bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective sound-absorbing material for transport technological machines of railway transport
Authors: Popova I , Leonteva L , Danilov I
Published: November 2019

The article discusses the types and features of the operation of transport technological machines of the railways of the Russian Federation on the example of the most frequently used track machines, and presents methods for noise reducing on the railways of the Russian Federation. The most effective method to reduce the noise arising during the operation of track machines is identified - this is the installation of a steel soundproofing hood (casing) over the electric motor. The calculation of the effectiveness of sound-absorbing materials used for cladding steel bonnet is given. According to the results of the calculation, the material «asbestos felt» turned out to be the most effective, but the other materials under consideration, and in particular, «glass wool», «mineral wool» and «construction felt», turned out to be also applicable to the lining of the steel bonnet, since the calculations revealed the applicable level of sound absorption, which is less than a decibel in terms of noise reduction to the material «asbestos felt».
Optimization of work of urban passenger transport
Authors: Popova I , Abdulina E , Danilov Yu , Danilov I
Published: November 2019

Recommendations for improving the organization of the logistics system of urban passenger traffic based on the formation of adaptive properties proposed. Definitions of organization and lack of organization of the system, target entropy, orderliness, disorder are considered. The calculation of these indicators allows us to conclude how the company is adapted to the external environment. An important feature of all production systems is the focus of their functioning. If such a system is functioning, it means, first of all, that it solves a finite set of tasks to ensure the adaptability of the urban passenger traffic management system to the flow of passengers and with a certain accuracy the goals of organization and management, of which there is also a finite set. The authors come to a fair conclusion that the lack of organization of functioning is a consequence of the influence of the external environment on the control object, while organization is a quantitative measure of the ability of the system to adapt to the effects of environmental factors. The indicator of organization can be proposed as a criterion that assesses the efficiency of the urban passenger transport system. The worse the internal structures are organized, the less efficiently the control system works and the more mobile and uncertain the external environment, the greater the discrepancy between the goal and the final result.
Thermodynamic modeling of a heat pump unit as part of a cogeneration turbine operating in ventilation mode
Authors: Souri K , Antipov Y A , Shkarin K V
Published: November 2019

Currently, much attention is paid to improving the efficiency of energy generating facilities through the use of secondary energy resources. This article presented a cogeneration turbine in the general energy scheme with a heat pump installation. During the winter period, due to the increased consumption of heat energy, heat-generating turbines, by closing the regulating diaphragm, are switched to full steam extraction mode from the low-pressure flow part to heat the supply water. In this case, the last stages of the turbine are transferred to the ventilation mode with the release of heat due to the vortex flows on the blades of the low pressure part. In order to obtain additional heat energy for network water, the article considers the option of using secondary energy resources with the help of a heat pump unit operating in a steam turbine plant scheme. All necessary calculations of thermodynamic modeling were carried out according to the EES heat pump, the program working as part of a cogeneration turbine, and the results were obtained of increasing the efficiency of using secondary energy resources with various refrigerants.
Magnetization modes modelling and analysis for controlled reactors with a rotating field
Authors: Zabudskiy E I , Balandina G I
Published: November 2019

Electromagnetic reactors are used to carry out practical tasks of automatic control of power lines operation modes, distribution grids and energy supply systems of the industrial enterprises. The reactors’ characteristics significantly depend on the harmonic’s manifestation magnetic field saturation, which is different in the magnetization modes of reactors: forced, free and symmetrical. For the purpose of their analysis, a generalized mathematical model of the cross-sectional magnetic circuits of static ferromagnetic devices with rotating magnetic field has been developed on the base of nonlinear magnetic circuits theories. It was found that the best mode is symmetric magnetization, characterized by the following advantages: an increased range of reactive power control, enhanced stabilizing effect on the controlled current, reduced losses in steel, increased speed and the absence of “shaking” vibrations of the reactor magnetic core. It is shown that the free magnetization mode is close in its merits to the symmetric magnetization mode.
Accounting for physically nonlinear deformation of the shell under flat loading based on the finite element method
Authors: Sh Dzhabrailov A , Klochkov Yu V , Nikolaev A P
Published: November 2019

On the basis of the theory of small elastic plastic deformations obtained at the loading step in the curvilinear coordinate system of the relationship between stress increments and strain increments, which are implemented in the matrix of shell stiffness under flat loading In this paper, algorithms for obtaining physically nonlinear relations at the loading step in finite element calculations of shells under flat loading are developed.On the basis of relations of deformation theory of plasticity the equations of connection between increments of stresses and increments of deformations at flat loading in elastic plastic stage of work are received. The coefficients of proportionality are obtained when using the strain diagram of the material. The found defining relations are implemented in the algorithm of forming the stiffness matrix of the finite element of the shell under flat loading. Specific examples show the effectiveness of the developed algorithms for the calculation of the shell with a flat loading beyond the elasticity limits.
Spectral determination of novel methacryloyl guanidine compounds in water solutions
Authors: Tikhomirov V A , Mendeleev D I , Kurenkov V V , Menyashev M R , Sivov N A , Gerasin V A
Published: November 2019

