Predictors of Gastrointestinal Transit Times in Colon Capsule Endoscopy

Optimizing the accuracy of colon capsule endoscopy (CCE) requires high completion rates. To prevent incomplete CCE, we aimed to identify predictors associated with slow CCE transit times. METHODS: In this population-based study, participants received CCE with a split-dose polyethylene glycol bowel preparation and booster regimen (0.5 L oral sulfate solution and 10 mg metoclopramide if capsule remained in stomach for > 1 hour). The following predictors were assessed: age, sex, body mass index (BMI), smoking, coffee and fiber intake, diet quality, physical activity, dyspeptic complaints, stool pattern, history of abdominal surgery, medication use, and CCE findings. Multivariable logistic and linear regressions with backward elimination were performed. RESULTS: We analyzed 451 CCE procedures with a completion rate of 51.9%. The completion rate was higher among older participants (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.04–2.28, P = 0.03) and participants with a changed stool pattern (OR 2.27, 95% CI 1.20–4.30, P = 0.01). Participants with a history of abdominal surgery had a lower completion rate (OR 0.54, 95% CI 0.36–0.80, P = 0.003). Participants with higher BMI had faster stomach, small bowel, and total transit times (β = −0.10, P = 0.01; β = −0.14, P = 0.001; β = −0.12, P = 0.01). A faster small bowel transit was found in participants with a changed stool pattern (β = −0.08, P = 0.049) and the use of metoclopramide (β = −0.14, P = 0.001). Participants with high fiber intake had a slower colonic transit (β = 0.11, P = 0.03). DISCUSSION: Younger age, unchanged stool pattern, history of abdominal surgery, low BMI, and high fiber intake resulted in slower CCE transit times and lower completion rates. In future practice, these factors can be considered to adjust preparation protocols

Gravitational fields as generalized string models

We show that Einstein's main equations for stationary axisymmetric fields in vacuum are equivalent to the motion equations for bosonic strings moving on a special nonflat background. This new representation is based on the analysis of generalized harmonic maps in which the metric of the target space explicitly depends on the parametrization of the base space. It is shown that this representation is valid for any gravitational field which possesses two commuting Killing vector fields. We introduce the concept of dimensional extension which allows us to consider this type of gravitational fields as strings embedded in D-dimensional nonflat backgrounds, even in the limiting case where the Killing vector fields are hypersurface orthogonal.Comment: latex, 25 page

NikR mediates nickel-responsive transcriptional induction of urease expression in Helicobacter pylori

The important human pathogen Helicobacter pylori requires the abundant expression and activity of its urease enzyme for colonization of the gastric mucosa. The transcription, expression, and activity of H. pylori urease were previously demonstrated to be induced by nickel supplementation of growth media. Here it is demonstrated that the HP1338 protein, an ortholog of the Escherichia coli nickel regulatory protein NikR, mediates nickel-responsive induction of urease expression in H. pylori. Mutation of the HP1338 gene (nikR) of H. pylori strain 26695 resulted in significant growth inhibition of the nikR mutant in the presence of supplementation with NiCl(2) at > or =100 microM, whereas the wild-type strain tolerated more than 10-fold-higher levels of NiCl(2). Mutation of nikR did not affect urease subunit expression or urease enzyme activity in unsupplemented growth media. However, the nickel-induced increase in urease subunit expression and urease enzyme activity observed in wild-type H. pylori was absent in the H. pylori nikR mutant. A similar lack of nickel responsiveness was observed upon removal of a 19-bp palindromic sequence in the ureA promoter, as demonstrated by using a genomic ureA::lacZ reporter gene fusion. In conclusion, the H. pylori NikR protein and a 19-bp operator sequence in the ureA promoter are both essential for nickel-responsive induction of urease expression in H. pylori

Simulation of heat transport in low-dimensional oscillator lattices

The study of heat transport in low-dimensional oscillator lattices presents a formidable challenge. Theoretical efforts have been made trying to reveal the underlying mechanism of diversified heat transport behaviors. In lack of a unified rigorous treatment, approximate theories often may embody controversial predictions. It is therefore of ultimate importance that one can rely on numerical simulations in the investigation of heat transfer processes in low-dimensional lattices. The simulation of heat transport using the non-equilibrium heat bath method and the Green-Kubo method will be introduced. It is found that one-dimensional (1D), two-dimensional (2D) and three-dimensional (3D) momentum-conserving nonlinear lattices display power-law divergent, logarithmic divergent and constant thermal conductivities, respectively. Next, a novel diffusion method is also introduced. The heat diffusion theory connects the energy diffusion and heat conduction in a straightforward manner. This enables one to use the diffusion method to investigate the objective of heat transport. In addition, it contains fundamental information about the heat transport process which cannot readily be gathered otherwise.Comment: Article published in: Thermal transport in low dimensions: From statistical physics to nanoscale heat transfer, S. Lepri, ed. Lecture Notes in Physics, vol. 921, pp. 239 - 274, Springer-Verlag, Berlin, Heidelberg, New York (2016

