5-day Test Research Articles

Improving Intimate Partner Violence Services in Home Visiting: A Multisite Learning Collaborative Approach

To improve intimate partner violence (IPV) service delivery, the Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Initiative’s continuous quality improvement (CQI) team implemented a Breakthrough Series model Learning Collaborative with eight program sites. Using mixed-methods, we: examined post-Collaborative changes in Florida MIECHV home visitors’ knowledge, system awareness, and confidence; identified strategies to address challenges in supporting families with IPV; and assessed post-Collaborative program improvements. The Collaborative included three interactive 2-day sessions, six webinars, and testing strategies using the Model for Improvement (Plan-Do-Study-Act). Three online surveys assessed changes influencing IPV screening, referrals, and safety planning. Thematic content analysis of qualitative data revealed existing barriers and strategies to address challenges. Home visitors reported accurate knowledge (change: 2.3%-34.8%), confidence (change: 31.8%-37.9%), and system awareness (change: 22.7%-53.5%) for all items from baseline to final survey. There was also an increase in rates of IPV screening (change: 88.0%-91.0%) and referrals (change: 43.0%-100.0%). Strategies for addressing challenges in supporting families experiencing IPV were identified at the individual (self-care, continuous education); interpersonal (reflective supervision, trauma-informed approach); organizational (defining success, supportive agency/program, policies); and community (collaboration with IPV service providers) levels. Lessons learned from the MIECHV IPV Learning Collaborative informed future CQI projects.

Diagnostic sensitivity of 2-day cardiopulmonary exercise testing in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

BackgroundThere are no known objective biomarkers to assist with the diagnosis of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A small number of studies have shown that ME/CFS patients exhibit an earlier onset of ventilatory threshold (VT) on the second of two cardiopulmonary exercise tests (CPET) performed on consecutive days. However, cut-off values which could be used to differentiate between ME/CFS patients have not been established.Methods16 ME/CFS patients and 10 healthy controls underwent CPET on a cycle-ergometer on 2-consecutive days. Heart rate (HR), ventilation, ratings of perceived exertion (RPE) and work rate (WR) were assessed on both days.ResultsWR at VT decreased from day 1 to day 2 and by a greater magnitude in ME/CFS patients (p < 0.01 group × time interaction). No interaction effects were found for any other parameters. ROC curve analysis of the percentage change in WR at VT revealed decreases of − 6.3% to − 9.8% provided optimal sensitivity and specificity respectively for distinguishing between patients with ME/CFS and controls.ConclusionThe decrease in WR at VT of 6.3–9.8% on the 2nd day of consecutive-day CPET may represent an objective biomarker that can be used to assist with the diagnosis of ME/CFS.

Application of deoxygenation-aeration cycling to control the predatory bacterium Vampirovibrio chlorellavorus in Chlorella sorokiniana cultures

A previously untested approach was evaluated to enable management of the predatory bacterium, Vampirovibrio chlorellavorus, a pathogen of Chlorella sorokiniana, in suspension cultures grown in a laboratory test reactor. Because V. chlorellavorus is an obligate aerobic bacterium, whereas C. sorokiniana grows under aerobic and anaerobic conditions, deoxygenation of the culture was expected to be detrimental to the pathogen, but not to the algal host. The effect of deoxygenation on the uninfected (healthy) C. sorokiniana suspension cells, compared to the C. sorokiniana-V. chlorellavorus co-culture, was studied in relation to biomass, dissolved oxygen, ratio of C. sorokiniana to V. chlorellavorus DNA, and visual and light microscopic observations. Preliminary experiments were conducted to test the effects of different deoxygenation-aeration cycling regimes on performance of V. chlorellavorus-free C. sorokiniana cultures. To an aerobic culture, pure nitrogen gas was introduced to create anoxic conditions, followed by the injection of ambient air to re-establish an aerobic environment. Under this repeated cycling regime, C. sorokiniana was shown to tolerate the anoxic conditions for extended timespans that ranged from 2 to 8 h over a 5-day test period. The analogous aerobic-anoxic cycling with the C. sorokiniana-V. chlorellavorus co-cultures resulted in ‘near-normal’ growth cycle and harvestable biomass, whereas the continuously-aerated (aerobic) co-cultures that were grown without the deoxygenation step in the cycle collapsed in 3 days. Visual and light microscopic observations revealed intact C. sorokiniana cells were present in the deoxygenated cultures, compared to the aerobically-grown, brown-colored algal cultures consisting of collapsed cells. Quantitative polymerase chain reaction analysis showed continuous increases in the ratio of V. chlorellavorus (16S rDNA) to C. sorokiniana (18S rDNA) DNA in the aerated co-cultures, with greater increases during dark periods, while the pathogen-to-host DNA ratio in the deoxygenated co-cultures was relatively low and algal cells did not collapse, as would be expected following pathogen attack.

