Multicenter, randomized study to optimize bowel for colon capsule endoscopy

AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy (CCE) bowel preparation regimen. METHODS This was a multicenter, prospective, randomized, controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system (PillCam® COLON 2; Medtronic, Yoqneam, Israel) was utilized. Preparation regimens differed in the 1st and 2nd boosts with the Study regimen using oral sulfate solution (89 mL) with diatrizoate meglumine and diatrizoate sodium solution (“diatrizoate solution”) (boost 1 = 60 mL, boost 2 = 30 mL) and the Control regimen oral sulfate solution (89 mL) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety, polyp detection, colonic transit, CCE completion and capsule excretion = 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon (Adequate: Study = 75.9%, Control = 77.3%; P = 0.88) and individual segments. In the Study group, CCE completion was superior (Study = 90.9%, Control = 76.9%; P = 0.048) and colonic transit was more often \u3c 40 min (Study = 21.8%, Control = 4%; P = 0.0073). More Study regimen subjects experienced adverse events (Study = 19.4%, Control = 3.4%; P = 0.0061), and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen, but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract, from ingestion to excretion, was shorter with the Study regimen while mean colonic transit times were similar for both study groups. CONCLUSION A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective, safe, and achieved superior CCE completion. © The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved

Maximum weight cycle packing in directed graphs, with application to kidney exchange programs

Centralized matching programs have been established in several countries to organize kidney exchanges between incompatible patient-donor pairs. At the heart of these programs are algorithms to solve kidney exchange problems, which can be modelled as cycle packing problems in a directed graph, involving cycles of length 2, 3, or even longer. Usually, the goal is to maximize the number of transplants, but sometimes the total benefit is maximized by considering the differences between suitable kidneys. These problems correspond to computing cycle packings of maximum size or maximum weight in directed graphs. Here we prove the APX-completeness of the problem of finding a maximum size exchange involving only 2-cycles and 3-cycles. We also present an approximation algorithm and an exact algorithm for the problem of finding a maximum weight exchange involving cycles of bounded length. The exact algorithm has been used to provide optimal solutions to real kidney exchange problems arising from the National Matching Scheme for Paired Donation run by NHS Blood and Transplant, and we describe practical experience based on this collaboration

3D Volumetric Modeling and Microvascular Reconstruction of Irradiated Lumbosacral Defects after Oncologic Resection

Background: Locoregional flaps are sufficient in most sacral reconstructions. However, large sacral defects due to malignancy necessitate a different reconstructive approach, with local flaps compromised by radiation and regional flaps inadequate for broad surface areas or substantial volume obliteration. In this report, we present our experience using free muscle transfer for volumetric reconstruction in such cases, and demonstrate 3D haptic models of the sacral defect to aid preoperative planning.Methods: Five consecutive patients with irradiated sacral defects secondary to oncologic resections were included, surface area ranging from 143-600cm2. Latissimus dorsi-based free flap sacral reconstruction was performed in each case, between 2005 and 2011. Where the superior gluteal artery was compromised, the subcostal artery was used as a recipient vessel. Microvascular technique, complications and outcomes are reported. The use of volumetric analysis and 3D printing is also demonstrated, with imaging data converted to 3D images suitable for 3D printing with Osirix software (Pixmeo, Geneva, Switzerland). An office-based, desktop 3D printer was used to print 3D models of sacral defects, used to demonstrate surface area and contour and produce a volumetric print of the dead space needed for flap obliteration. Results: The clinical series of latissimus dorsi free flap reconstructions is presented, with successful transfer in all cases, and adequate soft-tissue cover and volume obliteration achieved. The original use of the subcostal artery as a recipient vessel was successfully achieved. All wounds healed uneventfully. 3D printing is also demonstrated as a useful tool for 3D evaluation of volume and dead-space.Conclusion: Free flaps offer unique benefits in sacral reconstruction where local tissue is compromised by irradiation and tumor recurrence, and dead-space requires accurate volumetric reconstruction. We describe for the first time the use of the subcostal artery as a recipient in free flap sacral reconstruction. 3D printing of haptic bio-models is a rapidly evolving field with a substantial role in preoperative planning

REVISITING THE PHILIPPINE BS PHARMACY CURRICULUM AFTER 13 YEARS: A SURVEY ON PHARMACIST PRACTITIONERS FOR THE UPCOMING CURRICULUM REVISION

