The aim of this prospective study was to determine the prevalence and characteristics of acid gastro-oesophageal reflux (GER) in patients with idiopathic pulmonary fibrosis (IPF). Sixty-five ...consecutive patients with well-defined IPF were subjected to 24-h pH monitoring and oesophageal manometry. A total of 133 consecutive patients with intractable asthma and symptoms of GER were used as comparisons. The prevalence of abnormal acid GER in IPF patients was 87%, with 76% and 63% demonstrating abnormal distal and proximal oesophageal acid exposures, respectively. Abnormal acid GER was significantly more common in IPF patients than asthma patients. Only 47% of IPF patients experienced classic GER symptoms. Despite treatment with standard doses of proton pump inhibitors (PPIs), 12 out of 19 patients receiving PPIs during the 24-h pH monitoring had abnormal oesophageal acid exposures by pH probe. There was no correlation between IPF severity and acid GER severity. In conclusion, abnormal acid gastro-oesophageal reflux is highly prevalent, but often clinically occult in patients with idiopathic pulmonary fibrosis. Standard doses of proton pump inhibitors may not suppress the acid gastro-oesophageal reflux in this population. Therefore, further studies are needed to determine if acid abnormal gastro-oesophageal reflux represents an important risk factor for idiopathic pulmonary fibrosis development or progression, and if optimal suppression of acid gastro-oesophageal reflux slows the progression of idiopathic pulmonary fibrosis and/or decreases episodic exacerbations of idiopathic pulmonary fibrosis.
The unique optoelectronic properties of graphene make it an ideal platform for a variety of photonic applications, including fast photodetectors, transparent electrodes in displays and photovoltaic ...modules, optical modulators, plasmonic devices, microcavities, and ultra-fast lasers. Owing to its high carrier mobility, gapless spectrum and frequency-independent absorption, graphene is a very promising material for the development of detectors and modulators operating in the terahertz region of the electromagnetic spectrum (wavelengths in the hundreds of micrometres), still severely lacking in terms of solid-state devices. Here we demonstrate terahertz detectors based on antenna-coupled graphene field-effect transistors. These exploit the nonlinear response to the oscillating radiation field at the gate electrode, with contributions of thermoelectric and photoconductive origin. We demonstrate room temperature operation at 0.3 THz, showing that our devices can already be used in realistic settings, enabling large-area, fast imaging of macroscopic samples.
Objective
The development of an enzymatic assay for the specific quantification of the C1-oxidation product, i.e. gluconic acid of cellulose active lytic polysaccharide monooxygenases (LPMOs).
...Results
In combination with a β-glucosidase, the spectrophotometrical assay can reliably quantify the specific C1- oxidation product of LPMOs acting on cellulose. It is applicable for a pure cellulose model substrate as well as lignocellulosic biomass. The enzymatic assay compares well with the quantification performed by HPAEC-PAD. In addition, we show that simple boiling is not sufficient to inactivate LPMOs and we suggest to apply a metal chelator in addition to boiling or to drastically increase pH for proper inactivation.
Conclusions
We conclude that the versatility of this simple enzymatic assay makes it useful in a wide range of experiments in basic and applied LPMO research and without the need for expensive instrumentation, e.g. HPAEC-PAD.
•OECD/NEA project “Benchmark Study of the Accident at the Fukushima Daiichi Nuclear Power Plant (BSAF), phase 2.•Severe accident analyses for Unit 2 of Fukushima Daiichi.•Fukushima Daiichi Unit 2 ...specific aspects will be highlighted, Unit 1 and 3 aspects are presented separately.•Special focus is on reactor pressure vessel status, melt release and fission product behavior and release.
This is the second paper in a series of 3 in which results of severe accident analyses for Unit 2 of Fukushima Daiichi are presented, gained in phase 2 of the OECD/NEA project “Benchmark Study of the Accident at the Fukushima Daiichi Nuclear Power Plant (BSAF)”. Nine organizations of six countries (CNL Canada; CRIEPI, IAE, JAEA and NRA Japan; IRSN France; KAERI Korea; NRC/DOE/SNL U.S. and VTT Finland) submitted results of their calculated severe accident scenarios for Unit 2 of Fukushima Daiichi using different severe accident codes (ASTEC, MAAP, MELCOR, SAMPSON, THALES-KICHE).
