Dietary treatment of Crohn’s disease: perceptions of families with children treated by exclusive enteral nutrition, a questionnaire survey

Background: Diet is strongly associated with the aetiology of Crohn’s Disease (CD) and exclusive enteral nutrition (EEN) is the primary induction treatment in paediatric CD. This study explored opinions around the use of EEN and alternative novel, solid food-based diets (SFDs) expressed by paediatric patients with CD, previously treated with EEN and their parents. Methods: This anonymous questionnaire surveyed families of CD patients treated with EEN over 1 year. Two questionnaire forms were completed; one asking the patients’ opinions and another referring to their main carer. This questionnaire explored participants’ demographic characteristics; acceptability of a repeat EEN course to treat a future flare (EEN repeat); their opinion on how difficult EEN would be compared to an example SFD; and their intention to participate in a future clinical trial assessing the therapeutic efficacy of an SFD in CD. Results: Forty-one families of CD patients were approached with 29 sending replies (71%). Most of our participants were positive on completing another EEN course, however the majority would choose an SFD alternative (Patients: 66, Parents:72%). Both patients and their parents rated EEN to be more difficult to adhere to compared to an example SFD (p < 0.05), and their ratings were strongly correlated (EEN:r = 0.83, SFD:r = 0.75, p < 0.001). The majority of our respondents would agree to participate in a clinical trial assessing an SFD’s effectiveness (Patients:79, Parents:72%) for the management of active CD. Conclusions: While patients with CD and their families would accept an EEN repeat, the majority would prefer an SFD alternative. CD families surveyed are supportive of the development of solid food-based dietary treatments

Beta Samati: discovery and excavation of an Aksumite town

The Empire of Aksum was one of Africa's most influential ancient civilisations. Traditionally, most archaeological fieldwork has focused on the capital city of Aksum, but recent research at the site of Beta Samati has investigated a contemporaneous trade and religious centre located between Aksum and the Red Sea. The authors outline the discovery of the site and present important finds from the initial excavations, including an early basilica, inscriptions and a gold intaglio ring. From daily life and ritual praxis to international trade, this work illuminates the role of Beta Samati as an administrative centre and its significance within the wider Aksumite world

Safety and efficacy of recombinant activated coagulation factor VII in congenital hemophilia with inhibitors in the home treatment setting: A review of clinical studies and registries

Self‐administration of factor and bypassing agents by persons with hemophilia in the home setting is recommended to facilitate earlier intervention after bleeding episodes. The objective of this review was to summarize recombinant activated coagulation factor VII (rFVIIa) safety and efficacy data from clinical trials and patient registries documenting use in the home treatment setting in people with congenital hemophilia with inhibitors (CHwI). A total of 16 studies and registries were identified for inclusion; 14 evaluated on‐demand treatment of acute bleeding episodes (865 patients, 9024 bleeding episodes) and 2 evaluated use for secondary prophylaxis (108 patients, 42,861 prophylaxis days). In the on‐demand studies, efficacy was consistently high (81%‐96%), and thrombotic events were uncommon (n = 3). In the secondary prophylaxis studies, rFVIIa was associated with a 45% to 59% reduction in bleeding episodes and no thrombotic events. These data support the clinical practice of administering rFVIIa in patients in the home treatment setting after initiation under a physician’s care.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138258/1/ajh24811_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138258/2/ajh24811.pd

Processing changes when listening to foreign-accented speech

This study investigates the mechanisms responsible for fast changes in processing foreign-accented speech. Event Related brain Potentials (ERPs) were obtained while native speakers of Spanish listened to native and foreign-accented speakers of Spanish. We observed a less positive P200 component for foreign-accented speech relative to native speech comprehension. This suggests that the extraction of spectral information and other important acoustic features was hampered during foreign-accented speech comprehension. However, the amplitude of the N400 component for foreign-accented speech comprehension decreased across the experiment, suggesting the use of a higher level, lexical mechanism. Furthermore, during native speech comprehension, semantic violations in the critical words elicited an N400 effect followed by a late positivity. During foreign-accented speech comprehension, semantic violations only elicited an N400 effect. Overall, our results suggest that, despite a lack of improvement in phonetic discrimination, native listeners experience changes at lexical-semantic levels of processing after brief exposure to foreign-accented speech. Moreover, these results suggest that lexical access, semantic integration and linguistic re-analysis processes are permeable to external factors, such as the accent of the speaker

