Rural inflammatory bowel disease care in Australia: disease outcomes and perceived barriers to optimal care

Background: This study aimed to describe and compare disease outcomes in rural patients with Inflammatory Bowel Disease (IBD), review perspectives regarding barriers to optimal rural IBD care and define non-gastroenterologist healthcare practitioners’ exposure to and knowledge of IBD. Method and Materials: Rural patients who had previously completed an IBD questionnaire were identified from a tertiary hospital IBD database and matched for disease, age and gender to metropolitan patients from this same database. A further rural IBD cohort was identified from a rural general practice database in Mount Gambier, South Australia. These patients were invited to complete the same IBD questionnaire relating to disease characteristics and a further questionnaire relating to perceived barriers to optimal care. A questionnaire was also sent to rural healthcare practitioners seeking perspectives on IBD practice, knowledge of IBD management and perceived barriers to care for rural IBD patients. Results: No statistically significant difference was found between rural and metropolitan IBD patients identified on the database. Thirty-three Mount Gambier rural patients returned questionnaires (response rate 30%). No significant difference was found between the Mount Gambier rural cohort and the IBD database metropolitan cohort for the majority of disease complications and outcomes; however variance in medication use and access to imaging was found. A total of 233 healthcare practitioners completed questionnaires (response rate 21%). The majority of rural practitioners felt comfortable with managing IBD, yet 80% of general practitioners felt uncomfortable using immunomodulators. Disease knowledge using a validated tool appeared satisfactory. Teleconferencing and information sessions were suggested as possible interventions to overcome the identified barriers. Conclusion: No statistically significant differences in the rate of patient reported disease complications were found. A variance of practice with respect to methotrexate, iron replacement and hydrocortisone therapy and use of MRI was noted. Descriptive data regarding perceived barriers in addition to these findings will help guide future interventions to enable equality of care for patients with IBD living in regional and remote locations.Bennett AL, Wichmann M, Chi JK, Andrews JM and Bampton P

Comparison of the Interactions of Transferrin Receptor and Transferrin Receptor 2 with Transferrin and the Hereditary Hemochromatosis Protein HFE

The transferrin receptor (TfR) interacts with two proteins important for iron metabolism, transferrin (Tf) and HFE, the protein mutated in hereditary hemochromatosis. A second receptor for Tf, TfR2, was recently identified and found to be functional for iron uptake in transfected cells (Kawabata, H., Germain, R. S., Vuong, P. T., Nakamaki, T., Said, J. W., and Koeffler, H. P. (2000) J. Biol. Chem. 275, 16618-16625). TfR2 has a pattern of expression and regulation that is distinct from TfR, and mutations in TfR2 have been recognized as the cause of a non-HFE linked form of hemochromatosis (Camaschella, C., Roetto, A., Cali, A., De Gobbi, M., Garozzo, G., Carella, M., Majorano, N., Totaro, A., and Gasparini, P. (2000) Nat. Genet. 25, 14-15). To investigate the relationship between TfR, TfR2, Tf, and HFE, we performed a series of binding experiments using soluble forms of these proteins. We find no detectable binding between TfR2 and HFE by co-immunoprecipitation or using a surface plasmon resonance-based assay. The affinity of TfR2 for iron-loaded Tf was determined to be 27 nM, 25-fold lower than the affinity of TfR for Tf. These results imply that HFE regulates Tf-mediated iron uptake only from the classical TfR and that TfR2 does not compete for HFE binding in cells expressing both forms of TfR

Rural inflammatory bowel disease care in Australia: disease outcomes and perceived barriers to optimal care

Background: This study aimed to describe and compare disease outcomes in rural patients with Inflammatory Bowel Disease (IBD), review perspectives regarding barriers to optimal rural IBD care and define non-gastroenterologist healthcare practitioners’ exposure to and knowledge of IBD. Method and Materials: Rural patients who had previously completed an IBD questionnaire were identified from a tertiary hospital IBD database and matched for disease, age and gender to metropolitan patients from this same database. A further rural IBD cohort was identified from a rural general practice database in Mount Gambier, South Australia. These patients were invited to complete the same IBD questionnaire relating to disease characteristics and a further questionnaire relating to perceived barriers to optimal care. A questionnaire was also sent to rural healthcare practitioners seeking perspectives on IBD practice, knowledge of IBD management and perceived barriers to care for rural IBD patients. Results: No statistically significant difference was found between rural and metropolitan IBD patients identified on the database. Thirty-three Mount Gambier rural patients returned questionnaires (response rate 30%). No significant difference was found between the Mount Gambier rural cohort and the IBD database metropolitan cohort for the majority of disease complications and outcomes; however variance in medication use and access to imaging was found. A total of 233 healthcare practitioners completed questionnaires (response rate 21%). The majority of rural practitioners felt comfortable with managing IBD, yet 80% of general practitioners felt uncomfortable using immunomodulators. Disease knowledge using a validated tool appeared satisfactory. Teleconferencing and information sessions were suggested as possible interventions to overcome the identified barriers. Conclusion: No statistically significant differences in the rate of patient reported disease complications were found. A variance of practice with respect to methotrexate, iron replacement and hydrocortisone therapy and use of MRI was noted. Descriptive data regarding perceived barriers in addition to these findings will help guide future interventions to enable equality of care for patients with IBD living in regional and remote locations.Bennett AL, Wichmann M, Chi JK, Andrews JM and Bampton P

