Leonard Wood: Forgotten Greatness

Leonard Wood: Rough Rider, Surgeon, Architect of American Imperialism, by Jack McCallu

Small intestinal bacterial overgrowth in irritable bowel syndrome: are there any predictors?

<p>Abstract</p> <p>Background</p> <p>Small intestinal bacterial overgrowth (SIBO) is a condition in which excessive levels of bacteria, mainly the colonic-type species are present in the small intestine. Recent data suggest that SIBO may contribute to the pathophysiology of Irritable bowel syndrome (IBS). The purpose of this study was to identify potential predictors of SIBO in patients with IBS.</p> <p>Methods</p> <p>Adults with IBS based on Rome II criteria who had predominance of bloating and flatulence underwent a glucose breath test (GBT) to determine the presence of SIBO. Breath samples were obtained at baseline and at 30, 45, 60, 75 and 90 minutes after ingestion of 50 g of glucose dissolved in 150 mL of water. Results of the glucose breath test, which measures hydrogen and methane levels in the breath, were considered positive for SIBO if 1) the hydrogen or methane peak was >20 ppm when the baseline was <10 ppm, or 2) the hydrogen or methane peak increased by 12 ppm when baseline was ≥10 ppm.</p> <p>Results</p> <p>Ninety-eight patients were identified who underwent a GBT (mean age, 49 y; 78% female). Thirty-five patients (36%) had a positive GBT result suggestive of SIBO. A positive GBT result was more likely in patients >55 years of age (odds ratio [OR], 3.6; 95% confidence interval [CI], 1.4-9.0) and in females (OR, 4.0; 95% CI, 1.1-14.5). Hydrogen was detected more frequently in patients with diarrhea-predominant IBS (OR, 8; 95% CI, 1.4-45), and methane was the main gas detected in patients with constipation-predominant IBS (OR, 8; 95% CI, 1.3-44). There was no significant correlation between the presence of SIBO and the predominant bowel pattern or concurrent use of tegaserod, proton pump inhibitors, or opiate analgesics.</p> <p>Conclusions</p> <p>Small intestinal bacterial overgrowth was present in a sizeable percentage of patients with IBS with predominance of bloating and flatulence. Older age and female sex were predictors of SIBO in patients with IBS. Identification of possible predictors of SIBO in patients with IBS could aid in the development of successful treatment plans.</p

Gastroparesis secondary to a demyelinating disease: a case series

BACKGROUND: Gastroparesis has a number of etiologies. The main ones are secondary to a complication from diabetes mellitus, related to post vagotomy or post gastric surgical resections, or idiopathic when the etiology is unclear. Gastroparesis secondary to a demyelinating disease of the brain is unusual. CASE PRESENTATION: A 22-year-old woman was referred for acute onset of intractable nausea and vomiting. She also had cerebellar deficits, dysphagia and paresthesias. Magnetic resonance imaging (MRI) of the brain revealed an isolated area of demyelination in the medullary region. Another 24-year-old woman had a similar presentation with right hemiplegia and MRI of the brain revealed a distal medullary region. Both these patients had an abnormal gastric emptying test. Gastroparesis and neurological deficits improved with intravenous corticosteroids. While the former patient has had no further recurrences, the latter patient developed multiple sclerosis within three months of presentation. CONCLUSION: A demyelinating disease is a rare cause gastropareis, but should be suspected when symptoms of gastroparesis are associated with neurological deficits. MRI might help in the diagnosis and intravenous coriticosteroids can address the underlying disease process and improve gastric emptying, especially when used early during the course of the disease

A sociological approach to Christian-Muslim relations

The increasingly politicized presence of Muslim communities in Britain today is raising issues not only for society in general but for other faith communities as well. Among these the Evangelical constituency, including the members of various Christian diasporas, is struggling to find a coherent response which is true to its Bible-based, activist roots. This thesis discusses the relationship of religion to the theoretical notion of the public sphere. Specifically it hypothesizes an Evangelical micro public sphere as the framework for an empirical exploration of the responses of British Evangelicals to Muslims since the events of 11th September 2001. It describes the formation, composition and discourse of this sphere drawing on data gathered from books, articles, lectures and interviews with key participants. The data reveal a marked tension, indeed a polarization, amongst Evangelicals, with an increasingly sharp disagreement between ‘confrontationalists’ and ‘conciliators’. A detailed analysis of the interaction of this sphere with Muslims, the national media and church leaders follows, leading to a concluding discussion of the future trajectory of the British Evangelical movement. Whilst it is still too early to say whether Evangelicalism will be strengthened or weakened, its encounter with Islam is likely to be an increasingly significant factor in British public life for the foreseeable future.Spalding TrustSir Richard Stapley Educational TrustSt Lukes College Foundatio

