GDP Forecast of the Biggest GCC Economies Using ARIMA

Gulf Cooperation Council (GCC) members are considered one of the fastest growing economies. This paper aims to empirically forecast the economic activity of the vastest GCC countries: Qatar, Saudi Arabia, and the United Arab Emirates. An Auto-Regressive Moving Average (ARIMA) model for the three countries Gross Domestic Product is obtained using the Box-Jenkins methodology during the 1980 - 2020 period. The appropriate models for the three economies are of ARIMA (0,2,1), the forecasts are at a 95% confidence level and predicts a growth in the three countries for the upcoming five years

Knowledge, attitudes and beliefs of women in the reproductive age towards prenatal screening for congenital malformations, Alexandria-Egypt

Background: The study was conducted to explore the Egyptian women’s attitudes toward the prenatal screening (PNS) for congenital malformations and termination of pregnancy if medically indicated and assessing their knowledge and beliefs regarding prenatal screening.Methods: A total of 351 Egyptian women in the reproductive age giving birth to at least one child completed a structured questionnaire to assess their knowledge of prenatal diagnosis and their willingness to undergo prenatal screening as well as their opinions on termination of pregnancy if medically indicated. Women's beliefs were also assessed.Results: More than half of studied women (52.71%) are lacking knowledge about the availability of the accurate tests for prenatal screening of congenital malformations. After giving information about PNS, more than three quarters (77.5%) of the studied women held positive attitudes toward the prenatal screening for congenital malformations. The other one quarter was either refusing or not sure about their opinion (4.6% and 17.9% respectively). Only 58.7% accepting termination of pregnancy if medically indicated. Positive attitude towards PNS was significantly higher among females with older age (P=0.019) as well as those of higher social class as indicated by higher level of education (p=0.026), urban residency (p=0.046) and working women (p=0.005). Perceived seriousness of congenital malformations and believing in the importance of early detection of such condition were the significant motives to undergo PNS.Conclusions: There is marked lack of knowledge about the prenatal screening tests among the studied women. After giving information about PNS, most of them shows a positive attitude towards carrying out these tests and about half of them reported their acceptance for termination of pregnancy if medically indicated based on prenatal diagnosis of sever congenital malformations. Emphasis national needs for health education programs about PNS importance and development of well-structured national program for PNS

Pengaruh Penambahan Kolin Klorida Pada Pakan Terhadap Kadar Kolesterol Dan Lipoprotein Darah Sapi Perah Laktasi

The purpose of this study was to evaluate the effects of choline chloride addition in feed on cholesterol, low density lipoprotein (LDL), and high density lipoprotein (HDL) levels in blood of lactating dairy cow, as indicator of lipid anabolism in the body. Eight of lactating dairy cows (61 to 91 days in milk; 2nd lactation period and 456 ± 31 kg of BW average as equal to 99 ± 5 kg BW0.75) were fed total mixed diet containing Napier grass and concentrate (40:60) and additive 30 g/d choline chloride 60% corn-cob as 18 g/d choline chloride (as equal to 0.02 % BW0.75). The experiment was set as cross-over designs with two experiments and eight replications. The treatments were T0 = 0 g/d choline chloride and T1= 30 g/d choline chloride, within 2 periods in which each period was 4 weeks and the data was analyzed using analysis of variance (ANOVA). The results showed that the addition of 30 g/d choline chloride in feed did not affect (P>0,05) the cholesterol, LDL and HDL levels in blood of lactating dairy cows. The conclusion of this study was the choline chloride addition in feed did not increase cholesterol, LDL, and HDL levels in blood of lactating dairy cows as the indicator of lipid anabolism

Multisystem inflammatory syndrome in children (MIS-C) and “Near MIS-C”: A continuum?

