Diet and effects of diet management on symptoms and quality of life in patients with irritable bowel syndrome

Background: Irritable bowel syndrome (IBS) is a gastrointestinal disorder manifested by abdominal discomfort or pain, bloating and abdominal distension, and changes in the defecation pattern between diarrhoea and constipation. A significant proportion of IBS patients attribute their symptoms to food items and food intolerance. More information is needed on the effect of diet management in the treatment of IBS and this thesis is a contribution with effort to advance our knowledge about this aspect of the disorder. Aim: To investigate the diet and quality of life in IBS patients in comparison with the background population. Furthermore, to study the effects of guidance on diet management on changes in food intake, quality of life and symptoms. Design and methods: The study group included 35 healthy controls, 36 unguided IBS patients and 43 IBS patients who received guidance in diet management two years earlier. The controls and patients were asked to complete a Food Frequency Questionnaire (FFQ), a Short -Form Nepean Dyspepsia Index (SF-NDI) questionnaire, an Irritable Bowel Syndrome- Quality Of Life questionnaire (IBS-QOL) and a Birmingham IBS symptom score questionnaire. Results: With or without dietary guidance, there were no statistical differences in the intake of calories, carbohydrates, proteins and fat between the IBS patients and the controls. IBS patients made a conscious choice to avoid some foods belonging to the FODMAP group (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). However, they consumed other food items which are rich in FODMAPs and avoided food sources which are important for their health. Two years after receiving guidance on diet management, IBS patient had a different diet profile. They consumed less FODMAP-rich foods, consumed more foods with probiotic supplements and less frequently avoided food sources that were important for their health as compared with unguided IBS patients. In addition, quality of life was improved and IBS symptoms was reduced. Conclusion: Although at the first sight the diet of IBS patients does not seem to differ from that of the background population, detailed examination shows avoidance of certain food items. Guidance on the management of diet improves their choice of a healthier diet, improves quality of life and reduces symptoms.Master i Klinisk ernæringNUCLI395MAMD-NUCL

On the timing between terrestrial gamma ray flashes, radio atmospherics, and optical lightning emission

On 25 October 2012 the Reuven Ramaty High Energy Solar Spectroscope Imager (RHESSI) and the Tropical Rainfall Measuring Mission (TRMM) satellites passed over a thunderstorm on the coast of Sri Lanka. RHESSI observed a terrestrial gamma ray flash (TGF) originating from this thunderstorm. Optical measurements of the causative lightning stroke were made by the lightning imaging sensor (LIS) on board TRMM. The World Wide Lightning Location Network (WWLLN) detected the very low frequency (VLF) radio emissions from the lightning stroke. The geolocation from WWLLN, which we also assume is the TGF source location, was in the convective core of the cloud. By using new information about both RHESSI and LIS timing accuracy, we find that the peak in the TGF light curve occurs 230 $\mu$s before the WWLLN time. Analysis of the optical signal from LIS shows that within the uncertainties, we cannot conclude which comes first: the gamma emission or the optical emission. We have also applied the new information about the LIS timing on a previously published event by {\O}stgaard et al. (2012). Also for this event we are not able to conclude which signal comes first. More accurate instruments are needed in order to get the exact timing between the TGF and the optical signal

A new population of terrestrial gamma-ray flashes in the RHESSI data

Terrestrial gamma-ray flashes (TGFs) are the most energetic photon phenomenon occurring naturally on Earth. An outstanding question is as follows: Are these flashes just a rare exotic phenomenon or are they an intrinsic part of lightning discharges and therefore occurring more frequently than previously thought? All measurements of TGFs so far have been limited by the dynamic range and sensitivity of spaceborne instruments. In this paper we show that there is a new population of weak TGFs that has not been identified by search algorithms. We use the World Wide Lightning Location Network (WWLLN) to identify lightning that occurred in 2006 and 2012 within the 800 km field of view of Reuven Ramaty High Energy Solar Spectroscopic Imager (RHESSI). By superposing 740,210 100 ms RHESSI data intervals, centered at the time of the WWLLN detected lightning, we identify at least 141 and probably as many as 191 weak TGFs that were not part of the second RHESSI data catalogue. This supports the suggestion that the global TGF production rate is larger than previously reported

Constraints to do realistic modeling of the electric field ahead of the tip of a lightning leader

