660 research outputs found
PTU-112 Incidence and predictors of buried bumper syndrome following gastrostomy insertion: a systematic review
Introduction Gastrostomies are widely used to provide enteral nutrition support. Buried Bumper Syndrome (BBS) is a recognised complication seen following gastrostomy insertion, describing the migration of the internal bumper along the stoma tract towards the skin. The consequences of BBS can be fatal. Currently, there is a paucity of knowledge about the incidence and predictors of BBS, which is addressed in this study by systematically reviewing the medical literature.
Method A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines (PRISMA). Four databases (EMBASE, MEDLINE, CINHAL, Web of Science) were utilised, and studies identified by searching for key terms relating to gastrostomy and BBS (Jan 1980 -Dec 2016). Unpublished studies were identified from conference abstract booklets. Two independent reviewers screened studies to identify those that included description of adult patients with BBS. Data was extracted relating to patient demographics, incidence, time to presentation and factors associated with BBS.
Results 434 studies were initially identified (database search and grey literature). Of these, 299 (68.9%) were excluded following screening review of title and abstract (Kappa coefficient of reviewers=0.753). Of the remaining 135 studies, 85 met inclusion criteria (35 case studies, 11 case series and 39 cohort studies). No controlled trials were retrieved. In total, 16 627 patients were described post gastrostomy placement. 473 cases of BBS were reported in the literature, giving a pooled estimate incidence of 2.8% (0.46%–8.80%). The median age of presentation was 66 years, with 59.1% being in males. BBS was most frequently associated with gastrostomy tubes with thinner internal bumpers (40.7% of all reported cases), however reporting bias may have heavily influenced this outcome. The time to BBS presentation ranged from 3 days to 7 years. Common predictors of BBS reported in the literature include tight external bumpers and increased external traction made directly by the patient or during gastrostomy care.
Conclusion This is the first study to systematically review the incidence of Buried Bumper syndrome and assess factors predicting its development. The paucity of high quality studies identified in this systematic review, provides the impetus to develop a national gastrostomy registry accurately assessing gastrostomy outcomes. Healthcare professionals, patients and their caregivers need to be appropriately educated about BBS, considering factors such as tightness of external bumpers and minimising external traction
First Tests of the Indiana Silicon Sphere (ISiS)
This research was sponsored by the National Science Foundation Grant NSF PHY-931478
Factors Influencing the Participation of Older People in Clinical Trials : Data Analysis from the MAVIS Trial
Peer reviewedPostprin
Inflation, cold dark matter, and the central density problem
A problem with high central densities in dark halos has arisen in the context
of LCDM cosmologies with scale-invariant initial power spectra. Although n=1 is
often justified by appealing to the inflation scenario, inflationary models
with mild deviations from scale-invariance are not uncommon and models with
significant running of the spectral index are plausible. Even mild deviations
from scale-invariance can be important because halo collapse times and
densities depend on the relative amount of small-scale power. We choose several
popular models of inflation and work out the ramifications for galaxy central
densities. For each model, we calculate its COBE-normalized power spectrum and
deduce the implied halo densities using a semi-analytic method calibrated
against N-body simulations. We compare our predictions to a sample of dark
matter-dominated galaxies using a non-parametric measure of the density. While
standard n=1, LCDM halos are overdense by a factor of 6, several of our example
inflation+CDM models predict halo densities well within the range preferred by
observations. We also show how the presence of massive (0.5 eV) neutrinos may
help to alleviate the central density problem even with n=1. We conclude that
galaxy central densities may not be as problematic for the CDM paradigm as is
sometimes assumed: rather than telling us something about the nature of the
dark matter, galaxy rotation curves may be telling us something about inflation
and/or neutrinos. An important test of this idea will be an eventual consensus
on the value of sigma_8, the rms overdensity on the scale 8 h^-1 Mpc. Our
successful models have values of sigma_8 approximately 0.75, which is within
the range of recent determinations. Finally, models with n>1 (or sigma_8 > 1)
are highly disfavored.Comment: 13 pages, 6 figures. Minor changes made to reflect referee's
Comments, error in Eq. (18) corrected, references updated and corrected,
conclusions unchanged. Version accepted for publication in Phys. Rev. D,
scheduled for 15 August 200
Repeating the Errors of Our Parents? Family-of-Origin Spouse Violence and Observed Conflict Management in Engaged Couples
Based on a developmental social learning analysis, it was hypothesized that observing parental violence predisposes partners to difficulties in managing couple conflict. Seventy-one engaged couples were assessed on their observation of parental violence in their family of origin. All couples were videotaped discussing two areas of current relationship conflict, and their cognitions during the interactions were assessed using a video-mediated recall procedure. Couples in which the male partner reported observing parental violence (male-exposed couples) showed more negative affect and communication during conflict discussions than couples in which neither partner reported observing parental violence (unexposed couples). Couples in which only the female partner reported observing parental violence (female- exposed couples) did not differ from unexposed couples in their affect or behavior. Female-exposed couples reported more negative cognitions than unexposed couples, but male-exposed couples did not differ from unexposed couples in their reported cognitions
First Measurement of Z/gamma* Production in Compton Scattering of Quasi-real Photons
We report the first observation of Z/gamma* production in Compton scattering
of quasi-real photons. This is a subprocess of the reaction e+e- to
e+e-Z/gamma*, where one of the final state electrons is undetected.
