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We study the asymptotic behaviour of the powers of a composition operator on various Banach spaces of holomorphic functions on the disc, namely, standard weighted Bergman spaces (finite and infinite order), Bloch space, little Bloch space, Bloch-type space and Dirichlet space. Moreover, we give a complete characterization of those composition operators that are similar to an isometry on these various Banach spaces. We conclude by studying the asymptotic behaviour of semigroups of composition operators on these various Banach spaces.
The Single Ventricle Reconstruction Trial randomised neonates with hypoplastic left heart syndrome to a shunt strategy but otherwise retained standard of care. We aimed to describe centre-level practice variation at Fontan completion.
Centre-level data are reported as median or median frequency across all centres and range of medians or frequencies across centres. Classification and regression tree analysis assessed the association of centre-level factors with length of stay and percentage of patients with prolonged pleural effusion (>7 days).
The median Fontan age (14 centres, 320 patients) was 3.1 years (range from 1.7 to 3.9), and the weight-for-age z-score was −0.56 (−1.35 + 0.44). Extra-cardiac Fontans were performed in 79% (4–100%) of patients at the 13 centres performing this procedure; lateral tunnels were performed in 32% (3–100%) at the 11 centres performing it. Deep hypothermic circulatory arrest (nine centres) ranged from 6 to 100%. Major complications occurred in 17% (7–33%). The length of stay was 9.5 days (9–12); 15% (6–33%) had prolonged pleural effusion. Centres with fewer patients (<6%) with prolonged pleural effusion and fewer (<41%) complications had a shorter length of stay (<10 days; sensitivity 1.0; specificity 0.71; area under the curve 0.96). Avoiding deep hypothermic circulatory arrest and higher weight-for-age z-score were associated with a lower percentage of patients with prolonged effusions (<9.5%; sensitivity 1.0; specificity = 0.86; area under the curve 0.98).
Fontan perioperative practices varied widely among study centres. Strategies to decrease the duration of pleural effusion and minimise complications may decrease the length of stay. Further research regarding deep hypothermic circulatory arrest is needed to understand its association with prolonged pleural effusion.
To assess the effect of tranexamic acid on intra-operative bleeding and surgical field visualisation.
Fifty patients undergoing various endoscopic ear surgical procedures, including endoscopic tympanoplasty, endoscopic atticotomy or mastoidectomy, endoscopic ossiculoplasty, and endoscopic stapedotomy, were randomly assigned to: a study group that received tranexamic acid or a control group which received normal saline. The intra-operative bleeding and operative field visualisation was graded using the Das and Mitra endoscopic ear surgery bleeding and field visibility score, which was separately analysed for the external auditory canal and the middle ear.
The Das and Mitra score was better (p < 0.05) in the group that received tranexamic acid as a haemostat when working in the external auditory canal; with respect to the middle ear, no statistically significant difference was found between the two agents. Mean values for mean arterial pressure, heart rate and surgical time were comparable in both groups, with no statistically significant differences.
Tranexamic acid appears to be an effective haemostat in endoscopic ear surgery, thus improving surgical field visualisation, especially during manipulation of the external auditory canal soft tissues.
In interventions for at-risk children, Tom Dishion strongly exhorted programs that are short term, cost-effective, and delivered in families’ own communities, just as resilience researchers underscore the need for programs that provide ongoing support for children's primary caregivers, and are implementable on a large scale. Presented here are preliminary results on a short-term intervention for mothers, the Authentic Connections Virtual Groups. A previous randomized trial of the in-person version of this program, conducted with mothers at high risk for stress and burnout, showed significant benefits. There had been zero dropouts across the 3-month program, and participants showed significant improvements on psychological indices as well as cortisol, even 3 months after the program ended. In the present study, virtual groups were conducted with five sets of women, all white-collar professionals with highly stressful, exacting careers, and most also primary caregivers of their children. Again, there were zero dropouts. Mean satisfaction ratings were 9.6 of 10, and the Net Promoter Score (promoters vs. detractors) fell in the “world class” range. To illuminate mechanisms of change, participants’ responses to open-ended questions on the groups’ value are presented verbatim. Recurrently mentioned were the development of new, authentic connections and invaluable ongoing support. These results, with the low costs and ease of women's attendance, attest to the value of expanding offerings such as these, toward benefiting even more highly stressed mothers themselves as well as the children for whose care they are responsible.
