Surgical Innovations for GERD: Comparing Outcomes of Magnetic Sphincter Augmentation and Nissen Fundoplication

Gastroesophageal reflux disease (GERD) is a common chronic upper gastrointestinal disease with both objective and subjective components. It is defined as a reflux of gastric contents into the esophagus, which causes symptoms such as heartburn, regurgitation, and dysphagia. Severity of the disease is dependent on both severity of the symptoms and severity of the mucosal damage done by the reflux. While many cases of GERD can be managed with oral medication, persistent and refractory cases require surgical intervention. The purpose of this literature review is to compare the efficacy of GERD’s gold standard surgical technique, the Nissen fundoplication, with a new surgical technique, magnetic sphincter augmentation. Studies were included if they analyzed either procedure against itself or directly compared the two procedures. No specific requirements were set, but special attention was paid to the patient inclusion criteria to assess for common themes between the studies. The data available at this time indicates that in patients who qualify for both procedures, magnetic sphincter augmentation and Nissen fundoplication produce similar levels of efficacy and patient satisfaction

Upper Bound on the Dark Matter Total Annihilation Cross Section

We consider dark matter annihilation into Standard Model particles and show that the least detectable final states, namely neutrinos, define an upper bound on the total cross section. Calculating the cosmic diffuse neutrino signal, and comparing it to the measured terrestrial atmospheric neutrino background, we derive a strong and general bound. This can be evaded if the annihilation products are dominantly new and truly invisible particles. Our bound is much stronger than the unitarity bound at the most interesting masses, shows that dark matter halos cannot be significantly modified by annihilations, and can be improved by a factor of 10--100 with existing neutrino experiments.Comment: 4 pages, 3 figures; version accepted for publication in PR

WE-MAP: Crowdsourced map based mobile application for the wheelchair accessibility

Ce travail de Bachelor fait partie du projet WE-MAP de l’Institut d’informatique de gestion. Dans ce travail, nous nous sommes tout d’abord penchés sur l’état de l’art des techniques de calcul d’itinéraire. Nous avons étudié les outils existants pour la manipulation de cartes. Puis nous avons ajouté une fonctionnalité d’itinéraire à la plateforme existante de l’Institut d’informatique de gestion. Cette fonctionnalité tient compte des particularités liées aux personnes à mobilité réduite. L’application WE- MAP dispose d’une base de données contenant des informations sur les difficultés d’accès, telles que pente trop raide, trottoir trop étroit ou obstacle, et sur les services, tels que parking ou toilettes pour handicapés ou accès sans marches. Cette base de données a déjà été complétée par les facteurs de Sierre, du Val d’Anniviers et de Sion qui ont recensé environ 800 points. Nous avons ensuite étudié les méthodes permettant de motiver les utilisateurs à saisir des informations, car le point fort de l’application est la possibilité d’améliorer la base de données grâce au crowdsourcing. Nous avons terminé ce travail par une analyse qualitative de l’application dans sa forme actuelle. Cette analyse a été faite en focus groups. Elle a permis d’apporter quelques améliorations à l’application dans le cadre de ce travail

From Zoom to the Clinic: Unique Student Challenges in Physical Therapy Clinical Education

While the abrupt shift in PT education (PTE) brought on by the pandemic created opportunities for educational innovation, it also brought relational separation and fragmented learning due to lockdowns, social distancing, face masks, and communication limited to virtual platforms. Academic programs increased use of virtual learning, rearranged curriculum, reduced lab and simulated learning time, and provided fewer, if any, opportunities for service learning and patient contact. Clinic sites paused clinic education experiences or hosted fewer students to maintain social distancing and limit disease exposure. As PTE returns to more typical curricular schedules and practices, it is important to be aware of the current challenges students may be facing. Common challenges include not only increased levels of anxiety and depression, but also problems with self-esteem and confidence, resilience, a growth mindset, and metacognition. This session will investigate the implications of the rise in prevalence of issues in internalizing professional identity and clinical competency for clinical education; the characteristics of unique mental health challenges, such as impostor phenomenon, compassion fatigue, and burnout; screening tools; and suggestions for successfully mentoring students who have low self-esteem, a lack of confidence, decreased resiliency, and imposter feelings