IntroductionReports of multisystem inflammatory syndrome in children (MIS-C), following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, have been increasing worldwide, with an incidence varying significantly across studies based on the definition used for the diagnosis. At our tertiary medical center in Lebanon, we encountered several cases that presented a diagnostic challenge because they mimicked MIS-C but did not meet the US Centers for Disease Control and Prevention (CDC) definition. We decided to review these cases and describe their features in comparison with cases that met the CDC criteria of MIS-C and those that had an alternative diagnosis.MethodsThis is a retrospective chart review of subjects aged <19 years old admitted to the American University of Beirut Medical Center (AUBMC) between March 1, 2020, and May 31, 2021, with suspected or confirmed MIS-C, following documented COVID-19 infection, with sufficient or insufficient criteria for diagnosis. Subjects were classified into 3 groups: “MIS-C”, “Near MIS-C” and “Alternative Diagnosis”.ResultsA total number of 29 subjects were included in our cohort. Fever was present in all subjects. In the MIS-C group, evidence for cardiovascular system involvement was the most common feature followed by the mucocutaneous and gastrointestinal systems. In the “Near MIS-C” and “Alternative Diagnosis” group, gastrointestinal symptoms were the most common with only one patient with cardiac abnormalities and none with coagulopathy. Subjects with typical MIS-C presentation had higher inflammatory markers when compared to subjects in the other groups. Almost all the subjects had positive IgG for SARS-CoV-2. Of the 29 subjects, the Royal College of Paediatrics and Child Health (RCPCH) case definition would have identified all suspected cases without an alternative diagnosis as MIS-C, whereas the World Health Organization (WHO) and the CDC definitions would have excluded 6 and 10 subjects, respectively.ConclusionMIS-C presents a diagnostic challenge due to the nonspecific symptoms, lack of pathognomonic findings, and potentially fatal complications. More research is needed to fully understand its pathogenesis, clinical presentation spectrum, and diagnostic criteria. Based on our experience, we favor the hypothesis that MIS-C has a continuum of severity that necessitates revisiting and unifying the current definitions

Chemical composition, antioxidant, and antimicrobial properties of Mentha subtomentella: in sight in vitro and in silico analysis

Our research focused on assessing essential oils (MSEO) and aqueous extracts (MSAE) derived from M. subtomentella leaves, with a primary focus on evaluating their properties. From 1 kg of leaves, we successfully obtained 18 mL of essential oil. Upon conducting GC/MS analysis, we identified eleven compounds within the oil, collectively accounting for 100% of the constituents identified. Notably, the predominant compounds in the leaf oil were p-Menth-48) -en-3-one (50.48%), 9-Ethylbicyclo (3.3.1) nonan-9-ol (10.04%) (E)-3,3-Dimethyl-delta-1, alpha-cyclohexaneacetaldehyde (8.53%), and D-Limonene (7.22%). Furthermore, utilizing HPLC/DAD, we explored the phenolic profile of MSAE, extracted through decoction. This analysis revealed the presence of fifty-eight compounds, with five major components collectively constituting 61% of the total compounds identified, rosmarinic acid as the major one. We evaluated the antimicrobial effectiveness of the MSEO against ten different strains, observing its notable efficacy against A. Niger (MIC = 0.09%), P. digitatum (MIC = 0.5%), and G. candidum (MIC = 1%). However, the essential oil demonstrated comparatively lower efficacy against bacteria than fungi. In contrast, the MSAE did not exhibit any antimicrobial activity against the tested strains. Regarding antioxidant