Abstract
Introduction
A new clinician-administered inflammatory bowel disease (IBD) Disability Index (IBDDI) was recently developed and validated among a population in France. We aimed to validate ...the IBDDI in a North American setting and adapt for use as a self-report tool.
Methods
Persons 18-65 years old from the population-based University of Manitoba IBD Research Registry were mailed a self-administered survey. This survey included the IBDDI and several scales that should correlate with a disability measure- the World Health Organization (WHO) Disability Assessment Scale (WHODAS) 2.0, Work and Social Adjustment Scale (WSAS), the Inflammatory Bowel Disease Questionnaire (IBDQ), and the K6-Kessler Emotional Distress Scale. We used Pearson correlation coefficients to assess construct validity, Cronbach's alpha to assess internal consistency, and Factor analysis to assess which of the IBDDI items likely belonged to a single IBD-related disability factor.
Results
In response to the survey request,1143 (46% of those contacted) participated (61% female, mean age 51, 52% with Crohn's disease). On an index scale from 0-100, 14% had a score ≥50 (extreme disability, 18% of those with Crohn's disease; 10% of those with ulcerative colitis). There were strong correlations between IBDDI and WSAS (0.76), WHODAS (0.76), K6 (0.73), and an inverse correlation with IBDQ (-0.86). The Cronbach's alpha was high (0.88). All but 2 items (number of liquid stools in the past week and arthritis/arthralgia) of the 14 identified for IBDDI loaded highly onto a single factor (factor loading > 0.40).
Conclusions
The findings support the validity of this new self-report version of the IBDDI as a sound measure of disability in IBD.
Background
Previous research has assessed anxiety around colonoscopy procedures, but has not considered anxiety related to different aspects related to the colonoscopy process.
Aims
Before ...colonoscopy, we assessed anxiety about: bowel preparation, the procedure, and the anticipated results. We evaluated associations between patient characteristics and anxiety in each area.
Methods
An anonymous survey was distributed to patients immediately prior to their outpatient colonoscopy in six hospitals and two ambulatory care centers in Winnipeg, Canada. Anxiety was assessed using a visual analog scale. For each aspect, logistic regression models were used to explore associations between patient characteristics and high anxiety.
Results
A total of 1316 respondents completed the questions about anxiety (52% female, median age 56 years). Anxiety scores > 70 (high anxiety) were reported by 18% about bowel preparation, 29% about the procedure, and 28% about the procedure results. High anxiety about bowel preparation was associated with female sex, perceived unclear instructions, unfinished laxative, and no previous colonoscopies. High anxiety about the procedure was associated with female sex, no previous colonoscopies, and confusing instructions. High anxiety about the results was associated with symptoms as an indication for colonoscopy and instructions perceived as confusing.
Conclusions
Fewer people had high anxiety about preparation than about the procedure and findings of the procedure. There are unique predictors of anxiety about each colonoscopy aspect. Understanding the nuanced differences in aspects of anxiety may help to design strategies to reduce anxiety, leading to improved acceptance of the procedure, compliance with preparation instructions, and less discomfort with the procedure.
Cleavage of amyloid precursor protein (APP) by the β- and γ-secretases
generates the amino and carboxy termini, respectively, of the Aβ amyloidogenic
peptides Aβ40 and Aβ42-the major constituents of ...the amyloid
plaques in the brain parenchyma of Alzheimer's disease patients.