The objective of this study is to supposedly investigate the current 4-year BS Pharmacy curriculum in the Philippines in relation to the eventual shift to a 5-year BS Pharmacy curriculum by 2018 which did not materialize including modifications in the curricular topics and internship strategies. To do this, a cross-sectional study was done using purposive sampling answered by 119 practicing Filipino Pharmacists from the different areas of practice and regions in the Philippines. About this study, 72.88% prevalence rate of those who agree and strongly agree of the BS Pharmacy curriculum shift to a 5-year program was evident. There is also a strong percentage (highest subject is 98.6% and lowest subject is 59.3%) calling for improvement on all curricular topics. On the other hand, 63.3% of the respondents agree that increasing specialty rotations during internship would be more appropriate internship strategy but the new curriculum increases the internship hours instead that only gathers 4.6% support, the lowest among the options. It can be concluded, that it is only appropriate to shift to the 5-year BS Pharmacy program based on the perception of the respondents and improvement of all curricular topics must come with it.  Article visualizations

Kinematic properties of early-type galaxy haloes using planetary nebulae

We present new planetary nebulae (PNe) positions, radial velocities, and magnitudes for 6 early-type galaxies obtained with the Planetary Nebulae Spectrograph, their two-dimensional velocity and velocity dispersion fields. We extend this study to include an additional 10 early-type galaxies with PNe radial velocity measurements available from the literature, to obtain a broader description of the outer-halo kinematics in early-type galaxies. These data extend the information derived from stellar kinematics to typically up to ~8 Re. The combination of photometry, stellar and PNe kinematics shows: i) good agreement between the PNe number density and the stellar surface brightness in the region where the two data sets overlap; ii) good agreement between PNe and stellar kinematics; iii) that the mean rms velocity profiles fall into two groups: with of the galaxies characterized by slowly decreasing profiles and the remainder having steeply falling profiles; iv) a larger variety of velocity dispersion profiles; v) that twists and misalignments in the velocity fields are more frequent at large radii, including some fast rotators; vi) that outer haloes are characterised by more complex radial profiles of the specific angular momentum-related lambda_R parameter than observed within 1Re; vii) that many objects are more rotationally dominated at large radii than in their central parts; and viii) that the halo kinematics are correlated with other galaxy properties, such as total luminosity, isophotal shape, total stellar mass, V/sigma, and alpha parameter, with a clear separation between fast and slow rotators.Comment: 36 pages, 21 figures, revised version for MNRA

Search for Low Scale Gravity Effects in e+e- Collisions at LEP

Recent theories propose that quantum gravity effects may be observable at LEP energies via gravitons that couple to Standard Model particles and propagate into extra spatial dimensions. The associated production of a graviton and a photon is searched for as well as the effects of virtual graviton exchange in the processes: e+e- -> gamma gamma, ZZ, WW, mu mu, tau tau, qq and ee No evidence for this new interaction is found in the data sample collected by the L3 detector at LEP at centre-of-mass energies up to 183 GeV. Limits close to 1 TeV on the scale of this new scenario of quantum gravity are set

Search for Charginos with a Small Mass Difference with the Lightest Supersymmetric Particle at \sqrt{s} = 189 GeV

A search for charginos nearly mass-degenerate with the lightest supersymmetric particle is performed using the 176 pb^-1 of data collected at 189 GeV in 1998 with the L3 detector. Mass differences between the chargino and the lightest supersymmetric particle below 4 GeV are considered. The presence of a high transverse momentum photon is required to single out the signal from the photon-photon interaction background. No evidence for charginos is found and upper limits on the cross section for chargino pair production are set. For the first time, in the case of heavy scalar leptons, chargino mass limits are obtained for any \tilde{\chi}^{+-}_1 - \tilde{\chi}^0_1 mass difference

Operational experience on the generation and control of high brightness electron bunch trains at SPARC-LAB

Sub-picosecond, high-brightness electron bunch trains are routinely produced at SPARC-LAB via the velocity bunching technique. Such bunch trains can be used to drive multi-color Free Electron Lasers (FELs) and plasma wake field accelerators. In this paper we present recent results at SPARC-LAB on the generation of such beams, highlighting the key points of our scheme. We will discuss also the on-going machine upgrades to allow driving FELs with plasma accelerated beams or with short electron pulses at an increased energy