Employee demand for skills: evidence and policy review : UK Commission for Employment and Skills Research Report no. 3

This report presents the results of a detailed review of evidence and policy relating to the factors that influence the engagement of the individual in skills development. It incorporates a broad range of formal and informal learning activities, delivered in a range of institutional settings and through different media, including work-based, classroombased, distance learning and community based learning. The review is deliberately broad in its focus, drawing on evidence and policy relating to people in different positions within the labour market - in or out of work, new entrants into employment, younger and older workers, people with and without qualifications and/or with higher and lower skills. However, a key focus for the research was the barriers and factors affecting access to skills development opportunities among lower skilled and lower qualified people. The review was undertaken by WM Enterprise and the Employment Research Institute, Edinburgh Napier University for the UK Commission for Employment and Skills (UK Commission)

Are Scattering Properties of Graphs Uniquely Connected to Their Shapes?

The famous question of Mark Kac "Can one hear the shape of a drum?" addressing the unique connection between the shape of a planar region and the spectrum of the corresponding Laplace operator can be legitimately extended to scattering systems. In the modified version one asks whether the geometry of a vibrating system can be determined by scattering experiments. We present the first experimental approach to this problem in the case of microwave graphs (networks) simulating quantum graphs. Our experimental results strongly indicate a negative answer. To demonstrate this we consider scattering from a pair of isospectral microwave networks consisting of vertices connected by microwave coaxial cables and extended to scattering systems by connecting leads to infinity to form isoscattering networks. We show that the amplitudes and phases of the determinants of the scattering matrices of such networks are the same within the experimental uncertainties. Furthermore, we demonstrate that the scattering matrices of the networks are conjugated by the, so called, transplantation relation.Comment: 3 figures; Physical Review Letters, 201

Kliniczne znaczenie mikroprzerzutów w węzłach chłonnych w raku szyjki macicy

In most cancers of epithelial origin, metastases to the lymph nodes constitute the most important prognostic factor and are predictive of the results of the surgical and adjuvant therapies. Data on the lymph node status allows to design an appropriate treatment plan. Despite advances in gynecologic oncology, the importance of lymph node micrometastases in cervical cancer, especially in nonsentinel lymph nodes which are detected by ultrastaging, has not been fully elucidated. The purpose of the article is to familiarize the reader with the state of current knowledge on cervical cancer micrometastases. The authors attempt to answer the question about the benefits of lymph node assessment in the search for micrometastases in cervical cancer, as well as to address emerging doubts.Przerzuty do węzłów chłonnych większości nowotworów pochodzenia nabłonkowego stanowią najważniejszy czynnik rokowniczy oraz pozwalają przewidzieć wyniki leczenia operacyjnego i adjuwantowego. Informacja o stanie węzłów chłonnych pozwala zaplanować właściwe leczenie. Pomimo postępu w onkologii ginekologicznej wciąż nie zostało ustalone znaczenie, jakie mogą mieć mikroprzerzuty w raku szyjki macicy, a w szczególności mikroprzerzuty znalezione w pozawartowniczych węzłach chłonnych, oceniane metodą ultrastagingu. Celem artykułu jest zapoznanie czytelnika ze stanem aktualnej wiedzy na temat mikroprzerzutów w raku szyjki macicy. Autorzy starają się dać odpowiedź na pytanie o korzyści wynikające z oceny węzłów chłonnych w poszukiwaniu mikroprzerzutów w raku szyjki macicy i omówić wyłaniające się wątpliwości