Inflammatory monocytes require type I interferon receptor signaling to activate NK cells via IL-18 during a mucosal viral infection

The requirement of type I interferon (IFN) for natural killer (NK) cell activation in response to viral infection is known, but the underlying mechanism remains unclear. Here, we demonstrate that type I IFN signaling in inflammatory monocytes, but not in dendritic cells (DCs) or NK cells, is essential for NK cell function in response to a mucosal herpes simplex virus type 2 (HSV-2) infection. Mice deficient in type I IFN signaling, Ifnar(-/-) and Irf9(-/-) mice, had significantly lower levels of inflammatory monocytes, were deficient in IL-18 production, and lacked NK cell-derived IFN-gamma. Depletion of inflammatory monocytes, but not DCs or other myeloid cells, resulted in lower levels of IL-18 and a complete abrogation of NK cell function in HSV-2 infection. Moreover, this resulted in higher susceptibility to HSV-2 infection. Although Il18(-/-) mice had normal levels of inflammatory monocytes, their NK cells were unresponsive to HSV-2 challenge. This study highlights the importance of type I IFN signaling in inflammatory monocytes and the induction of the early innate antiviral response

Psychometric Evaluation and Design of Patient-Centered Communication Measures for Cancer Care Settings

Objective To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC). Methods Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty. For each Function we conducted factor analyses, item response theory modeling, and tests for differential item functioning, and assessed reliability and construct validity. Results Participants included 501 respondents; 46% had a high school education or less. Reliability within each Function ranged from 0.90 to 0.96. The PCC-Ca-36 (36-question survey; reliability=0.94) and PCC-Ca-6 (6-question survey; reliability=0.92) measures differentiated between individuals with poor and good health (i.e., known-groups validity) and were highly correlated with the HINTS communication scale (i.e., convergent validity). Conclusion This study provides theory-grounded PCC measures found to be reliable and valid in colorectal cancer patients in North Carolina. Future work should evaluate measure validity over time and in other cancer populations. Practice implications The PCC-Ca-36 and PCC-Ca-6 measures may be used for surveillance, intervention research, and quality improvement initiatives

The Effects of 5-Hydroxytryptophan in Combination with Different Fatty Acids on Gastrointestinal Functions: A Pilot Experiment

Background. Fat affects gastric emptying (GE). 5-Hydroxythryptophan (5-HTP) is involved in central and peripheral satiety mechanisms. Influence of 5-HTP in addition to saturated or monounsaturated fatty acids (FA) on GE and hormone release was investigated. Subjects/Methods. 24 healthy individuals (12f : 12m, 22-29 years, BMI 19-25.7 kg/m(2)) were tested on 4 days with either 5-HTP + short-chain saturated FA (butter), placebo + butter, 5-HTP + monounsaturated FA (olive oil), or placebo + olive oil in double-blinded randomized order. Two hours after FA/5-HTP or placebo intake, a C-13 octanoid acid test was conducted. Cortisol, serotonin, cholecystokinin (CCK), and ghrelin were measured, as were mood and GE. Results. GE was delayed with butter and was normal with olive (P < 0.05) but not affected by 5-HTP. 5-HTP supplementation did not affect serotonin levels. Food intake increased plasma CCK (F = 6.136; P < 0.05) irrespective of the FA. Ghrelin levels significantly decreased with oil/5-HTP (F = 9.166; P < 0.001). The diurnal cortisol profile was unaffected by FA or 5-HTP, as were ratings of mood, hunger, and stool urgency. Conclusion. Diverse FAs have different effects on GE and secretion of orexigenic and anorexigenic hormones. Supplementation of 5-HTP had no effect on plasma serotonin and central functions. Further studies are needed to explain the complex interplay

