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A high rate of rise of fine-grained mine tailings slurry on disposal in a tailings storage facility (TSF) may maintain their condition as underconsolidated. The proper simulation of such field deposition of tailings in conventional laboratory consolidation testing is challenging. A slurry consolidation test using a high constant rate of loading (CRL) simulates a faster rate of tailings disposal in a TSF. A better simulation is achieved, however, by applying accelerated loading in a slurry consolidometer to allow for the increased drainage path length as tailings are built up in the TSF. CRL and accelerated loading were used in a purpose-built, large, instrumented, stress-controlled slurry consolidometer to examine and compare the consolidation behaviour of coal tailings, red mud and gold tailings. At the end of the CRL and accelerated loading tests, the excess pore water pressures had not fully dissipated and the maximum applied stress was maintained to achieve full primary consolidation. The findings of this study showed that the consolidation behaviour of the tailings studied varied with the nature of the tailings and with the loading applied.

Immune thrombocytopenia (ITP) is an autoimmune disease causing platelet destruction, and is a common cause of symptomatic thrombocytopenia in children. Intravenous immune globulin (IVIG) is a treatment for ITP that increases the platelet counts of most patients within 24 to 48 hours. This study aimed to calculate the rate of rise in pediatric ITP after a dose of IVIG and to analyze if patient characteristics affected the rate. For 116 children treated for ITP with IVIG at Hershey Medical Center, the rate of rise of the platelet count for all patients was calculated. The rate of rise ranged from -0.1 to +4.2 K/µL/hour (average 1.3, median 1.2). 78% of patients had a rate of rise of over 0.5 K/µL/hour. There was a statistically significant correlation between the rate rise of the platelet count and the initial platelet count (P=0.0197), but rate was not affected by age or sex. This study was able to demonstrate that IVIG is effective in most patients and that demographic features do not affect the rate of rise. By providing a nomogram showing when to expect a meaningful rise in the platelet count after IVIG, we give guidance for timing of the postinfusion platelet count to avoid administering a second dose. Future studies are needed to test this nomogram prospectively.

INTRODUCTION. Previous research has predominately relied on person-level or single characteristics of drinking episodes to characterise patterns of drinking that may confer risk. This research often relies on self-report measures. Advancements in wearable alcohol biosensors provide a multi-faceted objective measure of drinking. The current study aimed to characterise drinking episodes using data derived from a wearable alcohol biosensor. METHODS. Participants (n = 45) were adult heavy drinkers who wore the Secure Continuous Remote Alcohol Monitoring (SCRAM) bracelet and reported on their drinking behaviours. Cluster analysis was used to evaluate unique combinations of alcohol episode characteristics. Associations between clusters and self-reported person and event-level factors were also examined in univariable and multivariable models. RESULTS. Results suggested three unique clusters: Cluster 1 (most common, slowest rate of rise to and decline from peak), Cluster 2 (highest peak transdermal alcohol concentration and area under the curve) and Cluster 3 (fastest rate of decline from peak). Univariable analyses distinguished Cluster 1 as having fewer self-reported drinks and fewer episodes that occurred on weekends relative to Cluster 2. The effect for number of drinks remained in multivariable analyses. DISCUSSION AND CONCLUSIONS. This is the first study to characterise drinking patterns at the event-level using objective data. Results suggest that it is possible to distinguish drinking episodes based on several characteristics derived from wearable alcohol biosensors. This examination lays the groundwork for future studies to characterise patterns of drinking and their association with consequences of drinking behaviour.

