Real-time MRI for dynamic assessment of gastroesophageal reflux disease: comparison to pH-metry and impedance

Purpose To evaluate the diagnostic potential of real-time MRI for dynamic assessment of gastroesophageal reflux in patients with GERD (gastroesophageal reflux disease)-like symptoms compared to pH-metry and impedance. Methods Patients who underwent real-time MRI and pH-metry between 2015–2018 were included in this retrospective study. Real-time MRI at 3 T was achieved by undersampled radial FLASH acquisitions with iterative image reconstruction by NLINV. Real-time MRI visualized transit of pineapple juice through the gastroesophageal junction and during Valsalva maneuver. MRI results were compared to 24 h pH-metry to assess acidic reflux (following Lyon Consensus guidelines) and to impedance to assess non-acidic reflux. A standard 2 × 2 table was chosen to calculate diagnostic performance. Results 91/93 eligible patients fulfilled inclusion criteria (male n = 49; female n = 42; median age 55 y). All MRI studies were successfully completed without adverse events at a mean examination time of 15 min. On real-time MRI, reflux was evident in 60 patients (66 %). pH-metry revealed reflux in 41 patients (45 %), and impedance in 54 patients (59 %). Compared to pH-metry and impedance, real-time MRI sensitivity was 0.78 (95 % CI: 0.66-0.87), specificity 0.67 (95 % CI: 0.45-0.84) and PPV 0.87 (95 % CI: 0.75-0.94). Conclusion Real-time MRI is an imaging method for assessment of gastroesophageal reflux in patients with GERD-like symptoms. Considering its high positive predictive value, real-time MRI can accurately identify patients in which further invasive testing with pH-metry and impedance might be considered

Assessment of esophageal motility disorders by real-time MRI

Purpose To investigate imaging findings of esophageal motility disorders on dynamic real-time. Material and methods 102 patients with GERD-like symptoms were included in this retrospective study between 2015−2018. Dynamic real-time MRI visualized the transit of a 10 mL pineapple juice bolus through the esophagus and EGJ with a temporal resolution of 40 ms. Dynamic and anatomic parameters were measured by consensus reading. Imaging findings were compared to HRM utilizing the Chicago classification of esophageal motility disorders, v3.0. Results All 102 patients completed real-time MRI in a median examination time of 15 min. On HRM, 14 patients presented with disorders with EGJ outlet obstruction (EGJOO) (13.7 %), 7 patients with major disorders of peristalsis (6.9 %), and 32 patients with minor disorders of peristalsis (31.4 %). HRM was normal in 49 patients (48.0 %). Incomplete bolus clearance was significantly more frequent in patients with esophageal motility disorders on HRM than in patients with normal HRM (p = 0.0002). In patients with motility disorders with EGJOO and major disorders of peristalsis, the esophageal diameter tended to be wider (23.6 ± 8.0 vs. 21.2 ± 3.5 mm, p = 0.089) and the sphincter length longer (19.7 ± 7.3 vs. 16.7 ± 3.0 mm, p = 0.091) compared to patients with normal HRM. 3/7 patients with achalasia type II were correctly identified by real-time MRI and one further achalasia type II patient was diagnosed with a motility disorder on MRI films. The other 3/7 patients presented no specific imaging features. Conclusion Real-time MRI is an auxiliary diagnostic tool for the assessment of swallowing events. Imaging parameters may assist in the detection of esophageal motility disorders

Assessment of esophagogastric junction morphology by dynamic real-time MRI: comparison of imaging features to high-resolution manometry

Purpose To assess the esophagogastric junction (EGJ) on real-time MRI and compare imaging parameters to EGJ morphol- ogy on high-resolution manometry (HRM). Methods A total of 105 of 117 eligible patients who underwent real-time MRI and high-resolution manometry for GERD- like symptoms between 2015 and 2018 at a single center were retrospectively evaluated (male n = 57; female n = 48; mean age 52.5 ± 15.4 years). Real-time MRI was performed at a median investigation time of 15 min (1 frame/40 ms). On HRM, EGJ morphology was assessed according to the Chicago classification of esophageal motility disorders. Real-time MRI was performed at 3 T using highly undersampled radial fast low-angle shot acquisitions with NLINV image reconstruction. A 10 mL pineapple juice bolus served as oral contrast agent at supine position. Real-time MRI films of the EGJ were acquired during swallowing events and during Valsalva maneuver. Anatomic and functional MRI parameters were compared to EGJ morphology on HRM. Results On HRM, n = 42 patients presented with EGJ type I (40.0%), n= 33 with EGJ type II (31.4%), and n= 30 with EGJ type III (28.6%). On real-time MRI, hiatal hernia was more common in patients with EGJ type III (66.7%) than in patients with EGJ type I (26.2%) and EGJ type II (30.3%; p < 0.001). Sliding hiatal hernia was more frequent in patients with EGJ type II (33.3%) than in patients with EGJ type III (16.7%) and EGJ type I (7.1%; p = 0.017). The mean esophagus–fundus angle of patients was 85 ± 31° at rest and increased to 101 ± 36° during Valsalva maneuver. Conclusion Real-time MRI is a non-invasive imaging method for assessment of the esophagogastric junction. Real-time MRI can visualize dynamic changes of the EGJ during swallowing events

The Little Review on Leptogenesis

This is a brief review on the scenario of baryogenesis through leptogenesis. Leptogenesis is an appealing scenario that may relate the observed baryon asymmetry in the Universe to the low-energy neutrino data. In this review talk, particular emphasis is put on recent developments on the field, such as the flavourdynamics of leptogenesis and resonant leptogenesis near the electroweak phase transition. It is illustrated how these recent developments enable the modelling of phenomenologically predictive scenarios that can directly be tested at the LHC and indirectly in low-energy experiments of lepton-number and lepton-flavour violation.Comment: 15 pages, based on a plenary presentation given at the DISCRETE'08 Symposium, 11-16 December 2008, Valencia, Spai

