Effect of Roasting Temperature on the Quality and Acceptability of Dakuwa

The effect of roasting temperature on the quality of dakuwa was studied with a view to ascertaining the best temperature at which to roast the maize grains and groundnut for the production of dakuwa. Maize grains and groundnut were germinated for 72 hours after which they were dried and roasted at 120, 130, 140 and 1500C. The groundnut was decoated after which both maize and groundnut were milled separately. After milling, the maize flour and groundnut paste were mixed together in equal ratio. To this mixture, 10% and 5% respectively of table sugar and granulated red pepper were added. The mixture was then milled and moulded into balls. The dakuwa produced were analysed for proximate composition, mineral content, microbial count and organoleptic properties using standard methods. Results of proximate composition and mineral content showed significant (p<0.05) variations in moisture (3.2-5.9%), protein (16.5-19.1%) and iron (0.00-0.03mg/100g) contents. The total microbial count, colour and overall acceptability also differed significantly (p<0.05). The sample roasted at 1400C had the best results. Keywords: Dakuwa, roasting, proximate composition, mineral, sensory

Denosumab, raloxifene, romosozumab and teriparatide to prevent osteoporotic fragility fractures: a systematic review and economic evaluation

Background Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. Objectives The objectives were to evaluate the clinical effectiveness, safety and cost-effectiveness of non-bisphosphonates {denosumab [Prolia®; Amgen Inc., Thousand Oaks, CA, USA], raloxifene [Evista®; Daiichi Sankyo Company, Ltd, Tokyo, Japan], romosozumab [Evenity®; Union Chimique Belge (UCB) S.A. (Brussels, Belgium) and Amgen Inc.] and teriparatide [Forsteo®; Eli Lilly and Company, Indianapolis, IN, USA]}, compared with each other, bisphosphonates or no treatment, for the prevention of fragility fracture. Data sources For the clinical effectiveness review, nine electronic databases (including MEDLINE, EMBASE and the World Health Organization International Clinical Trials Registry Platform) were searched up to July 2018. Review methods A systematic review and network meta-analysis of fracture and femoral neck bone mineral density were conducted. A review of published economic analyses was undertaken and a model previously used to evaluate bisphosphonates was adapted. Discrete event simulation was used to estimate lifetime costs and quality-adjusted life-years for a simulated cohort of patients with heterogeneous characteristics. This was done for each non-bisphosphonate treatment, a strategy of no treatment, and the five bisphosphonate treatments previously evaluated. The model was populated with effectiveness evidence from the systematic review and network meta-analysis. All other parameters were estimated from published sources. An NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Fracture risk was estimated from patient characteristics using the QFracture® (QFracture-2012 open source revision 38, Clinrisk Ltd, Leeds, UK) and FRAX® (web version 3.9, University of Sheffield, Sheffield, UK) tools. The relationship between fracture risk and incremental net monetary benefit was estimated using non-parametric regression. A probabilistic sensitivity analysis and scenario analyses were used to assess uncertainty. Results Fifty-two randomised controlled trials of non-bisphosphonates were included in the clinical effectiveness systematic review and an additional 51 randomised controlled trials of bisphosphonates were included in the network meta-analysis. All treatments had beneficial effects compared with placebo for vertebral, non-vertebral and hip fractures, with hazard ratios varying from 0.23 to 0.94, depending on treatment and fracture type. The effects on vertebral fractures and the percentage change in bone mineral density were statistically significant for all treatments. The rate of serious adverse events varied across trials (0–33%), with most between-group differences not being statistically significant for comparisons with placebo/no active treatment, non-bisphosphonates or bisphosphonates. The incremental cost-effectiveness ratios were > £20,000 per quality-adjusted life-year for all non-bisphosphonate interventions compared with no treatment across the range of QFracture and FRAX scores expected in the population eligible for fracture risk assessment. The incremental cost-effectiveness ratio for denosumab may fall below £30,000 per quality-adjusted life-year at very high levels of risk or for high-risk patients with specific characteristics. Raloxifene was dominated by no treatment (resulted in fewer quality-adjusted life-years) in most risk categories. Limitations The incremental cost-effectiveness ratios are uncertain for very high-risk patients. Conclusions Non-bisphosphonates are effective in preventing fragility fractures, but the incremental cost-effectiveness ratios are generally greater than the commonly applied threshold of £20,000–30,000 per quality-adjusted life-year. Study registration This study is registered as PROSPERO CRD42018107651. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 29. See the NIHR Journals Library website for further project information