activity, the aqueous extract displayed a significantly higher antioxidant capacity than the essential oil, which exhibited relatively lower antioxidant activity. The IC50 values were determined to be 0.04 ± 0.01 mg/mL, 0.17 ± 0.01 mg/mL, and 13% ± 0.01% (V/V), for ascorbic acid MSAE and MSEO, respectively. We used a computational method called molecular docking to investigate how certain plant compounds affect antioxidant, antibacterial, and antifungal activities. This involved analyzing the interactions between these compounds and specific protein targets known for their roles in these activities

Assessing disparities in medical students’ knowledge and attitude about monkeypox: a cross-sectional study of 27 countries across three continents

Background and aimsThe recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students’ knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries.MethodsA cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses.Results46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox.ConclusionThere were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control

Multiphysics and Thermodynamic Formulations for Equilibrium and Non-equilibrium Interactions: Non-linear Finite Elements Applied to Multi-coupled Active Materials

[EN] Combining several theories this paper presents a general multiphysics framework applied to the study of coupled and active materials, considering mechanical, electric, magnetic and thermal fields. The framework is based on thermodynamic equilibrium and non-equilibrium interactions, both linked by a two-temperature model. The multi-coupled governing equations are obtained from energy, momentum and entropy balances; the total energy is the sum of thermal, mechanical and electromagnetic parts. The momentum balance considers mechanical plus electromagnetic balances; for the latter the Abraham rep- resentation using the Maxwell stress tensor is formulated. This tensor is manipulated to automatically fulfill the angular momentum balance. The entropy balance is for- mulated using the classical Gibbs equation for equilibrium interactions and non-equilibrium thermodynamics. For the non-linear finite element formulations, this equation requires the transformation of thermoelectric coupling and conductivities into tensorial form. The two-way thermoe- lastic Biot term introduces damping: thermomechanical, pyromagnetic and pyroelectric converse electromagnetic dynamic interactions. Ponderomotrix and electromagnetic forces are also considered. The governing equations are converted into a variational formulation with the resulting four-field, multi-coupled formalism implemented and val- idated with two custom-made finite elements in the research code FEAP. Standard first-order isoparametric eight-node elements with seven degrees of freedom (dof) per node (three displacements, voltage and magnetic scalar potentials plus two temperatures) are used. Non-linearities and dynamics are solved with Newton-Raphson and New- mark-b algorithms, respectively. Results of thermoelectric, thermoelastic, thermomagnetic, piezoelectric, piezomag- netic, pyroelectric, pyromagnetic and galvanomagnetic interactions are presented, including non-linear depen- dency on temperature and some second-order interactions.This research was partially supported by grants CSD2008-00037 Canfranc Underground Physics, Polytechnic University of Valencia under programs PAID 02-11-1828 and 05-10-2674. The first author used the grant Generalitat Valenciana BEST/2014/232 for the completion of this work.Pérez-Aparicio, JL.; Palma, R.; Taylor, R. (2016). Multiphysics and Thermodynamic Formulations for Equilibrium and Non-equilibrium Interactions: Non-linear Finite Elements Applied to Multi-coupled Active Materials. Archives of Computational Methods in Engineering. 