Projecting prevalence by stage of care for prostate cancer and estimating future health service needs: protocol for a modelling study

Introduction Current strategies for the management of prostate cancer are inadequate in Australia. We will, in this study, estimate current service needs and project the future needs for prostate cancer patients in Australia. Methods and analysis First, we will project the future prevalence of prostate cancer for 2010-2018 using data for 1972-2008 from the New South Wales (NSW) Central Cancer Registry. These projections, based on modelled incidence and survival estimates, will be estimated using PIAMOD (Prevalence, Incidence, Analysis MODel) software. Then the total prevalence will be decomposed into five stages of care: initial care, continued monitoring, recurrence, last year of life and long-term survivor. Finally, data from the NSW Prostate Cancer Care and Outcomes Study, including data on patterns of treatment and associated quality of life, will be used to estimate the type and amount of services that will be needed by prostate cancer patients in each stage of care. In addition, Central Cancer Registry episode data will be used to estimate transition rates from localised or locally advanced prostate cancer to metastatic disease. Medicare and Pharmaceutical Benefits data, linked with Prostate Cancer Care and Outcomes Study data, will be used to complement the Cancer Registry episode data. The methods developed will be applied Australia-wide to obtain national estimates of the future prevalence of prostate cancer for different stages of clinical care. Ethics and dissemination This study was approved by the NSW Population and Health Services Research Ethics Committee. Results of the study will be disseminated widely to different interest groups and organisations through a report, conference presentations and peer-reviewed articles.This work is supported by the Prostate Cancer Foundation of Australia (grant number: PCFA – YI 0410). Both David Smith and Xue Qin Yu are supported by an Australian NHMRC Training Fellowship (Ref 1016598, 550002). Mark Clements is supported by an Australian NHMRC Career Development Award (Ref 471491)

A review of cyclist head injury, impact characteristics and the implications for helmet assessment methods

Head injuries are common for cyclists involved in collisions. Such collision scenarios result in a range of injuries, with different head impact speeds, angles, locations, or surfaces. A clear understanding of these collision characteristics is vital to design high fidelity test methods for evaluating the performance of helmets. We review literature detailing real-world cyclist collision scenarios and report on these key characteristics. Our review shows that helmeted cyclists have a considerable reduction in skull fracture and focal brain pathologies compared to non-helmeted cyclists, as well as a reduction in all brain pathologies. The considerable reduction in focal head pathologies is likely to be due to helmet standards mandating thresholds of linear acceleration. The less considerable reduction in diffuse brain injuries is likely to be due to the lack of monitoring head rotation in test methods. We performed a novel meta-analysis of the location of 1809 head impacts from ten studies. Most studies showed that the side and front regions are frequently impacted, with one large, contemporary study highlighting a high proportion of occipital impacts. Helmets frequently had impact locations low down near the rim line. The face is not well protected by most conventional bicycle helmets. Several papers determine head impact speed and angle from in-depth reconstructions and computer simulations. They report head impact speeds from 5 to 16 m/s, with a concentration around 5 to 8 m/s and higher speeds when there was another vehicle involved in the collision. Reported angles range from 10° to 80° to the normal, and are concentrated around 30°-50°. Our review also shows that in nearly 80% of the cases, the head impact is reported to be against a flat surface. This review highlights current gaps in data, and calls for more research and data to better inform improvements in testing methods of standards and rating schemes and raise helmet safety

The effect of cell-to-cell variations and thermal gradients on the performance and degradation of lithium-ion battery packs

The performance of lithium-ion battery packs are often extrapolated from single cell performance however uneven currents in parallel strings due to cell-to-cell variations, thermal gradients and/or cell interconnects can reduce the overall performance of a large scale lithium-ion battery pack. In this work, we investigate the performance implications caused by these factors by simulating six parallel connected batteries based on a thermally coupled single particle model with the solid electrolyte interphase growth degradation mechanism modelled. Experimentally validated simulations show that cells closest to the load points of a pack experience higher currents than cells further away due to uneven overpotentials caused by the interconnects. When a cell with a four times greater internal impedance was placed in the location with the higher currents this actually helped to equalise the cell-to-cell current distribution, however if this was placed at a location furthest from the load point this would cause a ~6% reduction in accessible energy at 1.5 C. The influence of thermal gradients can further affect this current heterogeneity leading to accelerated aging. Simulations show that in all cases, cells degrade at different rates in a pack due to the uneven currents, with this being amplified by thermal gradients. In the presented work a 5.2% increase in degradation rate, from -7.71 mWh/cycle (isothermal) to - 8.11 mWh/cycle (non-isothermal) can be observed. Therefore, the insights from this paper highlight the highly coupled nature of battery pack performance and can inform designs for higher performance and longer lasting battery packs

Efficacy of drugs against clonorchiasis and opisthorchiasis: a systematic review and network meta-analysis