Adapting relationships with place: Investigating the evolving place attachment and ‘sense of place’ of UK higher education students during a period of intense transition

In recent years interest has emerged regarding the geographies of higher education students, particularly in patterns of mobility and dispersion. While anecdotal rhetoric suggests a ‘typical student’ exists within UK institutions. What resonates is the notion that students are inherently heterogeneous, experiencing University in differing ways and times according to their circumstances and year of study. This paper uses ‘walking interviews’ conducted with University of Portsmouth students as a method to unpack how ‘non-local’ students might go about interpreting their sense of place within their term-time location. This methodology was designed specifically to ensure discussions of ‘sense of place’ remain directly in the context of the city and recognises the adaptive relationships students have with their term-time locations. This is important as there is a tendency within the literature to focus solely on the transition into University, ignoring that students often experience pressures throughout their degree pathway. These pressures can be linked to various social and spatial changes, such as insecurities regarding fitting in amongst unfamiliar peer groups or a lack of confidence concerning engagement with academic and non-academic practices, and draws attention to the non-linearity of students’ associations with their term-time location

A Systematic Account on Aromatic Hydroxylation by a Cytochrome P450 Model Compound I:A Low-Pressure Mass Spectrometry and Computational Study

Cytochrome P450 enzymes are heme containing mono-oxygenases that mainly react through oxygen atom transfer. Specific features of substrate and oxidant that determine the reaction rate constant for oxygen atom transfer are still poorly understood and, therefore, we did a systematic gas-phase study on reactions by iron(IV)-oxo porphyrin cation radical structures with arenes. We present here the first results obtained by using Fourier transform-ion cyclotron resonance mass spectrometry and provide rate constants and product distributions for the assayed reactions. Product distributions and kinetic isotope effect studies implicate a rate determining aromatic hydroxylation reaction that correlates with the ionization energy of the substrate and no evidence of aliphatic hydroxylation products is observed. To further understand the details of the reaction mechanism, a computational study on a model complex was performed. These studies confirm the experimental hypothesis of dominant aromatic over aliphatic hydroxylation and show that the lack of an axial ligand affects the aliphatic pathways. Moreover, a two parabola valence bond model is used to rationalize the rate constant and identify key properties of the oxidant and substrate that drive the reaction. In particular, the work shows that aromatic hydroxylation rates correlate with the ionization energy of the substrate as well as with the electron affinity of the oxidant

Coupled Motions Direct Electrons along Human Microsomal P450 Chains

Directional electron transfer through biological redox chains can be achieved by coupling reaction chemistry to conformational changes in individual redox enzymes

A Review of Interventions to Reduce Mechanical Restraint and Seclusion among Adult Psychiatric Inpatients

Objective: This review examines nature and effectiveness of interventions to reduce the use of mechanical restraint and seclusion among adult psychiatric inpatients. Method: Electronic searches were conducted to locate post-1960 empirical studies of restraint and seclusion reduction in English. A total of 36 studies were identified, mostly from the USA. Analysis was conducted using a structured data extraction tool. Results: The majority of studies reported reduced levels or mechanical restraint and/or seclusion, but the standard of evidence was poor. There were no randomised trials. Most were retrospective studies of official records before and after the intervention was introduced, with varying follow-up periods. The interventions were diverse, but tended to include one or more of the following: new restraint and/or seclusion policies, staffing changes, staff training, review procedures and crisis management initiatives. The research was unable to address which of these elements was most effective. There was also evidence that some improved outcomes were achieved by substituting restraint or seclusion for each other or for alternatives forms of containment (medication in particular). Nurses’ attitudes, skills and approach to patient care were absent from the literature. Conclusions: Interventions probably can reduce the use of restraint and seclusion, but better designed research is required to demonstrate their effectiveness conclusively. More attention should also be paid to understanding how interventions work, particularly from the perspective of nursing staff. This is essential to the successful implementation of restraint and seclusion interventions across different psychiatric settings and treatment populations