Update on celiac disease

Celiac disease is a chronic autoimmune process that is modulated by an environmental trigger, namely glladin; a part of gluten which is present in wheat, barley and rye, Celiac disease is clearly increasing in prevalence worldwide and with easier access to screening tools the notion that it is a disease of Western society is in increasingly being challenged, We have also seen a broader gamut of symptoms and disease conditions that are associated with celiac disease to the extent that the nomenclature of classic and non-classic manifestations seems redundant. The increased recognition in prevalence is poorly understood but seems to also reflect a true increase in incidence, These observations supported by constantly improving diagnostic techniques; including serologic, genetic testing and endoscopic moralities has frustratingly not been paralleled in any measure by any breakthrough in managementpeer-reviewe

Plastic dilation rate characteristic of concrete confined with steel tube

The use of external confining devices to confine concrete has become widely used. One of the purposes is to gain additional concrete strength and ductility. Although there are many types of external confining devices, in this paper, the attention is limited to the use ofthe steel tube as anexternal confining device. One of the main objectives ofthis research is to study the plastic dilation rate behavior of concrete-filled-steel-tube (CFST) columns. The experimental data for the plastic dilation rate is extracted, and compared with the authors concrete plasticity model. In the authors’ previous research, the calibration of the plastic dilation rate model was based on confined concrete tested under both active and passive confinement using FRP wraps. Since the behavior of the steel tube and the FRP materials are different, the author’s plastic dilation rate model needs to be re-evaluated for CFST columns. Comparisons of the extracted experimental plastic dilation rates with the model prediction for CFST specimens with normal strength concrete show good agreement and requires no adjustment in the formulation. However, for a specimen with 80 MPa concrete, the proposed formulation showsslightly lowerplastic dilation rates.More experimental data for CFST using high strength concretes is required for further investigation. For the sake of completeness, the overall response of two CFST specimensisalso evaluated using anin-house three-dimensional non-linear finite element analysis (3D-NLFEA) using the author’s proposed plasticity formulation for confined concrete

Compliance with protocols in dental conditions

The aims of this study were to assess compliance with the developed treatment protocols through the dissemination of case studies. Out of 203 questionnaires distributed, 125 (62%) were collected. Community pharmacists were asked to complete case studies within a fortnight to indicate their line of action in three conditions presented. Average percentage compliance with the protocols was 73%.peer-reviewe

New gastrointestinal diagnostic modalities : capsule endoscopy

With an approximate length of 15 feet, the small intestine presents a daunting challenge to the clinician faced with symptoms referable to this relatively inaccessible area. In the last decade, capsule endoscopy (CE) has established an increasingly broad niche in the diagnostic armamentarium of both paediatric and adult clinicians; it is now the established standard of care in the work up of obscure gastrointestinal hemorrhage, suspected Crohn's Disease, polyposis syndromes and arguably, chronic abdominal pain.peer-reviewe

Health and the Economy : a statement of concern

The relationship between health and the economy is an intimate and complex one. The economy of health and the apportioning of funds to different medical services and health care programs are issues that depend on the health profile of a given community as well as the expectations of its members. Decisions ultimately depend on available resources and political priorities. Health and the economy cannot be isolated and contrasted, as the integrity of a given economic system clearly depends on the state of health of the community both at an individual level as well as at a population level.peer-reviewe

Benthic oxygen exchange in a live coralline algal bed and an adjacent sandy habitat: an eddy covariance study

Coralline algal (maerl) beds are widespread, slow-growing, structurally complex perennial habitats that support high biodiversity, yet are significantly understudied compared to seagrass beds or kelp forests. We present the first eddy covariance (EC) study on a live maerl bed, assessing the community benthic gross primary productivity (GPP), respiration (R), and net ecosystem metabolism (NEM) derived from diel EC time series collected during 5 seasonal measurement campaigns in temperate Loch Sween, Scotland. Measurements were also carried out at an adjacent (~20 m distant) permeable sandy habitat. The O2 exchange rate was highly dynamic, driven by light availability and the ambient tidally-driven flow velocity. Linear relationships between the EC O2 fluxes and available light indicate that the benthic phototrophic communities were lightlimited. Compensation irradiance (Ec) varied seasonally and was typically ~1.8-fold lower at the maerl bed compared to the sand. Substantial GPP was evident at both sites; however, the maerl bed and the sand habitat were net heterotrophic during each sampling campaign. Additional inputs of ~4 and ~7 mol m-2 yr-1 of carbon at the maerl bed and sand site, respectively, were required to sustain the benthic O2 demand. Thus, the 2 benthic habitats efficiently entrap organic carbon and are sinks of organic material in the coastal zone. Parallel deployment of 0.1 m2 benthic chambers during nighttime revealed O2 uptake rates that varied by up to ~8-fold between replicate chambers (from -0.4 to -3.0 mmol O2 m-2 h-1; n = 4). However, despite extensive O2 flux variability on meter horizontal scales, mean rates of O2 uptake as resolved in parallel by chambers and EC were typically within 20% of one another

Technical note: Estimating light-use efficiency of benthic habitats using underwater O2 eddy covariance

