MULTIVARIATE META-ANALYSIS METHODS FOR BIAS REDUCTION IN SYSTEMATIC REVIEWS

Background: Missing treatment effect estimates for particular outcomes in a study have the potential to affect the conclusions in a meta-analysis (MA), especially if missingness is a result of outcome reporting bias (ORB). ORB comes from the results-based selection for publication of a subset of the original measured outcome variables and can result in overestimating treatment effects, resulting in bias. As well as missing treatment effect estimates at the study level, outcome data may also be missing within studies at the individual participant level. Multivariate meta-analysis (MVMA) of individual participant data (IPD) has the potential to overcome the impact of both these problems, by utilising the correlation between outcomes. Methods: An assessment of ORB was carried out in a cohort of systematic reviews (SR) with a core set of outcomes investigating pharmacological treatments for rheumatoid arthritis (RA). Novel IPD- MVMA methods to borrow strength across correlated outcomes were applied and evaluated through simulation, with the aim to show and quantify how this approach can reduce bias and improve precision of MA results, compared to traditional univariate methods, when there is missing outcome data as a result of both ORB and missing participant data. ORB assessments and the MVMA methods were applied to examples in RA. Results: Of the 167 assessable trials from 21 Cochrane RA reviews, 23% contained high suspicion of ORB in at least one of the core outcomes. Results from the simulations showed that the ‘borrowing of strength’ (BoS) in a multivariate model can reduce the magnitude of bias and increase precision in the pooled estimates. Results showed that when an ORB mechanism is introduced or there was missing IPD, MVMA tends to reduce the bias, increase the precision and improve the coverage when compared to a univariate analysis. In some instances, these benefits observed were also found in applying MVMA to the RA reviews. Conclusions: MVMA is not the solution to all missing data related problems within review meta- analyses, but, informed by this thesis, it can unquestionably be seen as a route to address missing outcome data in SRs. The BoS, reduction in bias and increase in precision can all be seen as promising

Physiopathology and biomechanics of hip osteoarthritis

Several factors seem to play a relevant role in the pathogenesis of hip osteoarthritis. Among these, an altered biomechanic and neuromuscular integrity of the hip joint should be considered. This is a review of the recent international literature concerning the role of loads and strengths acting on the hip joint, in order to better understand the pathogenesis and the physiopathology of the hip osteoarthritis. The study of these factors might be important to prevent the development of the osteoarthritis and might suggest the conservative treatment. In particular, the role of the balance among the muscles working in maintaining the equilibrium of the acting strengths is matter of discussion. The articular and neuromuscular dysfunction might induce an altered load distribution in the hip, particularly on the articular cartilage surface, and seems to favour the development of hip osteoarthritis..

The sterno-clavicular joint: anatomy, biomechanic, clinical features and aspects of manual therapy

The sterno-clavicular joint covers one remarkable importance in the complex of the shoulder girdle. This review investigates the anatomy, biomechanics, main affections and involvement of this joint in the pathological processes of the shoulder girdle in its complex. Moreover, it focuses on the opportunities offered from the conservative treatment, using in particular the manual therapy. Active and passive, as well as against isometric resistance movements, are discussed. In particular, the passive mobilization is demonstrated effective in the restoration of joint mobility. The sterno- clavicular joint is not structured in order to complete great work loads and has the tendency to become hypermotile or unstable, if subordinate to overload works, becoming painful. In this case, the techniques of passive mobilization and of modulation of the pain turn out effective

