All but two, strongly correlated SNPs (rs4442975 G/T and rs6721996 G/A) are excluded as candidate causal variants at odds against >100:1. The best functional candidate, rs4442975, is associated with oestrogen receptor positive (ER+) disease with an odds ratio (OR) in Europeans of 0.85 (95% confidence interval=0.84-0.87; P=1.7 × 10(-43)) per t-allele. This SNP flanks a transcriptional enhancer that physically interacts with the promoter of IGFBP5 (encoding insulin-like growth factor-binding protein 5) and displays allele-specific gene expression, FOXA1 binding and chromatin looping. Evidence suggests that the g-allele confers increased breast cancer susceptibility through relative downregulation of IGFBP5, a gene with known roles in breast cell biology

Gene expression profiling and histopathological characterization of triple-negative/basal-like breast carcinomas

INTRODUCTION: Breast cancer is a heterogeneous group of tumors, and can be subdivided on the basis of histopathological features, genetic alterations and gene-expression profiles. One well-defined subtype of breast cancer is characterized by a lack of HER2 gene amplification and estrogen and progesterone receptor expression ('triple-negative tumors'). We examined the histopathological and gene-expression profile of triple-negative tumors to define subgroups with specific characteristics, including risk of developing distant metastases. METHODS: 97 triple-negative tumors were selected from the fresh-frozen tissue bank of the Netherlands Cancer Institute, and gene-expression profiles were generated using 35K oligonucleotide microarrays. In addition, histopathological and immunohistochemical characterization was performed, and the findings were associated to clinical features. RESULTS : All triple-negative tumors were classified as basal-like tumors on the basis of their overall gene-expression profile. Hierarchical cluster analysis revealed five distinct subgroups of triple-negative breast cancers. Multivariable analysis showed that a large amount of lymphocytic infiltrate (HR = 0.30, 95% CI 0.09-0.96) and absence of central fibrosis in the tumors (HR = 0.14, 95% CI 0.03-0.62) were associated with distant metastasis-free survival. CONCLUSION: Triple-negative tumors are synonymous with basal-like tumors, and can be identified by immunohistochemistry. Based on gene-expression profiling, basal-like tumors are still heterogeneous and can be subdivided into at least five distinct subgroups. The development of distant metastasis in basal-like tumors is associated with the presence of central fibrosis and a small amount of lymphocytic infiltrat