Spinal cord injuries and bowel stomas:timing and satisfaction with stoma formation and alterations in quality of life

STUDY DESIGN: Cross-sectional study.OBJECTIVES: Neurogenic bowel dysfunction (NBD) is frequent among individuals with spinal cord injury (SCI) and is often difficult to treat. A bowel stoma is considered the last-resort treatment option for individuals with SCI and severe NBD. This study aims to explore whether individuals are satisfied with their bowel stoma and how they feel about the timing of stoma formation. Furthermore, we want to explore side effects addressing diversion colitis and changes in quality of life (QOL) after stoma formation.SETTING: Netherlands, community.METHODS: We included participants aged at least 18 years with a traumatic or non-traumatic SCI and bowel stoma. Questions regarding timing of stoma formation, alterations in QOL after stoma formation and experienced side effects of the bowel stoma were addressed in an online questionnaire.RESULTS: In total 23 participants filled out the online survey. Twenty-two participants (96%) were satisfied with their bowel stoma and 83% felt their stoma was placed too late or far too late. The large majority (&gt;80%) reported improvements in the four QOL domains after the procedure. Nine participants reported stoma-related problems in the last month. In the last three months, seven participants (30%) reported to have diversion colitis. Four of these seven participants experienced this at least once a week or more. Two participants stated this had moderate influence on daily activities.CONCLUSIONS: Most participants with SCI experienced improvement in QOL and in retrospect wanted their bowel stoma earlier. Early, extensive conversations to inform individuals about bowel stoma as a treatment option is recommended.</p

VARIATION IN AGGRESSIVENESS AND AFLP AMONG Alternaria solani ISOLATES FROM INDONESIA

Alternaria solani is a necrotroph fungus that causes three-phased diseases in tomato. Management of the pathogen by using resistant cultivars requires knowledge on the aggressiveness and genetic diversity of the fungus. The aims of this study were to isolate A. solani from major tomato and potato producing areas in Indonesia and to study their aggressiveness and genetic variability. Twenty two A. solani isolates were recovered from early blighted tomato and potato in Central and West Java.  A. alternata was also isolated from tomato leaves in West Java and North Sumatra, indicating that early blight in Indonesia may be caused by more than one Alternaria species. Resistance tests of four tomato genotypes to selected A. solani isolates revealed that local isolates were more aggressive in inciting early blight and stem lesion than an imported isolate from USA. This implies that introduced breeding materials must be tested to local isolates to obtain effective resistance genes. Cluster analysis based on amplified fragment length polymorphism (AFLP) obtained from EcoRI+AG and MseI+C primer amplification separated 28 local and Taiwan isolates from the US isolate, which was coincided with aggressiveness separation between the local isolates and the US isolate. Three clusters of AFLP genotypes which did not associate with geographic origin were observed among tropical isolates. The low genetic diversity among the Indonesian isolates suggests clonal population structure with wide distribution. Successful local tomato breeding requires the availability of local A. solani collection with well-characterized aggressiveness level and molecular diversity to obtain effective resistance genes

Tissue culture response of CIMMYT elite bread wheat cultlvars and evaluation of regenerated plants

