The opportunistic replacement and inspection problem for components with a stochastic life time

The problem of finding efficient maintenance and inspection schemes in the case of components with a stochastic life time is studied and a mixed integer programming solution is proposed. The problem is compared with the two simpler problems of which the studied problem is a generalisation: The opportunistic replacement problem, assuming components with a deterministic life time and The opportunistic replacement problem for components with a stochastic life time, for maintenance schemes without inspections

A randomised trial of prophylactic oropharyngeal surfactant for preterm infants

Background: Preterm infants are at high risk of developing respiratory distress syndrome (RDS). Endotracheal surfactant is effective in preventing and treating RDS; however, intubation is invasive and associated with adverse effects. Half of infants born <29 weeks’ gestation initially managed with continuous positive airway pressure (CPAP) are ultimately intubated for surfactant. Administration of surfactant into the pharynx has been reported in preterm animals and humans and may be effective. We wished to determine whether giving oropharyngeal surfactant at birth reduces the rate of endotracheal intubation for respiratory failure in preterm infants within 120 hours. Methods/design: Infants born before 29 weeks’ gestation who were free of major anomalies were enrolled to this unblinded study at nine centres in six European countries. They were randomly assigned to receive oropharyngeal surfactant at birth in addition to CPAP or CPAP alone. The primary outcome was intubation within 120 h of birth, either for bradycardia and/or apnoea despite respiratory support in the delivery room, or for pre-specified respiratory failure criteria in the neonatal intensive care unit. Secondary outcomes included incidence of mechanical ventilation, chronic lung disease, and death before hospital discharge. Results: A total of 251 infants were included in the study; 126 infants were assigned to oropharyngeal surfactant and 125 infants to control. The groups were well matched at study entry; their mean (SD) gestational age was 26 (2) vs 26 (2) weeks, and their mean (SD) birth weight was 874 (261) vs 851 (253) g respectively. There was no difference between groups in the rate of intubation at 120 hours [79/126 (63) vs 81/125 (65)%, p = 0.793] (table). There were no differences between the groups in the rate or duration of mechanical ventilation; the rates of bronchopulmonary dysplasia, chronic lung disease, or postnatal steroid use; or in the rate of death before hospital discharge. Conclusion: Administration of surfactant into the oropharynx immediately after birth in addition to CPAP compared to CPAP alone did not reduce the rate of intubation amongst infants born before 29 weeks’ gestation in the first 5 days of life.Contexte : Les enfants prématurés présentent un risque élevé de développer un syndrome de détresse respiratoire (SDR). Le surfactant endotrachéal est efficace pour prévenir et traiter le SDR, mais l'intubation est invasive et associée à des effets indésirables. La moitié des nourrissons nés à moins de 29 semaines de gestation initialement traités par pression positive continue (CPAP) sont finalement intubés pour recevoir du surfactant. L'administration de surfactant dans le pharynx a été rapportée chez des animaux et des humains prématurés et pourrait être efficace. Nous avons voulu déterminer si l'administration de surfactant oropharyngé à la naissance réduit le taux de intubation endotrachéale pour insuffisance respiratoire chez les prématurés dans les 120 heures. Méthodes : Les enfants nés avant 29 semaines de gestation et ne présentant pas d'anomalie majeure ont été recrutés pour cette étude en aveugle dans neuf centres de six pays européens. Ils ont été randomisés pour recevoir du surfactant oropharyngé à la naissance en plus de la PPC ou de la PPC seule. L'issue primaire était l'intubation dans les 120 heures suivant la naissance, soit pour bradycardie et/ou et/ou d'apnée malgré l'assistance respiratoire en salle d'accouchement, soit pour des critères pré-spécifiés d'insuffisance respiratoire dans l'unité de soins intensifs néonatals. Les résultats secondaires comprenaient l'incidence de la ventilation mécanique, de maladies pulmonaires chroniques et de décès avant la sortie de l'hôpital. Résultats : Au total, 251 nourrissons ont été inclus dans l'étude ; 126 nourrissons ont été assignés à un traitement par surfactant oropharyngé et 125 nourrissons au groupe contrôle. Les groupes étaient bien appariés au début de l'étude; leur âge gestationnel moyen (ET) était de 26 (2) contre 26 (2) semaines, et leur poids de naissance moyen (ET) étaient respectivement de 874 (261) et 851 (253) grammes. Il n'y avait pas de différence entre les groupes en ce qui concerne le taux d'intubation à 120 heures [79/126 (63) vs 81/125 (65) %, p = 0,793] (tableau). Il n'y avait aucune différence entre les groupes en ce qui concerne le taux ou la durée de la ventilation mécanique ; les taux de dysplasie broncho-pulmonaire, de maladie pulmonaire chronique ou d'utilisation de stéroïdes en période postnatale, ni de décès avant la sortie de l'hôpital. Conclusion : L'administration de surfactant dans l'oropharynx immédiatement après la naissance, en plus de la PPC, par rapport à la PPC seule, n'a pas réduit le taux d'intubation chez les enfants nés avant 29 semaines de gestation au cours des 5 premiers jours de vie. Traduit avec www.DeepL.com/Translator (version gratuite

