Esophageal Carcinoma Histology Affects Perioperative Morbidity Following Open Esophagogastrectomy

Background. Esophagectomy for esophageal cancer is being practiced routinely with favorable results at many centers. We sought to determine if tumor histology is a powerful surrogate marker for perioperative morbidity. Methods. Seventy three consecutive patients managed operatively were reviewed from our prospectively maintained database. Results. Adenocarcinoma (AC) was present in 52 (71%) and squamous cell (SCC) in 21 (29%). The use of neoadjuvant therapy was similar for the AC (34.62%) and SCC (42.86%) groups. The SCC group had a higher incidence of prior pulmonary disease than the AC group (23.8% versus 5.8%, resp.; P = .03). SCC patients were more likely to have a prolonged ICU stay than AC patients (P = .004) despite similar complication rates, EBL, and prognostic nutritional index. The SCC group did, however, experience higher grades of complications (P = .0053). Conclusions. Presence of SCC was the single best predictor of prolonged ICU stay and more severe complications as defined by this study. Only a past history of pulmonary disease was different between the two histologic subgroups

Steady-state and pseudo-steady-state photocrystallographic studies on linkage isomers of [Ni(Et₄dien)(η²-O,ON)(η¹-NO₂)]:Identification of a new linkage isomer

At temperatures below 150 K, the photoactivated metastable endo‐nitrito linkage isomer [Ni(Et4dien)(η2‐O,ON)(η1‐ONO)] (Et4dien=N,N,N′,N′‐tetraethyldiethylenetriamine) can be generated with 100 % conversion from the ground state nitro‐(η1‐NO2) isomer on irradiation with 500 nm light, in the single crystal by steady‐state photocrystallographic techniques. Kinetic studies show the system is no longer metastable above 150 K, decaying back to the ground state nitro‐(η1‐NO2) arrangement over several hours at 150 K. Variable‐temperature kinetic measurements in the range of 150–160 K show that the rate of endo‐nitrito decay is highly dependent on temperature, and an activation energy of Eact=+48.6(4) kJ mol−1 is calculated for the decay process. Pseudo‐steady‐state experiments, where the crystal is continually pumped by the light source for the duration of the X‐ray experiment, show the production of a previously unobserved, exo‐nitrito‐(η1‐ONO) linkage isomer only at temperatures close to the metastable limit (ca. 140–190 K). This exo isomer is considered to be a transient excited‐state species, as it is only observed in data collected by pseudo‐steady‐state methods

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

A Multivariate Exponentially Weighted Moving Average Control Chart

A multivariate extension of the exponentially weighted moving average (EWMA) control chart is presented, and guidelines given for designing this easy-to-implement multivariate procedure. A comparison shows that the average run length (ARL) performance of this chart is similar to that of multivariate cumulative sum (CUSUM) control charts in detecting a shift in the mean vector of a multivariate normal distribution. As with the Hotelling\u27s χ2 and multivariate CUSUM charts, the ARL performance of the multivariate EWMA chart depends on the underlying mean vector and covariance matrix only through the value of the noncentrality parameter. Worst-case scenarios show that Hotelling\u27s χ2 charts should always be used in conjunction with multivariate CUSUM and EWMA charts to avoid potential inertia problems. Examples are given to illustrate the use of the proposed procedure

Nebraska’s Forests

Highlights; Background; Forest Features; Forest Health Indicators; Forest Products; Data Sources and Techniques; Literature Cite

Nebraska’s Forests: Resource Bulletin NRS-27

Results of the first annual inventory of Nebraska’s forests (2001-05) show an estimated 1.24 million acres of forest land; 1.17 million acres meet the definition of timberland. Softwood forest types account for one-third of all forest land area, with ponderosa pine being the most prevalent type. Hardwood forest types comprise 58 percent of Nebraska’s forest land. Elm/ash/cottonwood is the predominant forest-type group in the State, accounting for 26 percent of all forest land area. Livetree volume on timberland increased from 1.3 to 1.8 billion cubic feet between the 1994 and 2005 inventories. This report includes information on forest attributes, forest health, and agents of change: the introduction of nonnative invasive plants, insects and diseases, and the rapid expansion of eastern redcedar