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Adequate management of acute pain in the older population is crucial. However, it is inherently complex because of multiple physiological changes that significantly impact both the pharmacokinetics and pharmacodynamics of medications. Current guidelines promote paracetamol as the first-line analgesic for acute pain in older adults, whereas opioids are advised cautiously for moderate to severe acute pain. However, opioids come with a significant array of side effects, which can be more pronounced in older individuals. Ketamine administered via intranasal (IN) and nebulised inhalation in the emergency department for managing acute pain in older patients shows promising potential for improving pain management and reducing opioid reliance Kampan, Thong-on, Sri-on (2024, Age Ageing , 53, afad255). Nebulised ketamine appears superior in terms of adverse event incidence. However, the adoption of IN or nebulised ketamine in older adult acute pain management remains unclear because of the lack of definitive conclusions and clear guidelines. Nevertheless, these modalities can be valuable options for patients where opioid analgesics are contraindicated or when intravenous morphine titration is impractical or contraindicated. Here, we review these concepts, the latest evidence and propose avenues for research. [ABSTRACT FROM AUTHOR]

AbstractUsing an optimized implementation of the three-dimensional (3D) method of characteristics for neutron transport, along with a novel equivalence method for transport calculations that was designed to correct self-shielding errors from neglecting the angular dependence of resonant group absorption, a 3D full-core light water reactor hybrid stochastic-deterministic eigenvalue calculation was achieved. This paper presents the optimizations developed and compares the transport solutions obtained. For the statepoint, run times near 10 000 CPU hours are achieved—improving on previous works by an order of magnitude—with near 1% error on pin fission to 238U capture ratios and a few dozen pcms on the eigenvalue. [ABSTRACT FROM AUTHOR]

A new method for directly sampling the resonance upscattering effect is presented. Alternatives have relied on inefficient rejection sampling techniques or large tabular storage of relative velocities. None of these approaches, which require pointwise energy data, are particularly well suited to the windowed multipole cross-section representation. The new method, called multipole analytic resonance scattering, overcomes these limitations by inverse transform sampling from the target relative velocity distribution where the cross section is expressed in the multipole formalism. The closed-form relative speed distribution contains a novel special function we deem the incomplete Faddeeva function, and we present the first results on its efficient numerical evaluation. [ABSTRACT FROM AUTHOR]

In the biobjective branch-and-bound literature, a key ingredient is objective branching, that is, to create smaller and disjoint subproblems in the objective space, obtained from the partial dominance of the lower bound set by the upper bound set. When considering three or more objective functions, however, applying objective branching becomes more complex, and its benefit has so far been unclear. In this paper, we investigate several ingredients that allow us to better exploit objective branching in a multiobjective setting. We extend the idea of probing to multiple objectives for the 0-1 case, enhance it in several ways, and show that, when coupled with objective branching, it results in significant speedups in terms of CPU times. We also show how to adapt it to the general integer case. Furthermore, we investigate cut generation based on the objective branching constraints. Besides, we generalize the best bound idea for node selection to multiple objectives, and we show that the proposed rules outperform, in the multiobjective literature, the commonly employed depth-first and breadth-first strategies. We also analyze problem-specific branching rules. We test the proposed ideas on available benchmark instances for three problem classes with three and four objectives, namely, the capacitated facility location problem, the uncapacitated facility location problem, and the knapsack problem. Our enhanced multiobjective branch-and-bound algorithm outperforms the best existing branch-and-bound–based approach and is the first to obtain competitive and even slightly better results than a state-of-the-art objective space search method on a subset of the problem classes. History: Accepted by Andrea Lodi, Area Editor for Design & Analysis of Algorithms – Discrete. Funding: This work was supported in whole, or in part, by the Austrian Science Fund [Grant P 31366]. Supplemental Material: The online supplement is available at https://doi.org/10.1287/ijoc.2022.0299. [ABSTRACT FROM AUTHOR]

Canada responded to the COVID‐19 pandemic with a series of supports, including direct payments to workers displaced by public health measures. While not a true basic income, the experience highlighted a number of issues including challenges with implementation and intergovernmental relations that affected public opinion and must be dealt with by basic income advocates. The operation of the Canadian social‐liberal welfare state informed pandemic policy making and exhibited the path dependence of a deserving/undeserving binary that resulted in conditionality. The income supports associated with the pandemic represent a pragmatic response to an exogenous shock that highlights the inadequacies of existing policy and offers the possibility of change. [ABSTRACT FROM AUTHOR]

Cancer is a growing global burden; there were an estimated 18 million new cancer diagnoses worldwide in 2020. Excisional surgery remains one of the main treatments for solid organ tumours in cancer patients and is potentially curative. Cancer- and surgery-induced inflammatory processes can facilitate residual tumour cell survival, growth, and subsequent recurrence. However, it has been hypothesised that anaesthetic and analgesic techniques during surgery might influence the risk of cancer recurrence. This narrative review aims to provide an updated summary of recent observational studies and new randomised controlled clinical trials on whether certain specific anaesthetic and analgesic techniques or perioperative interventions during tumour resection surgery of curative intent materially affect long-term oncologic outcomes. [ABSTRACT FROM AUTHOR]