The Influence of Expectancy Level and Personal Characteristics on Placebo Effects: Psychological Underpinnings.

Placebo effects benefit a wide range of clinical practice, which can be profoundly influenced by expectancy level and personal characteristics. However, research on the issue of whether these factors independently or interdependently affect the placebo effects is still in its infancy. Here, we adopted a 3-day between-subject placebo analgesia paradigm (2-day conditioning and 1-day test) to investigate the influence of expectancy levels (i.e., No, Low, and High) and personal characteristics (i.e., gender, dispositional optimism, and anxiety state) on placebo effects in 120 healthy participants (60 females). Our results showed that the reduction of pain intensity in the test phase was influenced by the interaction between expectancy and gender, as mainly reflected by greater reductions of pain intensity in females at Low expectancy level than females at No/High expectancy levels, and greater reductions of pain intensity in males than in females at High expectancy level. Additionally, the reduction of pain unpleasantness was not only modulated by the interaction between expectancy and gender, but also by the interaction between expectancy and dispositional optimism, as well as the interaction between expectancy and anxiety state. Specifically, participants who were more optimistic in Low expectancy group, or those who were less anxious in High expectancy group showed greater reductions of pain unpleasantness. To sum up, we emphasized on regulating the expectancy level individually based on the assessment of personal characteristics to maximize placebo effects in clinical conditions.

Isolation of an acid producing Bacillus sp. EEEL02: Potential for bauxite residue neutralization

Bauxite residue deposit area (BRDA) is a typical abandoned mining wasteland representing extreme hostile environment with increased alkalinity. Microbially-driven neutralization of bauxite residue, based on the microbial acid producing metabolisms, is a novel strategy for achieving rapid pH neutralization and thus improving its environmental outcomes. The hypothesis was that these extreme conditions promote microbial communities which are capable of novel ecologically relevant functions. Several alkaliphilic acid producing bacteria were isolated in this study. One strain was selected for its superior growth pattern and acid metabolism (termed EEEL02). Based on the phylogenetic analysis, this strain was identified as Bacillus thuringiensis. The optimized fermentation conditions were as follows: pH 10; NaCl concentration 5%; temperature 25 °C; EEEL02 preferred glucose and peptone as carbon and nitrogen sources, respectively. Based on optimal fermentation conditions, EEEL02 induced a significant pH reduction from 10.26 to 5.62 in 5-day incubation test. Acetic acid, propionic acid and CO2 (g) were the major acid metabolites of fermentation, suggesting that the pH reduction in bauxite residue may be caused by acid neutralization derived from microbial metabolism. This finding provided the basis of a novel strategy for achieving rapid pH neutralization of bauxite residue.