For production and application of novel biocidal guanidine polymer compounds techniques for monitoring the toxic monomer and oligomer components in polymer aqueous solutions are required. A direct spectroscopic method is offered for determination of methacryloyl guanidine salts, polymer and copolymer in water solutions at native pH. The impact of unsubstituted guanidine and methacrylate guanidine contaminants is also discussed. The spectroscopic method offered is simple, rapid and effective for monitoring contamination of polymethacryloylguanidines with toxic monomer components during synthesis of polymers and copolymers from different monomer salts, during dialysis and other manufacturing stages of biocidal polymers.
The choice of dynamic variables in quantum theory
Authors: Samsonenko N V , Ndahayo F , Usman Manga A , Semin M V
Published: November 2019

The influence of various choices of dynamic variables in quantum theory on the interpretation of measurement results and experiments are discussed. Dynamic variables in the generally accepted quantum mechanics have no visual sense, which in turn leads to the loss of the image of the studied phenomena and processes of the microworld. Thus, quantum mechanics forces us to abandon the possibility of even mentally imagining the conditions that determine the behavior of an individual system in a quantum region. Also, various representations of the wave function and their use in solving dynamic equations are shown. By now, quantum mechanics is not a complete theory. It resembles classical (Newtonian) mechanics, which explains how movement occurs as a result of the action of certain forces, but does not say what kind of forces it is. Thus, before the advent of basic theories, the application of quantum mechanics to specific physical problems always implied the need to build certain guesses about the nature of these forces.
Stability of metal cylindrical grid shell structures
Authors: Siyanov A I , Rynkovskaya M , Tupikova E
Published: November 2019

Based on the fundamental thin shell theory applied to thin continuous cylindrical shells, a method for calculating the stability of the corresponding grid shell structures is developed. Mathematical modeling is performed and factors of critical state of structures are determined. Critical deformation zones are identified and the patterns of changes in shell geometry under actual loads are established. The dependencies of strength and shape-forming parameters are obtained depending on the material and the number of half-waves of the stability loss shape. The critical load is determined taking into account the possible rigidity of multi-element grids, and the results of numerical studies are presented. A noticeable difference in the values of critical load is shown and the admissible limits of applicability of geometric parameters are found. A significant sensitivity of shells with a rhombic mesh are noted.
Radiative properties of Tm3+ doped TeO2-ZnO-Na2O-TiO2 glasses studied using Judd-Ofelt Theory
Authors: Marzuki A , Riyatun  , Larasati M , Singgih G T
Published: November 2019

New Tm3+-doped tellurite glasses were prepared by melt quenching technique. X-ray Diffraction (XRD) characterization were carried out to confirm the glassy state of the samples. Characterization using UV-VIS-NIR spectrophotometer and FTIR were performed in order to determine the width of the transparent window, optical band gap and bonding structure of the samples. Density and refractive index were measured at room temperature using pycnometer and Brewster’s angle technique. Utilizing these data, lasing performance of the samples was predicted. For this purpose, the Judd-Ofelt theory was applied to calculate Judd-Ofelt parameters (Ωt
). From these results several radiative transitions were studied in terms of transition probabilities (Ai
), branching ratios (βi
) and radiative lifetime (τ). The predicted results were then compared to that obtained from fluorescence spectra measurement so that quantum efficiency of the samples can be calculated.
Optical Aharonov–Bohm effect due to toroidal moment inspired by general relativity
Authors: Besharat A , Miri M , Nouri-Zonoz M
Published: November 2019

We study the analogy between propagation of light rays in a stationary curved spacetime and in a toroidal (meta-)material. After introducing a novel gravitational analog of the index of refraction of a magneto-electric medium, it is argued that light rays not only feel a Lorentz-like force in a magneto-electric medium due to the non-vanishing curl of the toroidal moment, but also there exists an optical analog of Aharonov–Bohm effect for the rays traveling in a region with a curl-free toroidal moment. Experimental realization of this effect could utilize either a multiferroic material or a toroidal metamaterial.
Nanodevices at terahertz frequency based on 2D materials
Authors: Vitiello Miriam Serena
Published: November 2019

Artificial semiconductor heterostructures played a pivotal role in modern electronic and photonic technologies, providing a highly effective mean for the manipulation and control of carriers, from the visible to the terahertz frequency range. Despite their exceptional versatility, they commonly require challenging epitaxial growth procedures, due to the need of clean and abrupt interfaces, lattice matching or limited and controlled lattice mismatch, which proved to be major obstacles for the development of room-temperature devices, like sources, detectors or modulators, especially in the far-infrared. The discovery of graphene and the related fascinating capabilities have triggered an unprecedented interest in inorganic two-dimensional materials. Layered materials such as graphene, hexagonal boron nitride, transition metal dichalcogenides, and the more recently re-discovered black phosphorus display an exceptional technological potential for engineering nano-electronic and nano-photonic devices and components ‘by design’, offering a unique platform for developing devices with a variety of properties. Here, I review our latest achievements in the design and developments of graphene based nanodetectors, saturable absorbers and near field probes operating across the far-infrared.
Lifting Agent Granuloma
Authors: Westbrook Lindsey M , Henn Patrick A , Cornish Toby C
Published: November 2019

Objectives

Histologic findings after endoscopic resection using submucosal lifting agents Eleview and ORISE gel are described.

