Proton pump inhibitor prescribing following Endoscopic diagnosis in a district general hospital

Focal points: A systematic review of the use of proton pump inhibitors was conducted among patients undergoing diagnostic fibreoptic endoscopic examination of the upper gastrointestinal tract during the period July 2001 to February 2002 inclusive A total of 2,557 patients received a PPI following endoscopy and healing doses were prescribed to 75.3 per cent of these patients An “unknown indication” was stated as a diagnosis in 958 patients (37.5 per cent) of patients studied Although endoscopic diagnosis does not appear possible in all cases, the present study demonstrates that NICE guidance to employ the lowest appropriate dose of PPI is followed

Simple design method for gain-flattened three-pump Raman amplifiers

A simple and efficient approach to the optimal design of 3-wavelength backward-pumped Raman amplifiers is proposed. Gain flatness of 1.7 dB is demonstrated in a spectral range of 1520-1595 nm using only three pumps with wavelengths within the 1420-1480 nm interval.

High performance liquid level monitoring system based on polymer fiber Bragg gratings embedded in silicone rubber diaphragm

Liquid-level sensing technologies have attracted great prominence, because such measurements are essential to industrial applications, such as fuel storage, flood warning and in the biochemical industry. Traditional liquid level sensors are based on electromechanical techniques; however they suffer from intrinsic safety concerns in explosive environments. In recent years, given that optical fiber sensors have lots of well-established advantages such as high accuracy, costeffectiveness, compact size, and ease of multiplexing, several optical fiber liquid level sensors have been investigated which are based on different operating principles such as side-polishing the cladding and a portion of core, using a spiral side-emitting optical fiber or using silica fiber gratings. The present work proposes a novel and highly sensitive liquid level sensor making use of polymer optical fiber Bragg gratings (POFBGs). The key elements of the system are a set of POFBGs embedded in silicone rubber diaphragms. This is a new development building on the idea of determining liquid level by measuring the pressure at the bottom of a liquid container, however it has a number of critical advantages. The system features several FBG-based pressure sensors as described above placed at different depths. Any sensor above the surface of the liquid will read the same ambient pressure. Sensors below the surface of the liquid will read pressures that increase linearly with depth. The position of the liquid surface can therefore be approximately identified as lying between the first sensor to read an above-ambient pressure and the next higher sensor. This level of precision would not in general be sufficient for most liquid level monitoring applications; however a much more precise determination of liquid level can be made by linear regression to the pressure readings from the sub-surface sensors. There are numerous advantages to this multi-sensor approach. First, the use of linear regression using multiple sensors is inherently more accurate than using a single pressure reading to estimate depth. Second, common mode temperature induced wavelength shifts in the individual sensors are automatically compensated. Thirdly, temperature induced changes in the sensor pressure sensitivity are also compensated. Fourthly, the approach provides the possibility to detect and compensate for malfunctioning sensors. Finally, the system is immune to changes in the density of the monitored fluid and even to changes in the effective force of gravity, as might be obtained in an aerospace application. The performance of an individual sensor was characterized and displays a sensitivity (54 pm/cm), enhanced by more than a factor of 2 when compared to a sensor head configuration based on a silica FBG published in the literature, resulting from the much lower elastic modulus of POF. Furthermore, the temperature/humidity behavior and measurement resolution were also studied in detail. The proposed configuration also displays a highly linear response, high resolution and good repeatability. The results suggest the new configuration can be a useful tool in many different applications, such as aircraft fuel monitoring, and biochemical and environmental sensing, where accuracy and stability are fundamental. © (2015) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

The impact of pump phase-modulation and filtering on WDM signals in a fibre optical parametric amplifier

WDM signal degradation from pump phase-modulation in a one-pump 20dB net-gain fibre optical parametric amplifier is experimentally and numerically characterised for the first time using 10x59Gb/s QPSK signals.

