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This paper reports on the introduction of SWM technology, soil moisture and nutrient monitoring tools, alongside Agricultural Innovation Platforms (AIP) in three small-scale irrigation schemes in southern Africa. Quantitative and qualitative data are presented on the changes and benefits that have resulted, including increased yield and profitability. The findings emphasize that information prior and subsequent to adoption is needed, and the importance of understanding and enhancing the incentive framework for behavioural change, including both economic and physical returns. The findings illustrate SWM technology is strengthened when introduced with credible multi-stakeholder processes, such as an AIP, that facilitate institutional innovation. [ABSTRACT FROM AUTHOR]

The decay of the photoluminescence at 1.54 μm from erbium-implanted silicon has been recorded over nearly three decades of intensity. Two components of the decay are observed at 7.5 K, one with a decay time constant of ∼40-160 μs, and the other with a characteristic time of between 800 and 1200 μs. It is found that the proportions of fast and slow components can vary depending upon the amount of implantation-induced damage, and this variation correlates with a broadening on the high energy side of the erbium related emission. The temperature dependence of the fastest decay is not consistent with it being due to an Auger process involving free carriers, and it is suggested that extended defects in the layers are responsible for this part of the decay curve. The broadening of the erbium line is attributed to the overlap of the dislocation-related line D1 with the erbium emission. Selective chemical etching and scanning electron microscopy show that there are extended defects present in samples with a short fast decay component. © 2001 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Minimally invasive techniques in transhiatal esophagectomy (THE) were introduced to reduce morbidity and enhance postoperative recovery. Aim of this study was to systematically review the current status and possible beneficial effects of the minimally invasive approach in THE. A systematic search was performed in PubMed, the Cochrane Library, and Embase to identify English articles published on laparoscopic THE. Comparative cohort studies were included for critical appraisal. Data describing perioperative and oncological outcomes were analyzed. A total of four comparative cohort studies that compared laparoscopic THE (n=122) with open THE (n=144) and four noncomparative cohort studies reporting on laparoscopic THE (n=212) were included in this review. Median blood loss was significantly lower in the laparoscopic group in all studies (100-500 vs. 526-900 mL). Length of hospital stay was also significantly shorter for the laparoscopic approach in all studies (9-13 vs. 12-16 days). One study reported less major postoperative complications after laparoscopic THE (12 vs. 23%), in the other studies no differences were found. Also no differences were found with regard to operating time, postoperative morbidity, radicality, and lymph node retrieval. Based on these pioneer studies, laparoscopic THE was demonstrated to be safe and feasible with evidence of reduced blood loss and shorter hospital stays. However, level 1 evidence is lacking and further research is warranted to confirm these findings and also to evaluate long-term oncologic outcomes. [ABSTRACT FROM AUTHOR]

Background The optimal neoadjuvant approach for patients with adenocarcinomas of the gastroesophageal junction (GEJ) remains unclear. Aim of this study was to evaluate the usefulness of perioperative chemotherapy in these patients. Method Consecutive patients with GEJ adenocarcinoma, treated with surgery alone or chemotherapy plus surgery, were included from a prospective database (2003–2013). Propensity score matching was used to build comparable groups. Response to chemotherapy was assessed according to standardized regression grading. Results After propensity score matching, 196 patients were included. Chemotherapy was administered in 124 patients (63%). There was no difference between the chemotherapy plus surgery and surgery-alone group regarding overall and disease-free survival ( p = 0.351 and p = 0.529). Pathological good response (i.e. tumor regression grading [TRG] 1–3) was achieved in 32 patients (34%), whereas 81 (66%) had poor response (TRG 4). Good responders had lower ypT-stage ( p < 0.001), lower ypN-stage ( p < 0.001) and more R0-resections (100% vs. 78%, p = 0.016) compared to surgery-alone patients, which improved the 5-year survival from 35% to 67% ( p = 0.002). They also developed less recurrences (35% vs. 57%, p = 0.048). In poor responders, histopathology did not differ compared to surgery-alone and more recurrences were found (73% vs. 57%, p = 0.037). Overall survival in poor responders was 21% compared to 35% in surgery-alone patients ( p = 0.551). Conclusion Perioperative chemotherapy for GEJ adenocarcinoma leads to increased survival in good responders (34%) as compared to surgery alone. Poor responders had no survival benefit and developed more recurrences, which underlines the importance of the search for predictive biological or radiological markers to predict or assess chemotherapy sensitivity. [ABSTRACT FROM AUTHOR]

