Every infant has a right to bodily integrity. Removing healthy tissue from an infant is only permissible if there is an immediate medical indication. In the case of infant male circumcision there is ...no evidence of an immediate need to perform the procedure. As a German court recently held, any benefit to circumcision can be obtained by delaying the procedure until the male is old enough to give his own fully informed consent. With the option of delaying circumcision providing all of the purported benefits, circumcising an infant is an unnecessary violation of his bodily integrity as well as an ethically invalid form of medical violence. Parental proxy ‘consent’ for newborn circumcision is invalid. Male circumcision also violates four core human rights documents—the Universal Declaration of Human Rights, the Convention on the Rights of the Child, the International Covenant on Civil and Political Rights, and the Convention Against Torture. Social norm theory predicts that once the circumcision rate falls below a critical value, the social norms that currently distort our perception of the practice will dissolve and rates will quickly fall.
The crayfish plague pathogen, Aphanomyces astaci Schikora, has become one of the most well‐studied pathogens of invertebrates. Since its introduction to Europe in the mid‐19th century, it has caused ...mass crayfish mortalities, resulting in drastic declines of local populations. In contrast, North American crayfish usually serve as latent carriers, although they may also be negatively affected by A. astaci infections under some circumstances. Recent research benefiting from molecular tools has improved our knowledge about various aspects of A. astaci biology. In this review, we summarize these advances, particularly with respect to the host range and transmission. We highlight several aspects that have recently received particular attention, in particular newly confirmed or suspected A. astaci hosts, latent A. astaci infections in populations of European crayfish, and the relationship between A. astaci genotype groups and host taxa.
Ungulates are key components of ecosystems due to their effects on lower trophic levels, role as prey, and value for recreational and subsistence harvests. Understanding factors that drive ungulate ...population dynamics can inform protection of important habitat and successful management of populations. To ascertain correlates of ungulate population dynamics, we evaluated the effects of five non-exclusive hypotheses on ungulate abundance and recruitment: winter severity, spring nutritional limitation (spring bottleneck), summer-autumn maternal condition carryover, predation, and timber harvest. We used weather, reconstructed brown bear (Ursus arctos) abundance, and timber harvest data to estimate support for these hypotheses on early calf recruitment (calves per 100 adult females in July-August) and population counts of Roosevelt elk (Cervus canadensis roosevelti) on Afognak and Raspberry islands, Alaska, USA, 1958-2020. Increasing winter temperatures positively affected elk abundance, supporting the winter severity hypothesis, while a later first fall freeze had a positive effect on elk recruitment, supporting the maternal carry-over hypothesis. Increased brown bear abundance was negatively associated with elk recruitment, supporting the predation hypothesis. Recruitment was unaffected by spring climate conditions or timber harvest. Severe winter weather likely increased elk energy deficits, reducing elk survival and subsequent abundance in the following year. Colder and shorter falls likely reduced late-season forage, resulting in poor maternal condition which limited elk recruitment more than winter severity or late-winter nutritional bottlenecks. Our results additionally demonstrated potential negative effects of brown bears on elk recruitment. The apparent long-term decline in elk recruitment did not result in a decline of abundance, which suggests that less severe winters may increase elk survival and counteract the potential effects of predation on elk abundance.
Although tactical athletes (eg, military service members, law enforcement personnel, fire fighters) are exposed to several known risk factors, it remains unclear if they are at increased risk for ...osteoarthritis (OA). The purpose of this systematic review was to investigate the association between serving as a tactical athlete and the incidence and prevalence of OA.
We completed a comprehensive systematic literature search in November 2014 using 12 bibliographic databases (eg, PubMed, Ovid, SportDiscus) supplemented with manual searches of reference lists.
Studies were included if they met the following criteria: (1) an aim of the study was to investigate an association between tactical athletes and OA; (2) the outcome measure was radiographic OA, clinical OA, total joint replacement, self-reported diagnosis of OA, or placement on a waiting list for a total joint replacement; (3) the study design was a cohort study; and (4) the study was written in English.
One investigator extracted data from articles that met all inclusion criteria (eg, group descriptions, measures of disease burden, source of nonexposed controls).