The use of non-invasive stool tests for verification of Helicobacter pylori eradication and clarithromycin resistance

Background: Clarithromycin resistance of Helicobacter pylori (H. pylori) represents a major challenge in eradication therapy. In this study, we assessed if non-invasive stool tests can be used to verify successful H. pylori eradication and determine clarithromycin resistance. Materials and methods:In this prospective study, patients undergoing urea breath testing (UBT) for confirmation of H. pylori eradication were asked to collect the stool as both a dry fecal sample and fecal immunochemical test (FIT). Stool H. pylori antigen testing (SAT) was performed on these samples and assessed for its accuracy in eradication verification. Type and duration of antibiotic treatment were retrospectively collected from patient records and compared with clarithromycin resistance determined by PCR of stool samples. Results: H. pylori eradication information was available for a total of 145 patients (42.7% male, median age: 51.2). Successful eradication was achieved in 68.1% of patients. SAT on FIT samples had similar accuracy for eradication assessment compared to dry fecal samples, 72.1% [95% CI 61.4–81.2] versus 72.2% [95% CI 60.9–81.7]. Clarithromycin resistance rate was 13.4%. Conclusion: H. pylori antigen testing on FIT stool samples to verify H. pylori eradication is feasible and has similar accuracy as H. pylori antigen testing on dry stool samples. Dry stool, but not FIT, was suitable for non-invasive identification of H. pylori clarithromycin resistance by rt-PCR personalizing antibiotic treatment strategies without the need for invasive diagnostics is desirable, as the cure rate of first-line empirical H. pylori treatment remains low.</p

Nonexistence of marginally trapped surfaces and geons in 2+1 gravity

We use existence results for Jang's equation and marginally outer trapped surfaces (MOTSs) in 2+1 gravity to obtain nonexistence of geons in 2+1 gravity. In particular, our results show that any 2+1 initial data set, which obeys the dominant energy condition with cosmological constant \Lambda \geq 0 and which satisfies a mild asymptotic condition, must have trivial topology. Moreover, any data set obeying these conditions cannot contain a MOTS. The asymptotic condition involves a cutoff at a finite boundary at which a null mean convexity condition is assumed to hold; this null mean convexity condition is satisfied by all the standard asymptotic boundary conditions. The results presented here strengthen various aspects of previous related results in the literature. These results not only have implications for classical 2+1 gravity but also apply to quantum 2+1 gravity when formulated using Witten's solution space quantization.Comment: v3: Elements from the original two proofs of the main result have been combined to give a single proof, thereby circumventing an issue with the second proof associated with potential blow-ups of solutions to Jang's equation. To appear in Commun. Math. Phy

Optical detection of NMR J-spectra at zero magnetic field

Scalar couplings of the form J I_1 \cdot I_2 between nuclei impart valuable information about molecular structure to nuclear magnetic-resonance spectra. Here we demonstrate direct detection of J-spectra due to both heteronuclear and homonuclear J-coupling in a zero-field environment where the Zeeman interaction is completely absent. We show that characteristic functional groups exhibit distinct spectra with straightforward interpretation for chemical identification. Detection is performed with a microfabricated optical atomic magnetometer, providing high sensitivity to samples of microliter volumes. We obtain 0.1 Hz linewidths and measure scalar-coupling parameters with 4-mHz statistical uncertainty. We anticipate that the technique described here will provide a new modality for high-precision "J spectroscopy" using small samples on microchip devices for multiplexed screening, assaying, and sample identification in chemistry and biomedicine.Comment: 15 pages, 4 Figure

ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients’ perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.The document facilitates standardisation of conducting, reporting and interpreting cardiopulmonary exercise tests in chronic lung diseases for comparison of reference data, multi-centre studies and assessment of interventional efficacy. http://bit.ly/31SXeB

Dressing with Control: using integrability to generate desired solutions to Einstein's equations

21 pages, no figures21 pages, no figures21 pages, no figures21 pages, no figuresMotivated by integrability of the sine-Gordon equation, we investigate a technique for constructing desired solutions to Einstein's equations by combining a dressing technique with a control-theory approach. After reviewing classical integrability, we recall two well-known Killing field reductions of Einstein's equations, unify them using a harmonic map formulation, and state two results on the integrability of the equations and solvability of the dressing system. The resulting algorithm is then combined with an asymptotic analysis to produce constraints on the degrees of freedom arising in the solution-generation mechanism. The approach is carried out explicitly for the Einstein vacuum equations. Applications of the technique to other geometric field theories are also discussed