Multicenter, randomized study to optimize bowel for colon capsule endoscopy

AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy (CCE) bowel preparation regimen. METHODS This was a multicenter, prospective, randomized, controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system (PillCam® COLON 2; Medtronic, Yoqneam, Israel) was utilized. Preparation regimens differed in the 1st and 2nd boosts with the Study regimen using oral sulfate solution (89 mL) with diatrizoate meglumine and diatrizoate sodium solution (“diatrizoate solution”) (boost 1 = 60 mL, boost 2 = 30 mL) and the Control regimen oral sulfate solution (89 mL) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety, polyp detection, colonic transit, CCE completion and capsule excretion = 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon (Adequate: Study = 75.9%, Control = 77.3%; P = 0.88) and individual segments. In the Study group, CCE completion was superior (Study = 90.9%, Control = 76.9%; P = 0.048) and colonic transit was more often \u3c 40 min (Study = 21.8%, Control = 4%; P = 0.0073). More Study regimen subjects experienced adverse events (Study = 19.4%, Control = 3.4%; P = 0.0061), and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen, but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract, from ingestion to excretion, was shorter with the Study regimen while mean colonic transit times were similar for both study groups. CONCLUSION A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective, safe, and achieved superior CCE completion. © The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved

Differences in level of confidence in diabetes care between different groups of trainees: the TOPDOC diabetes study

Background There is an increasing prevalence of diabetes. Doctors in training, irrespective of specialty, will have patients with diabetes under their care. The aim of this further evaluation of the TOPDOC Diabetes Study data was to identify if there was any variation in confidence in managing diabetes depending on the geographical location of trainees and career aspirations. Methods An online national survey using a pre-validated questionnaire was administered to trainee doctors. A 4-point confidence rating scale was used to rate confidence in managing aspects of diabetes care and a 6-point scale used to quantify how often trainees would contribute to the management of patients with diabetes. Responses were grouped depending on which UK country trainees were based and their intended career choice. Results Trainees in Northern Ireland reported being less confident in IGT diagnosis, use of IV insulin and peri-operative management and were less likely to adjust oral treatment, contact specialist, educate lifestyle, and optimise treatment. Trainees in Scotland were less likely to contact a specialist, but more likely to educate on lifestyle, change insulin, and offer follow-up advice. In Northern Ireland, Undergraduate (UG) and Postgraduate (PG) training in diagnosis was felt less adequate, PG training in emergencies less adequate, and reporting of need for further training higher. Trainees in Wales felt UG training to be inadequate. In Scotland more trainees felt UG training in diagnosis and optimising treatment was inadequate. Physicians were more likely to report confidence in managing patients with diabetes and to engage in different aspects of diabetes care. Aspiring physicians were less likely to feel the need for more training in diabetes care; however a clear majority still felt they needed more training in all aspects of care. Conclusions Doctors in training have poor confidence levels dealing with diabetes related care issues. Although there is variability between different groups of trainees according to geographical location and career aspirations, this is a UK wide issue. There should be a UK wide standardised approach to improving training for junior doctors in diabetes care with local training guided by specific needs.</p

Firefly Flashing is Controlled by Gating Oxygen to Light-Emitting Cells

Although many aspects of firefly bioluminescence are understood, the mechanism by which adult fireflies produce light as discrete rapid flashes is not. Here we examine the most postulated theory, that flashing is controlled by gating oxygen access to the light-emitting cells (photocytes). According to this theory, the dark state represents repression of bioluminescence by limiting oxygen, which is required for bioluminescence; relief from this repression by transiently allowing oxygen access to the photocytes allows the flash. We show that normobaric hyperoxia releases the repression of light emission in the dark state of both spontaneously flashing and non-flashing fireflies, causing continual glowing, and we measure the kinetics of this process. Secondly, we determine the length of the barriers to oxygen diffusion to the photocytes in the aqueous and gas phases. Thirdly, we provide constraints upon the distance between any gas-phase gating structure(s) and the photocytes. We conclude from these data that the flash of the adult firefly is controlled by gating of oxygen to the photocytes, and demonstrate that this control mechanism is likely to act by modulating the levels of fluid in the tracheoles supplying photocytes, providing a variable barrier to oxygen diffusion

