Modelling and optimisation of the operation of a radiant warmer

This paper presents numerical calculations of the temperature field obtained for the case of a neonate placed under a radiant warmer. The results of the simulations show a very non-uniform temperature distribution on the skin of the neonate, which may cause increased evaporation leading to severe dehydration. For this reason, we propose some modifications on the geometry and operation of the radiant warmer, in order to make the temperature distribution more uniform and prevent the high temperature gradients observed on the surface of the neonate. It is concluded that placing a high conductivity blanket over the neonate and introducing additional screens along the side of the mattress, thus recovering the radiation heat escaping through the side boundaries, helped providing more uniform temperature fields.The European Union for the Marie Curie Fellowship grant awarded to the Centre for CFD, University of Leeds

The Expenditures for Academic Inpatient Care of Inflammatory Bowel Disease Patients Are Almost Double Compared with Average Academic Gastroenterology and Hepatology Cases and Not Fully Recovered by Diagnosis-Related Group (DRG) Proceeds

Background Crohn’s disease (CD) and ulcerative colitis (UC) challenge economies worldwide. Detailed health economic data of DRG based academic inpatient care for inflammatory bowel disease (IBD) patients in Europe is unavailable. Methods IBD was identified through ICD-10 K50 and K51 code groups. We took an actual costing approach, compared expenditures to G-DRG and non-DRG proceeds and performed detailed cost center and type accounting to identify coverage determinants. Results Of all 3093 hospitalized cases at our department, 164 were CD and 157 UC inpatients in 2012. On average, they were 44.1 (CD 44.9 UC 43.3 all 58) years old, stayed 10.1 (CD 11.8 UC 8.4 vs. all 8) days, carried 5.8 (CD 6.4 UC 5.2 vs. all 6.8) secondary diagnoses, received 7.4 (CD 7.7 UC 7 vs. all 6.2) procedures, had a higher cost weight (CD 2.8 UC 2.4 vs. all 1.6) and required more intense nursing. Their care was more costly (means: total cost IBD 8477€ CD 9051€ UC 7903€ vs. all 5078€). However, expenditures were not fully recovered by DRG proceeds (means: IBD 7413€, CD 8441€, UC 6384€ vs all 4758€). We discovered substantial disease specific mismatches in cost centers and types and identified the medical ward personnel and materials budgets to be most imbalanced. Non-DRG proceeds were almost double (IBD 16.1% vs. all 8.2%), but did not balance deficits at total coverage analysis, that found medications (antimicrobials, biologics and blood products), medical materials (mostly endoscopy items) to contribute most to the deficit. Conclusions DRGs challenge sophisticated IBD care

Some Aspects of New CDM Models and CDM Detection Methods

We briefly review some recent Cold Dark Matter (CDM) models. Our main focus are charge symmetric models of WIMPs which are not the standard SUSY LSP's (Lightest Supersymmetric Partners). We indicate which experiments are most sensitive to certain aspects of the models. In particular we discuss the manifestations of the new models in neutrino telescopes and other set-ups. We also discuss some direct detection experiments and comment on measuring the direction of recoil ions--which is correlated with the direction of the incoming WIMP. This could yield daily variations providing along with the annual modulation signatures for CDM.Comment: 14 page

Crohn's disease

SummaryCrohn's disease is a relapsing systemic inflammatory disease, mainly affecting the gastrointestinal tract with extraintestinal manifestations and associated immune disorders. Genome wide association studies identified susceptibility loci that—triggered by environmental factors—result in a disturbed innate (ie, disturbed intestinal barrier, Paneth cell dysfunction, endoplasmic reticulum stress, defective unfolded protein response and autophagy, impaired recognition of microbes by pattern recognition receptors, such as nucleotide binding domain and Toll like receptors on dendritic cells and macrophages) and adaptive (ie, imbalance of effector and regulatory T cells and cytokines, migration and retention of leukocytes) immune response towards a diminished diversity of commensal microbiota. We discuss the epidemiology, immunobiology, amd natural history of Crohn's disease; describe new treatment goals and risk stratification of patients; and provide an evidence based rational approach to diagnosis (ie, work-up algorithm, new imaging methods [ie, enhanced endoscopy, ultrasound, MRI and CT] and biomarkers), management, evolving therapeutic targets (ie, integrins, chemokine receptors, cell-based and stem-cell-based therapies), prevention, and surveillance

METHODOLOGICAL CONSIDERATIONS FOR COMPARISONS OF UPPER EXTREMITY EMG BETWEEN INDIVIDUALS WITH AND WITHOUT PARAPLEGIA

This study compared normalization methods for surface electromyography (sEMG) for comparing individuals with (Para) and without (AB) paraplegia. Participants (Para, n=7, AB, n=11) performed 4 minutes of arm-cycling at several submaximal intensities, and an incremental maximal test to exhaustion, while sEMG of the right biceps brachii was recorded. This study analyzed sEMG at two intensities: rate of perceived exertion (RPE) 13 and at 60 W, with four methods of normalization: non-normalized, against a maximal voluntary contraction (MVIC), against a rate of perceived exertion (RPE) 9, and against the max test. Using submaximal exercise intensity based on RPE or power output will affect the results when comparing sEMG of Para and AB groups, regardless of which normalization method is used to inspect the data

Biological Therapies in Immune-Mediated Inflammatory Diseases: Can Biosimilars Reduce Access Inequities?