BACKGROUND: Clonorchis sinensis, Opisthorchis viverrini, and Opisthorchis felineus are the three most important human liver fluke species in the Opisthorchiidae family, infecting approximately 25 million people worldwide. Drug treatment is needed to control morbidity and is also useful in lowering transmission. Several drugs used in various regimens are available to treat these infections, but their comparative efficacy is uncertain. We aimed to compare the efficacy in terms of cure rate and egg reduction rate of currently registered drugs against human liver fluke infection. METHODS: We conducted a systematic review using readily available electronic databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, KoreaMed, China National Knowledge Infrastructure, and Wanfang Data) without language restrictions from inception until June 29, 2021. Clinical trials with pairwise comparison of drugs (praziquantel, albendazole, mebendazole, tribendimidine, or combinations of these drugs) against C sinensis, O viverrini, and O felineus were eligible, including trials comparing these drugs or their combinations with placebo. We compared efficacy in terms of cure rate by network meta-analysis. We conducted mixed binomial regression analyses for each species to derive predicted median cure rates for each drug regimen. The models included treatment and infection intensity as fixed factors, year of publication as covariate, and random effects of the different studies assumed to be normally distributed. We also assessed the quality of the included studies. This study was registered with PROSPERO (CRD42018109232). FINDINGS: Overall, 26 trials from 25 studies were included, of which 18 involved C sinensis, seven studied O viverrini, and one focused on O felineus. These trials included a total of 3340 participants. The two long-term treatment courses against C sinensis infection using 400 mg of albendazole (400 mg twice a day for 5 days and 400 mg twice a day for 7 days) resulted in cure rates of 100%, while two other multiple-dose regimens of albendazole resulted in high predicted cure rates: 300 mg twice a day for 5 days (93.9% [95% CI 49.6-99.6]) and 400 mg twice a day for 3 days (91.0% [50.9-99.0]). The WHO-recommended praziquantel regimen (25 mg/kg three times a day for 2 days) also showed a high predicted cure rate (98.5% [85.4-99.9]) in C sinensis infection, and predicted cure rates were above 90% for several other multiple-dose praziquantel regimens, including 20 mg/kg three times a day for 3 days (97.6% [74.7-99.8]), 14 mg/kg three times a day for 5 days (93.9% [44.8-99.7]), and 20 mg/kg twice a day for 3 days (91.0% [50.9-99.0]). In O viverrini infection, the regimen of 50 mg/kg and 25 mg/kg of praziquantel given in a single day showed the highest predicted cure rate (93.8% [85.7-97.5]), while a single dose of 50 mg/kg praziquantel also resulted in a high predicted cure rate (92.1% [64.9-98.6]). The single dose of 400 mg tribendimidine showed a high predicted cure rate of 89.8% (77.5-95.8). A low quality of evidence was demonstrated in most studies, especially those published before 2000. Selection bias due to poor random sequence generation and allocation concealment was high, and performance and detection biases were frequently unreported. INTERPRETATION: Praziquantel shows high efficacy against clonorchiasis and opisthorchiasis. Tribendimidine might serve as a treatment alternative and warrants further investigation. Although albendazole is efficacious when long treatment schedules (5 days or 7 days) are applied, limited size of studies and high risk of bias affect the interpretation of results. More high-quality studies are needed to promote the establishment of treatment guidelines for human liver fluke infection. FUNDING: Fourth Round of Three-Year Public Health Action Plan (2015-2017; Shanghai, China) and Swiss National Science Foundation

Bianchi Type I Massive String Magnetized Barotropic Perfect Fluid Cosmological Model in General Relativity

Bianchi type I massive string cosmological model with magnetic field of barotropic perfect fluid distribution through the techniques used by Latelier and Stachel, is investigated. To get the deterministic model of the universe, it is assumed that the universe is filled with barotropic perfect fluid distribution. The magnetic field is due to electric current produced along x-axis with infinite electrical conductivity. The behaviour of the model in presence and absence of magnetic field together with other physical aspects is further discussed.Comment: 10 pages, no figure. Chin. Phys. Lett., Vol. 24, No. 8 (2007), to appea

Smartphone-based, rapid, wide-field fundus photography for diagnosis of pediatric retinal diseases

PurposeAn important, unmet clinical need is for cost-effective, reliable, easy-to-use, and portable retinal photography to evaluate preventable causes of vision loss in children. This study presents the feasibility of a novel smartphone-based retinal imaging device tailored to imaging the pediatric fundus.MethodsSeveral modifications for children were made to our previous device, including a child-friendly 3D printed housing of animals, attention-grabbing targets, enhanced image stitching, and video-recording capabilities. Retinal photographs were obtained in children undergoing routine dilated eye examination. Experienced masked retina-specialist graders determined photograph quality and made diagnoses based on the images, which were compared to the treating clinician's diagnosis.ResultsDilated fundus photographs were acquired in 43 patients with a mean age of 6.7 years. The diagnoses included retinoblastoma, Coats' disease, commotio retinae, and optic nerve hypoplasia, among others. Mean time to acquire five standard photographs totaling 90-degree field of vision was 2.3 ± 1.1 minutes. Patients rated their experience of image acquisition favorably, with a Likert score of 4.6 ± 0.8 out of 5. There was 96% agreement between image-based diagnosis and the treating clinician's diagnosis.ConclusionsWe report a handheld smartphone-based device with modifications tailored for wide-field fundus photography in pediatric patients that can rapidly acquire fundus photos while being well-tolerated.Translational relevanceAdvances in handheld smartphone-based fundus photography devices decrease the technical barrier for image acquisition in children and may potentially increase access to ophthalmic care in communities with limited resources