23:535-583. https://doi.org/10.1007/s11831-015-9149-9S53558323Abraham M (1910) Sull’elettrodinamica di Minkowski. Rend Circ Mat 30:33–46Allik H, Hughes TJR (1970) Finite elment method for piezoelectric vibration. Int J Numer Methods Eng 2:151–157Antonova EE, Looman DC (2005) Finite elements for thermoelectric device analysis in ANSYS. In: International conference on thermoelectricsAtulasimha J, Flatau AB (2011) A review of magnetostrictive iron–gallium alloys. Smart Mater Struct 20:1–15Ballato A (1995) Piezoelectricity: old effect, new thrusts. IEEE Trans Ultrason Ferroelectr Freq Control 42(5):916–926Baoyuan S, Jiantong W, Jun Z, Min Q (2003) A new model describing physical effects in crystals: the diagrammatic and analytic methods for macro-phenomenological theory. J Mater Process Technol 139:444–447Bargmann S, Steinmann P (2005) Finite element approaches to non-classical heat conduction in solids. Comput Model Eng Sci 9(2):133–150Bargmann S, Steinmann P (2006) Theoretical and computational aspects of non-classical thermoelasticity. Comput Methods Appl Mech Eng 196:516–527Bargmann S, Steinmann P (2008) Modeling and simulation of first and second sound in solids. Int J Solids Struct 45:6067–6073Barnett SM (2010) Resolution of the Abraham–Minkowski dilemma. Phys Rev Lett 104:070401Benbouzid MH, Meunier G, Meunier G (1995) Dynamic modelling of giant magnetostriction in Terfenol-D rods by the finite element method. IEEE Trans Magn 31(3):1821–1824Benbouzid MH, Reyne G, Meunier G (1993) Nonlinear finite element modelling of giant magnetostriction. IEEE Trans Magn 29(6):2467–2469Benbouzid MH, Reyne G, Meunier G (1995) Finite elment modelling of magnetostrictive devices: investigations for the design of the magnetic circuit. IEEE Trans Magn 31(3):1813–1816Besbes M, Ren Z, Razek A (1996) Finite element analysis of magneto-mechanical coupled phenomena in magnetostrictive materials. IEEE Trans Magn 32(3):1058–1061Biot MA (1956) Thermoelasticity and irreversible thermodynamics. J Appl Phys 27(3):240–253Bisio G, Cartesegna M, Rubatto G (2001) Thermodynamic analysis of elastic systems. Energy Convers Manag 42:799–812Blun SL (1974) Materials for radiation detection. National Academy of Sciences, WashingtonBonet J, Wood RD (1997) Nonlinear continuum mechanics for finite element analysis. Cambridge University Press, CambridgeBorovik-Romanov AS (1960) Piezomagnetism in the antiferromagnetic fluorides of cobalt and manganese. Sov Phys 11:786Bowyer P (2005) The momentum of light in media: the Abraham–Minkowski controversy. http://bit.ly/1M7wyATBrauer JR, Ruehl JJ, MacNeal BE, Hirtenfelder F (1995) Finite element analysis of Hall effect and magnetoresistance. IEEE Trans Electron Devices 42(2):328–333Bustamante R, Dorfmann A, Ogden RW (2009) On electric body forces and Maxwell stresses in nonlinearly electroelastic solids. Int J Eng Sci 47:1131–1141Callen HB (1948) The application of Onsager’s reciprocal relations to thermoelectric, thermomagnetic, and galvanomagnetic effects. Phys Rev 73(11):1349–1358Callen HB (1985) Thermodynamics and an introduction to thermostatistics. Wiley, New YorkCarter JP, Booker JR (1989) Finite element analysis of coupled thermoelasticity. Comput Struct 31(1):73–80Cattaneo C (1938) Sulla conduzione del calore. Atti Semin Mat Fis Univ Modena 3:83–1013Chaplik AV (2000) Some exact solutions for the classical Hall effect in an inhomogeneous magnetic field. JETP Lett 72:503Chen PJ, Gurtin ME (1968) On a theory of heat conduction involving two temperatures. J Z Angew Math Phys ZAMP 19(4):614–627Chu LJ, Haus HA, Penfield P (1966) The force density in polarizable and magnetizable fluids. In: Proceedings of the IEEEClin Th, Turenne S, Vasilevskiy D, Masut RA (2009) Numerical simulation of the thermomechanical behavior of extruded bismuth telluride alloy module. J Electron Mater 38(7):994–1001Coleman BD (1964) Thermodynamics