Mikroprzerzuty w wartowniczym węźle chłonnym u chorych na raka endometrium

Background: Detection of micrometastases in sentinel lymph nodes (SLN) extends our knowledge of lymphatic spread in endometrial cancer, although its clinical significance has not yet been confirmed. Objectives: The aim of study was to determine the incidence of SLN micrometastases and to analyze the association between micrometastases and disease relapse. Material and methods: Fifty-four patients with endometrioid endometrial cancer underwent routine surgical therapy and sentinel lymph node biopsy (SLNB). SLNB was performed using two techniques: cervical injection of 99mTc-labelled albumin or blue dye and fundal injection of blue dye. SLNs were subjected to ultrastaging with immunohistochemistry (AE1/AE3, 150μm). Results: At least one SLN was detected in 51 patients (94.4%) and bilateral SLN detection was achieved in 80.4%. Nodal macrometastases were found in 3 patients (6.3%). SLNB enabled us to detect nodal macrometastases in 2 out of those 3 patients. In the third case, detection of SLN micrometastasis allowed to correctly determine the nodal status, thus avoiding the false negative result of SLNB. In 48 patients with detected 184 SLNs, there were 4 patients (8.3%) with micrometastases and 4 (8.3%) with ITC foci. No significant associations between the presence of risk factors (grade, myometrial invasion, cervical invasion, lymphovascular space invasion) and incidence of micrometastases and/or ITC foci in SLNs were found. Conclusions: Detection of micrometastases may result in lower false-negative rate, thus increasing SLNB safety.Wstęp: Technika identyfikacji węzła wartowniczego (SLNB) pozwala na dokładną ocenę zaawansowania choroby w obrębie układu limfatycznego, jednak kliniczna przydatność tej metody nie została jeszcze jednoznacznie określona. Cel pracy: Celem pracy jest określenie częstości mikroprzerzutów w wartowniczych węzłach chłonnych (SLN) oraz analiza wczesnych wznów u pacjentek z rakiem endometrium. Materiał i metoda: Analizie poddano 54 pacjentki z endometroidalnym rakiem błony śluzowej trzonu macicy, u których wykonano usunięcie macicy z przydatkami, (miedniczą i przyaortalną limfadenektomię u pacjentek wysokiego ryzyka) oraz SLNB z wykorzystaniem dwóch metod detekcji: doszyjkowego podania albuminy znakowanej 99mTc lub błękitu metylenowego oraz podsurowicówkowego podania błękitu metylenowego w obrębie dna macicy. Węzły wartownicze poddano procedurze ultrastaging z wykorzystaniem immunohistochemii (AE1/AE3, odstępy 150 μm). Wyniki: Przynajmniej jeden SLN wykryto w 94,4%, obustronna detekcja SLN wyniosła 80,4%. U 3 pacjentek wykryto makroprzerzuty w węzłach chłonnych (6,3%): w dwóch przypadkach SLNB umożliwiła prawidłowe wykrycie makroprzerzutów; u trzeciej pacjentki po wykonaniu ultrastaging wykryto mikroprzerzuty w SLN (co pozwoliło na właściwą ocenę zaawansowania choroby w układzie limfatycznym i uniknięcie fałszywie negatywnego wyniku SLNB). U 48 pacjentek, u których wykryto SLN w usuniętych 184 SLN stwierdzono 4 mikroprzerzuty (8,3%) oraz 4 ogniska izolowanych komórek nowotworowych (ITC) (8,3%). Nie stwierdzono korelacji pomiędzy czynnikami ryzyka (inwazja podścieliska szyjki, mięśniówki, grade, zajęcie przestrzeni limfatyczno-naczyniowej) a obecnością mikroprzerzutów lub ITC. Wnioski: Detekcja mikroprzerzutów pozwala zmniejszyć częstość występowania przypadków fałszywie ujemnych, a tym samym zwiększyć bezpieczeństwo SLNB

Employee Demand for Skills Development: a Review of Evidence and Policy

This report presents the results of a detailed review of evidence and policy relating to the factors that influence the engagement of the individual in skills development. It incorporates a broad range of formal and informal learning activities, delivered in a range of institutional settings and through different media, including work-based, classroombased, distance learning and community based learning. The review is deliberately broad in its focus, drawing on evidence and policy relating to people in different positions within the labour market - in or out of work, new entrants into employment, younger and older workers, people with and without qualifications and/or with higher and lower skills. However, a key focus for the research was the barriers and factors affecting access to skills development opportunities among lower skilled and lower qualified people. The review was undertaken by WM Enterprise and the Employment Research Institute, Edinburgh Napier University for the UK Commission for Employment and Skills (UK Commission)

The impact of low volume lymph node metastases and stage migration after pathologic ultrastaging of non-sentinel lymph nodes in early-stage cervical cancer: a study of 54 patients with 4.2 years of follow up

