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This article investigates reduced language in academic textchat. Previous work has suggested that frequency and context play a role in whether items can be reduced. It is demonstrated that students reduce more depending on the pedagogical set-up of the course, in that more reduction took place when the teacher-less pre-seminars came early in the course. Also, it was clear that high frequency items are more subject to reduction. When the topic is clear, items salient in such a discussion can be reduced. Also, the linguistic context of a full form of an item means that subsequent mentions can be reduced. Technical items vary in their behavior, and can be reduced or not. Another main conclusion, though, is that individuals also vary, and, when the context allows for it, can choose to reduce or not.

This chapter takes up the issue of authenticity in language pedagogy. Traditional views of authenticity take the native speaker to be the primary authority for linguistic norms. Written standard language is especially highly valued here. It is argued herein that TELL environments are equally valid as learning environments, and that students can use the freedom they provide to develop their own locally negotiated cultural and linguistic norms. Evidence is provided that students on a net-based MA program develop their own norms for reducing language, and use them and other means to mark membership of a local TELL community. Thus, TELL is a rich and authentic environment for learners of English to become what is referred to as “language practitioners.”

Summary Background Screening for Barrett's oesophagus relies on endoscopy, which is invasive and few who undergo the procedure are found to have the condition. We aimed to use machine learning techniques to develop and externally validate a simple risk prediction panel to screen individuals for Barrett's oesophagus. Methods In this prospective study, machine learning risk prediction in Barrett's oesophagus (MARK-BE), we used data from two case-control studies, BEST2 and BOOST, to compile training and validation datasets. From the BEST2 study, we analysed questionnaires from 1299 patients, of whom 880 (67·7%) had Barrett's oesophagus, including 40 with invasive oesophageal adenocarcinoma, and 419 (32·3%) were controls. We randomly split (6:4) the cohort using a computer algorithm into a training dataset of 776 patients and a testing dataset of 523 patients. We compiled an external validation cohort from the BOOST study, which included 398 patients, comprising 198 patients with Barrett's oesophagus (23 with oesophageal adenocarcinoma) and 200 controls. We identified independently important diagnostic features of Barrett's oesophagus using the machine learning techniques information gain and correlation-based feature selection. We assessed multiple classification tools to create a multivariable risk prediction model. Internal validation of the model using the BEST2 testing dataset was followed by external validation using the BOOST external validation dataset. From these data we created a prediction panel to identify at-risk individuals. Findings The BEST2 study included 40 diagnostic features. Of these, 19 added information gain but after correlation-based feature selection only eight showed independent diagnostic value including age, sex, cigarette smoking, waist circumference, frequency of stomach pain, duration of heartburn and acidic taste, and taking antireflux medication, of which all were associated with increased risk of Barrett's oesophagus, except frequency of stomach pain, with was inversely associated in a case-control population. Logistic regression offered the highest prediction quality with an area under the receiver-operator curve (AUC) of 0·87 (95% CI 0·84–0·90; sensitivity set at 90%; specificity of 68%). In the testing dataset, AUC was 0·86 (0·83–0·89; sensitivity set at 90%; specificity of 65%). In the external validation dataset, the AUC was 0·81 (0·74–0·84; sensitivity set at 90%; specificity of 58%). Interpretation Our diagnostic model offers valid predictions of diagnosis of Barrett's oesophagus in patients with symptomatic gastro-oesophageal reflux disease, assisting in identifying who should go forward to invasive confirmatory testing. Our predictive panel suggests that overweight men who have been taking antireflux medication for a long time might merit particular consideration for further testing. Our risk prediction panel is quick and simple to administer but will need further calibration and validation in a prospective study in primary care. Funding Charles Wolfson Charitable Trust and Guts UK.