of materials with memory. Arch Ration Mech Anal 17:1–46de Groot SR (1961) Non-equilibrium themodynamics of systems in an electromagnetic field. J Nucl Energy C Plasma Phys 2:188–194de Groot SR, Mazur P (1984) Non-equilibrium thermodynamics. Dover, MineolaDebye P (1913) On the theory of anomalous dispersion in the region of long-wave electromagnetic radiation. Verh dtsch phys Ges 15:777–793del Castillo LF, García-Colín LS (1986) Thermodynamic basis for dielectric relaxation in complex materials. Phys Rev B 33(7):4944–4951Delves RT (1964) Figure of merit for Ettingshausen cooling. Br J Appl Phys 15:105–106Dorf RC (1997) The electrical engineering handbook. CRC Press, UKEarle R, Richards JFC (1956) Theophrastus: on stones. Ohio State University, ColumbusEbling D, Jaegle M, Bartel M, Jacquot A, Bottner H (2009) Multiphysics simulation of thermoelectric systems for comparison with experimental device performance. J Electron Mater 38(7):1456–1461El-Karamany AS, Ezzat MA (2011) On the two-temperature Green–Naghdi thermoelasticity theories. J Therm Stress 34:1207–1226Eringen AC (1980) Mechanics of continua. Robert E Krieger, MalabarEringen AC, Maugin GA (1990) Electrodynamics of continua I. Springer, New YorkErsoy Y (1984) A new nonlinear constitutive theory for conducting magnetothermoelastic solids. Int J Eng Sci 22(6):683–705Ersoy Y (1986) A new nonlinear constitutive theory of electric and heat conductions for magnetoelastothermo-electrical anisotropic solids. Int J Eng Sci 24(6):867–882Ferrari A, Mittica A (2013) Thermodynamic formulation of the constitutive equations for solids and fluids. Energy Convers Manag 66:77–86Galushko D, Ermakov N, Karpovski M, Palevski A, Ishay JS, Bergman DJ (2005) Electrical, thermoelectric and thermophysical properties of hornet cuticle. Semicond Sci Technol 20:286–289Gao JL, Du QG, Zhang XD, Jiang XQ (2011) Thermal stress analysis and structure parameter selection for a Bi2Te3-based thermoelectric module. J Electron Mater 40(5):884–888Gaudenzi P, Bathe KJ (1995) An iterative finite element procedure for the analysis of piezoelectric continua. J Intell Mater Syst Struct 6:266–273Gavela D, Pérez-Aparicio JL (1998) Peltier pellet analysis with a coupled, non-linear 3D finite element model. In: 4th European workshop on thermoelectricsGoudreau GL, Taylor RL (1972) Evaluation of numerical integration methods in elastodynamics. Comput Methods Appl Mech Eng 2:69–97Griffiths DJ (1999) Introduction to electrodynamics. Prentice-Hall Inc, Upper Saddle RiverGros L, Reyne G, Body C, Meunier G (1998) Strong coupling magneto mechanical methods applied to model heavy magnetostrictive actuators. IEEE Trans Magn 34(5):3150–3153Gurtin ME, Williams WO (1966) On the Clausius–Duhem inequality. J Z Angew Math Phys ZAMP 17(5):626–633Hamader VM, Patil TA, Chovan SH (1987) Free vibration response of two-dimensional magneto-electro-elastic laminated plates. Build Mater Sci 9:249–253Hausler C, Milde G, Balke H, Bahr HA, Gerlach G (2001) 3-D modeling of pyroelectric sensor arrays part I: multiphysics finite-element simulation. IEEE Sens J 8(12):2080–2087He Y (2004) Heat capacity, thermal conductivity and thermal expansion of barium titanate-based ceramics. Thermochimica 419:135–141Hernández-Lemus E, Orgaz E (2002) Hysteresis in nonequilibrium steady states: the role of dissipative couplings. Rev Mex Fís 48:38–45Hinds EA (2009) Momentum exchange between light and a single atom: Abraham or Minkowski? Phys Rev Lett 102:050403Hirsinger L, Billardon R (1995) Magneto-elastic finite element analysis including magnetic forces and magnetostriction effects. IEEE Trans Magn 31(3):1877–1880Huang MJ, Chou PK, Lin MC (2008) An investigation of the thermal stresses induced in a thin-film thermoelectric cooler. J Therm Stress 31:438–454IEEE Standards Board (1988) IEEE standard on piezoelectricity. ANSI/IEEE