Clinical outcomes in the management of iron deficiency anemia in patients with inflammatory bowel disease

INTRODUCTION: Anemia is a frequent complication in patients with inflammatory bowel disease (IBD). The inflammation observed in IBD negatively impact absorption of iron. This could lead to increased hospitalizations, affect growth and development, and decrease overall quality of life. This is especially pronounced in the pediatric population. The screening and treatment of iron deficiency anemia (IDA) varies between centers, and as a result, roughly 40-60% of pediatric IBD patients are iron deficient. OBJECTIVES: The objective of this study is to assess the efficacy and safety profile of intravenous and enteral iron therapy in a population of iron deficient patients with IBD. The secondary aim of this study is to determine if oral or intravenous iron therapy can improve hematologic and iron parameters. We will also examine the longitudinal changes in gastrointestinal (GI) symptoms and quality of life in patients receiving oral and intravenous iron supplementation. METHODS: We conducted a prospective cohort study in pediatric patients with IBD admitted to the inpatient GI service at Boston Children’s Hospital from 09/05/2017 to 03/05/2018. Forty-six IBD patients were screened, and twenty-nine (63%) were identified as iron deficient and were consented for data collection through chart review and administration of the IMPACT-III quality of life questionnaire. RESULTS: Out of the twenty-nine IBD patients, eighteen (62%) received intravenous iron, seven (24%) received oral iron, and four (14%) were untreated and served as controls. The mean change in hemoglobin in patients receiving parenteral, oral, or no iron therapy was 1.6g/dl±0.5, 1.1g/dl±0.4, and 0.2g/dl±0.5, respectively. The change in hemoglobin was significant between the parenteral and oral iron group (P<0.05). The mean change in health-related quality of life scores in patients receiving parenteral or oral iron therapy was 11.6±11.4 and 3.8l±7.5, respectively. CONCLUSION: Our study demonstrates that intravenous iron therapy was more efficacious than oral iron in improving hematologic and iron parameters in IBD patients. This improvement was concomitant with higher scores on the IMPACT-III quality of life questionnaire, suggesting that iron supplementation improves health-related quality of life in IBD patients with iron deficiency anemia

On the Optimality of a Class of LP-based Algorithms

In this paper we will be concerned with a class of packing and covering problems which includes Vertex Cover and Independent Set. Typically, one can write an LP relaxation and then round the solution. In this paper, we explain why the simple LP-based rounding algorithm for the \\VC problem is optimal assuming the UGC. Complementing Raghavendra's result, our result generalizes to a class of strict, covering/packing type CSPs

On Quadratic Programming with a Ratio Objective

Quadratic Programming (QP) is the well-studied problem of maximizing over {-1,1} values the quadratic form \sum_{i \ne j} a_{ij} x_i x_j. QP captures many known combinatorial optimization problems, and assuming the unique games conjecture, semidefinite programming techniques give optimal approximation algorithms. We extend this body of work by initiating the study of Quadratic Programming problems where the variables take values in the domain {-1,0,1}. The specific problems we study are QP-Ratio : \max_{\{-1,0,1\}^n} \frac{\sum_{i \not = j} a_{ij} x_i x_j}{\sum x_i^2}, and Normalized QP-Ratio : \max_{\{-1,0,1\}^n} \frac{\sum_{i \not = j} a_{ij} x_i x_j}{\sum d_i x_i^2}, where d_i = \sum_j |a_{ij}| We consider an SDP relaxation obtained by adding constraints to the natural eigenvalue (or SDP) relaxation for this problem. Using this, we obtain an $\tilde{O}(n^{1/3})$ algorithm for QP-ratio. We also obtain an $\tilde{O}(n^{1/4})$ approximation for bipartite graphs, and better algorithms for special cases. As with other problems with ratio objectives (e.g. uniform sparsest cut), it seems difficult to obtain inapproximability results based on P!=NP. We give two results that indicate that QP-Ratio is hard to approximate to within any constant factor. We also give a natural distribution on instances of QP-Ratio for which an n^\epsilon approximation (for \epsilon roughly 1/10) seems out of reach of current techniques

Seasonal variations and distribution of sea grass associated macrofauna in Uppanar estuary, southeast coast of India

The occurrence of sea grass in relation to the distribution, relative abundance and seasonal variations along with the Physio-chemical parameters influencing the growth and distribution of associated fauna in Uppanar estuary, have been studied for a period of one year from April 2005 to March 2006. Totally three species of sea grass were collected. The sea grass showed definite levels of zonation. They also showed seasonal changes in growth pattern in relation to the changes in Physio-chemical parameters. Totally about three major groups of organisms i.e. Polychaetes, Crustaceans and Molluscs were recorded. The Molluscans were the most dominant organisms amounting to 41% and between  this, Polychaetes above contributed to the tune of 37%. Crustaceans 19% and others 3%. The study area water quality parameters are favorable for juvenile and existence of different biotic communities in the estuary

Improved NP-Inapproximability for 2-Variable Linear Equations

An instance of the 2-Lin(2) problem is a system of equations of the form "x_i + x_j = b (mod 2)". Given such a system in which it\u27s possible to satisfy all but an epsilon fraction of the equations, we show it is NP-hard to satisfy all but a C*epsilon fraction of the equations, for any C < 11/8 = 1.375 (and any 0 < epsilon <= 1/8). The previous best result, standing for over 15 years, had 5/4 in place of 11/8. Our result provides the best known NP-hardness even for the Unique Games problem, and it also holds for the special case of Max-Cut. The precise factor 11/8 is unlikely to be best possible; we also give a conjecture concerning analysis of Boolean functions which, if true, would yield a larger hardness factor of 3/2. Our proof is by a modified gadget reduction from a pairwise-independent predicate. We also show an inherent limitation to this type of gadget reduction. In particular, any such reduction can never establish a hardness factor C greater than 2.54. Previously, no such limitation on gadget reductions was known

Role of Viral Genetics in Dengue Epidemiological Fitness

Ph.DDOCTOR OF PHILOSOPH

PERSONAL PLANNER (PERPLAN)-MOBILE APPLICATION

This project is a mobile application called PerPlan. The main purpose of developing the PerPlan is to cater features like tracking activities daily or monthly, managing and tracking finances of events as well as generating graphs to visualize the finances of an event in one platform instead of alternating apps back and forth for these features. There are also features that enable the user to retrieve backdated activities in the system with a simple search mechanism. This search mechanism, in turn, will fetch details according to the types of activities from the database. Besides that, there are challenges in the proposed project which are structuring logic for tracking daily activities, managing finances based on existing events, and appropriate graphs to visualize data. The existing issues of digital planners in the current market is the stepping stone to the development of PerPlan. Issues such as free limited features for usage like Google Calendar or orientated toward project management like Trello. User from different background or field of work finds it difficult to comprehend how to use these planners. Free accounts can only be used for a specific timeframe. Thus, these are the reasons which have contributed to the development of this project. In order to solve these issues, the PerPlan app is the solution since it is designed in a way that has the capability to resolve most of the issues. For a user to utilize the offered features in this project, they are required to have a registered account in the system. PerPlan is built using the Rapid Application Development method since it does not consume time as much as other approaches. This method is chosen because it is iterative in nature and able to support application development in a short timeframe. It also allows the developer to make changes as the project progresses which affects the project schedule