Six elite CIMMYT bread wheat genotypes Pavon 76, Seri M82, Opata M85, Mochis T88, Baviacora M93, and the advanced line Attila were evaluated for their response to in vitro tissue culture. Donor plants were grown at EI Batan and CIANO experiment stations in Mexico in 1992. Immature embryos, about 1.0 mm in length, were excised and placed scutellum side up on callus initiation media. Basal N6 medium supplemented with dicamba (E1), MS medium containing 2,40 (E3), or MS medium containing 2,40 plus different amino acids (E5) was used for callus initiation and maintenance. Plant regeneration and rooting were achieved on basal MS medium with IAA and BAP. Embryogenic calli with regeneration potentials of 10-92% were obtained on E3 and E5 media; each embryo produced 5-50 plants. A total of 800 regenerated plants were transferred to pots in the greenhouse for evaluation and seed production. Of the regenerated plants, 85% were morphologically normal. reached full maturity, and produced seeds. Seeds (R1) of 360 plants regenerated from Mochis T88, Baviacora M93, and Altila were planted in the field. Field observations indicated that embryos cultured on E3 medium resulted in 29% of the progeny producing deviating plants, compared with 21 % of those grown on E5 medium. These results will form the basis for future efforts aimed at transforming CIMMYT bread wheat varieties. IntroductionSix elite CIMMYT bread wheat genotypes Pavon 76, Seri M82, Opata M85, Mochis T88, Baviacora M93, and the advanced line Attila were evaluated for their response to in vitro tissue culture. Donor plants were grown at EI Batan and CIANO experiment stations in Mexico in 1992. Immature embryos, about 1.0 mm in length, were excised and placed scutellum side up on callus initiation media. Basal N6 medium supplemented with dicamba (E1), MS medium containing 2,40 (E3), or MS medium containing 2,40 plus different amino acids (E5) was used for callus initiation and maintenance. Plant regeneration and rooting were achieved on basal MS medium with IAA and BAP. Embryogenic calli with regeneration potentials of 10-92% were obtained on E3 and E5 media; each embryo produced 5-50 plants. A total of 800 regenerated plants were transferred to pots in the greenhouse for evaluation and seed production. Of the regenerated plants, 85% were morphologically normal. reached full maturity, and produced seeds. Seeds (R1) of 360 plants regenerated from Mochis T88, Baviacora M93, and Altila were planted in the field. Field observations indicated that embryos cultured on E3 medium resulted in 29% of the progeny producing deviating plants, compared with 21 % of those grown on E5 medium. These results will form the basis for future efforts aimed at transforming CIMMYT bread wheat varieties. Introductio

Variation In Aggressiveness And Aflp Among Alternaria Solani Isolates From Indonesia

Alternaria solani is a necrotroph fungus that causes three-phased diseases in tomato. Management of the pathogen by using resistant cultivars requires knowledge on the aggressiveness and genetic diversity of the fungus. The aims of this study were to isolate A. solani from major tomato and potato producing areas in Indonesia and to study their aggressiveness and genetic variability. Twenty two A. solani isolates were recovered from early blighted tomato and potato in Central and West Java. A. alternata was also isolated from tomato leaves in West Java and North Sumatra, indicating that early blight in Indonesia may be caused by more than one Alternaria species. Resistance tests of four tomato genotypes to selected A. solani isolates revealed that local isolates were more aggressive in inciting early blight and stem lesion than an imported isolate from USA. This implies that introduced breeding materials must be tested to local isolates to obtain effective resistance genes. Cluster analysis based on amplified fragment length polymorphism (AFLP) obtained from EcoRI+AG and MseI+C primer amplification separated 28 local and Taiwan isolates from the US isolate, which was coincided with aggressiveness separation between the local isolates and the US isolate. Three clusters of AFLP genotypes which did not associate with geographic origin were observed among tropical isolates. The low genetic diversity among the Indonesian isolates suggests clonal population structure with wide distribution. Successful local tomato breeding requires the availability of local A. solani collection with well-characterized aggressiveness level and molecular diversity to obtain effective resistance genes

The oncological outcomes of isolated limb perfusion and neo-adjuvant radiotherapy in soft tissue sarcoma patients:A nationwide multicenter study

