953 research outputs found
Formiminoglutamic acid urine excretion : clinical studies in individuals exposed to nitrous oxide
A pre-design sensitivity analysis tool for consideration of full electrical aircraft propulsion electrical power system architectures
Turbo-electric distributed power (TeDP) systems proposed for hybrid wing body (HWB) N3-X aircraft are complex, superconducting electrical networks, which must be developed to meet challenging weight, efficiency and propulsor power requirements. An integrated system sensitivity analysis tool is presented, which can be used to support rapid appraisal studies of architectures, protection systems and redundancy requirements for TeDP systems. The use of this tool can help direct future research on TeDP systems towards the key challenges relevant to meeting the stringent weight and efficiency targets set out for N+3 aircraft concepts
Ceftazidime-avibactam or best available therapy in patients with ceftazidime-resistant Enterobacteriaceae and Pseudomonas aeruginosa complicated urinary tract infections or complicated intra-abdominal infections (REPRISE): a randomised, pathogen-directed, phase 3 study
Background
Carbapenems are frequently the last line of defence in serious infections due to multidrug-resistant Gram-negative bacteria, but their use is threatened by the growing prevalence of carbapenemase-producing pathogens. Ceftazidime-avibactam is a potential new agent for use in such infections. We aimed to assess the efficacy, safety, and tolerability of ceftazidime-avibactam compared with best available therapy in patients with complicated urinary tract infection or complicated intra-abdominal infection due to ceftazidime-resistant Gram-negative pathogens.
Methods
REPRISE was a pathogen-directed, international, randomised, open-label, phase 3 trial that recruited patients from hospitals across 16 countries worldwide. Eligible patients were aged 18â90 years with complicated urinary tract infection or complicated intra-abdominal infection caused by ceftazidime-resistant Enterobacteriaceae or Pseudomonas aeruginosa. Patients were randomised (1:1) to 5â21 days of treatment with either ceftazidime-avibactam (a combination of 2000 mg ceftazidime plus 500 mg avibactam, administered via a 2-h intravenous infusion every 8 h) or best available therapy. The primary endpoint was clinical response at the test-of-cure visit, 7â10 days after last infusion of study therapy, analysed in all patients who had at least one ceftazidime-resistant Gram-negative pathogen, as confirmed by the central laboratory, and who received at least one dose of study drug. Safety endpoints were assessed in all patients who received at least one dose of study drug. This study is registered with ClinicalTrials.gov, number NCT01644643.
Findings
Between Jan 7, 2013, and Aug 29, 2014, 333 patients were randomly assigned, 165 to ceftazidime-avibactam and 168 to best available therapy. Of these, 154 assigned to ceftazidime-avibactam (144 with complicated urinary tract infection and ten with complicated intra-abdominal infection) and 148 assigned to best available therapy (137 with complicated urinary tract infection and 11 with complicated intra-abdominal infection) were analysed for the primary outcome. 163 (97%) of 168 patients in the best available therapy group received a carbapenem, 161 (96%) as monotherapy. The overall proportions of patients with a clinical cure at the test-of-cure visit were similar with ceftazidime-avibactam (140 [91%; 95% CI 85·6â94·7] of 154 patients) and best available therapy (135 [91%; 85·9â95·0] of 148 patients). 51 (31%) of 164 patients in the ceftazidime-avibactam group and 66 (39%) of 168 in the best available therapy group had an adverse event, most of which were mild or moderate in intensity. Gastrointestinal disorders were the most frequently reported treatment-emergent adverse events with both ceftazidime-avibactam (21 [13%] of 164 patients) and best available therapy (30 [18%] of 168 patients). No new safety concerns were identified for ceftazidime-avibactam.
Interpretation
These results provide evidence of the efficacy of ceftazidime-avibactam as a potential alternative to carbapenems in patients with ceftazidime-resistant Enterobacteriaceae and P aeruginosa.