Massive reservoirs of subsurface water ice in equilibrium with atmospheric water vapor are found poleward of 45° latitude on Mars. The absence of CO2 frost on steep pole‐facing slopes and simulations of atmospheric‐soil water exchanges suggested that water ice could be stable underneath these slopes down to 25° latitude. We revisit these arguments with a new slope microclimate model. Our model shows that below 30° latitude, slopes are warmer than previously estimated as the air above is heated by warm surrounding plains. This additional heat prevents the formation of surface CO2 frost and subsurface water ice for most slopes. Our model suggests the presence of subsurface water ice beneath pole‐facing slopes down to 30° latitude, and possibly 25° latitude on sparse steep dusty slopes. While unstable ice deposits might be present, our results suggest that water ice is rarer than previously thought in the ±30° latitude range considered for human exploration. Plain Language Summary: The presence of water ice near the equator is a key issue for future human exploration of Mars. In the current climate, this ice cannot exist near the equator but could be stable at accessible depths below pole‐facing slopes down to latitudes of 25°, that is, close enough to the equator for a crewed mission. Here, we study the possible presence of this subsurface ice with a new model that simulates the microclimates associated with slopes on Mars. Our results show that, contrary to the arguments put forward in the literature, the slopes close to the equator (20°–30°) may in fact be too warm to allow subsurface water ice to be stable, and that the observations that suggested the presence of ice under these slopes can be explained otherwise by our model. Thus, the widespread presence of water ice under these slopes at subtropical latitudes is not demonstrated. However, our model cannot rule out the presence of ancient ice reservoirs, that would be slowly sublimating today. Key Points: We use a new model of steep slope microclimates to explore the stability of subsurface water ice on Mars at latitudes lower than 30°Our model shows that warm plains and large‐scale atmospheric dynamics heat these slopes, preventing ice from being stableSubsurface ice is predicted to be present down to 30° of latitude, possibly down to 25° but for sparse slopes with favorable conditions [ABSTRACT FROM AUTHOR]

Whereas most transit systems are built line-by-line under a centralized authority, each of the original three networks of the subway was built fragment-by-fragment within a decentralized system of authority descended from the laissez-faire political climate responsible for the explosive and unregulated growth of the city in the nineteenth century. Infrastructural and way-finding initiatives were launched in an attempt to normalize the logic of the subway with respect to other mass transit systems, culminating in 1967 with the adoption of wayfinding conventions portraying the system, deceptively, as a network composed of color-coded service lines. 5 The IRT is the Interborough Rapid Transit Company, the first original system; the BMT is the Brooklyn-Manhattan Transit Corporation, the second original system; the IND is the Independent Subway System, the third original system, which was the only publicly operated system of the three before consolidation. Subway riders navigate through stations, platforms, and track corridors differently from their peers in other systems, and they have grown accustomed to a system that changes without growth. [Extracted from the article]

Accurate representation of thermal neutron scattering in Monte Carlo transport simulations requires that the molecular vibrations of the target material be accounted for. Historically, this has been achieved by precomputing large multidimensional tables that are a function of temperature and the cosine of the scattering angle, as well as incoming and outgoing neutron energy. Most commonly used sampling techniques for thermal neutron scattering rely on large multidimensional tables, where higher resolution results in an increase in required memory and attempts to reduce memory can result in grid coarseness errors. An alternative sampling method is introduced here that is a significant departure from precomputed tables and instead relies on a more physical model of the scattering behavior. The phonon sampling method classifies neutron scattering events by the number of phonons excited/de-excited during the scattering collision. In doing so, energy exchange may be obtained via rejection sampling, and an analytical representation of the momentum exchange is obtained. This sampling method has been tested on graphite, yttrium hydride, and uranium nitride, and preliminary implementation of the phonon sampling method shows accurate results for angular and energy distributions, though resulting in up to a 40% slowdown in overall calculation time. This notable slowdown is countered, however, by a large reduction in storage (over 99% reduction compared to standard multidimensional tables). [ABSTRACT FROM AUTHOR]

Background: Opioid analgesics are the most effective pharmacological agents for moderate and severe pain. However, opioid use has several limitations such as opioid-induced hyperalgesia (OIH), which refers to the increased pain sensitivity that occurs once analgesia wears off after opioid administration. Several pharmacological interventions have been suggested for OIH, but the current literature does not provide guidelines on which interventions are the most effective and whether they differ depending on the opioid that induces hyperalgesia. This scoping review aimed to identify and describe all the preclinical trials investigating pharmacological interventions for OIH caused by remifentanil, fentanyl, or morphine as the first step towards evaluating whether the most effective OIH interventions are different for different opioids. Methods: Electronic database searches were carried out in Embase, PubMed, and Web of Science. Detailed data extraction was conducted on the eligible trials. Results: 72 trials were eligible for the review. Of these, 27 trials investigated remifentanil, 14 trials investigated fentanyl, and 31 trials investigated morphine. A total of 82 interventions were identified. The most studied interventions were ketamine (eight trials) and gabapentin (four trials). The majority of the interventions were studied in only one trial. The most common mechanism suggested for the interventions was inhibition of N-methyl-D-aspartate (NMDA) receptors. Conclusion: This scoping review identified plenty of preclinical trials investigating pharmacological interventions for OIH. Using the current literature, it is not possible to directly compare the effectiveness of the interventions. Hence, to identify the most effective interventions for each opioid, the interventions must be indirectly compared in a meta-analysis. [ABSTRACT FROM AUTHOR]

David Green (2022) argues that MINCOME data do not support claims that a GAI reduces health care costs. I stand behind the conclusions drawn in "The Town with No Poverty" (2011): MINCOME is associated with a significant reduction in hospitalization rates among subjects relative to matched comparators. Green's critique depends heavily on data from 1974 and 1975 which were biased by the pre-announcement of MINCOME. It also rests on implicit and questionable assumptions about how hospitals operate, particularly in rural and remote parts of Canada, and how social determinants, including income, affect health outcomes. I provide evidence that corroborates my analytical choices and supports the conclusion drawn in the original paper. [ABSTRACT FROM AUTHOR]