In this paper, longitudinal and lateral-directional aerodynamic characterisation of the Cropped Delta Reflex Wing (CDRW) configuration–based unmanned aerial vehicle is carried out by means of full-scale static wind-tunnel tests followed by full-scale flight testing. A predecided set of longitudinal and lateral/directional manoeuvres is performed to acquire the respective flight data, using a dedicated onboard flight data acquisition system. The compatibility of the acquired dynamics is quantified, in terms of scale factors and biases of the measured variables, using Kinematic consistency check. Maximum likelihood (ML), least squares and newly emerging neural Gauss–Newton (NGN) methods were implemented for a wing-alone delta configuration, mainly to capture the dynamic derivatives for both longitudinal and lateral directional cases. Estimated damping and weak dynamic derivatives, which are in general challenging to capture for a wing alone configuration, are consistent using ML and NGN methods. Validation of the estimated parameters with aerodynamic model is performed by proof-of-match exercise and are presented therein.
Fracture of crystalline silicon (c-Si) solar cells in photovoltaic modules is a big concern to the photovoltaics (PV) industry. Cell cracks cause performance degradation and warranty issues to the manufacturers. The roots of cell fractures lie in the manufacturing and integration process of the cells and modules as they go through a series of elevated temperature and pressure processes, involving bonding of dissimilar materials, causing residual stresses. Evaluation of the exact physical mechanisms leading to these thermomechanical stresses is highly essential to quantify them and optimize the PV modules to address them. We present a novel synchrotron X-ray microdiffraction based techniques to characterize the stress and fracture in the crystalline silicon PV modules. We show the detailed stress state after soldering and lamination process, using the synchrotron X-ray microdiffraction experiments. We also calculate the maximum tolerable microcrack size in the c-Si cells to sustain the residual stress after lamination. We further demonstrate the effect of these residual stresses on the cell fractures using the widely accepted fracture (4-point bending) tests. These test results show that the soldering and lamination induced localized residual stresses indeed reduce the load-carrying capacity of the c-Si cells.
This paper aims at understanding the texture evolution in extruded oxide dispersion strengthened 18Cr ferritic steel during high-temperature uniaxial compression testing at 1,423 K at a strain rate of 0.01/s based on extensive electron back scatter diffraction characterization. The α-fiber texture is observed along the extrusion direction (ED) in the initial microstructure. The flow curves generated during uniaxial compression test are used to determine the associated hardening parameters. In addition, the degree of texture evolution after deformation along the ED and the transverse direction (TD) with respect to the initial condition has been predicted using VPSC-5 constitutive model. The prediction shows that the deformation along the ED produces a dominant γ-fiber texture in contrast to the TD. This is in agreement with the experimental results where γ-fiber texture is observed, due to enhanced dynamic recrystallization at high-temperature deformation.
Pre-weaning animals exit a flock through death induced by various reasons, causing significant economic losses to the goat producers. In this study, we investigated the survival from birth to weaning of Sirohi goat kids within framework of the survival analysis. Kid records were accessed from 1997 to 2017, with the information on 4417 pre-weaning animals of farmed Sirohi goat native to the Rajasthan State of India. A multivariable Cox regression was fitted to the data after checking the assumptions of regression. The explanatory variables were sex, type of birth, season of birth, birthweight, doe weight at kidding and year of birth. Model selection eliminated doe weight from the model, and sex, type of birth, season of birth, birthweight and year of birth were retained in the model. With model calibration also, these five covariates were retained in the model. The mortality on the first day after birth was 0.3%, constituting 3.5% of all pre-weaning mortality. The mortality until the end of weaning period was 7.8%. Regression analysis revealed that the higher birthweight at kidding was associated with reduced hazard of death among the kids. Male kids had higher hazards of death compared with female kids. The single-born kids had lower risks of death compared with twin-born kids after accounting for heterogeneity. The winter season had a very high adverse effect on the survival of the kids. With each passing year, risks of death decreased. The results of this study indicate that better survival of kids can be achieved by controlling both environmental and animal-related factors.
At GE Research, we are combining “physics” with artificial intelligence and machine learning to advance manufacturing design, processing, and inspection, turning innovative technologies into real products and solutions across our industrial portfolio. This article provides a snapshot of how this physical plus digital transformation is evolving at GE.
To compare round window niche visibility as seen endoscopically during cochlear implant surgery with pre-operative high-resolution computed tomography of the temporal bone.
Nineteen patients scheduled for cochlear implantation, aged 2–20 years, were referred for computed tomography from October 2016 to March 2018. Angles were measured between the lines passing through the mid-sagittal plane and cochlear basal turn on the scans. Endoscopic round window niche visibility during posterior tympanotomy was categorised as: type I = 100 per cent, type IIa = more than 50 per cent, type IIb = less than 50 per cent or type III = 0 per cent. Pre-operative computed tomography measurements were used to predict round window niche visibility before surgery and correlated with intra-operative findings.
The mean (range) of pre-operative angles on computed tomography for endoscopic visibility types I, IIa and IIb, were 64.06° (61.16–69.37°), 63.81° (58.61–71.35°) and 56.48° (50.37–59.05°), respectively, a statistically significant finding (one-way analysis of variance test, p = 0.016).