Managing Human-Habituated Bears to Enhance Survival, Habitat Effectiveness, and Public Viewing

The negative impacts on bears (Ursus spp.) from human activities associated with roads and developments are well documented. These impacts include displacement of bears from high-quality foods and habitats, diminished habitat effectiveness, and reduced survival rates. Additionally, increased public visitations to national parks accompanied with benign encounters with bears along park roads have caused more bears to habituate to the presence of people. In some contexts, habituation can predispose bears to being exposed to and rewarded by anthropogenic foods, which can also lower survival rates. The managers and staff of Yellowstone National Park located in Wyoming, Montana, and Idaho, USA, and Grand Teton National Park in northwestern Wyoming, USA have implemented several proactive strategies to mitigate the negative aspects of bear habituation. These strategies include providing park visitors with educational information on bear viewing etiquette, managing roadside viewing opportunities, installing bear-resistant infrastructure, hazing bears from developments, enforcing food and garbage storage regulations, and making human activities as predictable as possible to bears. Under the current management strategies, thousands of visitors are still able to view, photograph, and appreciate bears while visiting these parks each year. The opportunity to view bears provides a positive visitor experience and contributes millions of dollars to the local economies of park gateway communities. Positive bear viewing experiences also help build an important appreciation and conservation ethic for bears in people that visit national parks. For many years, managers were concerned about decreasing and threatened bear populations. Now more jurisdictions are facing new challenges caused by increasing bear populations. This paper highlights a successful attempt to address these issues

Sustainable Grazing on Saline Land in Western Australia - Multidisciplinary Research Linking Producers and Scientists

Dryland salinity is one of the most critical environmental issues challenging Western Australian farmers. Currently 10% of the cropping zone (1.8 million ha) is salt-affected and this is predicted to increase dramatically in the next 50 years (NLWRA, 2001). Animals grazing saline pasture systems represent the most likely large-scale opportunity for economic return from saline land in the short to medium term. To date, few farmers have invested in large-scale revegetation of saline land as the economic return from grazing has not been perceived to cover costs. Furthermore other benefits of saltland pasture systems, such as biodiversity, water use and improved quality of animal products have not been quantified

Book Reviews

Book Review 1Book Title: Early Life Histories of Fishes: New Developmental, Ecological and Evolutionary PerspectivesBook Author: Edited by E.K. BalonDr W. Junk, Dordrecht. 280 pp.Book Review 2Book Title: Comparative Aspects of Extracellular Acid-base BalanceBook Author: J.P. TruchotSpringer, 1987. 248 pp. 51 figures.Book Review 3Book Title: Insect Flight: Dispersal and MigrationBook Author: Edited by W. DanthanarayanaSpringer-Verlag, Berlin, 1986. 289 pp.Book Review 4Book Title:  The Mammalian Herbivore Stomach. Comparative Anatomy, Function and EvolutionBook Author: Peter LangerGustav Fischer, Stuttgart, 1988. 557 pages, 246 figures and 72 tablesBook Review 5Book Title:  Biology of the Integument. Vol. 2: VertebratesBook Authors: Edited by J. Bereiter-Hahn, A.G. Matoltsy &amp; K.S. RichardsSpringer, Berlin, 1986. 855 pp.Book Review 6Book Title:  Advances in the Biology of Turbellarians and related PlatyhelminthesBook Author: Edited by Seth TylerDr. W. Junk Publishers, 1986. 357 pages; 253 figuresBook Review 7Book Title: Evolutionary Physiological EcologyBook Author: Edited by P. CalowCambridge University Press, Cambridge. 239 pp.Book Review 8Book Title: DragonfliesBook Author: Peter L. MillerCambridge University Press, Cambridge, New York and Melbourne, 1987. 84 pp

Domestication of the Annual Legume \u3cem\u3eTrigonella balansae\u3c/em\u3e for Mixed Farming Systems in Southern Australia