Purpose: Concerns gradually arose about misuse of gabapentinoids (gabapentin and pregabalin), especially when used in combination with opioids. Because it can be a driver of usage, trends in prescribing habits may be interesting to analyse. The aim of this study is to examine the evolution of prescriptions of opioids and gabapentinoids in England from 2015 to 2020 at a regional level. Methods: This study included data from April 2015 to February 2020, focusing on prescribing data, extracted the OpenPrescribing database. We described the evolution of the prescriptions of opioids and gabapentinoids and calculated their ratios for each month. We used Analyses of Variance (ANOVAs) to compare data between and within regions (over time). Results: During this period, opioid prescriptions remained stable (from -3.3% to +2.2%/year) and increased for gabapentinoids generally (from +1.5% to +2.2%). The ratio between gabapentinoid to opioid prescriptions increased by more than 20% in 2020 compared to 2015, variably between regions (F(6,406) = [120.2]; P<0.001; LSD Test: P<0.001; ANOVA for repeated measures: P<0.05). In 2019, a decline in the ratio occurred in all regions, but only persisting in the London commissioning region in 2020 (-14.4% in comparison with 2018, 95%CI: -12.8 to -16.3). Conclusions: Gabapentinoids are increasingly prescribed in England. The ratio of gabapentinoid to opioid prescriptions in England increased from 2015 to 2020. The reclassification of gabapentinoids as controlled drugs, in 2019, may have been associated with a significant reduction, although larger prescribers may have been less influenced. [ABSTRACT FROM AUTHOR]

The article discusses the importance of a patient-centered approach in pain management. It emphasizes that pain is a subjective experience that can vary based on factors such as emotional state, cultural context, and past experiences. The article suggests that healthcare professionals should actively listen to patients, consider their perspectives, and involve them in decision-making. This approach can lead to improved patient satisfaction, compliance with treatment, and resource allocation. The article also highlights the need for staff development in patient-centered strategies and the involvement of patients in research agendas. Overall, the article presents solutions for improving pain management through a collaborative and empathetic approach. [Extracted from the article]

The study examines the relationship between electricity prices and household welfare in South Africa. The study employs a demand system framework on annual time-series data from 2000 to 2018 and the analysis involves the calculation of price elasticities and measurement of welfare changes. The price elasticities in this study are drawn from the linear expenditure demand model. To analyse welfare change, we consider the impact of electricity pricing policies on cost of living (proxied by the consumer price index and households' expenditure patterns). The study achieves this: (i) by comparing electricity price movements to changes in the rate of inflation between 2000 and 2018; (ii) by regressing total household energy expenditure against household expenditure on electricity, to examine how electricity costs affect a household's overall energy bills; and (iii) thirdly, by regressing household food expenditure against households' electricity expenditure to determine how the latter affects a household's ability to spend on other basic goods and services. The results of the study show: (i) South African household electricity demand is inelastic to changes in price of electricity; (ii) electricity prices in the country increased at a higher rate than the rate of inflation for most of the time during the study period, suggesting that households incurred increased expenditures to achieve their desired utility or satisfy their energy needs during this period; (iii) household total electricity expenditure is positively related to household total energy expenditure, implying that high household expenditure on electricity exerts upward pressure on the overall household energy budgets; and (iv) household total food expenditure is negatively related to household total energy expenditure. This shows that while policy makers achieved significant success with providing physical access to electricity, affordable access to this basic service is still a concern and affects the overall welfare of households in the country. The study recommends a review of the country's electricity tariff structure to make affordability a key objective. Moreover, the study calls for coordinated efforts in addressing Eskom challenges which have also played a contributing role to the current energy crisis, characterized by an unreliable electricity supply and constantly increasing electricity prices. [ABSTRACT FROM AUTHOR]

This exploratory case study using a mixed analytic approach aimed to assess the assistance dog's effects on social behaviors (SB) of a child with ASD. The first objective was to examine the frequency of 26 SB. The second objective aimed to assess symptoms of ASD. The third objective was to describe the mother's experience. One family participated in 17 sessions of direct observations. The mother completed the Social Communication Questionnaire (SCQ), the Gilliam Autism Rating Scale-Second Edition (GARS-2), and a semi-structured interview. The findings showed a discrepancy between the effects measured by direct observations and the parent's perceived benefits. [ABSTRACT FROM AUTHOR]

Temperature profiles retrieved using the first set of data of the Emirates Mars InfraRed Spectrometer obtained during the science phase of the Emirates Mars Mission are used for the analysis of migrating thermal tides in the Martian atmosphere. The selected data cover a solar longitude (LS) range of 60°–90° of Martian Year 36. The novel orbit design of the Hope Probe leads to a good geographic and local time coverage that significantly improves the analysis. Wave mode decomposition suggests dominant diurnal tide and important semi‐diurnal tide with maximal amplitudes of 6 and 2 K, respectively, as well as the existence of ∼0.5 K ter‐diurnal tide. The results agree well with predictions by the Mars Planetary Climate Model, but the observed diurnal tide has an earlier phase (3 hr), and the semi‐diurnal tide has an unexpectedly large wavelength (∼200 km). Plain Language Summary: As a result of its small thickness, the Martian atmosphere experiences large temperature variations within each Martian day due to the incoming sunlight. Such rapid and large temperature variations excite waves propagating in the Martian atmosphere that highly influence winds, cloud formation, and dust transport. In this work, we use the atmospheric temperature measurements derived using observations obtained by an infrared spectrometer onboard the Hope Probe to analyze the diurnal temperature variations and the excited waves. The novel design of the spacecraft's orbit provides good data coverage in location and time, leading to the success of detailed analyses of the waves that propagate in the Martian atmosphere synchronously with the movement of the Sun, among which a new wave mode with a period of one third of a Martian day is detected. We compare the results with predictions provided by numerical simulations, and they show good agreements in the wave strengths, but the observed waves have different wavelengths and phases. Key Points: Migrating thermal tides in the Martian atmosphere are analyzed using the first set of Emirates Mars Mission/Emirates Mars InfraRed Spectrometer observationsThe observed amplitudes of diurnal and semi‐diurnal tides agree well with model predictions, but with different phases and wavelengthsTer‐diurnal tide is detected with an amplitude of ∼0.5 K, due to the observations covering the full range of local times [ABSTRACT FROM AUTHOR]

