The Regulations governing Materials Recovery Facilities (MRFs) in England require that they report on the quality of both the incoming mixed wastes and the single-stream recyclate products, with the ...results being made available on a public register. In this investigation, tests were conducted on a number of mixed wastes from different suppliers being processed at a qualifying MRF to evaluate how effective the Regulations (or MRF Code of Practice (MRF CoP)) were in generating useful, meaningful information. The empirical evidence obtained showed that MRF CoP in its current form has a number of serious flaws which detract from the validity and value of the reported operational data. The statutory definition of ‘material particles’ in the mixed wastes given in the MRF CoP means that compliance with the MRF CoP is impracticable, and in order to overcome this it will be necessary to re-word the definition of ‘material particles’. Empirical evidence also invalidated the explicit assumption made in the MRF CoP that the composition of the material particles is identical to that of the bulk materials, and consequently the basis for the mandatory apportioning of the weight of the material particles has no logical foundation and apportioning leads to distortion in the reported data. Changes will be required to the present statutory requirements for reporting operational results if the recorded information is to have meaning and relevance for stakeholders in the system.
The operation of qualifying materials recovery facilities (MRFs) in England is governed by the MRF code of practice (MRF CoP), which mandates certain sampling and testing practices for the mixed ...wastes being processed by the MRF. The results of this testing are required to be reported to the system regulator and are then made publicly available in a register. The MRF CoP is critically examined and certain aspects of the testing methodology are shown to be invalid, resulting in inaccurate information being included in the register. The current investigation looks at the extent of these inaccuracies and shows how they have very real financial implications for commercial operators of MRFs, especially where ‘shared basket’ contracts have been entered into, typically with local authorities.
Lung volume reduction surgery (LVRS) and bronchoscopic lung volume reduction (BLVR) with endobronchial valves can improve outcomes in appropriately selected patients with emphysema. However, no ...direct comparison data exist to inform clinical decision making in people who appear suitable for both procedures. Our aim was to investigate whether LVRS produces superior health outcomes when compared with BLVR at 12 months.
This multicentre, single-blind, parallel-group trial randomised patients from five UK hospitals, who were suitable for a targeted lung volume reduction procedure, to either LVRS or BLVR and compared outcomes at 1 year using the i-BODE score. This composite disease severity measure includes body mass index, airflow obstruction, dyspnoea and exercise capacity (incremental shuttle walk test). The researchers responsible for collecting outcomes were masked to treatment allocation. All outcomes were assessed in the intention-to-treat population.
88 participants (48% female, mean±sd age 64.6±7.7 years, forced expiratory volume in 1 s percent predicted 31.0±7.9%) were recruited at five specialist centres across the UK and randomised to either LVRS (n=41) or BLVR (n=47). At 12 months follow-up, the complete i-BODE was available in 49 participants (21 LVRS/28 BLVR). Neither improvement in the i-BODE score (LVRS -1.10±1.44
BLVR -0.82±1.61; p=0.54) nor in its individual components differed between groups. Both treatments produced similar improvements in gas trapping (residual volume percent predicted: LVRS -36.1% (95% CI -54.6- -10%)
BLVR -30.1% (95% CI -53.7- -9%); p=0.81). There was one death in each treatment arm.
Our findings do not support the hypothesis that LVRS is a substantially superior treatment to BLVR in individuals who are suitable for both treatments.
Q in Matthew Kirk, Alan
2016, 2016-08-11, Volume:
564
eBook
Advocates of the established hypotheses on the origins of the Synoptic gospels and their interrelationships (the Synoptic Problem), and especially those defending or contesting the existence of the ...“source” (Q), are increasingly being called upon to justify their position with reference to ancient media practices. Still others go so far as to claim that ancient media realities force a radical rethinking of the whole project of Synoptic source criticism, and they question whether traditional documentary approaches remain valid at all. This debate has been hampered to date by the patchy reception of research on ancient media in Synoptic scholarship. Seeking to rectify this problem, Alan Kirk here mounts a defense, grounded in the practices of memory and manuscript transmission in the Roman world, of the Two Document Hypothesis. He shows how ancient media/memory approaches in fact offer new leverage on classic research problems in scholarship on the Synoptic Gospels, and that they have the potential to break the current impasse in the Synoptic Problem. The results of his analysis open up new insights to the early reception and scribal transmission of the Jesus tradition and cast new light on some long-conflicted questions in Christian origins.
The IASLC 8th TNM Staging 8th differentiates between a greater number of T-stages. Resection remains the mainstay of curative treatment with often significant waiting times. This study aims to ...quantify the T-stage progression and growth of non-small cell lung cancers (NSCLCs) between radiological diagnosis and resection, and its impact on disease recurrence and survival.
A retrospective analysis of NSCLC resections (289) in a high-volume centre between July 01, 2015 and June 30, 2016. Baseline demographics, time from diagnostic CT to surgery, tumour size (cm) and T-stage from diagnostic CT, PET-CT and post-operative histopathology reports were recorded. The primary outcome was increase in T-stage from diagnostic CT to resection. Kaplan-Meier and cox proportional hazard analyses were used to determine recurrence-free survival and survival.