An accession of the annual legume Trigonella balansae Boiss. and Reuter. has been selected for commercial release in Australia. The annual legume has significant potential as a self-regenerating pasture within mixed farming systems. As part of a duty-of-care assessment, we tested the hypothesis that sheep grazing the trigonella cultivar will have similar liveweight, condition scores, health and wool production to sheep grazing two widely adopted annual legumes, subterranean clover (Trifolium subterraneum L. cv Dalkeith) and French serradella (Ornithopus sativus Brot. cv. Erica). Forage dry matter digestibility (DMD), crude protein (CP), fibre, mineral content and isoflavones were measured across the plant’s lifecycle. The data supported the hypotheses and there were no significant differences in liveweight, wool growth, wool yield or condition score that were associated with pasture species. The mineral content of trigonella requires further investigation

The Lantern Vol. 14, No. 3, June 1946

• Girl on the Park Bench • To a God Unknown • Atomic Concept • To a Swan • Mimi and Me • Conversation Between Thought & Mind • The Prices These Days! • The Magic Pebbles • Awe at the Beauty of Spring • Faith of the Hungry • Huey Fallow • Sketches • Narcissahttps://digitalcommons.ursinus.edu/lantern/1039/thumbnail.jp

Is null-point reconnection important for solar flux emergence?

The role of null-point reconnection in a 3D numerical MHD model of solar emerging flux is investigated. The model consists of a twisted magnetic flux tube rising through a stratified convection zone and atmosphere to interact and reconnect with a horizontal overlying magnetic field in the atmosphere. Null points appear as the reconnection begins and persist throughout the rest of the emergence, where they can be found mostly in the model photosphere and transition region, forming two loose clusters on either side of the emerging flux tube. Up to 26 nulls are present at any one time, and tracking in time shows that there is a total of 305 overall, despite the initial simplicity of the magnetic field configuration. We find evidence for the reality of the nulls in terms of their methods of creation and destruction, their balance of signs, their long lifetimes, and their geometrical stability. We then show that due to the low parallel electric fields associated with the nulls, null-point reconnection is not the main type of magnetic reconnection involved in the interaction of the newly emerged flux with the overlying field. However, the large number of nulls implies that the topological structure of the magnetic field must be very complex and the importance of reconnection along separators or separatrix surfaces for flux emergence cannot be ruled out.Comment: 26 pages, 12 figures. Added one referenc

Evidence for density-dependent effects on body composition of a large omnivore in changing Greater Yellowstone Ecosystem

Understanding the density-dependent processes that drive population demography in a changing world is critical in ecology, yet measuring performance–density relationships in long-lived mammalian species demands long-term data, limiting scientists' ability to observe such mechanisms. We tested performance–density relationships for an opportunistic omnivore, grizzly bears (Ursus arctos, Linnaeus, 1758) in the Greater Yellowstone Ecosystem, with estimates of body composition (lean body mass and percent body fat) serving as indicators of individual performance over two decades (2000–2020) during which time pronounced environmental changes have occurred. Several high-calorie foods for grizzly bears have mostly declined in recent decades (e.g., whitebark pine [Pinus albicaulis, Engelm, 1863]), while increasing human impacts from recreation, development, and long-term shifts in temperatures and precipitation are altering the ecosystem. We hypothesized that individual lean body mass declines as population density increases (H1), and that this effect would be more pronounced among growing individuals (H2). We also hypothesized that omnivory helps grizzly bears buffer energy intake from changing foods, with body fat levels being independent from population density and environmental changes (H3). Our analyses showed that individual lean body mass was negatively related to population density, particularly among growing-age females, supporting H1 and partially H2. In contrast, population density or sex had little effect on body fat levels and rate of accumulation, indicating that sufficient food resources were available on the landscape to accommodate successful use of shifting food sources, supporting H3. Our results offer important insights into ecological feedback mechanisms driving individual performances within a population undergoing demographic and ecosystem-level changes. However, synergistic effects of continued climate change and increased human impacts could lead to more extreme changes in food availability and affect observed population resilience mechanisms. Our findings underscore the importance of long-term studies in protected areas when investigating complex ecological relationships in an increasingly anthropogenic worl