Analysis of the esophagogastric junction using the 3D high resolution manometry

Contexte & Objectifs : La manométrie perfusée conventionnelle et la manométrie haute résolution (HRM) ont permis le développement d’une variété de paramètres pour mieux comprendre la motilité de l'œsophage et quantifier les caractéristiques de la jonction œsophago-gastrique (JOG). Cependant, l'anatomie de la JOG est complexe et les enregistrements de manométrie détectent à la fois la pression des structures intrinsèques et des structures extrinsèques à l'œsophage. Ces différents composants ont des rôles distincts au niveau de la JOG. Les pressions dominantes ainsi détectées au niveau de la JOG sont attribuables au sphincter œsophagien inférieur (SOI) et aux piliers du diaphragme (CD), mais aucune des technologies manométriques actuelles n’est capable de distinguer ces différents composants de la JOG. Lorsqu’on analyse les caractéristiques de la JOG au repos, celle ci se comporte avant tout comme une barrière antireflux. Les paramètres manométriques les plus couramment utilisés dans ce but sont la longueur de la JOG et le point d’inversion respiratoire (RIP), défini comme le lieu où le pic de la courbe de pression inspiratoire change de positif (dans l’abdomen) à négatif (dans le thorax), lors de la classique manœuvre de « pull-through ». Cependant, l'importance de ces mesures reste marginale comme en témoigne une récente prise de position de l’American Gastroenterology Association Institute (AGAI) (1) qui concluait que « le rôle actuel de la manométrie dans le reflux gastro-œsophagien (RGO) est d'exclure les troubles moteurs comme cause des symptômes présentés par la patient ». Lors de la déglutition, la mesure objective de la relaxation de la JOG est la pression de relaxation intégrée (IRP), qui permet de faire la distinction entre une relaxation normale et une relaxation anormale de la JOG. Toutefois, puisque la HRM utilise des pressions moyennes à chaque niveau de capteurs, certaines études de manométrie laissent suggérer qu’il existe une zone de haute pression persistante au niveau de la JOG même si un transit est mis en évidence en vidéofluoroscopie. Récemment, la manométrie haute résolution « 3D » (3D-HRM) a été développée (Given Imaging, Duluth, GA) avec le potentiel de simplifier l'évaluation de la morphologie et de la physiologie de la JOG. Le segment « 3D » de ce cathéter de HRM permet l'enregistrement de la pression à la fois de façon axiale et radiale tout en maintenant une position fixe de la sonde, et évitant ainsi la manœuvre de « pull-through ». Par conséquent, la 3D-HRM devrait permettre la mesure de paramètres importants de la JOG tels que sa longueur et le RIP. Les données extraites de l'enregistrement fait par 3D-HRM permettraient également de différencier les signaux de pression attribuables au SOI des éléments qui l’entourent. De plus, l’enregistrement des pressions de façon radiaire permettrait d’enregistrer la pression minimale de chaque niveau de capteurs et devrait corriger cette zone de haute pression parfois persistante lors la déglutition. Ainsi, les objectifs de ce travail étaient: 1) de décrire la morphologie de la JOG au repos en tant que barrière antireflux, en comparant les mesures effectuées avec la 3D-HRM en temps réel, par rapport à celle simulées lors d’une manœuvre de « pull-through » et de déterminer quelles sont les signatures des pressions attribuables au SOI et au diaphragme; 2) d’évaluer la relaxation de la JOG pendant la déglutition en testant l'hypothèse selon laquelle la 3D-HRM permet le développement d’un nouveau paradigme (appelé « 3D eSleeve ») pour le calcul de l’IRP, fondé sur l’utilisation de la pression radiale minimale à chaque niveau de capteur de pression le long de la JOG. Ce nouveau paradigme sera comparé à une étude de transit en vidéofluoroscopie pour évaluer le gradient de pression à travers la JOG. Méthodes : Nous avons utilisé un cathéter 3D-HRM, qui incorpore un segment dit « 3D » de 9 cm au sein d’un cathéter HRM par ailleurs standard. Le segment 3D est composé de 12 niveaux (espacés de 7.5mm) de 8 capteurs de pression disposés radialement, soit un total de 96 capteurs. Neuf volontaires ont été étudiés au repos, où des enregistrements ont été effectués en temps réel et pendant une manœuvre de « pull-through » du segment 3D (mobilisation successive du cathéter de 5 mm, pour que le segment 3D se déplace le long de la JOG). Les mesures de la longueur du SOI et la détermination du RIP ont été réalisées. La longueur de la JOG a été mesurée lors du « pull-through » en utilisant 4 capteurs du segment 3D dispersés radialement et les marges de la