Esophageal and gastric cancer is associated with a poor prognosis since many patients develop recurrent disease. Treatment requires specific expertise and a structured multidisciplinary approach. In the Netherlands, this type of expertise is mainly found at the University Medical Centers ( UMCs) and a few specialized nonacademic centers. Aim of this study is to implement a national infrastructure for research to gain more insight in the etiology and prognosis of esophageal and gastric cancer and to evaluate and improve the response on (neoadjuvant) treatment. Clinical data are collected in a prospective database, which is linked to the patients' biomaterial. The collection and storage of biomaterial is performed according to standard operating procedures in all participating UMCs as established within the Parelsnoer Institute. The collected biomaterial consists of tumor biopsies, blood samples, samples of malignant and healthy tissue of the resected specimen and biopsies of recurrence. The collected material is stored in the local biobanks and is encoded to respect the privacy of the donors. After approval of the study was obtained from the Institutional Review Board, the first patient was included in October 2014. The target aim is to include 300 patients annually. In conclusion, the eight UMCs of the Netherlands collaborated to establish a nationwide database of clinical information and biomaterial of patients with esophageal and gastric cancer. Due to the national coverage, a high number of patients are expected to be included. This will provide opportunity for future studies to gain more insight in the etiology, treatment and prognosis of esophageal and gastric cancer. [ABSTRACT FROM AUTHOR]

Background Clinical staging of adenocarcinoma of the gastroesophageal junction (GEJ) determines the curative treatment regimen containing either neoadjuvant chemotherapy or chemoradiotherapy followed by either gastrectomy or esophagectomy. The value of current diagnostic tools is a matter of debate. Methods A prospective database (2003–2013) was used to identify 266 consecutive patients with adenocarcinoma of the GEJ in order to evaluate the accuracy of endoscopic ultrasound (EUS) and computed tomography (CT) regarding tumor localization according to Siewert, nodal status and its consequences on treatment strategy. Results Overall accuracy in determining tumor localization was 73% for endoscopy/EUS and 61% for CT (p = 0.018). With endoscopy/EUS, the accuracy was 97%, 66% and 75% respectively for type I, II and III. With CT this was respectively 69%, 57% and 80%. The overall accuracy for determining N-status (N0/N+) per patient was 75% for EUS and 71% for CT. Accuracy for determining a positive nodal station in patients without neoadjuvant therapy was 77% for EUS and 71% for CT (p = 0.001). Accuracy for detecting positive upper mediastinal nodes was 80–92%, whereas for peritumoral and abdominal nodes this was 50–80% in both EUS and CT. In 8/266 patients (3%) the type of surgery changed due to intraoperative findings. A radical resection was performed in 233 patients (88%). Conclusions Despite the suboptimal accuracy of determining tumor localization with EUS and CT, in only a small number of patients an intraoperative change of surgical treatment was needed. EUS is superior to CT in determining nodal status and tumor localization in GEJ tumors. [ABSTRACT FROM AUTHOR]

The article discusses the response of the Pennsylvania government to race and labor riots in Pittsburgh, Pennsylvania, and Philadelphia, Pennsylvania, during the 19th century. It examines the legislature's focus upon the County of Philadelphia and Allegheny County as the responsible parties regarding property damages resulting from riots in laws passed in 1841 and 1849. The article explores the political debates within the state legislature over liability in riots and what the author describes as the unified efforts of legislators from Philadelphia and Pittsburgh to shift costs to the entire state.

This radiographic retrospective cohort study aims to identify relations between the prearthrotic anatomy of the hip joint and the type of subsequent osteoarthrosis (OA). Radiographs of 64 hips in 47 patients were evaluated. Several anatomical indices were measured on radiographs obtained before the onset of OA. The location, type and grade of OA were recorded on subsequent radiographs. Due to the small number of hips available, only three potential risk factors could be considered for both OA location and OA type (weight-bearing surface angle, spherical sector and neck shaft angle for both outcomes). The only variable that was found to be a significant predictor of OA location was the degree of inclination of the acetabular sourcil. Patients with craniomedial sourcils were more likely to have medial OA. No predictors of OA type could be identified. Our results suggest that the anatomy of the hip joint is a factor determining the location of developing osteoarthrosis. [ABSTRACT FROM AUTHOR]

The effects of diazepam on the pharmacokinetics and pharmacodynamics of two lipophilic beta-adrenoceptor antagonists (propranolol and metoprolol) and a hydrophilic beta-adrenoceptor antagonist (atenolol) were compared in 12 subjects. Administration of propranolol and metoprolol produced small increases in the AUC0-8h for diazepam compared with placebo (P less than 0.05 for metoprolol). Atenolol had no significant effect on the AUC0-8h for diazepam. The increase in the AUC0-8h was accompanied by increases in the plasma concentrations of N- desmethyldiazepam. Diazepam had no significant effect on the pharmacokinetics of either propranolol or atenolol. The pharmacokinetic interaction could be attributed to inhibition of diazepam metabolism by the lipophilic beta-adrenoceptor antagonists. The pharmacodynamic studies showed that when compared with placebo or atenolol there was a significant impairment of kinetic visual acuity (KVA) when diazepam was co-administered with metoprolol. Although there was a significant correlation (P less than 0.02) between plasma concentrations of diazepam and impairment of KVA, the pharmacodynamic interactions may not be due solely to the small pharmacokinetic interaction observed. [ABSTRACT FROM AUTHOR]