Diagnosis and outcome of oesophageal Crohn's disease

BACKGROUND AND AIMS: Crohn's disease (CD) can involve any part of the gastrointestinal tract. We aimed to characterize clinical, endoscopic, histologic features and treatment outcomes of CD patients with oesophageal involvement. METHODS: We collected cases through a retrospective multicentre European Crohn's and Colitis Organisation CONFER [COllaborative Network For Exceptionally Rare case reports] project. Clinical data were recorded in a standardized case report form. RESULTS: A total of 40 patients were reported [22 males, mean (±SD, range) age at oesophageal CD diagnosis: 25 (±13.3, 10-71) years and mean time of follow-up: 67 (±68.1, 3-240) months]. Oesophageal involvement was established at CD diagnosis in 26 patients (65%) and during follow-up in 14. CD was exclusively located in the oesophagus in 2 patients. Thirteen patients (32.2%) were asymptomatic at oesophageal disease diagnosis. Oesophageal strictures were present in 5 patients and fistulizing oesophageal disease in one. Eight patients exhibited granulomas on biopsies. Proton-pump inhibitors (PPIs) were administered in 37 patients (92.5%). Three patients underwent endoscopic dilation for symptomatic strictures and none oesophageal-related surgery. Diagnosis in pre-established CD resulted in treatment modifications in 9/14 patients. Clinical remission of oesophageal disease was seen in 33/40 patients (82.5%) after a mean time of 7 (±5.6, 1-18) months. Follow-up endoscopy was performed in 29/40 patients and 26/29 (89.7%) achieved mucosal healing. CONCLUSION: In this case series the endoscopic and histologic characteristics of isolated oesophageal CD were similar to those reported in other sites of involvement. Treatment was primarily conservative, with PPIs administered in the majority of patients and modifications in pre-existing IBD-related therapy occurring in two thirds of them. Clinical and endoscopic remission was achieved in more than 80% of the patients.info:eu-repo/semantics/publishedVersio

Picture-Hanging Puzzles

We show how to hang a picture by wrapping rope around n nails, making a polynomial number of twists, such that the picture falls whenever any k out of the n nails get removed, and the picture remains hanging when fewer than k nails get removed. This construction makes for some fun mathematical magic performances. More generally, we characterize the possible Boolean functions characterizing when the picture falls in terms of which nails get removed as all monotone Boolean functions. This construction requires an exponential number of twists in the worst case, but exponential complexity is almost always necessary for general functions.Comment: 18 pages, 8 figures, 11 puzzles. Journal version of FUN 2012 pape

Integrating expertises and ambitions for data-driven digital building permits - the EUNET4DBP

The digitalization of the process for building permit (involving the use of 3D information systems) is seen as a priority in a wide part of the world. Since it is a very multidisciplinary use case, involving a variety of stakeholders tackling complex issues and topics, some of them joined their efforts and skills in the European Network for Digital Building Permit. The initial activity of the network, after a review of on-going experiences, was a workshop to share knowledge about the topics involved and to identify the main ambitions of the network with respect to three pillars (i.e. Process - Rules and Requirements - Technology) and the related requirements. It was achieved through a collective brainstorming activity guided by digital tools, whose results were further analysed in a post-processing phase. Such results are presented in this paper and will be the base for planning the future network activity. © Authors 2020

Gridded global surface ozone metrics for atmospheric chemistry model evaluation

The concentration of ozone at the Earth's surface is measured at many locations across the globe for the purposes of air quality monitoring and atmospheric chemistry research. We have brought together all publicly available surface ozone observations from online databases from the modern era to build a consistent data set for the evaluation of chemical transport and chemistry-climate (Earth System) models for projects such as the Chemistry-Climate Model Initiative and Aer-Chem-MIP. From a total data set of approximately 6600 sites and 500 million hourly observations from 1971-2015, approximately 2200 sites and 200 million hourly observations pass screening as high-quality sites in regionally representative locations that are appropriate for use in global model evaluation. There is generally good data volume since the start of air quality monitoring networks in 1990 through 2013. Ozone observations are biased heavily toward North America and Europe with sparse coverage over the rest of the globe. This data set is made available for the purposes of model evaluation as a set of gridded metrics intended to describe the distribution of ozone concentrations on monthly and annual timescales. Metrics include the moments of the distribution, percentiles, maximum daily 8-hour average (MDA8), sum of means over 35 ppb (daily maximum 8-h; SOMO35), accumulated ozone exposure above a threshold of 40 ppbv (AOT40), and metrics related to air quality regulatory thresholds. Gridded data sets are stored as netCDF-4 files and are available to download from the British Atmospheric Data Centre (doi:10.5285/08fbe63d-fa6d-4a7a-b952-5932e3ab0452). We provide recommendations to the ozone measurement community regarding improving metadata reporting to simplify ongoing and future efforts in working with ozone data from disparate networks in a consistent manner