Uplink Non-Orthogonal Multiple Access with Finite-Alphabet Inputs

This paper focuses on the non-orthogonal multiple access (NOMA) design for a classical two-user multiple access channel (MAC) with finite-alphabet inputs. We consider practical quadrature amplitude modulation (QAM) constellations at both transmitters, the sizes of which are assumed to be not necessarily identical. We propose to maximize the minimum Euclidean distance of the received sum-constellation with a maximum likelihood (ML) detector by adjusting the scaling factors (i.e., instantaneous transmitted powers and phases) of both users. The formulated problem is a mixed continuous-discrete optimization problem, which is nontrivial to resolve in general. By carefully observing the structure of the objective function, we discover that Farey sequence can be applied to tackle the formulated problem. However, the existing Farey sequence is not applicable when the constellation sizes of the two users are not the same. Motivated by this, we define a new type of Farey sequence, termed punched Farey sequence. Based on this, we manage to achieve a closed-form optimal solution to the original problem by first dividing the entire feasible region into a finite number of Farey intervals and then taking the maximum over all the possible intervals. The resulting sum-constellation is proved to be a regular QAM constellation of a larger size. Moreover, the superiority of NOMA over time-division multiple access (TDMA) in terms of minimum Euclidean distance is rigorously proved. Furthermore, the optimal rate allocation among the two users is obtained in closed-form to further maximize the obtained minimum Euclidean distance of the received signal subject to a total rate constraint. Finally, simulation results are provided to verify our theoretical analysis and demonstrate the merits of the proposed NOMA over existing orthogonal and non-orthogonal designs.Comment: Submitted for possible journal publicatio

AAC Viewfield Hard Red Spring Wheat

AAC Viewfield hard red spring wheat (Triticum aestivum L.) has grain yield significantly higher than the check cultivars Katepwa and Lillian and is similar to Carberry. AAC Viewfield matures significantly later than Katewpa and Lillian but is similar to Carberry. AAC Viewfield has an awned spike, a low lodging score indicative of strong straw, and significantly shorter plant stature than all checks. AAC Viewfield expressed resistance to prevalent races of yellow rust and stem rust, moderate resistance to leaf rust and common bunt, and intermediate resistance to Fusarium head blight. AAC Viewfield has quality attributes within the range of the check cultivars and is eligible for grades of Canada Western Red Spring

Endemic Infection of the Amphibian Chytrid Fungus in a Frog Community Post-Decline

The chytrid fungus Batrachochytrium dendrobatidis has been implicated in the decline and extinction of numerous frog species worldwide. In Queensland, Australia, it has been proposed as the cause of the decline or apparent extinction of at least 14 high-elevation rainforest frog species. One of these, Taudactylus eungellensis, disappeared from rainforest streams in Eungella National Park in 1985–1986, but a few remnant populations were subsequently discovered. Here, we report the analysis of B. dendrobatidis infections in toe tips of T. eungellensis and sympatric species collected in a mark-recapture study between 1994 and 1998. This longitudinal study of the fungus in individually marked frogs sheds new light on the effect of this threatening infectious process in field, as distinct from laboratory, conditions. We found a seasonal peak of infection in the cooler months, with no evidence of interannual variation. The overall prevalence of infection was 18% in T. eungellensis and 28% in Litoria wilcoxii/jungguy, a sympatric frog that appeared not to decline in 1985–1986. No infection was found in any of the other sympatric species. Most importantly, we found no consistent evidence of lower survival in T. eungellensis that were infected at the time of first capture, compared with uninfected individuals. These results refute the hypothesis that remnant populations of T. eungellensis recovered after a B. dendrobatidis epidemic because the pathogen had disappeared. They show that populations of T. eungellensis now persist with stable, endemic infections of B. dendrobatidis