Predicting the development of psychological morbidity in inflammatory bowel disease : a systematic review

Background: Psychological morbidity in inflammatory bowel disease is common with significant impact on quality of life and health outcomes, but factors which predict the development of psychological morbidity are unclear. Aim: To undertake a systematic literature review of the predictors of psychological morbidity in patients with inflammatory bowel disease. Methods: Electronic searches for English-language articles were performed with keywords relating to psychological morbidity according to the Diagnostic and Statistical Manual of Mental Disorders IV and subsequent criteria, and inflammatory bowel disease; in MEDLINE, PsychInfo, Web of Science and EMBASE for studies published from January 1997 to 25 January 2019. Results: Of 660 studies identified, seven met the inclusion criteria. All measured depression, with three also measuring anxiety. Follow-up duration was variable (median of 18 months range 6–96 months). Risk factors identified for development of psychological morbidity included physical factors: aggressive disease (HR 5.77, 95% CI 1.89 to 17.7) and greater comorbidity burden (OR 4.31, 95% CI 2.83 to 6.57) and psychological risk factors: degree of gratitude (r=−0.43, p<0.01) and parenting stress (R-change=0.03, F(1,58)=35.6, p<0.05). Age-specific risk was identified with young people (13–17 years) at increased risk. Conclusions: Identifiable risks for the development of psychological morbidity in inflammatory bowel disease include physical and psychological factors. Further research is required from large prospective studies to enable early interventions in those at risk and reduce the impact of psychological morbidity

Prospective study of psychological morbidity and illness perceptions in young people with inflammatory bowel disease

Background and Aims: Psychological morbidity is increased in young people with inflammatory bowel disease (IBD). Illness perceptions may be an important factor. This study aimed to describe the prevalence and severity of psychological morbidity and examine relationships between baseline illness perceptions and anxiety, depression and health-related quality of life (HRQoL) at baseline and 12-months later in 16-21-years olds with IBD. Methods: IBD patients (n = 121) completed measures of anxiety, depression, HRQoL, and illness perceptions (IPQ-R) at baseline and follow-up (n = 100, 83%). Results: mong the 121 patients at baseline (median age 19.3 years, 40% female, 62% Crohn's disease, 73% in clinical remission), 55% reported elevated symptoms of anxiety/depression and 83% low HRQoL. Negative illness perceptions at baseline were significantly correlated with greater anxiety, depression and lower HRQoL at baseline and follow-up. In regression analysis at baseline, IPQ-R domain of greater perception of a cyclical nature of IBD was an independent predictor of anxiety, whilst a greater perceived emotional impact of IBD was an independent predictor of anxiety, depression and HRQoL. Female gender and clinical relapse were also independent predictors of lower HRQoL. After controlling for baseline measures, clinical risk factors and illness perceptions did not explain additional variance in psychological morbidity at follow-up. Conclusion: A high prevalence of psychological morbidity, stable over one year, was demonstrated in young people with IBD. Having negative illness perceptions, being female and active disease predicted those at greatest risk of psychological morbidity. Illness perceptions may be an appropriate target for psychological interventions

Intraoperative high resolution duplex imaging during carotid endarterectomy: Which abnormalities require surgical correction?

Objectives:This study evaluates high resolution, duplex ultrasound imaging for quality control of carotid endarterectomy in order to determine which technical factors were linked to residual stenosis and to define duplex criteria for reexploration.Design, material and methods:A consecutive series of 100 patients undergoing carotid endarterectomy were evaluated. Duplex imaging was performed prior to wound closure and repeated at 6–8 weeks postoperatively. Stenoses were classified as non-significant, moderate or severe based on duplex criteria. Intimal flaps, shelves, kinks, clamp damage and fronds were identified by ultrasound imaging.Results:Five moderate stenoses were noted in the proximal endarterectomy site (PES), and at follow-up three had resolved. Adherent fronds were detected in 83% of vessels and resolved in all but three cases. At the distal endarterectomy site there were 10 severe and 12 moderate stenoses. Intimal flaps were associated with an increased incidence of residual stenosis (p = 0.010).Conclusions:We conclude that severe stenoses with an intimal flap should be corrected immediately. Further data is required to establish the significance of kinks. Residual intimal flaps in the PES appear to remodel. The role of completion duplex may lie in the modification of surgical technique to eradicate anatomical and haemodynamic imperfections