JOG ont été définies par une augmentation de la pression de 2 mmHg par rapport à la pression gastrique ou de l’œsophage. Pour le calcul en temps réel, les limites distale et proximale de la JOG ont été définies par une augmentation de pression circonférentielle de 2 mmHg par rapport à la pression de l'estomac. Le RIP a été déterminée, A) dans le mode de tracé conventionnel avec la méthode du « pull-through » [le RIP est la valeur moyenne de 4 mesures] et B) en position fixe, dans le mode de représentation topographique de la pression de l’œsophage, en utilisant l’outil logiciel pour déterminer le point d'inversion de la pression (PIP). Pour l'étude de la relaxation de la JOG lors de la déglutition, 25 volontaires ont été étudiés et ont subi 3 études de manométrie (10 déglutitions de 5ml d’eau) en position couchée avec un cathéter HRM standard et un cathéter 3D-HRM. Avec la 3D-HRM, l’analyse a été effectuée une fois avec le segment 3D et une fois avec une partie non 3D du cathéter (capteurs standard de HRM). Ainsi, pour chaque individu, l'IRP a été calculée de quatre façons: 1) avec la méthode conventionnelle en utilisant le cathéter HRM standard, 2) avec la méthode conventionnelle en utilisant le segment standard du cathéter 3D-HRM, 3) avec la méthode conventionnelle en utilisant le segment « 3D » du cathéter 3D-HRM, et 4) avec le nouveau paradigme (3D eSleeve) qui recueille la pression minimale de chaque niveau de capteurs (segment 3D). Quatorze autres sujets ont subi une vidéofluoroscopie simultanée à l’étude de manométrie avec le cathéter 3D-HRM. Les données de pression ont été exportés vers MATLAB ™ et quatre pressions ont été mesurées simultanément : 1) la pression du corps de l’œsophage, 2cm au-dessus de la JOG, 2) la pression intragastrique, 3) la pression radiale moyenne de la JOG (pression du eSleeve) et 4) la pression de la JOG en utilisant la pression minimale de chaque niveau de capteurs (pression du 3D eSleeve). Ces données ont permis de déterminer le temps permissif d'écoulement du bolus (FPT), caractérisé par la période au cours de laquelle un gradient de pression existe à travers la JOG (pression œsophagienne > pression de relaxation de la JOG > pression gastrique). La présence ou l'absence du bolus en vidéofluoroscopie et le FPT ont été codés avec des valeurs dichotomiques pour chaque période de 0,1 s. Nous avons alors calculé la sensibilité et la spécificité correspondant à la valeur du FPT pour la pression du eSleeve et pour la pression du 3D eSleeve, avec la vidéofluoroscopie pour référence. Résultats : Les enregistrements avec la 3D-HRM laissent suggérer que la longueur du sphincter évaluée avec la méthode du « pull-through » était grandement exagéré en incorporant dans la mesure du SOI les signaux de pression extrinsèques à l’œsophage, asymétriques et attribuables aux piliers du diaphragme et aux structures vasculaires. L’enregistrement en temps réel a permis de constater que les principaux constituants de la pression de la JOG au repos étaient attribuables au diaphragme. L’IRP calculé avec le nouveau paradigme 3D eSleeve était significativement inférieur à tous les autres calculs d'IRP avec une limite supérieure de la normale de 12 mmHg contre 17 mmHg pour l’IRP calculé avec la HRM standard. La sensibilité (0,78) et la spécificité (0,88) du 3D eSleeve étaient meilleurs que le eSleeve standard (0,55 et 0,85 respectivement) pour prédire le FPT par rapport à la vidéofluoroscopie. Discussion et conclusion : Nos observations suggèrent que la 3D-HRM permet l'enregistrement en temps réel des attributs de la JOG, facilitant l'analyse des constituants responsables de sa fonction au repos en tant que barrière antireflux. La résolution spatiale axiale et radiale du segment « 3D » pourrait permettre de poursuivre cette étude pour quantifier les signaux de pression de la JOG attribuable au SOI et aux structures extrinsèques (diaphragme et artéfacts vasculaires). Ces attributs du cathéter 3D-HRM suggèrent qu'il s'agit d'un nouvel outil prometteur pour l'étude de la physiopathologie du RGO. Au cours de la déglutition, nous avons évalué la faisabilité d’améliorer la mesure de l’IRP en utilisant ce nouveau cathéter de manométrie 3D avec un nouveau paradigme (3D eSleeve) basé sur l’utilisation de la pression radiale minimale à chaque niveau de capteurs de pression. Nos résultats suggèrent que cette approche est plus précise que celle de la manométrie haute résolution standard. La 3D-HRM devrait certainement améliorer la précision des mesures de relaxation de la JOG et cela devrait avoir un impact sur la recherche pour modéliser la JOG au cours de la déglutition et dans le RGO.

