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 Unpublished studies were identified from conference abstract booklets.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

“Inside these fences is our own little world”: Prison-based hiv testing and hiv-related stigma among incarcerated men and women

Correctional facilities offer opportunities to provide comprehensive HIV services including education, testing, treatment, and coordination of post- release care. However, these services may be undermined by unaddressed HIV stigma. As part of a prison-based HIV testing study, we interviewed 76 incarcerated men and women from the North Carolina State prison system. The sample was 72% men, median age 31.5 years (range: 19 to 60). Thematic analysis revealed high levels of HIV-related fear and stigma, homophobia, incomplete HIV transmission knowledge, beliefs that HIV is highly contagious within prisons (“HIV miasma”), and the View of HIV testing as protective. Interviewees described social distancing behaviors and coping mechanisms they perceived to be protective, including knowing their HIV status and avoiding contact with others and shared objects. Interviewees endorsed universal testing, public HIV status disclosure, and segregation of HIV-positive inmates. Intensified education and counseling efforts are needed to ameliorate entrenched HIV-transmission fears and stigmatizing beliefs

Closely related alpha-tropomyosin mRNAs in quail fibroblasts and skeletal muscle cells.

We describe the analysis of two quail cDNA clones representing distinct but closely related alpha-tropomyosin mRNAs. cDNA clone cC101 corresponds to a 1.2-kilobase RNA which accumulates to high levels during myoblast differentiation and which encodes the major isoform of skeletal muscle alpha-tropomyosin. cDNA clone cC102 corresponds to a 2-kilobase RNA which is abundant in cultured embryonic skin fibroblasts and which encodes one of two alpha-tropomyosin-related fibroblast tropomyosins of 35,000 and 34,000 daltons apparent molecular mass (class 1 tropomyosins). The cC102 protein is unique among reported nonstriated-muscle tropomyosins in being identical in amino acid sequence to the major isoform of skeletal muscle alpha-tropomyosin over an uninterrupted stretch of at least 183 amino acids (residues 75-257). The two protein sequences differ in the COOH-terminal region beginning with residue 258. Because the cC101 and cC102 RNAs share an extensive region (at least 373 nucleotides) of nucleotide sequence identity upstream of the codon for residue 258, they are likely derived from a single gene by alternative RNA splicing, as was recently proposed in the case of related beta-tropomyosin mRNAs in human fibroblasts and skeletal muscle (MacLeod, A. R., Houlker, C., Reinach, R. C., Smillie, L. B., Talbot, K., Modi, G., and Walsh, F. S. (1985) Proc. Natl. Acad. Sci. U.S.A. 82, 7835-7837). No alpha-tropomyosin-related RNAs are abundant in undifferentiated myoblasts. This suggests the possibility of a fibroblast-specific function, as opposed to a general nonmuscle-cell function for class 1 tropomyosins and also has implications for the regulation of alpha-tropomyosin gene expression during embryonic development

Modelling negative linear compressibility in tetragonal beam structures

Copyright © 2012 Elsevier. NOTICE: this is the author’s version of a work that was accepted for publication in Mechanics of Materials. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Mechanics of Materials, Volume 46 (2012), DOI: 10.1016/j.mechmat.2011.12.007Most materials compress axially in all directions when loaded hydrostatically. Contrary to this, some materials have been discovered that exhibit negative linear compressibility and, as such, expand along a specific axis or plane. This paper analyses a fundamental mechanism by using a combination of finite element simulations and analytical derivations to show that negative linear compressibility can be found in a body-centred or face-centred tetragonal network of nodes connected by a network of beams. The magnitude and direction of this behaviour depends on the cross geometry in the network

Convection in colloidal suspensions with particle-concentration-dependent viscosity

The onset of thermal convection in a horizontal layer of a colloidal suspension is investigated in terms of a continuum model for binary-fluid mixtures where the viscosity depends on the local concentration of colloidal particles. With an increasing difference between the viscosity at the warmer and the colder boundary the threshold of convection is reduced in the range of positive values of the separation ratio psi with the onset of stationary convection as well as in the range of negative values of psi with an oscillatory Hopf bifurcation. Additionally the convection rolls are shifted downwards with respect to the center of the horizontal layer for stationary convection (psi>0) and upwards for the Hopf bifurcation (psi<0).Comment: 8 pages, 6 figures, submitted to European Physical Journal