In-vitro and in-vivo antimalarial activity of caffeic acid and some of its derivatives

To explore the in-vitro and in-vivo antimalarial potential of caffeic acid and derivatives. Two common phenolic acids (caffeic acid and chlorogenic acid) were evaluated for in-vitro and in-vivo antiplasmodial activity in comparison with some semi-synthetic derivatives that were synthesized. An in-vitro assay based on plasmodial lactate dehydrogenase activity, and the classical in-vivo 5-day suppressive test from Peters on an artemisinin-resistant Plasmodium berghei strain was used. Parasitic stage sensitivity to ethyl caffeate was determined in this work. Phenolic acid esters derivatives showed better antiplasmodial activity than corresponding phenolic acids. The derivative with the highest in-vitro activity being caffeic acid ethyl ester, exhibiting an IC50 =21.9±9.4μm. Ethyl caffeate and methyl caffeate were then evaluated for antimalarial activity invivo and ethyl caffeate showed a growth inhibition of 55% at 100mg/kg. Finally, it seems that ethyl caffeate blocks the growth of young parasitic forms. Our study provides evidence for an antimalarial potential of caffeic acid derivatives which are common in several medicinal plants traditionally used against malaria. It also demonstrates the possibility to use such derivatives in the treatment of malaria.

Provocation Tests in Nonimmediate Hypersensitivity Reactions to β-Lactam Antibiotics in Children: Are Extended Challenges Needed?

β-Lactam antibiotics are the most common trigger of reactions in children with most of them being nonimmediate (85.5%), but proven allergy after the allergological workup is between 7% and 10%. There is no agreement on how to perform the provocation tests in these types of hypersensitivity reactions. To determine whether or not repeated doses of the β-lactams are required to reproduce a nonimmediate reaction in children. This is a retrospective observational study. We included children under 14 years who were referred for a nonimmediate reaction to β-lactams. All patients underwent a 1-day hospital provocation and were kept under observation at home during the following days for at least the time elapsed between the first dose and the symptoms of the index reaction. If no reaction was triggered, the patient resumed the provocation at home with 2 daily therapeutic doses for an equal of interval time. Ninety-seven patients were included in the study. A positive reaction was recorded in 14 of them (14.4%). The short hospital provocation triggered 3 immediate reactions and 8 delayed reactions. The home rechallenge developed 1 immediate reaction and 2 delayed reactions. Nonimmediate reactions to β-lactams in children may be triggered with a 1-day provocation test. We suggest to perform a 1-day provocation test followed by an observational period of at least the time interval of the index reaction. If this challenge is negative, an extended home provocation could subsequently be carried out.

Differences in the persistence of spatial memory deficits induced by a chronic stressor in adolescents compared to juveniles.

Adolescence is thought of as a stress-sensitive developmental period. While many studies have compared adolescent responses to stress relative to that of adults, a growing body of work has examined stress responses in juveniles. Here we investigated if a chronic stressor has a differential effect on spatial memory in rats depending on whether it occurs during adolescence or the juvenile period. Male rats were exposed to the stress hormone corticosterone (Cort) in their drinking water, a vehicle control (2.5% ethanol), or water, for 7days before being tested on a novel Object/Place task 6days or 6weeks later. Exposure to Cort or ethanol at either age impaired spatial memory at the 6-day test. The ethanol induced impairment was attenuated 6 weeks later. However, rats given Cort during adolescence, but not the juvenile period, were still impaired. Together, these results suggest that adolescence is indeed a stress-sensitive period.

Enhanced localized and uniform corrosion resistances of bulk nanocrystalline 304 stainless steel in high-concentration hydrochloric acid solutions at room temperature

The localized and uniform corrosion resistances of bulk nanocrystalline 304 stainless steel (NC-304SS) produced by severe rolling technique, and its conventional polycrystalline 304 stainless steel (CC-304SS) counterpart, were investigated in high-concentration hydrochloric acid solutions at room temperature. NC-304SS can scarcely suffer from localized corrosion in 4 mol/L and 5 mol/L HCl solutions during 5-day immersion tests, and in 1–3mol/L HCl solutions during thirty-five-day immersion tests. The corrosion rate of NC-304SS was also less than that of CC-304SS during these immersion tests. The improved localized and uniform corrosion resistances of NC-304SS were explained in terms of the adsorption and chemical activity of Cl− on NC-304SS and CC-304SS characterized by X-ray photoelectron spectroscopy, and the valence electron configurations of NC-304SS and CC-304SS were characterized by ultra-violet photoelectron spectroscopy rather than conventional electrochemical results.