“Studies on the Biology, Morphometrics and Biochemical composition of the Ommastrephid squid, Sthenoteuthis oualaniensis (Lesson,1830) of the south west coast of India”

With the stabilization of world finfish catches in general, and the depletion of a number of fish stocks that used to support industrial-scale fisheries, increasing attention is now being paid, to the so-called unconventional marine resources, which include many species of cephalopods. One of such important cephalopod resource is the tropical Indo-Pacific pelagic oceanic squid Sthenoteuthis oualaniensis. It is the most abundant large sized squid in the Indo- Pacific region with an estimated biomass of 8-11 metric tons. However, its distribution, biology, life cycle and nutrient value in the south west coast of India are still poorly known. So any new information of this species in the waters off the south west coast of India has important scientific significance for effective and rational utilization of this Oceanic fishery resources, especially during the time of depletion of shallow water resources. In view of that this study investigated different aspects of the Sthenoteuthis oualaniensis, such as morphometry, growth, mortality, maturation, spawning, food, feeding and biochemical composition in the south west coast of India to understand its possible prospective importance for commercial fishing and management of its fishery

Biogeochemistry of the shelf sediments of south eastern Arabian sea: Effect on benthic bacterial heterotrophs

The composition and variability of heterotrophic bacteria along the shelf sediments of south west coast of India and its relationship with the sediment biogeochemistry was investigated. The bacterial abundance ranged from 1.12 x 103 – 1.88 x 106 CFU g-1 dry wt. of sediment. The population showed significant positive correlation with silt (r = 0.529, p< 0.05), organic carbon (OC) (r = 0.679, p< 0.05), total nitrogen (TN) (r = 0.638, p< 0.05), total protein (TPRT) (r = 0.615, p< 0.05) and total carbohydrate (TCHO) (r = 0.675, p< 0.05) and significant negative correlation with sand (r = -0.488, p< 0.05). Community was mainly composed of Bacillus, Alteromonas, Vibrio, Coryneforms, Micrococcus, Planococcus, Staphylococcus, Moraxella, Alcaligenes, Enterobacteriaceae, Pseudomonas, Acinetobacter, Flavobacterium and Aeromonas. BIOENV analysis explained the best possible environmental parameters i.e., carbohydrate, total nitrogen, temperature, pH and sand at 50m depth and organic matter, BPC, protein, lipid and temperature at 200m depth controlling the distribution pattern of heterotrophic bacterial population in shelf sediments. The Principal Component Analysis (PCA) of the environmental variables showed that the first and second principal component accounted for 65% and 30.6% of the data variance respectively. Canonical Correspondence Analysis (CCA) revealed a strong correspondence between bacterial distribution and environmental variables in the study area. Moreover, non-metric MDS (Multidimensional Scaling) analysis demarcated the northern and southern latitudes of the study area based on the bioavailable organic matter

A concise summary of the International System of Units, the SI

The Bureau International des Poids et Mesures, the BIPM, was established by Article 1 of the Convention du Mètre, on 20 May 1875, and is charged with providing the basis for a single, coherent system of measurements to be used throughout the world. The decimal metric system, dating from the time of the French Revolution, was based on the metre and the kilogram. Under the terms of the 1875 Convention, new international prototypes of the metre and kilogram were made and formally adopted by the first Conférence Générale des Poids et Mesures (CGPM) in 1889. Over time this system developed, so that it now includes seven base units. In 1960 it was decided at the 11th CGPM that it should be called the Système International d’Unités, the SI (in English: the International System of Units). The SI is not static but evolves to match the world’s increasingly demanding requirements for measurements at all levels of precision and in all areas of science, technology, and human endeavour. This document is a summary of the SI Brochure, a publication of the BIPM which is a statement of the current status of the SI. The seven base units of the SI, listed in Table 1, provide the reference used to define all the measurement units of the International System. As science advances, and methods of measurement are refined, their definitions have to be revised. The more accurate the measurements, the greater the care required in the realization of the units of measurement.

