Estimating Multiattribute Spatial Choice Models

In this paper, an interactive computer program for estimating the parameters of spatial choice models with multiattribute utilities is presented. The models to be calibrated may be unconstrained, singly constrained, or doubly constrained random utility choice or entropy-maximizing interaction models. Utilities may be associated with choice alternatives (zones) or with the choices themselves (trips). The program maximizes the likelihood of the choice matrix (trip table) given observed choices (trips) using a combination of gradient search and Newton-Raphson iteration methods. The paper contains a specification of the range of models that can be calibrated with the program and a description of its solution algorithm and organization, as well as an illustrative application and a listing of the source code

On the equivalence of Lambda(t) and gravitationally induced particle production cosmologies

The correspondence between cosmological models powered by a decaying vacuum energy density and gravitationally induced particle production is investigated. Although being physically different in the physics behind them we show that both classes of cosmologies under certain conditions can exhibit the same dynamic and thermodynamic behavior. Our method is applied to obtain three specific models that may be described either as Lambda(t)CDM or gravitationally induced particle creation cosmologies. In the point of view of particle production models, the later class of cosmologies can be interpreted as a kind of one-component unification of the dark sector. By using current type Ia supernovae data, recent estimates of the cosmic microwave background shift parameter and baryon acoustic oscillations measurements we also perform a statistical analysis to test the observational viability within the two equivalent classes of models and we obtain the best-fit of the free parameters. By adopting the Akaike information criterion we also determine the rank of the models considered here. Finally, the particle production cosmologies (and the associated decaying Lambda(t)-models) are modeled in the framework of field theory by a phenomenological scalar field model.Comment: 9 pages, 3 figures, new comments and 8 references added. Accepted for publication in Physics Letters

Health advantages of transition to batch management system in farrow-to-finish pig herds

Sow batch management systems have become more popular due to advantages in labour planning, piglet batch sizes, all-in all-out practices and health management. The present study investigated the potential health advantages of 10 selected farrow-to-finish pig herds before and after transition from a one week batch management system to a four or five week batch management system. Five different animal categories (gilts, sows, piglets, growers and finishers) were sampled at three time points (T0, T1 and T2) before and after transition to a four or five week batch management system. Different matrices of the animals were collected: blood, nasal swabs and faeces. Several economically important diseases were monitored through serology: Lawsonia intracellularis, Porcine Reproductive and Respiratory Syndrome virus (PRRSv), Mycoplasma hyopneumoniae, Actinobacillus pleuropneurnoniae; and PCR-testing: Pasteurella multocida dermonecrotic toxin (DNT) and Brachyspira species, especially the major pathogenic Brachyspira hyodysenteriae. Following serological analysis, the percentage of positive animals per category and sampling occasion were calculated. Health improvement based on serology was defined as the reduction in the percentage of positive animals for a specific disease in a specified animal category. All samples were negative for P. multocida DNT and B. hyodysenteriae. Little to no improvement could be observed for PRRSv. For L. intracellularis an improvement could be observed in piglets (71%) and growers (56%; P < 0.05). For both of the respiratory pathogens, M. hyopneumoniae and A. pleuropneumoniae, significant improvement was observed in finishers (34 and 24%, respectively). In growers, only M. hyopneumoniae showed a significant improvement (34%). In conclusion, the transition from a one week batch management system to a four or five week batch management system in the present herds resulted in a reduction of the percentage of seropositive animals for three of the monitored economically important diseases: L. intracellularis, M. hyopneumoniae and A. pleuropneumoniae

Weak solutions for nonlinear fractional differential equations on reflexive Banach spaces

The aim of this paper is to investigate a class of boundary value problem for fractional differential equations involving nonlinear integral conditions. The main tool used in our considerations is the technique associated with measures of weak noncompactness

Inhibiting tryptophan metabolism enhances interferon therapy in kidney cancer.