Genre-based approaches are known for their benefits in first and second language classes. In Québec, the intensive English program offered in sixth grade focuses on the teaching of English - less time is therefore devoted to other disciplines, including French. Through this study, our pedagogical goal was to help students develop their writing skills in both French and English. To do so, we invited a classroom teacher and a second language English teacher to bilingually coteach a unit that zeroes in on the characteristics of a specific genre, the written recommendation of a narrative piece. The analysis of approximately 30 recommendations written by students at the end of this unit sheds light on the characteristics found in these texts. More specifically, this article highlights how writers address the reader, how they summarize the narrative pieces, and how they showcase the quality of the pieces in both their English and French texts. These results allow us to believe that pupils build a good understanding of the genre at stake and that the unit created in the context of this study should be developed further. [ABSTRACT FROM AUTHOR]

We present here a novel strategy based on the covalent grafting of a C-functionalized Ni–cyclam complex onto glassy carbon to achieve heterogeneous electrocatalytic CO2 reduction in neutral water at low overpotential (−500 mV vs. NHE), with moderate turnover number (TON = 454), high selectivity (85% CO produced) and good faradaic efficiency (56% CO). Direct comparison with the N-functionalized Ni–cyclam analogue highlights the benefits of this approach in terms of CO2 electroreduction. [ABSTRACT FROM AUTHOR]

At high latitudes, the polar night poses a great challenge to photosynthetic organisms that must survive up to six months without light. Numerous studies have already shed light on the physiological changes involved in the acclimation of microalgae to prolonged darkness and subsequent re‐illumination. However, these studies have never considered inter‐individual variability because they have mainly been conducted with bulk measurements. On the other hand, such long periods are likely to impact within‐population selection processes. In this study, we hypothesized that distinct subpopulations with specific traits may emerge during acclimation of a population of diatoms to darkness. We addressed this hypothesis using flow cytometry (FCM), which allow to individually characterize large numbers of cells. The ecologically dominant polar pennate diatom Fragilariopsis cylindrus was subjected to three dark acclimation (DA) experiments of one, three, and five months duration, during which all cultures showed signs of recovery once light became available again. Our results suggest that darkness survival of F. cylindrus relies on reduction of metabolic activity and consumption of carbon reserves. In addition, FCM allowed us to record three different causes of death, each shared by significant numbers of individuals. The first rendered cells were unable to survive the stress caused by the return to light, probably due to a lack of sufficient photoprotective defenses. The other two were observed in two subpopulations of cells whose physiological state deviated from the original population. The data suggest that starvation and failure to maintain dormancy were the cause of cell mortality in these two subpopulations. [ABSTRACT FROM AUTHOR]

Background: This consensus statement was developed because there are concerns about the appropriate use of opioids for acute pain management, with opposing views in the literature. Consensus statement on policies for system-level interventions may help inform organisations such as management structures, government agencies and funding bodies.Methods: We conducted a multi-stakeholder survey using a modified Delphi methodology focusing on policies, at the system level, rather than at the prescriber or patient level. We aimed to provide consensus statements for current developments and priorities for future developments.Results: Twenty-five experts from a variety of fields with experience in acute pain management were invited to join a review panel, of whom 23 completed a modified Delphi survey of policies designed to improve the safety and quality of opioids prescribing for acute pain in the secondary care setting. Strong agreement, defined as consistent among> 75% of panellists, was observed for ten statements.Conclusions: Using a modified Delphi study, we found agreement among a multidisciplinary panel, including patient representation, on prioritisation of policies for system-level interventions, to improve governance, pain management, patient/consumers care, safety and engagement. [ABSTRACT FROM AUTHOR]

Background: We expect a difference in drug cost between private drug plans and the Public Drug Plan (PDP) because the dispensing fee is fixed and regulated by the PDP for publicly insured patients, whereas it is determined freely by the pharmacy owner for privately insured patients. This study compared the drug cost of Quebec residents covered by private drug plans with those covered by PDP.Methods: We used a sample of prescriptions filled between 1 January 2015 and 23 May 2019 selected from reMed, a database of Quebecers' drug claims. We created strata of prescriptions filled by privately insured patients and matched them with strata of prescriptions filled by publicly insured patients based on the Drug Identification Number, quantity dispensed, number of days of supply, pharmacy identifier, and a date corresponding to the publication of List of Medications of Régie de l'Assurance Maladie du Québec. The differences in drug cost between private plans and the PDP were analyzed with linear regression models using prescription strata as the unit of analysis.Results: Based on 38 896 prescription strata, we observed that privately insured patients payed $9·35 (95% confidence interval [CI]: 5·58; 13·01) more on average per drug prescription than publicly insured patients, representing a difference of 17·6%.Conclusions: This study showed that, on average, drug cost is substantially higher for privately insured Quebecers. Knowing that adherence to treatment is affected by drug cost, these results will help public health authorities to make informed decisions about drug policies. [ABSTRACT FROM AUTHOR]

Major evaluations have been updated in the latest release of the Evaluated Nuclear Data library (ENDF/B-VIII.0) and is the currently recommended pointwise library for criticality and depletion analysis in the open-source Monte Carlo code — OpenMC. However, the currently released OpenMC library does not yet include an accompanying windowed multipole library (WMP) that enables on-the-fly Doppler broadening. This paper revisits the windowed multipole representation and fixes a major drawback that has prevented its use for depletion analysis. The new WMP library presented in this paper explicitly treats key absorption reactions as separate channels such that proper reaction rates are provided during depletion analysis. Based on this improvement, the new WMP library is processed for ENDF/B-VIII.0 and then verified against the pointwise data through direct comparison, criticality benchmarks and fuel assembly depletion. The numerical results show good agreement and efficiency with the pointwise library. • The Windowed Multipole Library (WMP) for ENDF/B-VIII.0 has been released to support the OpenMC criticality and depletion analysis. • The current implementation of WMP library has been extended to include explicit absorption reaction cross sections in resolved resonance range. • The computational efficiency of WMP-based Doppler Broadening has been investigated against stochastic interpolation in criticality and depletion analysis. [ABSTRACT FROM AUTHOR]

