Maintaining real-time precise point positioning during outages of orbit and clock corrections

The precise point positioning (PPP) is a popular positioning technique that is dependent on the use of precise orbits and clock corrections. One serious problem for real-time PPP applications such as natural hazard early warning systems and hydrographic surveying is when a sudden communication break takes place resulting in a discontinuity in receiving these orbit and clock corrections for a period that may extend from a few minutes to hours. A method is presented to maintain real-time PPP with 3D accuracy less than a decimeter when such a break takes place. We focus on the open-access International GNSS Service (IGS) real-time service (RTS) products and propose predicting the precise orbit and clock corrections as time series. For a short corrections outage of a few minutes, we predict the IGS-RTS orbits using a high-order polynomial, and for longer outages up to 3 h, the most recent IGS ultra-rapid orbits are used. The IGS-RTS clock corrections are predicted using a second-order polynomial and sinusoidal terms. The model parameters are estimated sequentially using a sliding time window such that they are available when needed. The prediction model of the clock correction is built based on the analysis of their properties, including their temporal behavior and stability. Evaluation of the proposed method in static and kinematic testing shows that positioning precision of less than 10 cm can be maintained for up to 2 h after the break. When PPP re-initialization is needed during the break, the solution convergence time increases; however, positioning precision remains less than a decimeter after convergence

Hybrid Wavelet and Principal Component Analyses Approach for Extracting Dynamic Motion Characteristics from Displacement Series Derived from Multipath-Affected High-Rate GNSS Observations

Nowadays, the high rate GNSS (Global Navigation Satellite Systems) positioning methods are widely used as a complementary tool to other geotechnical sensors, such as accelerometers, seismometers, and inertial measurement units (IMU), to evaluate dynamic displacement responses of engineering structures. However, the most common problem in structural health monitoring (SHM) using GNSS is the presence of surrounding structures that cause multipath errors in GNSS observations. Skyscrapers and high-rise buildings in metropolitan cities are generally close to each other, and long-span bridges have towers, main cable, and suspender cables. Therefore, multipath error in GNSS observations, which is typically added to the measurement noise, is inevitable while monitoring such flexible engineering structures. Unlike other errors like atmospheric errors, which are mostly reduced or modeled out, multipath errors are the largest remaining unmanaged error sources. The high noise levels of high-rate GNSS solutions limit their structural monitoring application for detecting load-induced semi-static and dynamic displacements. This study investigates the estimation of accurate dynamic characteristics (frequency and amplitude) of structural or seismic motions derived from multipath-affected high-rate GNSS observations. To this end, a novel hybrid model using both wavelet-based multiscale principal component analysis (MSPCA) and wavelet transform (MSPCAW) is designed to extract the amplitude and frequency of both GNSS relative- and PPP- (Precise Point Positioning) derived displacement motions. To evaluate the method, a shaking table with a GNSS receiver attached to it, collecting 10 Hz data, was set up close to a building. The table was used to generate various amplitudes and frequencies of harmonic motions. In addition, 50-Hz linear variable differential transformer (LVDT) observations were collected to verify the MSMPCAW model by comparing their results. The results showed that the MSPCAW could be efficiently used to extract the dynamic characteristics of noisy dynamic movements under seismic loads. Furthermore, the dynamic behavior of seismic motions can be extracted accurately using GNSS-PPP, and its dominant frequency equals that extracted by LVDT and relative GNSS positioning method. Its accuracy in determining the amplitude approaches 91.5% relative to the LVDT observations

On biases in precise point positioning with multi-constellation and multi-frequency GNSS data

© 2016 IOP Publishing Ltd. Various types of biases in Global Navigation Satellite System (GNSS) data preclude integer ambiguity fixing and degrade solution accuracy when not being corrected during precise point positioning (PPP). In this contribution, these biases are first reviewed, including satellite and receiver hardware biases, differential code biases, differential phase biases, initial fractional phase biases, inter-system receiver time biases, and system time scale offset. PPP models that take account of these biases are presented for two cases using ionosphere-free observations. The first case is when using primary signals that are used to generate precise orbits and clock corrections. The second case applies when using additional signals to the primary ones. In both cases, measurements from single and multiple constellations are addressed. It is suggested that the satellite-related code biases be handled as calibrated quantities that are obtained from multi-GNSS experiment products and the fractional phase cycle biases obtained from a network to allow for integer ambiguity fixing. Some receiver-related biases are removed using between-satellite single differencing, whereas other receiver biases such as inter-system biases are lumped with differential code and phase biases and need to be estimated. The testing results show that the treatment of biases significantly improves solution convergence in the float ambiguity PPP mode, and leads to ambiguity-fixed PPP within a few minutes with a small improvement in solution precision

Próteses parciais fixas reforçadas por fibras: um estudo clínico retrospectivo preliminar