Management of Platelet-Directed Pharmacotherapy in Patients With Atherosclerotic Coronary Artery Disease Undergoing Elective Endoscopic Gastrointestinal Procedures

The periprocedural management of patients with atherosclerotic coronary heart disease, including those who have heart disease and those who are undergoing percutaneous coronary intervention and stent placement who might require temporary interruption of platelet-directed pharmacotherapy for the purpose of an elective endoscopic gastrointestinal procedure, is a common clinical scenario in daily practice. Herein, we summarize the available information that can be employed for making management decisions and provide general guidance for risk assessment

The relationship between chronic kidney disease–associated pruritus and health-related quality of life: a systematic review

Background Chronic kidney disease–associated pruritus (CKD-aP) is a common and burdensome condition for end-stage kidney disease (ESKD) patients, especially those receiving haemodialysis. High-quality evidence of the relationship between CKD-aP and health-related quality of life (HRQoL) can therefore inform clinicians and policymakers about treatment choice and reimbursement decisions. Methods A systematic literature review and narrative synthesis stratified by study design and HRQoL instrument was conducted to evaluate in adult ESKD patients receiving in-centre haemodialysis the relationship between CKD-aP and HRQoL assessed using multi dimensional generic or condition-specific preference- or non-preference-based measures. MEDLINE, Embase, Web of Science, BIOSIS Citation Index, Cochrane Library and PsycINFO from inception to March 2020 were searched, with two reviewers extracting data independently. Results Searches identified 2684 unique records, of which 20 papers relating to 18 unique studies [5 randomised controlled trials (RCTs) and 13 observational studies] were included. HRQoL was assessed using four generic and eight disease-specific measures. The impact of CKD-aP was assessed by comparison of means, linear regression and correlation. Observational studies employing comprehensively adjusted multivariable linear regression largely found associations between CKD-aP severities and HRQoL. Analyses suggest this relationship is partially mediated by the sleep disturbance caused by CKD-aP. RCTs showing improvements in CKD-aP severity were associated with clinically meaningful improvements in HRQoL. Compared with generic measures, disease-specific HRQoL instruments reported greater changes with reduced CKD-aP. Heterogeneity in study design and reporting precluded meta-analysis. Conclusions CKD-aP severity was found to be associated with a worsening of HRQoL in the majority of observational and RCT studies. Parallel improvements in CKD-aP and HRQoL with interventions may support their use (PROSPERO registration 175035)

Tunneling of quantum rotobreathers

We analyze the quantum properties of a system consisting of two nonlinearly coupled pendula. This non-integrable system exhibits two different symmetries: a permutational symmetry (permutation of the pendula) and another one related to the reversal of the total momentum of the system. Each of these symmetries is responsible for the existence of two kinds of quasi-degenerated states. At sufficiently high energy, pairs of symmetry-related states glue together to form quadruplets. We show that, starting from the anti-continuous limit, particular quadruplets allow us to construct quantum states whose properties are very similar to those of classical rotobreathers. By diagonalizing numerically the quantum Hamiltonian, we investigate their properties and show that such states are able to store the main part of the total energy on one of the pendula. Contrary to the classical situation, the coupling between pendula necessarily introduces a periodic exchange of energy between them with a frequency which is proportional to the energy splitting between quasi-degenerated states related to the permutation symmetry. This splitting may remain very small as the coupling strength increases and is a decreasing function of the pair energy. The energy may be therefore stored in one pendulum during a time period very long as compared to the inverse of the internal rotobreather frequency.Comment: 20 pages, 11 figures, REVTeX4 styl