Separability and Fourier representations of density matrices

Using the finite Fourier transform, we introduce a generalization of Pauli-spin matrices for $d$-dimensional spaces, and the resulting set of unitary matrices $S(d)$ is a basis for $d\times d$ matrices. If $N=d_{1}\times d_{2}\times...\times d_{b}$ and H^{[ N]}=\bigotimes H^{% [ d_{k}]}, we give a sufficient condition for separability of a density matrix $\rho$ relative to the $H^{[ d_{k}]}$ in terms of the $L_{1}$ norm of the spin coefficients of $\rho >.$ Since the spin representation depends on the form of the tensor product, the theory applies to both full and partial separability on a given space $H^{[ N]}$% . It follows from this result that for a prescribed form of separability, there is always a neighborhood of the normalized identity in which every density matrix is separable. We also show that for every prime $p$ and $n>1$ the generalized Werner density matrix $W^{[ p^{n}]}(s)$ is fully separable if and only if $s\leq (1+p^{n-1}) ^{-1}$

Age and Growth of Spotted Sand Bass, Paralabrax maculatofasciatus, in Bahia de Los Angeles, Baja California, Mexico, with Age Validation using Otolith Edge Analysis

Spotted sand bass, Paralabrax maculatofasciatus, were collected from Bahia de Los Angeles, Baja California, Mexico covering as wide a size range as possible over four seasons (spring, summer, fall, and winter). Age was estimated and growth parameters calculated from growth zones counted in transverse otolith sections. An otolith edge analysis indicated an opaque growth zone was deposited once per year during the summer, validating the annual periodicity. Spotted sand bass from this region are fast growing with a relatively short life span of up to 11 years. Growth differs from the disjunct Pacific coast population by having a higher growth rate and a shorter longevity

Bitter-blockers as a taste masking strategy: a systematic review towards their utility in pharmaceuticals

Acceptable palatability of an oral dosage form is crucial to patient compliance. Excipients can be utilised within a formulation to mask the bitterness of a drug. One such category is the bitter-blockers. This term is used inconsistently within the literature and has historically been used to describe any additive which alters the taste of an unpleasant compound. This review defines a bitter-blocker as a compound which interacts with the molecular pathway of bitterness at a taste-cell level and compiles data obtained from publication screening of such compounds. Here, a novel scoring system is created to assess their potential utility in a medicinal product using factors such as usability, safety, efficacy and quality of evidence to understand their taste-masking ability. Sodium acetate, sodium gluconate and adenosine 5'monophophate each have a good usability and safety profile and are generally regarded as safe and have shown evidence of bitter-blocking in human sensory panels. These compounds could offer a much needed option to taste-mask particularly aversive medicines where traditional methods alone are insufficient

Energy Monitoring & Management System (EMMS)

The Energy Monitoring and Management System (EMMS) is developing an electrical power meter to help make electricity more available in energy impoverished regions of the world. The meter fills a unique niche for energy tracking and regulation within micro-grid systems. The EMMS project has partners in Burkina Faso and Zimbabwe: Open Door Development (ODD), the Institut Missiologique du Sahel (IMS), and the Theological College of Zimbabwe (TCZ). Ties are also maintained on a regular basis with IEEE Smart Village for potential future widespread system implementation. Recent work on the EMMS meter has been focused on resolving the last few remaining bugs, establishing a robust communication system, and developing a centralized server-based interface which aids with meter configuration and administration. The team has also begun several future developments which include datalogging and remote access features.https://mosaic.messiah.edu/engr2021/1004/thumbnail.jp

The Structure of the Non-SUSY Baryonic Branch of Klebanov-Strassler

We study the two-dimensional space of supergravity solutions corresponding to non-supersymmetric deformations of the baryonic branch of Klebanov-Strassler. By combining analytical methods with a numerical survey of the parameter space, we find that this solution space includes as limits the softly-broken N=1 solutions of Gubser et al. and those of Dymarsky and Kuperstein. We also identify a one-dimensional family of solutions corresponding to a natural non-supersymmetric generalisation of Klebanov-Strassler, and one corresponding to the limit in which supersymmetry is completely absent, even in the far UV. For almost all of the parameter space we find indications that much of the structure of the supersymmetric baryonic branch survives.Comment: 29 pages plus appendices, 11 figure

Classification of multi-qubit mixed states: separability and distillability properties

We give a complete, hierarchic classification for arbitrary multi-qubit mixed states based on the separability properties of certain partitions. We introduce a family of N-qubit states to which any arbitrary state can be depolarized. This family can be viewed as the generalization of Werner states to multi-qubit systems. We fully classify those states with respect to their separability and distillability properties. This provides sufficient conditions for nonseparability and distillability for arbitrary states.Comment: 12 pages, 2 figure