Background
Despite potential adverse‐events in a paediatric population, corticosteroids are used to induce remission in paediatric Crohn's disease. Exclusive enteral nutrition also induces remission, ...but is infrequently used in the USA because corticosteroids are considered the superior therapy. New data have become available since the publication of the most recent meta‐analysis in 2007.
Aim
To see if current literature supports the use of EEN versus CS in paediatric populations.
Methods
All studies with comparator arms of exclusive enteral nutrition and an exclusive corticosteroids, with remission clearly defined were identified by searching eight online databases.
Results
Of 2795 identified sources, nine studies met our inclusion criteria. Eight of these (n = 451), had data that could be ed into our meta‐analysis. Exclusive enteral nutrition was as effective as corticosteroids in inducing remission (OR = 1.26 95% CI 0.77, 2.05) in paediatric Crohn's disease. There was no difference between Exclusive enteral nutrition and corticosteroids efficacy when comparing newly diagnosed Crohn's (OR = 1.61 95% CI .87, 2.98) or relapsed (OR = 0.76 95% CI .29‐1.98). Intestinal healing was significantly more likely among patients receiving Exclusive enteral nutrition compared to corticosteroids (OR = 4.5 95% CI 1.64, 12.32). There was no difference in the frequency of biomarker normalisation including CRP (OR = 0.85 95% CI .44, 1.67) and faecal calprotectin (OR 2.79 95% CI .79‐10.90).
Conclusions
There is no difference in efficacy between exclusive enteral nutrition and corticosteroids in induction of remission in Crohn's disease in a paediatric population. Exploratory analyses suggest that a greater proportion of patients treated with exclusive enteral nutrition achieved mucosal healing.
Linked ContentThis article is linked to Dai et al and Feathers et al and Logan et al and Feathers et al papers. To view these articles visit https://doi.org/10.1111/apt.14337, https://doi.org/10.1111/apt.14359, https://doi.org/10.1111/apt.14351 and https://doi.org/10.1111/apt.14360.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract The controlling parameters regarding tritium burn efficiency (TBE) are derived from first principles and shown to depend fundamentally on the permitted He gas fraction in the divertor and ...effective pumping speeds of He ash and unburned hydrogenic fuel. The analysis is generic to any equilibrated magnet fusion plasma using a divertor for particle exhaust. The He gas fraction in the plasma limits the maximum TBE due to the link between ash dilution effects in the core plasma and fusion performance. High TBE in magnetic fusion devices is counter-correlated to achieving high gain and power density for commercial fusion. The impact of TBE on fusion performance for several figures of merit are derived, including power density, required n − τ e product, and plasma energy gain Q p . The TBE formulation presented here is applied to existing devices, based on published data of enrichment and τ He ∗ from research tokamaks. This assessment strongly motivates exploration of technologies that would enhance the effective pumping speed of He to fuel out of the plasma.
There is growing understanding that the consumer’s voice in research needs to be stronger. Translational research studies need consumer inclusion in order to be effectively implemented. This ...narrative article provides the perspective of a Veteran with spinal cord injury (SCI) who is an active member of several study teams and serves as a Consumer Advocate, providing the voice of the person with SCI. Factors that drive people to develop new research ideas are considered. Consumer involvement offers helpful insight into project outcomes that are valuable to the end-user. It is also recognized that data can be interpreted in several different ways depending on the observer. Including the consumer in a research project enables another interpretation, creating a more complete evaluation. Participating in health research is becoming a new standard for persons with many different illnesses and diseases. Greater things are accomplished by physicians, healthcare scientists, engineers, and healthcare consumers interacting together to increase both the quality of research projects and the quality of life for everyone involved, especially the person with the disorder. There will be more acceptance of ideas or projects when consumers are involved from the early steps and learn how the process works from beginning to end.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Linked Content
This article is linked to Swaminath et al and Logan et al papers. To view these articles visit https://doi.org/10.1111/apt.14253 and https://doi.org/10.1111/apt.14351.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Linked Content
This article is linked to Dai et al and Swaminath et al papers. To view these articles visit https://doi.org/10.1111/apt.14337 and https://doi.org/10.1111/apt.14253.