A cross-cultural examination of the psychometric properties of responses to the Achievement Goal Questionnaire

The psychometric properties of scores from the Achievement Goal Questionnaire were examined in samples of Japanese (N = 326) and Canadian (N = 307) post secondary students. Previous research found evidence of a four-factor structure of achievement goals in U.S. samples. Using confirmatory factor-analytic techniques, the authors found strong evidence for the four-factor structure of achievement goals in both the Canadian and Japanese populations. Subsequent multi group structural equation modeling indicated the metric invariance of this four-factor structure across the two populations.

A comparison of GOCE and drifter-based estimates of the North Atlantic steady-state surface circulation

Over the last decade, due to the Gravity Recovery And Climate Experiment (GRACE) mission and, more recently, the Gravity and steady state Ocean Circulation Explorer (GOCE) mission, our ability to measure the ocean’s mean dynamic topography (MDT) from space has improved dramatically. Here we use GOCE to measure surface current speeds in the North Atlantic and compare our results with a range of independent estimates that use drifter data to improve small scales. We find that, with filtering, GOCE can recover 70% of the Gulf Steam strength relative to the best drifter-based estimates. In the subpolar gyre the boundary currents obtained from GOCE are close to the drifter-based estimates. Crucial to this result is careful filtering which is required to remove small-scale errors, or noise, in the computed surface. We show that our heuristic noise metric, used to determine the degree of filtering, compares well with the quadratic sum of mean sea surface and formal geoid errors obtained from the error variance–covariance matrix associated with the GOCE gravity model. At a resolution of 100 km the North Atlantic mean GOCE MDT error before filtering is 5 cm with almost all of this coming from the GOCE gravity model.

Psychometric properties of the parent-infant caregiving touch scale

Recent work in animals suggests that the extent of early tactile stimulation by parents of offspring is an important element in early caregiving. We evaluate the psychometric properties of a new parent-report measure designed to assess frequency of tactile stimulation across multiple caregiving domains in infancy. We describe the full item set of the Parent-Infant Caregiving Touch Scale (PICTS) and, using data from a UK longitudinal Child Health and Development Study, the response frequencies and factor structure and whether it was invariant over two time points in early development (5 and 9 weeks). When their infant was 9 weeks old, 838 mothers responded on the PICTS while a stratified subsample of 268 mothers completed PICTS at an earlier 5 week old assessment (229 responded on both occasions). Three PICTS factors were identified reflecting stroking, holding and affective communication. These were moderately to strongly correlated at each of the two time points of interest and were unrelated to, and therefore distinct from, a traditional measure of maternal sensitivity at 7-months. A wholly stable psychometry over 5 and 9-week assessments was not identified which suggests that behavior profiles differ slightly for younger and older infants. Tests of measurement invariance demonstrated that all three factors are characterized by full configural and metric invariance, as well as a moderate degree of evidence of scalar invariance for the stroking factor. We propose the PICTS as a valuable new measure of important aspects of caregiving in infancy.

Predictability of the Arctic sea ice edge

Skillful sea ice forecasts from days to years ahead are becoming increasingly important for the operation and planning of human activities in the Arctic. Here we analyze the potential predictability of the Arctic sea ice edge in six climate models. We introduce the integrated ice-edge error (IIEE), a user-relevant verification metric defined as the area where the forecast and the “truth” disagree on the ice concentration being above or below 15%. The IIEE lends itself to decomposition into an absolute extent error, corresponding to the common sea ice extent error, and a misplacement error. We find that the often-neglected misplacement error makes up more than half of the climatological IIEE. In idealized forecast ensembles initialized on 1 July, the IIEE grows faster than the absolute extent error. This means that the Arctic sea ice edge is less predictable than sea ice extent, particularly in September, with implications for the potential skill of end-user relevant forecasts.

The long wavelength limit of hard thermal loop effective actions

We derive a closed form expression for the long wavelength limit of the effective action for hard thermal loops in an external gravitational field. It is a function of the metric, independent of time derivatives. It is compared and contrasted with the static limit, and with the corresponding limits in an external Yang-Mills field. (C) 2009 Elsevier B.V. All rights reserved.