Microbubbles (MBs) are optimal ultrasound contrast agents because their unique acoustic response allows for exquisite sensitivity in vivo. This unique response is derived from MBs’ elasticity that allows them to oscillate differently from surrounding tissues. While the main use of MBs in the clinic is for cardiac and perfusion imaging, imparting MBs with bioresponsive properties would expand their use to detect pathophysiologic changes. This can be achieved by damping MBs’ oscillations to silence their signal and rescuing it when they encounter the biomarker of interest to improve detection and specificity of diseases such as deep vein thrombosis (DVT). Here, we demonstrate that conjugating perfluorobutane-filled MBs with hyaluronic acid (HA) and cross-linking HA with biodegradable linkers eliminates harmonic signal because of increased MB stiffness and decreased oscillation. In this proof-of-concept study, we used a reversible pH-sensitive cross-linker to establish and validate this targeted and activatable pH-sensitive MB (pH-MB) platform. Conjugation of HA to MBs and targeting of pH-MBs to CD44-positive cells were validated. Harmonic signal loss due to stiffening of pH-MBs’ shell was confirmed using a clinical ultrasound scanner equipped with Cadence contrast pulse sequencing. pH-MBs imaged before and after acidification increased harmonic signal fivefold. Because the cleavage of the cross-linker we used is reversible, harmonic signal was silenced again when the acidic suspension was neutralized, confirming that harmonic signal is dependent on the cross-linked HA. The rate of rise and the magnitude of harmonic signal increase could be manipulated by varying the phospholipid composition and the number of HA cross-linkers, indicating that the platform can be tuned to the desired response needed. In this study, we established the feasibility of using targeted and activatable MBs and plan to apply this platform to aid in the diagnosis and management of patients with DVT and potentially other conditions.

Excess pore water pressure (PWP) in gold tailings, deposited in the laboratory in a settling column, was observed for various rates of deposition. Rates of rise (vertical increase in height of sett...

To assess the postnatal rate of rise (ROR) of total serum bilirubin (TSB) in very low birth weight (VLBW) preterm infants, to determine risk factors associated with a rapid rise (>90th percentile), and to compare ROR and hour-specific TSB at postnatal 12–48 h with data of term infants retrieved from the literature. Retrospective analysis of 2430 routine TSB concentrations obtained between birth and initiation of phototherapy in 483 VLBW infants. TSB increased by a median (interquartile range) ROR of 0.15 (0.11–0.19) mg/dL/h. The 50th percentile of TSB was below the 40th percentile of (near-)term counterparts at 12–48 h. TSB ROR correlated with the age at initiation (RS = −0.687; p 90th percentile (>0.25 mg/dL/h) was associated with lower gestational ages [27.2 (25.4–29.3) vs. 28.4 (26.4–30.4) weeks], lower birth weights [978 (665–1120) vs. 1045 (814–1300) g], and lower 5-min Apgar scores [7 (7–8) vs. 8 (7–9)]. ROR of TSB is an indicator for early and prolonged phototherapy. While hour-specific TSB and ROR at 12–48 h are lower than those reported for (near-)term infants, TSB appears to rise more rapidly in infants with low gestational age, low birth weight, and low 5-min Apgar score.

Objectives To study trends in Bacillus Calmette-Guerin (BCG) utilization for nonmuscle invasive bladder cancer (NMIBC) before and during national BCG shortages. Methods The National Cancer Database was used to identify patients with localized NMIBC. Multivariate logistic regression was used to assess factors associated with BCG use. Temporal trends in BCG use were studied using segmented regression analysis. Results We identified 238,279 patients with NMIBC from 2004 to 2015. Overall, 33,660 (14.1%) patients with NMIBC received intravesical BCG during the study period. Segmented regression revealed a slower rate of rise of BCG utilization following major supply interruptions in 2011 and 2012 (2004-2012: +0.62% increase per year [P Conclusions BCG utilization for NMIBC increased significantly over the study period, possibly representing increased adoption of national guidelines for BCG in NMIBC. In the years following interruptions in BCG supply, BCG use appears to have been rationed based on clinical risk, with the steepest declines in BCG use occurring in the lowest risk patients.