Pre-operative high-resolution temporal bone computed tomography measurements are useful in predicting round window niche visualisation as viewed endoscopically during posterior tympanotomy. The angle was more acute in type IIb compared to type I.
Introduction: Abdominal pain is one of the most frequent reasons for an emergency department (ED) visit. Most cases are functional and no therapy has proven effective. Our objective was to determine if hyoscine butylbromide (HBB) (BuscopanTM) is effective for children who present to the ED with functional abdominal pain. Methods: We conducted a randomized, blinded, superiority trial comparing HBB 10 mg plus acetaminophen placebo to oral acetaminophen 15 mg/kg (max 975 mg) plus HBB placebo using a double-dummy approach. We included children 8-17 years presenting to the ED at London Health Sciences Centre with colicky abdominal pain rated >40 mm on a 100 mm visual analog scale (VAS). The primary outcome was VAS pain score at 80 minutes post-administration. Secondary outcomes included adverse effects; caregiver satisfaction with pain management using a five-item Likert scale; recidivism and missed surgical diagnoses within 24-hours of discharge. Analysis was based on intention to treat. Results: We analyzed 225 participants (112 acetaminophen; 113 HBB). The mean (SD) age was 12.4 (3.0) years and 148/225 (65.8%) were females. Prior to enrollment, the median (IQR) duration of pain prior was 2 (4.5) hours and analgesia was provided to 101/225 (44.9%) of participants. The mean (SD) pre-intervention pain scores in the acetaminophen and HBB groups were 62.7 (15.9) mm and 60.3 (17.3) mm, respectively. At 80 minutes, the mean (SD) pain scores in the acetaminophen and HBB groups were 30.1 (28.8) mm and 29.4 (26.4) mm, respectively and there were no significant differences adjusting for pre-intervention scores (p = 0.96). The median (IQR) caregiver satisfaction was high in the acetaminophen [5 (2)] and HBB [5 (1)] groups (p = 0.79). The median (IQR) length of stay between acetaminophen [235 (101)] and HBB [234 (103)] was not significantly different (p = 0.53). The proportion of participants with a return visit for abdominal pain was 4/112 (3.5%) in the acetaminophen group and 6/113 (5.3%) in the HBB group. The most common adverse effect was nausea (9% in each group) and there were no significant differences in adverse effects between acetaminophen (26/112, 23.2%) and HBB (31/113, 27.4%) (p = 0.52). There were no missed surgical diagnoses. Conclusion: For children with presumed functional abdominal pain who present to the ED, both acetaminophen and HBB produce a clinically important (VAS < 30 mm) reduction in pain and should be routinely considered in this clinical setting.
In this work, simple, low profile, compact quarter-mode substrate-integrated waveguide (QMSIW)-based antennas are proposed for Wireless Local Area Network (WLAN) at 5.2/5.5 GHz and Wireless Body Area Network (WBAN) at 5.8 GHz, respectively. By implementing QMSIW technique, the electrical size of the antenna is reduced up to 1/4th of the conventional circular SIW cavities. Thanks to the quarter mode concept, the antenna size is reduced significantly by preserving its dominant mode. The resonant frequency of the dominant mode TM010 is independently tuned at 5.2, 5.5, and 5.8 GHz after loading the QMSIW cavity with metalized via holes, subsequently. The on-body performance of the antenna is verified on pork tissues at 5.8 GHz and it is found to be insensitive with respect to surroundings. The measured gain and simulated efficiency of the proposed antenna at 5.8 GHz in free space are 4.8 dBi and 92%, while in the proximity of pork tissues values are 3.25 dBi and 57%, respectively. Moreover, the measurement results demonstrate a good matching with the simulation results.
A cross-sectional study on six dairy farms was conducted to ascertain the occurrence of carbapenem-resistant Escherichia coli in calves. Two-hundred and seventy-nine isolates of E. coli were recovered from 90 faecal samples from apparently healthy (45) and diarrhoeal (45) calves. The isolates were screened for phenotypic susceptibility to carbapenems and production of metallo β-lactamase, as well as five carbapenemase resistance genes by PCR, and overexpression of efflux pumps. Eighty-one isolates (29.03%) were resistant to at least one of three carbapenem antibiotics [meropenem (23.30%), imipenem (2.15%) and ertapenem (1.43%)], and one isolate was positive for the blaVIM gene which was located on an Incl1 plasmid of a novel sequence type (ST 297) by multilocus sequence typing. The majority (83.95%) of isolates had an active efflux pump. Calves housed on concrete floors were approximately seven times more likely to acquire meropenem-resistant isolates than those housed on earthen floors (95% CI 1.27–41.54). In India, carbapenem drugs are not used in food animal treatment, hence carbapenem-resistant strains in calves possibly originate from the natural environment or human contact and is of public health importance. To our knowledge, this is the first report of blaVIM carbapenemases gene in calves from India.
