Endoluminal calprotectin measurement in assessment of pouchitis and a new index of disease activity. A pilot study

Pouchitis is the most common complication following proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis (UC). To provide a standardized definition of pouchitis clinical, endoscopic and histological markers were grouped and weighted in the pouch disease activity index (PDAI). However, the delay in the assessment of the final score due to the time requested for histological analysis remains the main obstacle to the index implementation in clinical practice so that the use of modified-PDAI (mPDAI) with exclusion of histologic subscore has been proposed. We tested the ability of calprotectin measurement in the pouch endoluminal content to mimic the histologic score as defined in the PDAI, the index that we adopted as gold standard for pouchitis diagnosis. Calprotectin was measured by ELISA in the pouch endoluminal content collected during endoscopy in 40 consecutive patients with J-pouch. In each patient PDAI and mPDAI were calculated and 15% of patients were erroneously classified by mPDAI. ROC analysis of calprotectin values vs. acute histological subscore 3 identified different calprotectin cut-off values with corresponding sensitivity and specificity allowing the definition and scoring of different range of calprotectin subscores. We incorporated the calprotectin score in the mPDAI obtaining a new score that shows the same specificity as PDAI for diagnosis of pouchitis and higher sensitivity when compared with mPDAI. The use of the proposed new score, once validated in a larger series of patients, might be useful in the early management of patients with symptoms of pouchitis

Identification of the TeV Gamma-ray Source ARGO J2031+4157 with the Cygnus Cocoon

The extended TeV gamma-ray source ARGO J2031+4157 (or MGRO J2031+41) is positionally consistent with the Cygnus Cocoon discovered by $Fermi$-LAT at GeV energies in the Cygnus superbubble. Reanalyzing the ARGO-YBJ data collected from November 2007 to January 2013, the angular extension and energy spectrum of ARGO J2031+4157 are evaluated. After subtracting the contribution of the overlapping TeV sources, the ARGO-YBJ excess map is fitted with a two-dimensional Gaussian function in a square region of $10^{\circ}\times 10^{\circ}$, finding a source extension $\sigma_{ext}$= 1$^{\circ}$.8$\pm$0$^{\circ}$.5. The observed differential energy spectrum is $dN/dE =(2.5\pm0.4) \times 10^{-11}(E/1 TeV)^{-2.6\pm0.3}$ photons cm$^{-2}$ s$^{-1}$ TeV$^{-1}$, in the energy range 0.2-10 TeV. The angular extension is consistent with that of the Cygnus Cocoon as measured by $Fermi$-LAT, and the spectrum also shows a good connection with the one measured in the 1-100 GeV energy range. These features suggest to identify ARGO J2031+4157 as the counterpart of the Cygnus Cocoon at TeV energies. The Cygnus Cocoon, located in the star-forming region of Cygnus X, is interpreted as a cocoon of freshly accelerated cosmic rays related to the Cygnus superbubble. The spectral similarity with Supernova Remnants indicates that the particle acceleration inside a superbubble is similar to that in a SNR. The spectral measurements from 1 GeV to 10 TeV allows for the first time to determine the possible spectrum slope of the underlying particle distribution. A hadronic model is adopted to explain the spectral energy distribution.Comment: 16 pages, 3 figures, has been accepted by ApJ for publicatio

Co-Incineration of Textile ETP Sludge in Captive Power House Boiler

The ETP Sludge generated by Raymond Textile Ltd.  Boregaon District – Chhindwara India is Co-incinerated in the Captive Power House Boiler in irreversible and environmental sound manner without influencing emissions on partial replacement of traditial fuel. Co-incineration benefits upgrade waste management, reduce environmental impacts, improver the industrial sector’s competitiveness decreases largely the cost of waste management of ETP sludge. The analysis results of the stack parameters revealed that the emission values are well below the standards set by Central Pollution Control Board for the common Hazardous Waste Incinerations. The Captive Power House perforce requires high temperature in the boiler around 10000C. Such high temperature conditions ensure no noxious emission during the co-incineration of the waste materials.ÂÂ

Combined use of x-ray fluorescence microscopy, phase contrast imaging for high resolution quantitative iron mapping in inflamed cells

X-ray fluorescence microscopy (XRFM) is a powerful technique to detect and localize elements in cells. To derive information useful for biology and medicine, it is essential not only to localize, but also to map quantitatively the element concentration. Here we applied quantitative XRFM to iron in phagocytic cells. Iron, a primary component of living cells, can become toxic when present in excess. In human fluids, free iron is maintained at 10-18 M concentration thanks to iron binding proteins as lactoferrin (Lf). The iron homeostasis, involving the physiological ratio of iron between tissues/secretions and blood, is strictly regulated by ferroportin, the sole protein able to export iron from cells to blood. Inflammatory processes induced by lipopolysaccharide (LPS) or bacterial pathoge inhibit ferroportin synthesis in epithelial and phagocytic cells thus hindering iron export, increasing intracellular iron and bacterial multiplication. In this respect, Lf is emerging as an important regulator of both iron and inflammatory homeostasis. Here we studied phagocytic cells inflamed by bacterial LPS and untreated or treated with milk derived bovine Lf. Quantitative mapping of iron concentration and mass fraction at high spatial resolution is obtained combining X-ray fluorescence microscopy, atomic force microscopy and synchrotron phase contrast imaging

