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Translating research findings into policy is important. Health policy researchers often testify before Congressional subcommittees and provide background on health policy issues. A rarely used, but important, tool for facilitating translation of research into policy is via filing a Citizen Petition.

Logistic regression is a statistical tool of paramount significance in the field of epidemiology

A mathematical model for the operation of a thermal lance is developed and validated, with the focus on its heat transfer and kinetics behavior. It has been found that there is a "window"of combustion rates in which the thermal lance can operate, which is mainly dictated by the oxygen partial pressure. The particular value of the combustion rate can be set by adjusting the flow rate of the oxygen supply, which is practically done by manipulating the oxygen supply pressure. An open issue is the lack of experimental kinetics data for thermal lance combustion.

This paper presents the results of a recent field test carried out before the opening phases of the Szapáry motorway bridge across the Tisza River in central Hungary. The evaluation test was based on static and dynamic load tests that provided information on deflection, stresses, and dynamic mode shapes along the bridge. The structure has two large continuous independent steel box girders that cover spans across the floodplain and river. Various configurations of truck loading applied up to 6400 kN of loading on the deck. During the static tests, string potentiometers recorded deflections at mid-span. Additionally, strain gauges enabled strain/stress measurements at the mid-point of the longest span and directly above one support. Dynamic loadings showed variation in deflection response due to vehicle speed, and ambient vibration testing led to determining vibration modes and frequencies. A three-dimensional finite-element model produced similar deflections, stresses, and modal behavior. Measured and modeled deflections and stresses indicated that the bridge performed within design margins. The testing and analysis results will be part of a future program assessing conditioned-based maintenance.

The EU, the USA, and Japan account for the majority of biological pharmacotherapy use worldwide. Biosimilar regulatory approval pathways were authorised in the EU (2006), in Japan (2009), and in the USA (2015), to facilitate approval of biological drugs that are highly similar to reference products and to encourage market competition. Between 2007 and 2020, 33 biosimilars for oncology were approved by the European Medicines Agency (EMA), 16 by the US Food and Drug Administration (FDA), and ten by the Japan Pharmaceuticals and Medical Devices Agency (PMDA). Some of these approved applications were initially rejected because of manufacturing concerns (four of 36 [11%] with the EMA, seven of 16 [44%] with the FDA, none of ten for the PMDA). Median times from initial regulatory submission before approval of oncology biosimilars were 1·5 years (EMA), 1·3 years (FDA), and 0·9 years (PMDA). Pharmacists can substitute biosimilars for reference biologics in some EU countries, but not in the USA or Japan. US regulation prohibits substitution, unless the biosimilar has been approved as interchangeable, a designation not yet achieved for any biosimilar in the USA. Japan does not permit biosimilar substitution, as prescribers must include the product name on each prescription and that specific product must be given to the patient. Policy Reviews published in 2014 and 2016 in The Lancet Oncology focused on premarket and postmarket policies for oncology biosimilars before most of these drugs received regulatory approval. In this Policy Review from the Southern Network on Adverse Reactions, we identify factors preventing the effective launch of oncology biosimilars. Introduction to the market has been more challenging with therapeutic than for supportive care oncology biosimilars. Addressing region-specific competition barriers and educational needs would improve the regulatory approval process and market launches for these biologics, therefore expanding patient access to these products in the EU, the USA, and Japan.