3D‐bioprinting (3DBP) possesses several elements necessary to overcome the deficiencies of conventional tissue engineering, such as defining tissue shape a priori, and serves as a bridge to clinical translation. This transformative potential of 3DBP hinges on the development of the next generation of bioinks that possess attributes for clinical use. Toward this end, in addition to physicochemical characteristics essential for printing, bioinks need to possess proregenerative attributes, while enabling printing of stable structures with a defined biological function that survives implantation and evolves in vivo into functional tissue. With a focus on bioinks for extrusion‐based bioprinting, this perspective review advocates a rigorous biology‐based approach to engineering bioinks, emphasizing efficiency, reproducibility, and a streamlined translation process that places the clinical endpoint front and center. A blueprint for engineering the next generation of bioinks that satisfy the aforementioned performance criteria for various translational levels (TRL1‐5) and a characterization tool kit is presented. [ABSTRACT FROM AUTHOR]

How can the interweaving of knowledge silos help to engage girls who are becoming disinterested in science? This study describes how convergence points in research practices within the fields of art and science can mitigate gender stereotypes associated with the STEM field. A case study of four women working at the intersection of art and science revealed common aspects of their practices: an appreciation of the natural world, a sense of aesthetics, a drawing practice and a reliance on meaningful research questions, suggesting that these can act as bridges between both fields of study. [ABSTRACT FROM AUTHOR]

The implementation of Industry 4.0 technologies suggests significant impacts on production systems productivity and decision-making process improvements. However, many manufacturers have difficulty determining to what extent these various technologies can reinforce the autonomy of teams and operational systems. This article addresses this issue by proposing a model describing different types of autonomy and the contribution of 4.0 technologies in the various steps of the decision-making processes. The model was confronted with a set of application cases from the literature. It emerges that new technologies' improvements are significant from a decision-making point of view and may eventually favor implementing new modes of autonomy. Decision-makers can rely on the proposed model to better understand the opportunities linked to the fusion of cybernetic, physical, and social spaces made possible by Industry 4.0. [ABSTRACT FROM AUTHOR]

Background: A confidence evaluation helps to make informed decisions about the results of meta-analyses. The goal of this work is to perform a confidence evaluation of results of a network meta-analysis (NMA) on the digestive side effects of tapentadol in patients with chronic pain. Methods: An updated search in PubMed/Medline and Web of Science search until March 2020 was done to perform pairwise meta-analyses with NMA using random-effect models and confidence in network meta-analysis (CiNeMA) for the confidence analysis. Results: Twenty-five studies were included in the final analyses. Pairwise and indirect comparisons showed a reduced risk of constipation with tapentadol compared to oxycodone. The confidence evaluation did not raise any concerns in terms of confidence for the oxycodone versus tapentadol comparisons. The oxycodone-naloxone versus tapentadol comparisons showed some concerns, particularly in terms of imprecision and incoherence. Regarding the overall risk of any side effects, the confidence evaluation showed a major concern regarding imprecision, but not for the comparison between tapentadol and oxycodone. However, this comparison showed a major heterogeneity. Discussion and conclusions: A confidence evaluation in meta-analysis on the effect of tapentadol compared to other opioids in chronic pain showed possible imprecision, heterogeneity and/or incoherence. However, with a high level of confidence, tapentadol was associated with a lower incidence of constipation than oxycodone. Confidence analyses can help to get more information from meta-analyses. [ABSTRACT FROM AUTHOR]

The study examines the relationship between savings and economic growth in South Africa for the period 1986–2018. The Johansen cointegration technique and the Vector Error Correction Model were employed as methods of analysis. The findings from the study indicate that the effect of savings on economic growth in South Africa is negative. However, a positive relationship between the two variables was established in the short-run. Granger causality tests were also utilised to determine the direction of causality between savings and economic growth. The results revealed that the relationship runs from economic growth to gross domestic savings. Another important observation from the study is the role of investment which was found to have a positive effect on economic growth. This result also supports the idea of promoting investment if the country is to achieve sustainable economic growth. [ABSTRACT FROM AUTHOR]

Objectives: The introduction of a new technology has the potential to modify clinical practices, especially if easy to use, reliable and non-invasive. This observational before/after multicenter service evaluation compares fluid management practices during surgery (with fluids volumes as primary outcome), and clinical outcomes (secondary outcomes) before and after the introduction of the Pleth Variability Index (PVI), a non-invasive fluid responsiveness monitoring. Results: In five centers, 23 anesthesiologists participated during a 2-years period. Eighty-eight procedures were included. Median fluid volumes infused during surgery were similar before and after PVI introduction (respectively, 1000 ml [interquartile range 25–75 [750–1700] and 1000 ml [750–2000]). The follow-up was complete for 60 from these and outcomes were similar. No detectable change in the fluid management was observed after the introduction of a new technology in low to moderate risk surgery. These results suggest that the introduction of a new technology should be associated with an implementation strategy if it is intended to be associated with changes in clinical practice. [ABSTRACT FROM AUTHOR]

A myriad of nuclear reactor designs are currently being considered for next-generation power production. These designs utilize unique geometries and materials and can rely on multiphysics effects for safety and operation. This work develops a neutron transport tool, MOCkingbird, capable of three-dimensional (3D), full-core reactor simulation for previously intractable geometries. The solver is based on the method of characteristics, utilizing unstructured mesh for the geometric description. MOCkingbird is built using the MOOSE multiphysics framework, allowing for straightforward linking to other physics in the future. A description of the algorithms and implementation is given, and solutions are computed for two-dimensional/3D C5G7 and the Massachusetts Institute of Technology BEAVRS benchmark. The final result shows the application of MOCkingbird to a 3D, full-core simulation utilizing 1.4 billion elements and solved using 12 000 processors. [ABSTRACT FROM AUTHOR]