The aim of this study was to evaluate the clinical performance (retention rate) of fiber-reinforced composite fixed partial dentures (FPDs). Polyethylene fiber (Ribbond®) was used combined with restorative composite during FPDs fabrication. FPDs were placed in thirteen patients in a private clinic. Nineteen FPDs were evaluated. The prosthetic space was filled with only one pontic using extracted teeth (2 cases), acrylic resin teeth (11 cases), or with composite resin (6 cases), combined with Polyethylene fiber. The clinical criterion used was based on retention rate of FPDs. If FPDs were in function in the mouth at the time of examination without previous repair they were classified as Complete Survival (CS) restorations. A classification of Survival with Rebonding (SR) was assigned in the event of an adhesive failure, but after rebonding the FPD still remained under evaluation. Treatment was classified as a Failure (F) if the FPD restoration was lost. The time of evaluation was 41.15 months (±15.13). The FPDs evaluated were retained (CS=94.75%), and no failure was found except for in one situation which required rebonding (SR=5.25%). According to the survival estimation method of Kaplan-Meyer the mean survival time was 42.3 months. At the time of evaluation investigated, polyethylene-reinforced FPDs showed a favorable retention rate in preliminary data.O objetivo deste estudo foi avaliar a performance clínica (percentagem de retenção) de próteses parciais fixas reforçadas por fibras. Fibras de polietileno (Ribbond®) foram usadas em combinação com resina composta durante a confecção das próteses. Os tratamentos foram realizadas em 13 pacientes, em uma clínica privada., sendo que 19 próteses foram reavaliadas. O espaço protético era preenchido com um pôntico usando o próprio dente extraído (2 casos), dentes de acrílico (11 casos) ou confeccionados com resina composta (6 casos), em todas as situações eram empregadas fibras de polietileno. Os critérios clínicos usados foram baseados na percentagem de retenção das próteses parciais fixas. As próteses que estavam em função no momento da avaliação, sem nunca necessitar de qualquer reparo prévio, foram classificadas como sobrevivência completa (SC). A classificação de sobrevivência com nova colagem (SR) foi utilizada para os casos de falha adesiva, com posterior cimentação da peça, a qual permanecia em função. O tratamento era classificado como falha (F) quando a restauração era perdida. O tempo médio de avaliação foi de 41,15 meses (±15,13). Nenhum caso de falha foi detectado, em apenas um caso houve falha adesiva com posterior colagem da peça (SR=5,25%) e em 94.75% dos casos as próteses permaneciam em função.. De acordo com o método de sobrevida de Kaplan-Meyer o tempo médio de sobrevida foi de 42,3 meses. As próteses parciais fixas reforçadas por fibras mostraram uma percentagem de retenção favorável neste estudo preliminar

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

What Is New for an Old Molecule? Systematic Review and Recommendations on the Use of Resveratrol

Stilbenes are naturally occurring phytoalexins that generally exist as their more stable E isomers. The most well known natural stilbene is resveratrol (Res), firstly isolated in 1939 from roots of Veratrum grandiflorum (white hellebore) (1) and since then found in various edible plants, notably in Vitis vinifera L. (Vitaceae) (2). The therapeutic potential of Res covers a wide range of diseases, and multiple beneficial effects on human health such as antioxidant, anti-inflammatory and anti-cancer activities have been suggested based on several in vitro and animal studies (3). In particular, Res has been reported to be an inhibitor of carcinogenesis at multiple stages via its ability to inhibit cyclooxygenase, and is an anticancer agent with a role in antiangiogenesis (4). Moreover, both in vitro and in vivo studies showed that Res induces cell cycle arrest and apoptosis in tumor cells (4). However, clinical studies in humans evidenced that Res is rapidly absorbed after oral intake, and that the low level observed in the blood stream is caused by a fast conversion into metabolites that are readily excreted from the body (5). Thus, considerable efforts have gone in the design and synthesis of Res analogues with enhanced metabolic stability. Considering that reduced Res (dihydro- resveratrol, D-Res) conjugates may account for as much as 50% of an oral Res dose (5), and that D-Res has a strong proliferative effect on hormone-sensitive cancer cell lines such as breast cancer cell line MCF7 (6), we recently devoted our synthetic efforts to the preparation of trans-restricted analogues of Res in which the E carbon-carbon double bond is embedded into an imidazole nucleus. To keep the trans geometry, the two aryl rings were linked to the heteroaromatic core in a 1,3 fashion. Based on this design, we successfully prepared a variety of 1,4-, 2,4- and 2,5-diaryl substituted imidazoles including Res analogues 1, 2 and 3, respectively, by procedures that involve transition metal-catalyzed Suzuki-Miyaura cross-coupling reactions and highly selective N-H or C-H direct arylation reactions as key synthetic steps. The anticancer activity of compounds 1–3 was evaluated against the 60 human cancer cell lines panel of the National Cancer Institute (NCI, USA). The obtained results, that will be showed and discussed along with the protocols developed for the preparation of imidazoles 1–3, confirmed that a structural optimization of Res may provide analogues with improved potency in inhibiting the growth of human cancer cell lines in vitro when compared to their natural lead. (1) Takaoka,M.J.Chem.Soc.Jpn.1939,60,1090-1100. (2) Langcake, P.; Pryce, R. J. Physiological. Plant Patology 1976, 9, 77-86. (3) Vang, O.; et al. PLoS ONE 2011, 6, e19881. doi:10.1371/journal.pone.0019881 (4) Kraft, T. E.; et al. Critical Reviews in Food Science and Nutrition 2009, 49, 782-799. (5) Walle, T. Ann. N.Y. Acad. Sci. 2011, 1215, 9-15. doi: 10.1111/j.1749-6632.2010.05842.x (6) Gakh,A.A.;etal.Bioorg.Med.Chem.Lett.2010,20,6149-6151

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

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&lt;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&lt;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