Std 176-1987. doi: 10.1109/IEEESTD.1988.79638IEEE Standards Board (1991) IEEE standard on magnetostrictive materials: piezomagnetic nomenclature. IEEE Std 319-1990. doi: 10.1109/IEEESTD.1991.101048Ioffe Institute (2013) INSb—indium antimonide. Ioffe Institute. www.ioffe.rssi.ru/SVA/NSM/Semicond/InSb/index.htmlJackson JD (1962) Classical electrodynamics. Wiley, New YorkJaegle M (2008) Multiphysics simulation of thermoelectric systems—modeling of Peltier—cooling and thermoelectric generation. In: Proceedings of the COMSOLJaegle M, Bartel M, Ebling D, Jacquot A, Bottner H (2008) Multiphysics simulation of thermoelectric systems. In: European conference on thermoelectrics ECT2008Jiménez JL, Campos I (1996) Advanced electromagnetism: foundations, theory and applications, chapter The balance equations of energy and momentum in classical electrodynamics. World Scientific Publishing, SingaporeJohnstone S (2008) Is there potential for use of the Hall effect in analytical science? Analyst 133:293–296Jou D, Lebon G (1996) Extended irreversible thermodynamics. Springer, BerlinKaltenbacher M, Kaltenbacher B, Hegewald T, Lerch R (2010) Finite element formulation for ferroelectric hysteresis of piezoelectric materials. J Intell Mater Syst Struct 21:773–785Kaltenbacher M, Meiler M, Ertl M (2009) Physical modeling and numerical computation of magnetostriction. Int J Comput Math Electr Electron Eng 28(4):819–832Kamlah M, Bohle U (2001) Finite element analysis of piezoceramic components taking into account ferroelectric hysteresis behavior. Int J Solids Struct 38:605–633Kannan KS, Dasgupta A (1997) A nonlinear Galerkin finite-element theory for modeling magnetostrictive smart structures. Smart Mater Struct 6:341–350Kiang J, Tong L (2010) Nonlinear magneto-mechanical finite element analysis of Ni–Mn–Ga single crystals. Smart Mater Struct 19:1–17Kinsler P, Favaro A, McCall MW (2009) Four Poynting theorems. Eur J Phys 30:983–993Klinckel S, Linnemann K (2008) A phenomenological constitutive model for magnetostrictive materials and ferroelectric ceramics. Proc Appl Math Mech 8:10507–10508Kosmeier D (2013) Hornets: Gentle Giants! Wikipedia: the free encyclopedia. www.hornissenschutz.de/hornets.htmLahmer T (2008) Forward and inverse problems in piezoelectricity. PhD thesis, Universität Erlangen-NürnbergLandau LD, Lifshitz EM (1982) Mechanics. Butterworth-Heinemann, OxfordLandau LD, Lifshitz EM (1984) Electrodynamics of continuous media. Pergamon Press, OxfordLandis CM (2002) A new finite-element formulation for electromechanical boundary value problems. Int J Numer Methods Eng 55:613–628Díaz Lantada A (2011) Handbook of active materials for medical devices: advances and applications. CRC Press, Boca RatonLebon G, Jou D, Casas-Vázquez J (2008) Understanding non-equilibrium thermodynamics. Springer, BerlinLinnemann K, Klinkel S (2006) A constitutive model for magnetostrictive materials—theory and finite element implementation. Proc Appl Math Mech 6:393–394Linnemann K, Klinkel S, Wagner W (2009) A constitutive model for magnetostrictive and piezoelectric materials. Int J Solids Struct 46:1149–1166Llebot JE, Jou D, Casas-Vázquez J (1983) A thermodynamic approach to heat and electric conduction in solids. Physica 121(A):552–562Lu X, Hanagud V (2004) Extended irreversible thermodynamics modeling for self-heating and dissipation in piezoelectric ceramics. IEEE Trans Ultrason Ferroelectr Freq Control 51(12):1582–1592Lubarda VA (2004) On thermodynamic potentials in linear thermoelasticity. Int J Solids Struct 41:7377–7398Mansuripur M (2012) Trouble with the lorentz law of force: incompatibility with special relativity and momentum conservation. Phys Rev Lett 108:193901Maruszewski B, Lebon G (1986) An extended irreversible thermodynamic description of electrothermoelastic semiconductors. Int J Eng Sci 24(4):583–593McMeeking