Chronic wounds, defined by their resistance to care after four weeks, are a major concern, affecting millions of patients every year. They can be divided into three types of lesions: diabetic foot ...ulcers (DFU), pressure ulcers (PU), and venous/arterial ulcers. Once established, the classical treatment for chronic wounds includes tissue debridement at regular intervals to decrease biofilm mass constituted by microorganisms physiologically colonizing the wound. This particular niche hosts a dynamic bacterial population constituting the bed of interaction between the various microorganisms. The temporal reshuffle of biofilm relies on an organized architecture. Microbial community turnover is mainly associated with debridement (allowing transitioning from one major representant to another), but also with microbial competition and/or collaboration within wounds. This complex network of species and interactions has the potential, through diversity in antagonist and/or synergistic crosstalk, to accelerate, delay, or worsen wound healing. Understanding these interactions between microorganisms encountered in this clinical situation is essential to improve the management of chronic wounds.
Adherence is a critical factor to consider when interpreting study results from randomized clinical trials (RCTs) comparing one diet to another, but it is frequently not reported by researchers. The ...purpose of this secondary analysis of the Keto-Med randomized trial was to provide a detailed examination and comparison of the adherence to the two study diets (Well Formulated Ketogenic Diet (WFKD) and Mediterranean Plus (Med-Plus)) under the two conditions: all food being provided (delivered) and all food being obtained by individual participants (self-provided). Diet was assessed at six time points including baseline (×1), week 4 of each phase when participants were receiving food deliveries (×2), week 12 of each phase when participants were preparing and providing food on their own (×2), and 12 weeks after participants completed both diet phases and were free to choose their own diet pattern (×1). The adherence scores for WFKD and Med-Plus were developed specifically for this study. Average adherence to the two diet patterns was very similar during both on-study time points of the intervention. Throughout the study, a wide range of adherence was observed among participants-for both diet types and during both the delivery phase and self-provided phase. Insight from this assessment of adherence may aid other researchers when answering the important question of how to improve behavioral adherence during dietary trials. This study is registered at clinicaltrials.gov NCT03810378.
This study presents a single-phase grid-tied photovoltaic (PV) system based on a global maximum power point tracking (MPPT) technique, which is performed by means of the particle swarm optimisation ...(PSO) method. The PSO-based MPPT technique is employed to solve problems related to mismatching phenomena, such as partial shading, in which the PV arrays are commonly submitted. Considering the search of the global maximum power point under partial shading, the effectiveness of the PSO-based MPPT technique is highlighted when compared with the well-known perturb and observe MPPT technique, since both the mentioned MPPT techniques are used to determine the dc-bus voltage reference to ensure a proper grid-tied inverter operation. A current generator algorithm based on a synchronous reference frame is proposed, which operates in conjunction with a dc-bus controller and MPPT algorithms, computing the reference current of the grid-tied inverter. In addition, the current generator controls the energy processed by the PV system to avoid over power rating of the grid-tied inverter, since the active power injection into the grid, reactive power compensation and harmonic currents suppression are carried out simultaneously. The performance and feasibility of the grid-tied PV system are evaluated by means of simulation and experimental results.
Insecticide treatment resistance is considered to be a major factor in the increasing number of infestations by head lice. The large insecticide selection pressure induced by conventional topical ...pediculicides has led to the emergence and spread of resistance in many parts of the world. Possible mechanisms of resistance include accelerated detoxification of insecticides by enzyme-mediated reduction, esterification, oxidation that may be overcome by synergistic agents such as piperonyl butoxide, alteration of the binding site, e.g. altered acetylcholinesterase or altered nerve voltage-gated sodium channel, and knockdown resistance (kdr). Clinical, parasitological and molecular data on resistance to conventional topical pediculicides show that treatments with neurotoxic insecticides have suffered considerable loss of activity worldwide. In particular, resistance to synthetic pyrethroids has become prominent, probably because of their extensive use. As other treatment options, including non-insecticidal pediculicides such as dimeticone, are now available, the use of older insecticides, such as lindane and carbaryl, should be minimized, owing to their loss of efficacy and safety concerns. The organophosphorus insecticide malathion remains effective, except in the UK, mostly in formulations that include terpineol.