Development of an Analytical System Based on a Magneto-pneumatic Oxygen Analyzer for Atmospheric Oxygen Determination.

A high-precision analytical system to observe the variations in the amount fractions of atmospheric oxygen with a very small uncertainty was developed. The system comprises a magneto-pneumatic oxygen analyzer and three automatic pressure controllers. The drift of the analyzer's signal intensity can be reduced when the amount fractions of oxygen in the sample and reference gases are similar because the temperature coefficient of the analyzer linearly depends on the difference between these amount fractions. The repeatability of oxygen determination and the long-term stability of the system were tested to assess the applicability of the analyzer to field-based measurements for continuous atmospheric observations. The standard deviation of the average for 10-min measurements in the 5-day long-term stability test was 0.7 μmol mol-1 after a temperature correction. This indicates that the system can continuously measure the amount fractions of oxygen in the atmosphere for a few days without interruption for any calibration and/or compensation for the signal drift.

A comparison of the agreement, internal consistency, and 2-day test stability of the InBody 720, GE iDXA, and BOD POD® gold standard for assessing body composition

ABSTRACTThe study compared the agreement, internal consistency, and measurement stability of the GE iDXA, BOD POD, and InBody 720. Body composition of 43 men and 37 women (31.4 ± 10.7 years; 90% Caucasian and 10% other) was assessed in triplicate using each method over two different days. Mean percent body fat (% BF) of the participants was different for all three machines (27.6 ± 10.0% [GE iDXA)] 25.6 ± 10.4% [BOD POD], and 21.3 ± 10.6% [InBody 720]; p < .05). The coefficient of variation for same day repeated measures was 1.06% (GE iDXA), 3.29% (BOD POD), and 2.97% (InBody 720). The coefficient of variation for 2-day repeated measures was 1.81% (GE iDXA), 4.61% (BOD POD), and 4.24% (InBody 720). The difference between the GE iDXA and BOD POD was within acceptable variability, while the InBody 720 significantly underestimated % BF. The internal consistency was highest for the GE iDXA, followed by the InBody 720, and then the BOD POD.

Phytoremediation of domestic wastewater using a hybrid constructed wetland in mountainous rural area

ABSTRACTThe purpose of this study is to evaluate the efficiency of hybrid constructed wetlands (HCWs) in a rural mountainous area. The experiment was set up in small rural community named Tidili within the region of Marrakech, Morocco. The wastewater treatment plant was composed of three vertical flow constructed wetlands (VFCWs) working in parallel, followed by two parallel horizontal-subsurface flow constructed wetlands (HFCWs), with hydraulic loading rates of 0.5 and 0.75 m3/m2.d, respectively. The two units were planted with Phragmites australis at a density of 4 plants/m2. Wastewater samples were collected at the inlet of the storage tank and at the outlet of the whole system (VFCWs, HFCWs) stages. The main removal percentages of total suspended solids (TSS), biochemical oxygen demand measured in a 5-day test (BOD5), chemical oxygen demand (COD), total nitrogen, and total phosphorus were respectively 95%, 93%, 91%, 67%, and 62%. The system showed a very high capacity to remove total coliforms, fecal coliforms, and fecal streptococci (4.46, 4.31, and 4.10 Log units, respectively). Artificial neural networks (ANNs) were used to model the quality parameters (TSS, BOD5, COD) and total coliforms and fecal streptococci. Based on the obtained results, the ANN model could be considered as an efficient tool to predict the studied phytoremediation performances using HCWs.