The chronology provides a record of flash flood events in Britain based on data collated mainly between 1700 and 2020. The primary purpose of the chronology is to improve the risk assessment of flash floods of given magnitude. It is divided into 18 regions of the country and contains descriptions of nearly 8000 events. It extends a previous chronology covering northern and southwest England which is provided as an online resource in (http://ceg-fepsys.ncl.ac.uk/outputs/). Flash floods have had a variety of previous definitions but are here defined in terms of the speed of onset which can apply to both river floods and surface water floods. The chronology for the first time provides a comprehensive list of surface water floods and their recorded impact on cities, towns and villages. It also draws attention to the prevalence of very rapid rates of rise in river level either as ‘walls of water’, or at a rate likely to endanger life as a result of intense rainfall. Nearly 300 such events have been identified mainly in upland areas of northern England, Wales and Scotland. Practical and theoretical issues with respect to flood risk assessment and warning are discussed. The chronology is available to download and is hosted on https://www.jbatrust.org/how-we-help/publications-resources/rivers-and-coasts/uk-chronology-of-flash-floods-1/

BACKGROUND AND OBJECTIVES: Bilirubin screening before discharge is performed to identify neonates at risk for future hyperbilirubinemia. The American Academy of Pediatrics recommends using a graph of bilirubin levels by age (the Bhutani Nomogram) to guide follow-up and a different graph to determine phototherapy recommendations. Our objective was to evaluate predictive models that incorporate the difference between the last total serum bilirubin (TSB) before discharge and the American Academy of Pediatrics phototherapy threshold (Δ-TSB) to predict a postdischarge TSB above the phototherapy threshold by using a single graph. METHODS: We studied 148 162 infants born at ≥35 weeks’ gestation at 11 Kaiser Permanente Northern California facilities from 2012 to 2017 whose TSB did not exceed phototherapy levels and who did not receive phototherapy during the birth hospitalization. We compared 3 logistic models (Δ-TSB; Δ-TSB-Plus, which included additional variables; and the Bhutani Nomogram) by using the area under the receiver operating characteristic curve (AUC) in a 20% validation subset. RESULTS: A total of 2623 infants (1.8%) exceeded the phototherapy threshold postdischarge. The predicted probability of exceeding the phototherapy threshold after discharge ranged from 56% for a predischarge Δ-TSB 0 to 1 mg/dL below the threshold to 0.008% for Δ-TSB >7 mg/dL below the threshold. Discrimination was better for the Δ-TSB model (AUC 0.93) and the Δ-TSB-Plus model (AUC 0.95) than for the Bhutani Nomogram (AUC 0.88). CONCLUSIONS: The use of Δ-TSB models had excellent ability to predict postdischarge TSB above phototherapy thresholds and may be simpler to use than the Bhutani Nomogram.

Central systolic blood pressure (cSBP, the peak of the central waveform) is usually regarded as the determinant of peripheral systolic blood pressure with amplification of peripheral systolic blood pressure (pSBP) measured with reference to cSBP. However, the earlier portion of the central waveform up to the first systolic shoulder (P1) may be the major determinant of pSBP. We performed in silico simulation studies and examined previously acquired experimental data (n = 131) in which peripheral and central blood pressure waveforms had been acquired both invasively and noninvasively to examine the determinants of pSBP. Measurements were made at baseline and during perturbation of hemodynamics by inotropic and vasoactive drugs. In silico simulations using a central-to-peripheral transfer function demonstrated that pSBP is dependent on P1 and the rate of change (dP/dt) of central pressure up to the time of P1 but not cSBP. In computational simulations, peripheral reflection in the radial artery was closely related to dP/dt, and 97% of the variability in amplification as measured with reference to P1 was explained by dP/dt. In vivo, amplification of pSBP over P1 was correlated with dP/dt (R > 0.75, P < 0.0001 for all data sets), and P1 and dP/dt were independently correlated with pSBP, explaining 90% of the variability in pSBP. We conclude that P1 and dP/dt are major determinants of pSBP and that pSBP and cSBP are, in part, determined by different cardiac, central, and peripheral vascular properties.NEW & NOTEWORTHY Peripheral systolic BP is determined mainly by the first shoulder and the rate of rise of the central systolic blood pressure waveform rather than the peak of this waveform (central systolic BP). Peripheral and central systolic blood pressure are determined by different cardiac and vascular properties.