Action of the gravitational field on the dynamical Casimir effect

In this paper, we analyze the action of the gravitational field on the dynamical Casimir effect. We consider a massless scalar field confined in a cuboid cavity placed in a gravitational field described by a static and diagonal metric. With one of the plane mirrors of the cavity allowed to move, we compute the average number of particles created inside the cavity by means of the Bogoliubov coefficients computed through perturbative expansions. We apply our result to the case of an oscillatory motion of the mirror, assuming a weak gravitational field described by the Schwarzschild metric. The regime of parametric amplification is analyzed in detail, demonstrating that our computed result for the mean number of particles created agrees with specific associated cases in the literature. Our results, obtained in the framework of the perturbation theory, are restricted, under resonant conditions, to a short-time limit.

GENOTYPE CHARACTERIZATION OF THE Haematobia irritans (DIPTERA: MUSCIDAE) FROM BRAZIL, DOMINICAN REPUBLIC AND COLOMBIA BASED ON RANDOMLY AMPLIFIED POLYMORPHIC DNA (RAPD) ANALYSIS

Blood-sucking flies are important parasites in animal production systems, especially regarding confinement conditions. Haematobia irritans, the horn fly, is one of the most troublesome species within bovine production systems, due to the intense stress imposed to the animals. H. irritans is one of the parasites of cattle that cause significant economic losses in many parts of the world, including South America. In the present work, Brazilian, Colombian and Dominican Republic populations of this species were studied by Random Amplified Polymorphic DNA(RAPD) to assess basically genetic variability between populations. Fifteen different decamer random primers were employed in the genomic DNA amplification, yielding 196 fragments in the three H. irritans populations. Among h. irritans samples, that from Colombia produced the smallest numbers of polymorphic hands. This high genetic homogeneity may be ascribed to its geographic origin, which causes high isolation, low gene flow, unlike the other American populations, from Brazil and Dominican Republic. Molecular marker fragments, which its produced exclusive bands, detected in every sample enabled the population origin to be characterized, but they are also potentially useful for further approaches such as the putative origin of Brazilian, Colombian and Dominican Republic populations of horn fly from South America. Similarity indices produced by chemo metric analysis showed the closest relationships between flies from Brazil and Dominican Republic, while flies from Colombia showed the greatest genotypic differentiation relative to the others populations.

The fish zonation of the Itanha,m river basin in the Atlantic Forest of southeast Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Gravitational Lorentz force and the description of the gravitational interaction

In the context of a gauge theory for the translation group, we have obtained, for a spinless particle, a gravitational analogue of the Lorentz force. Then, we have shown that this force equation can be rewritten in terms of magnitudes related to either the teleparallel or the Riemannian structures induced in spacetime by the presence of the gravitational field. In the first case, it gives a force equation, with torsion playing the role of force. In the second, it gives the usual geodesic equation of general relativity. The main conclusion is that scalar matter is able to feel any one of the above spacetime geometries, the teleparallel and the metric ones. Furthermore, both descriptions are found to be completely equivalent in the sense that they give the same physical trajectory for a spinless particle in a gravitational field.

Riemannian and teleparallel descriptions of the scalar field gravitational interaction

A comparative study between the metric and the teleparallel descriptions of gravitation is made for the case of a scalar field. In contrast to the current belief that only spin matter could detect the teleparallel geometry, scalar matter being able to feel the metric geometry only, we show that a scalar field is able not only to feel anyone of these geometries, but also to produce torsion. Furthermore, both descriptions are found to be completely equivalent, which means that in fact, besides coupling to curvature, a scalar field couples also to torsion.

On the Acoustic Filtering of the Pipe and Sensor in a Buried Plastic Water Pipe and its Effect on Leak Detection: An Experimental Investigation

Acoustic techniques have been used for many years to find and locate leaks in buried water distribution systems. Hydrophones and accelerometers are typically used as sensors. Although geophones could be used as well, they are not generally used for leak detection. A simple acoustic model of the pipe and the sensors has been proposed previously by some of the authors of this paper, and their model was used to explain some of the features observed in measurements. However, simultaneous measurements of a leak using all three sensor-types in controlled conditions for plastic pipes has not been reported to-date and hence they have not yet been compared directly. This paper fills that gap in knowledge. A set of measurements was made on a bespoke buried plastic water distribution pipe test rig to validate the previously reported analytical model. There is qualitative agreement between the experimental results and the model predictions in terms of the differing filtering properties of the pipe-sensor systems. A quality measure for the data is also presented, which is the ratio of the bandwidth over which the analysis is carried out divided by the centre frequency of this bandwidth. Based on this metric, the accelerometer was found to be the best sensor to use for the test rig described in this paper. However, for a system in which the distance between the sensors is large or the attenuation factor of the system is high, then it would be advantageous to use hydrophones, even though they are invasive sensors.