Median increase in tumour size between diagnosis and resection was 0.3 cm (p < 0.0001). Median percentage increase in size was 13%. T-stage increased in 133 (46.0%) patients. N stage increased in 51 patients (17.7%), 32 (11.1%) to N2 disease. Mean survival in those upstaged was 43.5 (39.9–47.1) months versus 53.4 (50.0–56.8) months in patients not upstaged (p = 0.025). Mean recurrence-free survival in those upstaged was 39.1 (35.2–43.0) months versus 47.7 (43.9–51.4) months in patients not upstaged (p = 0.117). Upstaging was independently associated with inferior survival (HR 1.674, p = 0.006) and inferior recurrence-free survival (HR 1.423, p = 0.038).
A significant number of patients are upstaged between diagnostic and resection resulting in reduced survival and recurrence-free survival. A change in management pathways are required to improve outcomes in NSCLC.
•Non-small cell lung cancers were staged using the IASLC 8th TNM classification at diagnostic CT, PET-CT and at pathology.•Tumours grew by a median of 13% (0.3 cm) between diagnostic CT and resection, with increase in T-stage in 133 patients.•N-stage increased in 51 patients, with 32 patients upstaged to N2 disease and requiring adjuvant chemotherapy.•Patients T upstaged had a reduced survival of 9.9 months and a reduced disease free survival of 8.6 months.•Some tumors show rapid growth awaiting resection, resulting in increased morbidity and mortality post-resection.
The olive fruit fly, Bactrocera oleae, has been a key pest of olives in Europe and North America. We conducted the largest exploration for parasitoids associated with the fly across Sub-Saharan ...Africa (Kenya, Namibia, and South Africa) including some of the fly's adjoining regions (Canary Islands, Morocco, Réunion Island and Tunisia). From Sub-Saharan regions, four braconids were collected: Bracon celer, Psytallia humilis, P. lounsburyi, and Utetes africanus. Results showed that their regional dominance was related to climate niches, with P. humilis dominant in hot semi-arid areas of Namibia, P. lounsburyi dominant in more tropical areas of Kenya, and U. africanus prevalent in Mediterranean climates of South Africa. Psytallia concolor was found in the Canary Islands, Morocco and Tunisian, and the Afrotropical braconid Diachasmimorpha sp. near fullawayi on Réunion Island. Furthermore, we monitored the seasonal dynamics of the fly and parasitoids in Cape Province of South Africa. Results showed that fruit maturity, seasonal variations in climates and interspecific interactions shape the local parasitoid diversity that contribute to the low fly populations. The results are discussed with regard to ecological adaptations of closely associated parasitoids, and how their adaptations impact biocontrol.
Pulmonary metastasectomy has become an established mode of therapy in the management of certain patients with metastatic colorectal cancer. All patients undergoing pulmonary resection for metastatic ...colorectal cancer between March 2008 and February 2014 were studied. 190 patients were identified. Most had a single metastasis (83%); 17% had multiple lesions (maximum: 4). The approach was thoracotomy in 92 and VATS in 98. 67% underwent wedge resection and 33% lobectomy. The size of the resected lesions was 8-110 mm (median: 24). 13% of patients underwent more than one procedure (maximum: 4); 8% had prior hepatic metastasectomy. There was no operative mortality. The 1-, 3- and 5-year survival was 92, 87 and 82%, respectively. Guidelines for referral and follow-up of these patients should be developed.
Contemporary Q scholarship imagines the existence of a ‘Galilean Q Community’ furnished with a simple religious piety standing over against Judean/Jerusalem-centered Judaism with its narrow ethnic ...particularism, its cult ritualism, and its scribal legalism. The ‘Galilean Q community’ plays the same role vis-à-vis Judean Judaism in the imaginary of contemporary Q scholarship that Sufi Islam does in past and present western Orientalist discourses on Islam: in G. A. Lipton’s words, as embodying ‘a type of philosophical Protestantism freed from all outward prescriptions of religious law’, as an ‘Oriental version of a Kantian universal faith’ over against Islamic orthodoxy, which is Semitic, legalistic, obsessed with Sharia, dogmatic, ritualistic, intolerant, coercive, and politicized. This essay explores the roots of this Orientalist paradigm in nineteenth-century Synoptic source criticism and its continued influence in circles of 2DH scholarship.
The larvae of Lasioptera donacis Coutin feed on fungal communities lining galleries within the mesophyll of leaf sheaths of Arundo donax in an aggregative manner. It has been stated that L. donacis ...could have established a fundamental symbiotic relationship with one fungus, although the fungal composition of these communities remains unsettled. Using a culture-dependent approach and ITS sequencing, the present work characterizes and compares the fungal communities associated with L. donacis in Eurasia with the endophytes of A. donax in Texas where L. donacis is absent. The 65 cultivable isolates obtained from L. donacis fungal communities were sorted into 15 MOTUs, among which Fusarium and Sarocladium predominated. No particular MOTU was systematically recovered from these communities regardless of the sites. The 19 isolates obtained in Texas were sorted into 11 MOTUs. Sarocladium and Fusarium were commonly found in Texas and Eurasia. Our finding indicate that the communities were composed of a diverse assemblage of non-systemic endophytes, rather than an exclusive fungal symbiont. From ovipositors and ovarioles of L. donacis emerging from plants in France, we opportunistically isolated the endophyte Apiospora arundinis, which lies at the origin of further research pertaining to its role in the feeding and oviposition of L. donacis.
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