Context. In active galaxies, matter is accreted onto super massive black holes (SMBH). This accretion process causes a region roughly the size of our solar system to outshine the entire host galaxy, forming an active galactic nucleus (AGN). In some of these active galaxies, highly relativistic particle jets are formed parallel to the rotation axis of the super massive black hole. A fraction of these sources is observed under a small inclination angle between the pointing direction of the jet and the observing line of sight. These sources are called blazars. Due to the small inclination angle and the highly relativistic speeds of the particles in the jet, beaming effects occur in the radiation of these particles. Blazars can be subdivided into the high luminosity flat spectrum radio quasars (FSRQs) and the low luminosity BL Lacertae objects (BL Lacs). As all AGN, blazars are broadband emitters and therefore observable from the longest wavelengths in the radio regime to the shortest wavelengths in the gamma-ray regime. In this thesis I will analyze blazars at these two extremes with respect to their parsec-scale properties in the radio and their time evolution properties in gamma-ray flux. Method. In the radio regime the technique of very long baseline interferometry (VLBI) can be used in order to spatially resolve the synchrotron radiation coming from those objects down to sub-parsec scales. This information can be used to observe the time evolution of the structure of such sources. This is done in large monitoring programs such as the MOJAVE (15 GHz) and the Boston University blazar monitoring program (43 GHz). In this thesis I utilize data of 28 sources from these monitoring programs spanning 10 years of observation from 2003 to 2013, resulting in over 1800 observed epochs, to study the brightness temperature and diameter gradients of these jets. I conduct a search for systematic geometry transitions in the radio jets. The synchrotron cooling time in the radio core of the jets is used to determine the magnetic field strength in the radio core. Considering the jet geometry, these magnetic field strengths are scaled to the ergosphere of the SMBH in order to obtain the distance of the radio core to the SMBH. In the gamma-regime these blazars cannot be spatially resolved. Due to this, it is hard to put strong constrains onto where the gamma-ray emitting region is. Blazars have shown to be variable at high energies on time scales down to minutes. The nature of this variability can be studied in order to put constrains on the particle acceleration mechanism and possibly the region and size of the gamma-ray emitting region. The variability of blazars in the energy range between 0.1 GeV and 1 GeV can for example be observed with the pair-conversion telescope on board the Fermi satellite. I use 10 years of data from the Fermi-LAT (LAT: Large Area Telescope) satellite in order to study the variability of a large sample of blazars (300-800, depending on the used significance filters for data points). I quantify this variability with the Ornstein-Uhlenbeck (OU) parameters and the power spectral density (PSD) slopes. The same procedure is applied to 20 light curves available for the radio sample. Results. The diameter evolution along the jet axis of the radio sources suggests, that FSRQs feature flatter gradients than BL Lacs. Fitting these gradients, it is revealed that BL Lacs are systematically better described by a simple single power law than FSRQs. I found 9 sources with a strongly constrained geometry transition. The sources are 0219+421, 0336-019, 0415+379, 0528+134, 0836+710, 1101+384, 1156+295, 1253-055 and 2200+420. In all of these sources, the geometry transition regions are further out in the jet than the Bondi sphere. The magnetic field strengths of BL Lacs is systematically larger than that of FSRQs. However the scaling of these fields suggest that the radio cores of BL Lac objects are closer to the SMBHs than the radio cores of FSRQs. Analyzing the variability of Fermi-LAT light curves yields consistent results for all samples. FSRQs show systematically steeper PSD slopes and feature OU parameters more favorable to strong variability than BL Lacs. The Fermi-LAT light curves of the sub-sample of radio jets, suggest an anticorrelation between the jet complexity from the radio observations and the OU-parameters as well as the PSD slopes from the gamma-ray observations. Conclusion. The flatter diameter gradients of FSRQs suggest that these sources are more collimated further down the jet than BL Lacs. The systematically better description of the diameter and brightness