Methods

Four cases were identified based on the histologic presence of ORISE gel. Cases were selected to illustrate the histologic appearance of the lifting agent immediately after injection (day 0) and after an interval of approximately 2 months.

Results

Immediately after injection, the gel had an appearance similar to acellular mucin on H&E stain and showed mucicarmine positivity but was negative for periodic acid-Schiff stain and Alcian blue. At 2 months, the appearance changed drastically and was characterized by a hard, homogenous eosinophilic quality and elicited a robust foreign body-type giant cell reaction; we have proposed the name lifting agent granuloma for this histologic appearance. The aged material may be mistaken for amyloid or a pulse (legume) granuloma; however, the material was negative on Congo red stain and had a different clinical history and distribution in the tissue from those of a pulse granuloma.

Conclusions

It is important to take note of the histologic appearance of these new submucosal lifting agents over a varying time interval, as outlined here, so that they are readily recognized and not mistaken for other entities.
A multiomics approach to heterogeneity in Alzheimer’s disease: focused review and roadmap
Authors: Badhwar AmanPreet , McFall G Peggy , Sapkota Shraddha , Black Sandra E , Chertkow Howard , Duchesne Simon , Masellis Mario , Li Liang , Dixon Roger A , Bellec Pierre
Published: November 2019

Aetiological and clinical heterogeneity is increasingly recognized as a common characteristic of Alzheimer’s disease and related dementias. This heterogeneity complicates diagnosis, treatment, and the design and testing of new drugs. An important line of research is discovery of multimodal biomarkers that will facilitate the targeting of subpopulations with homogeneous pathophysiological signatures. High-throughput ‘omics’ are unbiased data-driven techniques that probe the complex aetiology of Alzheimer’s disease from multiple levels (e.g. network, cellular, and molecular) and thereby account for pathophysiological heterogeneity in clinical populations. This review focuses on data reduction analyses that identify complementary disease-relevant perturbations for three omics techniques: neuroimaging-based subtypes, metabolomics-derived metabolite panels, and genomics-related polygenic risk scores. Neuroimaging can track accrued neurodegeneration and other sources of network impairments, metabolomics provides a global small-molecule snapshot that is sensitive to ongoing pathological processes, and genomics characterizes relatively invariant genetic risk factors representing key pathways associated with Alzheimer’s disease. Following this focused review, we present a roadmap for assembling these multiomics measurements into a diagnostic tool highly predictive of individual clinical trajectories, to further the goal of personalized medicine in Alzheimer’s disease.
Screening of non-invasive miRNA biomarker candidates for metastasis of gastric cancer by small RNA sequencing of plasma exosomes
Authors: Zhang Yingyi , Han Ting , Feng Dan , Li Jie , Wu Meihong , Peng Xiaobo , Wang Bin , Zhan Xianbao , Fu Peng
Published: November 2019

Gastric cancer remains one of the most lethal and prevalent malignancies, particularly in China. The majority of patients are diagnosed with gastric cancer at the late stages of the disease. Besides, the high relapse rate also contributes to the high mortality. Therefore, there exists an imperative need for the development of gastric cancer diagnostic techniques as well as novel indicators for gastric cancer metastasis. Exosomes, secreted by a variety of cell types, play critical roles in intercellular communication, which emerge as promising diagnostic biomarkers for gastric cancer. In this study, we present for the first time, at least to the best of our knowledge, the small RNA sequencing spectra of exosomes derived from the gastric cancer patient plasma using next-generation sequencing, focusing on the exploration of metastasis-related biomarkers. The exosomes enriched from patient plasma samples were well characterized by western blotting, transmission electron microscopy and nanoparticle-tracking analysis. In the following bioinformatic analysis of exosomal miRNAs, three candidates were proposed as the biomarkers for metastasis of gastric cancer, namely miR-10b-5p, miR-101-3p and miR-143-5p, for gastric cancer with lymph node metastasis, gastric cancer with ovarian metastasis and gastric cancer with liver metastasis, respectively. RT–qPCR was performed to test the accuracy of these candidates for validation. In conclusion, we successfully isolated and purified exosomes from plasma of patients with gastric cancer and identified several potential exosomal miRNA markers to distinguish gastric cancer patients with various kinds of metastasis.
Modern Clinician-initiated Clinical Trials to Determine Optimal Therapy for Multidrug-resistant Gram-negative Infections
Authors: Stewart Adam G , Harris Patrick N A , Chatfield Mark , Evans Scott R , van Duin David , Paterson David L
Published: November 2019

Treatment options for multidrug-resistant (MDR) gram-negative infection are growing. However, postregistration, pragmatic, and clinician-led clinical trials in this field are few, recruit small sample sizes, and experience deficiencies in design and operations. MDR gram-negative therapeutic trials are often inefficient, only evaluating a single antibiotic or strategy at a time. Novel clinical trial designs offer potential solutions by attempting to obtain clinically meaningful conclusions at the end or during a trial, for many treatment strategies, simultaneously. An integrated, consensus approach to MDR gram-negative infection trial design is crucial.
Tuberculosis in Hospitalized Patients With Human Immunodeficiency Virus: Clinical Characteristics, Mortality, and Implications From the Rapid Urine-based Screening for Tuberculosis to Reduce AIDS Related Mortality in Hospitalized Patients in Africa
Authors: Gupta-Wright Ankur , Fielding Katherine , Wilson Douglas , van Oosterhout Joep J , Grint Daniel , Mwandumba Henry C , Alufandika-Moyo Melanie , Peters Jurgens A , Chiume Lingstone , Lawn Stephen D , Corbett Elizabeth L
Published: November 2019

Background

Tuberculosis (TB) is the major killer of people living with human immunodeficiency virus (HIV) globally, with suboptimal diagnostics and management contributing to high case-fatality rates.