Renal cell carcinoma (RCC) is increasing in incidence, and a complete cure remains elusive. While immune-checkpoint antibodies are promising, interferon-based immunotherapy has been disappointing. Tryptophan metabolism, which produces immunosuppressive metabolites, is enhanced in RCC. Here we show indolamine-2,3-dioxygenase-1 (IDO1) expression, a kynurenine pathway enzyme, is increased not only in tumor cells but also in the microenvironment of human RCC compared to normal kidney tissues. Neither kynurenine metabolites nor IDO inhibitors affected the survival or proliferation of human RCC or murine renal cell adenocarcinoma (RENCA) cells in vitro. However, interferon-gamma (IFNγ) induced high levels of IDO1 in both RCC and RENCA cells, concomitant with enhanced kynurenine levels in conditioned media. Induction of IDO1 by IFNα was weaker than by IFNγ. Neither the IDO1 inhibitor methyl-thiohydantoin-DL-tryptophan (MTH-trp) nor IFNα alone inhibited RENCA tumor growth, however the combination of MTH-trp and IFNα reduced tumor growth compared to IFNα. Thus, the failure of IFNα therapy for human RCC is likely due to its inability to overcome the immunosuppressive environment created by increased IDO1. Based on our data, and given that IDO inhibitors are already in clinical trials for other malignancies, IFNα therapy with an IDO inhibitor should be revisited for RCC

Therapeutic anticoagulation complications in the elderly: a case report

Background: The demographic transition leads to a continuously growing number of elderly patients who receive therapeutic anticoagulation by reason of several comorbidities. Though therapeutic anticoagulation may reduce the number of embolic complications in these patients, major complications such as bleeding complications need to be kept in mind when considering such therapy. However, evidence regarding the choice of anticoagulation agents in chronic kidney disease patients of higher age is limited. In this report, a guideline-based anticoagulation treatment which led to a fulminant atraumatic bleeding complication is discussed. Case presentation: We present the case of an 85-year-old female stage V chronic kidney disease patient who suffered from a diffuse arterial, subcutaneous bleeding in her lower left leg due a therapeutic anticoagulation using low molecular weight heparin (LMWH). Anticoagulation was started in accordance with general recommendations for patients with atrial fibrillation, and the dosage was adapted for the patient's renal function. Nevertheless, the above-mentioned complication occurred, and the bleeding led to a hemorrhagic shock and an acute kidney injury on top of a chronic kidney disease. The hematoma required surgical evacuation and local coagulation in the operating room. In the further course, the patient underwent additional four surgical interventions due to a superinfected skin necrosis, including skin grafting. Furthermore, the patient needed continuous renal replacement therapy, as well as intensive care unit treatment, for a total of 47 days followed by 36 days of geriatric rehabilitation. Afterwards, she was discharged from the hospital to her previous nursing home. Discussion and conclusions: Although therapeutic anticoagulation may sufficiently protect patients at cardiovascular risk, major complications such as bleeding complications may occur at any time. Therefore, physicians need to regularly re-evaluate any prior indication for therapeutic anticoagulation. With this case report, we hope to draw attention to the cohort of geriatric patients and the need for more and well differentiated study settings to preferably prevent any potentially avoidable complications

Comparing Perioperative Outcome Measures of the Dynamic Hip Screw and the Femoral Neck System