Twelve articles met the inclusion criteria and described retrospective cohort studies. Firefighters, active-duty military service members, and veteran military parachutists consistently had a higher incidence or prevalence of knee, hip, or any OA diagnosis (4 studies). Active-duty pilots and veteran military parachutists may have a higher prevalence of spine OA, but this was not statistically significant (2 studies). Occupational risk factors for OA among tactical athletes include rank and branch of military service. The risk of OA among individuals who completed mandatory national military service remains unclear (6 studies).
The incidence of OA among tactical athletes appears to be significantly higher when compared with nonexposed controls. Further research is needed to specifically identify modifiable risk factors within this high-risk population to develop and implement effective risk-reduction strategies.
A rigorous concept for diffusion of hydrogen is presented that allows for the role of trapping and/or hydrostatic stress. Nonlinear partial differential equations for the concentration of freely ...diffusing hydrogen in the lattice and for the total concentration of hydrogen both in the lattice and traps are derived. A generalized chemical diffusion coefficient can be deduced and is compared with reported relations from the literature. Simulation results are presented for different amounts of traps and their different energetic levels (depths), both for hydrogen concentration profiles and the total amount of hydrogen in the case of charging or discharging a cylindrical specimen. A significant charging/discharging asymmetry occurs for high hydrogen concentrations and high amounts of traps of sufficient depth. Comparisons of the chemical diffusion coefficient with experimental results from the literature are also presented.
Ibrutinib, idelalisib, and venetoclax are approved for treating CLL patients in the United States. However, there is no guidance as to their optimal sequence.
We conducted a multicenter, ...retrospective analysis of CLL patients treated with kinase inhibitors (KIs) or venetoclax. We examined demographics, discontinuation reasons, overall response rates (ORR), survival, and post-KI salvage strategies. Primary endpoint was progression-free survival (PFS).
A total of 683 patients were identified. Baseline characteristics were similar in the ibrutinib and idelalisib groups. ORR to ibrutinib and idelalisib as first KI was 69% and 81%, respectively. With a median follow-up of 17 months (range 1–60), median PFS and OS for the entire cohort were 35 months and not reached. Patients treated with ibrutinib (versus idelalisib) as first KI had a significantly better PFS in all settings; front-line hazard ratios (HR) 2.8, CI 1.3–6.3, P = 0.01, relapsed-refractory (HR 2.8, CI 1.9–4.1, P < 0.001), del17p (HR 2.0, CI 1.2–3.4, P = 0.008), and complex karyotype (HR 2.5, CI 1.2–5.2, P = 0.02). At the time of initial KI failure, use of an alternate KI or venetoclax had a superior PFS when compared with chemoimmunotherapy. Furthermore, patients who discontinued ibrutinib due to progression or toxicity had marginally improved outcomes if they received venetoclax (ORR 79%) versus idelalisib (ORR 46%) (PFS HR .6, CI.3–1.0, P = 0.06).
In the largest real-world experience of novel agents in CLL, ibrutinib appears superior to idelalisib as first KI. Furthermore, in the setting of KI failure, alternate KI or venetoclax therapy appear superior to chemoimmunotherapy combinations. The use of venetoclax upon ibrutinib failure might be superior to idelalisib. These data support the need for trials testing sequencing strategies to optimize treatment algorithms.
A matter of fact is that extremal principles have been introduced in mechanics in more (Euler, Lagrange) or less (Hamilton) than 200 years ago. One may also observe an impact of thermodynamic ...extremal principles based on maximum dissipation due to all the entropy production expressed in several disciplines. According fields are theory of communication, statistical mechanics and later physics of earth since already 70 years. The current paper offers some (historical) overview on several applications. “Ziegler’s principle” is an implementation of the maximum entropy production going out to the dissipation and yielding a maximum dissipation. The goal of this paper is now the implementation of this extremal principle performed along an algebraic concept. Such a concept can be extended to a system with several internal variables as outlined by Coleman and Gurtin in context with the Gibbs (free) energy.
Modelling of Processing Steps of New Generation ODS Alloys Svoboda, J.; Horník, V.; Riedel, H.
