Mechanisms of Esophago-Pharyngeal Acid Regurgitation in Human Subjects

Esophago-pharyngeal regurgitation is implicated in various otolaryngologic and respiratory disorders. The pathophysiological mechanisms causing regurgitation are still largely unknown

Efficient Mixing at low Reynolds numbers using polymer additives

Mixing in fluids is a rapidly developing field of fluid mechanics \cite{Sreen,Shr,War}, being an important industrial and environmental problem. The mixing of liquids at low Reynolds numbers is usually quite weak in simple flows, and it requires special devices to be efficient. Recently, the problem of mixing was solved analytically for a simple case of random flow, known as the Batchelor regime \cite{Bat,Kraich,Fal,Sig,Fouxon}. Here we demonstrate experimentally that very viscous liquids at low Reynolds number, $Re$. Here we show that very viscous liquids containing a small amount of high molecular weight polymers can be mixed quite efficiently at very low Reynolds numbers, for a simple flow in a curved channel. A polymer concentration of only 0.001% suffices. The presence of the polymers leads to an elastic instability \cite{LMS} and to irregular flow \cite{Ours}, with velocity spectra corresponding to the Batchelor regime \cite{Bat,Kraich,Fal,Sig,Fouxon}. Our detailed observations of the mixing in this regime enable us to confirm sevearl important theoretical predictions: the probability distributions of the concentration exhibit exponential tails \cite{Fal,Fouxon}, moments of the distribution decay exponentially along the flow \cite{Fouxon}, and the spatial correlation function of concentration decays logarithmically.Comment: 11 pages, 5 figure

Teaching clinical informatics to third-year medical students: negative results from two controlled trials

BACKGROUND: Prior educational interventions to increase seeking evidence by medical students have been unsuccessful. METHODS: We report two quasirandomized controlled trials to increase seeking of medical evidence by third-year medical students. In the first trial (1997–1998), we placed computers in clinical locations and taught their use in a 6-hour course. Based on negative results, we created SUMSearch(TM), an Internet site that automates searching for medical evidence by simultaneous meta-searching of MEDLINE and other sites. In the second trial (1999–2000), we taught SUMSearch's use in a 5½-hour course. Both courses were taught during the medicine clerkship. For each trial, we surveyed the entire third-year class at 6 months, after half of the students had taken the course (intervention group). The students who had not received the intervention were the control group. We measured self-report of search frequency and satisfaction with search quality and speed. RESULTS: The proportion of all students who reported searching at least weekly for medical evidence significantly increased from 19% (1997–1998) to 42% (1999–2000). The proportion of all students who were satisfied with their search results increased significantly between study years. However, in neither study year did the interventions increase searching or satisfaction with results. Satisfaction with the speed of searching was 27% in 1999–2000. This did not increase between studies years and was not changed by the interventions. CONCLUSION: None of our interventions affected searching habits. Even with automated searching, students report low satisfaction with search speed. We are concerned that students using current strategies for seeking medical evidence will be less likely to seek and appraise original studies when they enter medical practice and have less time

Understanding the culture of antimicrobial prescribing in agriculture: a qualitative study of UK pig veterinary surgeons

Objectives The use of antimicrobials in food-producing animals has been linked with the emergence of antimicrobial resistance in bacterial populations, with consequences for animal and public health. This study explored the underpinning drivers, motivators and reasoning behind prescribing decisions made by veterinary surgeons working in the UK pig industry. Methods A qualitative interview study was conducted with 21 veterinary surgeons purposively selected from all UK pig veterinary surgeons. Thematic analysis was used to analyse transcripts. Results Ensuring optimum pig health and welfare was described as a driver for antimicrobial use by many veterinary surgeons and was considered a professional and moral obligation. Veterinary surgeons also exhibited a strong sense of social responsibility over the need to ensure that antimicrobial use was responsible. A close relationship between management practices, health and economics was evident, with improvements in management commonly identified as being potential routes to reduce antimicrobial usage; however, these were not always considered economically viable. The relationship with clients was identified as being a source of professional stress for practitioners due to pressure from farmers requesting antimicrobial prescriptions, and concern over poor compliance of antimicrobial administration by some farmers. Conclusions The drivers behind prescribing decisions by veterinary surgeons were complex and diverse. A combination of education, improving communication between veterinary surgeons and farmers, and changes in regulations, in farm management and in consumer/retailer demands may all be needed to ensure that antimicrobial prescribing is optimal and to achieve significant reductions in use