A randomised trial of prophylactic oropharyngeal surfactant for preterm infants

Background: Preterm infants are at high risk of developing respiratory distress syndrome (RDS). Endotracheal surfactant is effective in preventing and treating RDS; however, intubation is invasive and associated with adverse effects. Half of infants born <29 weeks’ gestation initially managed with continuous positive airway pressure (CPAP) are ultimately intubated for surfactant. Administration of surfactant into the pharynx has been reported in preterm animals and humans and may be effective. Objective: We wished to determine whether giving oropharyngeal surfactant at birth reduces the rate of endotracheal intubation for respiratory failure in preterm infants within 120 hours. Design/Methods: Infants born before 29 weeks’ gestation who were free of major anomalies were enrolled to this unblinded study at 9 centres in 6 European countries. They were randomly assigned to receive oropharyngeal surfactant at birth in addition to CPAP or CPAP alone. The primary outcome was intubation within 120 hours of birth, either for bradycardia and/or apnoea despite respiratory support in the delivery room, or for pre-specified respiratory failure criteria in the neonatal intensive care unit. Secondary outcomes included incidence of mechanical ventilation, chronic lung disease, and death before hospital discharge. Results: A total of 251 infants were included in the study; 126 infants were assigned to oropharyngeal surfactant and 125 infants to control. The groups were well matched at study entry (table 1); their mean (SD) gestational age was 26 (2) vs 26 (2) weeks, and their mean (SD) birth weight was 874 (261) vs 851 (253) g respectively. There was no difference between groups in the rate of intubation at 120 hours [79/126 (63) vs 81/125 (65) %, p=0.793] (table 2). There were no differences between the groups in the rate or duration of mechanical ventilation; the rates of bronchopulmonary dysplasia, chronic lung disease, or postnatal steroid use; or in the rate of death before hospital discharge. Conclusion(s): Administration of surfactant into the oropharynx immediately after birth in addition to CPAP compared to CPAP alone did not reduce the rate of intubation amongst infants born before 29 weeks’ gestation in the first 5 days of life

Prophylactic Oropharyngeal Surfactant for Preterm Newborns at Birth: A Randomized Clinical Trial