Sea-level budgets account for the contributions of processes driving sea-level change, but are predominantly focused on global-mean sea level and limited to the 20th and 21st centuries. Here we estimate site-specific sea-level budgets along the U.S. Atlantic coast during the Common Era (0–2000 CE) by separating relative sea-level (RSL) records into process-related signals on different spatial scales. Regional-scale, temporally linear processes driven by glacial isostatic adjustment dominate RSL change and exhibit a spatial gradient, with fastest rates of rise in southern New Jersey (1.6 ± 0.02 mm yr−1). Regional and local, temporally non-linear processes, such as ocean/atmosphere dynamics and groundwater withdrawal, contributed between −0.3 and 0.4 mm yr−1 over centennial timescales. The most significant change in the budgets is the increasing influence of the common global signal due to ice melt and thermal expansion since 1800 CE, which became a dominant contributor to RSL with a 20th century rate of 1.3 ± 0.1 mm yr−1., Sea-level rise is an important part of climate change, but most sea-level budgets are global and cannot capture important regional changes. Here the authors estimate sea-level budgets along the U.S. Atlantic coast, finding a faster rate of rise during the 20th century than any time in the past 2000 years.

It is well accepted that a myopia epidemic is occurring globally, with 50% of the global population predicted to have myopia by the year 2050. Parts of East and Southeast Asia, such as China, South Korea, and Singapore, have the most rapidly increasing rates of myopia compared to other parts of the world. The rate of rise in myopia differs between geographical locations and, even within a country, varying according to the level of urbanization of the studied region and between ethnic groups. Genetic factors are known to play a part in the myopia epidemic, with over 100 genes associated with myopia or its ocular traits already identified. Children in families where one or both parents have myopia are more likely to develop myopia. However, the epidemic is likely to be the result of environmental risk factors, such as higher levels of education, increased near work, and decreased time spent outdoors, rather than genetic factors. These environmental factors may predispose individuals who are genetically susceptible to develop myopia and may provide a target for early intervention and prevention.