Political Party Mortality in Established Party Systems:A Hierarchical Competing Risks Approach

Existing scholarship offers few answers to fundamental questions about the mortality of political parties in established party systems. Linking party research to the organization literature, we conceptualize two types of party death, dissolution and merger, reflecting distinct theoretical rationales. They underpin a new framework on party organizational mortality theorizing three sets of factors: those shaping mortality generally and those shaping dissolution or merger death exclusively. We test this framework on a new data set covering the complete life cycles of 184 parties that entered 21 consolidated party systems over the last five decades, resorting to multilevel competing risks models to estimate the impact of party and country characteristics on the hazards of both types of death. Our findings not only show that dissolution and merger death are driven by distinct factors, but also that they represent separate logics not intrinsically related at either the party or systemic level

Population-Based Correlates of Covid-19 infection: an analysis From the Dfw Covid-19 Prevalence Study

BACKGROUND: COVID-19 has resulted in over 1 million deaths in the U.S. as of June 2022, with continued surges after vaccine availability. Information on related attitudes and behaviors are needed to inform public health strategies. We aimed to estimate the prevalence of COVID-19, risk factors of infection, and related attitudes and behaviors in a racially, ethnically, and socioeconomically diverse urban population. METHODS: The DFW COVID-19 Prevalence Study Protocol 1 was conducted from July 2020 to March 2021 on a randomly selected sample of adults aged 18-89 years, living in Dallas or Tarrant Counties, Texas. Participants were asked to complete a 15-minute questionnaire and COVID-19 PCR and antibody testing. COVID-19 prevalence estimates were calculated with survey-weighted data. RESULTS: Of 2969 adults who completed the questionnaire (7.4% weighted response), 1772 (53.9% weighted) completed COVID-19 testing. Overall, 11.5% of adults had evidence of COVID-19 infection, with a higher prevalence among Hispanic and non-Hispanic Black persons, essential workers, those in low-income neighborhoods, and those with lower education attainment compared to their counterparts. We observed differences in attitudes and behaviors by race and ethnicity, with non-Hispanic White persons being less likely to believe in the importance of mask wearing, and racial and ethnic minorities more likely to attend social gatherings. CONCLUSION: Over 10% of an urban population was infected with COVID-19 early during the pandemic. Differences in attitudes and behaviors likely contribute to sociodemographic disparities in COVID-19 prevalence

Psychological Factors Associated With Development of TMD: The OPPERA Prospective Cohort Study

Case-control studies have consistently associated psychological factors with chronic pain in general and with temporomandibular disorders (TMD) specifically. However, only a handful of prospective studies has explored whether pre-existing psychological characteristics represent risk factors for first-onset TMD. The current findings derive from the prospective cohort study of the Orofacial Pain Prospective Evaluation and Risk Assessment (OPPERA) cooperative agreement. For this study, 3,263 TMD-free participants completed a battery of psychological instruments assessing general psychological adjustment and personality, affective distress, psychosocial stress, somatic symptoms, and pain coping and catastrophizing. Study participants were then followed prospectively for an average of 2.8 years to ascertain cases of first-onset of TMD, and 2,737 provided follow-up data and were considered in the analyses of TMD onset. In bivariate and demographically-adjusted analyses, several psychological variables predicted increased risk of first-onset TMD, including reported somatic symptoms, psychosocial stress, and affective distress. Principal component analysis of 26 psychological scores was used to identify latent constructs, revealing four components: stress and negative affectivity, global psychological and somatic symptoms, passive pain coping, and active pain coping. In multivariable analyses, global psychological and somatic symptoms emerged as the most robust risk factor for incident TMD. These findings provide evidence that measures of psychological functioning can predict first-onset of TMD. Future analyses in the OPPERA cohort will determine whether these psychological factors interact with other variables to increase risk for TMD onset and persistence