Light-use efficiency defines the ability of primary producers to convert sunlight energy to primary production and is computed as the ratio between the gross primary production and the intercepted photosynthetic active radiation. While this measure has been applied broadly within terrestrial ecology to investigate habitat resource-use efficiency, it remains underused within the aquatic realm. This report provides a conceptual framework to compute hourly and daily light-use efficiency using underwater O-2 eddy covariance, a recent technological development that produces habitat-scale rates of primary production under unaltered in situ conditions. The analysis, tested on two benthic flux datasets, documents that hourly light-use efficiency may approach the theoretical limit of 0.125 O-2 per photon under low-light conditions, but it decreases rapidly towards the middle of the day and is typically 10-fold lower on a 24 h basis. Overall, light- use efficiency provides a useful measure of habitat functioning and facilitates site comparison in time and space.Peer reviewe

Future low-carbon transport scenarios: Practice theory-based visioning for backcasting studies

Backcasting is a well-established methodology particularly suitable for analyzing complex problems where the business-as-usual projection is no longer appropriate, which can be used to effectively address the challenges of climate change mitigation in transport. It is characterised by designing endpoints in the future and working backward from these visions to establish policy pathways that can achieve desired futures. The visioning phase, which involves the construction of a set of scenarios describing alternative futures, is the first phase in backcasting, and engaging different stakeholders during the visioning phase is considered an important aspect in transport studies. This paper aims to demonstrate the findings from a participatory visioning exercise carried out as part of a backcasting study on sustainable transport in the islands of Malta. It is based on a methodological approach that combines social practice theory with stakeholder workshops. The visioning exercise resulted in the development of four different scenarios: the business-as-usual scenario and three alternative scenarios for transport in 2050 in Malta; High-Tech Mobility (with a focus on clean technology); Local Mobility (with more local travel and reducing the need to travel over longer distances); and Green and Active Mobility (where active forms of travel are prioritised over motorised forms of transport). In the alternative scenarios, the elements of mobility practices and other social practices influencing mobility have been reconfigured to allow for low-carbon travel and significantly reducing GHG emissions. The results of this study demonstrate how insights from a theory of social practices approach can be utilized to provide narratives for future visions in transport backcasting studies, and how this approach could open new possibilities for the transition towards more sustainable mobility through the reconfiguration of mobility and other everyday social practices

Latency-Based and Psychophysiological Measures of Sexual Interest Show Convergent and Concurrent Validity.

Latency-based measures of sexual interest require additional evidence of validity, as do newer pupil dilation approaches. A total of 102 community men completed six latency-based measures of sexual interest. Pupillary responses were recorded during three of these tasks and in an additional task where no participant response was required. For adult stimuli, there was a high degree of intercorrelation between measures, suggesting that tasks may be measuring the same underlying construct (convergent validity). In addition to being correlated with one another, measures also predicted participants' self-reported sexual interest, demonstrating concurrent validity (i.e., the ability of a task to predict a more validated, simultaneously recorded, measure). Latency-based and pupillometric approaches also showed preliminary evidence of concurrent validity in predicting both self-reported interest in child molestation and viewing pornographic material containing children. Taken together, the study findings build on the evidence base for the validity of latency-based and pupillometric measures of sexual interest

Comparison of minimally invasive parathyroidectomy under local anaesthesia and minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism: A cost analysis

Background: Primary hyperparathyroidism (PHPT) origins from a solitary adenoma in 70-95% of cases. Moreover, the advances in methods for localizing an abnormal parathyroid gland made minimally invasive techniques more prominent. This study presents a micro-cost analysis of two parathyroidectomy techniques. Patients and methods: 72 consecutive patients who underwent minimally invasive parathyroidectomy, video-assisted (MIVAP, group A, 52 patients) or "open" under local anaesthesia (OMIP, group B, 20 patients) for PHPT were reviewed. Operating room, consumable, anaesthesia, maintenance costs, equipment depreciation and surgeons/anaesthesiologists fees were evaluated. The patient's satisfaction and the rate of conversion to conventional parathyroidectomy were investigated. T-Student's, Kolmogorov-Smirnov tests and Odds Ratio were used for statistical analysis. Results: 1 patient of the group A and 2 of the group B were excluded from the cost analysis because of the conversion to the conventional technique. Concerning the remnant patients, the overall average costs were: for Operative Room, 1186,69 \u20ac for the MIVAP group (51 patients) and 836,11 \u20ac for the OMIP group (p<0,001); for the Team, 122,93 \u20ac (group A) and 90,02 \u20ac (group B) (p<0,001); the other operative costs were 1388,32 \u20ac (group A) and 928,23 \u20ac (group B) (p<0,001). The patient's satisfaction was very strongly in favour of the group B (Odds Ratio 20,5 with a 95% confidence interval). Conclusions: MIVAP is more expensive compared to the "open" parathyroidectomy under local anaesthesia due to the costs of general anaesthesia and the longer operative time. Moreover, the patients generally prefer the local anaesthesia. Nevertheless, the rate of conversion to the conventional parathyroidectomy was relevant in the group of the local anaesthesia compared to the MIVAP, since the latter allows a four-gland exploration