temperature gradient by a single power law of BL Lacs, suggest that FSRQs are more complex with respect to the diameter evolution along the jet and the surface brightness distribution than BL Lac objects. FSRQs often feature regions where recollimation can occur in distinct knots within the jets. For the sources where a geometry transition could be constrained, the Bondi radius, being systematically smaller than the position of the transition region along the jet axis, suggest that changing pressure gradients are not the sole cause for these systematic geometry transitions. Nevertheless they may be responsible for recollimation regions, found typically downstream the jet, beyond the Bondi radius and the transition zone. The difference in the distance of the radio cores between FSRQs and BL Lacs is most likely due to the combination of differences in SMBH masses and systematically smaller jet powers in BL Lacs. The variability in energy ranges above 100 MeV and above 1 GeV-regime suggest that many light curves of BL Lac objects are more likely to be white noise while the PSD slopes and the OU parameters of FSRQ gamma-ray light curves favor stronger variability on larger time scales with respect to the time binning of the analyzed light curve. Although the anticorrelation of the jet complexity acquired from the radio observations and the PSD slopes and OU parameters from the gamma-observations suggest that more complex sources favor OU parameters and PSD slopes resulting in more variability (not white noise) it is beyond the scope of this thesis to pinpoint whether this correlation results from causation. The question whether a complex jet causes more gamma-ray variability or more gamma-ray variability causes more complex jets cannot be answered at this point. Nevertheless the computed correlation measures suggest that this dependence is most likely not linear and therefore an indication that these effects might even interact., Einordnung. Durch Akkretion von Materie auf supermassive schwarze Löcher (engl.: super massive black holes, SMBH) in den Zentren von aktiven Galaxien (engl.: active galactic nuclei, AGN) wird auf einer Skala von der Größe unseres Sonnensystems eine Energie freigesetzt, die den Rest der Galaxie dieser AGN überstrahlt. In einigen dieser AGN werden, parallel zur Rotationsachse des SMBHs, hochrelativistische Teilchenströme (Jets) erzeugt. Einige dieser AGN werden unter einem kleinen Winkel zwischen der Jetachse und der Beobachtungssichtlinie erfasst. Ist dies der Fall, führt der kleine Sichtwinkel bei gleichzeitigem Bestehen hochrelativistischer Geschwindigkeiten der Teilchen im Jet dazu, dass die Strahlung der Teilchen den sogenannten Beaming-Effekten unterliegt. Diese AGN nennt man Blazare, welche anhand der Leuchtkraft unterschieden werden können in Radioquasare, die ein flaches Radiospektrum aufweisen (engl.: flat spectrum radio quasars, FSRQs), mit einer hohen Leuchtkraft und BL Lacertae Ojekte (BL Lacs) mit einer niedrigen Leuchtkraft. Blazare sind Breitbandemitter und daher mit den längsten Wellenlängen im Radiobereich bis zu den kleinsten Wellenlängen im gamma-Bereich beobachtbar. In dieser Arbeit werde ich Eigenschaften dieser Blazare auf Parsecskalen durch Radiobeobachtungen und die Zeitentwicklung der Helligkeit dieser im gamma-Bereich analysieren. Methoden. Im Radioregime wird die Technik der sehr langen Basislinieninterferometrie (engl. very long baseline interferometry, VLBI) genutzt, um die Synchrotronstrahlung von Blazaren auf sub-Parsecskalen räumlich aufzulösen. Große Monitoringprogramme wie 'MOJAVE' (Beobachtungen bei 15 GHz) und das 'Boston University blazar monitoring program' (Beobachtungen bei 43 GHz) beobachten diese Quellen mit einer circa monatlichen Kadenz. Bei jeder Beobachtung spricht man von einer Epoche. Für diese Arbeit werde ich Daten von 28 Quellen dieser Programme aus einem Zeitraum von zehn Jahren (2003 bis 2013) nutzen. Das ergibt mehr als 1800 Epochen. Anhand dieser Daten sollen die Helligkeitstemperaturen und Geometrien der Jets analysiert werden. Des Weiteren werde ich nach systematischen Geometrieübergängen in den Jets der Blazare suchen und die Synchrotronkühlzeit nutzen, um die Magnetfeldstärken in den Radiokernen der Jets zu berechnen. Diese Kernmagnetfeldstärken können genutzt werden, um die Abstände der Radiokerne von den Ergosphären der SMBHs zu berechnen. Im gamma-Bereich können diese Quellen nicht räumlich aufgelöst werden. Daher ist es schwierig auszumachen, woher genau in einer solchen Quelle die gamma-Strahlung stammt. In diesem Energiebereich sind Blazare sehr variabel. Variabilitätszeitskalen können in den hellsten