A New Method to Evaluate Lower Esophageal Distension Capacity in Eosinophilic Esophagitis by Using Functional Lumen Imaging Probe (EndoFLIP™).

Endoluminal functional lumen impedance planimetry (EndoFLIPTM) has become the gold standard to evaluate esophageal distensibility, although the study itself and its analysis present challenges. We propose here a new method to assess lower esophageal distension capacity that overcomes several limitations of prior approaches, including incomplete and corrupted EndoFLIPTM recordings. Esophageal distension capacity was evaluated with a 16-channel EndoFLIPTM in 10 controls and 14 patients with eosinophilic esophagitis (EoE). Controls were evaluated once. EoE patients were evaluated at baseline and after at least six weeks of treatment with orodispersible budesonide tablets, 1 mg bd. Balloon volumes were increased by 5 mL stepwise, either reaching a maximum volume of 60 mL or a maximum balloon pressure of 60 mmHg. Recordings were analyzed with a homemade R script. The mean esophageal diameter at 60 mL, D (60 mL), was calculated or extrapolated depending on whether the 60 mL volume was reached. By fitting a Michaelis-Menten curve across all measured diameters throughout all constant volume steps, the mean D (60 mL) was estimated. For control subjects, the mean ± SD value of D (60 mL) was 17.08 ± 1.69 mm, and for EoE patients at baseline, D (60 mL) was 14.51 ± 2.68 mm. After six weeks of treatment of EoE patients, D (60 mL) significantly increased to 16.22 ± 1.86 mm (paired Wilcoxon signed test: p = 0.0052), although the values for control subjects were not reached. The estimated mean esophageal diameter at 60 mL is a good proxy for esophageal distension capacity, which correlates with clinical outcomes in EoE. The method presented in this study overcomes difficulties encountered during the standard measurement protocol, allowing the analysis of recordings from incomplete and corrupted registries.

Sample size bias in the empirical assessment of the acute risks associated with daylight saving time transitions.

The assessment of the acute impact of daylight saving time (DST) transitions is a question of great interest for an understanding of the benefits and inconveniences of a practice that is now under public scrutiny in Europe and America. Here, we report a thorough analysis of a record of 13 well-known research studies that reported increased risks associated with DST transitions in health issues - acute myocardial infarction, ischemic strokes and trauma admissions - and in societal issues - accidents, traffic accidents and fatal motor vehicle accidents. We found that a five percent increase of the risks suffices to understand the reported increased risks associated with the spring transition. Reported values above this threshold are impacted by the sample size of the study. In the case of the autumn transition, no increase in the risks is found.

A chronobiological evaluation of the risks of canceling daylight saving time.

The long-term impact of seasonal regulation of clocks (Daylight Saving Time) is analyzed showing that it helped to mitigate the advance of the phase of human activity during the twentieth century and the exposure to the hours of the dawn in winter. The increased risks induced by circadian misalignment around transition dates are balanced by a better alignment of social clocks to the natural day in summer and in winter.

Proton pump inhibitor therapy reverses endoscopic features of fibrosis in eosinophilic esophagitis.

BACKGROUND: Long-standing inflammation leads to esophageal remodeling with stricture formation in patients with eosinophilic esophagitis (EoE). The ability of proton pump inhibitors (PPI) to reverse endoscopic features of fibrosis is still unknown. OBJECTIVE: To investigate the effect of a short course of PPI treatment in reducing endoscopic findings indicative of esophageal fibrosis in EoE patients. METHODS: Cross-sectional analysis of the EoE CONNECT registry. Patients who received PPI to induce EoE remission were evaluated. Endoscopic features were graded using the EoE Endoscopic Reference Score (EREFS), with rings and strictures indicating fibrosis. Results were compared to those from patients treated with swallowed topic corticosteroids (STC). RESULTS: Clinico-histological remission was achieved in 83/166 adult patients treated with PPI (50%) and in 65/79 (82%) treated with STC; among responders, 60 (36%) and 57 (72%) patients respectively achieved deep histological remission (<5 eosinophils/hpf). At baseline, mean±SD EREFS was lower in patients treated with PPI compared to those who received STC (p < 0.001). Short term treatment significantly reduced EREFS scores in patients treated either with PPI or STC as well as rings and strictures. Among patients treated with PPI, deep histological remission (<5 eosinophils/hpf) provided further reduction in total EREFS score. CONCLUSION: Effective PPI therapy for EoE significantly reduced endoscopic esophageal fibrosis in the short term.