Methods

A prospective cohort of patients with confirmed TB (Xpert MTB/RIF and/or Determine TB-LAM Ag positive) identified through screening HIV-positive inpatients with sputum and urine diagnostics in Malawi and South Africa (Rapid urine-based Screening for Tuberculosis to reduce AIDS Related Mortality in hospitalized Patients in Africa [STAMP] trial). Urine was tested prospectively (intervention) or retrospectively (standard of care arm). We defined baseline clinical phenotypes using hierarchical cluster analysis, and also used Cox regression analysis to identify associations with early mortality (≤56 days).

Results

Of 322 patients with TB confirmed between October 2015 and September 2018, 78.0% had ≥1 positive urine test. Antiretroviral therapy (ART) coverage was 80.2% among those not newly diagnosed, but with median CD4 count 75 cells/µL and high HIV viral loads. Early mortality was 30.7% (99/322), despite near-universal prompt TB treatment. Older age, male sex, ART before admission, poor nutritional status, lower hemoglobin, and positive urine tests (TB-LAM and/or Xpert MTB/RIF) were associated with increased mortality in multivariate analyses. Cluster analysis (on baseline variables) defined 4 patient subgroups with early mortality ranging from 9.8% to 52.5%. Although unadjusted mortality was 9.3% lower in South Africa than Malawi, in adjusted models mortality was similar in both countries (hazard ratio, 0.9; P = .729).

Conclusions

Mortality following prompt inpatient diagnosis of HIV-associated TB remained unacceptably high, even in South Africa. Intensified management strategies are urgently needed, for which prognostic indicators could potentially guide both development and subsequent use.
Validity of a tool designed to assess the preventability of potentially preventable hospitalizations for chronic conditions
Authors: Johnston Jennifer J , Longman Jo M , Ewald Dan P , Rolfe Margaret I , Diez Alvarez Sergio , Gilliland Adrian H B , Chung Steven C , Das Sumon K , King Jonathan M , Passey Megan E
Published: November 2019

Background

Potentially preventable hospitalizations (PPH) are defined as unplanned hospital admissions which could potentially have been prevented with the provision of effective, timely outpatient care. To better understand and ultimately reduce rates of PPH, a means of identifying those which are actually preventable is required. The Preventability Assessment Tool (PAT) was designed for use by hospital clinicians to assess the preventability of unplanned admissions for chronic conditions.

Objective

The present study examined the ability of the PAT to distinguish between those unplanned admissions which are preventable and those which are not, compared to the assessments of an Expert Panel.

Methods

Data were collected between November 2014 and June 2017 at three hospitals in NSW, Australia. Participants were community-dwelling patients with unplanned hospital admissions for congestive heart failure, chronic obstructive pulmonary disease, diabetes complications or angina pectoris. A nurse and a doctor caring for the patient made assessments of the preventability of the admission using the PAT. Expert Panels made assessments of the preventability of each admission based on a comprehensive case report and consensus process.

Results

There was little concordance between the hospital doctors and nurses regarding the preventability of admissions, nor between the assessments of the Expert Panel and the hospital nurse or the Expert Panel and the hospital doctor.

Conclusions

The PAT demonstrated poor concurrent validity and is not a valid tool for assessing the preventability of unplanned hospital admissions. The use of Expert Panels provides a more rigorous approach to assessing the preventability of such admissions.
Development and psychometric study of a simple instrument to assess patient communication and comprehension skills: the AsCkS
Authors: González-De Paz Luis , Gálvez-Henández Pablo , Navarro-Rubio María Dolores
Published: November 2019

Background

Instruments to examine patients’ communication skills are impractical for daily clinical practice in primary health care, and it is assumed that health care professionals are always aware of the communication and comprehension status of patients.

Objective

To design and examine the psychometric properties of a new questionnaire (AsCkS) to screen patients’ risk of low communication and comprehension skills.

Methods

Designing the new questionnaire involved: (i) a content validity study to generate a set of items, (ii) administration of a questionnaire in a sample of patients and (iii) study of the psychometric properties using a Rasch probabilistic model. The test probability function was used to detect patients at risk of having low communication and comprehension skills, and the associated factors were studied using multivariate logistic regression.

Results

Five items were generated and 369 patients screened. In the Rasch analysis, one item was removed due to a lack of goodness-of-fit (Outfit = 3.64). The final set of four items showed good reliability (person separation index = 0.90). Convergent validity was moderate for the health literacy construct (r = 0.53) and low for the patient activation (r = 0.38): 77 patients (20.86%) were at risk of having low communication and comprehension skills. After adjustment, the associated factors were age (p < 0.001) and lower educational level (p < 0.001).

