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Background. Assessment methods for atopic dermatitis (AD) are not standardized, and therapeutic studies are difficult to interpret. Aims. To obtain a consensus on assessment methods in AD and to use a statistical method to develop a composite severity index.Methods. Consensus definitions were given for items used in the scoring system (extent, intensity, subjective) and illustrated for intensity items. Slides were reviewed to address within and between-observer variability by a group of 10 trained clinicians, and data were statistically evaluated with a two way analysis of variance. Two variants of an assessment system were compared in 88 patients at 5 different institutions. Data were analyzed using principal-component analysis. Results. For 5 intensity items studied (erythema, edema/papulation, oozing/crusts, excoriations, lichenification), within- and between-observer variability was good overall, except for edema/papulation which was difficult to assess with slides. In the series of 88 patients, principal-component analysis allowed to extract two unrelated components: the first one accounting for 33% of total variance was interpreted as a ‘severity’ component; the second one, accounting for 18% of variance, was interpreted as a ‘profile’ component distinguishing patients with mostly erythema and subjective symptoms and those with mostly lichenification and dryness and lower subjective symptoms. Of the two evaluation systems used, the one using the rule of nine to assess extent was found more workable than the one using a distribution × intensity product. A scoring index (SCORAD) combining extent, severity and subjective symptoms was mathematically derived from the first system and showed a normal distribution of the population studied. Conclusion. The final choice for the evaluation system was mostly made based on simplicity and easy routine use in outpatient clinics. Based on mathematical appreciation of weights of the items used in the assessment of AD, extent and subjective symptoms account for around 20% each of the total score, intensity items representing 60%. The so-designed composite index SCORAD needs to be further tested in clinical trials.

Main RecommendationsThe following recommendations should only be applied after a thorough diagnostic evaluation including a contrast-enhanced computed tomography (CT) scan. 1 ESGE recommends colonic stenting to be reserved for patients with clinical symptoms and radiological signs of malignant large-bowel obstruction, without signs of perforation. ESGE does not recommend prophylactic stent placement.Strong recommendation, low quality evidence. 2 ESGE recommends stenting as a bridge to surgery to be discussed, within a shared decision-making process, as a treatment option in patients with potentially curable left-sided obstructing colon cancer as an alternative to emergency resection.Strong recommendation, high quality evidence. 3 ESGE recommends colonic stenting as the preferred treatment for palliation of malignant colonic obstruction.Strong recommendation, high quality evidence. 4 ESGE suggests consideration of colonic stenting for malignant obstruction of the proximal colon either as a bridge to surgery or in a palliative setting.Weak recommendation, low quality evidence. 5 ESGE suggests a time interval of approximately 2 weeks until resection when colonic stenting is performed as a bridge to elective surgery in patients with curable left-sided colon cancer.Weak recommendation, low quality evidence. 6 ESGE recommends that colonic stenting should be performed or directly supervised by an operator who can demonstrate competence in both colonoscopy and fluoroscopic techniques and who performs colonic stenting on a regular basis.Strong recommendation, low quality evidence. 7 ESGE suggests that a decompressing stoma as a bridge to elective surgery is a valid option if the patient is not a candidate for colonic stenting or when stenting expertise is not available.Weak recommendation, low quality evidence.

We present a new fabrication method for epitaxial graphene on SiC which enables the growth of ultrasmooth defect-and bilayer-free graphene sheets with an unprecedented reproducibility, a necessary prerequisite for wafer-scale fabrication of high quality graphene-based electronic devices. The inherent but unfavorable formation of high SiC surface terrace steps during high temperature sublimation growth is suppressed by rapid formation of the graphene buffer layer which stabilizes the SiC surface. The enhanced nucleation is enforced by decomposition of polymer adsorbates which act as a carbon source. With most of the steps well below 0.75 nm pure monolayer graphene without bilayer inclusions is formed with lateral dimensions only limited by the size of the substrate. This makes the polymer assisted sublimation growth technique the most promising method for commercial wafer scale epitaxial graphene fabrication. The extraordinary electronic quality is evidenced by quantum resistance metrology at 4.2 K with until now unreached precision and high electron mobilities on mm scale devices. Main TextThe success of graphene as a basis for new applications depends crucially on the reliability of the available technologies to fabricate large areas of homogenous high quality graphene layers. Epitaxial growth on metals as well as on SiC substrates is employed with specific benefits and drawbacks.Single graphene layers epitaxially grown on SiC offer a high potential for electronic device applications. They combine excellent properties, e.g. high electron mobilities, with the opportunity for wafer-scale fabrication and direct processing on semi-insulating substrates without the need to transfer the graphene to a suitable substrate (Avouris & Dimitrakopoulos 2012). Some progress has been achieved during the recent years. In particular, high temperature sublimation growth under Ar atmosphere (Virojanadara et al. 2008),(Emtsev et al. 2009 or by confinement control (Heer et al. 2011), (Real et al. 2012) was a breakthrough for synthesizing large-area graphene on SiC substrates.The coverage of graphene bilayers could be reduced from wide stripes formed along the terraces to small micrometer-sized bilayer patches (Virojanadara et al. 2009). Further it was found that beyond pure sublimation growth from SiC graphene formation can be assisted by additional carbon supply from external sources (Al-Temimy et al. 2009;Moreau et al. 2010). In particular, by using propane in