Background: Endoscopy within 24 hours of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24h of admission). Methods: This prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between Nov-Dec 2017. Analyses were performed to identify factors associated with delayed endoscopy, and to compare patient outcomes, including length of stay and mortality rates, between early and delayed endoscopy groups. Results: Across 348 patients from 20 centres, the median time to endoscopy was 21.2h (IQR 12.0- 35.7), comprising median admission to referral and referral to endoscopy times of 8.1h (IQR 3.7- 18.1) and 6.7h (IQR 3.0-23.1) respectively. Early endoscopy was achieved in 58.9%, although this varied by centre (range: 31.0% - 87.5%, p=0.002). On multivariable analysis, lower Glasgow-Blatchford score, delayed referral, admissions between 7am-7pm or via the Emergency Department were independent predictors of delayed endoscopy. Early endoscopy was associated with reduced length of stay (median difference 1d; p= 0.004), but not 30-day mortality (p=0.344). Conclusions: The majority of centres did not meet national standards for time to endoscopy. Strategic initiatives involving acute care services may be necessary to improve this outcome.

This article contains a personal reflection of experiences in terrorism research over the past few decades. It begins by discussing early academic struggles to recognize the legitimacy of terrorism research, especially in the field of criminal justice. This is followed by a selective description of events where the author correctly predicted events as well as those where he was blindsided by surprises. It closes with an appeal to both the academy and the American public to move beyond ideology and populist understandings of terrorism to grapple with the multiple forms and complexities of terrorist violence.

Gastric adenocarcinoma develops after stepwise progression from normal mucosa through to adenocarcinoma most commonly after being triggered by Helicobacter pylori (H. pylori) infection. As disease is often diagnosed late, the prognosis for gastric adenocarcinoma is poor. Identifying pre-malignant mucosal lesions such as atrophic gastritis, intestinal metaplasia and dysplasia is one strategy adopted by clinicians to reduce cancer related mortality. Surveillance of high-risk individuals and endoscopic resection of dysplastic lesions is recommended by international and UK guidelines. The early detection and endoscopic management reduce the need for invasive surgery. The advancement of image enhanced endoscopy technology, endoscopic training, risk stratification and histological assessment has proven pivotal to the management of pre-malignant lesions. In this review we outline the development of a high-risk stomach, endoscopic assessment and review practical guidelines on identifying pre-malignant gastric mucosa.

This chapter investigates norms of English usage in a community of novice students on a net-based MA program. They communicated in academic seminars using textchat. They were found to develop their own norms for using reduced forms to speed up communication. Their teachers, who in the Vietnamese and Bangladeshi native cultures of the students should have been given great respect, did not have much influence on the norm-setting process, and even were addressed very informally in the discussions. The author argues that this is an affordance of net-based education that the discourse community sets its own norms of English usage, despite the members' lack of experience.

This article presents an investigation into what norms are negotiated in a CALL classrooms by non-native speakers of English who are Internet novices. There is an on-going debate regarding the status of non-native speaker norms. Although there is more and more recognition that they are valid learner targets, native speaker norms are still reported to have the highest status for learners. Internet language use, though, has led to a change in the perception of norms, as communities of non-native speakers can set their own norms over those of native speakers. Data are analysed from academic textchat seminars which show that a community of inexperienced Internet users set their own norms, which go directly against their L1 community cultural norms of respect towards teachers. This paper proposes that it is an affordance of CALL environments that they can do this. This work is further evidence that it is smaller discourse communities that set norms separate from those of larger geo-political national communities.

BACKGROUND & AIMS Screening for oesophageal varices (OV) using conventional oesophagogastroduodenoscopy (C-OGD) is invasive and requires costly monitoring, recovery, and decontamination facilities. We aimed to evaluate the technical feasibility, acceptability and accuracy of a novel, portable and disposable office-based transnasal endoscope (EG Scan™ ) compared to C-OGD as the reference standard. METHODS This was a prospective cohort study. Consecutive adult patients with cirrhosis were invited to participate. All subjects underwent the two procedures on the same day performed by two endoscopists in a blinded design. Patients completed preference and validated tolerability (10-point visual analogue scale (VAS)) questionnaires on day 0 and day 14 post procedures. RESULTS Forty-five of 50 patients (90%) completed both interventions. Mean age was 59 years and OV prevalence was 49%. Patients reported higher preference (percentage) and better experience (mean VAS) with EG Scan compared to C-OGD on day 0 (76.5% vs. 23.5%, P < 0.001; 7.8 vs. 6.8, P = 0.058, respectively) and day 14 (77.8% vs. 22.2%, P < 0.001; 7.0 vs. 5.5, P = 0.0013 respectively). Sensitivity and specificity of the EG Scan for the diagnosis of any size OV were 0.82 (95% confidence interval (CI) 0.60-0.95), and 0.78 (95% CI 0.56-0.93) respectively. Corresponding values for the diagnosis of clinically significant (medium/large) OV were 0.92 (95% CI 0.62-1.0), 0.97 (95% CI 0.84-1.0) respectively. No serious adverse events occurred. CONCLUSIONS EG Scan accuracy was higher for the diagnosis of medium/large OV compared to any size OV. Patients' preference and overall experience of the EG Scan was favourable compared to C-OGD 14 days after procedures.

