Clinical Features and Risk Factors of Autoimmune Liver Involvement in Pediatric Inflammatory Bowel Disease

OBJECTIVES:Autoimmune liver disease is reported in up to 7.8% of children with inflammatory bowel disease. A distinct inflammatory bowel disease phenotype has been suggested in adults and in small pediatric cohorts. The aim of the study was to evaluate the features of inflammatory bowel disease associated with autoimmune liver diseases and to analyze the characteristics of the liver disease. METHODS:Information on patients was obtained from the Italian Pediatric Inflammatory Bowel Disease Registry. Data of patients with and without autoimmune liver disease were compared. RESULTS:Autoimmune liver disease was detected in 6.8% of the 677 patients enrolled and was significantly associated with the diagnosis of ulcerative colitis (83%), with pancolonic involvement (84%), and with perinuclear antineutrophil cytoplasmic antibody positivity (41%) (all Ps < 0.05). Autoimmune liver disease was defined as sclerosing cholangitis in 61% of the patients and as an overlap syndrome in 33%. Concomitant intra- and extrahepatic biliary involvement was reported in 61% of cases, whereas exclusive extrahepatic lesions were reported in 21%. Hepatobiliary complications were observed in 9% of the patients during follow-up. CONCLUSIONS:Autoimmune liver disease, especially sclerosing cholangitis, was significantly more common in patients with extensive ulcerative colitis. Although complications are relatively rare in the pediatric age, monitoring is recommended

Kinship Past, Kinship Present: Bio-Essentialism in the Study of Kinship

In this article, I reconsider bio-essentialism in the study of kinship, centering on David Schneider’s influential critique that concluded that kinship was “a non-subject” (1972:51). Schneider’s critique is often taken to have shown the limitations of and problems with past views of kinship based on biology, genealogy, and reproduction, a critique that subsequently led those reworking kinship as relatedness in the new kinship studies to view their enterprise as divorced from such bio-essentialist studies. Beginning with an alternative narrative connecting kinship past and present and concluding by introducing a novel way of thinking about kinship, I have three constituent aims in this research article: (1) to reconceptualize the relationship between kinship past and kinship present; (2) to reevaluate Schneider’s critique of bio-essentialism and what this implies for the contemporary study of kinship; and (3) subsequently to redirect theoretical discussion of what kinship is. This concluding discussion introduces a general view, the homeostatic property cluster (HPC) view of kinds, into anthropology, providing a theoretical framework that facilitates realization of the often-touted desideratum of the integration of biological and social features of kinship. [bio-essentialism, kinship studies, homeostatic property cluster kinds, Schneider, genealogy

Measurement of gut permeability using fluorescent tracer agent technology

Abstract The healthy gut restricts macromolecular and bacterial movement across tight junctions, while increased intestinal permeability accompanies many intestinal disorders. Dual sugar absorption tests, which measure intestinal permeability in humans, present challenges. Therefore, we asked if enterally administered fluorescent tracers could ascertain mucosal integrity, because transcutaneous measurement of differentially absorbed molecules could enable specimen-free evaluation of permeability. We induced small bowel injury in rats using high- (15 mg/kg), intermediate- (10 mg/kg), and low- (5 mg/kg) dose indomethacin. Then, we compared urinary ratios of enterally administered fluorescent tracers MB-402 and MB-301 to urinary ratios of sugar tracers lactulose and rhamnose. We also tested the ability of transcutaneous sensors to measure the ratios of absorbed fluorophores. Urinary fluorophore and sugar ratios reflect gut injury in an indomethacin dose dependent manner. The fluorophores generated smooth curvilinear ratio trajectories with wide dynamic ranges. The more chaotic sugar ratios had narrower dynamic ranges. Fluorophore ratios measured through the skin distinguished indomethacin-challenged from same day control rats. Enterally administered fluorophores can identify intestinal injury in a rat model. Fluorophore ratios are measureable through the skin, obviating drawbacks of dual sugar absorption tests. Pending validation, this technology should be considered for human use

Effect of Enzymatic Tempering of Wheat Kernels on Milling and Baking Performance

This study examined the effect of cell-wall-degrading enzymes added to temper water on wheat milling performance and flour quality. An enzyme cocktail consisting of cellulase, xylanase, and pectinase and five independent variables (enzyme concentration, incubation time, incubation temperature, tempered wheat moisture content, and tempering water pH) were manipulated in a response surface methodology (RSM) central composite design. A single pure cultivar of hard red winter wheat was tempered under defined conditions and milled on a Ross experimental laboratory mill. Some treatment combinations affected flour yield from the break rolls more than that from the reduction rolls. However, a maximum for flour yield was not found in the range of parameters studied. Though treatments did not affect the optimum water absorption for breadmaking, enzyme-treated flours produced dough exhibiting shorter mixing times and slack and sticky textures compared with the control. Regardless of differences in mixing times, specific loaf volumes were not significantly different among treatments. Crumb firmness of bread baked with flour milled from enzyme-treated wheat was comparable to the control after 1 day but became firmer during storage up to 5 days

Lesson Plan, Social Studies, 2nd Grade

TEKS (Texas Essential Knowledge and Skills): 2.4 The student understands how historical figures, patriots, and good citizens helped, shape the community, state, and nation. 2.20 The student uses problem-solving and decision-making skills, working independently and with others, in a variety of settings. The student is expected to: (B) use a decision-making process to identify a situation that requires a decision, gather information, generate options, predict outcomes, act to implement a decision, and reflect on the effectiveness of that decision. Lesson objective(s): 1. The Learner will (TLW) make connections using problem solving strategies. 2. TLW use prior knowledge to connect to the article. Differentiation strategies to meet diverse learner needs: The Teacher will (TTW) will differentiation by using grouping, different types of media for example pictures related to topic and think-pair share strategy