ATLAS Pixel Opto-Electronics

We have developed two radiation-hard ASICs for optical data transmission in the ATLAS pixel detector at the LHC at CERN: a driver chip for a Vertical Cavity Surface Emitting Laser (VCSEL) diode for 80 Mbit/s data transmission from the detector, and a Bi-Phase Mark decoder chip to recover the control data and 40 MHz clock received optically by a PIN diode. We have successfully implemented both ASICs in 0.25 micron CMOS technology using enclosed layout transistors and guard rings for increased radiation hardness. We present results of the performance of these chips, including irradiation with 24 GeV protons up to 61 Mrad (2.3 x 10e15 p/cm^2).Comment: 17 pages, 23 figures, submitted to NIM Added references. Added figure 15. Moved sec. IV to sec. I

Thresholds and prediction models to support the sustainable management of herbivorous insects in wheat. A review

Wheat is one of the most important arable crops grown worldwide, providing a significant proportion of the daily calorific intake for countries across the globe. Wheat crops are attacked by a diverse range of herbivorous invertebrates, pests, that cause significant yield loss. It is anticipated that yield loss caused by pests will increase in response to a changing climate. Currently, these pests are primarily controlled using pesticides; however, there is an increased need for more sustainable pest management solutions. Economic thresholds represent one avenue that can support the sustainable management of pests. Briefly, thresholds are the number of pests above which there is sufficient risk of yield loss. Here, we review the economic thresholds and prediction methods available for sustainable pest management in wheat. We focus on five economically damaging pests affecting wheat crops in the UK and Europe. For each, we highlight the key period of crop risk to pest attack, identify economic thresholds, and provide an overview of current decision support models that can help estimate crop risk and advise sustainable pest management; we end by proposing areas for future improvement for each pest. Furthermore, we take a novel approach by discussing economic thresholds and their applications to sustainable pest management within the context of crop physiology and the capacity for crops to tolerate pest damage, a consideration that is often overlooked when developing pest management strategies. We use the stem-boring pest, the gout fly, as a case study and use the economic injury level equation to conduct a theoretical assessment of the appropriateness of the current gout fly threshold. This theoretical assessment indicates that wheat crops can tolerate greater gout fly damage than currently considered, and shows that by incorporating crop physiology into sustainable pest tolerance schemes we can work towards developing more appropriate physiological-based pest thresholds

Life path analysis: scaling indicates priming effects of social and habitat factors on dispersal distances

1. Movements of many animals along a life-path can be separated into repetitive ones within home ranges and transitions between home ranges. We sought relationships of social and environmental factors with initiation and distance of transition movements in 114 buzzards Buteo buteo that were marked as nestlings with long-life radio tags. 2. Ex-natal dispersal movements of 51 buzzards in autumn were longer than for 30 later in their first year and than 35 extra-natal movements between home ranges after leaving nest areas. In the second and third springs, distances moved from winter focal points by birds that paired were the same or less than for unpaired birds. No post-nuptial movement exceeded 2 km. 3. Initiation of early ex-natal dispersal was enhanced by presence of many sibs, but also by lack of worm-rich loam soils. Distances travelled were greatest for birds from small broods and with relatively little short grass-feeding habitat near the nest. Later movements were generally enhanced by the absence of loam soils and short grassland, especially with abundance of other buzzards and probable poor feeding habitats (heathland, long grass). 4. Buzzards tended to persist in their first autumn where arable land was abundant, but subsequently showed a strong tendency to move from this habitat. 5. Factors that acted most strongly in ½-km buffers round nests, or round subsequent focal points, usually promoted movement compared with factors acting at a larger scale. Strong relationships between movement distances and environmental characteristics in ½-km buffers, especially during early ex-natal dispersal, suggested that buzzards became primed by these factors to travel far. 6. Movements were also farthest for buzzards that had already moved far from their natal nests, perhaps reflecting genetic predisposition, long-term priming or poor habitat beyond the study area