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Laryngopharyngeal reflux disease (LPRD) is a condition with nonspecific symptoms and most of times patients present late with advanced disease which may predispose to malignancy. The magnitude and clinical characteristics of this condition are not well known among patients attending Otorhinolaryngology services in Tanzania.

We study the long-time behavior of solutions for a general class of nonlinear fractional differential equations. These equations involve Hadamard fractional derivatives of different orders. We determine sufficient conditions on the nonlinear terms which guarantee that solutions exist globally and decay to zero as a logarithmic function. For this purpose, we combine and generalize some versions of Gronwall–Bellman inequality, appropriate regularization techniques and several properties of the Hadamard fractional derivative. Our findings are illustrated by examples.

This paper presents finite element analyses and modeling techniques of Igirder highway bridges. A wheel load distribution formula is developed using the results of finite element analysis, which can be used to calculate the flexural stresses in slabongirder bridges. A typical bridge design was selected, and one parameter was allowed to vary within practical ranges while the remaining parameters were held constant. The parameters considered were the size and spacing of steel girders, presence of cross bracing, concrete slab thickness, span length, single and continuous spans, and composite and noncomposite behavior. The developed wheel load distribution formula is similar in format to the current AASHTO specifications. The results predicted by the formula are compared with recently published research, which highlighted the importance of span length in calculating the wheel load distribution factors. This paper will assist bridge engineers and researchers in modeling and predicting the actual wheel load distribution in highway bridges.

This paper presents finite element analyses and modeling techniques of I‐girder highway bridges. A wheel load distribution formula is developed using the results of finite element analysis, which can be used to calculate the flexural stresses in slab‐on‐girder bridges. A typical bridge design was selected, and one parameter was allowed to vary within practical ranges while the remaining parameters were held constant. The parameters considered were the size and spacing of steel girders, presence of cross bracing, concrete slab thickness, span length, single and continuous spans, and composite and noncomposite behavior. The developed wheel load distribution formula is similar in format to the current AASHTO specifications. The results predicted by the formula are compared with recently published research, which highlighted the importance of span length in calculating the wheel load distribution factors. This paper will assist bridge engineers and researchers in modeling and predicting the actual wheel load distribution in highway bridges.

AimsCoeliac disease (CD) is a malabsorptive condition, which increases the risks of calcium and Vitamin D deficiencies, osteoporosis and pathological fractures when compared to the general population. Vitamin D monitoring and supplementation advice is not included in the 2013 British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) guideline. However NICE in 2015 has advised further research for paediatric patients. Current adult coeliac guideline advice is to monitor and supplement as required. We aim to contribute to the discussion for a consistent practice nationally for paediatric units.MethodsRetrospective casenote analysis of 40 patients with CD to assess when serum Vitamin D levels were done, and the number of patients requiring supplementation. Standardised proforma assessed blood tests and interventions within the first 12 months of diagnosis. This is because patients are deemed to be most vulnerable until their gluten free diet is fully established. Data was analysed using Excel software.ResultsPatients ranged from age 13 months to 17 years at initial presentation. 17 patients (42.5%) had serum levels tested within the first year of diagnosis, but only 1 patient (2.5%) was tested at initial presentation, which was confirmed to be positive for deficiency. 6 patients (15%) required treatment, of which 5 were started in the first year of diagnosis. 1 patient (2.5%) required treatment twice, occurring at 5 and 7 years post diagnosis. 1 patient had a long bone fracture due to trauma, but with normal serum Vitamin D and bone profile levels.ConclusionsThere is no current guidance on the frequency of monitoring Vitamin D levels for paediatric patients, and our practice reflects this. Monitoring serum Vitamin D levels in the first year of diagnosis is important as these patients are most vulnerable to developing mineral and vitamin deficiencies in this period. We propose that serum Vitamin D levels are checked at diagnosis, and annually thereafter.

MEASUREMENTS of the thermal radio emission from Mercury at 11.3 cm have shown that the brightness temperature is approximately 300° K and does not vary significantly with phase angle1. This is not inconsistent with the observed rotation rate of Mercury of 58.4 ± 0.4 days2if the thermal inertia of the planet is sufficiently great for the temperature to remain reasonably constant at the depth at which the 11 cm emission originates. It might be expected, however, that a phase effect may exist at shorter wavelengths where the radio emission originates closer to the surface and where the temperature may be more closely related to the instantaneous value of the solar radiation. It is somewhat surprising therefore that Epstein3, who observed at 3.4 mm wavelength, claims no phase effect, with an anomalously low temperature of only ∼ 200° K.