Biological therapies are an effective treatment for a range of immune-mediated inflammatory diseases (IMIDs), including rheumatoid arthritis, psoriasis, and inflammatory bowel diseases. However, due to their high costs, considerable differences in their utilization exist across the world, even among the various European countries, with many countries restricting access despite professional society guideline recommendations. Adoption of biologics by healthcare providers has been particularly poor in many Central and Eastern European countries. Differences in utilization have also been observed across medical specialties, healthcare providers, and at a regional and national level. The objective of this paper is to provide an overview of the different market access policies for biologics in Europe and to investigate reasons for such differences. One of the potential solutions for providing broader access to IMID patients, where cost is the major barrier, is to encourage the use of biosimilars in place of their reference products. Biosimilars are generally less expensive alternatives to already licensed biological therapies and are approved on the basis that they are similar to the reference product in terms of quality, safety, and efficacy. Budget impact models predict considerable cost savings following the introduction of biosimilars in the next few years. These savings could be used to increase access to biologics and other innovative therapies

Electrostatic Design and Conditioning of a Triple Point Junction Shield for a −200 kV DC High Voltage Photogun

Nuclear physics experiments performed at the Continuous Electron Beam Accelerator Facility (CEBAF) at the Jefferson Lab require a DC high voltage photogun to generate polarized electron beams from GaAs photocathodes. The photogun uses a tapered ceramic insulator that extends into the vacuum chamber and mechanically holds the cathode electrode. Increasing the operating voltage from nominal −130 kV to −200 kV will provide lower beam emittance, better transmission through injector apertures, and improved photocathode lifetime. This desire to increase the photogun operating voltage led to the design of a triple-point-junction shield electrode which minimizes the electric field at the delicate insulator-metal-vacuum interface and linearizes the potential across the insulator, thus reducing the risk of arcing along the ceramic insulator. This work describes the results obtained using COMSOL® electrostatic-field simulation software and presents the high voltage conditioning results of the upgraded −200 kV CEBAF photogun. Published by AIP Publishing

A randomised phase I study of etrolizumab (rhuMAb β7) in moderate to severe ulcerative colitis.

ObjectiveEtrolizumab (rhuMAb β7, anti-β7, PRO145223) is a humanised monoclonal antibody targeting the β7 subunit of the heterodimeric integrins α4β7 and αEβ7, which are implicated in leucocyte migration and retention in ulcerative colitis (UC). This randomised phase I study evaluated the safety and pharmacology of etrolizumab in patients with moderate to severe UC.DesignIn the single ascending dose (SAD) stage, etrolizumab (0.3, 1.0, 3.0, 10 mg/kg intravenous, 3.0 mg/kg subcutaneous (SC) or placebo) was administered 4:1 (n=25) in each cohort. In the multiple dose (MD) stage, new patients received monthly etrolizumab (0.5 mg/kg SC (n=4), 1.5 mg/kg SC (n=5), 3.0 mg/kg SC (n=4), 4.0 mg/kg intravenous (n=5)) or placebo (n=5). The pharmacokinetics was studied and Mayo Clinic Score evaluated at baseline, day 29 (SAD), and days 43 and 71 (MD).ResultsIn the SAD stage, there were no dose limiting toxicities, infusion or injection site reactions. Two impaired wound healing serious adverse events occurred in two patients receiving etrolizumab. In the MD stage, there were no dose limiting toxicities, and no infusion or injection site reactions. Headache was the most common adverse event, occurring more often in etrolizumab patients. Antietrolizumab antibodies were detected in two subjects. The duration of β7 receptor full occupancy was dose related. A clinical response was observed in 12/18 patients, and clinical remission in 3/18 patients treated with etrolizumab in the MD stage, compared with 4/5 and 1/5 placebo patients, respectively.ConclusionEtrolizumab is well tolerated in moderate to severe UC. Further investigation is warranted

A vehicle mounted multi-sensor array for waste site characterization

Personnel at AlliedSignal Aerospace, Kirtland Operations (formerly EG&G Energy Measurements, Kirtland Operations) and EG&G Energy Measurements, Los Alamos Operations, have successfully developed and demonstrated a number of technologies which can be applied to the environmental remediation and waste management problem. These applications have included the development of self-contained and towed remote sensing platforms and advanced signal analysis techniques for the detection and characterization of subsurface features. This presentation will provide a brief overview of applications that have been and are currently being fielded by both AlliedSignal and EG&G Energy Measurements personnel and will describe some of the ways that such technologies can and are being used for the detection and characterization of hazardous waste sites