Conclusion

The AsCkS is a reliable and valid instrument and may be used to detect patients requiring a greater effort by the physician to communicate health care messages.
Early growth of different tree species on agricultural land along a latitudinal transect in Sweden
Authors: Rytter Lars , Lutter Reimo
Published: November 2019

Fast-growing tree species will be an important tool in the future production of renewables and in substituting non-renewable fossil energy sources. Sweden, like other countries around the Baltic Sea, has large areas of abandoned farmland usable for biomass production, but knowledge of growth performance of tree species candidates is insufficient. An experiment was initiated where six potentially high-producing tree species were compared. The best available plant material for each species was used on five sites over latitudes 56–64°N in Sweden. Results from the first 8–9 years are reported. Short rotation coppice willow (Salix schwerinii Wolf × S. viminalis L., clone ‘Tora’) had the fastest initial growth and production in southern Sweden. Hybrid aspen (Populus tremula L. × P. tremuloides Michx.) and poplar (Populus spp., section Tacamahaca), grown as short rotation forest, grew well over all sites and showed the highest productivity at the two northern sites. Hybrid larch (Larix ×eurolepis Henry) displayed a high potential at the two most southerly sites, whilst silver birch (Betula pendula Roth) was a medium-producing species at all sites. Norway spruce (Picea abies (L.) Karst.) started slowly, and Siberian larch (L. sukaczewii Dylis) produced poorly at the two northern sites in the initial stage. All tree species followed existing height development curves for the respective species on a high site quality level. Currently, well-growing clones of Populus spp. indicated that a wider selection of tree species can be used at high latitudes under climate change. The study showed a high growth potential for most species on former agricultural lands. However, measures to reduce climate and biological damage must be included in future efforts.
Age at natural menopause and development of chronic conditions and multimorbidity: results from an Australian prospective cohort
Authors: Xu Xiaolin , Jones Mark , Mishra Gita D
Published: November 2019

STUDY QUESTION

Is age at natural menopause (ANM) associated with the development of multiple chronic conditions (multimorbidity) in postmenopausal life?

SUMMARY ANSWER

Women with premature menopause experience increased odds of developing individual chronic conditions and multimorbidity.

WHAT IS KNOWN ALREADY

ANM is considered as a marker of age-related morbidity and mortality in postmenopausal life. Multimorbidity affects more than 60% of older women and has been recognized as the most common ‘chronic condition’. Few studies have examined the association between ANM and the development of multimorbidity.

STUDY DESIGN, SIZE, DURATION

A prospective national cohort study of 11 258 Australian women, aged 45–50 years in 1996. Women were followed from 1996 to 2016.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Information about ANM and 11 chronic conditions (diabetes, hypertension, heart disease, stroke, arthritis, osteoporosis, asthma, chronic obstructive pulmonary disease, depression, anxiety and breast cancer) were estimated approximately every 3 years. Multimorbidity is defined as 2 or more of these 11 conditions. Generalized estimating equations were used to link the categorical ANM with individual chronic conditions and multimorbidity.

MAIN RESULTS AND THE ROLE OF CHANCE

Among 5107 women reporting ANM, 2.3% experienced premature menopause (≤40 years) and 55.1% developed multimorbidity. Compared with women who experienced menopause at age 50–51 years, women with premature menopause had twice the odds of experiencing multimorbidity by age 60 (OR = 1.98, 95% CI 1.31 to 2.98) and three times the odds of developing multimorbidity in their 60s (OR = 3.03, 95% CI 1.62 to 5.64). Women with premature menopause also experienced higher incidence of most individual chronic conditions.

LIMITATIONS, REASONS FOR CAUTION

The main limitation of this study was the use of self-reported data, but with repeated assessments from prospective study design and the validity of most of the chronic conditions from hospital data, the potential for non-differential misclassification is minimized.

WIDE IMPLICATIONS OF THE FINDINGS

To our knowledge, this is the first study to assess the association of premature menopause and development of multimorbidity in a larger national cohort of mid-aged women. Health professionals should consider comprehensive screening and assessment of risk factors for multimorbidity when treating women who experienced premature menopause.

STUDY FUNDING/COMPETING INTEREST(S)

The Australian Longitudinal Study on Women’s Health was supported by the Australian Government Department of Health. X.X. is funded by an International Postgraduate Research Scholarship from the Australian government and a UQ Centennial Scholarship from The University of Queensland. G.D.M. is supported by the National Health and Medical Research Council Principal Research Fellowship (APP1121844). None of the authors has any conflicts of interest to declare.
Cost-effectiveness and Clinical Outcomes of Early Anti–Tumor Necrosis Factor–α Intervention in Pediatric Crohn’s Disease
Authors: Bashir Naazish S , Walters Thomas D , Griffiths Anne M , Ito Shinya , Ungar Wendy J
Published: November 2019

Background

Anti–tumor necrosis factor–α (anti-TNF-α) treatments are increasingly used to treat pediatric Crohn’s disease, even without a prior trial of immunomodulators, but the cost-effectiveness of such treatment algorithms has not been formally examined. Drug plan decision-makers require evidence of cost-effectiveness to inform funding decisions. The objective was to assess the incremental cost-effectiveness of early intervention with anti-TNF-α treatment vs a conventional step-up strategy per steroid-free remission-week gained from public health care and societal payer perspectives over 3 years.