Objectives: To assess the significance of pathologic ultrastaging (PU) of sentinel (SLN) and non-sentinel (nSLN) lymph nodes (LNs) and the influence on cancer staging in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA2-IB1 cervical cancer. Material and methods: A retrospective study was conducted with 54 patients divided into two equal-sized groups. In test group (n1), at least one SLN/patient was detected with blue dye. All excised LNs in this group were subjected to PU (4 μm slices/150 μm intervals) with hematoxylin-eosin staining and immunohistochemistry (AE1-AE3 antibodies). In none of the control group (n2) was PU performed, but in 2 patients SLN concept was performed. Patients in both groups underwent radical hysterectomy and lymphadenectomy. The effect of PU was expressed in puTNM and compared with both standard pTNM and FIGO systems. The influence of PU on patients’ disease-free survival (DFS) and overall survival (OS) was assessed using Kaplan-Meier curves. Results: In total, 516 LNs were extracted (66 SLNs, 36% bilaterally). Micrometastases (MIC) or isolated tumor cells (ITC) were detected in 34 of the 482 LNs (7.1%), including 16 MICs and 9 ITC in non-SLNs. False negative rates were: 3.7%/side-specific, and 7.4%/both sides. The use of PU resulted in stage change in 2 cases (N and M status change), FIGO stage did not changed. No PU impact on DFS or OS was observed. Conclusions: The risk of TNM stage migration in early cervical cancer is low, is more likely in inattentively evaluated patients, and has indeterminate prognostic and predictive value. Selection of cases with cT ≤ 2 cm and cN0 is sufficient to avoid the risk of improper staging

Employee demand for skills development: a research and policy review

This report presents the results of a detailed review of evidence and policy relating to the factors that influence the engagement of the individual in skills development. It incorporates a broad range of formal and informal learning activities, delivered in a range of institutional settings and through different media, including work-based, classroombased, distance learning and community based learning. The review is deliberately broad in its focus, drawing on evidence and policy relating to people in different positions within the labour market - in or out of work, new entrants into employment, younger and older workers, people with and without qualifications and/or with higher and lower skills. However, a key focus for the research was the barriers and factors affecting access to skills development opportunities among lower skilled and lower qualified people. The review was undertaken by WM Enterprise and the Employment Research Institute, Edinburgh Napier University for the UK Commission for Employment and Skills (UK Commission)

Elective lung resection increases spatial QRS-T angle and QTc interval

Background: Lung resection changes intra-thoracic anatomy, which may affect electrocardiographic results. While postoperative cardiac arrhythmias have been recognized after lung resection, no study has documented changes in vectorcardiographic variables in patients undergoing this surgery. The purpose of this study was to analyse changes in spatial QRS-T angle (spQRS-T) and corrected QT interval (QTc) after lung resection.Methods: Adult patients undergoing elective lung resection under general anaesthesia were studied. The patients were allocated into four groups: those undergoing (1) left lobectomy (LL); (2) left pneumonectomy (LP); (3) right lobectomy (RL); and (4) right pneumonectomy (RP). The spQRS-T angle and QTc interval were measured one day before surgery (baseline) and 24, 48 and 72 h after surgery.Results: Seventy-one adult patients (47 men and 24 women) aged 47–80 (65 ± 7) years were studied. In the study group as a whole, lung resection was associated with significant increases in spQRS-T (p < 0.001) and QTc (p < 0.05 at 24 and 48 h and p < 0.01 at 72 h). The greatest changes were noted in patients undergoing LP. Postoperative atrial fibrillation (AF) was noted in 6.4% of patients studied, in whom the widest spQRS-T angle and the most prolonged QTc intervals were also noted.Conclusions: Lung resection widens the spQRS-T angle and prolongs the QTc interval, especially in patients undergoing LP. While postoperative AF was a relatively rare complication after lung resection in this study, it was associated with the widest spQRS-T angles and most prolonged QTc intervals

Clinical feasibility and diagnostic accuracy of detecting micrometastatic lymph node disease in sentinel and non-sentinel lymph nodes in cervical cancer: outcomes and implications

Background: Lymph node (LN) micrometastatic disease has come to prominence since ultrastaging was shown to improve the quality of LN procedures in epithelial cancers. The aim of the study was to evaluate the feasibility and diagnostic usefulness of detecting micrometastases in sentinel (SLN) and non-sentinel LNs (nSLN) in cervical cancer. Material and methods: Twelve consecutive patients with cervical cancer stages IA to IIA, classified according to the Union for International Cancer Control (UICC) and divided into two groups: A (7) and B (5), with and without SLN procedure with methylene blue dye, who underwent radical hysterectomy and lymph nodes removal, were recruited for the study. All LNs were evaluated in hematoxylin-eosin (HE) staining and immunohistochemically (IHC) in ultrastaging with anti-cytokeratin AE1/AE3 antibodies. A detailed analysis was performed with regard to the technical and histopathological aspects of the procedure. Results: More LNs could be extracted and studied in group A as compared to group B (210 vs. 70, mean 30 vs. 14, respectively,