Full text
Available for:
BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
We describe the development of a position-sensitive Gas Electron Multiplier detector prototype, providing for each ionizing event three coordinates: the cartesian X and Y, and U at 45°. Simultaneous ...recording of the three projections permits ambiguity-free reconstruction of multiple tracks, and aims at operation in very high intensity radiation fields.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
7.
The MAPS foil Beolé, S.; Carnesecchi, F.; Contin, G. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
01/2023, Volume:
1046, Issue:
C
Journal Article
Peer reviewed
Open access
We present a method of embedding a Monolithic Active Pixel Sensor (MAPS) into a flexible printed circuit board (FPC) and its interconnection by means of through-hole copper plating. The resulting ...assembly, baptised “MAPS foil”, is a flexible, light, protected, and fully integrated detector module. By using widely available printed circuit board manufacturing techniques, the production of these devices can be scaled easily in size and volume, making it a compelling candidate for future large-scale applications.
A first series of prototypes that embed the ALPIDE chip has been produced, functionally tested, and shown to be working.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Abstract The MANTA (Modular Adjustable Negative Triangularity ARC-class) design study investigated how negative-triangularity (NT) may be leveraged in a compact, fusion pilot plant (FPP) to take a ...‘power-handling first’ approach. The result is a pulsed, radiative, ELM-free tokamak that satisfies and exceeds the FPP requirements described in the 2021 National Academies of Sciences, Engineering, and Medicine (NASEM) report ‘Bringing Fusion to the U.S. Grid’ (2021 Bringing Fusion to the U.S. Grid ). A self-consistent integrated modeling workflow predicts a fusion power of 450 MW and a plasma gain of 11.5 with only 23.5 MW of power to the scrape-off layer (SOL). This low P SOL together with impurity seeding and high density at the separatrix results in a peak heat flux of just 2.8 MW m −2 . MANTA’s high aspect ratio provides space for a large central solenoid (CS), resulting in ∼15 minute inductive pulses. In spite of the high B fields on the CS and the other REBCO-based magnets, the electromagnetic stresses remain below structural and critical current density limits. Iterative optimization of neutron shielding and tritium breeding blanket yield tritium self-sufficiency with a breeding ratio of 1.15, a blanket power multiplication factor of 1.11, toroidal field coil lifetimes of 3100 ± 400 MW · yr, and poloidal field coil lifetimes of at least 890 ± 40 MW · yr. Following balance of plant modeling, MANTA is projected to generate 90 MW of net electricity at an electricity gain factor of ∼ 2.4 . Systems-level economic analysis estimates an overnight cost of US$3.4 billion, meeting the NASEM FPP requirement that this first-of-a-kind be less than US$5 billion. The toroidal field coil cost and replacement time are the most critical upfront and lifetime cost drivers, respectively.
Abstract
Removing ambiguities within a single stage becomes crucial when one can not use multiple
detectors behind each other to resolve them which naturally is the case for neutral radiation. An
...example would be RICH detectors. Commonly, pixilated readout is choosen for this
purpose. However, this causes a remarkable increase in quantity of channels. Thus, the overall
costs of the detector would increase. Therefore, the XYU-GEM was proposed as a three coordinate
strip-readout which is combined with a triple GEM detector. The readout complements a common XY
readout with an additional projection which is tilted by 45°. The overdetermination due to three
projections can be used to resovle ambiguities. Following the detector design will be explained,
first measurements discussed to understand the response of the detector and a way to change the
charge sharing without changing the manufacturing parameters of the readout.
Internet attacks are a frequent occurrence and the incidence is always increasing every year, therefore Matagaruda project is built to monitor and analyze internet attacks using IDS (Intrusion ...Detection System). Unfortunately, the Matagaruda project has lacked in the absence of trend analysis and spatiotemporal analysis. It causes difficulties to get information about the usual seasonal attacks, then which sector is the most attacked and also the country or territory where the internet attack originated. Due to the number of unknown clusters, this paper proposes a new method of automatic bisecting K-means with the average of SSE is 93 percents better than K-means and bisecting K-means. The usage of big spark data is highly scalable for processing massive data attack.
PDF