The present paper describes the findings of the comparison of the participants’ results for Unit 2 against each other and against plant data, the evaluation of the accident progression and the final status inside the reactors. Special focus is on reactor pressure vessel status, melt release and fission product behavior and release. Unit 2 specific aspects will be highlighted and points of consensus as well as remaining uncertainties and data needs will be summarized.
Vertical heterostructures combining different layered materials offer novel opportunities for applications and fundamental studies. Here we report a new class of heterostructures comprising a ...single-layer (or bilayer) graphene in close proximity to a quantum well created in GaAs and supporting a high-mobility two-dimensional electron gas. In our devices, graphene is naturally hole-doped, thereby allowing for the investigation of electron-hole interactions. We focus on the Coulomb drag transport measurements, which are sensitive to many-body effects, and find that the Coulomb drag resistivity significantly increases for temperatures <5-10 K. The low-temperature data follow a logarithmic law, therefore displaying a notable departure from the ordinary quadratic temperature dependence expected in a weakly correlated Fermi-liquid. This anomalous behaviour is consistent with the onset of strong interlayer correlations. Our heterostructures represent a new platform for the creation of coherent circuits and topologically protected quantum bits.
The standard Heller myotomy (SM) for achalasia extends 1 to 2 cm on to the stomach. The authors perform an extended myotomy (EM) (>3 cm) with the goal of reducing postoperative dysphagia. This study ...examines the long-term efficacy and durability of EM compared with SM.
Patients with achalasia who underwent a laparoscopic Heller myotomy were identified from a prospective database that includes symptom evaluation and results of esophageal functional studies. From September 1994 to August 1998, the authors performed SM with Dor fundoplication, and from September 1998 through 2003, they performed EM with Toupet fundoplication. In 2001, they performed a telephone survey of all available patients. This was repeated in 2005 for the EM group. The survey included scales of symptom frequency (0 never, 1 once per month, 2 once per week, 3 once per day, 4 more than once per day) and severity (0 no symptoms to 10 symptoms equal to preoperative state) as well as the need to undergo postoperative intervention for dysphagia.
For this study, 52 patients underwent SM with Dor fundoplication (median follow-up period, 46 +/- 24 months), and 63 patients underwent EM with Toupet fundoplication (median follow-up period, 45 +/- 17 months. Postoperative dysphagia severity was significantly better in the EM group (4.8 +/- 2.3 vs 3.1 +/- 2.6; p < 0.005). There was no significant difference in postoperative heartburn frequency, esophageal acid exposure, or lower esophageal sphincter pressure. In the SM group, 9 patients (17%) required reintervention for dysphagia: 14 endoscopic interventions for 5 patients (10%) and reoperation for 4 patients. Three patients (5%) in the EM group required reintervention for dysphagia: one endoscopic intervention each and no reoperations (p < 0.05). A total of 30 patients in the EM group were contacted in both 2001 (median follow-up period, 19 +/- 11 months) and 2005 (median follow-up period, 63 +/- 10 months). There was no significant change over time in dysphagia severity (2.6 +/- 1.9 vs 3.7 +/- 2.0; p = 0.19).
For the treatment of achalasia, EM with Toupet fundoplication provides excellent durable dysphagia relief that is superior to SM with Dor fundoplication.
