Evaluation of Three Rapid Tests for Diagnosis of P. Falciparum and P. Vivax Malaria in Colombia.

The diagnostic capacity of three malaria rapid diagnostic tests (RDTs), NOW-Malaria-ICT, OptiMAL-IT, and Paracheck-Pf, was evaluated against expert microscopy in Colombia. We tested 896 patients, of whom microscopy confirmed 139 P. falciparum, 279 P. vivax, and 13 mixed P.f/P.v infections and 465 negatives. Paracheck-Pf and NOW-malaria-ICT were more accurate in detecting P. falciparum (sensitivities 90.8% and 90.1%, respectively) in comparison with Optimal-IT (83.6%). NOW showed an acceptable Pf detection rate at low densities (< 500/microL), but resulted in a higher proportion of false positives. For P. vivax diagnosis, Optimal-IT had a higher sensitivity than NOW (91.0% and 81.4%, respectively). The choice between the two Pf/Pv detecting RDTs balances P. falciparum and P. vivax detection rates. Considering some degree of P. falciparum overtreatment and failure to detect all P. vivax cases as more acceptable than missing some cases of P. falciparum, we recommend careful implementation of NOW-malaria-ICT in areas where microscopy is lacking. The price is however still a constraint

Mechanics of cooling liquids by forced evaporation in bubbles

Injecting a non-dissolvable gas into a saturated liquid results in sub-cooling of the liquid due to forced evaporation into the bubble. Previous studies assumed the rate of evaporation of liquid into the bubble to be independent of the degree of sub-cooling. In our study we quantify the bubble growth by direct observation using high speed imaging and prove that this hypothesis is not true. A phenomenological model of the bubble growth as a function of the degree of sub-cooling is developed and we find excellent agreement between the measurements and theory. This bubble cooling process is employed in cooling a liquid. By identification of all heat flows, we can well describe the cool down curve using bubble cooling. Bubble cooling provides an alternative cooling method for liquids without the use of complicated cooling techniques

A minimal model of an autonomous thermal motor

We consider a model of a Brownian motor composed of two coupled overdamped degrees of freedom moving in periodic potentials and driven by two heat reservoirs. This model exhibits a spontaneous breaking of symmetry and gives rise to directed transport in the case of a non- vanishing interparticle interaction strength. For strong coupling between the particles we derive an expression for the propagation velocity valid for arbitrary periodic potentials. In the limit of strong coupling the model is equivalent to the B\"uttiker-Landauer model [1-3] for a single particle diffusing in an environment with position dependent temperature. By using numerical calculations of the Fokker-Planck equation and simulations of the Langevin equations we study the model for arbitrary coupling, retrieving many features of the strong coupling limit. In particular, directed transport emerges even for symmetric potentials. For distinct heat reservoirs the heat currents are well-defined quantities allowing a study of the motor efficiency. We show that the optimal working regime occurs for moderate coupling. Finally, we introduce a model with discrete phase space which captures the essential features of the continuous model, can be solved in the limit of weak coupling, and exhibits a larger efficiency than the continuous counterpart.Comment: Revised version. Extended discussion on the discrete model. To appear in EP

The Dutch multidisciplinary guideline osteoporosis and fracture prevention, taking a local guideline to the international arena

Background: In 2018, a grant was provided for an evidence-based guideline on osteoporosis and fracture prevention based on 10 clinically relevant questions. Methods: A multidisciplinary working group was formed with delegates from Dutch scientific and professional societies, including representatives from the patient’s organization and the Dutch Institute for Medical Knowledge. The purpose was to obtain a broad consensus among all participating societies to facilitate the implementation of the updated guideline. Results: Novel recommendations in our guideline are as follows: - In patients with an indication for DXA of the lumbar spine and hips, there is also an indication for VFA. - Directly starting with anabolic drugs (teriparatide or romosozumab) in patients with a very high fracture risk; - Directly starting with zoledronic acid in patients 75 years and over with a hip fracture (independent of DXA); - Directly starting with parenteral drugs (denosumab, teriparatide, zoledronic acid) in glucocorticoid-induced osteoporosis with very high fracture risk; - A lifelong fracture risk management, including lifestyle, is indicated from the start of the first treatment. Conclusion: In our new multidisciplinary guideline osteoporosis and fracture prevention, we developed 5 “relatively new statements” that are all a crucial step forward in the optimization of diagnosis and treatment for fracture prevention. We also developed 5 flowcharts, and we suppose that this may be helpful for individual doctors and their patients in daily practice and may facilitate implementation.</p

The Dutch multidisciplinary guideline osteoporosis and fracture prevention, taking a local guideline to the international arena

Background: In 2018, a grant was provided for an evidence-based guideline on osteoporosis and fracture prevention based on 10 clinically relevant questions. Methods: A multidisciplinary working group was formed with delegates from Dutch scientific and professional societies, including representatives from the patient’s organization and the Dutch Institute for Medical Knowledge. The purpose was to obtain a broad consensus among all participating societies to facilitate the implementation of the updated guideline. Results: Novel recommendations in our guideline are as follows: - In patients with an indication for DXA of the lumbar spine and hips, there is also an indication for VFA. - Directly starting with anabolic drugs (teriparatide or romosozumab) in patients with a very high fracture risk; - Directly starting with zoledronic acid in patients 75 years and over with a hip fracture (independent of DXA); - Directly starting with parenteral drugs (denosumab, teriparatide, zoledronic acid) in glucocorticoid-induced osteoporosis with very high fracture risk; - A lifelong fracture risk management, including lifestyle, is indicated from the start of the first treatment. Conclusion: In our new multidisciplinary guideline osteoporosis and fracture prevention, we developed 5 “relatively new statements” that are all a crucial step forward in the optimization of diagnosis and treatment for fracture prevention. We also developed 5 flowcharts, and we suppose that this may be helpful for individual doctors and their patients in daily practice and may facilitate implementation.</p