Einleitung: In den ersten Lebenstagen kommt es bei Neugeborenen zu einem Anstieg des Gesamtserumbilirubins (GSB). Dies kann zu irreversiblen Schäden des zentralen Nervensystems führen. Frühgeborene gelten als besonders gefährdet, schwere neurologische Folgeschäden zu entwickeln. Über den postnatalen Bilirubinanstieg ist bei Frühgeborenen bisher wenig bekannt. Ziel der vorliegenden Forschungsarbeit ist es, den postnatalen Verlauf der GSB-Konzentration bei Frühgeborenen mit einem sehr niedrigen Geburtsgewicht < 1500 g (VLBW) bis zum Beginn der Fototherapie zu analysieren, die Anstiegsgeschwindigkeit des GSB als Indikator für den Beginn und die Dauer der Fototherapie zu evaluieren, Risikofaktoren für einen steilen Anstieg des GSB > 90. Perzentile zu identifizieren sowie die altersbezogenen GSB-Konzentrationen und den Anstieg des GSB zwischen der 12.–48. Lebensstunde mit publizierten Daten reifer Neugeborener aus der Literatur zu vergleichen. Insgesamt soll dies zu einem besseren Verständnis des postnatalen Bilirubinanstiegs bei VLBW Frühgeborenen beitragen. Methodik: In einer retrospektiven Studie wurden 2430 postnatale GSB-Messungen vor dem Beginn der Fototherapie bei 483 Frühgeborenen mit einem Geburtsgewicht < 1500 g aus drei Jahren analysiert. Ergebnisse: Die Anstiegsgeschwindigkeit des GSB vor dem Beginn der Fototherapie beträgt bei VLBW Frühgeborenen 0,15 (0,11–0,19) mg/dl/h. Die Anstiegsgeschwindigkeit des GSB korreliert mit dem Alter bei Beginn (RS = –0,687; p < 0,001) und der Dauer der Fototherapie (RS = 0,444; p < 0,001). Ein steiler Anstieg des GSB > 90. Perzentile (> 0,25 mg/dl/h) ist mit einem niedrigen Gestationsalter [27,2 (25,4–29,3) vs. 28,4 (26,4–30,4) Schwangerschaftswochen], einem niedrigen Geburtsgewicht [978,0 (665,0–1120,0) vs. 1045,0 (814,0–1300,0) g] und einem niedrigen 5-min in Apgar Score [7 (7–8) vs. 8 (7–9)] assoziiert. Die 50. Perzentile des GSB von VLBW Frühgeborenen verläuft zwischen der 12.–48. Lebensstunde unterhalb der 40. Perzentile publizierter GSB-Konzentrationen reifer Neugeborener aus der Literatur. Schlussfolgerung: Die Anstiegsgeschwindigkeit des GSB ist ein Indikator für einen frühzeitigen Beginn und eine lange Behandlungsdauer der Fototherapie. Ein niedriges Gestationsalter, ein niedriges Geburtsgewicht sowie ein niedriger 5-min Apgar Score sind mit einem steilen Anstieg des GSB > 90. Perzentile assoziiert. Zwischen der 12.–48. Lebensstunde weisen VLBW Frühgeborene im Vergleich zu reifen Neugeborenen sowohl eine niedrigere absolute GSB-Konzentration als auch einen niedrigeren Anstieg des GSB auf. Insgesamt trägt die Forschungsarbeit zu einem verbesserten Verständnis des postnatalen Bilirubinanstiegs bei Frühgeborenen mit einem sehr niedrigen Geburtsgewicht < 1500 g bei und liefert wesentliche Erkenntnisse für Folgestudien. Zukünftige Studien könnten ein verbessertes, individualisiertes Management der Hyperbilirubinämie bei VLBW Frühgeborenen zum Ziel haben., Introduction: Newborn infants display a rise of total serum bilirubin (TSB) concentrations after birth. This can lead to irreversible damage of the central nervous system. Preterm infants are considered at high risk for bilirubin-mediated brain damage. To date, only little is known about the postnatal bilirubin increase in preterm infants. By analyzing the natural course of postnatal TSB concentrations in very low birth weight (VLBW) preterm infants, evaluating the rate of rise (ROR) of TSB (TSB ROR) as an indicator for the initiation and duration of phototherapy, assessing risk factors associated with a rapid rise of TSB > 90th percentile and comparing hour-specific TSB and TSB ROR at postnatal 12–48 hours with data of term infants retrieved from the literature, the present work aims to contribute to a better understanding of postnatal bilirubin increase in VLBW preterm infants. Methods: A retrospective analysis of 2430 routine capillary TSB measurements obtained between birth and initiation of phototherapy in 483 VLBW preterm infants was performed during a three-year study period. Results: In VLBW preterm infants postnatal TSB increases with an overall TSB ROR of 0.15 (0.11–0.19) mg/dL/h prior to the initiation of phototherapy. TSB ROR correlates with the age at initiation (RS = –0.687; p < 0.001) and the duration of phototherapy (RS = 0.444; p < 0.001). A rapid rise of TSB > 90th percentile (> 0.25 mg/dL/h) is associated with low gestational age [27.2 (25.4–29.3) vs. 28.4 (26.4–30.4) weeks], low birth weight [978.0 (665.0–1120.0) vs. 1045.0 (814.0–1300.0) g] and low 5-min Apgar scores [7 (7–8) vs. 8 (7–9)]. At postnatal 12–48 hours, the 50th percentile of TSB of VLBW preterm infants is below the 40th percentile of term infants retrieved from the literature. Conclusion: TSB ROR is an indicator for early and prolonged phototherapy. A low gestational age, a low birth weight and a low 5-min Apgar score are associated with a rapid rise of TSB > 90th percentile. At 12–48 hours, hour-specific TSB and TSB ROR are lower in VLBW preterm infants compared to term infants. Overall, the present work contributes to a better understanding of postnatal bilirubin increase in VLBW preterm infants and provides important knowledge for future studies. Future studies should be dedicated to contribute to a better and more individualized management of hyperbilirubinemia in VLBW preterm infants.