The use of recycled materials, such as the fine recycled aggregate made from concrete waste and carbon fiber (CF) product of industrial waste, for the manufacture of conductive recycled mortars ...(CRM), transforms the mortar base cement normally made with cement:sand in a sustainable multifunctional material, conferring satisfactory mechanical and electrical properties for non-structural uses. This action provides ecological benefits, reducing the use of natural fine aggregates from rivers and the amount of concrete waste deposited in landfills resulting from construction waste. In this investigation the effect of the addition of CF on electrical properties in hardened, wet and dry state, electric percolation in dry state and fluidity of the wet mixture of a cement based CRM was evaluated: fine recycled aggregate: graphite powder, CRM specimens with dimensions of 4 × 4 × 16 cm. were manufactured for 3, 7 and 28 days of age and sand/cement ratios = 1.00, graphite/cement = 1.00, water/cement = 0.60 and CF = 0.1, 0.3, 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0% compared to the weight of cement. The results demonstrated the effect of the addition of CF in CRM, reducing fluidity of the mixtures due to the opposition generated by its physical interaction of CF with recycled sand or recycled fine aggregate and graphite powder (GP), in its case, placing the electric percolation percolation at 0.30% and 0.45% of CF for CRM with and without GP, respectively. Increases in electrical conductivity (EC) without the presence of GP are defined by the contact between the CF and the conductive paths formed. In contrast, with the presence of GP, the EC is defined by the contact between the CF and the GP simultaneously, forming conductive routes with greater performance in its EC.
Idiopathic pulmonary fibrosis (IPF) is a progressive, fatal interstitial lung disease (ILD) of unknown etiology. Introduction of acid into the respiratory tree can produce pulmonary fibrosis. ...Gastroesophageal reflux (GER) has previously been associated with several other respiratory conditions, including pneumonia, bronchitis, and asthma. To investigate prospectively the possible association of GER and IPF, 17 consecutive patients with biopsy-proven IPF and eight control patients with ILD other than IPF underwent dual-channel, ambulatory esophageal pH monitoring. Sixteen of 17 patients with IPF had abnormal distal and/or proximal esophageal acid exposure compared with four of eight control patients (p = 0.02). In the patients with IPF, mean percent distal total (13.6 versus 3.34, p = 0.006), distal upright (12.4 versus 5.1, p = 0.04), distal supine (14.7 versus 0.88, p = 0.02), and proximal supine (7.48 versus 0.24, p = 0.04) esophageal acid exposure times were significantly greater than those in control patients. Only four patients with IPF (25%) with increased acid exposure had typical reflux symptoms such as heartburn or regurgitation. Patients with IPF have a high prevalence of increased esophageal acid exposure, usually without typical GER symptoms. GER in these patients tends to occur at night and extend into the proximal esophagus. Acid reflux may be a contributing factor in the pathogenesis of IPF.
The incorporation of new devices into surgical practice often requires that surgeons acquire and master new skills. We studied the learning curve for intracorporeal knot tying in robotic surgery.
We ...developed an objective scoring system to evaluate knot tying and tested eight attending surgeons during 3 weeks of training on a surgical robot. Each performed intracorporeal knot tying tasks both before and after robotic skills training. These performances were compared to their laparoscopic knots and analyzed to determine and define skill improvement.
Baseline laparoscopic knot completion took 140 sec (range, 47-432), with a mean composite score of 77 (100 possible), whereas robotic knot tying took 390 sec, with a mean composite score of 40. After initial robotic training, times decreased by 65% to 139 sec and scores increased to 71. With more training, completion times and composite scores were improved and errors were reduced.
Like any new technology, surgical robotics requires dedicated training to achieve mastery. Initially, even experienced laparoscopists may register an inferior performance. However, after adequate training, surgeons can exceed their laparoscopic performance, completing intracorporeal knots better and faster using robotics.
The diffusion of tree crops has continuously increased during the last decades all over the world. The market boost has favored the adoption of intensive and highly mechanized cultivation, often ...triggering the degradation of the soil physical-hydrological qualities, mainly through enhanced soil erosion and compaction. Several papers have been published on soil degradation and restoration strategies in specific perennial crops and environments. This review paper collects such studies showing the sensitivity of soil under tree crops to the degradation of their physical-hydrological qualities. Then it reports the state of the art on the methodologies used for the evaluation of the physical-hydrological qualities in the field and in the laboratory, also suggesting an improved methodology for estimating the actual available water capacity. Some updated and promising experiences to recover the physical-hydrological qualities of soil are then illustrated. In particular, subsoiling and placement of drainages, spreading of organic amendments, compost, biochar, using of cover crops, and biological inoculants. A key point in applying the restoration practices is that they should not only be specific for the soil and tree rooting system, but also tailored according to the ecosystem functions that need to be improved besides plant health and yield.
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