Several computer models exist to explain the observation of terrestrial gamma-ray flashes (TGFs). Some of these models estimate the electric field ahead of lightning leaders and its effects on electron acceleration and multiplication. In this paper, we derive a new set of constraints to do more realistic modeling. We determine initial conditions based on in situ measurements of electric field and vertical separation between the main charge layers of thunderclouds. A maximum electric field strength of 50 kV/cm at sea level is introduced as the upper constraint for the leader electric field. The threshold for electron avalanches to develop of 2.86 kV/cm at sea level is introduced as the lower value. With these constraints, we determine a region where acceleration and multiplication of electrons occur. The maximum potential difference in this region is found to be $\sim$52 MV, and the corresponding number of avalanche multiplication lengths is $\sim$3.5. We then quantify the effect of the ambient electric field compared to the leader field at the upper altitude of the negative tip. Finally, we argue that only leaders with the highest potential difference between its tips ($\sim$600 MV) can be candidates for the production of TGFs. However, with the assumptions we have used, these cannot explain the observed maximum energies of at least 40 MeV. Open questions with regard to the temporal development of the streamer zone and its effect on the shape of the electric field remain

Ionospheric conductances derived from satellite measurements of auroral UV and X-ray emissions, and ground-based electromagnetic data: a comparison

International audienceGlobal instantaneous conductance maps can be derived from remote sensing of UV and X-ray emissions by the UVI and PIXIE cameras on board the Polar satellite. Another technique called the 1-D method of characteristics provides mesoscale instantaneous conductance profiles from the MIRACLE ground-based network in Northern Scandinavia, using electric field measurements from the STARE coherent scatter radar and ground magnetometer data from the IMAGE network. The method based on UVI and PIXIE data gives conductance maps with a resolution of ~800km in space and ~4.5min in time, while the 1-D method of characteristics establishes conductances every 20s and with a spatial resolution of ~50km. In this study, we examine three periods with substorm activity in 1998 to investigate whether the two techniques converge when the results from the 1-D method of characteristics are averaged over the spatial and temporal resolution of the UVI/PIXIE data. In general, we find that the calculated conductance sets do not correlate. However, a fairly good agreement may be reached when the ionosphere is in a state that does not exhibit strong local turbulence. By defining a certain tolerance level of turbulence, we show that 14 of the 15 calculated conductance pairs during relatively uniform ionospheric conditions differ less than ±30%. The same is true for only 4 of the 9 data points derived when the ionosphere is in a highly turbulent state. A correlation coefficient between the two conductance sets of 0.27 is derived when all the measurements are included. By removing the data points from time periods when too much ionospheric turbulence occurs, the correlation coefficient raises to 0.57. Considering the two very different techniques used in this study to derive the conductances, with different assumptions, limitations and scale sizes, our results indicate that simple averaging of mesoscale results allows a continuous transition to large-scale results. Therefore, it is possible to use a combined approach to study ionospheric events with satellite optical and ground-based electrodynamic data of different spatial and temporal resolutions. We must be careful, though, when using these two techniques during disturbed conditions. The two methods will only give results that systematically converge when relatively uniform conditions exist

Meter-scale spark X-ray spectrumstatistics

X-ray emission by sparks implies bremsstrahlung from a population of energetic electrons, but the details of this process remain a mystery. We present detailed statistical analysis of X-ray spectra detected by multiple detectors during sparks produced by 1 MV negative high-voltage pulses with 1 $\mu$s risetime. With over 900 shots, we statistically analyze the signals, assuming that the distribution of spark X-ray fluence behaves as a power law and that the energy spectrum of X-rays detectable after traversing $\sim$2 m of air and a thin aluminum shield is exponential. We then determine the parameters of those distributions by fitting cumulative distribution functions to the observations. The fit results match the observations very well if the mean of the exponential X-ray energy distribution is 86 $\pm$ 7 keV and the spark X-ray fluence power law distribution has index -1.29 $\pm$ 0.04 and spans at least 3 orders of magnitude in fluence

Radio emissions from double RHESSI TGFs

A detailed analysis of Reuven Ramaty High Energy Solar Spectroscopic Imager (RHESSI) terrestrial gamma ray flashes (TGFs) is performed in association with World Wide Lightning Location Network (WWLLN) sources and very low frequency (VLF) sferics recorded at Duke University. RHESSI clock offset is evaluated and found to experience changes on the 5 August 2005 and 21 October 2013, based on the analysis of TGF-WWLLN matches. The clock offsets were found for all three periods of observations with standard deviations less than 100 {\mu}s. This result opens the possibility for the precise comparative analyses of RHESSI TGFs with the other types of data (WWLLN, radio measurements, etc.) In case of multiple-peak TGFs, WWLLN detections are observed to be simultaneous with the last TGF peak for all 16 cases of multipeak RHESSI TGFs simultaneous with WWLLN sources. VLF magnetic field sferics were recorded for two of these 16 events at Duke University. These radio measurements also attribute VLF sferics to the second peak of the double TGFs, exhibiting no detectable radio emission during the first TGF peak. Possible scenarios explaining these observations are proposed. Double (multipeak) TGFs could help to distinguish between the VLF radio emission radiated by the recoil currents in the +IC leader channel and the VLF emission from the TGF producing electrons