Bio-ethylene Production: from Reaction Kinetics to Plant Scale

Ethylene production from renewable bio-ethanol has been recently proposed as sustainable alternative to fossil sources. The possibility to exploit diluted bioethanol as less expensive feedstock was studied both experimentally, using different catalysts at lab-level, and through preliminary process design. In this work, a full-scale plant simulation is presented, built on a detailed reaction kinetics. Rate equations for the primary and side reactions are revised and implemented with a process simulation package, using a range of thermodynamic methods as best suited to the different process stages. The catalyst loading within the reactor can be effectively distributed according to the underlying kinetic, and the overall plant layout let foresee the best routes for the material recycles. The detailed reaction modeling and the choice of the thermodynamic models are essential to obtain reliable predictions. Setting a target yield of 105 t/year of polymer-grade ethylene, the reactive section must be fed with 76 t/h of diluted ethanol and operated at 400 \ub0C. 85% of the fed carbon mass is found as ethylene, 12% remains as ethanol and a 2% as longer olefins. Considering also the recycle of ethanol the carbon conversion and recovery increases to the value of 97.6%. The global ethylene recovery is 90.7%: most of the loss takes place in the last stage due to the non-condensable purification and to the adopted strategy of having low reflux ratio \u2013 and then a closed cryogenic balance \u2013 in the last purification column. Full heat integration of the process with upstream bioethanol production and purification sections allows process intensification and consistent energy savings. This newly designed process sets the sustainable ethylene production on a detailed and reassessed computational basis and has been assessed as for Capital and Operational Expenditures and Total Investment costs

High current and low q95 scenario studies for FAST in the view of ITER and DEMO

The Fusion Advanced Study Torus (FAST) has been proposed as a possible European satellite, in view of ITER and DEMO, in order to: a) explore plasma wall interaction in reactor relevant conditions b) test tools and scenarios for safe and reliable tokamak operation up to the border of stability c) address fusion plasmas with a significant population of fast particles. A new FAST scenario has been designed focusing on low-q operation, at plasma current IP=10 MA, toroidal field BT=8.5T, with a q95=2.3 that would correspond to IP=20 MA in ITER. The flat-top of the discharge can last a couple of seconds (i.e. half the diffusive resistive time and twice the energy confinement time), and is limited by the heating of the toroidal field coils. A preliminary evaluation of the end-of-pulse temperatures and of the electromagnetic forces acting on the central solenoid pack and poloidal field coils has been performed. Moreover, a VDE plasma disruption has been simulated and the maximum total vertical force applied on the vacuum vessel has been estimated

Eurofusion-DEMO Divertor - Cassette Design and Integration

The Eurofusion-DEMO design will complete the Pre Conceptual Design phase (PCD) with a PCD Gate, named G1, scheduled to take place in Q4 2020 that will focus on assessing the feasibility of the plant and its main components prior to entering into the Conceptual Design phase. In the paper first an overview is given of the Eurofusion-DEMO Divertor Assembly including design and interface description, systems and functional requirements, load specification, system classification, manufacturing procedures and cost estimate. Then critical issues are discussed and potential design solutions are proposed, e.g.: - Neutron material damage limits of the different (structural) materials present in the divertor assembly (as CuCrZr, Eurofer) and in the vacuum vessel (AISI 316 L(N)-IG); - Temperature hot spots in parts of the divertor assembly exposed to high nuclear heating and high heat radiation (from the plasma core or the separatrix) causing difficulties for active or passive cooling (e.g. cassette body structure, liner support structures, mechanical supports, divertor toroidal rails); - Arrangement and design of plasma-facing components and liner with pumping slot in the divertor cassette to enable pumping of exhaust gases from the lower port

Near term perspectives for fusion research and new contributions by the Ignitor program