The status of GEO 600

The GEO 600 laser interferometer with 600m armlength is part of a worldwide network of gravitational wave detectors. GEO 600 is unique in having advanced multiple pendulum suspensions with a monolithic last stage and in employing a signal recycled optical design. This paper describes the recent commissioning of the interferometer and its operation in signal recycled mode

Combined LHC/ILC analysis of a SUSY scenario with heavy sfermions

We discuss the potential of combined analyses at the Large Hadron Collider and the planned International Linear Collider to explore low-energy supersymmetry in a difficult region of the parameter space characterized by masses of the scalar SUSY particles around 2 TeV. Precision analyses of cross sections for light chargino production and forward--backward asymmetries of decay leptons and hadrons at the ILC, together with mass information on chi^0_2 and squarks from the LHC, allow us to determine the underlying fundamental gaugino/higgsino MSSM parameters and to constrain the masses of the heavy, kinematically inaccessible sparticles. No assumptions on a specific SUSY-breaking mechanism are imposed. For this analysis the complete spin correlations between production and decay processes are taken into account.Comment: new figure added, updated to match the published versio

Top Squarks and Bottom Squarks in the MSSM with Complex Parameters

We present a phenomenological study of top squarks (~t_1,2) and bottom squarks (~b_1,2) in the Minimal Supersymmetric Standard Model (MSSM) with complex parameters A_t, A_b, \mu and M_1. In particular we focus on the CP phase dependence of the branching ratios of (~t_1,2) and (~b_1,2) decays. We give the formulae of the two-body decay widths and present numerical results. We find that the effect of the phases on the (~t_1,2) and (~b_1,2) decays can be quite significant in a large region of the MSSM parameter space. This could have important implications for (~t_1,2) and (~b_1,2) searches and the MSSM parameter determination in future collider experiments. We have also estimated the accuracy expected in the determination of the parameters of ~t_i and ~b_i by a global fit of the measured masses, decay branching ratios and production cross sections at e^+ e^- linear colliders with polarized beams. Analysing two scenarios, we find that the fundamental parameters apart from A_t and A_b can be determined with errors of 1% to 2%, assuming an integrated luminosity of 1 ab^-1 and a sufficiently large c.m.s. energy to produce also the heavier ~t_2 and ~b_2 states. The parameter A_t can be determined with an error of 2 - 3%, whereas the error on A_b is likely to be of the order of 50%.Comment: 31 pages, 8 figures, comments and references added, conclusions unchanged; version to appear in Phys. Rev.

KEYNOTE-716: Phase III study of adjuvant pembrolizumab versus placebo in resected high-risk stage II melanoma.

Patients with high-risk stage II melanoma are at significant risk for recurrence after surgical resection. Adjuvant treatment options to lower the risk for distant metastases are limited. Although adjuvant IFN-α2b is associated with improved relapse-free survival in patients with high-risk melanoma, toxicity and limited overall survival benefits limit its use. Adjuvant treatment with the PD-1 inhibitor pembrolizumab significantly improved recurrence-free survival, compared with placebo, in patients with resected stage III melanoma in the Phase III KEYNOTE-054 trial; efficacy in patients with stage II disease has not been established. This article describes the design and rationale of KEYNOTE-716 (NCT03553836), a two-part, randomized, placebo-controlled, multicenter Phase III study of adjuvant pembrolizumab in patients with surgically resected high-risk stage II melanoma. Clinical trial registry & ID: ClinicalTrials.gov, NCT0355383

Search for Rare and Forbidden 3-body Di-muon Decays of the Charmed Mesons D+ and Ds+

Using a high statistics sample of photo-produced charm particles from the FOCUS experiment at Fermilab, we report results of a search for eight rare and Standard-Model-forbidden decays: D+, Ds+ > h+/- muon-/+ muon+ (with h=pion or Kaon). Improvement over previous results by a factor of 1.7--14 is realized. Our branching ratio upper limit D+ > pion+ muon- muon+ of 8.8E-6 at the 90% C.L. is below the current MSSM R-Parity violating constraint.Comment: 17 pages, 7 figure file