Methods

A probabilistic microsimulation model was constructed for children with newly diagnosed moderate to severe Crohn’s disease receiving anti-TNF-α treatment and concomitant treatments within the first 3 months of diagnosis compared with children receiving standard care consisting of steroids and/or immunomodulators with the possibility of anti-TNF-α treatment after 3 months of diagnosis. A North American multicenter observational study with 360 patients provided input into clinical outcomes and health care resource use.

Results

Early intervention with anti-TNF-α treatment was more costly, with an incremental cost of CAD$31,112 (95% confidence interval [CI], $2939–$91,715), and more effective, with 11.3 more weeks in steroid-free remission (95% CI, 10.6–11.6) compared with standard care, resulting in an incremental cost per steroid-free remission-week gained of CAD$2756 from an Ontario public health care perspective and CAD$2968 from a societal perspective. The incremental cost-effectiveness ratio was sensitive to the price of infliximab.

Conclusions

The results suggest that although early anti-TNF-α was not cost-effective, it was clinically beneficial. These findings, along with other randomized controlled trial evidence, may inform formulary decision-making.
Is online case-based learning effective in helping undergraduate medical students choose the appropriate antibiotics to treat important infections?
Authors: Stevens Niall T , Bruen Catherine , Boland Fiona , Pawlikowska Teresa , Fitzpatrick Fidelma , Humphreys Hilary
Published: November 2019

Background

Medical students are frequently confused about indication for and choice of antibiotic. We developed an online learning resource that focused on antibiotic stewardship and important infections where medical students could practise their antibiotic decision-making skills safely.

Methods

The resource was made available to third-year undergraduate medical students via their virtual learning environment. It covered the theory and fundamentals of antibiotic stewardship and five clinical cases covering important infections. We assessed the number of attempts taken to achieve the required level of understanding to pass each activity and surveyed a selection of students for their feedback.

Results

Of 310 students, over 80% engaged with the theory-based components, with an average score exceeding 90% (range 93.4%–99.7%). Eighty-three percent (258/310) engaged with the first two cases (Clostridioides difficile infection and pyelonephritis) but only 61% (189/310) of students completed the fifth case on bacterial meningitis. Only 49.4% (153/310) of students completed all five cases, with 48% (73/153) of these achieving ≥90% on their first attempt of the associated quizzes. Fifty-nine percent (23/39) agreed or strongly agreed that the quality of the learning resource was excellent. Seventy-two percent (28/39) agreed or strongly agreed that the objectives of the resource were relevant to their needs as undergraduate medical students. Only 33% (13/39) reported the resource would change their practice.

Conclusions

Student feedback was positive but engagement with the cases needs improvement. Highlighting the utility of case-based technology-enhanced learning as a safe place to practise antibiotic decision-making skills among students may improve this.
Conflict Related Hunger, ‘Starvation Crimes’ and UN Security Council Resolution 2417 (2018)
Authors: Zappalà Salvatore
Published: November 2019

There is no doubt that Security Council Resolution 2417 (2018) is a first of its kind. More than its content, however, it is its adoption (by unanimity) that represents a success. For the first time, the Security Council engaged in a thematic manner with the issue of hunger (or food insecurity) in armed conflict, highlighting the vicious circle between food insecurity and armed conflicts and the duties of parties to conflicts to protect civilian populations and allow passage for humanitarian assistance and relief measures, as well as reiterating the prohibition of starvation as a method of combat, and its potential prosecution as war crime. On the basis of this resolution (which, inter alia, requests the Secretary-General to report on the matter more robustly, including through a form of early-warning mechanism that is per se an important new contribution) there is room for strengthened commitment to act more decisively on the part of the United Nations system as well as the Member States and other international actors. Moreover, the resolution paves the way for creative solutions which could entail, for example, the adoption of measures at the domestic level leading to more stringent regulation (and potential prosecution) of ‘starvation crimes’ and of any forms of deliberate obstruction to the delivery of humanitarian assistance. The resolution could also provide arguments for interpreting existing rules more in line with the objective, clearly promoted by the resolution itself, to strengthen the protection of civilians in armed conflicts.
Demographic consequences and characteristics of recent population mixing and colonization in Steller sea lions, Eumetopias jubatus
Authors: Hastings Kelly K , Rehberg Michael J , O’corry-Crowe Gregory M , Pendleton Grey W , Jemison Lauri A , Gelatt Thomas S
Published: November 2019