Introduction: Patients with locally extensive high-grade extremity soft tissue sarcomas (eSTS) are often presented in multidisciplinary teams to decide between ablative surgery (amputation) or limb-salvage surgery supplemented with either neo-adjuvant radiotherapy (RT) or induction isolated limb perfusion (ILP). In The Netherlands, ILP typically aims to reduce the size of tumors that would otherwise be considered irresectable, whereas neo-adjuvant RT aims mainly at improving local control and reducing morbidity of required marginal margins. This study presents a 15-year nationwide cohort to describe the oncological outcomes of both pre-operative treatment strategies. Methods: All consecutive patients with locally extensive primary high-grade eSTS surgically treated between 2000 and 2015 at five tertiary sarcoma centers that received neo-adjuvant ILP or RT were included. 169 patients met the inclusion criteria (89 ILP, 80 RT). Median follow-up was 7.3 years. Results: Limb salvage was achieved in 84% of cases in the ILP group (80% for patients with amputation indication) and 96% of cases in the RT group. 5-Year overall survival was 47% in the ILP group, 69% in the RT group. 5-Year local recurrence rate was 14% in the ILP group, 10% in the RT group. Distant metastasis rate was 55% in the ILP group, 36% in the RT group. Conclusion: We find oncological outcomes and limb salvage rates in line with existing literature for both treatment modalities. Whether the tumor was locally advanced with an indication for induction therapy to prevent amputation or morbid surgery appeared to be the main determinant in choosing between neo-adjuvant ILP or RT

Border skirmishes and the question of belonging: An authoethnographic account of everyday exclusion in multicultural society

Transnational migration has transformed most European countries, making the problem of how to 'integrate' an increasingly popular topic in public debates and social policy. It is assumed that as long as the newcomer learns the language, adapts to the local customs and finds work, s/he will be integrated and welcomed with open arms as a full-fledged member of society. Based on an autoethnography of our experiences as US-born, long-term and fully 'integrated' residents of the Netherlands, one of Europe's most multicultural societies, we have explored some of the subtle, well-intentioned practices of distancing and exclusion that are part of the fabric of everyday life. We will show how, contrary to the official discourse of integration, 'Dutch-ness' as a white/ethnic national identity is continuously constructed as a 'we', which excludes all 'others'. And, indeed, we have discovered that, paradoxically, the closer the 'other' comes to being completely assimilated into Dutch society, the more the symbolic borders of national belonging may need to be policed and tightened. © The Author(s) 2011

Evidence for a narrow dip structure at 1.9 GeV/c2^2 in 3π+3π−3\pi^+ 3\pi^- diffractive photoproduction

A narrow dip structure has been observed at 1.9 GeV/c$^2$ in a study of diffractive photoproduction of the $~3\pi^+3\pi^-$ final state performed by the Fermilab experiment E687.Comment: The data of Figure 6 can be obtained by downloading the raw data file e687_6pi.txt. v5 (2nov2018): added Fig. 7, the 6 pion energy distribution as requested by a reade

A tale of two worlds:assessing the vulnerability of enclave shielding runtimes

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Erythromycin lacks colon prokinetic effect in children with functional gastrointestinal disorders: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Motilin, a peptide hormone has a direct excitatory effect on circular smooth muscle strips derived from the human colon. Reduced plasma motilin concentration has been reported in adults with chronic constipation. Erythromycin, a non-peptide motilin receptor agonist, induces phase 3 of the migrating motor complex (MMC) in the antro-duodenum and also reduces oro-cecal transit time. A pediatric study has reported an improvement in clinical symptoms of constipation following erythromycin administration, but the effect on colon motility in children has not been formally evaluated. We used colon manometry to study the effect of intravenous erythromycin lactobionate at 1 mg/kg on colon motiltiy in ten children.</p> <p>Methods</p> <p>We selected patients with normal antroduodenal and colon manometry studies that were performed simultaneously. All studies were performed for clinically indicated reasons. We quantified the effect of erythromycin on colon contraction by calculating the area under the curve (AUC).</p> <p>Results</p> <p>The mean (SE of mean) AUC in the colon during the fasting, post-erythromycin and postprandial phases of the study was 2.1 mmHg/sec (0.35), 0.99 mmHg/sec (0.17) and 3.05 mmHg/sec (0.70) respectively. The AUC following erythromycin was significantly less compared to the fasting phase of the study (p < 0.01).</p> <p>Conclusion</p> <p>Erythromycin lacks colon prokinetic effect in children with chronic constipation evaluated by colon manometry.</p