First- and second-order necessary conditions with respect to components for discrete optimal control problems

This paper is devoted to the study of discrete optimal control problems. We aim to obtain more constructive optimality conditions under weakened convexity assumptions. Based on a new approach introduced in this work, an optimality condition with respect to every component is obtained in the form of a global maximum principle. In addition, an optimality condition with respect to one of the components of a control in the form of the global maximum principle and with respect to another component of a control in the form of the linearized maximum principle are obtained. Furthermore, various second-order optimality conditions in terms of singular and quasi-singular controls with respect to the components are obtained on the fly

Prevalence, predictors, and outcomes of patient prosthesis mismatch in women undergoing TAVI for severe aortic stenosis: Insights from the WIN-TAVI registry

Objective: To evaluate the incidence, predictors and outcomes of female patients with patient-prosthesis mismatch (PPM) following transcatheter aortic valve intervention (TAVI) for severe aortic stenosis (AS). Background: Female AS TAVI recipients have a significantly lower mortality than surgical aortic valve replacement (SAVR) recipients, which could be attributed to the potentially lower PPM rates. TAVI has been associated with lower rates of PPM compared to SAVR. PPM in females post TAVI has not been investigated to date. Methods: The WIN-TAVI (Women's INternational Transcatheter Aortic Valve Implantation) registry i

Theory of Chemical Kinetics and Charge Transfer based on Nonequilibrium Thermodynamics

Classical theories of chemical kinetics assume independent reactions in dilute solutions, whose rates are determined by mean concentrations. In condensed matter, strong interactions alter chemical activities and create inhomogeneities that can dramatically affect the reaction rate. The extreme case is that of a reaction coupled to a phase transformation, whose kinetics must depend on the order parameter -- and its gradients, at phase boundaries. This Account presents a general theory of chemical kinetics based on nonequilibrium thermodynamics. The reaction rate is a nonlinear function of the thermodynamic driving force (free energy of reaction) expressed in terms of variational chemical potentials. The Cahn-Hilliard and Allen-Cahn equations are unified and extended via a master equation for non-equilibrium chemical thermodynamics. For electrochemistry, both Marcus and Butler-Volmer kinetics are generalized for concentrated solutions and ionic solids. The theory is applied to intercalation dynamics in the phase separating Li-ion battery material Li$_x$FePO$_4$.Comment: research account, 17 two-column pages, 12 figs, 78 refs - some typos corrected Accounts of Chemical Research (2013

First- and second-order necessary conditions with respect to components for discrete optimal control problems

This paper is devoted to the study of discrete optimal control problems. We aim to obtain more constructive optimality conditions under weakened convexity assumptions. Based on a new approach introduced in this work, an optimality condition with respect to every component is obtained in the form of a global maximum principle. In addition, an optimality condition with respect to one of the components of a control in the form of the global maximum principle and with respect to another component of a control in the form of the linearized maximum principle are obtained. Furthermore, various second-order optimality conditions in terms of singular and quasi-singular controls with respect to the components are obtained on the fly

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)