This paper investigates the effect of foreign ownership on firm performance in the South African informal sector. Using the data of 1097 informal businesses sourced from the World Bank Enterprises Survey conducted in four Township provinces in South Africa (Gauteng, KwaZulu-Natal, Eastern Cape and Western Cape) in 2020, the paper aims to address two issues: what is the effect of foreign ownership on performance in the South African informal sector and what factors drive foreign-ownership gap in the South African informal sector if it exists? The empirical analysis uses the multivariable decomposition technique and finds a performance gap between locally and foreign-owned businesses in the South African informal sector. A decomposition of factors shows that differences in endowments can explain the bulk of the gap. Discriminatory/unexplained factors, likely capturing the business culture, also play a significant role. Caution is given when seeking to curb foreign business participation in the informalsector. [ABSTRACT FROM AUTHOR]

Assistance and companion dogs have numerous positive effects for family of autistic children, such as supporting their rehabilitation and improving their quality of life. To date, very few studies have compared the effects of both types of dogs. This comparison, considering the limited access to assistance dogs, could be helpful for families wanting to adopt a dog. An explanatory sequential design with a mixed-method approach was used. First, 85 parents (nassistance dogs = 57; ncompanion dogs = 28) of children aged between 3 and 17 years old (M = 10.73, SD = 3.67) completed an online questionnaire including sociodemographic questions and the Treatment Acceptability Rating Form-Revised (TARF-R). Then, 17 of these participants (nassistance dogs = 14; ncompanion dogs = 3) completed a semi-structured interview. The quantitative data analyses showed that parents with assistance dogs were significantly more satisfied: t (83) = −2.12, p =.037, d = 0.49. Significant associations between some sociodemographic variables (e.g., number of children, comorbid condition, reasons for acquiring a dog) and acceptability/satisfaction (TARF-R total scores) were found. The qualitative analysis revealed that families with both dog types observed positive effects. In brief, having an assistance dog constitutes a significant added value; nevertheless, both types of dogs are appreciated. Parents of children on the autism spectrum show significantly higher levels of satisfaction with having an assistance dog to assist the rehabilitation of their child on the autism spectrum when compared to a companion dog. Assistance and companion dogs are both perceived as beneficial by parents and as an important source of support for the rehabilitation of children on the autism spectrum and other members of their family. Companion dogs trained specifically to assist the rehabilitation of children on the autism spectrum should be offered to families in the context of limited access to assistance dogs. [ABSTRACT FROM AUTHOR]

Out of thousands of international non-governmental organizations (INGOs), only five benefit from immunities from jurisdiction and execution: the International Committee of the Red Cross (ICRC), the International Union for Conservation of Nature (IUCN), the Global Fund to Fight AIDS, Tuberculosis, and Malaria; Gavi, the Vaccine Alliance (Gavi), and the World Anti-Doping Agency (WADA). Based on empirical research, this article argues that there is an emerging State practice in granting immunity only to INGOs that meet two cumulative criteria: a hybridity character and a mission of international interest, formally recognized in a source of international law. This article proposes a new approach based on both Functionalism and Institutionalism that addresses the specificities of INGOs and thus shows that international law provides guidance on the granting of immunities. [ABSTRACT FROM AUTHOR]

Out of 1,578 cataloged and named craters on the Moon, only 32 are named after women. That is a scant 2%. To highlight the underrepresentation of women in science, the author created two connected art projects. The initial project, Women With Impact, is a series of drawings of Moon craters named after women. Building on this oeuvre is One Small Step, a participatory project that invites prominent female astronomers to perform a meditative walk while wearing 3D-printed shoe soles that create a small Moon crater with each step. [ABSTRACT FROM AUTHOR]

Tie2-expressing monocytes/macrophages (TEMs) are a distinct subset of proangiogenic monocytes selectively recruited to tumors in breast cancer. Because of the hypoxic nature of solid tumors, we investigated if oxygen, via hypoxia-inducible transcription factors HIF-1α and HIF-2α, regulates TEM function in the hypoxic tumor microenvironment. We orthotopically implanted PyMT breast tumor cells into the mammary fat pads of syngeneic LysMcre, HIF-1αfl/fl/LysMcre, or HIF-2αfl/fl/LysMcre mice and evaluated the tumor TEM population. There was no difference in the percentage of tumor macrophages among the mouse groups. In contrast, HIF-1afl/fl/LysMcre mice had a significantly smaller percentage of tumor TEMs compared with control and HIF-2αfl/fl/LysMcre mice. Proangiogenic TEMs in macrophage HIF-2α-deficient tumors presented significantly more CD31+ microvessel density but exacerbated hypoxia and tissue necrosis. Reduced numbers of proangiogenic TEMs in macrophage HIF-1a-deficient tumors presented significantly less microvessel density but tumor vessels that were more functional as lectin injection revealed more perfusion, and functional electron paramagnetic resonance analysis revealed more oxygen in those tumors. Macrophage HIF-1a-deficient tumors also responded significantly to chemotherapy. These data introduce a previously undescribed and counterintuitive prohypoxia role for proangiogenic TEMs in breast cancer which is, in part, suppressed by HIF-2α. [ABSTRACT FROM AUTHOR]

Atlantic bluefin tuna (Thunnus thynnus) (ABFT) frequently engage in surface basking and foraging behaviour that makes them detectable from afar. This behaviour is utilized for the development of fisheries-independent abundance indices based on aerial surveys, although changes in the surface-feeding dynamics of ABFT are not yet accounted for. We investigated the daytime surfacing behaviour of ABFT at different temporal and vertical resolutions based on 24 individuals (117–158 cm fork length), tagged with pop-up archival tags in the Gulf of Lion, NW-Mediterranean Sea between 2015 and 2016. The results suggest that ABFT remain usually <2 min continuously within the visible surface (0–1 m) during daytime. ABFT presence in the 0–1 and 0–20 m layers varied over time and between individuals but showed a seasonal decline towards autumn with the breakdown of thermal stratification. Furthermore, the rate of surfacing events was highly correlated with the time spent in the 0–20 m layer. Geolocation estimates confirm a strong site fidelity of ABFT during the aerial survey period (August–October) in the Gulf of Lion. Our results support the choice of the survey region and period, but related indices should account for the seasonality of ABFT surface behaviour [i.e. the time spent in the 0–20 m layer. [ABSTRACT FROM AUTHOR]