Aviation fuel gauging sensor utilizing multiple diaphragm sensors incorporating polymer optical fiber Bragg gratings

A high-performance fuel gauging sensor is described that uses five diaphragm-based pressure sensors, which are monitored using a linear array of polymer optical fiber Bragg gratings. The sensors were initially characterized using water, revealing a sensitivity of 98 pm/cm for four of the sensors and 86 pm/cm for the fifth. The discrepancy in the sensitivity of the fifth sensor has been explained as being a result of the annealing of the other four sensors. Initial testing in JET A-1 aviation fuel revealed the unsuitability of silicone rubber diaphragms for prolonged usage in fuel. A second set of sensors manufactured with a polyurethane-based diaphragm showed no measurable deterioration over a three month period immersed in fuel. These sensors exhibited a sensitivity of 39 pm/cm, which is less than the silicone rubber devices due to the stiffer nature of the polyurethane material used.

Analisi dinamica e a regime del convertitore Dickson-Charge-Pump

I circuti di tipo charge-pump trovano vasto impiego nell'elettronica moderna in quanto offrono un metodo semplice e totalmente integrato per elevare le basse tensioni di alimentazione tipiche dei circuiti digitali e trasformarle nelle alimentazioni adatte al pilotaggio di circuti di programmazione delle memorie, al pilotaggio dei mos di potenza, alla generazione della tensione di riferimento dei VCO nei PLL e in numerose altre applicazioni. Questa tesi studia il circuito charge-pump di Dickson nel suo comportamento sia a regime stazionario sia a regime dinamico. Al fine di aumentare l'efficienza è infatti importante attivare il circuito solo all'occorrenza, prestando attenzione al transitorio di accensione. Ogni aspetto teorico viene verificato per mezzo di simulazioni su LTSpice. Si è quindi potuto constatare che un dimensionamento corretto del numero di stadi ottimizza le prestazioni sia statiche che dinamiche sotto il vincolo di una massima occupazione d'area. L'impiego dei circuiti charge-pump si prevede possa essere sempre più diffuso in futuro, visto il trend verso un maggiore livello di integrazione dei sistemi elettronici e la tendenza ad utilizzare tensioni di alimentazione sempre più basse.

Woman rests aching feet by taking off high-heeled pump (these uncomfortable shoes hamper a woman's mobility)

Inscriptions: Verso: [stamped] Photograph by Freda Leinwand. [463 West Street, Studio 229G, New York, NY 10014].

Individual Proton Pump Inhibitors and Outcomes in Patients With Coronary Artery Disease on Dual Antiplatelet Therapy: A Systematic Review.

BACKGROUND: Observational studies evaluating the possible interaction between proton pump inhibitors (PPIs) and clopidogrel have shown mixed results. We conducted a systematic review comparing the safety of individual PPIs in patients with coronary artery disease taking clopidogrel. METHODS AND RESULTS: Studies performed from January 1995 to December 2013 were screened for inclusion. Data were extracted, and study quality was graded for 34 potential studies. For those studies in which follow-up period, outcomes, and multivariable adjustment were comparable, meta-analysis was performed.The adjusted odds or hazard ratios for the composite of cardiovascular or all-cause death, myocardial infarction, and stroke at 1 year were reported in 6 observational studies with data on individual PPIs. Random-effects meta-analyses of the 6 studies revealed an increased risk for adverse cardiovascular events for those taking pantoprazole (hazard ratio 1.38; 95% CI 1.12-1.70), lansoprazole (hazard ratio 1.29; 95% CI 1.09-1.52), or esomeprazole (hazard ratio 1.27; 95% CI 1.02-1.58) compared with patients on no PPI. This association was not significant for omeprazole (hazard ratio 1.16; 95% CI 0.93-1.44). Sensitivity analyses for the coronary artery disease population (acute coronary syndrome versus mixed) and exclusion of a single study due to heterogeneity of reported results did not have significant influence on the effect estimates for any PPIs. CONCLUSIONS: Several frequently used PPIs previously thought to be safe for concomitant use with clopidogrel were associated with greater risk of adverse cardiovascular events. Although the data are observational, they highlight the need for randomized controlled trials to evaluate the safety of concomitant PPI and clopidogrel use in patients with coronary artery disease.

