Diagnostic imaging and radiation exposure in inflammatory bowel disease.

Diagnostic imaging plays a key role in the diagnosis and management of inflammatory bowel disease (IBD). However due to the relapsing nature of IBD, there is growing concern that IBD patients may be exposed to potentially harmful cumulative levels of ionising radiation in their lifetime, increasing malignant potential in a population already at risk. In this review we explore the proportion of IBD patients exposed to high cumulative radiation doses, the risk factors associated with higher radiation exposures, and we compare conventional diagnostic imaging with newer radiation-free imaging techniques used in the evaluation of patients with IBD. While computed tomography (CT) performs well as an imaging modality for IBD, the effective radiation dose is considerably higher than other abdominal imaging modalities. It is increasingly recognised that CT imaging remains responsible for the majority of diagnostic medical radiation to which IBD patients are exposed. Magnetic resonance imaging (MRI) and small intestine contrast enhanced ultrasonography (SICUS) have now emerged as suitable radiation-free alternatives to CT imaging, with comparable diagnostic accuracy. The routine use of MRI and SICUS for the clinical evaluation of patients with known or suspected small bowel Crohn's disease is to be encouraged wherever possible. More provision is needed for out-of-hours radiation-free imaging modalities to reduce the need for CT

Parenting styles and academic procrastination

The present study examined the relationship between the parenting styles and academic procrastination. Three-hundred-ninety- five Shiraz University students (261 girls and 134 boys) were participants of the study. Steinberg's Parenting Styles Scale (2005) and Solomon & Rothblum's Academic Procrastination Scale (1984) were used as measures of the study. Simultaneous multiple regression of academic procrastination total score on the parenting styles subscales, revealed that the “acceptance-involvement” and “psychological autonomy-granting” styles were significant and negative predictor of the academic procrastination, whereas the “behavioral strictness-supervision” style had a significant predict power for the academic rocrastination

A note on quasi-Gorenstein rings

In this paper, after giving a criterion for a Noetherian local ring to be quasi-Gorenstein, we obtain some sufficient conditions for a quasi- Gorenstein ring to be Gorenstein. In the course, we provide a slight generalization of a theorem of Evans and Griffith.Comment: To appear in Arch. Mat

Bleeding Risk with Invasive Procedures in Patients with Cirrhosis and Coagulopathy

PURPOSE OF REVIEW: Previous perceptions of cirrhosis as a hypocoagulable state have resulted in empirical blood product transfusions prior to invasive procedures. We evaluate procedure-related bleeding risks in patients with cirrhosis, assess the utility of conventional and newer global coagulation tests, and explore evidence surrounding prophylactic transfusion strategies. RECENT FINDINGS: Recent literature supports the concept of a rebalanced, albeit fragile, haemostasis equilibrium in cirrhosis, with a potential hypercoagulable tendency in stable patients. Standard coagulation tests provide a poor reflection of bleeding risks and yet are relied upon for transfusion thresholds. Consequently, a sizeable proportion of patients receive unnecessary blood products. The role of viscoelastic tests to guide transfusions requires further evaluation. In stable cirrhotic patients, procedure-related bleeding rates appear low. Prophylactic transfusion strategies based on arbitrary thresholds lack evidence of clinical benefit. There is a pressing need for point-of-care coagulation tests that represent the complex coagulopathy of cirrhosis and well-powered randomised controlled trials to develop evidence-based pre-procedure transfusion guidelines

Effects of amino acid supplementation of lysine and methionine on body biochemical composition and amino acid profile of Sobaity sea bream (Sparidentex hasta) juveniles

