Search

Baseline impedance measured during high-resolution impedance manometry (HRIM) can distinguish patients with gastroesophageal reflux disease (GERD) from controls, presumably due to differences in esophageal acid exposure. The characteristics of regurgitation and reflux in rumination syndrome and GERD are very different, and thus we investigated whether baseline esophageal impedance would differ in these 2 patient groups compared with controls.We compared 20 patients with rumination syndrome with 20 patients who had GERD and 40 controls. Baseline impedance was measured over 15 seconds during the landmark period of HRIM in all 18 impedance sensors on a HRIM catheter.The mean distal baseline impedance measured in ohms during HRIM was 1336 Ω [95% confidence interval (CI)=799, 1873) in patients with GERD, 1536 Ω in rumination syndrome (95% CI=1012, 2061), and 3379 Ω in controls (95% CI=2999, 3759) (P0.0001). Proximal impedance was significantly lower in the GERD and rumination groups compared with controls; rumination syndrome (2026; 95% CI=1493, 2559 Ω), GERD (2572; 95% CI=2027, 3118 Ω), and controls (3412; 95% CI=3026, 3798 Ω) (P0.001).Baseline impedance measured during HRIM in patients with rumination syndrome is significantly lower than controls and appears similar to patients with GERD both in the proximal and distal esophagus. These findings suggest that the postprandial regurgitation in rumination syndrome alters both the distal and proximal esophageal mucosal barrier.

Margaret Cavendish has been identified as a crypto-atheist in a number of modern studies of her life and works. In her own time, Cavendish voiced serious concern that she would be accused of atheism by her contemporaries, writing in Philosophical and Physical Opinions (1655), “pray account me not an Atheist, but believe as I do in God Almighty” when explaining that she discourses on natural philosophy, not theology. However, despite Cavendish’s attempt to distance herself from religious matters to avoid such accusations, natural philosophy and theology do converge at times in her writings, revealing an impulse shared by many early Enlightenment thinkers to establish the apposite relationship between matter and metaphysics, (proto) scientific reasoning and the Christian faith. This essay focuses on one aspect of Cavendish’s thought—her evolving treatment of the nature and operation of the soul(s)—to demonstrate that she works to produce over a fifteen-year period a flexible, if complex and inexact, theory that reveals God and nature, spirit and matter operating in conjunction. This negotiation of faith and reason in her work undergirds her claim that she seeks to be both “a good Christian, and a good Natural Philosopher” ( Philosophical Letters , 210).

O one can escape the substance of his time any more than he can jump out of his skin,” wrote Georg Hegel, leading him to conclude that bible commentaries “do not so much acquaint us with content of scripture as with the mode of thought of their age.”� Gerald L. Bruns, reflecting on Hegelian hermeneutics, observes: “It is not enough to reproduce another’s thought; it is necessary to think it as one’s own. The dead letter must be reinvested with one’s own spirit, meaning that one . . . appropriates it, not merely as a preserved artifact but as something internalized, that is, essential to one’s self-reflection and self-identity.” � The verse and prose translations of Henry Vaughan, a poet known for his “unusual reliance upon prior texts,” reveal this very historicity or cultural embeddedness of language; for in these works, Vaughan responds to the philosophy and politics of the volatile world he inhabits. � His source texts are refracted through the prism of his life context and conceptual frame. Louise Imogen Guiney discerned � Henry Vaughan’s facility in Greek suggests that he could read the Septuagint and he may, like his twin brother Thomas, have been able to read the Old Testament in Hebrew. However, the semantics and syntax of his translations indicate that he took the Autho rized Version as his primary source and model. jonathan Post, in Henry Vaughan: The Unfolding Vision (Princeton: Princeton u niversity Press, 1982), and Philip West, in Henry Vaughan’s “Silex Scintillans”: Scripture Uses (Oxford: Oxford university Press, 2001), refer to Vaughan’s psalms as translations, likely using the term in its loosest sense, and I follow this practice here. � Georg Hegel, Introduction to the Lectures on the History of Philosophy, quoted in Gerald L. Bruns, Hermeneutics: Ancient and Modern (New Haven: Yale u niversity Press, 1992), 151. � Bruns, Hermeneutics: Ancient and Modern, 150. � Thomas O. Calhoun, Henry Vaughan: The Achievement of “Silex Scintillans” (Newark: university of Delaware Press, 1981), 67.

Shakespeare's Macbeth does not present a particular position on Anglo-Scottish politics that defines itself in relation to the belief system of one small political body, as is often argued, but confronts three models of the Union recorded in the pamphlet literature of the period and dramatized on the Jacobean stage. The construction of the drama as a whole—the configuration of character, form, and genre and the use of geographical space—produces a number of colliding and competing positions on the Union, reflecting the complexity of its relationship to the Court and to the marketplace.

The ARPANET was originally conceived to support high-data-rate distant communication between large mainframe computers. Because of the hardware limitations of the Honeywell 316/516 processor, which was selected as the original ARPANET interface message processor (IMP), most ARPANET IMPs are resticted to supporting a maximum of four host attachments (computers or gateways to other networks). As the ARPANET community expanded many sites experienced the need for more than four host ports. The response was to install additional IMPS. With the H316/516 no longer available and the C/30 IMP, being developed by the BBN Computer Company not expected to arrive until 1981. no more ARPANET community, hosts attached to IMPs have increasingly tended toward less powerful types, such as the DEC PDP-11 minicomputer. Many of these microcomputer hosts require only moderate data-rate network communication or occasional access. Newer node-switching equipment utilizes the Bolt Beranek and Newman Pluribus, which eliminates hardware constraints upon the number of host attachments. Nevertheless, the large majority of deployed IMPs are still of the older Honeywell type. The desire to attach a large number of minicomputers or microcomputers to the ARPANET induced DARPA to assign SRI the task of developing the port expander concept into a working product. This manual describes the functions, installations, and operation of the port expander.