Shallow geothermal energy potential for heating and cooling of buildings with regeneration under climate change scenarios

Shallow ground-source heat pumps (GSHPs) are a promising technology for contributing to the decarbonisation of the energy sector. In heating-dominated climates, the combined use of GSHPs for both heating and cooling increases their technical potential, defined as the maximum energy that can be exchanged with the ground, as the re-injection of excess heat from space cooling leads to a seasonal regeneration of the ground. This paper proposes a new approach to quantify the technical potential of GSHPs, accounting for effects of seasonal regeneration, and to estimate the useful energy to supply building energy demands at regional scale. The useful energy is obtained for direct heat exchange and for district heating and cooling (DHC) under several scenarios for climate change and market penetration levels of cooling systems. The case study in western Switzerland suggests that seasonal regeneration allows for annual maximum heat extraction densities above 300 kWh/m2 at heat injection densities above 330 kWh/m2. Results also show that GSHPs may cover up to 55% of heating demand while covering 57% of service-sector cooling demand for individual GSHPs in 2050, which increases to around 85% with DHC. The regional-scale results may serve to inform decision making on strategic areas for installing GSHPs

Modelling of COVID-19 Using Fractional Differential Equations

In this work, we have described the mathematical modeling of COVID-19 transmission using fractional differential equations. The mathematical modeling of infectious disease goes back to the 1760s when the famous mathematician Daniel Bernoulli used an elementary version of compartmental modeling to find the effectiveness of deliberate smallpox inoculation on life expectancy. We have used the well-known SIR (Susceptible, Infected and Recovered) model of Kermack & McKendrick to extend the analysis further by including exposure, quarantining, insusceptibility and deaths in a SEIQRDP model. Further, we have generalized this model by using the solutions of Fractional Differential Equations to test the accuracy and validity of the mathematical modeling techniques against Canadian COVID-19 trends and spread of real-world disease. Our work also emphasizes the importance of Personal Protection Equipment (PPE) and impact of social distancing on controlling the spread of COVID-19

Probing astrophysically important states in the ²⁶Mg nucleus to study neutron sources for the s process

Background: The ²²Ne(α,n) ²⁵Mg reaction is the dominant neutron source for the slow neutron capture process (s process) in massive stars, and contributes, together with C¹³(α,n)O¹⁶, to the production of neutrons for the s process in asymptotic giant branch (AGB) stars. However, the reaction is endothermic and competes directly with ²²Ne(α,γ)²⁶Mg radiative capture. The uncertainties for both reactions are large owing to the uncertainty in the level structure of ²⁶Mg near the α and neutron separation energies. These uncertainties affect the s-process nucleosynthesis calculations in theoretical stellar models. Purpose: Indirect studies in the past have been successful in determining the energies and the γ-ray and neutron widths of the Mg26 states in the energy region of interest. But, the high Coulomb barrier hinders a direct measurement of the resonance strengths, which are determined by the α widths for these states. The goal of the present experiments is to identify the critical resonance states and to precisely measure the α widths by α-transfer techniques. Methods: The α-inelastic scattering and α-transfer measurements were performed on a solid ²⁶Mg target and a ²²Ne gas target, respectively, using the Grand Raiden Spectrometer at the Research Center for Nuclear Physics in Osaka, Japan. The (α,α′) measurements were performed at 0.45°, 4.1°, 8.6°, and 11.1° and the (⁶Li,d) measurements at 0° and 10°. The scattered α particles and deuterons were detected by the focal plane detection system consisting of multiwire drift chambers and plastic scintillators. The focal plane energy calibration allowed the study of ²⁶Mg levels from Eₓ = 7.69–12.06 MeV in the (α,α′) measurement and Eₓ = 7.36–11.32 MeV in the (⁶Li,d) measurement. Results: Six levels (Eₓ = 10717, 10822, 10951, 11085, 11167, and 11317 keV) were observed above the α threshold in the region of interest (10.61–11.32 MeV). The α widths were calculated for these states from the experimental data. The results were used to determine the α-capture induced reaction rates. Conclusion: The energy range above the α threshold in ²⁶Mg was investigated using a high resolution spectrometer. A number of states were observed for the first time in α-scattering and α-transfer reactions. The excitation energies and spin-parities were determined. Good agreement is observed for previously known levels in ²⁶Mg. From the observed resonance levels the Eₓ = 10717 keV state has a negligible contribution to the α-induced reaction rates. The rates are dominated in both reaction channels by the resonance contributions of the states at Ex = 10951, 11167, and 11317 keV. The Eₓ = 11167 keV state has the most appreciable impact on the (α,γ) rate and therefore plays an important role in the prediction of the neutron production in s-process environments