RM, Landis CM (2005) Electrostatic forces and stored energy for deformable dielectric materials. J Appl Mech 72:581–590McMeeking RM, Landis CM, Jimenez MA (2007) A principle of virtual work for combined electrostatic and mechanical loading of materials. Int J Non Linear Mech 42:831–838MELCOR (2000) Thermoelectric handbook. Melcor, a unit of Laird Technologies. http://www.lairdtech.comMinkowski H (1908) Nachr. ges. wiss. Gottingen 53Naranjo B, Gimzewski JK, Putterman S (2005) Observation of nuclear fusion driven by a pyroelectric crystal. Nature 28(434):1115–1117Nédélec JC (1980) Mixed finite elements in $${R}^3$$ R 3 . Numer Math 35:314–345Nettleton RE, Sobolev SL (1995) Applications of extended thermodynamics to chemical, rheological, and transport processes: a special survey part I. approaches and scalar rate processes. J Non-Equilib Thermodyn 20:205–229Nettleton RE, Sobolev SL (1995) Applications of extended thermodynamics to chemical, rheological, and transport processes: a special survey part II. vector transport processes, shear relaxation and rheology. J Non-Equilib Thermodyn 20:297–331Nettleton RE, Sobolev SL (1996) Applications of extended thermodynamics to chemical, rheological, and transport processes: a special survey part III. wave phenomena. J Non-Equilib Thermodyn 21:1–16Newmark N (1959) A method of computation for structural dynamics. ASCE J Eng Mech 85:67–94Newnham RE (2005) Properties of materials: anisotropy, symmetry, structure. Oxford University Press, OxfordNour AE, Abd-Alla N, Maugin GA (1990) Nonlinear equations for thermoelastic magnetizable conductors. Int J Eng Sci 27(7):589–603Nowacki A (1962) International series of monographs in aeronautics and astronautics. Pergamon Press, OxfordOkumura H, Hasegawa Y, Nakamura H, Yamaguchi S (1999) A computational model of thermoelectric and thermomagnetic semiconductors. In: 18th international conference on thermoelectricsOkumura H, Yamaguchi S, Nakamura H, Ikeda K, Sawada K (1998) Numerical computation of thermoelectric and thermomagnetic effects. In: 17th international conference on thermoelectricsOliver X, Agelet C (2000) Continuum mechanics for engineers. Edicions UPC, Barcelona. http://hdl.handle.net/2099.3/36197Shankar K, Kondaiah P, Ganesan N (2013) Pyroelectric and pyromagnetic effects on multiphase magneto-electro-elastic cylindrical shells for axisymmetric temperature. Smart Mater Struct 22(2):025007Palma R, Pérez-Aparicio JL, Bravo R (2013) Study of hysteretic thermoelectric behavior in photovoltaic materials using the finite element method, extended thermodynamics and inverse problems. Energy Convers Manag 65:557–563Palma R, Pérez-Aparicio JL, Taylor RL (2012) Non-linear finite element formulation applied to thermoelectric materials under hyperbolic heat conduction model. Comput Method Appl Mech Eng 213–216:93–103Palma R, Rus G, Gallego R (2009) Probabilistic inverse problem and system uncertainties for damage detection in piezoelectrics. Mech Mater 41:1000–1016Pérez-Aparicio JL, Gavela D (1998) 3D, non-linear coupled, finite element model of thermoelectricity. In: 4th European workshop on thermoelectricsPérez-Aparicio JL, Palma R, Taylor RL (2012) Finite element analysis and material sensitivity of Peltier thermoelectric cells coolers. Int J Heat Mass Transf 55:1363–1374Pérez-Aparicio JL, Sosa H (2004) A continuum three-dimensional, fully coupled, dynamic, non-linear finite element formulation for magnetostrictive materials. Smart Mater Struct 13:493–502Perez-Aparicio JL, Sosa H, Palma R (2007) Numerical investigations of field-defect interactions in piezoelectric ceramics. Int J Solids Struct 44:4892–4908Pérez-Aparicio JL, Taylor RL, Gavela D (2007) Finite element analysis of nonlinear fully coupled thermoelectric materials. Comput Mech 40:35–45Qi H, Fang D, Yao Z (1997) FEM analysis of electro-mechanical coupling