Approximately 55 pb-1 of data collected in the year 1997 at an e+e-
centre-of-mass energy of 183 GeV with the OPAL detector at LEP have been
analysed. The Z/gamma* from Compton scattering has been detected in the
hadronic decay channel. Within well defined kinematic bounds, we measure the
product of cross-section and Z/gamma* branching ratio to hadrons to be
(0.9+-0.3+-0.1) pb for events with a hadronic mass larger than 60 GeV,
dominated by (e)eZ production. In the hadronic mass region between 5 GeV and 60
GeV, dominated by (e)egamma* production, this product is found to be
(4.1+-1.6+-0.6) pb. Our results agree with the predictions of two Monte Carlo
event generators, grc4f and PYTHIA.Comment: 18 pages, LaTeX, 5 eps figures included, submitted to Physics Letters
Search for Higgs Bosons in e+e- Collisions at 183 GeV
The data collected by the OPAL experiment at sqrts=183 GeV were used to
search for Higgs bosons which are predicted by the Standard Model and various
extensions, such as general models with two Higgs field doublets and the
Minimal Supersymmetric Standard Model (MSSM). The data correspond to an
integrated luminosity of approximately 54pb-1. None of the searches for neutral
and charged Higgs bosons have revealed an excess of events beyond the expected
background. This negative outcome, in combination with similar results from
searches at lower energies, leads to new limits for the Higgs boson masses and
other model parameters. In particular, the 95% confidence level lower limit for
the mass of the Standard Model Higgs boson is 88.3 GeV. Charged Higgs bosons
can be excluded for masses up to 59.5 GeV. In the MSSM, mh > 70.5 GeV and mA >
72.0 GeV are obtained for tan{beta}>1, no and maximal scalar top mixing and
soft SUSY-breaking masses of 1 TeV. The range 0.8 < tanb < 1.9 is excluded for
minimal scalar top mixing and m{top} < 175 GeV. More general scans of the MSSM
parameter space are also considered.Comment: 49 pages. LaTeX, including 33 eps figures, submitted to European
Physical Journal
A Measurement of the Product Branching Ratio f(b->Lambda_b).BR(Lambda_b->Lambda X) in Z0 Decays
The product branching ratio, f(b->Lambda_b).BR(Lambda_b->Lambda X), where
Lambda_b denotes any weakly-decaying b-baryon, has been measured using the OPAL
detector at LEP. Lambda_b are selected by the presence of energetic Lambda
particles in bottom events tagged by the presence of displaced secondary
vertices. A fit to the momenta of the Lambda particles separates signal from B
meson and fragmentation backgrounds. The measured product branching ratio is
f(b->Lambda_b).BR(Lambda_b->Lambda X) = (2.67+-0.38(stat)+0.67-0.60(sys))%
Combined with a previous OPAL measurement, one obtains
f(b->Lambda_b).BR(Lambda_b->Lambda X) = (3.50+-0.32(stat)+-0.35(sys))%.Comment: 16 pages, LaTeX, 3 eps figs included, submitted to the European
Physical Journal
Measurement of the Michel Parameters in Leptonic Tau Decays
The Michel parameters of the leptonic tau decays are measured using the OPAL
detector at LEP. The Michel parameters are extracted from the energy spectra of
the charged decay leptons and from their energy-energy correlations. A new
method involving a global likelihood fit of Monte Carlo generated events with
complete detector simulation and background treatment has been applied to the
data recorded at center-of-mass energies close to sqrt(s) = M(Z) corresponding
to an integrated luminosity of 155 pb-1 during the years 1990 to 1995. If e-mu
universality is assumed and inferring the tau polarization from neutral current
data, the measured Michel parameters are extracted. Limits on non-standard
coupling constants and on the masses of new gauge bosons are obtained. The
results are in agreement with the V-A prediction of the Standard Model.Comment: 32 pages, LaTeX, 9 eps figures included, submitted to the European
Physical Journal
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