Spread of Salt through a Looped Water Distribution System and an Alternative to Conventional System Flushing

Saltwater intrusion in fresh water aquifers due to excessive groundwater pumping and sea-level rise has become a major concern mostly in coastal cities around the world. Subsequently, salt can be drawn to water distribution systems and can cause health problems if the amount is excessive. To document the time and location of unsafe levels of salt, system network modeling was performed here for a realistic looped water distribution system having 958 pipes, 874 junctions, one tank, and one ground water source. It was found that (1) the salt reaches the upstream portions quickly, (2) salt spread is sensitive to the conditions of outer junctions, and (3) salt level oscillates due to oscillating user demand. In addition, the optimal location of a flushing pond was examined as an alternative to conventional system flushing, where the flushing pond will capture the maximum amount of contaminated water possible. It was found that a flushing pond can reduce the amount of contaminated water discharged to the environment and the pond holding capacity is sensitive to its location

The gastric cardia in gastro-oesophageal disease

Background—There have been conflicting reports concerning the use of cardia biopsies in screening patients for gastro-oesophageal disease. Aim—To define the histopathological changes in the gastric cardia of patients with and without gastro-oesophageal disease. Methods—Topographically mapped gastric biopsy specimens were obtained from patients with gastro-oesophageal disease and from controls. Biopsies were scored on a visual analogue scale of 0 to 5 for Helicobacter pylori, intestinal metaplasia, pancreatic metaplasia, foveolar hyperplasia, and active inflammation. The presence or absence of cardiac glands was recorded. Results—Sixty five patients with gastro-oesophageal disease and 71 controls were examined. Intestinal metaplasia was present in cardia biopsies of 10 patients with gastro-oesophageal disease and 11 controls. Only two patients with gastro-oesophageal disease and intestinal metaplasia in the cardia had no evidence of exposure to H pylori. Intestinal metaplasia was not found in the cardia of those with long segment Barrett's oesophagus. Carditis was strongly associated with active H pylori infection (p = 0.000) and resolved after treatment of the infection. A negative association was present between gastro-oesophageal disease and the presence of cardiac glands in cardiac biopsies (p = 0.003). Pancreatic metaplasia was found in 15 of 65 and foveolar hyperplasia in 19 of 65 cases but neither was related to gastro-oesophageal disease. Conclusion—Intestinal metaplasia in the cardia is uncommon in gastro-oesophageal disease in the absence of H pylori infection. With chronic H pylori infection the junction between the cardia and corpus expands in a cardia–corpal direction. Key Words: Barrett's oesophagus • gastro-oesophageal disease • cardia • Helicobacter pylor

International Consensus Recommendations for Eosinophilic Gastrointestinal Disease Nomenclature.

Substantial heterogeneity in terminology used for eosinophilic gastrointestinal diseases (EGIDs), particularly the catchall term "eosinophilic gastroenteritis," limits clinical and research advances. We aimed to achieve an international consensus for standardized EGID nomenclature. This consensus process utilized Delphi methodology. An initial naming framework was proposed and refined in iterative fashion, then assessed in a first round of Delphi voting. Results were discussed in 2 consensus meetings, and the framework was updated and reassessed in a second Delphi vote, with a 70% threshold set for agreement. Of 91 experts participating, 85 (93%) completed the first and 82 (90%) completed the second Delphi surveys. Consensus was reached on all but 2 statements. "EGID" was the preferred umbrella term for disorders of gastrointestinal (GI) tract eosinophilic inflammation in the absence of secondary causes (100% agreement). Involved GI tract segments will be named specifically and use an "Eo" abbreviation convention: eosinophilic gastritis (now abbreviated EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). The term "eosinophilic gastroenteritis" is no longer preferred as the overall name (96% agreement). When >2 GI tract areas are involved, the name should reflect all of the involved areas. This international process resulted in consensus for updated EGID nomenclature for both clinical and research use. EGID will be the umbrella term, rather than "eosinophilic gastroenteritis," and specific naming conventions by location of GI tract involvement are recommended. As more data are developed, this framework can be updated to reflect best practices and the underlying science