A comparative cost-effectiveness analysis of mechanical and pharmacological VTE prophylaxis after lower limb arthroplasty in Australia

Background Venous thromboembolism (VTE) is a complication following surgery. Low-molecular-weight heparin (LMWH) or direct oral anticoagulants (DOACs) are efficacious but come with inherent bleeding risk. Mechanical prophylaxis, such as intermittent pneumatic compression (IPC), does not induce bleeding but may be difficult to implement beyond the immediate post-operative period. This study compared the cost and quality-adjusted life years (QALYs) saved of commonly used VTE prophylaxis regimens after lower limb arthroplasty. Methods A previously published cost-utility model considering major efficacy and safety endpoints was updated to estimate the 1-year cost-effectiveness of different VTE prophylaxis regimens. The VTE strategies assessed included apixaban, dabigatran, rivaroxaban, LMWH, IPC, IPC + LMWH and IPC + apixaban. Efficacy data were derived from studies in PubMed, and cost data came from the 2017 Australian AR-DRG and PBS pricing schemes. Results Costs for VTE prophylaxis including treatment of its associated complications over the first year after surgery ranged from AUD $644 (IPC) to AUD$956 (rivaroxaban). Across 500 simulations, IPC was the cheapest measure in 73% of simulations. In 97% of simulations, a DOAC was associated with the highest resulting QALYs. Compared to IPC, apixaban was cost-effective in 76.4% of simulations and apixaban + IPC in 87.8% of simulations. For VTE events avoided, the DOACs and IPC were on par. LMWH and LMWH + IPC were negatively dominated. Conclusions Apixaban, IPC or a sequential/simultaneous combination of both is currently the most cost-effective VTE prophylaxis regimens. The choice between them is best guided by the relative VTE and bleeding risks of individual patients

Magnetic Reconnection, Cosmic Ray Acceleration, and Gamma-Ray emission around Black Holes and Relativistic Jets

Particle acceleration by magnetic reconnection is now recognized as an important process in magnetically dominated regions of galactic and extragalactic black hole sources. This process helps to solve current puzzles specially related to the origin of the very high energy flare emission in these sources. In this review, we discuss this acceleration mechanism and show recent analytical studies and multidimensional numerical SRMHD and GRMHD (special and general relativistic magnetohydrodynamical) simulations with the injection of test particles, which help us to understand this process both in relativistic jets and coronal regions of these sources. The very high energy and neutrino emission resulting from the accelerated particles by reconnection is also discussed.Comment: Invited Review at the International Conference on Black Holes as Cosmic Batteries: UHECRs and Multimessenger Astronomy - BHCB2018, 12-15 September, 2018, Foz du Iguazu, Brasil, in press in Procs. of Science. arXiv admin note: text overlap with arXiv:1608.0317

Probing the Dzyaloshinskii-Moriya interaction in CoFeB ultrathin films using domain wall creep and Brillouin light spectroscopy

We have characterized the strength of the interfacial Dyzaloshinskii-Moriya interaction (DMI) in ultrathin perpendicularly magnetized CoFeB/MgO films, grown on different underlayers of W, TaN, and Hf, using two experimental methods. First, we determined the effective DMI field from measurements of field-driven domain wall motion in the creep regime, where applied in-plane magnetic fields induce an anisotropy in the wall propagation that is correlated with the DMI strength. Second, Brillouin light spectroscopy was employed to quantify the frequency non-reciprocity of spin waves in the CoFeB layers, which yielded an independent measurement of the DMI. By combining these results, we show that DMI estimates from the different techniques only yield qualitative agreement, which suggests that open questions remain on the underlying models used to interpret these results.Comment: 8 page

Análisis de la superficie de cultivo para la producción de bioplásticos

El presente trabajo establece el potencial de mercado de los Bioplásticos (BPL), en tres escenarios: Escenario CB (crecimiento bajo), Escenario CM (crecimiento medio) y Escenario CR (crecimiento rápido). El objetivo final es Obtener las superficies de cultivo necesarias para satisfacer la demanda de las empresas productoras de BPL, según los tres escenarios. Las regiones geográficas estudiadas son: La Unión Europea (UE-27), Estados Unidos (EE.UU) y la región de Asia-Pacífico, entendiéndose, que esta última región comprende la parte del Centro, Este y Sur de Asia, además de Australia y Nueva Zelanda. Son las principales zonas donde se encuentran las empresas productoras de los BPL estudiados. Más del 95% de los BPL son elaborados en estas regiones. Se han realizado tres proyecciones para los años 2010, 2015 y 2020

Capsule endoscopy in Crohn’s disease surveillance: A monocentric, retrospective analysis in Italy

Background: Crohn’s disease (CD) is a potentially debilitating condition that burdens Italian healthcare substantially. The symptomatic management relies on prompt therapy adjustment to reduce flares and follow-up diagnostic inputs to maximise remission. Capsule endoscopy (CE) has introduced advantages in CD diagnostics, allowing the direct inspection of the entire gastrointestinal mucosa. The diagnostic procedure is comparable in effort to standard ileocolonoscopy (IC) but requires no anaesthesia. Whether CE follow-up improves clinical outcomes remains to be defined. Objectives: To provide a preliminary evaluation of CE in terms of clinical outcomes with respect to the standard of care ileocolonoscopy/MRE in Italy. Methods: This retrospective analysis utilises anonymised, monocentric data from the S. Orsola-Malpighi Hospital IBD database in Bologna, Italy, collected between 1999 and 2019. Out of 421 adult patient records, 100 were included in the analysis (50 per arm, matched per demographic and clinical characteristics). The CE represented the intervention arm, whereas ileocolonoscopy/magnetic resonance enterography was the standard of care. The use of biologics, symptomatology course, and surgery were the outcomes. Results: The two techniques performed similarly overall. In general, no significant difference emerged in the use of biologics. The use of biologics appears reduced in the CE group, only in L4 patients after the first follow-up year. Similarly, surgery was seemingly less frequent among L4 patients in the CE group. No difference was found between groups in flare occurrence and duration. CE patients might have experienced longer and earlier first remissions, but no long-term difference persisted. Conclusions: The CE group showed an apparent reduction in biologics and surgery, limiting to L4 diagnoses. More extensive, prospective, multicentre, randomised studies must corroborate these preliminary findings