The use of human hair in green technology to reduce human-wild hog conflict from the agricultural perspective

Human scalp hair (HSH) waste has often dumped without undergoing any proper treatment or even being reused. Past studies related to this waste in Malaysia is still not as wide as in others countries. However, in some rural areas, this waste is still used by farmers as pest controller to protect plantation from wild hog attacks. Unfortunately, the past practices does not expose their effectiveness as repellent. This study briefly discuss on the human-wild hog conflict, current practices used to control the invasive activity and to share the result of using HSH as repellent to help farmer of small orchid in Muar, Johor. In this pilot study, HSH were washed using the non-ionic detergent-acetone method as prior treatment to remove all impurities that might stick on them. In order to increase the probability of visitation, fermented corn bait has been used to lure the wild hog into the target area. Four (4) samples (A) 5kg whole corn; (B) 5kg whole corn mixed with 20g HSH; (C) 5kg whole corn mixed with 40g HSH; and (D) 5kg whole corn mixed with 60g HSH have been set on the private orchid and observed. The 5-day test indicates the potential of HSH as temporary wild hog repellent.

Effect of Hordeum vulgare, Moringa oleifera, and Vitex negundo extracts on the hippocampus and memory of Mus musculus

Background: Herbal medicines such as Hordeum vulgare, Moringa oleifera, and Vitex negundo are widely recognized around the world as dietary supplements, remedy for ailments, and bodily sustenance. Moreover, studies have shown that intake these herbal medicines can have an effect in the memory retention in mice; however, no further studies have been conducted in comparing between barley, moringa, and lagundi and their optimal dosages on treatments for the effect of memory in mice. Aims and Objectives: The aim of this study is to comparatively assess the effects barley, moringa, and lagundi extracts on the histology of the hippocampus and its effect on memory using the Morris Water Maze test. Materials and Methods: The extracts were orally administered to the mice with three specific dosages (250 mg/kg, 500 mg/kg, and 750 mg/kg) of each herbal supplements, barley, moringa, and lagundi. The mice were subjected to a 2-day water maze test, and mice were sacrificed thereafter. Neurological effects such as hippocampal reduction and degeneration were analyzed histologically. Results: Results showed that there are no differences between the different treatments at all dosages with the control group; therefore, memory improvement or impairment was not exhibited during the maze test. In the histological analysis, however, it showed that barley did not show any effect on the histology of hippocampal neurons with the cells within the normal limit and did not undergo cell degeneration. Moringa and lagundi, on the other hand, resulted to neurotropic effects of impaired hippocampal neurons with lagundi causing more damage than moringa. Conclusion: There are no effects on memory between the three treatments administered to the mice. However, neuronal damage on the other may result from moringa and lagundi administration.

Athletic on-field heart rate: a demand of modern cricket

Cricket has transformed very quickly from a gentleman’s game to a game which demand high standard of physical and physiological fitness. Cricket has a diversity of game formats ranging from 5-day test cricket to a shorter but dynamic t20 format. Since last two decades a lot of cricket is being played throughout the year, there is no discrimination of summers and winters as what used to happen during the prior days. For this reason now the standard of physiological demands of this sport has risen too. Good heart rate is always an important aspect of physiological fitness of athletes and it has a mighty impact on the performance of players in the grounds.

Gastroesophageal reflux disease-related symptom recurrence in patients discontinuing proton pump inhibitors for Bravo® wireless esophageal pH monitoring study.