Funding
AstraZeneca
Higher twists in the pion structure function
We calculate the QCD moments of the pion structure function using Drell-Yan
data on the quark distributions in the pion and a phenomenological model for
the resonance region. The extracted higher twist corrections are found to be
larger than those for the nucleon, contributing around 50% of the lowest moment
at Q^2=1 GeV^2.Comment: 8 pages, 3 figures, to appear in Phys. Rev.
Lichenometric dating (lichenometry) and the biology of the lichen genus rhizocarpon:challenges and future directions
Lichenometric dating (lichenometry) involves the use of lichen measurements to estimate the age of exposure of various substrata. Because of low radial growth rates and considerable longevity, species of the crustose lichen genus Rhizocarpon have been the most useful in lichenometry. The primary assumption of lichenometry is that colonization, growth and mortality of Rhizocarpon are similar on surfaces of known and unknown age so that the largest thalli present on the respective faces are of comparable age. This review describes the current state of knowledge regarding the biology of Rhizocarpon and considers two main questions: (1) to what extent does existing knowledge support this assumption; and (2) what further biological observations would be useful both to test its validity and to improve the accuracy of lichenometric dates? A review of the Rhizocarpon literature identified gaps in knowledge regarding early development, the growth rate/size curve, mortality, regeneration, competitive effects, colonization, and succession on rock surfaces. The data suggest that these processes may not be comparable on different rock surfaces, especially in regions where growth rates and thallus turnover are high. In addition, several variables could differ between rock surfaces and influence maximum thallus size, including rate and timing of colonization, radial growth rates, environmental differences, thallus fusion, allelopathy, thallus mortality, colonization and competition. Comparative measurements of these variables on surfaces of known and unknown age may help to determine whether the basic assumptions of lichenometry are valid. Ultimately, it may be possible to take these differences into account when interpreting estimated dates
Thermal rates for baryon and anti-baryon production
We use a form of the fluctuation-dissipation theorem to derive formulas
giving the rate of production of spin-1/2 baryons in terms of the fluctuations
of either meson or quark fields. The most general formulas do not assume
thermal or chemical equilibrium. When evaluated in a thermal ensemble we find
equilibration times on the order of 10 fm/c near the critical temperature in
QCD.Comment: 22 pages, 4 tables and 2 figures, REVTe
Self-optimization, community stability, and fluctuations in two individual-based models of biological coevolution
We compare and contrast the long-time dynamical properties of two
individual-based models of biological coevolution. Selection occurs via
multispecies, stochastic population dynamics with reproduction probabilities
that depend nonlinearly on the population densities of all species resident in
the community. New species are introduced through mutation. Both models are
amenable to exact linear stability analysis, and we compare the analytic
results with large-scale kinetic Monte Carlo simulations, obtaining the
population size as a function of an average interspecies interaction strength.
Over time, the models self-optimize through mutation and selection to
approximately maximize a community fitness function, subject only to
constraints internal to the particular model. If the interspecies interactions
are randomly distributed on an interval including positive values, the system
evolves toward self-sustaining, mutualistic communities. In contrast, for the
predator-prey case the matrix of interactions is antisymmetric, and a nonzero
population size must be sustained by an external resource. Time series of the
diversity and population size for both models show approximate 1/f noise and
power-law distributions for the lifetimes of communities and species. For the
mutualistic model, these two lifetime distributions have the same exponent,
while their exponents are different for the predator-prey model. The difference
is probably due to greater resilience toward mass extinctions in the food-web
like communities produced by the predator-prey model.Comment: 26 pages, 12 figures. Discussion of early-time dynamics added. J.
Math. Biol., in pres
Kinetic Turbulence
The weak collisionality typical of turbulence in many diffuse astrophysical
plasmas invalidates an MHD description of the turbulent dynamics, motivating
the development of a more comprehensive theory of kinetic turbulence. In
particular, a kinetic approach is essential for the investigation of the
physical mechanisms responsible for the dissipation of astrophysical turbulence
and the resulting heating of the plasma. This chapter reviews the limitations
of MHD turbulence theory and explains how kinetic considerations may be
incorporated to obtain a kinetic theory for astrophysical plasma turbulence.
