604 research outputs found
Development and Characterization of Inorganic Materials with Energy Sector Applications
Four classes of materials with energy sector applications have been developed or characterized herein. Processing requirements that lead to a toughened carbon fiber reinforced silicon carbide ceramic matrix composite with a compliant and oxidation resistance boron nitride interface coating were developed. Preliminary experiments resulted in highly brittle composites when BN was applied by CVD to as-received fiber. This led to a requirement of heat treating the carbon fiber to favorably modify the fiber surface prior to BN deposition. The compound ammonia borane was investigated as a potential chemical hydrogen storage material for hydrogen fuel cell applications. Two known thermal decomposition steps which yield hydrogen gas, borazine impurities, and residual B-N inorganic polymers were corroborated by several techniques. A high temperature decomposition step leading to boron nitride, and an unreported gaseous impurity from the two known decomposition steps were identified. The reactivity of a γ-alumina supported, fcc cobalt (Co/Al2O3) catalyst was evaluated in a CO2/H2 feedstock for activity towards CO, methane, C2+ hydrocarbons and methanol. Comparable methane selectivites were obtained at low and high pressures. At low pressures the balance was composed mostly of CO while at high pressures the balance was composed mostly of C2+ hydrocarbons. This suggest CO2* is preferentially hydrogenated at higher pressures instead of dissociating to CO* and O*. The evolution of the catalyst composition and structure during fabrication was tracked by a several techniques. The acid/base character of CO2(g) specifically towards exterior framework surfaces (to the exclusion of tunnel sites) on the manganese oxide octahedral molecular sieve OMS-2, was measured using synchrotron based soft X-Ray photoelectron spectroscopy. In addition to fundamental interest, the adsorption of CO2 on OMS-2 has direct relevance to several energy sector applications. CO2 is often considered to be a Lewis acid probe for surface basicity, but may also exhibit basic character towards acidic surface sites. Measurements of surface acidity and basicity aid in the determination of how these properties dictate the activity and selectivity of a heterogenous catalyst towards any given reaction
Effect of statins on venous thromboembolic events: a meta-analysis of published and unpublished evidence from randomised controlled trials
Background - It has been suggested that statins substantially reduce the risk of venous thromboembolic events. We sought to test this hypothesis by performing a meta-analysis of both published and unpublished results from randomised trials of statins.
Methods and Findings - We searched MEDLINE, EMBASE, and Cochrane CENTRAL up to March 2012 for randomised controlled trials comparing statin with no statin, or comparing high dose versus standard dose statin, with 100 or more randomised participants and at least 6 months' follow-up. Investigators were contacted for unpublished information about venous thromboembolic events during follow-up. Twenty-two trials of statin versus control (105,759 participants) and seven trials of an intensive versus a standard dose statin regimen (40,594 participants) were included. In trials of statin versus control, allocation to statin therapy did not significantly reduce the risk of venous thromboembolic events (465 [0.9%] statin versus 521 [1.0%] control, odds ratio [OR] = 0.89, 95% CI 0.78–1.01, p = 0.08) with no evidence of heterogeneity between effects on deep vein thrombosis (266 versus 311, OR 0.85, 95% CI 0.72–1.01) and effects on pulmonary embolism (205 versus 222, OR 0.92, 95% CI 0.76–1.12). Exclusion of the trial result that provided the motivation for our meta-analysis (JUPITER) had little impact on the findings for venous thromboembolic events (431 [0.9%] versus 461 [1.0%], OR = 0.93 [95% CI 0.82–1.07], p = 0.32 among the other 21 trials). There was no evidence that higher dose statin therapy reduced the risk of venous thromboembolic events compared with standard dose statin therapy (198 [1.0%] versus 202 [1.0%], OR = 0.98, 95% CI 0.80–1.20, p = 0.87). Risk of bias overall was small but a certain degree of effect underestimation due to random error cannot be ruled out.
Please see later in the article for the Editors' Summary.