Metallurgical and materials transactions. A, Physical metallurgy and materials science,
10/2020, Letnik:
51, Številka:
10
Journal Article
Recenzirano
The paper describes the processing of an oxide-dispersion strengthened (ODS) alloy with the chemical composition Fe-10Al-4Y
2
O
3
. A creep-resistant microstructure with coarse grains and a high ...volume fraction of finely dispersed oxides is obtained by a processing chain consisting of mechanical alloying of the powder, consolidation by hot rolling and subsequent annealing at 1200 °C. To understand the processes underlying the microstructural evolution during hot rolling and annealing, a model for strain hardening, recovery, recrystallization and grain growth is adapted. The quantitative model is able to describe the observed microstructural features and allows identifying processing windows in which the desired microstructure can be achieved.
Anti-CD19 chimeric antigen receptor T-cell immunotherapy (CAR-T) is now a standard treatment of relapsed or refractory B-cell non-Hodgkin lymphomas; however, a significant portion of patients do not ...respond to CAR-T and/or experience toxicities. Lymphodepleting chemotherapy is a critical component of CAR-T that enhances CAR-T-cell engraftment, expansion, cytotoxicity, and persistence. We hypothesized that the lymphodepletion regimen might affect the safety and efficacy of CAR-T.
We compared the safety and efficacy of lymphodepletion using either fludarabine/cyclophosphamide (n = 42) or bendamustine (n = 90) before tisagenlecleucel in two cohorts of patients with relapsed or refractory large B-cell lymphomas treated consecutively at three academic institutions in the United States (University of Pennsylvania, n = 90; Oregon Health & Science University, n = 35) and Europe (University of Vienna, n = 7). Response was assessed using the Lugano 2014 criteria and toxicities were assessed by the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and, when possible, the American Society for Transplantation and Cellular Therapy (ASTCT) consensus grading.
Fludarabine/cyclophosphamide led to more profound lymphocytopenia after tisagenlecleucel infusion compared with bendamustine, although the efficacy of tisagenlecleucel was similar between the two groups. We observed significant differences, however, in the frequency and severity of adverse events. In particular, patients treated with bendamustine had lower rates of cytokine release syndrome and neurotoxicity. In addition, higher rates of hematological toxicities were observed in patients receiving fludarabine/cyclophosphamide. Bendamustine-treated patients had higher nadir neutrophil counts, hemoglobin levels, and platelet counts, as well as a shorter time to blood count recovery, and received fewer platelet and red cell transfusions. Fewer episodes of infection, neutropenic fever, and post-infusion hospitalization were observed in the bendamustine cohort compared with patients receiving fludarabine/cyclophosphamide.
Bendamustine for lymphodepletion before tisagenlecleucel has efficacy similar to fludarabine/cyclophosphamide with reduced toxicities, including cytokine release syndrome, neurotoxicity, infectious and hematological toxicities, as well as reduced hospital utilization.
Acquisition of resources can be costly and individuals are predicted to optimize foraging strategies to maximize net energy gain. Wolves (Canis lupus) would be expected to scavenge on subsidies from ...anthropogenic resources when these resources provide an energetic benefit over the capture of wild prey. We examined the effects of subsidies from anthropogenic resources in the form of livestock carcass dumps (LCDs) on wolf space use, activity, tortuosity, and diet in portions of North America's northern hardwood/boreal ecosystem. We fitted 19 wolves with global positioning system collars during May-August of 2009-2011 and 2013-2015. Wolves with LCDs within their home ranges used areas adjacent to LCDs greater than non-LCD sites and had decreased home ranges and activity as compared to wolves without LCDs in their home ranges. Additionally, cattle comprised at least 22% of wolf diet from scavenging in areas with LCDs present as compared to no cattle in the diet of wolves without access to LCDs. Subsidies from anthropogenic resources in the form of LCDs can serve as attractants for wolves and alter wolf diet, activity, and ranging behavior. Apex predators may alter their behavior where subsidies from anthropogenic resources occur and management of these subsidies should be considered when attempting to reduce the impacts of humans on wolf behavior.
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