Key questions about the nature of kinetic turbulence that drive current
research efforts are identified. A comprehensive model of the kinetic turbulent
cascade is presented, with a detailed discussion of each component of the model
and a review of supporting and conflicting theoretical, numerical, and
observational evidence.Comment: 31 pages, 3 figures, 99 references, Chapter 6 in A. Lazarian et al.
(eds.), Magnetic Fields in Diffuse Media, Astrophysics and Space Science
Library 407, Springer-Verlag Berlin Heidelberg (2015
Identification of cardiac MRI thresholds for risk stratification in pulmonary arterial hypertension
Rationale: Pulmonary arterial hypertension (PAH) is a life-shortening condition. The European Society of Cardiology and European Respiratory Society and the REVEAL (North American Registry to Evaluate Early and Long-Term PAH Disease Management) risk score calculator (REVEAL 2.0) identify thresholds to predict 1-year mortality.
Objectives: This study evaluates whether cardiac magnetic resonance imaging (MRI) thresholds can be identified and used to aid risk stratification and facilitate decision-making.
Methods: Consecutive patients with PAH (nâ=â438) undergoing cardiac MRI were identified from the ASPIRE (Assessing the Spectrum of Pulmonary Hypertension Identified at a Referral Center) MRI database. Thresholds were identified from a discovery cohort and evaluated in a test cohort.
Measurements and Main Results: A percentage-predicted right ventricular end-systolic volume index threshold of 227% or a left ventricular end-diastolic volume index of 58 ml/m2 identified patients at low (10%) risk of 1-year mortality. These metrics respectively identified 63% and 34% of patients as low risk. Right ventricular ejection fraction >54%, 37â54%, and <37% identified 21%, 43%, and 36% of patients at low, intermediate, and high risk, respectively, of 1-year mortality. At follow-up cardiac MRI, patients who improved to or were maintained in a low-risk group had a 1-year mortality <5%. Percentage-predicted right ventricular end-systolic volume index independently predicted outcome and, when used in conjunction with the REVEAL 2.0 risk score calculator or a modified French Pulmonary Hypertension Registry approach, improved risk stratification for 1-year mortality.
Conclusions: Cardiac MRI can be used to risk stratify patients with PAH using a threshold approach. Percentage-predicted right ventricular end-systolic volume index can identify a high percentage of patients at low-risk of 1-year mortality and, when used in conjunction with current risk stratification approaches, can improve risk stratification. This study supports further evaluation of cardiac MRI in risk stratification in PAH
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Flow characteristics of Newtonian and non-Newtonian fluids in a vessel stirred by a 60° pitched blade impeller
Mean and rms velocity characteristics of two Newtonian flows at Reynolds numbers of 12,800 (glycerin solution) and 48,000 (water) and of a non-Newtonian flow (0.2% CMC solution, at a power number similar to the Newtonian glycerin flow) in a mixing vessel stirred by a 60° pitched blade impeller have been measured by laser Doppler velocimetry (LDV). The velocity measurements, resolved over 360° and 1.08° of impeller rotation, showed that the mean flow of the two power number matched glycerin and CMC flows were similar to within 3% of the impeller tip velocity and the turbulence intensities generally lower in the CMC flow by up to 5% of the tip velocity. The calculated mean flow quantities showed similar discharge coefficient and pumping efficiency in all three flows and similar strain rate between the two power number matched glycerin and CMC flows; the strain rate of the higher Reynolds number Newtonian flow was found to be slightly higher. The energy balance around the impeller indicated that the CMC flow dissipated up to 9% more of the total input power and converted 7% less into the turbulence compared to the glycerin flow with the same power input which could lead to less effective mixing processes where the micro-mixing is important
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