Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial

Background: Postoperative ileus is a common condition after abdominal surgery. Many prokinetic drugs have been evaluated including osmotic laxatives. The data on colon-stimulating laxatives are scarce. This prospective, randomized, double-blind trial investigates the effect of the colon-stimulating laxative bisacodyl on postoperative ileus in elective colorectal resections. Materials and methods: Between November 2004 and February 2007, 200 consecutive patients were randomly assigned to receive either bisacodyl or placebo. Primary endpoint was time to gastrointestinal recovery (mean time to first flatus passed, first defecation, and first solid food tolerated; GI-3). Secondary endpoints were incidence and duration of nasogastric tube reinsertion, incidence of vomiting, length of hospital stay, and visual analogue scores for pain, cramps, and nausea. Results: One hundred sixty-nine patients were analyzed, and 31 patients discontinued the study. Groups were comparable in baseline demographics. Time to GI-3 was significantly shorter in the bisacodyl group (3.0 versus 3.7days, P = 0.007). Of the single parameters defining GI-3, there was a 1-day difference in time to defecation in favor to the bisacodyl group (3.0 versus 4.0days, P = 0.001), whereas no significant difference in time to first flatus or tolerance of solid food was seen. No significant difference in the secondary endpoints was seen. Morbidity and mortality did not differ between groups. Conclusion: Bisacodyl accelerated gastrointestinal recovery and might be considered as part of multimodal recovery programs after colorectal surger

Hamilton-Jacobi Counterterms for Einstein-Gauss-Bonnet Gravity

The on-shell gravitational action and the boundary stress tensor are essential ingredients in the study of black hole thermodynamics. We employ the Hamilton-Jacobi method to calculate the boundary counterterms necessary to remove the divergences and allow the study of the thermodynamics of Einstein-Gauss-Bonnet black holes.Comment: 21 pages, LaTe

The influence of the deposition parameters on the porosity of thin alumina films on steel

The influence of the deposition parameters on the porosity of thin alumina films electrophoretically deposited on steel from aqueous suspensions was investigated. The effects of the applied voltage, deposition time, suspension temperature and the solid content of the aqueous suspension on the porosity of the obtained alumina films have been determined using optical microscopy coupled with image analysis. It was shown that the lowest film porosity was obtained from a suspension containing 20 wt.% alumina powder at the lowest applied voltage (30 V), for a longer deposition time (10 min) using a suspension temperature of 30 degreesC. This behavior can be explained by the smaller amount of hydrogen evolved on the cathode during the electrophoretic deposition process

IntAct:intra-operative fluorescence angiography to prevent anastomotic leak in rectal cancer surgery: a randomized controlled trial

Aim Anastomotic leak (AL) is a major complication of rectal cancer surgery. Despite advances in surgical practice, the rates of AL have remained static, at around 10–15%. The aetiology of AL is multifactorial, but one of the most crucial risk factors, which is mostly under the control of the surgeon, is blood supply to the anastomosis. The MRC/NIHR IntAct study will determine whether assessment of anastomotic perfusion using a fluorescent dye (indocyanine green) and near‐infrared laparoscopy can minimize the rate of AL leak compared with conventional white‐light laparoscopy. Two mechanistic sub‐studies will explore the role of the rectal microbiome in AL and the predictive value of CT angiography/perfusion studies. Method IntAct is a prospective, unblinded, parallel‐group, multicentre, European, randomized controlled trial comparing surgery with intra‐operative fluorescence angiography (IFA) against standard care (surgery with no IFA). The primary end‐point is rate of clinical AL at 90 days following surgery. Secondary end‐points include all AL (clinical and radiological), change in planned anastomosis, complications and re‐interventions, use of stoma, cost‐effectiveness of the intervention and quality of life. Patients should have a diagnosis of adenocarcinoma of the rectum suitable for potentially curative surgery by anterior resection. Over 3 years, 880 patients from 25 European centres will be recruited and followed up for 90 days. Discussion IntAct will rigorously evaluate the use of IFA in rectal cancer surgery and explore the role of the microbiome in AL and the predictive value of preoperative CT angiography/perfusion scanning

Generalizing Galileons

The Galileons are a set of terms within four-dimensional effective field theories, obeying symmetries that can be derived from the dynamics of a 3+1-dimensional flat brane embedded in a 5-dimensional Minkowski Bulk. These theories have some intriguing properties, including freedom from ghosts and a non-renormalization theorem that hints at possible applications in both particle physics and cosmology. In this brief review article, we will summarize our attempts over the last year to extend the Galileon idea in two important ways. We will discuss the effective field theory construction arising from co-dimension greater than one flat branes embedded in a flat background - the multiGalileons - and we will then describe symmetric covariant versions of the Galileons, more suitable for general cosmological applications. While all these Galileons can be thought of as interesting four-dimensional field theories in their own rights, the work described here may also make it easier to embed them into string theory, with its multiple extra dimensions and more general gravitational backgrounds.Comment: 16 pages; invited brief review article for a special issue of Classical and Quantum Gravity. Submitted to CQ

Gravity duals for logarithmic conformal field theories

Logarithmic conformal field theories with vanishing central charge describe systems with quenched disorder, percolation or dilute self-avoiding polymers. In these theories the energy momentum tensor acquires a logarithmic partner. In this talk we address the construction of possible gravity duals for these logarithmic conformal field theories and present two viable candidates for such duals, namely theories of massive gravity in three dimensions at a chiral point.Comment: 15 pages, 1 figure, invited plenary talk at the First Mediterranean Conference on Classical and Quantum Gravity, v2: published version, corrected typo in left eq. (5

What kind of illness is anorexia nervosa? Revisited: some preliminary thoughts to finding a cure.

Two decades have elapsed since our publication of 'What kind of illness is anorexia nervosa?'. The question remains whether our understanding of anorexia nervosa and its treatment thereof has evolved over this time. The verdict is disappointing at best. Our current gold standard treatments remain over-valued and clinical outcomes are modest at best. Those in our field are haunted by the constant reminder that anorexia nervosa carries the highest mortality rate of any psychiatric disorder. This cannot continue and demands immediate action. In this essay, we tackle the myths that bedevil our field and explore a deeper phenotyping of anorexia nervosa. We argue that we can no longer declare agnostic views of the disorder or conceive treatments that are "brainless": it is incumbent upon us to challenge the prevailing zeitgeist and reconceptualise anorexia nervosa. Here we provide a roadmap for the future

Cross-frequency coupling of brain oscillations in studying motivation and emotion

Research has shown that brain functions are realized by simultaneous oscillations in various frequency bands. In addition to examining oscillations in pre-specified bands, interactions and relations between the different frequency bandwidths is another important aspect that needs to be considered in unraveling the workings of the human brain and its functions. In this review we provide evidence that studying interdependencies between brain oscillations may be a valuable approach to study the electrophysiological processes associated with motivation and emotional states. Studies will be presented showing that amplitude-amplitude coupling between delta-alpha and delta-beta oscillations varies as a function of state anxiety and approach-avoidance-related motivation, and that changes in the association between delta-beta oscillations can be observed following successful psychotherapy. Together these studies suggest that cross-frequency coupling of brain oscillations may contribute to expanding our understanding of the neural processes underlying motivation and emotion