Aspirin and folic acid for the prevention of recurrent colorectal adenomas

BACKGROUND & AIMS: Although observational studies have found regular aspirin use to be associated with a reduced risk of colorectal neoplasia, results from randomized trials using aspirin have been inconsistent. Dietary folate intake also has been found to be associated with a reduced risk of colorectal neoplasms in observational studies.

METHODS: A multicenter, randomized, double-blind trial of aspirin (300 mg/day) and folate supplements (0.5 mg/day) to prevent colorectal adenoma recurrence was performed using a 2 x 2 factorial design. All patients had an adenoma (>/=0.5 cm) removed in the 6 months before recruitment and were followed-up at 4-month intervals with a second colonoscopy after approximately 3 years. The primary outcome measure was a colorectal adenoma diagnosed after baseline.

RESULTS: A total of 945 patients were recruited into the study, of whom 853 (90.3%) underwent a second colonoscopy. In total, 99 (22.8%) of 434 patients receiving aspirin had a recurrent adenoma compared with 121 (28.9%) of 419 patients receiving placebo (relative risk, 0.79; 95% confidence interval [CI], 0.63-0.99). A total of 104 patients developed an advanced colorectal adenoma; 41 (9.4%) of these were in the aspirin group and 63 (15.0%) were in the placebo group (relative risk, 0.63; 95% CI, 0.43-0.91). Folate supplementation was found to have no effect on adenoma recurrence (relative risk, 1.07; 95% CI, 0.85-1.34).

CONCLUSIONS: Aspirin (300 mg/day) but not folate (0.5 mg/day) use was found to reduce the risk of colorectal adenoma recurrence, with evidence that aspirin could have a significant role in preventing the development of advanced lesions.

New results on stability analysis of delayed recurrent neural networks based on the integral quadratic constraints approach

This paper is concerned with the analysis of the stability of delayed recurrent neural networks. In contrast to the widely used Lyapunov–Krasovskii functional approach, a new method is developed within the integral quadratic constraints framework. To achieve this, several lemmas are first given to propose integral quadratic separators to characterize the original delayed neural network. With these, the network is then reformulated as a special form of feedback-interconnected system by choosing proper integral quadratic constraints. Finally, new stability criteria are established based on the proposed approach. Numerical examples are given to illustrate the effectiveness of the new approach.

Framing Wrongs, Performing Rights in Northern Ireland: Toward a Butlerian Approach to Life in Abortion Strategising

Feminist strategising on abortion has been dominated by a “pro-choice” frame. Increasingly, however, pro-choice discourse is being viewed as inadequate to meet contemporary and complex feminist aims and analyses, in particular due to the individualising ontological framework upon which it appears to be based. The work of Judith Butler is one location where such concerns have been explored and an alternative approach based upon a renewed analysis of the concept of “life” has been asserted. Foregrounding the fundamental precariousness of intersubjective life and opening the socio-political conditions sustaining precarious life to democratic public engagement carries significant implications for feminist strategising for Butler, and envisages a reconceptualisation of debate on abortion. In this article Butler’s work on life will be combined with her theoretical tool of the frame to explore space which may exist within pro-choice strategising to potentially work towards such a renewed approach to life in social debate on abortion. This space may be used to rethink feminist strategising on abortion beyond pro-choice discourse, and presents an accessible starting point from which to do so. In carrying out this analysis insights will be drawn from feminist advocacy and activism in the contingent location of Northern Ireland where recent employment of a health frame and a rights frame demonstrate instances of pro-choice strategising which may be reiterated to shift feminist activism towards more radical engagement with life as a precarious social process demanding critical attention.

Recurrent Convolutional Network for Video-based Person Re-Identification

In this paper we propose a novel recurrent neural networkarchitecture for video-based person re-identification.Given the video sequence of a person, features are extracted from each frame using a convolutional neural network that incorporates a recurrent final layer, which allows information to flow between time-steps. The features from all time steps are then combined using temporal pooling to give an overall appearance feature for the complete sequence. The convolutional network, recurrent layer, and temporal pooling layer, are jointly trained to act as a feature extractor for video-based re-identification using a Siamese network architecture.Our approach makes use of colour and optical flow information in order to capture appearance and motion information which is useful for video re-identification. Experiments are conduced on the iLIDS-VID and PRID-2011 datasets to show that this approach outperforms existing methods of video-based re-identification.

https://github.com/niallmcl/Recurrent-Convolutional-Video-ReID
Project Source Code

Why is “blindsight” blind? A new perspective on primary visual cortex, recurrent activity and visual awareness

The neuropsychological phenomenon of blindsight has been taken to suggest that the primary visual cortex (V1) plays a unique role in visual awareness, and that extrastriate activation needs to be fed back to V1 in order for the content of that activation to be consciously perceived. The aim of this review is to evaluate this theoretical framework and to revisit its key tenets. Firstly, is blindsight truly a dissociation of awareness and visual detection? Secondly, is there sufficient evidence to rule out the possibility that the loss of awareness resulting from a V1 lesion simply reflects reduced extrastriate responsiveness, rather than a unique role of V1 in conscious experience? Evaluation of these arguments and the empirical evidence leads to the conclusion that the loss of phenomenal awareness in blindsight may not be due to feedback activity in V1 being the hallmark awareness. On the basis of existing literature, an alternative explanation of blindsight is proposed. In this view, visual awareness is a “global” cognitive function as its hallmark is the availability of information to a large number of perceptual and cognitive systems; this requires inter-areal long-range synchronous oscillatory activity. For these oscillations to arise, a specific temporal profile of neuronal activity is required, which is established through recurrent feedback activity involving V1 and the extrastriate cortex. When V1 is lesioned, the loss of recurrent activity prevents inter-areal networks on the basis of oscillatory activity. However, as limited amount of input can reach extrastriate cortex and some extrastriate neuronal selectivity is preserved, computations involving comparison of neural firing rates within a cortical area remain possible. This enables “local” read-out from specific brain regions, allowing for the detection and discrimination of basic visual attributes. Thus blindsight is blind due to lack of “global” long-range synchrony, and it functions via “local” neural readout from extrastriate areas.

You Can't Always Get What You Want: A Gewirthian Model of Rational Autonomy in Abortion

The law regulating the availability of abortion is problematic both legally and morally. It is dogmatic in its requirements of women and doctors and ignorant of would-be fathers. Practically, its usage is liberal - with s1(1)(a) Abortion Act 1967 treated as a ‘catch all’ ground - it allows abortion on demand. Yet this is not reflected in the ‘law’. Against this outdated legislation I propose a model of autonomy which seeks to tether our moral concerns with a new legal approach to abortion. I do so by maintaining that a legal conception of autonomy is derivable from the categorical imperative resulting from Gewirth’s argument to the Principle of Generic Consistency: Act in accordance with the generic rights of your recipients as well as of yourself. This model of Gewirthian Rational Autonomy, I suggest, provides a guide for both public and private notions of autonomy and how our autonomous interests can be balanced across social structures in order to legitimately empower choice. I claim, ultimately, that relevant rights in the context of abortion are derivable from this model.

Rights, Rationality and Reproduction: Balancing Interests in the Abortion Debate

As medical technology has advanced, so too have our attitudes towards the level of control we can or should expect to have over our procreative capacities. This creates a multidimensional problem for the law and family planning services in terms of access to services – whether to avoid conception or terminate a pregnancy – and the negligent provision of these services. These developments go to the heart of our perception of autonomy. Unsurprisingly, these matters also raise a moral dilemma for the law. Distinctively, discourse in this area is dominated by assertions of subjective moral value; in relation to life, to personal choice and to notions of the archetypal family. Against this, I stress that a model of objective morality can answer these challenging questions and resolve the inherent problems of legal regulation. Therefore, I argue that notions of autonomy must be based on a rational, action-based understanding of what it means to be a ‘moral agent’. I claim that from this we might support a legal standard, based on objective rational morality, which can frame our constitutional norms and our conception of justice in these contentious areas. This paper claims that the current regulation of abortion is outdated and requires radical reform. It proposes a scheme that would shift the choice towards the mother (and the father), remove the unnecessarily broad disability ground and involve doctors having a role of counsel (rather than gatekeeper).

Recurrent Acute Pancreatitis and Therapy for Ulcerative Colitis.

Drugs are a rare cause of pancreatitis. Whereas some drugs are well known to induce an attack of pancreatitis, some people may be more prone to develop pancreatitis because of personal susceptibility. We describe a recurrent case of acute pancreatitis after administration of several drugs in a patient with intestinal inflammatory bowel disease that needed to be treated with subsequent antiinflammatory agents. Genetic mutation in the CFTR gene was found in the patient that led us to postulate that CFTR was a trigger for drug-induced acute pancreatitis. In conclusion, genetic analysis should be advised in case of recurrent pancreatitis in patient with intestinal inflammatory bowel disease.

Importation of Acinetobacter baumannii into a burn unit: a recurrent outbreak of infection associated with widespread environmental contamination.

A burn patient was infected with Acinetobacter baumannii on transfer to the hospital after a terrorist attack. Two patients experienced cross-infection. Environmental swab samples were negative for A. baumannii. Six months later, the bacteria reemerged in 6 patients. Environmental swab samples obtained at this time were inoculated into a minimal mineral broth, and culture results showed widespread contamination. No case of infection occurred after closure of the unit for disinfection.

Recurrent left colonic diverticulis episodes : more severe than the intial diverticulis ?

Rapport de Synthése : Introducfíon : la maladie diverticulaire est devenue un problème majeur de santé communautaire et occupe la cinquième place en termes de coûts des maladies digestives. La diverticulite représente sa complication la plus fréquente chez environ 20-25% des patients avec une maladie diverticulaire. Son taux de récidive après un premier épisode de diverticulite est estimé à 20%. Historiquement, il était accepté que le taux de complications et d'échec du traitement conservateur de la diverticulite soient plus élevés lors de récidive qu'après un épisode initial. Ceci a amené la communauté médicale ä un consensus qui est de proposer une sigmoidectomie élective suite à un 2ème épisode de diverticulite. De nouvelles données et réinterprétations de travaux antérieurs ont remis en question ce consensus. Par ces faits, les dernières recommandations de la société américaine de chirurgie colorectale restent encore évasives dues au manque d'évidence. Le but de cette thèse est de déterminer si la récidive de diverticulite a une présentation clinique et radiologique différente d'un épisode initiale et si le risque d'échec du traitement est réellement plus élevé. Méthode : étude rétrospective .de 271 patients consécutifs admis dans le service. de chirurgie viscérale CHUV pour diverticulite, confirmée par CT-scan, de 2001 à 2004. 202 patients présentaient un épisode initial (groupe I), et 69 une récidive (groupe R). Au total 20 paramètres cliniques et 15 radiologiques ont été analysés et comparés entre les 2 groupes, dont le taux de prise en charge chirurgicale, la présentation clinique initiale, la réponse au traitement, les complications, les paramètres de laboratoires, la présence de liquide libre, d'abcès ou de pneumopéritoine au scanner. Une analyse statistique univariée a été effectuée. Résultats : aucun des paramètres cliniques ou radiologiques n'étaient différents entre les deux groupes. Concernant la chirurgie, 15.8% des patients dans le groupe I ont nécessité une prise en charge chirurgicale à l'admission comparé à 5.8% dans le groupe R (p=0.04). Le taux d'échec du traitement conservateur dans les deux groupes était similaire (10.7% vs 10.0% ; p=0.84). Le taux de mortalité à 30 jours était de 3% dans le groupe I et 0% dans le groupe R (p= 0.34). Conclusion : selon les résultats de cette étude, la récidive de diverticulite n'entraîne pas plus de complications ni d'échec du traitement conservateur. De plus, le taux de prise en charge chirurgicale à l'admission du patient est moins fréquent en cas de récidive. Ces résultats remettent en questions le consensus actuel de prise en charge chirurgicale élective.