Steller sea lions (Eumetopias jubatus) are composed of two genetically distinct metapopulations (an increasing “eastern” and a reduced and endangered “western” population, or stock for management purposes in U.S. waters) that are only recently mixing at new rookeries in northern Southeast Alaska, east of the current stock boundary. We used mark-recapture models and 18 years of resighting data of over 3,500 individuals marked at the new rookeries and at neighboring long-established rookeries in both populations to examine morphology, survival, and movement patterns of pups born at new rookeries based on whether they had mitochondrial DNA haplotypes from the western or eastern population (mtW or mtE); examine survival effects of dispersal to the Eastern Stock region for animals born in the Western Stock region; and estimate minimum proportions of animals with western genetic material in regions within Southeast Alaska. Pups born at new rookeries with mtW had similar mass, but reduced body condition and first-year survival (approximately −10%) compared to pups with mtE. mtE pups ranged more widely than mtW pups, including more to the sheltered waters of Southeast Alaska’s Inside Passage. Fitness benefits for western-born females that dispersed to Southeast Alaska were observed as higher female survival (+0.127, +0.099, and +0.032 at ages 1, 2, and 3+) and higher survival of their female offspring to breeding age (+0.15) compared to females that remained west of the boundary. We estimated that a minimum of 38% and 13% of animals in the North Outer Coast–Glacier Bay and Lynn Canal–Frederick Sound regions in Southeast Alaska, respectively, carry genetic information unique to the western population. Despite fitness benefits to western females that dispersed east, asymmetric dispersal costs or other genetic or maternal effects may limit the growth of the western genetic lineage at the new rookeries, and these factors require further study.
Mass and star formation rate of the host galaxies of compact binary mergers across cosmic time
Authors: Artale M Celeste , Mapelli Michela , Bouffanais Yann , Giacobbo Nicola , Pasquato Mario , Spera Mario
Published: November 2019

We investigate the properties of the host galaxies of compact binary mergers across cosmic time, by means of population-synthesis simulations combined with galaxy catalogues from the eagle suite. We analyse the merger rate per galaxy of binary neutron stars (BNSs), black hole–neutron star binaries (BHNSs), and binary black holes (BBHs) from redshift zero up to six. The binary merger rate per galaxy strongly correlates with the stellar mass of the host galaxy at any redshift considered here. This correlation is significantly steeper for BNSs than for both BHNSs and BBHs. Moreover, we find that the merger rate per galaxy depends also on host galaxy’s star formation rate (SFR) and metallicity. We derive a robust fitting formula that relates the merger rate per galaxy with galaxy’s SFR, stellar mass, and metallicity at different redshifts. The typical masses of the host galaxies increase significantly as redshift decreases, as a consequence of the interplay between delay time distribution of compact binaries and cosmic assembly of galaxies. Finally, we study the evolution of the merger rate density with redshift. At low redshift (z ≤ 0.1) early-type galaxies give a larger contribution to the merger rate density than late-type galaxies. This trend reverts at z ≥ 1.
Modelling the distributions of white dwarf atmospheric pollution: a low Mg abundance for accreted planetesimals?
Authors: Turner Samuel G D , Wyatt Mark C
Published: November 2019

The accretion of planetesimals onto white dwarf atmospheres allows determination of the composition of this polluting material. This composition is usually inferred from observed pollution levels by assuming it originated from a single body. This paper instead uses a stochastic model wherein polluting planetesimals are chosen randomly from a mass distribution, finding that the single body assumption is invalid in ${>20\%}$ of cases. Planetesimal compositions are modelled assuming parent bodies that differentiated into core, mantle and crust components. Atmospheric levels of Ca, Mg and Fe in the model are compared to a sample of 230 DZ white dwarfs for which such pollution is measured. A good fit is obtained when each planetesimal has its core, mantle and crust fractions chosen independently from logit-normal distributions which lead to average mass fractions of fCru = 0.15, fMan = 0.49 and fCor = 0.36. However, achieving this fit requires a factor 4 depletion of Mg relative to stellar material. This depletion is unlikely to originate in planetesimal formation processes, but might occur from heating while the star is on the giant branch. Alternatively the accreted material has stellar abundance, and either the inferred low Mg abundance was caused by an incorrect assumption that Mg sinks slower than Ca and Fe, or there are unmodelled biases in the observed sample. Finally, the model makes predictions for the timescale on which the observed pollutant composition varies, which should be the longer of the sinking and disc timescales, implying variability on decadal timescales for DA white dwarfs.
Translating current biomedical therapies for long duration, deep space missions
Authors: Iosim Sonia , MacKay Matthew , Westover Craig , Mason Christopher E
Published: November 2019

It is been shown that spaceflight-induced molecular, cellular, and physiologic changes cause alterations across many modalities of the human body, including cardiovascular, musculoskeletal, hematological, immunological, ocular, and neurological systems. The Twin Study, a multi-year, multi-omic study of human response to spaceflight, provided detailed and comprehensive molecular and cellular maps of the human response to radiation, microgravity, isolation, and stress. These rich data identified epigenetic, gene expression, inflammatory, and metabolic responses to spaceflight, facilitating a better biomedical roadmap of features that should be monitored and safe-guarded in upcoming missions. Further, by exploring new developments in pre-clinical models and clinical trials, we can begin to design potential cellular interventions for exploration-class missions to Mars and potentially farther. This paper will discuss the overall risks astronauts face during spaceflight, what is currently known about human response to these risks, what pharmaceutical interventions exist for use in space, and which tools of precision medicine and cellular engineering could be applied to aerospace and astronaut medicine.
Analytical investigations of high-energy electromagnetic showers in strong magnetic fields
Authors: Nakatsuka Takao
Published: November 2019