Importance - Preterm newborns at risk of respiratory distress syndrome are supported with continuous positive airway pressure (CPAP). Many newborns worsen despite CPAP and are intubated for surfactant administration, an effective therapy for treatment of respiratory distress syndrome. Endotracheal intubation is associated with adverse effects. Pharyngeal administration of surfactant to preterm animals and humans has been reported as an alternative. Objective - To assess whether giving prophylactic oropharyngeal surfactant to preterm newborns at birth would reduce the rate of intubation for respiratory failure. Design, Setting, and Participants - This unblinded, parallel-group randomized clinical trial (Prophylactic Oropharyngeal Surfactant for Preterm Infants [POPART]) was conducted from December 17, 2017, to September 11, 2020, at 9 tertiary neonatal intensive care units in 6 European countries. Newborns born before 29 weeks of gestation without severe congenital anomalies, for whom intensive care was planned, were eligible for inclusion. The data were analyzed from July 27, 2022, to June 20, 2023. Intervention - Newborns were randomly assigned to receive oropharyngeal surfactant at birth in addition to CPAP or CPAP alone. Randomization was stratified by center and gestational age (GA). Main Outcomes and Measures - The primary outcome was intubation in the delivery room for bradycardia and/or apnea or in the neonatal intensive care unit for prespecified respiratory failure criteria within 120 hours of birth. Caregivers were not masked to group assignment. Results - Among 251 participants (mean [SD] GA, 26 [1.5] weeks) who were well matched at study entry, 126 (69 [54.8%] male) with a mean (SD) birth weight of 858 (261) grams were assigned to the oropharyngeal surfactant group, and 125 (63 [50.4%] male) with a mean (SD) birth weight of 829 (253) grams were assigned to the control group. The proportion of newborns intubated within 120 hours was not different between the groups (80 [63.5%) in the oropharyngeal surfactant group and 81 [64.8%] in the control group; relative risk, 0.98 [95% CI, 0.81-1.18]). More newborns assigned to the oropharyngeal surfactant group were diagnosed with and treated for pneumothorax (21 [16.6%] vs 8 [6.4%]; P = .04). Conclusions and Relevance - This randomized clinical trial found that administration of prophylactic oropharyngeal surfactant to newborns born before 29 weeks’ GA did not reduce the rate of intubation in the first 120 hours of life. These findings suggest that administration of surfactant into the oropharynx immediately after birth in addition to CPAP should not be routinely used

Gas absorption and dust extinction towards the Orion Nebula Cluster

B. Hasenberger, et al, 'Gas absorption and dust extinction towards the Orion Nebula Cluster', Astronomy & Astrophysics, 593, A7, 2016. The version of record is available online at DOI: 10.1051/0004-6361/201628517. Published by EDP Sciences. © ESO, 2016We characterise the relation between the gas and dust content of the interstellar medium towards young stellar objects in the Orion Nebula Cluster. X-ray observations provide estimates of the absorbing equivalent hydrogen column density N_H based on spectral fits. Near-infrared extinction values are calculated from intrinsic and observed colour magnitudes (J-H) and (H-K_s) as given by the VISTA Orion A survey. A linear fit of the correlation between column density and extinction values A_V yields an estimate of the N_H/A_V ratio. We investigate systematic uncertainties of the results by describing and (if possible) quantifying the influence of circumstellar material and the adopted extinction law, X-ray models, and elemental abundances on the N_H/A_V ratio. Assuming a Galactic extinction law with R_V=3.1 and solar abundances by Anders & Grevesse (1989), we deduce an N_H/A_V ratio of (1.39 +- 0.14) x 10^21 cm^-2 mag^-1 for Class III sources in the Orion Nebula Cluster where the given error does not include systematic uncertainties. This ratio is consistent with similar studies in other star-forming regions and approximately 31% lower than the Galactic value. We find no obvious trends in the spatial distribution of N_H/A_V ratios. Changes in the assumed extinction law and elemental abundances are demonstrated to have a relevant impact on deduced A_V and N_H values, respectively. Large systematic uncertainties associated with metal abundances in the Orion Nebula Cluster represent the primary limitation for the deduction of a definitive N_H/A_V ratio and the physical interpretation of these results.Peer reviewe

The NORMAN Association and the European Partnership for Chemicals Risk Assessment (PARC): let’s cooperate! [Commentary]