Quellen bis zur Minutenskala aufgelöst werden. Die Eigenschaft dieser Variabilität kann Hinweise auf die Teilchenbeschleunigungsprozesse, die Region, aus der diese Strahlung stammt, und die Größe der Emissionsregion geben. Blazare können im Energiebereich zwischen 0.1 GeV und 1 GeV zum Beispiel mit dem Teilchenpaarumwandlungsteleskop auf dem Fermisatelliten beobachtet werden. In dieser Arbeit werden ca. 10 Jahre an \fermi-LAT-Beobachtungen verwendet (LAT: engl. large area telescope), um die Variabilität einer großen Zahl an Blazaren ca. 300-800 je nach Signifikanzfiltern) zu untersuchen. Dabei werden Ornstein-Uhlenbeck-Parameter (OU-Parameter), sowie die spektrale Leistungsdichte genutzt, um die Variabilität dieser Quellen zu untersuchen. Dies wird auch auf die gamma-Lichtkurven von 20 der 28 Radioquellen angewandt. Ergebnisse. Die Entwicklung des Jetdurchmessers entlang der Jetachse legt nahe, dass FSRQs, weiter außen im Jet, flachere Gradienten zeigen als BL Lacs. Eine einfache Potenzgesetzanpassung dieser Gradienten zeigt, dass FSRQs systematisch schlechter durch ein solches Potenzgesetz beschrieben werden als BL Lacs, sowohl in der Durchmesserentwicklung entlang der Jetachse, als auch in der Helligkeitstemperaturentwicklung. In neun der 28 Quellen, 0219+421, 0336-019, 0415+379, 0528+134, 0836+710, 1101+384, 1156+295, 1253-055 und 2200+420, ist es möglich einen systematischen Geometrieübergang im Jet zu finden. In jedem dieser Fälle ist die Position des Geometrieübergangs entlang der Jetachse außerhalb der Bondisphäre. BL Lac-Objekte zeigen systematisch größere Magnetfeldstärken in den Radiokernen als FSRQs. Skaliert man diese in die Ergosphäre des SMBHs, kann man zeigen, dass die Radiokerne der BL Lacs näher an den schwarzen Löchern liegen als die Radiokerne der FSRQs. Die Variabilitätsanalyse der gamma-Lichtkurven zeigt, dass FSRQs systematisch steilere spektrale Leistungsdichten aufweisen als BL Lacs und sich auch in den OU-Parametern von BL Lacs unterscheiden. Des Weiteren gibt es eine messbare Antikorrelation zwischen der Steigung der spektralen Leistungsdichten und der OU Parameter der gamma-Lichtkurven und der Komplexität der Radiojets. Schlussfolgerung. Flachere Jetdurchmessergradienten weisen darauf hin, dass FSRQs, weiter außen im Jet kollimierter sind als BL Lacs. Die Tatsache, dass FSRQs durch einfache Potenzgesetze in der Anpassung der Helligkeitstemperatur und der Jetgeometrie systematisch schlechter beschrieben sind als BL Lacs, zeigt, dass FSRQs komplexere Jetstrukturen aufweisen. Dies gilt sowohl für die Jetgeometrie, welche in einigen Quellen auch Regionen der Rekollimation aufweisen, als auch für die Oberflächenhelligkeitsverteilungen, die in FSRQs oft ausgeprägte Knoten aufweisen. In Quellen, in welchen ein Geometrieübergang festgestellt werden kann, ist es aufgrund der Position der Geometrieübergänge entlang der Jetachse, die systematisch außerhalb der Bondisphäre zu sehen sind, unwahrscheinlich, dass diese Übergänge allein durch sich ändernde äußere Druckgradienten erklärt werden können. Sich ändernde Druckgradienten können in manchen Quellen eine systematische Erhellung einer Region außerhalb der Bondisphäre und des Geoemtrieübergangs, einhergehend mit einer Rekollimation des Durchmessers, erklären. Die unterschiedlichen Abstände der Radiokerne von BL Lacs und FSRQs können vermutlich durch eine Kombination aus verschiedenen SMBH-Massen und Jetleistungen erklärt werden. Die Variabilität in den gamma-Lichtkurven bei Energien von mehr als 100 MeV und über 1 GeV legt nahe, dass BL Lac-Objekte mehr weißes Rauschen aufweisen als FSRQs, während die Steigung der spektralen Leistungsdichte und die OU-Parameter zeigen, dass FSRQs systematisch mehr Variabilität auf längeren Zeitskalen respektive des Zeitbinnings aufweisen als BL Lacs. Eine Antikorrelation zwischen den Steigungen der spektralen Leistungsdichten und der OU-Parameter aus den gamma-Lichtkurven mit den Komplexitäten der Radiojets ist messbar. Diese Antikorrelation zeigt, dass komplexere Jets eher variablere gamma-Lichtkurven aufweisen. Daraus lässt sich aber nicht die Region der gamma-Strahlung im Radiojet ableiten. Es ist nicht klar, ob diese Korrelation auf Kausalität beruht. Wenn diese Korrelation auf kausalen Zusammenhängen beruht, ist nicht klar, ob ein komplexer Jet stärkere gamma-Variabilität bedingt oder ob starke gamma-Variabilität komplexere Jets bedingen. Aus den verwendeten Korrelationstests geht jedoch hervor, dass die Art der Korrelation nicht auf einen einfachen linearen Zusammenhang zurückzuführen ist, was darauf hindeutet, dass beide Aspekte sich vermutlich gegenseitig bedingen.