‘Like the stranger at a funeral who cries more than the bereaved’: ethical dilemmas in ethnographic research with children

This article contributes to debates on the practicality and utility of prior ethical review in ethnography and qualitative research using an ethnography of children’s involvement in artisanal gold mining work in Ghana as a case study. Reflecting on dilemmas and obstacles encountered in attempts to employ prescribed institutional ethical guidance modelled for childhood research in the UK during the fieldwork, the discussion brings to attention some of the problems that can arise when ethical guidance is not anchored in the lived realities or value systems of the setting in which fieldwork is conducted. The article seeks to rejuvenate calls for more flexible and socio-culturally responsive ethical review and practice as an alternative to the prescriptive ethical regimes

Elective Modernism and the Politics of (Bio) Ethical Expertise

In this essay I consider whether the political perspective of third wave science studies – ‘elective modernism’ – offers a suitable framework for understanding the policy-making contributions that (bio)ethical experts might make. The question arises as a consequence of the fact that I have taken inspiration from the third wave in order to develop an account of (bio)ethical expertise. I offer a précis of this work and a brief summary of elective modernism before considering their relation. The view I set out suggests that elective modernism is a political philosophy and that although its use in relation to the use of scientific expertise in political and policy-making process has implications for the role of (bio)ethical expertise it does not, in the final analysis, provide an account that is appropriate for this latter form of specialist expertise. Nevertheless, it is an informative perspective, and one that can help us make sense of the political uses of (bio)ethical expertise

Long-Term Efficacy and Safety of Adalimumab in Pediatric Patients with Crohn's Disease

Background: IMAgINE 1 assessed 52-week efficacy and safety of adalimumab in children with moderate to severe Crohn's disease. Long-Term efficacy and safety of adalimumab for patients who entered the IMAgINE 2 extension are reported. Methods: Patients who completed IMAgINE 1 could enroll in IMAgINE 2. Endpoints assessed from weeks 0 to 240 of IMAgINE 2 were Pediatric Crohn's Disease Activity Index remission (Pediatric Crohn's Disease Activity Index ≤ 10) and response (Pediatric Crohn's Disease Activity Index decrease ≥15 from IMAgINE 1 baseline) using observed analysis and hybrid nonresponder imputation (hNRI). For hNRI, discontinued patients were imputed as failures unless they transitioned to commercial adalimumab (with study site closure) or adult care, where last observation was carried forward. Corticosteroid-free remission in patients receiving corticosteroids at IMAgINE 1 baseline, discontinuation of immunomodulators (IMMs) in patients receiving IMMs at IMAgINE 2 baseline, and linear growth improvement were reported as observed. Adverse events were assessed for patients receiving ≥1 adalimumab dose in IMAgINE 1 and 2 through January 2015. Results: Of 100 patients enrolled in IMAgINE 2, 41% and 48% achieved remission and response (hNRI) at IMAgINE 2 week 240. Remission rates were maintained by 45% (30/67, hNRI) of patients who entered IMAgINE 2 in remission. At IMAgINE 2 week 240, 63% (12/19) of patients receiving corticosteroids at IMAgINE 1 baseline achieved corticosteroid-free remission and 30% (6/20) of patients receiving IMMs at IMAgINE 2 baseline discontinued IMMs. Adalimumab treatment led to growth velocity normalization. No new safety signals were identified. Conclusions: Efficacy and safety profiles of prolonged adalimumab treatment in children with Crohn's disease were consistent with IMAgINE 1 and adult Crohn's disease adalimumab trials

Sediment production and delivery from timber harvest roads in Humboldt County, California

Sediment delivery from unpaved actively-used and relatively un-trafficked forest roads are one of the most common sources of impairment to aquatic ecosystems. Hence the objectives of this study were to: 1) compare the variability in erosion rates from actively used and relatively un-trafficked timber harvest roads across multiple water years in Railroad Gulch; 2) identify segment scale controls on road surface erosion and road-to-stream connectivity; 3) develop storm-based and annual segment scale models to predict road sediment production and compare the accuracy of these models to WEPP: Road; and 4) estimate road-related sediment loads to streams. Between 2014 and 2019 mean plume lengths were four meters for active roads and two meters for inactive roads, whereas mean rill lengths were three meters on inactive roads and two meters on active roads. Only plume deposition proved significantly greater (α \u3c 0.01) on active roads compared to inactive roads. The annual-based multiple regression model over-predicted sediment production by 28 percent and the storm-based underpredicted by 37 percent. WEPP: Road underestimated annual sediment loads by 95 percent. Segment-scale sediment production is significantly correlated (α \u3c 0.01) to the slope*area of a road segment, increased rill length (m), percent bare soil, and summed storm erosivity (MJ mm ha-1 h-1). Sediment production rates for active and inactive roads in Railroad Gulch ranged from 0.0 kg m2 yr-1 to 4.8 kg m2 yr-1. Since between one and two percent of active road lengths and between four and nine percent of inactive road lengths were connected between WY 2017 and 2019, an estimated five Mg and nine Mg of sediment would have delivered to the East and West Branch Railroad Gulch, respectively