The bacterial pathogen Helicobacter pylori commonly colonizes the human gastric mucosa during early childhood and persists throughout life. The organism has evolved multiple mechanisms for evading clearance by the immune system and, despite inducing inflammation in the stomach, the majority of infections are asymptomatic. H. pylori is the leading cause of peptic ulcer disease and gastric cancer. However, disease outcomes are related to the pattern and severity of chronic inflammation in the gastric mucosa, which in turn is influenced by both bacterial and host factors. Despite over 2 decades of intensive research, there remains an incomplete understanding of the circumstances leading to disease development, due to the fascinating complexity of the host-pathogen interactions. There is accumulating data concerning the virulence factors associated with increased risk of disease, and the majority of these have pro-inflammatory activities. Despite this, only a small proportion of those infected with virulent strains develop disease. Several H. pylori virulence factors have multiple effects on different cell types, including the induction of pro- and anti-inflammatory, immune stimulatory, and immune modulatory responses. The expression of multiple virulence factors is also often linked, making it difficult to assess the meaning of their effects in isolation. Overall, H. pylori is thought to usually modulate inflammation and limit acute damage to the mucosa, enabling the bacteria to persist. If this delicate balance is disturbed, disease may then develop.

This chapter examines the tactical aspects of terrorism. It begins by focusing on the nature of war and conflict in the 21st century, suggesting that technology, economic structures, and communication have changed the way war is waged. It argues that small groups of aggrieved people may conduct campaigns of unconventional warfare against individual nations or international alliances. Although such violence is manifested in many ways, it is typically labeled as “terrorism.” The chapter also demonstrates how large groups and nation states may participate in terrorist activities by either using terrorist tactics or supporting terrorist groups. The next part of the chapter focuses on the specific actions that constitute the tactics of terrorism, examining tactical innovations within various campaigns. The chapter concludes with an analysis of tactical force multipliers, and it introduces the role of the media within this context.

BACKGROUND & AIMS: Screening for Barrett's esophagus (BE) with conventional esophagogastroduodenoscopy (C-EGD) is expensive. We assessed the performance of a clinic-based, single use transnasal capsule endoscope (EG Scan II) for the detection of BE, compared to C-EGD as the reference standard. METHODS: We performed a prospective multicenter cohort study of patients with and without BE recruited from 3 referral centers (1 in the United States and 2 in the United Kingdom). Of 200 consenting participants, 178 (89%) completed both procedures (11% failed EG Scan due to the inability to intubate the nasopharynx). The mean age of participants was 57.9 years and 67% were male. The prevalence of BE was 53%. All subjects underwent the 2 procedures on the same day, performed by blinded endoscopists. Patients completed preference and validated tolerability (10-point visual analogue scale [VAS]) questionnaires within 14 days of the procedures. RESULTS: A higher proportion of patients preferred the EG Scan (54.2%) vs the C-EGD (16.7%) (P < .001) and the EG Scan had a higher VAS score (7.2) vs the C-EGD (6.4) (P = .0004). No serious adverse events occurred. The EG Scan identified any length BE with a sensitivity value of 0.90 (95% CI, 0.83-0.96) and a specificity value of 0.91 (95% CI, 0.82-0.96). The EG Scan identified long segment BE with a sensitivity value of 0.95 and short segment BE with a sensitivity values of 0.87. CONCLUSIONS: In a prospective study, we found the EG Scan to be safe and to detect BE with higher than 90% sensitivity and specificity. A higher proportion of patients preferred the EG Scan to C-EGD. This device might be used as a clinic-based tool to screen populations at risk for BE. ISRCTN registry identifier: 70595405; ClinicalTrials.gov no: NCT02066233.

