Vitamin D levels in the assessment of Crohn's disease activity and their relation to nutritional status and inflammation.

BACKGROUND: Crohn's disease (CD) is frequently associated with malnutrition, inflammation and a deficiency of vitamin D (VD) with the relationships between these symptoms being poorly defined. VD is a modulator of the immune system and is associated with the onset of CD and disease activity. The level of serum VD may have potential in the assessment of CD activity. This study aimed to evaluate the relationships between VD, nutritional status and inflammation, and to identify more accurate VD thresholds. METHODS: The study included 76 outpatients with CD diagnosed between October 2018 and October 2020 and 76 healthy volunteers. Levels of serum 25(OH)D and nutritional indicators, as well as biochemical and disease activity assessments, were conducted. RESULTS: Patients with CD and healthy participants were found to differ significantly in their 25(OH)D levels as well in levels of nutritional and inflammatory indicators. The optimal VD cut-off value was found to be 46.81 nmol/L for CD development and 35.32 nmol/L for disease activity. Levels of 25(OH)D were correlated with both nutritional status and inflammation. CONCLUSIONS: The VD level is likely to be a useful additional tool in the evaluation of CD patients and predicting the disease activity and clinical response. The VD level may relate both to the nutritional status and levels of inflammation in CD patients, and disease progression.

Dose distributions of an ¹9²Ir brachytherapy source in different media.

This study used MCNPX code to investigate the brachytherapy (192)Ir dose distributions in water, bone, and lung tissue and performed radiophotoluminescent glass dosimeter measurements to verify the obtained MCNPX results. The results showed that the dose-rate constant, radial dose function, and anisotropy function in water were highly consistent with data in the literature. However, the lung dose near the source would be overestimated by up to 12%, if the lung tissue is assumed to be water, and, hence, if a tumor is located in the lung, the tumor dose will be overestimated, if the material density is not taken into consideration. In contrast, the lung dose far from the source would be underestimated by up to 30%. Radial dose functions were found to depend not only on the phantom size but also on the material density. The phantom size affects the radial dose function in bone more than those in the other tissues. On the other hand, the anisotropy function in lung tissue was not dependent on the radial distance. Our simulation results could represent valid clinical reference data and be used to improve the accuracy of the doses delivered during brachytherapy applied to patients with lung cancer.

On tests of rate ratio under standard inverse sampling.

Inverse sampling suggests one continues to sample subjects until a pre-specified number of rare events of interest is observed. It is generally considered to be more appropriate than the usual binomial sampling when the subjects come sequentially, when the response probability is rare, and when maximum likelihood estimators of some epidemiological measures are undefined under binomial sampling. Reliable but conservative exact conditional procedure for the ratio of the response probabilities of subject without the attribute of interest has been studied. However, such a procedure is inapplicable to the risk ratio (i.e., ratio of the response probabilities of subject with the attribute of interest). In this paper, we investigate various test statistics (namely Wald-type, score and likelihood ratio test statistics) for testing non-unity risk ratio under standard inverse sampling scheme, which suggests one continue to sample until the predetermined number of index subjects with the attributes of interest is observed. Both asymptotic and numerical approximate unconditional methods are considered for P-value calculation. Performance of these test procedures are evaluated under different settings by means of Monte Carlo simulation. In general, the Wald-type test statistic is preferable for its satisfactory and stable performance with approximate unconditional procedures. The methodologies are illustrated with a real example from a heart disease study.