Patients with gastroesophageal reflux disease (GERD) are treated with proton pump inhibitors (PPIs). Those that do not achieve symptom relief, or non-responders, usually undergo esophageal pH monitoring off PPIs in order to confirm the presence of GERD. To assess the efficacy of the reverse-PPI trial in evaluating the presence of GERD or its recurrence rates, as well as to identify a correlation between the symptom recurrence rates and GERD severity determined by 48-hour Bravo® esophageal pH-monitor testing. A final total of 205 patients that underwent the 48-hour Bravo® esophageal pH-monitoring study were retrospectively included. Patients discontinued PPI usage for at least 7 days prior to testing, and completed symptom questionnaires during the 2-day test. The Bravo® test was considered positive if the percentage of time with esophageal pH <4 was >4.4%. A total of 363 patients underwent 48-hour Bravo® testing and of those patients, 205 were eligible for the study. Ninety-two patients reported symptoms as being «same/better» and 113 as being «worse» after stopping PPIs. Of the 92 patients with improved symptoms, 44 (48%) had documented acid reflux during the Bravo® study, compared with 65 of 113 (58%) patients with worsening symptoms that also complained of acid reflux. Of the 109 patients found to have confirmed GERD upon pH monitoring, 65 (59.6%) reported a worsening of symptoms, compared with 48 of 96 (50.0%) patients without GERD (p=0.043). Main symptoms stated to be worse included heartburn, chest pain, regurgitation, nausea, and belching (p<0.05). Of the 205 patients, 103 were off PPIs for 7 days. Seventy-two of them (68.9%) reported a worsening of symptoms, compared with 40 of the 102 (41.2%) patients that were off PPIs for>7 days (p=0.042) CONCLUSION: Symptom exacerbation following PPI cessation for at least 7 days correlated with acid reflux severity assessed by Bravo® testing. Patients off PPIs for 7 days had a higher likelihood of experiencing worsening symptoms, compared with those off PPIs for more than 7 days. These findings suggest that when PPIs are held for 7 days or less prior to Bravo® testing, acute worsening of upper GI symptoms due to the abrupt discontinuation of therapy may influence the Bravo® results. The etiology of this may be related to rebound acid hypersecretion and needs to be further elucidated in future studies.

Pro-neurogenic, Memory-Enhancing and Anti-stress Effects of DF302, a Novel Fluorine Gamma-Carboline Derivative with Multi-target Mechanism of Action

A comparative study performed in mice investigating the action of DF302, a novel fluoride-containing gamma-carboline derivative, in comparison to the structurally similar neuroprotective drug dimebon. Drug effects on learning and memory, emotionality, hippocampal neurogenesis and mitochondrial functions, as well as AMPA-mediated currents and the 5-HT6 receptor are reported. In the step-down avoidance and fear-conditioning paradigms, bolus administration of drugs at doses of 10 or 40mg/kg showed that only the higher dose of DF302 improved long-term memory while dimebon was ineffective at either dosage. Short-term memory and fear extinction remained unaltered across treatment groups. During the 5-day predation stress paradigm, oral drug treatment over a period of 2weeks at the higher dosage regimen decreased anxiety-like behaviour. Both compounds supressed inter-male aggression in CD1 mice, the most eminent being the effects of DF302 in its highest dose. DF302 at the higher dose decreased floating behaviour in a 2-day swim test and after 21-day ultrasound stress. The density of Ki67-positive cells, a marker of adult neurogenesis, was reduced in the dentate gyrus of stressed dimebon-treated and non-treated mice, but not in DF302-treated mice. Non-stressed mice that received DF302 had a higher density of Ki67-positive cells than controls unlike dimebon-treated mice. Similar to dimebon, DF302 effectively potentiated AMPA receptor-mediated currents, bound to the 5-HT6 receptor, inhibited mitochondrial permeability transition and displayed cytoprotective properties in cellular models of neurodegeneration. Thus, DF302 exerts multi-target effects on the key mechanisms of neurodegenerative pathologies and can be considered as an optimized novel analogue of the neuroprotective agent dimebon.

Sex and the housing: Effects on behavior, cortisol levels and weight in zebrafish

Studies with zebrafish use acclimatizing periods of at least one week immediately before the experiments. During this time, animals can be housed in sexually segregated conditions (only females or males in the tank) or in mixed-sex conditions (both sexes in the tank). The influence of sex and housing conditions regarding the presence of one or two sexes is largely unknown in zebrafish. Our aim was to evaluate the influence that sex and housing regarding the sex of animals had in the open tank task, in the inhibitory avoidance memory test, in cortisol levels and weight in zebrafish. Four groups of animals were used: 1) segregated housed females (only females were kept in the tank); 2) segregated housed males (only males were kept in the tank); 3) mixed-sex housed females (only females were analyzed from a tank containing 50% ratio of each sex); 4) mixed-sex housed males (only males were analyzed from a tank containing 50% ratio of each sex). Males showed higher total distance travelled and mean speed when compared to females. In the inhibitory avoidance memory, sexually segregated animals had higher latencies than their mixed-sex counterparts in the 1day test and sexually segregated females presented a memory that persisted longer and was able to be reinstated. Whole-body cortisol levels were higher in mixed-sex animals while weight was lower in these fish. To the best of our knowledge, this is the first time that effects of sex and housing regarding sex were investigated in behavior and physiology of zebrafish.