Background and aim: Some studies suggest that narrow-band imaging (NBI) can be more accurate at diagnosing gastric intestinal metaplasia and dysplasia than white-light endoscopy (WLE) alone. We aimed to assess the real-time diagnostic validity of high resolution endoscopy with and without NBI in the diagnosis of gastric premalignant conditions and to derive a classification for endoscopic grading of gastric intestinal metaplasia (EGGIM). Methods: A multicenter prospective study (five centers: Portugal, Italy, Romania, UK, USA) was performed involving the systematic use of high resolution gastroscopes with image registry with and without NBI in a centralized informatics platform (available online). All users used the same NBI classification. Histologic result was considered the diagnostic gold standard. Results: A total of 238 patients and 1123 endoscopic biopsies were included. NBI globally increased diagnostic accuracy by 11 percentage points (NBI 94 % vs. WLE 83 %; P Conclusions: In a real-time scenario, NBI demonstrates a high concordance with gastric histology, superior to WLE. Diagnostic accuracy higher than 90 % suggests that routine use of NBI allows targeted instead of random biopsy samples. EGGIM also permits immediate grading of intestinal metaplasia without biopsies and merits further investigation.

Some scholars argue that terrorism has existed throughout history, citing such examples as the ancient Jewish revolts against the Romans or the assassins' cult during the Middle Ages. Other histori...

In hematopoiesis, self-renewal, proliferation, differentiation and apoptosis represent opposing decisions made by stem cells and progenitor cells, which when dysregulated can result in leukaemia. Here, we have investigated the function of Myb proteins in regulating these key cellular decisions, using the cell line FDCP-mix A4 as a model of early hematopoiesis. High concentrations of IL-3 in these cells favour self-renewal over differentiation and apoptosis. However when endogenous Myb activity was inhibited with an inducible dominant interfering protein, self-renewal was replaced by apoptosis and differentiation. Differentiation was to granulocytes and monocyte/macrophages and was closely associated with a G1-S phase block in the cell cycle. As for normal hematopoiesis, cytokine-induced terminal differentiation of FDCP-mix cells is associated with concomitant proliferation prior to its completion. However, when Myb activity was inhibited during this process, proliferation and survival were both reduced, resulting in a much lower yield of mature cells. These results indicate multiple cellular roles of Myb proteins during normal hematopoiesis.

Combined vibration, thermal, and acoustic environments cause significant changes in the free and forced response characteristics of spacecraft metallic, ceramic, and carbon thermal protection systems, exhaust wash structures in fixed wing aircraft, and ground vehicle components exposed to blast loading. When structural components become damaged, the effects of combined loads are even more apparent on the structural response. A new combined vibration‐acoustic‐thermal apparatus designed to simultaneously expose specimens up to 4' by 4' with 10 g vibration up to either 100 Hz or 1 inch displacement vibrations, 140 dB acoustic pressures, and >400 °F temperatures will first be described in this paper. Then observations from experiments conducted on a sandwich metallic panel exposed to thermal loads will be described. Modal impact and active sensor data will be utilized to extract frequency response function models that change as a function of the loading. These frequency response models indicate significant ch...

A vibration‐based health monitoring technique is implemented to detect simulated damage in a sandwich metallic honeycomb under combined acoustic and thermal loading. Two types of damage are introduced into a gamma titanium aluminide panel; simulated oxidation damage in the form of a local mass addition and simulated bolt damage with a change in bolt torque. An active sensing approach is used to measure frequency response functions between a piezo‐stack actuator with force measurement and high‐frequency accelerometers. The measured frequency response function matrix is then used to estimate the virtual force due to damage. Temperatures up to 300 °F and sound pressures up to 110 dB are considered. It is shown that the measurement of damage changes with combined loading. For example, temperature changes cause bolt damage to be more apparent in the virtual force due to the effects of temperature on the attachment boundary conditions and to the temperature gradient across the panel causing global bending. Similarly, acoustic loading is shown to enhance the detection of simulated mass damage due to larger motions produced on the panel.