The multichannel switching mode of a controlled multigap switch is studied. The switch is designed for capacitive energy storage, with a charging voltage of up to 100 kV and an energy output time of about 100 ns. The interval between the high-voltage and low-voltage electrodes of this switch is divided into seven series-connected gaps using ball electrodes, and six parallel rows of these ball electrodes allow for multichannel switching. An optical system based on collimators and photodiodes was used to determine the number of channels in the switch gaps. Statistics on the number of channels were collected and the probability of ignition of parallel spark channels was calculated for each of the switch gaps under different operating conditions. We show that both the electrical isolation between the channels and the rate of rise of the triggering pulse significantly affect the number of parallel ignited channels and their distribution over consecutive gaps. At a high triggering voltage pulse rise rate ($\ensuremath{\sim}800\text{ }\text{ }\mathrm{kV}/\ensuremath{\mu}\mathrm{s}$), a larger number of spark channels are ignited in the switch with electrical isolation between the channels and the characteristics of this switch are better. At a low triggering voltage pulse rise rate (less than $250\text{ }\text{ }\mathrm{kV}\text{ }\ensuremath{\mu}\mathrm{s}$), better characteristics are realized in the switch without electrical isolation between the channels.

The fruits and vegetable waste has become the highest compared with the production rate. These types of wastes had reached up to 70% by 2019-2020 as estimated by Food and Agriculture Organization (FAO). Improvisation of the performance of still using fibre insulation (Artocarpus heterophyllus rags and Azadirachta indica gum (AHRAIG)) has been carried out in this study. Potable water demand in arid areas is a vast problem where fresh water is very expensive. The proposed solar still (PSS) retains the basin temperature and raises the rate of evaporation. Rags are latex-like filament extracted from the waste of the jackfruit peels and an adhesive agent from Azadirachta indica tree. A comparison is made among still without insulation (SWI), still with polystyrene insulation (SPI) and still with fibre insulation (SFI) in producing the fresh water under same ambient conditions. The experiments result a promising yield of 9.3% rate of rise of potable water produced using AHRAIG insulation related to conventional still. The energy efficiency is premeditated as 26.45%, while the exergy efficiency is 4.07%. The production of the potable water reached 2.58 L/m2 for still with polystyrene insulation, 3.26 L/m2 for fibre insulation and 1.93 L/m2 for still without insulation, respectively.

Purpose To compare real-time intraocular pressure (IOP) response to occlusion break event in 2 phacoemulsification systems. Setting Iladevi Cataract and IOL Research Center, India. Design Randomized, experimental study. Methods Rabbits were randomized to:Group I (n = 10 eyes), Centurion Vision system with active fluidics, or, Group II (n = 10 eyes), Centurion with Active Sentry. Within each group, parameter set 1 (IOP 30 mm Hg, aspiration flow rate [AFR] 20 mL/min, and vacuum 600 mm Hg) and parameter set 2 (IOP 50 mm Hg, AFR 25 mL/min, and vacuum 600 mm Hg) were tested. Real-time rate of drop and rise of IOP after occlusion break event (mm Hg per second) and percentage reduction of IOP from maximum during nuclear fragment removal were compared. Results 10 rabbits (20 eyes) were included. Rate of drop of IOP after occlusion break was not significantly different between groups. Rate of rise of IOP was statistically significantly higher in Group II with both parameter sets (199.09 ± 69.28 vs 94.33 ± 45.66 in parameter set 1, P = .006; and 256 ± 45.05 vs 165.25 ± 51.80 in parameter set 2, P = .005), suggesting faster recovery to baseline IOP after occlusion break. The mean percentage reduction of IOP from maximum was significantly higher in Group I (P = .003). Conclusions Rise of IOP to baseline after occlusion break event was faster and mean percentage reduction of IOP from maximum during nuclear fragment removal was lower when using the Centurion Vision system with the Active Sentry upgrade compared with the traditional handpiece. The ability to sense IOP at the level of the handpiece with the Active Sentry upgrade allows faster mitigation of surge response.