The diffusion equation of high-energy electromagnetic showers in strong magnetic fields is solved analytically, under the condition that the product of particle energy and field strength considerably exceeds $mc^2H_{\rm c}\simeq 2.3 \times 10^{7}$ TeV G, by applying Mellin and Laplace transforms. Differential and integral energy spectra of shower electrons/positrons and photons are evaluated by applying the saddle point method. Both spectra expressed by asymptotic expansions are also derived based on singularities of the Laplace–Mellin transform of the spectrum. The results are compared with those derived by a Monte Carlo method and numerical integration methods. Energy flows, peak positions, and peak values of transition curves, as well as track lengths of shower particles, are predicted and discussed, together with other characteristic properties of showers in strong magnetic fields, wherein good agreement between the low-energy limit of the power-law index for our differential energy spectra and the low-energy photon index of $\Gamma$ observed in Fermi LAT is pointed out and discussed.
Right? Wrong? Outdated?: An evaluation of the controversial Hunter v Moss
Authors: Chung Benny , Chiu Jason Chun Wing
Published: November 2019

Hunter v Moss is a landmark, but also controversial, English trusts law case. In this article, we argue that Hunter v Moss is, indeed, not as controversial or problematic as the academic critics have portrayed it to be, by explaining why those criticisms do not stand. We then argue that the biggest problem with this judgment is its inability to accommodate cases with a financial context, and we propose that the common law courts should rather adopt a facts-based approach.
Serinibacter arcticus sp. nov., isolated from a thawing ancient ice wedge
Authors: Filippova Svetlana N. , Surgucheva Natalya A. , Detkova Ekaterina N. , Rakitin Andrey L. , Beletsky Aleksey V. , Grouzdev Denis S. , Kolganova Tatyana V. , Mulyukin Andrey L.
Published: November 2019

A novel actinobacterium, strain K3-2T, was isolated in pure culture from a thawing ancient ice wedge at Mammoth Mountain (Eastern Siberia, Russia). Colonies of strain K3-2T were yellowish orange; cells had the fine structure typical of Gram-positive bacteria, were non-motile short rods and were non-spore-forming. Strain K3-2T was mesophilic (optimum growth at 28 °С), but capable of growing at 4 °С. The cell-wall peptidoglycan of strain K3-2T contained lysine (the diagnostic diamino acid), glutamic acid, alanine, ornithine, glycine and serine. The polar lipids were phosphatidylglycerol, lysophosphatidylserine, three unidentified phospholipids and glycolipids. The major fatty acids were anteiso-C15 : 0 and C16 : 0. The only menaquinone detected was MK-8(H4). 16S rRNA gene analysis indicated that strain K3-2T belongs to the genus

Serinibacter

. The closest taxonomically described relatives were

Serinibacter salmoneus

Kis4-28T and

Serinibacter tropicus

PS-14-7T, with 97.20 and 97.20 % 16 s rRNA gene sequence similarity, respectively. The average nucleotide identity value of the whole genome sequence between strain K3-2T and

S. salmoneus

Kis4-28T was 78.9 %. DNA–DNA relatedness values between strain K3-2T and

S. salmoneus

DSM 21801T (=Kis4-28T) and

S. tropicus

VKPM Ac 2044T (=PS-14-7T) were 41 and 47 %. Thus, strain K3-2T represents a novel species of the genus

Serinibacter

for which the name Serinibacter arcticus sp. nov. is proposed. The type strain is K3-2T (DSM 103859T=VKM Ас−2719T).
Arenibacter aquaticus sp. nov., a marine bacterium isolated from surface sea water in the South China Sea
Authors: Guo Jiaying , Sun Jia , Xu Yongle , Fang Lüping , Jiao Nianzhi , Zhang Rui
Published: November 2019

A Gram-stain-negative and facultatively anaerobic bacterial strain, designated GUOT, was isolated from surface water collected from the South China Sea. Cells were non-flagellate, yellow, non-spore-forming and rod-shaped. The 16S rRNA gene sequence comparisons with species in the genusArenibactershowed that strain GUOTshares the highest similarity of 97.5 % withArenibacter echinorumandArenibacter palladensis. Average nucleotide identity and digital DNA–DNA hybridization values between strain GUOTand its related type strains were 77.1–78.4% and 20.8–26.2 % respectively. Growth of strain GUOToccurred at 15–50°C (optimum, 20–25°C), pH 5–7.5 (pH 6) and in media containing 0–7 % NaCl (optimum, 0–1 %). Cells contained methanol-soluble yellow-coloured pigments but flexirubin-type pigments were absent. The major fatty acids (>5 %) were iso-C17 : 03-OH, iso-C15 : 0, anteiso-C15 : 0, C16 : 0, summed feature 3, iso-C15 : 1G and iso-C15 : 03-OH. The dominant polar lipids comprised phosphatidylethanolamine and some unidentified polar lipids. The main respiratory quinone was menaquinone-6. The DNA G+C content of strain GUOTwas 40.1 %. Based on the presented data, we consider strain GUOTto represent a novel species of the genusArenibacter, for which the nameArenibacter aquaticussp. nov. is proposed. The type strain is GUOT(=KCTC 62629T=MCCC 1K03559T)