Publisher Summary This chapter describes research aimed at discovering modulators of new nonpeptide-binding G-protein-coupled receptors (GPCRs), considered more druggable than their counterparts possessing peptidic ligands as potential therapies for type 2 diabetes (T2D), obesity, and related metabolic disorders. In particular, it focuses on GPCRs that have been deorphanized for which physiological ligands have been discovered, in the past few years. In human and rodent tissues, GPR119 (previously called GPCR) mRNA is principally localized in the pancreas and gastrointestinal tract. Many areas of the rodent brain also show GPR119 expression—a phenomenon that has not been demonstrated in humans. Within the rodent pancreas, immunofluorescent staining has implicated the islet b-cells as the main site of expression, a premise supported by evidence of GPR119 expression in b-cell derived insulinoma cell lines. The proteins of the GPR40 family, comprising GPR40, GPR41, and GPR43, have attracted attention recently as potential targets for diabetes and the metabolic syndrome due to their function as receptors for plasma-free fatty acids (FFAs) in cell types central to these conditions. The chapter also discusses GPR40 family; GPR120; GPR55 and GPR35; and GPR109A and GPR109B.

Hematopoiesis, the process by which mature blood cells arise, is controlled by multiple transcription factors, which act in stage- and lineage-specific complexes. It is a major goal to elucidate the genes regulated by these transcription factors, in order to obtain a full understanding of the process and its malignant counterpart, leukemia. Myb family transcription factors play a central role in hematopoiesis. To identify new Myb family target genes, we have used an inducible dominant-negative protein for a subtraction cloning protocol in a model cell system (FDCP-Mix) with many characteristics of normal hematopoiesis. We present here a novel group of 29 validated Myb family target genes of diverse functions.

Introduction IDA is prevalent in up to 5% of the developed world and endoscopy remains the most utilised investigation. Magnified white light endoscopy has been shown to accurately identify gastric atrophy, H. pylori gastritis and coeliac disease but the role of magnified NBI endoscopy (NBI-Z) in this context has not been evaluated. The study aim was to assess the ability of NBI-Z to make a real time diagnosis of these conditions compared to histology as the gold standard. Methods This prospective cohort study recruited patients undergoing endoscopic evaluation for IDA. All procedures were performed with an Olympus video endoscopy system by clinicians with advanced imaging experience. Systematic NBI-Z imaging in parts of the duodenum and gastric mucosa were taken with corresponding biopsies. A previously validated Nottingham Type 1–4 classification system was used to classify the characteristic gastric mucosal pit pattern, and magnified morphological features were used to describe intestinal metaplasia and villous atrophy. This allowed for a real time diagnosis to be made for villous atrophy, gastric atrophy and H. pylori gastritis. The specimens were examined by a single blinded GI pathologist. Results 105 patients were recruited over 3 years. Excluding those with an obvious cause (n = 11), a total of 94 patients were included in the final analysis. Female: male ratio was 1: 0.7, median age 66 years (range 21–85). 38% had significant co-morbidities. At time of endoscopy 52% were taking iron therapy, 19% aspirin, 30% PPI and 4% NSAIDs. The median (range) anaemia parameters were: Hb 10.8g/dL (7.7–12.6), MCV 82fl (60–97), Ferritin 10g/L (1–379) and iron 7.5 µmol/L (1–22). 73% had the procedure under sedation with median doses of 2.5 mg midazolam and 25 mg pethidine. Conclusion In patients with IDA, NBI-Z is highly specific in providing a real time diagnosis of gastric atrophy and coeliac disease. It is a useful technique to exclude H. pylori gastritis. The clinical relevance is that this technique allows for targeted biopsies, reducing the miss rate and thus increasing the diagnostic yield. Disclosure of Interest J. White: None Declared, S. Sami: None Declared, J. Ortiz Fernandez-Sordo: None Declared, J. Mannath: None Declared, K. Ragunath Grant/research support from: Olympus-Keymed UK, Speaker honoraria and consultancy fees from: Olympus-Keymed UK.