Ultrasonic Stimulation of Mouse Skin Reverses the Healing Delays in Diabetes and Aging by Activation of Rac1

Chronic skin-healing defects are one of the leading challenges to lifelong well-being, affecting 2–5% of populations. Chronic wound formation is linked to age and diabetes and frequently leads to major limb amputation. Here we identify a strategy to reverse fibroblast senescence and improve healing rates. In healthy skin, fibronectin activates Rac1 in fibroblasts, causing migration into the wound bed, and driving wound contraction. We discover that mechanical stimulation of the skin with ultrasound can overturn healing defects by activating a calcium/CamKinaseII/Tiam1/Rac1 pathway that substitutes for fibronectin-dependent signaling and promotes fibroblast migration. Treatment of diabetic and aged mice recruits fibroblasts to the wound bed and reduces healing times by 30%, restoring healing rates to those observed in young, healthy animals. Ultrasound treatment is equally effective in rescuing the healing defects of animals lacking fibronectin receptors, and can be blocked by pharmacological inhibition of the CamKinaseII pathway. Finally, we discover that the migration defects of fibroblasts from human venous leg ulcer patients can be reversed by ultrasound, demonstrating that the approach is applicable to human chronic samples. By demonstrating that this alternative Rac1 pathway can substitute for that normally operating in the skin, we identify future opportunities for management of chronic wounds

The effect of asymmetries on stock index return value-at-risk estimates

It is widely accepted that equity return volatility increases more following negative shocks rather than positive shocks. However, much of value-at-risk (VaR) analysis relies on the assumption that returns are normally distributed (a symmetric distribution). This article considers the effect of asymmetries on the evaluation and accuracy of VaR by comparing estimates based on various models

First detection of Edwardsiella ictaluri (Proteobacteria: Enterobacteriaceae) in wild Australian catfish

The bacterium Edwardsiella ictaluri is considered to be one of the most significant pathogens of farmed catfish in the United States of America and has also caused mortalities in farmed and wild fishes in many other parts of the world. E. ictaluri is not believed to be present in wild fish populations in Australia, although it has previously been detected in imported ornamental fishes held in quarantine facilities. In an attempt to confirm freedom from the bacterium in Australian native fishes, we undertook a risk-based survey of wild catfishes from 15 sites across northern Australia. E. ictaluri was detected by selective culturing, followed by DNA testing, in Wet Tropics tandan (Tandanus tropicanus) from the Tully River, at a prevalence of 0.40 (95% CI 0.21–0.61). The bacterium was not found in fishes sampled from any of the other 14 sites. This is the first report of E. ictaluri in wild fishes in Australia

Coherent vs incoherent interlayer transport in layered metals

The magnetic-field, temperature, and angular dependence of the interlayer magnetoresistance of two different quasi-two-dimensional (2D) organic superconductors is reported. For $\kappa$-(BEDT-TTF)$_2$I$_3$ we find a well-resolved peak in the angle-dependent magnetoresistance at $\Theta = 90^\circ$ (field parallel to the layers). This clear-cut proof for the coherent nature of the interlayer transport is absent for $\beta$''-(BEDT-TTF)$_2$SF$_5$CH$_2$CF$_2$SO$_3$. This and the non-metallic behavior of the magnetoresistance suggest an incoherent quasiparticle motion for the latter 2D metal.Comment: 4 pages, 4 figures. Phys. Rev. B, in pres

The Chiral Phase Transition in Dissipative Dynamics

Numerical simulations of the chiral phase transition in the (3+1)dimensional O(4)-model are presented. The evolutions of the chiral field follow purely dissipative dynamics, starting from random chirally symmetric initial configurations down to the true vacuum with spontaneously broken symmetry. The model stabilizes topological textures which are formed together with domains of disoriented chiral condensate (DCC) during the roll-down phase. The classically evolving field acts as source for the emission of pions and $\sigma$ mesons. The exponents of power laws for the growth of angular correlations and for emission rates are extracted. Fluctuations in the abundance ratios for neutral and charged pions are compared with those for uncorrelated sources as potential signature for the chiral phase transition after heavy-ion collisions. It is found that the presence of stabilizing textures (baryons and antibaryons) prevents sufficiently rapid growth of DCC-domain size, so observability of anomalous tails in the abundance ratios is unlikely. However, the transient formation of growing DCC domains causes sizable broadening of the distributions as compared to the statistical widths of generic sources.Comment: 28 pages, 8 figure