Background and Objective: Various fixation devices and surgical techniques are available for the management of proximal femur fractures. Recently, the femoral neck system (FNS) was introduced, and was promoted on the basis of less invasiveness, shorter operating time, and less fluoroscopy time compared to previous systems. The aim of this study was to compare two systems for the internal fixation of femoral neck fractures (FNF), namely the dynamic hip screw (DHS) with an anti-rotation screw (ARS) and an FNS. The outcome measures included operating room time (ORT), dose–area product (DAP), length of stay (LOS), perioperative changes in haemoglobin concentrations, and transfusion rate. Materials and Methods: A retrospective single-centre study was conducted. Patients treated for FNF between 1 January 2020 and 30 September 2021 were included, provided that they had undergone closed reduction and internal fixation. We measured the centrum-collum-diaphyseal (CCD) and the Pauwels angle preoperatively and one week postoperatively. Results: In total, 31 patients (16 females), with a mean age of 62.81 ± 15.05 years, were included. Fracture complexity assessed by the Pauwels and Garden classification did not differ between groups preoperatively. Nonetheless, the ORT (54 ± 26.1 min vs. 91.68 ± 23.96 min, p < 0.01) and DAP (721 ± 270.6 cGycm² vs. 1604 ± 1178 cGycm², p = 0.03) were significantly lower in the FNS group. The pre- and postoperative CCD and Pauwels angles did not differ statistically between groups. Perioperative haemoglobin concentration changes (–1.77 ± 1.19 g/dl vs. –1.74 ± 1.37 g/dl) and LOS (8 ± 5.27 days vs. 7.35 ± 3.43 days) were not statistically different. Conclusions: In this cohort, the ORT and DAP were almost halved in the patient group treated with FNS. This may confer a reduction in secondary risks related to surgery

Outcome Analysis of the Use of Cerament® in Patients with Chronic Osteomyelitis and Corticomedullary Defects

Background: Chronic osteomyelitis (OM) is a progressive but mostly low-grade infection of the bones. The management of this disease is highly challenging for physicians. Despite systematic treatment approaches, recurrence rates are high. Further, functional and patient-reported outcome data are lacking, especially after osseous defects are filled with bioresorbable antibiotic carriers. Objective: To assess functional and patient-reported outcome measures (PROM) following the administration of Cerament (R) G or V due to corticomedullary defects in chronic OM. Methods: We conducted a retrospective study from 2015 to 2020, including all patients who received Cerament (R) for the aforementioned reason. Patients were diagnosed and treated in accordance with globally valid recommendations, and corticomedullary defects were filled with Cerament (R) G or V, depending on the expected germ spectrum. Patients were systematically followed up, and outcome measures were collected during outpatient clinic visits. Results: Twenty patients with Cierny and Mader type III OM were included in this study and followed up for 20.2 +/- 17.2 months (95%CI 12.1-28.3). Ten of these patients needed at least one revision (2.0 +/- 1.3 revisions per patient (95%CI 1.1-2.9) during the study period due to OM persistence or local wound complications. There were no statistically significant differences in functional scores or PROMs between groups. Conclusion: The use of Cerament (R) G and V in chronic OM patients with corticomedullary defects appears to have good functional outcomes and satisfactory PROMs. However, the observed rate of local wound complications and the OM persistence rate may be higher when compared to previously published data

Transforming the German ICD-10 (ICD-10-GM) into Injury Severity Score (ISS)—Introducing a new method for automated re-coding

Background: While potentially timesaving, there is no program to automatically transform diagnosis codes of the ICD-10 German modification (ICD-10-GM) into the injury severity score (ISS). Objective: To develop a mapping method from ICD-10-GM into ICD-10 clinical modification (ICD-10-CM) to calculate the abbreviated injury scale (AIS) and ISS of each patient using the ICDPIC-R and to compare the manually and automatically calculated scores. Methods: Between January 2019 and June 2021, the most severe AIS of each body region and the ISS were manually calculated using medical documentation and radiology reports of all major trauma patients of a German level I trauma centre. The ICD-10-GM codes of these patients were exported from the electronic medical data system SAP, and a Java program was written to transform these into ICD-10-CM codes. Afterwards, the ICDPIC-R was used to automatically generate the most severe AIS of each body region and the ISS. The automatically and manually determined ISS and AIS scores were then tested for equivalence. Results: Statistical analysis revealed that the manually and automatically calculated ISS were significantly equivalent over the entire patient cohort. Further sub-group analysis, however, showed that equivalence could only be demonstrated for patients with an ISS between 16 and 24. Likewise, the highest AIS scores of each body region were not equal in the manually and automatically calculated group. Conclusion: Though achieving mapping results highly comparable to previous mapping methods of ICD-10-CM diagnosis codes, it is not unrestrictedly possible to automatically calculate the AIS and ISS using ICD-10-GM codes