There is evidence that the polytopic membrane-spanning proteins, presenilin
1 and 2 (PS1 and PS2), are important determinants of γ-secretase activity:
mutations in PS1 and PS2 that are associated with early-onset familial
Alzheimer's disease increase the production of Aβ42
(refs 4,5,6), the more amyloidogenic peptide; γ-secretase activity
is reduced in neuronal cultures derived from PS1-deficient mouse embryos; and directed mutagenesis of two conserved aspartates in transmembrane
segments of PS1 inactivates the ability of γ-secretase to catalyse processing
of APP within its transmembrane domain. It is unknown, however,
whether PS1 (which has little or no homology to any known aspartyl protease)
is itself a transmembrane aspartyl protease or a γ-secretase cofactor,
or helps to colocalize γ-secretase and APP. Here we report photoaffinity
labelling of PS1 (and PS2) by potent γ-secretase inhibitors that were
designed to function as transition state analogue inhibitors directed to the
active site of an aspartyl protease. This observation indicates that PS1 (and
PS2) may contain the active site of γ-secretase. Interestingly, the
intact, single-chain form of wild-type PS1 is not labelled by an active-site-directed
photoaffinity probe, suggesting that intact wild-type PS1 may be an aspartyl
protease zymogen.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract A predictive form of the extended 2-point model known as the ‘reverse 2-point model’, Rev2PM, is applied to a range of detachment levels in the open lower divertor of DIII-D, showing that ...the experimentally measured electron temperature ( T e ) and pressure ( p e ) at the divertor entrance can be calculated within 50% from target measurements, if and only if a posteriori corrections for convective heat flux are included in the model. Unlike the standard 2-point model, the Rev2PM calculates upstream scrape-off layer (SOL) quantities (such as separatrix T e and p e ) from target conditions (such as T e and parallel heat flux), with volumetric power and momentum losses depending solely on target T e . The Rev2PM is tested against a database of DIII-D inter-ELM divertor Thomson scattering measurements, built from a series of 6 MW, 1.3 MA, LSN H-mode discharges with varied main ion density, drift direction, and nitrogen puffing rate. Measured target T e ranged from 0.4–25 eV over this database, and upstream T e ranged from 5–60 eV. Poor agreement is found between upstream measurements and Rev2PM calculations that assume purely conductive parallel heat transport. However, introducing a posteriori corrections to account for convective heat transport brings the Rev2PM calculations within 50% of the measured upstream values across the dataset. These corrections imply that up to 99% of the parallel heat flux is carried by convection in detached conditions in the DIII-D open lower divertor, though further work is required to assess any potential dependencies on device size or divertor closure.
Summary
Background
It is believed that women with inflammatory bowel disease (IBD) have heightened symptoms around their menses. However, there is little information regarding normative changes and ...which symptoms emerge in relation to menses.
Aim
To determine the relationship between gastrointestinal and other symptoms and menses in a population‐based cohort of women with IBD vs. healthy women.
Methods
Women enrolled in the University of Manitoba IBD Research Registry who were between 18 and 65 years were mailed a survey. A control group of adult women were recruited through out‐patient gynaecology clinics. Participants were asked to consider their menstrual periods in the recent several months and report on symptoms 1–5 days prior to and during the days of their menses.
Results
There were 151 premenopausal women with Crohn's disease (CD), 87 with ulcerative colitis (UC) and 156 premenopausal controls. Mean age of menses onset was similar in all three cohorts and the percentage in each group with regular menstrual periods was similar. Premenstrually, abdominal pain was less commonly reported in UC (36.8%) than CD (51%, P = 0.034) and controls (57.6%, P = 0.002). Premenstrually, and during menses diarrhoea was more commonly reported in CD (47.7% and 59.6% respectively) than UC (26.4% P = 0.001 and 42.5%, P = 0.01 respectively) and controls (24.4%, P < 0.0001 and 28.2%, P < 0.0001 respectively). Premenstrually, women with CD (46%) vs. UC (26%) were more likely to report worsening of their IBD symptoms (P = 0.0007), but there was no difference between CD (47%) and UC (39%) for reporting worsening during menses (P = 0.24).
Conclusions
Compared to healthy women, women with IBD had similar symptom experiences premenstrually, except that those with CD were more likely to have increased diarrhoea premenstrually. During menses, women with CD or UC were more likely to experience diarrhoea than healthy controls.
Smell abilities differ greatly among vertebrate species due to distinct sensory needs, with exceptional variability reported in the number of olfactory genes and the size of the odour-processing ...regions of the brain. However, key environmental factors shaping genomic and phenotypic changes linked to the olfactory system remain difficult to identify at macroevolutionary scales. Here, we investigate the association between diverse ecological traits and the number of olfactory chemoreceptors in approximately two hundred ray-finned fishes.