Tools for BIM-GIS integration (IFC georeferencing and conversions): Results from the GeoBIM benchmark 2019

The integration of 3D city models with Building Information Models (BIM), coined as GeoBIM, facilitates improved data support to several applications, e.g., 3D map updates, building permits issuing, detailed city analysis, infrastructure design, context-based building design, to name a few. To solve the integration, several issues need to be tackled and solved, i.e., harmonization of features, interoperability, format conversions, integration of procedures. The GeoBIM benchmark 2019, funded by ISPRS and EuroSDR, evaluated the state of implementation of tools addressing some of those issues. In particular, in the part of the benchmark described in this paper, the application of georeferencing to Industry Foundation Classes (IFC) models and making consistent conversions between 3D city models and BIM are investigated, considering the OGC CityGML and buildingSMART IFC as reference standards. In the benchmark, sample datasets in the two reference standards were provided. External volunteers were asked to describe and test georeferencing procedures for IFC models and conversion tools between CityGML and IFC. From the analysis of the delivered answers and processed datasets, it was possible to notice that while there are tools and procedures available to support georeferencing and data conversion, comprehensive definition of the requirements, clear rules to perform such two tasks, as well as solid technological solutions implementing them, are still lacking in functionalities. Those specific issues can be a sensible starting point for planning the next GeoBIM integration agendas

Using space syntax and historical land-use data to interrogate narratives of high street ‘decline’ in two Greater London suburbs

The purpose of this paper is to provide some much needed theoretical grounding and historical-morphological context for the narratives of communal loss that recur in the reportage concerning the British high street. Given the topicality of this issue for policy-makers it is worth enquiring into precisely how far such narratives are in fact supported by a long-term perspective on historical changes in high street land uses in relation to the evolving spatial morphology of small town centres, in order to better distinguish the extent to which a further layer of socio-cultural explanation is required to account for the concern over ‘decline’. This research, undertaken as part of the EPSRC Adaptable Suburbs project at UCL, uses fully digitized historical maps, contemporary and historical land use data and space syntax analysis to identify historical-morphological parameters of change and continuity in and around two suburban high streets of Greater London since the nineteenth century: Surbiton and South Norwood. Drawing on Hillier and colleagues’ theory of ‘movement economy, the contemporary English high street, as it is represented in the case-study areas, emerges as a distinctive and resilient spatial morphology which has supported varied modes of land use over time. It concludes that the narrative of high street decline in part reflects a dominant focus on difficulties facing the UK retail sector and that a broader focus on the high street as a (re)generative social space rather than simply as a ‘retail attractor’ would allow for a broader appreciation of both its morphological and socio-economic capacities

Widespread FRA1-Dependent Control of Mesenchymal Transdifferentiation Programs in Colorectal Cancer Cells

