We present ADIOS 2, the latest version of the Adaptable Input Output (I/O) System. ADIOS 2 addresses scientific data management needs ranging from scalable I/O in supercomputers, to data analysis in ...personal computer and cloud systems. Version 2 introduces a unified application programming interface (API) that enables seamless data movement through files, wide-area-networks, and direct memory access, as well as high-level APIs for data analysis. The internal architecture provides a set of reusable and extendable components for managing data presentation and transport mechanisms for new applications. ADIOS 2 bindings are available in C++11, C, Fortran, Python, and Matlab and are currently used across different scientific communities. ADIOS 2 provides a communal framework to tackle data management challenges as we approach the exascale era of supercomputing.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Background
Manganese toxicity can occur as a complication of home parenteral nutrition (HPN). Patients can present with Parkinson disease–like symptoms. Preparations of trace elements (TEs) in ...parenteral nutrition (PN) generally provide amounts in excess of requirements. Our previous review observed 60% of adult HPN patients had high whole‐blood manganese levels. Multi‐TE (MTE) solutions were subsequently removed from all HPN formulations in January 2015. The aim of this evaluation was to determine whole‐blood concentrations of manganese in adult patients receiving HPN to establish whether levels are now maintained within the normal reference range.
Methods
A retrospective review of whole‐blood manganese levels in all patients receiving HPN between January 2018 and January 2019 from 1 hospital site was carried out.
Results
100 patients were included in the review (59 female and 41 male). Normal whole‐blood manganese levels (73–219 nmol/L) were observed in 70% of patients and elevated levels (>219 nmol/L) in 30% of patients. In the patients with elevated levels, 57% had not received manganese supplementation for at least 1 year prior to manganese being measured. Markers of cholestasis were similar between the 2 groups.
Conclusions
Incidence of elevated whole‐blood manganese concentrations in patients receiving HPN decreased from 60% to 30% upon discontinued use of an MTE solution. Elevated levels remain a concern despite patients being prescribed “manganese‐free” PN. Patients receive this TE in amounts adequate to meet requirements through contamination and dietary intake alone, suggesting additional parenteral supplementation of manganese is not required.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
We report a case of ileo-colonic Histoplasmosis without apparent respiratory involvement in a patient who had previously undergone an orthotopic liver transplant(OLT) for primary biliary cholangitis ...15 years earlier. The recipient lived in the United Kingdom,a non-endemic region for Histoplasmosis. However,she had previously lived in rural southern Africa prior to her OLT. The patient presented with iron deficiency anaemia,diarrhoea,abdominal pain and progressive weight loss. She reported no previous foreign travel,however,it later became known that following her OLT she had been on holiday to rural southern Africa. On investigation,a mild granulomatous colitis primarily affecting the right colon was identified,that initially improved with mesalazine. Her symptoms worsened after 18 mo with progressive ulceration of her distal small bowel and right colon. Mycobacterial,Yersinia,cytomegalovirus and human immunodeficiency virus infections were excluded and the patient was treated with prednisolone for a working diagnosis of Crohn’s disease. Despite some early symptom improvement following steroids,there was subsequent deterioration with the patient developing gram-negative sepsis and multi-organ failure,leading to her death. Post-mortem examination revealed that her ileo-colonic inflammation was caused by Histoplasmosis.
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5.
The epidemiology of hyperferritinaemia Hearnshaw, Sarah; Thompson, Nick-Paul; McGill, Andrew
World journal of gastroenterology : WJG,
09/2006, Volume:
12, Issue:
36
Journal Article
Open access
AIM： To discover the causes of markedly raised ferritin levels in patients seen at a teaching hospital in Newcastle Upon Tyne, United Kingdom. METHODS： Demographic and medical data were collected for ...all patients over 18 years who had a serum ferritin levels recorded as ≥ 1500 μg/L during the period January to September 2002. The cause or causes for their hyperferritinaemia were identified from their medical notes. Patients from a defined local population were identified. RESULTS： A total of 19 583 measurements were provided of which 406 from 199 patients were ≥ 1500 μg/L. An annual incidence for the local population was determined to be 0.44/1000. 150/199 medical notes were scrutinised and 81 patients were identified as having a single cause for their raised ferritin level. The most common single cause was alcoholic liver disease in the local population and renal failure was the most common single cause in the overall population. Confirmed hereditary haemochromatosis was the 10^th most common cause. Liver disease contributed to hyperferritinaemia in 44% of the patients. Weight loss may have contributed to hyperferritinaemia in up to 11%. CONCLUSION： Alcohol related liver disease, haematological disease, renal failure and neoplasia are much more common causes of marked hyperferritinaemia than haemochromatosis. The role of weight loss in hyperferritinaemia may warrant further investigation.