Cold-sprayed high-entropy alloy (HEA) coatings have been generated for the first time. Mechanically alloyed (MA) AlCoCrFeNi powder was chosen as feedstock, owing to the extensive literature on this alloy. Coatings were synthesized under various gas temperature and pressure conditions. Isothermal oxidation was conducted at 1100 °C for 25 h on the coating cold-sprayed at 400 °C and 10 bar on a Ni-base superalloy substrate. The as-sprayed coating retained the MA phases and formed a protective alumina layer upon oxidation. An interdiffusion zone at the interface and unanticipated Mo diffusion from the superalloy substrate into the coating were observed after oxidation. A comprehensive characterization at the coating–substrate interface suggests that diffusion in HEAs is not sluggish. The factors governing the coating’s oxidation are elucidated, and a plausible oxidation mechanism is discussed. These studies are aimed at developing oxidation-resistant HEA coatings for potential applications at high operating temperatures.
Residual stresses present in thin films evaporated on ceramic substrates, can lead to loss of adhesion of the metal features to the ceramic, or, between metal films in multi-level stacks. If the adhesion is good, ceramic cracking may occur around the metal features. Long term one must avoid stress corrosion cracking in the ceramic. These residual stresses are generated by a variety of causes. In general, defect incorporation during the deposition process and thermal expansion mismatch between thin film and substrate play major roles.
In this paper, we describe a method for determining the residual stresses that may be detrimental, or more accurately, the residual stress induced load that may cause reliability problems. This method involves evaporating metal pads or various thicknesses onto the ceramic to the point of failure, and measuring the residual stress loading on the substrate. A direct measure of this loading is the stress intensity factor which takes into account both the residual stress and pad or film thickness. Thus, a critical “load” or stress intensity at which substrate cracking or thin film delamination occurs can be estimated. This approach can be used to select the optimum metal-thickness combination for various substrates.
Oncolytic viral immunotherapy is an emerging treatment modality for cancer that exploits in vivo replication and other viral properties to enhance immune killing of malignant cells. The potential for horizontal transmission of native or engineered oncolytic viruses creates several unique infection control challenges. In 2015, talimogene laherparepvec (TVEC) became the first agent in this class to gain FDA approval for treatment of melanoma, and several others are being developed. Although some data on the transmissibility of TVEC are available from clinical studies, the aftermarket or real-world experience remains limited. We conducted a PUBMED-based search of the medical literature focusing on the safety and risk of TVEC transmission to close contacts including healthcare workers. The findings are summarized in this review and are intended to provide infection preventionists with practical guidance on handling issues related to administration and care of patients receiving TVEC. Additionally, we describe the current mechanism for evaluating the risk related to similar new agents entering clinical trials at our institution. Development of standarized approaches for the safe administration and precautions for ongoing care, especially in immunocompromised patients, are essential to support the broad adoption of this novel therapy.
Evolution and rapid spread of herbicide-resistant (HR) kochia has become a significant challenge for growers in the U.S. Great Plains. The main objectives of this research were to confirm and characterize the response of putative auxinic HR (Aux-HR) kochia accessions (designated as KS-4A, KS-4D, KS-4H, KS-10A, KS-10-G, and KS-10H) collected from two different corn fields near Garden City, KS, to dicamba and fluroxypyr and to determine the EPSPS gene copy number to detect whether those accessions were also resistant to glyphosate. Single-dose experiments indicated that putative Aux-HR kochia accessions had 78% to 100% and 85% to 100% survivors when treated with dicamba (560 g ae ha−1) and fluroxypyr (235 g ae ha−1), respectively. Whole-plant dicamba dose–response studies revealed that the selected Aux-HR accessions had 2.9- to 15.1- and 3.1- to 9.4-fold resistance to dicamba relative to two susceptible accessions (MT-SUS and KS-SUS). In a separate fluroxypyr dose–response experiment, the selected Aux-HR accessions also exhibited 3.8- to 7.3- and 3.0- to 8.6-fold resistance to fluroxypyr on the basis of shoot fresh and dry weight responses, respectively. The confirmed Aux-HR kochia accessions also had 3 to 13 EPSPS gene copies relative to MT-SUS and KS-SUS accessions (each with 1 EPSPS gene copy). These results suggest that the putative Aux-HR kochia accessions from Kansas had developed moderate to high levels of cross-resistance to dicamba and fluroxypyr and low to high levels of resistance to glyphosate. This is the first confirmation of kochia accessions with cross-resistance to dicamba and fluroxypyr in Kansas. Growers should use diverse kochia control programs, including the proper use of dicamba and fluroxypyr stewardship, use of cover crops, occasional tillage, diversified crop rotations, and alternative effective herbicides to prevent further evolution and spread of Aux-HR kochia on their fields.