Nursery functions of US West Coast drowned river valley estuaries are not well understood. Using long-term fish-monitoring data (1995–2017) in Suisun Marsh, San Francisco Estuary, California, USA, we ...examined spatial and temporal trends in abundance and apparent growth of fishes with diverse life-history types. Focal species were Sacramento splittail Pogonichthys macrolepidotus, striped bass Morone saxatilis, tule perch Hysterocarpus traski, and starry flounder Platichthys stellatus, which collectively represented 55% of total catch (n = 140 092). We identified keystone habitat patches that functioned as nursery hotspots during the peak young-of-the-year recruitment window. Deep, flow-through sloughs close to the open estuary were important nursery habitats for the marine transient starry flounder. In contrast, splittail and striped bass mostly migrated through such corridors to rear in shallow, dead-end sloughs transecting tidal marsh plains, managed tidal ponds, and uplands. Tule perch were concentrated in shallow, interior sloughs, reflecting their resident life-history type and adaptations to variable conditions in a small home range. Interactions among freshwater flows and stationary habitat features (e.g. channel depth, land-to-open-water ratio) were related to fish abundance; however, species and age classes differed in their relationships to these interactions, suggesting a mechanism for habitat partitioning in space and time. Overall, we inferred that habitat connectivity—longitudinal, lateral, and vertical—along the estuarine–terrestrial gradient was a driver of fish species diversity and productivity. Consideration of seascape–landscape dynamics across multiple spatial and temporal scales in estuaries should help maintain or increase fish populations and ecological resilience in the face of rising sea levels and other environmental stressors.
Chemical Ionisation Mass Spectrometer measurements of hydroxyl radical (OH) and the sum of hydroperoxy and organic peroxy (HO2+RO2) radicals were conducted during the MEGAPOLI summer field campaign ...at the SIRTA observatory near Paris, France, in July 2009. OH and (HO2+RO2) showed a typical diurnal variation with averaged daytime maxima values around 5×106 and 1.2×108 molecule cm−3, respectively. Simultaneously, a large number of ancillary measurements, such as NOx, O3, HONO, HCHO and other VOCs were also conducted. These data provide an opportunity to assess our understanding of the radical chemistry in a suburban environment by comparing the radical observations to calculations. First, OH mixing ratios were estimated by a simple Photo Stationary State (PSS) calculation. PSS calculations overestimate the OH mixing ratio by 50%, especially at NOx mixing ratios lower than 10 ppb, suggesting that some loss processes were missing in the calculation at low NOx. Then, a photochemical box model simulation based on the Master Chemical Mechanism (MCM) and constrained by ancillary measurements was run to calculate radical concentrations. Three different modelling procedures were tested, varying the way the unconstrained secondary species were estimated, to cope with the unavoidable lack of their measurements. They led to significant differences in simulated radical concentrations. OH and (HO2+RO2) concentrations estimated by two selected model version were compared with measurements. These versions of the model were chosen because they lead, respectively, to the higher and lower simulated radical concentrations and are thus the two extremes versions. The box model showed better results than PSS calculations, with a slight overestimation of 12% and 5%, for OH and (HO2+RO2) respectively, in average for the reference model, and an overestimation of approximately 20% for OH and an underestimation for (HO2+RO2) for the other selected model version. Thus, we can conclude from our study that OH and (HO2+RO2) radical levels agree on average with observations within the uncertainty range. Finally, an analysis of the radical budget, on a daily basis (06:00–18:00 UTC), indicates that HONO photolysis (~35%), O3 photolysis (~23%), and aldehydes and ketones photolysis (~16% for formaldehyde and 18% for others) are the main radical initiation pathways. According to the MCM modelling, the reactions of RO2 with NO2 (~19%), leading mainly to PAN formation, is a significant termination pathway in addition to the main net loss via reaction of OH with NO2 (~50%).
In this paper, an adaptive proportional-integral-derivative (PID) distributed power control algorithm (DPCA) for next generation passive optical networks (NG-PON) is investigated. The adaptive tuning ...procedures aiming to calibrate the PID gains (proportional, integral, and derivative) based on heuristic particle swarm optimization (PSO) is deployed to design the PID block control. For the DPCA-PID-PSO, important aspects of PID gains, including tuning procedure, algorithm convergence, algorithm performance under time-delay, and channel error estimation, as well as the computational complexity are investigated to evaluate the effectiveness and efficiency of the proposed scheme. Our numerical results have revealed that the proposed DPCA-PID-PSO scheme is effective and consistently robust to solve the power allocation problem with adequate velocity of the convergence and the quality of the solutions for different cost functions considering the time-delay and channel error estimation deviations.