effect of piezoelectric materials. Comput Mater Sci 8:283–290Pérez-Aparicio JL, Palma R, Abouali-Sánchez S (2014) Complete finite element method analysis of galvanomagnetic and thermomagnetic effects. Appl Therm Eng (submitted)Perez-Aparicio JL, Palma R, Moreno-Navarro P (2014) Elasto-thermoelectric non-linear, fully coupled, and dynamic finite element analysis of pulsed thermoelectrics. Appl Therm Eng (submitted)Ramírez F, Heyliger PR, Pan E (2006) Free vibration response of two-dimensional magneto-electro-elastic laminated plates. J Sound Vib 292:626–644Reitz JR, Milford FJ (1960) Foundations of electromagnetic theory. Addison-Wesley, BostonReng Z, Ionescu B, Besbes M, Razek A (1995) Calculation of mechanical deformation of magnetic materials in electromagnetic devices. IEEE Trans Magn 31(3):1873–1876Restuccia L (2010) On a thermodynamic theory for magnetic relaxation phenomena due to n microscopic phenomena described by n internal variables. J Non-Equilib Thermodyn 35:379–413Restuccia L, Kluitenberg GA (1988) On generalizations of the Debye equation for dielectric relaxation. Phys A 154:157–182Restuccia L, Kluitenberg GA (1992) On the heat dissipation function for dielectric relaxation phenomena in anisotropic media. Int J Eng Sci 30(3):305–315Riffat SB, Ma X (2003) Thermoelectrics: a review of present and potential applications. Appl Therm Eng 23:913–935Rinaldi C, Brenner H (2002) Body versus surface forces in continuum mechanics: is the Maxwell stress tensor a physically objective Cauchy stress? Phys Rev E 65:036615Rowe DM (ed) (1995) CRC handbook of thermoelectrics. CRC Press, UKRus G, Palma R, Pérez-Aparicio JL (2009) Optimal measurement setup for damage detection in piezoelectric plates. Int J Eng Sci 47:554–572Rus G, Palma R, Pérez-Aparicio JL (2012) Experimental design of dynamic model-based damage identification in piezoelectric ceramics. Mech Syst Signal Process 26:268–293Sadiku MNO (2001) Numerical techniques in electromagnetics. CRC Press LLC, Boca RatonSemenov AS, Kessler H, Liskowsky A, Balke H (2006) On a vector potential formulation for 3D electromechanical finite element analysis. Commun Numer Methods Eng 22:357–375Serra E, Bonaldi M (2008) A finite element formulation for thermoelastic damping analysis. Int J Numer Methods Eng 78(6):671–691Several. Wikipedia. Wikipedia: The Free Encyclopedia, SeveralSoh AK, Liu JX (2005) On the constitutive equations of magnetoelectroelastic solids. J Intell Mater Syst Struct 16:597–602Stefanescu DM (2011) Handbook of force transducers: principles and components. Springer, BerlinTamma KK, Namburu RR (1992) An effective finite element modeling/analysis approach for dynamic thermoelasticity due to second sound effects. Comput Mech 9:73–84Tang T, Yu W (2009) Micromechanical modeling of the multiphysical behavior of smart materials using the variational asymptotic method. Smart Mater Struct 18:1–14Taylor RL (2010) FEAP a finite element analysis program: user manual. University of California, Berkeley. http://www.ce.berkeley.edu/feapThurston RN (1994) Warren p. Mason (1900–1986) physicist, engineer, inventor, author, teacher. IEEE Trans Ultrason Ferroelectr Freq Control 41(4):425–434Tian X, Shen Y, Chen C, He T (2006) A direct finite element method study of generalized thermoelastic problems. Int J Solids Struct 43:2050–2063Tinder RF (2008) Tensor properties of solids: phenomenological development of the tensor properties of crystals. Morgan and Claypool, San RafaelTruesdell C (1968) Thermodynamics for beginners, in irreversible aspects of continuum mechanics. Springer, BerlinTzou HS, Ye R (1996) Pyroelectric and thermal strain effects of piezoelectric (PVDF and PZT) devices. Mech Syst Signal Process 10(4):459–469Walser R (1972) Application of pyromagnetic phenomena to radiation detection

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised