Health-related quality of life in patients with newly diagnosed inflammatory bowel disease: an observational prospective cohort study (IBSEN III)

PURPOSE

This unselected, population-based cohort study aimed to determine the level of health-related quality of life (HRQoL) in patients with Crohn's disease (CD) and ulcerative colitis (UC) at the time of diagnosis compared with a reference population and identify the demographic factors, psychosocial measures, and disease activity markers associated with HRQoL.

METHODS

Adult patients newly diagnosed with CD or UC were prospectively enrolled. HRQoL was measured using the Short Form 36 (SF-36) and Norwegian Inflammatory Bowel Disease Questionnaires. Clinical significance was assessed using Cohen's d effect size and further compared with a Norwegian reference population. Associations between HRQoL and symptom scores, demographic factors, psychosocial measures, and disease activity markers were analyzed.

RESULTS

Compared with the Norwegian reference population, patients with CD and UC reported significantly lower scores in all SF-36 dimensions, except for physical functioning. Cohen's d effect sizes for men and women in all SF-36 dimensions were at least moderate, except for bodily pain and emotional role for men with UC and physical functioning for both sexes and diagnoses. In the multivariate regression analysis, depression subscale scores ≥ 8 on the Hospital Anxiety and Depression Scale, substantial fatigue, and high symptom scores were associated with reduced HRQoL.

CONCLUSION

Patients newly diagnosed with CD and UC reported statistically and clinically significantly lower scores in seven of the eight SF-36 dimensions than the reference population. Symptoms of depression, fatigue, and elevated symptom scores were associated with poorer HRQoL.

Calibration process for rechargeable cell and battery test systems

Coulombic efficiency is a powerful metric for evaluating the performance of materials in rechargeable cells and batteries. The ideal Coulombic efficiency, the ratio of charge removed to charge inserted, is unity. Some specialized systems can accurately measure cell capacity and Coulombic efficiency within 0.001%, which requires precise control and measurement of current, voltage, time, and temperature. Most battery electrode and electrolyte research is not performed with such precise but complex systems. The purpose of this paper is to demonstrate a simple, robust procedure to measure and possibly improve the accuracy of capacity and Coulombic efficiency measurements on standard systems in their as-used state. This approach is built on a commercially available thin film rechargeable cell for micro or milliampere currents and can be extended to, e.g., 18 650, cells for higher currents. An improved method to display Coulombic efficiency data is also presented. Regular, consistent calibration of testing systems and reporting of system resolution at specified test conditions is encouraged.

Rate of Anastomotic Leakage After Rectal Anastomosis Depends on the Definition: Pelvic Abscesses are Significant

BACKGROUND AND AIMS

The International Study Group of Rectal Cancer has proposed that a pelvic abscess in the proximity of the anastomosis is considered an anastomotic leak, whether or not its point of origin is detectable. This study describes how the inclusion of pelvic abscesses alters the leakage rate.

MATERIAL AND METHODS

Risk factors and postoperative complications in patients with visible anastomotic leakage ("direct leakage"), pelvic abscesses alone in the vicinity of a visibly intact anastomosis ("abscess leakage"), and no leakage were retrospectively evaluated.

RESULTS

In total, 341 patients operated with anterior resections and who received an anastomosis within 15 cm as measured from the anal verge were included. A total of 37 patients (10.9%) had direct leakage, 13 (3.8%) had abscess leakage, and 291 (85.3%) had no leakage. The overall anastomotic leakage rate was 14.7% (50 patients). In accordance with the grading system outlined by International Study Group of Rectal Cancer, 7 patients (2.1%) experienced Grade A leakage, 19 (5.6%) Grade B, and 24 (7.0%) Grade C. Direct leak patients had more often a reoperation due to anastomotic complications (odds ratio = 19.7, p = 0.001), a permanent stoma (odds ratio = 28.5, p = 0.001), and a longer hospital stay than abscess leak patients (29.0 vs 15.5 days, p = 0.030).

CONCLUSION

Abscess leakage accounted for over one-fourth of the overall leakage rate, raising the leakage rate. Direct leak patients were at a higher risk of requiring a reoperation, permanent stoma, and longer hospital stay than abscess leak patients. Abscess leak patients were at a greater risk for a urinary tract infection, wound infection, and postoperative intestinal obstruction than non-leak patients.

All-metal AFM probes fabricated from microstructurally tailored Cu-Hf thin films

A growing number of atomic force microscope (AFM) applications make use of metal-coated probes. Probe metallization can cause adverse side-effects and disadvantages such as stress-induced cantilever bending, thermal expansion mismatch, increased tip radius and limited device lifetime due to coating wear. In this study we demonstrate how to overcome these limitations using microstructural design to create a metallic glass thin film alloy, from which monostructural all-metal AFM cantilevers are fabricated. A detailed compositional study of co-sputtered Cu-Hf films is performed using x-ray diffraction (XRD), nanoindentation, four-point probe and in situ multi-beam optical stress sensing (MOSS). Metallic glass Cu(90)Hf(10) films are found to possess an optimal combination of electrical resistivity (96 microOmega cm), nanoindentation hardness (5.2 GPa), ductility and incremental stress. A continuum model is developed which uses measured MOSS data to predict cantilever warping caused by stress gradients generated during film growth. Subsequently, a microfabrication process is developed to create Cu(90)Hf(10) AFM probes. Uncurled, 1 microm thick cantilevers having lengths of 100-400 microm are fabricated, with tip radii ranging from 10 to 40 nm. As a proof of principle, these all-metal Cu-Hf AFM probes are mounted in a commercial AFM and used to successfully image a known test structure.