S332 pump station, south of TS/Ph-1, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

CpxR activates MexAB-OprM efflux pump expression and enhances antibiotic resistance in both laboratory and clinical nalB-type isolates of Pseudomonas aeruginosa

Resistance-Nodulation-Division (RND) efflux pumps are responsible for multidrug resistance in Pseudomonas aeruginosa. In this study, we demonstrate that CpxR, previously identified as a regulator of the cell envelope stress response in Escherichia coli, is directly involved in activation of expression of RND efflux pump MexAB-OprM in P. aeruginosa. A conserved CpxR binding site was identified upstream of the mexA promoter in all genome-sequenced P. aeruginosa strains. CpxR is required to enhance mexAB-oprM expression and drug resistance, in the absence of repressor MexR, in P. aeruginosa strains PA14. As defective mexR is a genetic trait associated with the clinical emergence of nalB-type multidrug resistance in P. aeruginosa during antibiotic treatment, we investigated the involvement of CpxR in regulating multidrug resistance among resistant isolates generated in the laboratory via antibiotic treatment and collected in clinical settings. CpxR is required to activate expression of mexAB-oprM and enhances drug resistance, in the absence or presence of MexR, in ofloxacin-cefsulodin-resistant isolates generated in the laboratory. Furthermore, CpxR was also important in the mexR-defective clinical isolates. The newly identified regulatory linkage between CpxR and the MexAB-OprM efflux pump highlights the presence of a complex regulatory network modulating multidrug resistance in P. aeruginosa.

Development of variable displacement oil pump for internal combustion engines

In the last years the need to develop more environmentally friendly and efficient cars as led to the development of several technologies to improve the performance of internal combustion engines, a large part of the innovations are focused in the auxiliary systems of the engine, including, the oil pump, this is an element of great importance in the dynamics of the engine as well a considerable energy consumer. Most solutions for oil pumps to this day are fixed displacement, for medium and high speeds, the pump flow rate is higher than the needs of the engine, this excess flow leads to the need for recirculation of the fluid which represents a waste of energy. Recently, technological advances in this area have led to the creation of variable displacement oil pumps, these have become a 'must have' due to the numerous advantages they bring, although the working principle of vane or piston pumps is relatively well known, the application of this technology for the automotive industry is new and brings new challenges. The focus of this dissertation is to develop a new concept of variable displacement system for automotive oil pumps. The main objective is to obtain a concept that is totally adaptable to existing solutions on the market (engines), both dimensionally as in performance specifications, having at the same time an innovative mechanical system for obtaining variable displacement. The developed design is a vane pump with variable displacement going in line with existing commercial solutions, however, the variation of the eccentricity commonly used to provide an variable displacement delivery is not used, the variable displacement is achieved without varying the eccentricity of the system but with a variation of the length of the pumping chamber. The principle of operation of the pump is different to existing solutions while maintaining the ability to integrate standard parts such as control valves and mechanical safety valves, the pump is compatible with commercial solutions in terms of interfaces for connection between engine systems and pump. A concept prototype of the product was obtained in order to better evaluate the validity of the concept. The developed concept represents an innovation in oil pumps design, being unique in its mechanical system for variable displacement delivery.

Harmonization of Life Cycle Climate Performance and Its Improvements for Heat Pump Applications