Conclusions - The findings from this meta-analysis do not support the previous suggestion of a large protective effect of statins (or higher dose statins) on venous thromboembolic events. However, a more moderate reduction in risk up to about one-fifth cannot be ruled out
CV3 THE IMPACT OF PROTON PUMP INHIBITORS ON CARDIOVASCULARRELATED EVENT COSTS IN PATIENTS INITIATING CLOPIDOGREL
Operationalizing NIMH Research Domain Criteria (RDoC) in naturalistic clinical settings
Recently, the National Institute of Mental Health (NIMH) introduced the Research Domain Criteria (RDoC) initiative to address two major challenges facing the field of psychiatry: (1) the lack of new effective personalized treatments for psychiatric disorders, and (2) the limitations associated with categorically-defined psychiatric disorders. While the potential of RDoC to revolutionize personalized psychiatric medicine and psychiatric nosology has been acknowledged, it is unclear how to implement RDoC in naturalistic clinical settings as part of routine outcomes research. In this paper we present the major RDoC principles and then show how these principles are operationalized in the Menninger Clinic’s McNair Initiative for Neuroscience Discovery-Menninger & Baylor College of Medicine (MIND-MB) study. We discuss how RDoC-informed outcomes-based assessment in clinical settings can transform personalized clinical care through multimodal treatments
Secukinumab demonstrates superiority over narrow-band ultraviolet B phototherapy in new-onset moderate to severe plaque psoriasis patients: Week 52 results from the STEPIn study.
Biologic treatments have been studied mainly in patients with a long-term history of psoriasis and previous treatment failures.
The purpose of this primary analysis of the STEPIn study is to determine whether early intervention with secukinumab in patients with new-onset moderate to severe plaque psoriasis is superior to standard of care treatment with narrow band ultraviolet B (nb-UVB) phototherapy.
The STEPIn study is a randomized, open-label, multicentre study to investigate early intervention with 52 weeks of secukinumab 300 mg administered subcutaneously versus standard treatment with nb-UVB phototherapy in patients with new-onset (≤12 months) moderate to severe plaque psoriasis (NCT03020199). The primary and additional secondary endpoints were ≥90% improvement in Psoriasis Area and Severity Index (PASI 90) at Week 52 and Investigator's Global Assessment (IGA mod 2011) 0/1 response at Week 52, respectively.
In the secukinumab and nb-UVB study arms, 77/80 and 76/80 randomized patients received at least one dose of study treatment, respectively. The primary endpoint was achieved: 91.1% (70/77) of patients achieved a PASI 90 response at Week 52 in the secukinumab arm versus 42.3% (32/76) in the nb-UVB arm (p < 0.0001, odds ratio [OR] estimate [95% confidence intervals, CI] = 16.3 [5.6, 46.9]). The additional secondary endpoint was also achieved: 85.7% of patients achieved an IGA 0/1 response at Week 52 in the secukinumab arm versus 36.8% in the nb-UVB arm (p < 0.0001). The safety data were consistent with the safety profiles of secukinumab and nb-UVB with no new or unexpected safety signals.
Secukinumab was superior to nb-UVB in treating patients with new-onset moderate to severe plaque psoriasis. The high and sustained skin clearance observed indicates that biologic treatment for psoriasis may be more effective if used early in the disease course
Plasma metabolite profile for primary open-angle glaucoma in three US cohorts and the UK Biobank
Glaucoma is a progressive optic neuropathy and a leading cause of irreversible blindness worldwide. Primary open-angle glaucoma is the most common form, and yet the etiology of this multifactorial disease is poorly understood. We aimed to identify plasma metabolites associated with the risk of developing POAG in a case-control study (599 cases and 599 matched controls) nested within the Nurses' Health Studies, and Health Professionals' Follow-Up Study. Plasma metabolites were measured with LC-MS/MS at the Broad Institute (Cambridge, MA, USA); 369 metabolites from 18 metabolite classes passed quality control analyses. For comparison, in a cross-sectional study in the UK Biobank, 168 metabolites were measured in plasma samples from 2,238 prevalent glaucoma cases and 44,723 controls using NMR spectroscopy (Nightingale, Finland; version 2020). Here we show higher levels of diglycerides and triglycerides are adversely associated with glaucoma in all four cohorts, suggesting that they play an important role in glaucoma pathogenesis
Disseminating Evidence-Based Practices for Adults With PTSD and Severe Mental Illness in Public-Sector Mental Health Agencies
Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mental illnesses (SMI). The treatment of psychotic symptoms usually takes precedence in the care of adults with SMI. Such oversight is problematic in that PTSD in SMI populations is common (19-43%), contributes a significant illness burden, and hinders mental health care. Yet, few public-sector mental health agencies routinely provide specialized services for PTSD. The purpose of the paper is to describe strategies and efforts to disseminate trauma-focused empirically-based practices (EBPs) in a public-sector mental health system. Identified challenges include limited resources and commitment; knowledge deficits, attitudes, and biases; and limited practice accountability at provider, facility, and system levels. Proposed strategies for overcoming these challenges are: set clear goals; nurture broad-based organizational commitment and key stakeholder involvement; implement specialty training efforts to provide information and change attitudes; provide on-going supervision; conduct fidelity monitoring; and ensure accountability to the extent possible
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