Manually calculated oesophageal bolus clearance time increases in parallel with reflux severity at impedance-pH monitoring.

BACKGROUND Oesophageal clearance has been scarcely studied. AIMS Oesophageal clearance in endoscopy-negative heartburn was assessed to detect differences in bolus clearance time among patients sub-grouped according to impedance-pH findings. METHODS In 118 consecutive endoscopy-negative heartburn patients impedance-pH monitoring was performed off-therapy. Acid exposure time, number of refluxes, baseline impedance, post-reflux swallow-induced peristaltic wave index and both automated and manual bolus clearance time were calculated. Patients were sub-grouped into pH/impedance positive (abnormal acid exposure and/or number of refluxes) and pH/impedance negative (normal acid exposure and number of refluxes), the former further subdivided on the basis of abnormal/normal acid exposure time (pH+/-) and abnormal/normal number of refluxes (impedance+/-). RESULTS Poor correlation (r=0.35) between automated and manual bolus clearance time was found. Manual bolus clearance time progressively decreased from pH+/impedance+ (42.6s), pH+/impedance- (27.1s), pH-/impedance+ (17.8s) to pH-/impedance- (10.8s). There was an inverse correlation between manual bolus clearance time and both baseline impedance and post-reflux swallow-induced peristaltic wave index, and a direct correlation between manual bolus clearance and acid exposure time. A manual bolus clearance time value of 14.8s had an accuracy of 93% to differentiate pH/impedance positive from pH/impedance negative patients. CONCLUSIONS When manually measured, bolus clearance time reflects reflux severity, confirming the pathophysiological relevance of oesophageal clearance in reflux disease.

Bufferless Compression of Asynchronously Sampled ECG Signals in Cubic Hermitian Vector Space.

Asynchronous level crossing sampling analog-to-digital converters (ADCs) are known to be more energy efficient and produce fewer samples than their equidistantly sampling counterparts. However, as the required threshold voltage is lowered, the number of samples and, in turn, the data rate and the energy consumed by the overall system increases. In this paper, we present a cubic Hermitian vector-based technique for online compression of asynchronously sampled electrocardiogram signals. The proposed method is computationally efficient data compression. The algorithm has complexity O(n), thus well suited for asynchronous ADCs. Our algorithm requires no data buffering, maintaining the energy advantage of asynchronous ADCs. The proposed method of compression has a compression ratio of up to 90% with achievable percentage root-mean-square difference ratios as a low as 0.97. The algorithm preserves the superior feature-to-feature timing accuracy of asynchronously sampled signals. These advantages are achieved in a computationally efficient manner since algorithm boundary parameters for the signals are extracted a priori.

Training primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before-after and parallel group surveys.

OBJECTIVES Primary care physicians (PCPs) should prescribe faecal immunochemical testing (FIT) or colonoscopy for colorectal cancer screening based on their patient's values and preferences. However, there are wide variations between PCPs in the screening method prescribed. The objective was to assess the impact of an educational intervention on PCPs' intent to offer FIT or colonoscopy on an equal basis. DESIGN Survey before and after training seminars, with a parallel comparison through a mailed survey to PCPs not attending the training seminars. SETTING All PCPs in the canton of Vaud, Switzerland. PARTICIPANTS Of 592 eligible PCPs, 133 (22%) attended a seminar and 106 (80%) filled both surveys. 109 (24%) PCPs who did not attend the seminars returned the mailed survey. INTERVENTION A 2 h-long interactive seminar targeting PCP knowledge, skills and attitudes regarding offering a choice of colorectal cancer (CRC) screening options. OUTCOME MEASURES The primary outcome was PCP intention of having their patients screened with FIT and colonoscopy in equal proportions (between 40% and 60% each). Secondary outcomes were the perceived role of PCPs in screening decisions (from paternalistic to informed decision-making) and correct answer to a clinical vignette. RESULTS Before the seminars, 8% of PCPs reported that they had equal proportions of their patients screened for CRC by FIT and colonoscopy; after the seminar, 33% foresaw having their patients screened in equal proportions (p<0.001). Among those not attending, there was no change (13% vs 14%, p=0.8). Of those attending, there was no change in their perceived role in screening decisions, while the proportion responding correctly to a clinical vignette increased (88-99%, p<0.001). CONCLUSIONS An interactive training seminar increased the proportion of physicians with the intention to prescribe FIT and colonoscopy in equal proportions.

The influence of contact pressure, moisture, and compression time on the performance of cotton anti-contamination clothing

The objectives of this research were (1) to study the effect of contact pressure, compression time, and liquid (moisture content of the fabric) on the transfer by sliding contact of non-fixed surface contamination to protective clothing constructed from uncoated, woven fabrics, (2) to study the effect of contact pressure, compression time, and liquid content on the subsequent penetration through the fabric, and (3) to determine if varying the type of contaminant changes the effect of contact pressure, compression time, and liquid content on the transfer by sliding contact and penetration of non-fixed surface contamination. ^ It was found that the combined influence of the liquid (moisture content of the fabric), load (contact pressure), compression time, and their interactions significantly influenced the penetration of all three test agents, sucrose- 14C, triolein-3H, and starch-14C through 100% cotton fabric. The combined influence of the statistically significant main effects and their interactions increased the penetration of triolein- 3H by 32,548%, sucrose-14C by 7,006%, and starch- 14C by 1,900%. ^