Traffic accident increase attributed to Daylight Saving Time doubled after Energy Policy Act.

Martín-Olalla argues that an important factor in the association between motor vehicle fatalities and the switch to Daylight Saving Time is the timing of the switch, which in the US changed with the Energy Policy Act of 2005.

The long term impact of Daylight Saving Time regulations in daily life at several circles of latitude.

We analyze large scale (N ~ 10000) time use surveys in United States, Spain, Italy, France and Great Britain to ascertain seasonal variations in the sleep/wake cycle and the labor cycle after daylight saving time regulations have stood up for at least forty years. That is, not the usual search for the impact of the biannual transitions, but a search for how industrialized societies have answered to DST regulations at different circles of latitude. Results show that the labor cycle is equally distributed through seasons if measured in local time. It is an everyday experience which is a major outcome of DST. The sleep/wake cycle displays disturbances punctuated by solar events: sunrise, sunset and noon. In week-ends, under free preferences, sleep onset delays in summer, opposing to the regulation and following the delay in sunset time, while sleep offset advances, despite clock time already advanced in the spring transition. This advance still follows the advance in sunrise times. The best explanation for these findings is that human cycles are not misaligned by the size and direction of DST regulations, which explains the success of that practice. The sleep/wake cycle in Great Britain and France exhibit fewer statistically significant excursions than the sleep/wake cycle in Spain, Italy and United States, despite light and dark seasonal deviations are larger. That could be indicating that the preference for a seasonal regulation of time decreases with increasing latitude above 47°. The preferences for a seasonal regulation of clocks and for the choice of permanent summer time or permanent winter time are sketched from a previous report on human activity.

Publisher Correction: Seasonal synchronization of sleep timing in industrial and pre-industrial societies.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Seasonal synchronization of sleep timing in industrial and pre-industrial societies.

Artificial light has reshaped human sleep/wake cycle in industrial societies and raised concern on the misalignment of this cycle relative to the light and dark cycle. This manuscript contrasts sleep timing in extratropical, industrial societies (data from eight national time use surveys in countries with Daylight Saving Time -DST- regulations) and Subtropical, pre-industrial societies with and without access to artificial light (data from nine locations coming from seven previous reports) against the cycle of light and dark. Within the two process model of sleep, results show sleep onset and sleep offset keep bound to each other by the homeostatic process. In winter, the photoreceptive process aligns the phase of the sleep/wake cycle to sunrise. As a result the phase increasingly lags with increasing latitude up to a delay of 120 min at 55° latitude. In summer, the homeostatic process still binds sleep onset to speep offset but DST rules in industrialized societies reduce the lag by one third to 40 min at 55° latitude. Sleep timing is then stationary with latitude. The phase of the sleep/wake cycle is then governed by natural trends and no clues of misalignment are revealed.

Latitudinal trends in human primary activities: characterizing the winter day as a synchronizer.

This work analyzes time use surveys from 19 countries (17 European and 2 American) in the middle latitude (38-61 degree) accounting for 45% of world population in this range. Time marks for primary activities are contrasted against light/dark conditions. The analysis reveals winter sunrise synchronizes labor start time below 54 degree, occurring within winter civil twilight. Winter sunset is a source of synchronization for labor end times. Winter terminator punctuate meal times in Europe: dinner occurs 3 h after winter sunset time within 1 h; 40% narrower than variability of dinner local times. The sleep-wake cycle of laborers is shown to be related to winter sunrise whereas standard population's appears to be irrespective of latitude. The significance of the winter terminator depends on two competing factors average labor time (~7 h30 m) and the shortest photoperiod. Winter terminator gains significance when both roughly matches. That is within a latitude range from 38 degree to 54 degree. The significance of winter terminator as a source of synchronization is also related to contemporary year round time schedules: the shortest photoperiod represents the worst case scenario the society faces.

Avalanche correlations in the martensitic transition of a Cu-Zn-Al shape memory alloy: analysis of acoustic emission and calorimetry.

The existence of temporal correlations during the intermittent dynamics of a thermally driven structural phase transition is studied in a Cu-Zn-Al alloy. The sequence of avalanches is observed by means of two techniques: acoustic emission and high sensitivity calorimetry. Both methods reveal the existence of event clustering in a way that is equivalent to the Omori correlations between aftershocks in earthquakes as are commonly used in seismology.