The main advances made within the Ignitor program, that is aimed at investigating the physics of fusion burning plasmas near ignition, are described. In particular, the operation of the machine in the H and I regimes at the 10 MA plasma current levels has been considered and analyzed. The unique properties of the plasmas that can be generated by operating the machine with reduced parameters (lower magnetic fields and plasma currents) relative to those needed to achieve ignition are identified. A key feature of this operation is the relatively fast duty cycle that can be maintained. The Ideal Ignition Conditions, under which the density barrier due to bremsstrahlung emission in high density plasmas is removed, can be attained in this case. The plasma heating cycles are identified for which the contribution of ICRH is used both to enter the H-regime and to optimize the time needed for ignition. The on going effort to set up a test ICRH facility is described. The initial results (2 km/sec) of the high speed pellet injection system developed for Ignitor and operated at Oak Ridge are reported. The combined structural analysis and integration of the entire machine core (Load Assembly) is discussed. The adopted control system for both the machine and the plasma column has been designed and is described. The design solutions of the vertical field coils made of MgB2 and operating at 10 K have been identified and the relevant R&D program is underway. The analysis of the Caorso site and of its facility for the operation of the Ignitor with approved safety standards is completed. The relevant results are being made available for the operation of Ignitor at the Triniti site within the framework of the Italy-Russia agreement on the joint construction and operation of the Ignitor facility. A development effort concerning the advanced diagnostic systems that is being carried out for fusion burning plasma regimes is described. An initial analysis of the characteristics of a neutron source based on a system of Ignitor-like machines is reported

Impact of phosphorus application on drought resistant responses of Eucalyptus grandis seedlings

Eucalyptus grandis is the most widely planted tree species worldwide and can face severe drought during the initial months after planting because the root system is developing. A complete randomized design was used to study the effects of two water regimes (well-watered and water-stressed) and phosphorus (P) applications (with and without P) on the morphological and physio-biochemical responses of E. grandis. Drought had negative effects on the growth and metabolism of E. grandis, as indicated by changes in morphological traits, decreased net photosynthetic rates (Pn), pigment concentrations, leaf relative water contents (LRWCs), nitrogenous compounds, over-production of reactive oxygen species (ROS) and higher lipid peroxidation. However, E. grandis showed effective drought tolerance strategies, such as reduced leaf area and transpiration rate (E), higher accumulation of soluble sugars and proline and a strong antioxidative enzyme system. P fertilization had positive effects on well-watered seedlings due to improved growth and photosynthesis, which indicated the high P requirements during the initial E. grandis growth stage. In drought-stressed seedlings, P application had no effects on the morphological traits, but it significantly improved the LRWC, Pn, quantum efficiency of photosystem II (Fv/Fm), chlorophyll pigments, nitrogenous compounds and reduced lipid peroxidation. P fertilization improved E. grandis seedling growth under well-watered conditions but also ameliorated some leaf physiological traits under drought conditions. The effects of P fertilization are mainly due to the enhancement of plant N nutrition. Therefore, P can be used as a fertilizer to improve growth and production in the face of future climate change.Fil: Tariq, Akash. Chinese Academy of Sciences; República de China. University of Chinese Academy of Sciences; ChinaFil: Pan, Kaiwen. Chinese Academy of Sciences; República de ChinaFil: Olatunji, Olusanya A. Chinese Academy of Sciences; República de China. University of Chinese Academy of Sciences; ChinaFil: Graciano, Corina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Fisiología Vegetal. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Instituto de Fisiología Vegetal; ArgentinaFil: Li, Zilong. Chinese Academy of Sciences; República de China. University of Chinese Academy of Sciences; ChinaFil: Li, Ningning. Southwest University; ChinaFil: Song, Dagang. Chinese Academy of Sciences; República de China. University of Chinese Academy of Sciences; ChinaFil: Sun, Feng. Chinese Academy of Sciences; República de China. University of Chinese Academy of Sciences; ChinaFil: Wu, Xiaogang. Chinese Academy of Sciences; República de ChinaFil: Dakhil, Mohammed A.. Chinese Academy of Sciences; República de China. University of Chinese Academy of Sciences; China. Helwan University; EgiptoFil: Sun, Xiaoming. Chinese Academy of Sciences; República de ChinaFil: Zhang, Lin. Chinese Academy of Sciences; República de Chin

Bioquímica foliar e radicular de Stylosanthes scabra Vogel (Fabaceae) submetida ao déficit hídrico.

O objetivo do estudo foi avaliar alterações bioquímicas, foliares e radiculares de Stylosanthes scabra Vogel submetida a DH e reidratação (RI) em casa de vegetação