Geotechnical properties of shelf sdiments from the Prydz Bay

This paper presents a geotechnical characterization of the glacigenic sediments in Prydz Bay, East Antarctica, based on the shipboard physical properties data obtained during Leg 119, combined with results of land-based analyses of 24 whole-round core samples. Main emphasis is placed on the land-based studies, which included oedometer consolidation tests, triaxial and simple shear tests for undrained shear strength, permeability tests in oedometer and triaxial cell, Atterberg limits, and grain-size analyses. The bulk of the tested sediments comprise overconsolidated diamictites of a relatively uniform lithology. The overconsolidation results from a combination of glacial loading and sediment overburden subsequently removed by extensive glacial erosion of the shelf. This leads to downhole profiles of physical properties that have been observed not to change as a function of the thickness of present overburden. A number of fluctuations in the parameters shows a relatively systematic trend and most likely results from changes in the proximity to the ice sheet grounding line in response to variations in the glacial regime. Very low permeabilities mainly result from high preconsolidation stresses (Pc'). Pc' values up to 10,000 kPa were estimated from the oedometer tests, and empirical estimates based on undrained shear strengths (up to 2500 kPa) indicate that the oedometer results are conservative. The diamictites generally classify as inactive, of low to medium plasticity, and they consolidate with little deformation, even when subjected to great stresses. This is the first report of geotechnical data from deep boreholes on the Antarctic continental shelf, but material of similar character can also be expected in other areas around the Antarctic.

Compression and expansion index and void ratio of samples from Lomonosov Ridge and Yermak Plateau

With the coupled use of multibeam swath bathymetry, high-resolution subbottom profiling and sediment coring from icebreakers in the Arctic Ocean, there is a growing awareness of the prevalence of Quaternary ice-grounding events on many of the topographic highs found in present water depths of <1000 m. In some regions, such as the Lomonosov Ridge and Yermak Plateau, overconsolidated sediments sampled through either drilling or coring are found beneath seismically imaged unconformities of glacigenic origin. However, there exists no comprehensive analysis of the geotechnical properties of these sediments, or how their inferred stress state may be related to different glacigenic processes or types of ice-loading. Here we combine geophysical, stratigraphic and geotechnical measurements from the Lomonosov Ridge and Yermak Plateau and discuss the glacial geological implications of overconsolidated sediments. The degree of overconsolidation, determined from measurements of porosity and shear strength, is shown to result from consolidation and/or deformation below grounded ice and, with the exception of a single region on the Lomonosov Ridge, cannot be explained by erosion of overlying sediments. We demonstrate that the amount and depth of porosity loss associated with a middle Quaternary (~ 790-950 thousand years ago - ka) grounding on the Yermak Plateau is compatible with sediment consolidation under an ice sheet or ice rise. Conversely, geotechnical properties of sediments from beneath late Quaternary ice-groundings in both regions, independently dated to Marine Isotope Stage (MIS) 6, indicate a more transient event commensurate with a passing tabular iceberg calved from an ice shelf.

Stress tests of ODP Site 131-808 sediments

Sediments undergoing accretion in trench-forearc systems are subjected to conditions of large lateral thrusting. This stress regime controls the mechanism of faulting as well as the yield and strength properties of the sediment. Understanding them is therefore crucial for the construction of quantitative models of sediment dynamics in convergent margin settings. For this purpose triaxial and oedometer tests were performed on six whole-round core samples recovered from Site 808 from depths between 173 and 705 mbsf. Samples from five depth intervals were subjected to a triaxial test program that was primarily designed to define yield and strength behavior. Test specimens were cut parallel and normal to the core axis. Additional five oedometer tests with similarly prepared specimens were performed on samples from four depth intervals to evaluate the directional state and degree of sediment compaction. Test results show that the degree of sediment compaction is higher than expected from overburden. This overcompaction increases with depth. A well-developed mechanical anisotropy is evident in all samples tested, regardless of their depth and lithology. Values of yield limit, stiffness, and shear strength are up to 40% higher in the horizontal direction compared to the vertical direction. In addition the test data demonstrate that the axis of the volumetric yield loci have rotated into extensional stress field. This verifies that the mechanical state of sediment in the accretionary wedge is controlled by in-situ stress conditions of extensional nature. The coefficients of lateral stress inferred suggest that the extensional stress regime becomes increasingly effective with depth.

Fly-through movie for the reconstructed folds in the onset region of the Petermann Glacier, North Greenland

The increasing catalogue of high-quality ice-penetrating radar data provides a unique insight in the internal layering architecture of the Greenland ice sheet. The stratigraphy, an indicator of past deformation, highlights irregularities in ice flow and reveals large perturbations without obvious links to bedrock shape. In this work, to establish a new conceptual model for the formation process, we analysed the radar data at the onset of the Petermann Glacier, North Greenland, and created a three-dimensional model of several distinct stratigraphic layers. We demonstrate that the dominant structures are cylindrical folds sub-parallel to the ice flow. By numerical modelling, we show that these folds can be formed by lateral compression of mechanically anisotropic ice, while a general viscosity contrast between layers would not lead to folding for the same boundary conditions. We conclude that the folds primarily form by converging flow as the mechanically anisotropic ice is channelled towards the glacier.