Gastroesophageal reflux disease-related symptom recurrence in patients discontinuing proton pump inhibitors for Bravo wireless esophageal pH monitoring study

BackgroundPatients with gastroesophageal reflux disease (GERD) are treated with proton pump inhibitors (PPIs). Those that do not achieve symptom relief, or non-responders, usually undergo esophageal pH monitoring off PPIs in order to confirm the presence of GERD. AimsTo assess the efficacy of the reverse-PPI trial in evaluating the presence of GERD or its recurrence rates, as well as to identify a correlation between the symptom recurrence rates and GERD severity determined by 48-hour Bravo esophageal pH-monitor testing. MethodsA final total of 205 patients that underwent the 48-hour Bravo esophageal pH-monitoring study were retrospectively included. Patients discontinued PPI usage for at least 7 days prior to testing, and completed symptom questionnaires during the 2-day test. The Bravo test was considered positive if the percentage of time with esophageal pH <4 was >4.4%. ResultsA total of 363 patients underwent 48-hour Bravo testing and of those patients, 205 were eligible for the study. Ninety-two patients reported symptoms as being «same/better» and 113 as being «worse» after stopping PPIs. Of the 92 patients with improved symptoms, 44 (48%) had documented acid reflux during the Bravo study, compared with 65 of 113 (58%) patients with worsening symptoms that also complained of acid reflux. Of the 109 patients found to have confirmed GERD upon pH monitoring, 65 (59.6%) reported a worsening of symptoms, compared with 48 of 96 (50.0%) patients without GERD (p=0.043). Main symptoms stated to be worse included heartburn, chest pain, regurgitation, nausea, and belching (p<0.05). Of the 205 patients, 103 were off PPIs for 7 days. Seventy-two of them (68.9%) reported a worsening of symptoms, compared with 40 of the 102 (41.2%) patients that were off PPIs for>7 days (p=0.042) ConclusionSymptom exacerbation following PPI cessation for at least 7 days correlated with acid reflux severity assessed by Bravo testing. Patients off PPIs for 7 days had a higher likelihood of experiencing worsening symptoms, compared with those off PPIs for more than 7 days. These findings suggest that when PPIs are held for 7 days or less prior to Bravo testing, acute worsening of upper GI symptoms due to the abrupt discontinuation of therapy may influence the Bravo results. The etiology of this may be related to rebound acid hypersecretion and needs to be further elucidated in future studies.

Online total organic carbon (TOC) monitoring for water and wastewater treatment plants processes and operations optimization

Abstract. Organic measurements, such as biological oxygen demand (BOD) and chemical oxygen demand (COD) were developed decades ago in order to measure organics in water. Today, these time-consuming measurements are still used as parameters to check the water treatment quality; however, the time required to generate a result, ranging from hours to days, does not allow COD or BOD to be useful process control parameters – see (1) Standard Method 5210 B; 5-day BOD Test, 1997, and (2) ASTM D1252; COD Test, 2012. Online organic carbon monitoring allows for effective process control because results are generated every few minutes. Though it does not replace BOD or COD measurements still required for compliance reporting, it allows for smart, data-driven and rapid decision-making to improve process control and optimization or meet compliances. Thanks to the smart interpretation of generated data and the capability to now take real-time actions, municipal drinking water and wastewater treatment facility operators can positively impact their OPEX (operational expenditure) efficiencies and their capabilities to meet regulatory requirements. This paper describes how three municipal wastewater and drinking water plants gained process insights, and determined optimization opportunities thanks to the implementation of online total organic carbon (TOC) monitoring.