Finding your own way around: Experiences of health and social care provision for people with a visual impairment in the United Kingdom

Abstract The systems of support for people with a visual impairment in the UK are complex and can be difficult to access, involving input from a range of health and social care services. In this paper we report qualitative findings from research looking at people's experiences of accessing health and social care services. These highlight the inconsistencies and variability in current systems of support for people with a visual impairment, and show that access to services is largely dependent on the agency and initiative of individual service users in establishing networks of support for themselves. This means that those who are less able to do this may find themselves without the support necessary to maintain or improve their quality of life. We argue that health and social care agencies need to be more proactive in addressing the support needs of people with a visual impairment beyond the point of initial diagnosis or registration

From toothpick legs to dropping vaginas: Gender and sexuality in Joan Rivers' stand-up comedy performance

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2011 Intellect.This article employs sociocultural analysis to examine Joan Rivers’ stand-up comedy performances in order to reveal how she successfully operates in a sphere of artistic expression that has been, and continues to be, male-dominated. The analysis uncovers how Rivers’ stand-up comedy performance involves a complex combination of elements and how it fuses features that are regarded as ‘traditionally masculine’, such as aggression, with features frequently used by other female stand-up comedians, such as self-deprecating comedy and confessional comedy. Furthermore, the analysis exposes the complex ways in which constructions of gender and sexuality are negotiated and re-negotiated in Rivers’ stand-up comedy performance, and illustrates how dominant ideological identity constructions can be simultaneously reinforced and subverted within the same comic moment

Agreement between questionnaires and registry data on routes to diagnosis and milestone dates of the cancer diagnostic pathway

BACKGROUND The routes to diagnosis and the time intervals along the diagnostic pathway affect cancer outcomes. Some data on routes to diagnosis and milestone dates can be extracted from registries or databases. When this data is incomplete, inaccurate or non-existing, other data sources are needed. This study investigates the agreement between multiple data sources on routes to diagnosis and milestone dates of cancer pathway. METHODS Information on routes to diagnosis and milestone dates were compared across four data sources (cancer patients, general practitioners, cancer specialists and registries) for breast, colorectal, lung and ovarian cancers across the UK, Scandinavia, Canada and Australia. Agreement on routes to diagnosis and milestone dates was assessed by Kappa and AC1 coefficients and Lin’s concordance correlation coefficient (CCC). RESULTS 4502 patients were included in the analysis of routes to diagnosis. The agreement was almost perfect (kappa = 0.15–0.88, AC1 = 0.86–0.91) for breast cancer, substantial to almost perfect (kappa = 0.07–0.86, AC1 = 0.74–0.93) for colorectal and ovarian cancers, and substantial (kappa = 0.09–0.11, AC1 = 0.65–0.74) for lung cancer. 2287 patients were included in the analysis of milestone dates. The agreement was adequate for all cancer types (CCC = 0.88–0.99); highest agreement was seen for date of diagnosis (CCC = 0.94–0.99). CONCLUSION We found a reasonable agreement between patient/physician questionnaires and registry data for routes to diagnosis and milestone dates. The agreement on routes to diagnosis was generally higher for breast cancer than for colorectal, ovarian and lung cancers. Lower agreement was seen on date of first presentation to primary care and date of treatment initiation compared to date of diagnosis

SEARCH FOR GeV GAMMA-RAY BURSTS WITH THE ARGO-YBJ DETECTOR: SUMMARY OF EIGHT YEARS OF OBSERVATIONS

The search for gamma-ray burst (GRB) emission in the energy range of 1-100 GeV in coincidence with the satellite detection has been carried out using the Astrophysical Radiation with Ground-based Observatory at YangBaJing (ARGO-YBJ) experiment. The high-altitude location (4300 m a.s.l.), the large active surface (~6700 m2 of Resistive Plate Chambers), the wide field of view (~2 sr, limited only by the atmospheric absorption), and the high duty cycle (>86%) make the ARGO-YBJ experiment particularly suitable to detect short and unexpected events like GRBs. With the scaler mode technique, i.e., counting all the particles hitting the detector with no measurement of the primary energy and arrival direction, the minimum threshold of ~1 GeV can be reached, overlapping the direct measurements carried out by satellites. During the experiment lifetime from 2004 December 17 to 2013 February 7, a total of 206 GRBs occurring within the ARGO-YBJ field of view (zenith angle θ ≤ 45°) have been analyzed. This is the largest sample of GRBs investigated with a ground-based detector. Two light curve models have been assumed and since in both cases no significant excess has been found, the corresponding fluence upper limits in the 1-100 GeV energy region have been derived, with values as low as 10–5 erg cm–2. The analysis of a subset of 24 GRBs with known redshift has been used to constrain the fluence extrapolation to the GeV region together with possible cutoffs under different assumptions on the spectrum