In this study that lasted to 8 weeks, was conducted to determine the effects of dietary supplementation of lysine and methionine on body biochemical composition and amino acid profile of Sobaity sea bream, Sparidentex hasta. Therefore, 180 juvenile fish with an initial weight of 31.38 ±1.4 g were distributed randomly among eighteen tanks. Fish were fed to satiation three time per day (08:00, 13:00 and 18:00 hours) with formulated diets containing six different levels of dietary methionine and lysine; Diet 1: a control diet without dietary amino acid supplementation; Diet 2: 100% methionine supplementation; Diet 3: 75% methionine and 25% lysine supplementation; Diet 4: 50% methionine and 50% lysine supplementation; Diet 5: 25% methionine and 75% lysine supplementation and Diet 6: 100% lysine supplementation.The results of this study showed Carcass protein content was significantly affected by the amino acid supplements and the highest level of carcass protein observed in fish were fed by diet 3(P 0.05). In addition, essential amino acids (ΣEAA) and non-essential amino acids (ΣNEAA) and ratio ΣEAA / ΣNEAA, were affected by lysine and methionine amino acid supplementation as ΣEAA and ratio (ΣEAA) / (ΣNEAA) significantly increased with increasing levels of amino acid supplementation and the highest amount of this parameters observed in groups were fed by diet with high levels of methionine.The results showed that adding 75% dietary methionine supplementation and 25% lysine supplemtation to the diet containg 45/95% protein, have positive effects on biochemical composition and amino acid profile in rearing of Sobaity seabream juveniles

Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options

This study aimed to establish the optimal diagnostic and treatment algorithm for the management of gastric fistula in the chest (GFIC) after sleeve gastrectomy (SG) through a systematic review of published cases. A multi-database search was performed, which produced 1182 results, of which 26 studies were included in this systematic review. The initial presentation included subphrenic collections, leaks, or (recurrent) pneumonia with associated symptoms such as persistent cough, fever, and/or dyspnea. Computed tomography (CT) scan in combination with either upper gastrointestinal (UGI) series or an esophagogastroduodenoscopy (EGD) was used to adequately diagnose the fistulas. Initial treatment was either with clips and/or clips and stents that were placed endoscopically. When unsuccessful in the majority of the cases, the surgical treatment consisted of total gastrectomy and Roux-en-Y esophagojejunostomy in a laparoscopic or open fashion

Correlations, disorder, and multi-magnon processes in terahertz spin dynamics of magnetic nanostructures: A first-principles investigation

Understanding the profound impact of correlation effects and crystal imperfections is essential for an accurate description of solids. Here we study the role of correlation, disorder, and multi-magnon processes in THz magnons. Our findings reveal that a significant part of the electron self-energy, which goes beyond the adiabatic local spin density approximation, arises from the interaction between electrons and a virtual magnon gas. This interaction leads to a substantial modification of the exchange splitting and a renormalization of magnon energies, in agreement with the experimental data. We establish a quantitative hierarchy of magnon relaxation processes based on first principles

Physiological correlates of cognitive load in laparoscopic surgery

Laparoscopic surgery can be exhausting and frustrating, and the cognitive load experienced by surgeons may have a major impact on patient safety as well as healthcare economics. As cognitive load decreases with increasing proficiency, its robust assessment through physiological data can help to develop more effective training and certification procedures in this area. We measured data from 31 novices during laparoscopic exercises to extract features based on cardiac and ocular variables. These were compared with traditional behavioural and subjective measures in a dual-task setting. We found significant correlations between the features and the traditional measures. The subjective task difficulty, reaction time, and completion time were well predicted by the physiology features. Reaction times to randomly timed auditory stimuli were correlated with the mean of the heart rate (0.29 r =−) and heart rate variability (0.4 r =). Completion times were correlated with the physiologically predicted values with a correlation coefficient of 0.84. We found that the multi-modal set of physiology features was a better predictor than any individual feature and artificial neural networks performed better than linear regression. The physiological correlates studied in this paper, translated into technological products, could help develop standardised and more easily regulated frameworks for training and certification

Cross-validating models of continuous data from simulation and experiment by using linear regression and artificial neural networks

We are increasingly surrounded by sensors gathering massive amounts of data, and patterns in continuous variables are often discovered by using artificial neural networks (ANN), while linear regression (LR) is useful for detecting linear relationships. LR also provide preliminary estimates of potentially complex associations, and serve as a benchmark for the performance of ANNs. We show that while cross-validation (CV) is indispensable for insuring the robustness of the discovered patterns, it systematically leads, when combined with LR, to specific artefacts that underestimate the extent of the associations between predictor and target variables. We explain how this previously unnoticed type of artefact arises specifically from the combination of CV with LR and does not affect non-linear methods such as ANN. We also demonstrate through simulations that ANN were able to discover a wide range of complex associations missed by LR. The results were confirmed by the analysis of physiological, behavioural and subjective data collected from N=31 human subjects performing laparoscopy training experiments