Software-Defined Networking: A Comprehensive Survey

peer reviewedThe Internet has led to the creation of a digital society, where (almost) everything is connected and is accessible from anywhere. However, despite their widespread adoption, traditional IP networks are complex and very hard to manage. It is both difficult to configure the network according to predefined policies, and to reconfigure it to respond to faults, load, and changes. To make matters even more difficult, current networks are also vertically integrated: the control and data planes are bundled together. Software-defined networking (SDN) is an emerging paradigm that promises to change this state of affairs, by breaking vertical integration, separating the network's control logic from the underlying routers and switches, promoting (logical) centralization of network control, and introducing the ability to program the network. The separation of concerns, introduced between the definition of network policies, their implementation in switching hardware, and the forwarding of traffic, is key to the desired flexibility: by breaking the network control problem into tractable pieces, SDN makes it easier to create and introduce new abstractions in networking, simplifying network management and facilitating network evolution. In this paper, we present a comprehensive survey on SDN. We start by introducing the motivation for SDN, explain its main concepts and how it differs from traditional networking, its roots, and the standardization activities regarding this novel paradigm. Next, we present the key building blocks of an SDN infrastructure using a bottom-up, layered approach. We provide an in-depth analysis of the hardware infrastructure, southbound and northbound application programming interfaces (APIs), network virtualization layers, network operating systems (SDN controllers), network programming languages, and network applications. We also look at cross-layer problems such as debugging and troubleshooting. In an effort to anticipate the future evolution of this - ew paradigm, we discuss the main ongoing research efforts and challenges of SDN. In particular, we address the design of switches and control platforms—with a focus on aspects such as resiliency, scalability, performance, security, and dependability—as well as new opportunities for carrier transport networks and cloud providers. Last but not least, we analyze the position of SDN as a key enabler of a software-defined environment

The influence of nickel layer thickness on microhardness and hydrogen sorption rate of commercially pure titanium alloy

The influence of nickel coating thickness on microhardness and hydrogen sorption rate by commercially pure titanium alloy was established in this work. Coating deposition was carried out by magnetron sputtering method with prior ion cleaning of surface. It was shown that increase of sputtering time from 10 to 50 minutes leads to increase coating thickness from 0.56 to 3.78 ?m. It was established that increase of nickel coating thickness leads to increase of microhardness at loads less than 0.5 kg. Microhardness values for all samples are not significantly different at loads 1 kg. Hydrogen content in titanium alloy with nickel layer deposited at 10 and 20 minutes exceeds concentration in initial samples on one order of magnitude. Further increasing of deposition time of nickel coating leads to decreasing of hydrogen concentration in samples due to coating delamination in process of hydrogenation

The influence of nickel layer thickness on microhardness and hydrogen sorption rate of commercially pure titanium alloy

The influence of nickel coating thickness on microhardness and hydrogen sorption rate by commercially pure titanium alloy was established in this work. Coating deposition was carried out by magnetron sputtering method with prior ion cleaning of surface. It was shown that increase of sputtering time from 10 to 50 minutes leads to increase coating thickness from 0.56 to 3.78 ?m. It was established that increase of nickel coating thickness leads to increase of microhardness at loads less than 0.5 kg. Microhardness values for all samples are not significantly different at loads 1 kg. Hydrogen content in titanium alloy with nickel layer deposited at 10 and 20 minutes exceeds concentration in initial samples on one order of magnitude. Further increasing of deposition time of nickel coating leads to decreasing of hydrogen concentration in samples due to coating delamination in process of hydrogenation

The barrel DIRC of PANDA

Cooled antiproton beams of unprecedented intensities in the momentum range of 1.5-15 GeV/c will be used for the PANDA experiment at FAIR to perform high precision experiments in the charmed quark sector. The PANDA detector will investigate antiproton annihilations with beams in the momentum range of 1.5 GeV/c to 15 GeV/c on a fixed target. An almost 4π acceptance double spectrometer is divided in a forward spectrometer and a target spectrometer. The charged particle identification in the latter is performed by ring imaging Cherenkov counters employing the DIRC principle

The barrel DIRC of PANDA

Cooled antiproton beams of unprecedented intensities in the momentum range of 1.5-15 GeV/c will be used for the PANDA experiment at FAIR to perform high precision experiments in the charmed quark sector. The PANDA detector will investigate antiproton annihilations with beams in the momentum range of 1.5 GeV/c to 15 GeV/c on a fixed target. An almost 4π acceptance double spectrometer is divided in a forward spectrometer and a target spectrometer. The charged particle identification in the latter is performed by ring imaging Cherenkov counters employing the DIRC principle

Landscape science: a Russian geographical tradition

The Russian geographical tradition of landscape science (landshaftovedenie) is analyzed with particular reference to its initiator, Lev Semenovich Berg (1876-1950). The differences between prevailing Russian and Western concepts of landscape in geography are discussed, and their common origins in German geographical thought in the late nineteenth and early twentieth centuries are delineated. It is argued that the principal differences are accounted for by a number of factors, of which Russia's own distinctive tradition in environmental science deriving from the work of V. V. Dokuchaev (1846-1903), the activities of certain key individuals (such as Berg and C. O. Sauer), and the very different social and political circumstances in different parts of the world appear to be the most significant. At the same time it is noted that neither in Russia nor in the West have geographers succeeded in specifying an agreed and unproblematic understanding of landscape, or more broadly in promoting a common geographical conception of human-environment relationships. In light of such uncertainties, the latter part of the article argues for closer international links between the variant landscape traditions in geography as an important contribution to the quest for sustainability