Life Cycle Climate Performance (LCCP) is an evaluation method by which heating, ventilation, air conditioning and refrigeration systems can be evaluated for their global warming impact over the course of their complete life cycle. LCCP is more inclusive than previous metrics such as Total Equivalent Warming Impact. It is calculated as the sum of direct and indirect emissions generated over the lifetime of the system “from cradle to grave”. Direct emissions include all effects from the release of refrigerants into the atmosphere during the lifetime of the system. This includes annual leakage and losses during the disposal of the unit. The indirect emissions include emissions from the energy consumption during manufacturing process, lifetime operation, and disposal of the system. This thesis proposes a standardized approach to the use of LCCP and traceable data sources for all aspects of the calculation. An equation is proposed that unifies the efforts of previous researchers. Data sources are recommended for average values for all LCCP inputs. A residential heat pump sample problem is presented illustrating the methodology. The heat pump is evaluated at five U.S. locations in different climate zones. An excel tool was developed for residential heat pumps using the proposed method. The primary factor in the LCCP calculation is the energy consumption of the system. The effects of advanced vapor compression cycles are then investigated for heat pump applications. Advanced cycle options attempt to reduce the energy consumption in various ways. There are three categories of advanced cycle options: subcooling cycles, expansion loss recovery cycles and multi-stage cycles. The cycles selected for research are the suction line heat exchanger cycle, the expander cycle, the ejector cycle, and the vapor injection cycle. The cycles are modeled using Engineering Equation Solver and the results are applied to the LCCP methodology. The expander cycle, ejector cycle and vapor injection cycle are effective in reducing LCCP of a residential heat pump by 5.6%, 8.2% and 10.5%, respectively in Phoenix, AZ. The advanced cycles are evaluated with the use of low GWP refrigerants and are capable of reducing the LCCP of a residential heat by 13.7%, 16.3% and 18.6% using a refrigerant with a GWP of 10. To meet the U.S. Department of Energy’s goal of reducing residential energy use by 40% by 2025 with a proportional reduction in all other categories of residential energy consumption, a reduction in the energy consumption of a residential heat pump of 34.8% with a refrigerant GWP of 10 for Phoenix, AZ is necessary. A combination of advanced cycle, control options and low GWP refrigerants are necessary to meet this goal.

The effect of the proton pump inhibitor pantoprazole on the biology of Campylobacter jejuni

Campylobacter is a major cause of acute bacterial gastroenteritis worldwide, with the highest number of infections being attributed to Campylobacter jejuni. C. jejuni is a Gram negative, spiral, motile bacterium that belongs to the campylobacterales order and is related to both Helicobacter spp. and Wolinella sp.. It has long been established that proton pump inhibitors (PPIs) and other benzimidazole derivatives display anti-Helicobacter activity in vitro. PPIs have in the past been shown to affect Helicobacter pylori growth, survival, motility, morphology, adhesion/invasion potential and susceptibility to conventional antibiotics. PPIs are highly effective drugs that are well tolerated, safe for prolonged daily use and are therefore in high demand. Both the PPIs omeprazole and lansoprazole featured in the top ten drugs prescribed in England in 2014. In 2014 Campylobacter was also the most commonly diagnosed gastrointestinal infection in Scotland, in England and Wales and also in Europe. It has previously been generally accepted that patients who are being treated with PPIs are more susceptible to enteric infections such as Campylobacter than people not taking PPIs. The effect of PPI exposure on H. pylori has been investigated rigorously in the past. A single previous study has hinted that PPIs may also be capable of affecting the related organism C. jejuni,but investigations have been extremely limited in comparison to those investigating the effect of PPIs on H. pylori. This study has investigated the in vitro effects of direct contact with PPIs on the biology ofC. jejuni. Exposure to the PPI pantoprazole was found to affect C. jejuni growth/survival, motility, morphology, biofilm formation, invasion potential and susceptibility to some conventional antibiotics. Microarray studies showed that the cmeA and Cj0561c genes were significantly up-regulated in response to pantoprazole exposure and a CmeABC deficient mutant was found to be significantly more susceptible to killing by pantoprazole than was the parent strain. Proteomic analysis indicated that the oxidative stress response of C. jejuni was induced following exposure to sub-lethal concentrations of pantoprazole. C. jejuni gene expression was assessed using qRT-PCR and the genes encoding for thiol peroxidase and GroEL co-chaperonin (both involved in the C. jejuni oxidative stress response) were found to be around four times higher in response to exposure to sub-lethal concentrations of pantoprazole. Experiments using the oxidative stress inhibitors thiourea (a hydroxyl radical quencher) and bipyridyl (a ferrous iron chelator) showed that killing by pantoprazole was not mediated by hydroxyl radical production.