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Background The Coronavirus pandemic (COVID-19) curtailed endoscopy services, adding to diagnostic backlogs. Building on trial evidence for a non-endoscopic oesophageal cell collection device coupled with biomarkers (Cytosponge), an implementation pilot was launched for patients on waiting lists for reflux and Barrett's oesophagus surveillance. Aims (i) To review reflux referral patterns and Barrett's surveillance practices. (ii) To evaluate the range of Cytosponge findings and impact on endoscopy services. Design and methods Cytosponge data from centralized laboratory processing (trefoil factor 3 (TFF3) for intestinal metaplasia (IM), haematoxylin & eosin for cellular atypia and p53 for dysplasia) over a 2-year period were included. Results A total of 10 577 procedures were performed in 61 hospitals in England and Scotland, of which 92.5% (N  = 9784/10 577) were sufficient for analysis. In the reflux cohort (N  = 4074 with gastro-oesophageal junction sampling), 14.7% had one or more positive biomarkers (TFF3: 13.6% (N  = 550/4056), p53: 0.5% (21/3974), atypia: 1.5% (N  = 63/4071)), requiring endoscopy. Among samples from individuals undergoing Barrett's surveillance (N  = 5710 with sufficient gland groups), TFF3-positivity increased with segment length (odds ratio = 1.37 per cm (95% confidence interval: 1.33–1.41, P  < 0.001)). Some surveillance referrals (21.5%, N  = 1175/5471) had ≤1 cm segment length, of which 65.9% (707/1073) were TFF3 negative. Of all surveillance procedures, 8.3% had dysplastic biomarkers (4.0% (N  = 225/5630) for p53 and 7.6% (N  = 430/5694) for atypia), increasing to 11.8% (N  = 420/3552) in TFF3+ cases with confirmed IM and 19.7% (N  = 58/294) in ultra-long segments. Conclusions Cytosponge-biomarker tests enabled targeting of endoscopy services to higher-risk individuals, whereas those with TFF3 negative ultra-short segments could be reconsidered regarding their Barrett's oesophagus status and surveillance requirements. Long-term follow-up will be important in these cohorts. [ABSTRACT FROM AUTHOR]

This article provides information on the Liverpool Road Station in Manchester, England which was discussed at the 133rd Summer Meeting of the Royal Archaeology Institute in 1987. The idea behind the Liverpool and Manchester Railway was to establish the first modern railway. A number of requirements emerged in response to the traffic pattern proposed for the new railway. The railway, as a common carrier, was required to provide warehouse facilities and integrate these into the operational structure of the line. The technology adopted by water carriers was used to address the problems of merchandise handling. In addition, the design of the passenger terminals was governed by a clear functional criteria.

A total of 4,486 widowers of 55 years of age and older have been followed up for nine years since the death of their wives in 1957. Of these 213 died during the first six months of bereavement, 40% above the expected rate for married men of the same age. Thereafter the mortality rate fell gradually to that of married men and remained at about the same leveLThe greatest increase in mortality during the first six months was found in the widowers dying from coronary thrombosis and other arteriosclerotic and degenerative heart disease. There was also evidence of a true increase in mortality from other diseases, though the numbers in individual categories were too small for statistical analysis.In the first six months 22.5% of the deaths were from the same diagnostic group as the wife's death. Some evidence suggests that this may be a larger proportion than would be expected by chance association, but there is no evidence suggesting that the proportion is any different among widows and widowers who have been bereaved for more than six months.