Owing to difficulties in accessing the vast open ocean, the beta (β) diversity of pelagic fish assemblages remains poorly studied. We investigated the relationship between assemblage similarity and geographical distance between anchored fish aggregating devices (FADs), sampled by standardised underwater visual censuses in three anchored FAD arrays in the Indian Ocean—at the Maldives, the Seychelles and Mauritius. The use of two complementary indices of β-diversity, based on presence/absence data (Jaccard similarity coefficient) and abundance data (Bray–Curtis index), revealed that geographical distance between sampling sites (from 4 to 257 km) appeared to have no effect on the similarity of fish assemblages associated with FADs within each array. The results of this preliminary study question the generalisation of the paradigm of an increase in β-diversity with geographic distance to the open-ocean fish community. Large-scale studies using a variety of datasets should be conducted to further investigate patterns of β-diversity in the open ocean. [ABSTRACT FROM AUTHOR]

This study investigated temporal adjustment of children with autism spectrum disorder under a differential‐reinforcement‐of‐low‐rates (DRL) schedule. Sixteen participants, aged 3.2 to 7 years, were exposed to two conditions, DRL 5 s and DRL 20 s. Children participated in 7 sessions in each condition, except for 1 participant who attained the adjustment criteria in the DRL 5‐s schedule. Temporal adjustment was measured with the proportion of reinforced interresponse times (IRTs) and the mean IRT. The operant response was a press on a touch screen and the reinforcers were cartoons. IQ and receptive language were measured prior to the DRL sessions. Results showed that the mean proportion of reinforced IRTs was slightly higher in the DRL 5‐s schedule. The mean IRT was above the IRT requirement in both conditions. However, substantial individual variability was observed. Children with higher IQ and receptive language scores presented a greater proportion of reinforced IRTs in both conditions. Moreover, participants who adjusted their responses to the DRL 5‐s schedule were more likely to adjust responding to the DRL 20‐s schedule. This suggests that some children might be more sensitive to reinforcement contingencies than others. This study points at future research in the field of timing in children. [ABSTRACT FROM AUTHOR]

Introduction: Paracetamol is commonly used for its antipyretic properties and analgesic effects, but the central mechanism remains elusive. We designed a study in healthy volunteers to detect the central functional working mechanism of paracetamol. Subjects, material and methods: A total of 20 subjects had a baseline functional magnetic resonance imaging (fMRI) before the intake of 1000 mg paracetamol orally; 60 minutes later, a second fMRI was made aiming detection of regional blood flow differences. Results: A decreased connectivity was observed in the ventral volume of interest (VOI), with the posterior cingulate (with both the left anterior cingulate cortex (ACC) and right ACC: respectively, Ke = 576; t = −6.8894 and Ke = 185; t = −4.8178) and the inferior temporal left (Ke = 103; t = −5.0993); in the combined ventral and dorsal VOIs, the posterior cingulate (with the left ACC; Ke = 149; t = −4.5658) and, both with the right ACC, the inferior temporal left (Ke = 88; t = −3.8456) and the inferior frontal gyrus (Ke = 86; t = −4.3937) had a decrease in connectivity. An increase was seen in other regions, including, among others, the middle frontal and temporal gyri (respectively, Ke = 85; t = 4.4256 and Ke = 85; t = 5.6851), the inferior frontal (with the left ACC: Ke = 165; t = 4.4998) and the superior frontal gyrus (with the right ACC; Ke = 281; t = 4.5992), and the post/precentral gyrus (with the right ACC, respectively, Ke = 102; t = 6.0582 and Ke = 105; t = 4.0776). Conclusions: On fMRIs in healthy volunteers, the ingestion of paracetamol affects connections with the ACC. This suggests a central effect of paracetamol in cerebral areas known to be associated with pain. Further studies are needed to demonstrate the same effects in acute and chronic pain states. [ABSTRACT FROM AUTHOR]

Objective: There are important differences in frequency and type of offence committed by individuals with severe mental disorders (SMD), depending on whether their antisocial behaviors began at an early age or as adults. However, individuals having shown early antisocial behaviors do not form an homogenous group. This study's objective is to test if the antisocial behaviors earliness could explain this heterogeneity.Method: 137 men with SMD under 3 separate legal status were recruited. They were distributed in 3 groups according to the antisocial behaviors earliness.Results: The participants in the childhood group commit more violent offences and more of them present a substance use disorder compared with those in the adult group. A more frequent alcohol use disorder separates the youth group from the adult group. There is no significant difference between the childhood and the youth group, but there are more reported offences in the childhood group.Conclusions: Our results suggest that the age of antisocial behaviors onset should be considered in evaluating risk and managing individuals with SMD. [ABSTRACT FROM AUTHOR]

Background: Ketorolac has been associated with a lower risk of recurrence in retrospective studies, especially in patients with positive inflammatory markers. It is still unknown whether a single dose of pre-incisional ketorolac can prolong recurrence-free survival. Methods: The KBC trial is a multicenter, placebo-controlled, randomized phase III trial in high-risk breast cancer patients powered for 33% reduction in recurrence rate (from 60 to 40%). Patients received one dose of ketorolac tromethamine or a placebo before surgery. Eligible patients were breast cancer patients, planned for curative surgery, and with a Neutrophil-to-Lymphocyte Ratio≥4, node-positive disease or a triple-negative phenotype. The primary endpoint was Disease-Free Survival (DFS) at two years. Secondary endpoints included safety, pain assessment and overall survival. Findings: Between February 2013 and July 2015, 203 patients were assigned to ketorolac (n = 96) or placebo (n = 107). Baseline characteristics were similar between arms. Patients had a mean age of 55.7 (SD14) years. At two years, 83.1% of the patients were alive and disease free in the ketorolac vs. 89.7% in the placebo arm (HR: 1.23; 95%CI: 0.65–2.31) and, respectively, 96.8% vs. 98.1% were alive (HR: 1.09; 95%CI: 0.34–3.51). Conclusions: A single administration of 30 mg of ketorolac tromethamine before surgery does not increase disease-free survival in high risk breast cancer patients. Overall survival difference between ketorolac tromethamine group and placebo group was not statistically significant. The study was however underpowered because of lower recurrence rates than initially anticipated. No safety concerns were observed. Trial registration: ClinicalTrials.gov NCT01806259. [ABSTRACT FROM AUTHOR]