The Partnership for Chemicals Risk Assessment (PARC) is currently under development as a joint research and innovation programme to strengthen the scientific basis for chemical risk assessment in the EU. The plan is to bring chemical risk assessors and managers together with scientists to accelerate method development and the production of necessary data and knowledge, and to facilitate the transition to next-generation evidence-based risk assessment, a non-toxic environment and the European Green Deal. The NORMAN Network is an independent, well-established and competent network of more than 80 organisations in the field of emerging substances and has enormous potential to contribute to the implementation of the PARC partnership. NORMAN stands ready to provide expert advice to PARC, drawing on its long experience in the development, harmonisation and testing of advanced tools in relation to chemicals of emerging concern and in support of a European Early Warning System to unravel the risks of contaminants of emerging concern (CECs) and close the gap between research and innovation and regulatory processes. In this commentary we highlight the tools developed by NORMAN that we consider most relevant to supporting the PARC initiative: (i) joint data space and cutting-edge research tools for risk assessment of contaminants of emerging concern; (ii) collaborative European framework to improve data quality and comparability; (iii) advanced data analysis tools for a European early warning system and (iv) support to national and European chemical risk assessment thanks to harnessing, combining and sharing evidence and expertise on CECs. By combining the extensive knowledge and experience of the NORMAN network with the financial and policy-related strengths of the PARC initiative, a large step towards the goal of a non-toxic environment can be taken

The income distributional consequences of agrarian tariffs in Sweden on the eve of World War I

After 1870 Swedish agriculture was transformed in the direction of more animal husbandry. Small farmers in particular specialized in animal produce. Yet, agricultural protectionism primarily served the interest of large landowners specializing in bread-grain production. The paper explores the impact of agrarian tariffs on the factor rewards of landowners, capitalists and workers. Landowners predictably benefited from agrarian tariffs, the more so if they specialized in bread-grain, as did rural workers. With an integrated ruralurban labour market real incomes of urban workers would have come under pressure if agrarian tariffs had been dismantled while capitalists would have been little affected

Structural Change in the Swedish economy in the late nineteenth and early twentieth century – The role of import substitution and export demand

The paper presents input-output tables for the Swedish economy for 1885, 1898 and 1913. These tables are used to explore structural change and to decompose Swedish economic growth in 1885–1898 and 1898–1913 into different demand sources: exports, import substitution and home market growth. While the 1890’s was a decade of import substitution export demand was always important and a much more important source of demand growth than import substitution after the turn of the century 190

Protectionism, agricultural prices and relative factor incomes: Sweden’s wage-rental ratio, 1877-1926

Trends in wage-rental ratios have figured prominently in the recent literature on factor price convergence and globalisation in the late nineteenth century. In that literature Sweden has been described as a free trade country whose wage-rental ratio exhibited a distinguished upward trend before World War I. This article presents a new series of land prices which indicates an increase in land rentals and an evolution of the wage-rental ratio more in line with other European protectionist countries. We explore the determinants of the Swedish wage-rental ratio and assess the relative importance of protectionism and the change in the product mix from arable to animal products in Swedish agriculture

Enzymes and electron transport in microbial chlorate respiration

Microbial chlorate respiration plays an important role in the turnover of oxochlorates in nature and industrial waste management. This thesis deals with the characterization of the molecular components of chlorate respiration in Ideonella dechloratans. Chlorate respiration utilizes two soluble periplasmic enzymes, chlorate reductase and chlorite dismutase, to convert chlorate to chloride and oxygen. The genes encoding the enzymes participating in the chlorate degradation have been sequenced, and are found in close proximity, forming a gene cluster for chlorate metabolism. This work also includes the successful recombinant expression of three genes from Ideonella dechloratans. Two of the gene products, chlorite dismutase and the C subunit of chlorate reductase, participate in the chlorate respiration. The third gene, which is found close to the gene cluster for chlorate metabolism, encodes a soluble c-type cytochrome. The localization of the gene suggests the corresponding protein as a candidate for a role as electron donor to chlorate reductase. Also, the role of soluble periplasmic c cytochromes of Ideonella dechloratans in chlorate respiration was studied. At least one of the soluble c cytochromes was found capable of serving as electron donor for chlorate reduction. This c cytochrome, and several others, can also donate electrons to a terminal oxidase for subsequent reduction of oxygen, as required for the branched electron flow during chlorate respiration