Sonolytic Decomposition of Aqueous Bioxalate in the Presence of Ozone

Ultrasonic irradiation in the presence of ozone is demonstrated to be effective for the rapid oxidation of oxalic acid, bioxalate, and oxalate (H_(2)C_(2)O_(4)/HC_(2)O_(4)−/C_(2)O_(4)^2−) in aqueous solution to CO_2 and H_(2)O. The degradation rate of bioxalate exposed to “sonozone” (i.e., simultaneous ultrasonication and ozonolysis) was found to be 16-times faster than predicted by the linear addition of ozonolysis and ultrasonic irradiation rates. The hydroxyl radical (•OH) is the only oxy-radical produced that can oxidize oxalate on a relevant time-scale. Thus, plausible •OH production mechanisms are evaluated to explain the observed kinetic synergism of ultrasonication and ozonolysis toward bioxalate decomposition. •OH production via decomposition of O_3 in the cavitating bubble vapor and via the reaction of O_3 and H_(2)O_2 are considered, but kinetic estimations and experimental evidence indicate neither to be a sufficient source of •OH. A free-radical chain mechanism is proposed in which the HC_(2)O_(4)− + •OH reaction functions as a primary propagation step, while the termination occurs through the O_3 + CO_(2)•− reaction via an O-atom transfer mechanism. Kinetic simulations confirm that ozone reacts efficiently with the superoxide (O_(2)•−) ion that is produced by the reaction of O_2 and CO_(2)•− to form •OH radical, and that the reaction of O_3 + CO_(2)•− must be chain terminating. Oxalate is also readily oxidized by “peroxone” treatment (i.e., H_(2)O_2 and O_3). However, the addition of H_(2)O_2 during the course of the sonolytic ozonation of oxalic acid does not appear to increase the observed degradation rate and decreases rates at millimolar levels

Calcitonin gene-related peptide receptor antagonist BIBN 4096 BS for the acute treatment of migraine

Background: Calcitonin gene–related peptide (CGRP) may have a causative role in migraine. We therefore hypothesized that a CGRP-receptor antagonist might be effective in the treatment of migraine attacks. Methods: In an international, multicenter, double-blind, randomized clinical trial of BIBN 4096 BS, a highly specific and potent nonpeptide CGRP-receptor antagonist, 126 patients with migraine received one of the following: placebo or 0.25, 0.5, 1, 2.5, 5, or 10 mg of BIBN 4096 BS intravenously over a period of 10 minutes. A group-sequential adaptive treatment-assignment design was used to minimize the number of patients exposed. Results: The 2.5-mg dose was selected, with a response rate of 66 percent, as compared with 27 percent for placebo (P=0.001). The BIBN 4096 BS group as a whole had a response rate of 60 percent. Significant superiority over placebo was also observed with respect to most secondary end points: the pain-free rate at 2 hours; the rate of sustained response over a period of 24 hours; the rate of recurrence of headache; improvement in nausea, photophobia, phonophobia, and functional capacity; and the time to meaningful relief. An effect was apparent after 30 minutes and increased over the next few hours. The overall rate of adverse events was 25 percent after the 2.5-mg dose of the drug and 20 percent for the BIBN 4096 BS group as a whole, as compared with 12 percent for placebo. The most frequent side effect was paresthesia. There were no serious adverse events. Conclusions: The CGRP antagonist BIBN 4096 BS was effective in treating acute attacks of migraine

Enhanced Fusion-Evaporation Cross Sections in Neutron-Rich 132^{132}Sn on 64^{64}Ni

Evaporation residue cross sections have been measured with neutron-rich radioactive $^{132}$Sn beams on $^{64}$Ni in the vicinity of the Coulomb barrier. The average beam intensity was $2\times 10^{4}$ particles per second and the smallest cross section measured was less than 5 mb. Large subbarrier fusion enhancement was observed. Coupled-channels calculations taking into account inelastic excitation and neutron transfer underpredict the measured cross sections below the barrier.Comment: 4 pages including 1 table and 3 figure

An Illustration of Inverse Probability Weighting to Estimate Policy-Relevant Causal Effects

Traditional epidemiologic approaches allow us to compare counterfactual outcomes under 2 exposure distributions, usually 100% exposed and 100% unexposed. However, to estimate the population health effect of a proposed intervention, one may wish to compare factual outcomes under the observed exposure distribution to counterfactual outcomes under the exposure distribution produced by an intervention. Here, we used inverse probability weights to compare the 5-year mortality risk under observed antiretroviral therapy treatment plans to the 5-year mortality risk that would had been observed under an intervention in which all patients initiated therapy immediately upon entry into care among patients positive for human immunodeficiency virus in the US Centers for AIDS Research Network of Integrated Clinical Systems multisite cohort study between 1998 and 2013. Therapy-naïve patients (n = 14,700) were followed from entry into care until death, loss to follow-up, or censoring at 5 years or on December 31, 2013. The 5-year cumulative incidence of mortality was 11.65% under observed treatment plans and 10.10% under the intervention, yielding a risk difference of −1.57% (95% confidence interval: −3.08, −0.06). Comparing outcomes under the intervention with outcomes under observed treatment plans provides meaningful information about the potential consequences of new US guidelines to treat all patients with human immunodeficiency virus regardless of CD4 cell count under actual clinical conditions

Transportability of Trial Results Using Inverse Odds of Sampling Weights

Increasingly, the statistical and epidemiologic literature is focusing beyond issues of internal validity and turning its attention to questions of external validity. Here, we discuss some of the challenges of transporting a causal effect from a randomized trial to a specific target population. We present an inverse odds weighting approach that can easily operationalize transportability. We derive these weights in closed form and illustrate their use with a simple numerical example. We discuss how the conditions required for the identification of internally valid causal effects are translated to apply to the identification of externally valid causal effects. Estimating effects in target populations is an important goal, especially for policy or clinical decisions. Researchers and policy-makers should therefore consider use of statistical techniques such as inverse odds of sampling weights, which under careful assumptions can transport effect estimates from study samples to target populations

Target Validity and the Hierarchy of Study Designs

In recent years, increasing attention has been paid to problems of external validity, specifically to methodological approaches for both quantitative generalizability and transportability of study results. However, most approaches to these issues have considered external validity separately from internal validity. Here we argue that considering either internal or external validity in isolation may be problematic. Further, we argue that a joint measure of the validity of an effect estimate with respect to a specific population of interest may be more useful: We call this proposed measure target validity. In this work, we introduce and formally define target bias as the total difference between the true causal effect in the target population and the estimated causal effect in the study sample, and target validity as target bias = 0. We illustrate this measure with a series of examples and show how this measure may help us to think more clearly about comparisons between experimental and nonexperimental research results. Specifically, we show that even perfect internal validity does not ensure that a causal effect will be unbiased in a specific target population