Tumor invasion and metastasis involves complex remodeling of gene expression programs governing epithelial homeostasis. Mutational activation of the RAS-ERK is a frequent occurrence in many cancers and has been shown to drive overexpression of the AP-1 family transcription factor FRA1, a potent regulator of migration and invasion in a variety of tumor cell types. However, the nature of FRA1 transcriptional targets and the molecular pathways through which they promote tumor progression remain poorly understood. We found that FRA1 was strongly expressed in tumor cells at the invasive front of human colorectal cancers (CRCs), and that its depletion suppressed mesenchymal-like features in CRC cells in vitro. Genome-wide analysis of FRA1 chromatin occupancy and transcriptional regulation identified epithelial-mesenchymal transition (EMT)-related genes as a major class of direct FRA1 targets in CRC cells. Expression of the pro-mesenchymal subset of these genes predicted adverse outcomes in CRC patients, and involved FRA-1-dependent regulation and cooperation with TGFβ signaling pathway. Our findings reveal an unexpectedly widespread and direct role for FRA1 in control of epithelial-mesenchymal plasticity in CRC cells, and suggest that FRA1 plays an important role in mediating cross talk between oncogenic RAS-ERK and TGFβ signaling networks during tumor progression.This work was supported by project grants 1026228 and 1044168 (to A.S.D.) and Senior Research Fellowships (to R.D.H., R.B.P. and J.M.M.) from the National Health and Medical Research Council of Australia

Codi-strat - an interdisciplinary network geared towards sustainable management of chronic and infective diseases

A collaborative effort of clinicians, infectologists, molecular biologists, pharmacologists, veterinarians, bioinformaticians, management and education specialists is united in order to develop novel strategies of detecting early stages of chronic and infective diseases, their prevention and therapy. CODI-STRAT integrates 15 centers conducting leading–edge research of chronic inflammatory/infective diseases from seven European (five Mediterranean) countries and the USA, with specific aims to: i) establish long-standing partner center cross-disciplinary collaborations for clinical studies and research, ii) provide young investigators with broad and content-driven training and employability and iii) promote scientists up-skilled in genomics, transcriptomics, tissue expression, human serological and genetic studies, bioinformatics, chip technology, cell cultures and animal models, all directed toward clinical translation and chronic/infective disease management. This manuscript outlines the goals, partner roles and development of CODI-STRAT and its programme.peer-reviewe

A time and motion study of patients presenting at the accident and emergency department at Mater Dei Hospital

<p>Abstract</p> <p>Background</p> <p>To carry out a time and motion study of patients presenting at the Emergency Department (ED) by measuring waiting times at the ED dept throughout the day. The objectives were:</p> <p indent="1">• to determine whether waiting times are prolonged, and</p> <p indent="1">• if prolonged, at which station(s) bottlenecks occur most often in terms of duration and frequency.</p> <p>Results will be compared to the United Kingdom guidelines of stay at the emergency department.</p> <p>Methods</p> <p>A group of 11 medical students monitored all patients who attended ED between 0600 hours on the 25^thAugust and 0600 hours on the 1st September 2008. For each 24 hour period, students were assigned to the triage room and the 3 priority areas where they monitored all patient-related activity, movement and waiting times so that length of stay (LOS) could be recorded. The key data recorded included patient characteristics, waiting times at various ED process stages, tests performed, specialist consultations and follow up until admitted, discharged, or referred to another hospital area. Average waiting times were calculated for each priority area. Bottle-necks and major limiting factors were identified. Results were compared against the United Kingdom benchmarks - i.e. 1 hour until first assessment, and 4 hours before admitting/discharge.</p> <p>Results</p> <p>1779 patients presented to the ED in the week monitored. As expected, patients in the lesser priority areas (i.e. 2 & 3) waited longer before being assessed by staff. Patients requiring laboratory and imaging investigations had a prolonged length of stay, which varied depending on specific tests ordered. Specialty consultation was associated with longer waiting times. A major bottleneck identified was waiting times for inpatient admission.</p> <p>Conclusions</p> <p>In conclusion, it was found that 30.3% of priority 1 patients, 86.3% of priority 2 patients and 76.8% of priority 3 patients waited more than 1 hour for first assessment. We conclude by proposing several changes that may expedite throughput.</p

The Technological culture of war

The article proceeds from the argument that war is a social institution and not a historical inevitability of human interaction, that is, war can be “unlearned.” This process involves deconstructing/dismantling war as an institution in society. An important step in this process is to understand the philosophical and cultural bases on which technology is employed as “tools” of war. The article focuses on such questions as, Is technology just viewed as instruments in the hand of its human masters in war? Does technology take on an autonomous role in war? How should we assess the impact of context (political, economic, and cultural) of technology when employed in war? By exploring these points, the article hopes to provide input into the discussion on the control of war technologies and ultimately the dismantling of war as an institution in society