Implications of X-Ray Line Variations for 4U1822-371

4U 1822-371 is one of the proto-type accretion disk coronal sources with an orbital period of about 5.6 hours. The binary is viewed almost edge-on at a high inclination angle of 83 degrees, which makes it a unique candidate to study binary orbital and accretion disk dynamics in high powered X-ray sources. We observed the X-ray source in 4U 1822-371 with the Chandra High Energy Transmission Grating Spectrometer (HETGS) for almost nine binary orbits. X-ray eclipse times provide an update of the orbital ephemeris. We find that our result follows the quadratic function implied by previous observations; however, it suggests a flatter trend. Detailed line dynamics also confirm a previous suggestion that the observed photo-ionized line emission originates from a confined region in the outer edge of the accretion disk near the hot spot. Line properties allow us to impose limits on the size of accretion disk, the central corona, and the emission region. The photo-ionized plasma is consistent with ionization parameters of log(xi) > 2, and when combined with disk size and reasonable assumptions for the plasma density, this suggests illuminating disk luminosities which are over an order of magnitude higher than what is actually observed. That is, we do not directly observe the central emitting X-ray source. The spectral continua are best fit by a flat power law with a high energy cut-off and partial covering absorption (N_H ranging from 5.4-6.3x10^{22} cm^{-2}) with a covering fraction of about 50%. We discuss some implications of our findings with respect to the photo-ionized line emission for the basic properties of the X-ray source.Comment: Submitted to the Astrophysical Journa

Microscopic reversal magnetization mechanisms in CoCrPt thin films with perpendicular magnetic anisotropy: Fractal structure versus labyrinth stripe domains

The magnetization reversal of CoCrPt thin films has been examined as a function of thickness using magneto-optical Kerr effect (MOKE) microscopy and first-order reversal curves (FORC) techniques. MOKE images show differentiated magnetization reversal regimes for different film thicknesses: while the magnetic domains in 10-nm-thick CoCrPt film resemble a fractal structure, a labyrinth stripe domain configuration is observed for 20-nm-thick films. Although FORC distributions for both cases show two main features related to irreversible processes (propagation and annihilation fields) separated by a mostly flat region, this method can nonetheless distinguish which magnetization reversal process is active according to the horizontal profile of the first FORC peak, or propagation field. A single-peak FORC profile corresponds to the fractal magnetization reversal, whereas a flat-peak FORC profile corresponds to the labyrinth magnetization reversal

Microscopic reversal magnetization mechanisms in CoCrPt thin films with perpendicular magnetic anisotropy: fractal structure versus labyrinth stripe domains

Sem informaçãoThe magnetization reversal of CoCrPt thin films has been examined as a function of thickness using magneto-optical Kerr effect (MOKE) microscopy and first-order reversal curves (FORC) techniques. MOKE images show differentiated magnetization reversal regimes for different film thicknesses: while the magnetic domains in 10-nm-thick CoCrPt film resemble a fractal structure, a labyrinth stripe domain configuration is observed for 20-nm-thick films. Although FORC distributions for both cases show two main features related to irreversible processes (propagation and annihilation fields) separated by a mostly flat region, this method can nonetheless distinguish which magnetization reversal process is active according to the horizontal profile of the first FORC peak, or propagation field. A single-peak FORC profile corresponds to the fractal magnetization reversal, whereas a flat-peak FORC profile corresponds to the labyrinth magnetization reversal.961815Sem informaçãoSem informaçãoSem informaçãoThis work was supported by Spanish Grants No. AEI FIS2013-45469 and No. AEI FIS2016-76058, and UE FEDER “Una manera de hacer Europa”, the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie Grant Agreement No. 734801. D.N. thanks Fundaçao para a Ciência e Tecnologia (Contract No. IF/01191/2013) for financial support

Unidirectional Thermal Effects in Current-Induced Domain Wall Motion

We report experimental evidence of thermal effects on the displacement of vortex walls in NiFe nanostrips. With the use of nanosecond current pulses, a unidirectional motion of the magnetic domain walls towards the hotter part of the nanostrips is observed, in addition to current-induced domain wall motion. By tuning the heat dissipation in the samples and modeling the heat diffusion, we conclude that this unidirectional motion can only be explained by the presence of a temperature profile along the nanostrip. A quantitative analysis of the experiments shows that, on top of the classical thermodynamic pressure on the domain wall, another force, probably the magnonic spin Seebeck effect, is displacing the domain walls.Fil: Torrejon, J.. Centre National de la Recherche Scientifique; FranciaFil: Malinowski, G.. Centre National de la Recherche Scientifique; FranciaFil: Pelloux, M.. Centre National de la Recherche Scientifique; FranciaFil: Weil, R.. Centre National de la Recherche Scientifique; FranciaFil: Thiaville, A.. Centre National de la Recherche Scientifique; FranciaFil: Curiale, Carlos Javier. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte; ArgentinaFil: Lacour, D.. Centre National de la Recherche Scientifique; FranciaFil: Montaigne, F.. Centre National de la Recherche Scientifique; FranciaFil: Hehn, M.. Centre National de la Recherche Scientifique; Franci