This paper presents a finite element methodology for modelling solid media with any number of straight or curved reinforcing bars (rebars). The formulation can handle rebars arbitrarily located ...within a 2D or 3D finite element mesh without the need for nodal compatibility. A new continuous rod–solid interface (or joint) element is developed to connect bulk elements to the rebars, including a method that directly considers the relative displacements. An arbitrary constitutive model can be used in conjunction with the proposed interface element to represent slip behaviour. In this regard, we also present a cyclic nonlinear constitutive model. Unlike existing embedded approaches, the proposed method allows for the direct application of boundary conditions at reinforcements’ endpoints, including tip bearing. The formulation is verified by comparing with literature examples and analytical solutions. In all cases, excellent agreement is observed. The approach can be conveniently applied to the study of complex reinforced concrete structures or any solid medium where reinforcing bars improve its mechanical properties.
•A new, continuous rod–solid interface element is proposed.•The approach avoids line–solid element compatibility requirements.•Easy way to apply boundary conditions at rebars, including tip bearing conditions.•Relative displacements and bond stresses can be computed from the interface element.•Presenting a convenient cyclic constitutive model for the interface.
Background: The British Columbia randomized radiation trial was designed to determine the survival impact of locoregional radiation therapy in premenopausal patients with lymph node–positive breast ...cancer treated by modified radical mastectomy and adjuvant chemotherapy. Three hundred eighteen patients were assigned to receive no further therapy or radiation therapy (37.5 Gy in 16 fractions). Previous analysis at the 15-year follow-up showed that radiation therapy was associated with a statistically significant improvement in breast cancer survival but that improvement in overall survival was of only borderline statistical significance. We report the analysis of data from the 20-year follow-up. Methods: Survival was analyzed by the Kaplan–Meier method. Relative risk estimates were calculated by the Wald test from the proportional hazards regression model. All statistical tests were two-sided. Results: At the 20 year follow up (median follow up for live patients: 249 months) chemotherapy and radiation therapy, compared with chemotherapy alone, were associated with a statistically significant improvement in all end points analyzed, including survival free of isolated locoregional recurrences (74% versus 90%, respectively; relative risk RR = 0.36, 95% confidence interval CI = 0.18 to 0.71; P = .002), systemic relapse–free survival (31% versus 48%; RR = 0.66, 95% CI = 0.49 to 0.88; P = .004), breast cancer-free survival (48% versus 30%; RR = 0.63, 95% CI = 0.47 to 0.83; P = .001), event-free survival (35% versus 25%; RR = 0.70, 95% CI = 0.54 to 0.92; P = .009), breast cancer-specific survival (53% versus 38%; RR = 0.67, 95% CI = 0.49 to 0.90; P = .008), and, in contrast to the 15-year follow-up results, overall survival (47% versus 37%; RR = 0.73, 95% CI = 0.55 to 0.98; P = .03). Long-term toxicities, including cardiac deaths (1.8% versus 0.6%), were minimal for both arms. Conclusion: For patients with high-risk breast cancer treated with modified radical mastectomy, treatment with radiation therapy (schedule of 16 fractions) and adjuvant chemotherapy leads to better survival outcomes than chemotherapy alone, and it is well tolerated, with acceptable long-term toxicity.
This paper reviews what has been learned about Delta Smelt and its status since the publication of The State of Bay-Delta Science, 2008(Healey et al. 2008). The Delta Smelt is endemic to the upper ...San Francisco Estuary. Much of its historic habitat is no longer available and remaining habitat is increasingly unable to sustain the population. As a listed species living in the central node of California's water supply system, Delta Smelt has been the focus of a large research effort to understand causes of decline and identify ways to recover the species. Since 2008, a remarkable record of innovative research on Delta Smelt has been achieved, which is summarized here. Unfortunately, research has not prevented the smelt's continued decline, which is the result of multiple, interacting factors. A major driver of decline is change to the Delta ecosystem from water exports, resulting in reduced outflows and high levels of entrainment in the large pumps of the South Delta. Invasions of alien species, encouraged by environmental change, have also played a contributing role in the decline. Severe drought effects have pushed Delta Smelt to record low levels in 2014-2015. The rapid decline of the species and failure of recovery efforts demonstrate an inability to manage the Delta for the "co-equal goals" of maintaining a healthy ecosystem and providing a reliable water supply for Californians. Diverse and substantial management actions are needed to preserve Delta Smelt.
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