Background
This is the fourth updated Enhanced Recovery After Surgery (ERAS
®
) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded ...recommendations for each ERAS item within the ERAS
®
protocol.
Methods
A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.
Results
All recommendations on ERAS
®
protocol items are based on best available evidence; good-quality trials; meta-analyses of good-quality trials; or large cohort studies. The level of evidence for the use of each item is presented accordingly.
Conclusions
The evidence base and recommendation for items within the multimodal perioperative care pathway are presented by the ERAS
®
Society in this comprehensive consensus review.
A robust signal for sidereal anisotropy in nuclear recoils would support, perhaps more decisively than any other evidence, a discovery claim for a WIMP component of Dark Matter. I present a concept ...based on columnar recombination in dense xenon gas, sensing nuclear recoil direction relative to a TPC drift field. The central advance is that nuclear recoil directionality information is obtained through a comparison, event-by-event, of the ionization signal and recombination signal that are produced prior to drifting the track ionization. The optimum xenon density for this concept may be near ten bars, unlike conventional techniques that employ track visualization – with severe restrictions on gas density to about 1/10 bar. No restriction is imposed by diffusion during drift, facilitating the realization of a large monolithic room temperature xenon gas Time Projection Chamber at the ton-scale, with unprecedented sensitivity for both directionality and cross-section. Remarkably, the desired operating conditions for 0-νββ 136Xe experiment may be identical.
The nature of the neutrino is one of the major open questions in experimental nuclear and particle physics. The most sensitive known method to establish the Majorana nature of the neutrino is ...detection of the ultra-rare process of neutrinoless double beta decay. However, identification of one or a handful of decay events within a large mass of candidate isotope, without obfuscation by backgrounds is a formidable experimental challenge. One hypothetical method for achieving ultra- low-background neutrinoless double beta decay sensitivity is the detection of single
Ba ions produced in the decay of
Xe ("barium tagging"). To implement such a method, a single-ion-sensitive barium detector must be developed and demonstrated in bulk liquid or dry gaseous xenon. This paper reports on the development of two families of dry-phase barium chemosensor molecules for use in high pressure xenon gas detectors, synthesized specifically for this purpose. One particularly promising candidate, an anthracene substituted aza-18-crown-6 ether, is shown to respond in the dry phase with almost no intrinsic background from the unchelated state, and to be amenable to barium sensing through fluorescence microscopy. This interdisciplinary advance, paired with earlier work demonstrating sensitivity to single barium ions in solution, opens a new path toward single ion detection in high pressure xenon gas.
We aimed to link DNA methylation events occurring in cervical carcinomas to distinct stages of HPV-induced transformation. Methylation specific-multiplex ligation-dependent probe amplification ...(MS-MLPA) analysis of cervical carcinomas revealed promoter methylation of 12 out of 29 tumour suppressor genes analysed, with MGMT being most frequently methylated (92%). Subsequently, consecutive stages of HPV16/18-transfected keratinocytes (n=11), ranging from pre-immortal to anchorage-independent phenotypes, were analysed by MS-MLPA. Whereas no methylation was evident in pre-immortal cells, progression to anchorage independence was associated with an accumulation of frequent methylation events involving five genes, all of which were also methylated in cervical carcinomas. TP73 and ESR1 methylation became manifest in early immortal cells followed by RARbeta and DAPK1 methylation in late immortal passages. Complementary methylation of MGMT was related to anchorage independence. Analysis of nine cervical cancer cell lines, representing the tumorigenic phenotype, revealed in addition to these five genes frequent methylation of CADM1, CDH13 and CHFR. In conclusion, eight recurrent methylation events in cervical carcinomas could be assigned to different stages of HPV-induced transformation. Hence, our in vitro model system provides a valuable tool to further functionally address the epigenetic alterations that are common in cervical carcinomas.
A new method to tag the barium daughter in the double-beta decay of ^{136}Xe is reported. Using the technique of single molecule fluorescent imaging (SMFI), individual barium dication (Ba^{++}) ...resolution at a transparent scanning surface is demonstrated. A single-step photobleach confirms the single ion interpretation. Individual ions are localized with superresolution (∼2 nm), and detected with a statistical significance of 12.9σ over backgrounds. This lays the foundation for a new and potentially background-free neutrinoless double-beta decay technology, based on SMFI coupled to high pressure xenon gas time projection chambers.
Sex determining region Y-box 11 (SOX11) expression is specific for mantle cell lymphoma (MCL) as compared with other non-Hodgkin's lymphomas. However, the function and direct-binding targets of SOX11 ...in MCL are largely unknown. We used high-resolution chromatin immunoprecipitation sequencing to identify the direct target genes of SOX11 in a genome-wide, unbiased manner and elucidate its functional significance. Pathway analysis identified WNT, PKA and TGF-beta signaling pathways as significantly enriched by SOX11-target genes. Quantitative chromatin immunoprecipitation sequencing and promoter reporter assays confirmed that SOX11 directly binds to individual genes and modulates their transcription activities in these pathways in MCL. Functional studies using RNA interference demonstrate that SOX11 directly regulates WNT in MCL. We analyzed SOX11 expression in three independent well-annotated tissue microarrays from the University of Wisconsin (UW), Karolinska Institute and British Columbia Cancer Agency. Our findings suggest that high SOX11 expression is associated with improved survival in a subset of MCL patients, particularly those treated with intensive chemotherapy. Transcriptional regulation of WNT and other biological pathways affected by SOX11-target genes may help explain the impact of SOX11 expression on patient outcomes.
We present evidence of non-excimer-based secondary scintillation in gaseous xenon, obtained using both the NEXT-White time projection chamber (TPC) and a dedicated setup. Detailed comparison with ...first-principle calculations allows us to assign this scintillation mechanism to neutral bremsstrahlung (NBrS), a process that is postulated to exist in xenon that has been largely overlooked. For photon emission below 1000 nm, the NBrS yield increases from about10−2photon/e−cm−1bar−1at pressure-reduced electric field values of50Vcm−1bar−1to above3×10−1photon/e−cm−1bar−1at500Vcm−1bar−1. Above1.5kVcm−1bar−1, values that are typically employed for electroluminescence, it is estimated that NBrS is present with an intensity around1photon/e−cm−1bar−1, which is about 2 orders of magnitude lower than conventional, excimer-based electroluminescence. Despite being fainter than its excimeric counterpart, our calculations reveal that NBrS causes luminous backgrounds that can interfere, in either gas or liquid phase, with the ability to distinguish and/or to precisely measure low primary-scintillation signals (S1). In particular, we show this to be the case in the “buffer” region, where keeping the electric field below the electroluminescence threshold does not suffice to extinguish secondary scintillation. The electric field leakage in this region should be mitigated to avoid intolerable levels of NBrS emission. Furthermore, we show that this new source of light emission opens up a viable path toward obtaining S2 signals for discrimination purposes in future single-phase liquid TPCs for neutrino and dark matter physics, with estimated yields up to20–50photons/e−cm−1.
We report a measurement of the half-life of the 136Xe two-neutrino double-β decay performed with a novel direct-background-subtraction technique. The analysis relies on the data collected with the ...NEXT-White detector operated with 136Xe-enriched and 136Xe-depleted xenon, as well as on the topology of double-electron tracks. With a fiducial mass of only 3.5 kg of Xe, a half-life of 2.34$_{-0.46}^{+0.80}$(stat)$_{-0.17}^{+0.30}$(sys)×1021yr is derived from the background-subtracted energy spectrum. The presented technique demonstrates the feasibility of unique background-model-independent neutrinoless double-β-decay searches.
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