In the anti-human trafficking movement, multi-disciplinary teams have emerged as a best practice for collaborating and coordinating efforts in combating human trafficking. Many multi-disciplinary teams are comprised of federal, state and local partners representing law enforcement, prosecutors and service providers. The concept of sustaining the multi-disciplinary teams is a relatively new area of discussion in the anti-human trafficking movement. This paper explores the Greater New Orleans Human Trafficking Task Force sustainability process as an illustrative example to shed light on the issues that arose during the process for this Task Force, and which may be salient for other Task Forces. This retrospective presentation of the comments and observations made by the Greater New Orleans Human Trafficking Task Force members suggest emerging themes that may help to clarify the concepts other Task Forces should consider and to predict the sustainability outcomes. The members’ accounts incorporated in this article are presented as valid points of view for framing conclusions that may be applicable in other contexts and to further the conversation in this understudied area of sustainability. The key focal points related to sustainability explored in this conceptual paper include leadership, funding, collaboration, trust and relationship building, and change is constant.

Expansive soils exist in many countries worldwide, and their characteristics make them exceedingly difficult to engineer. Due to its significant swelling and shrinkage characteristics, expansive soil defies many of the stabilization solutions available to engineers. Differential heave or settlement occurs when expansive soil swells or shrinks, causing severe damage to foundations, buildings, roadways, and retaining structures. In such soils, it is necessary to construct a foundation that avoids the adverse effects of settlement. As a result, building the structure’s foundations on expansive soil necessitates special consideration. Helical piles provide resistance to uplift in light structures. However, they may not fully stabilize foundations in expansive soils. A granular anchor pile is another anchor technique that may provide the necessary resistance to uplift in expansive soils using simpler methods. This review and numerical study investigate the fundamental foundation treatments for expansive soils and the behavior of granular anchors and helical piles. Results indicate that granular anchor piles performed better than helical piles for uplift and settlement performance. For heave performance, the granular anchor and helical piles perform nearly identically. Both achieve heave reductions greater than 90% when L/H > 1.5 and D = 0.6 m.

Biosimilar filgrastims are primarily indicated for chemotherapy-induced neutropenia prevention. They are less expensive formulations of branded filgrastim, and biosimilar filgrastim was the first biosimilar oncology drug administered in European Union (EU) countries, Japan, and the U.S. Fourteen biosimilar filgrastims have been marketed in EU countries, Japan, the U.S., and Canada since 2008, 2012, 2015, and 2016, respectively. We reviewed experiences and policies for biosimilar filgrastim markets in EU countries and Japan, where uptake has been rapid, and in the U.S. and Canada, where experience is rapidly emerging. U.S. regulations for designating biosimilar interchangeability are under development, and such regulations have not been developed in most other countries. Pharmaceutical substitution is allowed for new filgrastim starts in some EU countries and in Canada, but not Japan and the U.S. In EU countries, biosimilar adoption is facilitated with favorable hospital tender offers. U.S. adoption is reportedly 24%, while the second filgrastim biosimilar is priced 30% lower than branded filgrastim and 20% lower than the first biosimilar filgrastim approved by the U.S. Food and Drug Administration. Utilization is about 60% in EU countries, where biosimilar filgrastim is marketed at a 30%–40% discount. In Japan, biosimilar filgrastim utilization is 45%, primarily because of 35% discounts negotiated by Central Insurance and hospital-only markets. Overall, biosimilar filgrastim adoption barriers are small in many EU countries and Japan and are diminishing in Canada in the U.S. Policies facilitating improved U.S. adoption of biosimilar filgrastim, based on positive experiences in EU countries and Japan, including favorable insurance coverage; larger price discount relative to reference filgrastim pricing; closing of the “rebate trap” with transparent pricing information; formal educational efforts of patients, physicians, caregivers, and providers; and allowance of pharmaceutical substitution of biosimilar versus reference filgrastim, should be considered. Implications for Practice We reviewed experiences and policies for biosimilar filgrastims in Europe, Japan, Canada, and the U.S. Postmarketing harmonization of regulatory policies for biosimilar filgrastims has not occurred. Acceptance of biosimilar filgrastims for branded filgrastim, increasing in the U.S. and in Canada, is commonplace in Japan and Europe. In the U.S., some factors, accepted in Europe or Japan, could improve uptake, including acceptance of biosimilars as safe and effective; larger cost savings, decreasing “rebate traps” where pharmaceutical benefit managers support branded filgrastim, decreased use of patent litigation/challenges, and allowing pharmacists to routinely substitute biosimilar for branded filgrastim.