We have studied the role of Ras GTPase activating protein (GAP) in the chronic myeloid leukaemia cell line K562 by downregulating its expression using antisense RNA. This had no effect on cell proliferation and survival, suggesting that other effector molecules mediate these roles of Ras. Differentiation to macrophages following treatment with the phorbol ester 12-O-tetradecanoyl phorbol-13-acetate was found to correlate with a significant increase in expression of GAP in K562 cells. When GAP expression was downregulated by antisense RNA, the degree of macrophage differentiation was increased, implicating GAP in the regulation of macrophage differentiation.

We have studied the effects of an antisense oligonucleotide to Ras GAP in leukaemia cell lines. When terminal phosphorothioate linkages were introduced into this oligonucleotide, it caused major growth inhibition and apoptosis in the chronic myeloid leukaemia (CML) cell line K562, but had little effect on the promyelocytic leukaemia cell line HL60. Neither the expression of Ras GAP mRNA nor p120 GAP protein was downregulated by the antisense oligonucleotide, suggesting a non-antisense mechanism for growth inhibition. The antisense oligonucleotide contained GGC triplets which have previously been reported to inhibit the activity of p210 bcr-abl both in vitro and in vivo. However, cellular phosphotyrosine levels were found to be unaffected, suggesting that the activity of p210 bcr-abl was normal and that the antisense oligonucleotide may be interacting aptamerically with a different cellular protein. Since K562 is very resistant to apoptotic cell death, the identity of the putative target molecule would be of considerable interest.

The myelodysplastic syndromes (MDS) have a significant frequency of evolution into acute myeloid leukaemia (AML). Approximately 30% of MDS patients show activating mutations of the N-RAS proto-oncogene, and these patients are at increased risk of leukaemic evolution. Long-term survivors of aplastic anaemia (AA) and paroxysmal nocturnal haemoglobinurea (PNH) are also at significant risk of developing AML. We have screened peripheral blood DNA from 42 AA patients and 15 PNH patients for the presence of N-RAS point mutations. No mutations were detected in these samples, indicating that the mechanisms of evolution into AML may be different from those in MDS.

and 4) revealed that only age had a significant inverse association with a providers’ ability to calculate non-HDL-C (odds ratio 0.45, 95% confidence interval 0.24–0.85). Type of provider (physician vs nonphysician), specialists versus nonspecialist provider, academic versus non-academic practice setting, years since completing training, percentage of patients with dyslipidemia in a provider’s panel, and provider’s use of specialized lipid testing were not associated with providers’ ability to calculate non-HDL-C levels or knowledge regarding non-HDL-C treatment goals. Conclusions: Major gaps remain in providers’ awareness regarding non-HDL-C treatment goals and their ability to calculate non-HDL-C levels. These gaps are systemic and not restricted to specialists or non-specialists. Therefore, there is a need to implement system level interventions across specialties to address these gaps.

Analytical studies conducted by the U.S. Navy for the future marine gas turbine propulsion engines have concentrated in the mid-20,000 horsepower (HP) range. This power range meets the propulsion requirements of current surface ships, such as auxiliary and amphibious, frigate, destroyer, and light-cruiser ship types. In looking at future ship propulsion requirements, the possibility of developing a 50,000 HP marine gas turbine should be considered. This paper discusses the results of an initial investigation into the feasibility of a 50,000 HP marine gas turbine propulsion engine for surface ships. The current U.S. Navy 25,000 HP marine gas turbine and a theoretical 50,000 HP marine gas turbine propulsion engine performance characteristics are compared to establish performance trends of simple cycle marine engines. In addition, an advanced cycle 50,000 HP gas turbine with intercooling and recuperating is analyzed. This paper provides comparative results of engine performance for various ship operating profiles, engine size and weight and developmental cost.

This article approaches the notion of crime control through a historical examination of a riot that occurred during the 1919 Boston police strike. In September of 1919, the police walked off the job and the city was engulfed in a riot. Order was restored eventually by the Massachusetts National Guard, acting under the authority of martial law. The riot seemed to demonstrate that police presence controlled social order and criminal behavior. Law enforcement administrators, politicians, the press, and many American people accepted this logic after the riot in Boston. Evidence, however, suggests that the riot was caused by other factors beyond the control of the police. These factors are examined in this article, and it is argued that social norms played a greater role than police activity in controlling crime.