We found independent expansions producing large gene repertoires in several lineages of nocturnal amphibious fishes, generally able to perform active terrestrial exploration. We reinforced this finding with on-purpose genomic and transcriptomic analysis of Channallabes apus, a catfish species from a clade with chemosensory-based aerial orientation. Furthermore, we also detected an augmented information-processing capacity in the olfactory bulb of nocturnal amphibious fishes by estimating the number of cells contained in this brain region in twenty-four actinopterygian species.
Overall, we report a convergent genomic and phenotypic magnification of the olfactory system in nocturnal amphibious fishes. This finding suggests the possibility of an analogous evolutionary event in fish-like tetrapod ancestors during the first steps of the water-to-land transition, favouring terrestrial adaptation through enhanced aerial orientation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Over the past 30 years, the prevalence of diabetes has steadily increased among Canadians, and is particularly evident among First Nations (FN) women. The interplay between FN ancestry, ...gestational diabetes and the development of subsequent diabetes among mothers remains unclear.
Methods
After excluding known pre‐existing diabetes, we explored whether FN ancestry may modify the association between gestational diabetes and post‐partum diabetes among women in Manitoba (1981–2011) via a historical prospective cohort database study. We analysed administrative data in the Population Health Research Data Repository using Kaplan–Meier survival analysis and Cox proportional hazards regression.
Results
Gestational diabetes was diagnosed in 11 906 of 404 736 deliveries (2.9%), 6.7% of FN and 2.2% of non‐FN pregnant women (P < 0.0001). Post‐partum diabetes during ≤ 30 years follow‐up was more than three times higher among FN women than among non‐FN women (P < 0.0001). Diabetes developed in 76.0% of FN and 56.2% of non‐FN women with gestational diabetes within the follow‐up period. The hazard ratio of gestational diabetes for post‐partum diabetes was 10.6 among non‐FN women and 5.4 among FN women. Other factors associated with a higher risk of diabetes included lower family income among FN and non‐FN women and rural/remote residences among FN women. Among non‐FN women, urban residence was associated with a higher risk of diabetes.
Conclusion
Gestational diabetes increases post‐partum diabetes in FN and non‐FN women. FN women had substantially more gestational diabetes or post‐partum diabetes than non‐FN women, partially due to socio‐economic and environmental barriers. Reductions in gestational diabetes and socio‐economic inequalities are required to prevent diabetes in women, particularly in FN population.
What's new?
This historical cohort study examined the impact of gestational diabetes after excluding pre‐existing diabetes in mothers who delivered between 1981 and 2011 in Manitoba, Canada.
First Nations (FN) women had two times more gestational diabetes and were three times more likely to develop post‐partum diabetes than non‐FN women.
Post‐partum diabetes in both FN and non‐FN mothers was affected by gestational diabetes, lower family income and rural residence.
The relative risk of developing post‐partum diabetes in non‐FN women was higher than in FN women.
The findings suggest that reductions in gestational diabetes and socio‐economic inequities are required to prevent post‐partum diabetes in FN and non‐FN women.
Organ donation remains a major public health challenge with over 114 000 people on the waitlist in the United States. Among other factors, extant research highlights the need to improve the ...identification and timely referral of potential donors by hospital healthcare providers (HCPs) to organ procurement organizations (OPOs). We implemented a national test of the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD) to identify assets and barriers to the organ donation and patient referral processes; assess hospital–OPO relationships and offer tailored recommendations for improving these processes. Having partnered with seven OPOs, data were collected at 70 hospitals with high donor potential in the form of direct observations and interviews with 2358 HCPs. We found that donation attitudes and knowledge among HCPs were high, but use of standard referral criteria was lacking. Significant differences were found in the donation‐related attitudes, knowledge and behaviors of physicians and emergency department staff as compared to other staff in intensive care units with high organ donor potential. Also, while OPO staff were generally viewed positively, they were often perceived as outsiders rather than members of healthcare teams. Recommendations for improving the referral and donation processes are discussed.
This article presents interim results of a national, multisite test of a hospital development intervention designed to increase the rates of timely referrals of potential donor‐eligible patients from hospital staff to organ procurement organizations.
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