The Method of Characteristics (MOC) has seen wide interest in reactor physics because of its accuracy and efficiency in computing lattice physics problems. While most of its use has been in solving 2D problems, there has been recent interest in extending MOC to 3D in order to more accurately calculate 3D power distributions in LWRs. While the method is naturally extensible to 3D, it presents significant computational difficulties. OpenMOC, an open source MOC simulator, has been extended from 2D to 3D capabilities. Simulation results are presented in this study for the full core 3D simulation of the BEAVRS benchmark, adequately resolved in space and angle. [ABSTRACT FROM AUTHOR]

Background: Immunotherapy has become a powerful treatment option for several solid tumor types. The presence of tumor-infiltrating lymphocytes (TIL) is correlated with better prognosis in ovarian cancer, pointing at the possibility to benefit from harnessing their anti-tumor activity. This preclinical study explores the feasibility of adoptive cell therapy (ACT) with TIL using an improved culture method. Methods: TIL from high-grade serous ovarian cancer were cultured using a combination of IL-2 with agonistic antibodies targeting 4-1BB and CD3. The cells were phenotyped using flow cytometry in the fresh tissue and after expansion. Tumor reactivity was assessed against HLA-matched ovarian cancer cell lines via IFN-γ ELISPOT. Results: Ovarian cancer is highly infiltrated with CD8+ TIL that are preferentially and robustly expanded with the addition of the agonistic antibodies. With a 95% success rate, the TIL are grown to ≥ 100 × 106 cells in 2–3 weeks without over differentiation. In addition, the CD8+ TIL grown with this method showed HLA-restricted tumor recognition. Conclusions: These results indicate the viability of TIL ACT for refractory ovarian cancer by allowing for the large expansion of anti-tumor TIL in a short time and consistent manner. [ABSTRACT FROM AUTHOR]

Wilms tumor is the most frequent pediatric renal malignancy, and its usual presentation is an abdominal mass or hematuria. Unusual presentations have also been reported, such as paraneoplastic syndromes (acquired von Willebrand disease, sudden death due to pulmonary embolism, and Cushing syndrome). These conditions can precede, occur concomitantly, or present in a later phase of tumor development. Precocious puberty, as paraneoplastic endocrine syndrome, has already been described in children with malignant tumors (brain, gonadal, adrenal tumors, and hepatoblastoma). However, little is known about central precocious puberty, as paraneoplastic manifestation of nephroblastoma or secondary to its specific chemotherapy. Here, we report a case of Wilms tumor and simultaneous precocious puberty in a 5-year-old girl. The initial diagnosis was premature telarche, but the clinical and biological pubertal progression changed our diagnosis to idiopathic central precocious puberty. Chemotherapy and nephrectomy were well tolerated, and we began treatment with a gonadotropin-releasing hormone agonist which showed favorable outcomes over the short term. We highlight the need for early diagnosis and work-up in all patients of precocious puberty, in order to institute timely management. [ABSTRACT FROM AUTHOR]

Pluto's surface is covered in numerous CH 4 ice deposits, that vary in texture and brightness, as revealed by the New Horizons spacecraft as it flew by Pluto in July 2015. These observations suggest that CH 4 on Pluto has a complex history, involving reservoirs of different composition, thickness and stability controlled by volatile processes occurring on different timescales. In order to interpret these observations, we use a Pluto volatile transport model able to simulate the cycles of N 2 and CH 4 ices over millions of years. By assuming fixed solid mixing ratios, we explore how changes in surface albedos, emissivities and thermal inertias impact volatile transport. This work is therefore a direct and natural continuation of the work by Bertrand et al. (2018), which only explored the N 2 cycles. Results show that bright CH 4 deposits can create cold traps for N 2 ice outside Sputnik Planitia, leading to a strong coupling between the N 2 and CH 4 cycles. Depending on the assumed albedo for CH 4 ice, the model predicts CH 4 ice accumulation (1) at the same equatorial latitudes where the Bladed Terrain Deposits are observed, supporting the idea that these CH 4 -rich deposits are massive and perennial, or (2) at mid-latitudes (25°− 70°), forming a thick mantle which is consistent with New Horizons observations. In our simulations, both CH 4 ice reservoirs are not in an equilibrium state and either one can dominate the other over long timescales, depending on the assumptions made for the CH 4 albedo. This suggests that long-term volatile transport exists between the observed reservoirs. The model also reproduces the formation of N 2 deposits at mid-latitudes and in the equatorial depressions surrounding the Bladed Terrain Deposits, as observed by New Horizons. At the poles, only seasonal CH 4 and N 2 deposits are obtained in Pluto's current orbital configuration. Finally, we show that Pluto's atmosphere always contained, over the last astronomical cycles, enough gaseous CH 4 to absorb most of the incoming Lyman- α flux. • We simulate N2 and CH4 volatile transport on Pluto over millions of years. • Net accumulation of CH4 ice is obtained in the equatorial regions, suggesting that the Bladed Terrain are thick CH4 deposits. • Results also suggest perennial CH4 ice deposits in the mid latitudes, which explains the thick mantle of volatile ice observed • Polar deposits and mid-latitude N2 ice deposits are seasonal in the model and should disappear in summer. • Pluto's atmosphere always contained enough gaseous CH4 to block most of the Lyman- α flux over the last astronomical cycles. [ABSTRACT FROM AUTHOR]