The van Bree paper 1 that Davies refers to does not perform a risk analysis; therefore, it does not, as he suggests, raise public awareness about the potential risks of raw food feeding. Davies might ...start by noting the thousands of conditions diagnosed and treated daily in the UK in dogs and cats fed kibble and tinned food; diseases such as recurrent colitis, chronic diarrhoea, adverse food reactions and atopy.
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Micronutrients are required in varying quantities to maintain essential functions within the body. Many of these are obtained through dietary sources, but access to a diet balanced in micronutrients ...varies worldwide; micronutrient deficiencies are the cause of reversible global health problems including iron deficiency anaemia and blindness in children. Lifestyle preferences including alcohol use and vegetarianism can predispose to micronutrient imbalance, with a range of acute and chronic diseases also putting patients at risk. Symptoms associated with micronutrient imbalance vary and multiple deficiencies can coexist because of shared sites of absorption between many micronutrients. In some individuals multivitamin ingestion proves sufficient to correct abnormalities, but specific micronutrient replacement is often required. Recognized biomarkers are often used to assess the response to replacement, with active inflammation a common factor for rendering these values less helpful. Some micronutrients in therapeutic doses can cause supratherapeutic concentrations, which can be toxic and lead to signs and symptoms that are important to recognize in clinical practice.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
ObjectiveTo determine whether development of localised protocol could reduce the number of non-targeted gastric biopsies taken at endoscopy, without risking harm from non-detection of malignant ...conditions.DesignRetrospective analysis of patient records over a 3-month period in 2013, repeated in 2015 following intervention.SettingTwo UK teaching hospitalsPatientsPatient record data on indication for endoscopy, endoscopy findings, histopathology results and patient outcome.InterventionsGuidance on upper gastrointestinal biopsy in the form of a new trust-wide protocol, as well as lecture-based education.Main outcome measuresRates of non-targeted and targeted biopsies before and after intervention, and differences between grade of endoscopist.ResultsBetween 2013 and 2015, there was a 36% reduction in non-targeted biopsies (10.4% vs 6.7%, p=0.001), predominantly within registrar and nurse endoscopist groups, with reduction in non-targeted biopsies of 9.5% and 64%, respectively. Percentage of targeted biopsies remained relatively static, 7.9% and 8.2%. In 2013, 92% of non-targeted biopsies had no management change based on histology; in 2015 this was 90%. Of patients with alteration to management, only 0.4% and 0.7% were due to malignancy, in known high-risk patients. Reduction in non-targeted biopsies resulted in estimated annual savings in this trust of £36,000.ConclusionDevelopment of local protocol reduces the numbers of non-targeted biopsies taken, without risk of harm from non-detection of malignant conditions, enabling a significant reduction in workload within busy histopathology services, with significant cost savings. Localised protocols are adaptable to local population demographics.
Abstract Purpose Methamphetamine (MA) has become the leading drug of abuse in northern Thailand over the past several years, particularly among youth. The current qualitative study examines factors ...associated with initiation of MA use. Methods Between March 2002 and January 2003, 48 in-depth interviews with young MA users were conducted in advance of a randomized, MA harm reduction, peer outreach intervention trial. The interviews were conducted in the city of Chiang Mai and the surrounding district. Data were inductively analyzed using the constant comparative method common to grounded theory methods. Atlas-ti was used for data management. Results Participants were 57% male and had a median age of 20 years (range 15–31 years). A culture of MA ubiquity characterized participants’ initiation stories. Drug ubiquity encompassed three elements: the extent of MA use within peer networks; the availability of MA; and exposure to MA before initiation. All participants were introduced to MA by people close to them, most often by their friends. Internal reasons for trying MA were curiosity, a way to lose weight or to enhance hard work, and a way to “forget life’s problems.” With the prevalence of MA use among participants’ peers, initiation seemed inevitable. Conclusions Initiation was characterized as ubiquitous in terms of peer networks’ use and availability. Because of the prevalent norm of MA use, these data indicate that interventions targeting social networks and young Thais before MA initiation are needed.
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