The Role of Column Density in the Formation of Stars and Black Holes

The stellar mass in disk galaxies scales approximately with the fourth power of the rotation velocity, and the masses of the central black holes in galactic nuclei scale approximately with the fourth power of the bulge velocity dispersion. It is shown here that these relations can be accounted for if, in a forming galaxy with an isothermal mass distribution, gas with a column density above about 8 Msun/pc^2 goes into stars while gas with a column density above about 2 g/cm^2 (10^4 Msun/pc^2) goes into a central black hole. The lower critical value is close to the column density of about 10 Msun/pc^2 at which atomic gas becomes molecular, and the upper value agrees approximately with the column density of about 1 g/cm^2 at which the gas becomes optically thick to its cooling radiation. These results are plausible because molecule formation is evidently necessary for star formation, and because the onset of a high optical depth in a galactic nucleus may suppress continuing star formation and favour the growth of a central black hole.Comment: Accepted by Nature Physic

Evolutionary stasis and lability in thermal physiology in a group of tropical lizards

Understanding how quickly physiological traits evolve is a topic of great interest, particularly in the context of how organisms can adapt in response to climate warming. Adjustment to novel thermal habitats may occur either through behavioural adjustments, physiological adaptation, or both. Here we test whether rates of evolution differ among physiological traits in the cybotoids, a clade of tropical Anolis lizards distributed in markedly different thermal environments on the Caribbean island of Hispaniola. We find that cold tolerance evolves considerably faster than heat tolerance, a difference that results because behavioural thermoregulation more effectively shields these organisms from selection on upper than lower temperature tolerances. Specifically, because lizards in very different environments behaviourally thermoregulate during the day to similar body temperatures, divergent selection on body temperature and heat tolerance is precluded, whereas night-time temperatures can only be partially buffered by behaviour, thereby exposing organisms to selection on cold tolerance. We discuss how exposure to selection on physiology influences divergence among tropical organisms and its implications for adaptive evolutionary response to climate warming

Yoga and pilates in the management of low back pain

Many interventions for the management of low back pain exist, however most have modest efficacy at best, and there are few with clearly demonstrated benefits once pain becomes chronic. Therapeutic exercise, on the other hand, does appear to have significant benefits for managing patients with chronic low back pain (CLBP) in terms of decreasing pain and improving function. In addition, because chronic pain is complex and does not fit a simple model, there have also been numerous trials investigating and demonstrating the efficacy of multidisciplinary pain programs for CLBP. It follows that interventions that treat more than one aspect of LBP would have significant benefits for this patient population. Yoga and Pilates which have, both been gaining in popularity over the last decade are two mind–body exercise interventions that address both the physical and mental aspects of pain with core strengthening, flexibility, and relaxation. There has been a slow evolution of these nontraditional exercise regimens into treatment paradigms for LBP, although few studies examining their effects have been published. The following article will focus on the scientific and theoretical basis of using yoga and Pilates in the management of CLBP

Ultrasonic Monitoring of Recrystallization Textures in Aluminum

The present paper is an attempt to use ultrasonic velocity measurements to characterize the texture of an aluminum-magnesium alloy (Al 5xxx) and to compare the results with orientation imaging microscopy (OIM) results. The results are characterized in terms of three orientation distribution coefficients (ODC’s), W400, W420, and W440, each of which describes a particular forming anisotropy, and each of which has significant impact on the final products

Tackling bogus self-employment: some lessons from Romania

In recent years, recognition that bogus self-employment is rapidly growing, not least because of the advent of what has been called the ‘gig,’ ‘sharing’ or ‘collaborative’ economy, has led governments to search for ways to tackle this form of dependent self-employment that is widely viewed as diminishing the quality of working conditions. Until now, however, there have been few ex-post evaluations of policy initiatives that seek to tackle this phenomenon. Therefore, the aim of this paper is to provide one of the first ex-post evaluations by examining the outcomes of a 2016 legislative initiative in Romania to tackle bogus self-employment. Reporting both descriptive statistics and OLS regression analysis on monthly official data from August 2014 to August 2016, the finding is that while other business types and waged employment rates followed a similar trend to the years before the introduction of the new legislation, the number of self-employed started a negative trend after the new legislation was announced. After controlling for other indicators related to the economy (i.e. GDP) and labor market (i.e. employees, other companies, vacancy rates), the impact of the new legislation on the self-employed remains negative, offering reasonable grounds for assuming bogus self-employed was lowered by the new legislation. The paper concludes by discussing the wider implications of these findings