© 2020 BMJ Publishing Group. All rights reserved. Short circuit fault occurrence in high-voltage DC (HVDC) systems causes extremely high currents in a fast raising time that does not experience current zero-crossing. To protect HVDC systems/grids against fault current, fast HVDC breaker is an essential equipment. This study presents the design procedure of a novel HVDC breaker based on solid-state controllable reactor which is able to reduce the fault current's rate of rise and fault current amplitude to less than grid nominal current in the breaking process. The main achievement of the proposed HVDC breaker is that not only breaker does not encounter fault current, but also none of the series HVDC equipment is influenced by the fault. The designed breaker performance is studied by PSCAD/EMTPS, and then the simulation results are validated by the developed laboratory experimental setup.

Relative sea level is the difference in height between the coast and sea surface. It changes across space and through time in response to many different physical processes operating on a range of scales. Using an example from North Carolina, USA, we introduce some of these key processes and explore how their importance varies on timescales from hours (e.g., hurricanes and tides) to millennia (e.g., ongoing subsidence of the coast). Below the salt marshes of North Carolina (and elsewhere) are sequences of sediment that accumulated over thousands of years and record relative sea-level changes. Geologists collect this sediment, establish its age and interrogate it to understand when and how relative sea level changed long before people began to make systematic measurements. This research shows that the rate of rise during the twentieth century was without precedent in ~2000 years.

Background and ObjectivesWhile the number of detected COVID-19 infections are widely available, an understanding of the extent of undetected COVID-19 cases is urgently needed for an effective tackling of the pandemic and as a guide to lifting the lockdown. The aim of this work is to estimate and predict the true number of COVID-19 (detected and undetected) infections in India for short to medium forecast horizons. In particular, using publicly available COVID-19 infection data up to 28th April 2020, we forecast the true number of infections in India till the end of lockdown (3rd May) and five days beyond (8th May).MethodsThe high death rate observed in most COVID-19 hit countries is suspected to be a function of the undetected infections existing in the population. An estimate of the age weighted infection fatality rate (IFR) of the disease of 0.41%, specifically calculated by taking into account the age structure of Indian population, is already available in the literature. In addition, the recorded case fatality rate (CFR= 1%) of Kerala, the first state in India to successfully flatten the curve by consistently reporting single digit new infections from 12-20 April, is used as a second estimate of the IFR. These estimates are used to formulate a relationship between deaths recorded and the true number of infections and recoveries. The estimated undetected and detected cases time series based on these two IFR estimates are then used to fit a discrete time multivariate infection model to predict the total infections at the end of the formal lockdown period.ResultsOver three consecutive fortnight periods during the lockdown, it was noted that the rise in detected infections has decreased by 8.2 times. For an IFR of 0.41%, the rise in undetected infections decreased 2.5 times, while for the higher IFR value of 1%, undetected cases decreased by 2.4 times. The predicted number of total infections in India on 3rd May for both IFRs varied from 2.8 - 6.8 lakhs.Interpretation and ConclusionsThe behaviour of the undetected cases over time effectively illustrates the effects of lockdown and increased testing. From our estimates, it is found that the lockdown has brought down the undetected to detected cases ratio, and has consequently dampened the increase in the number of total cases. However, even though the rate of rise in total infections has fallen, the lifting of the lockdown should be done keeping in mind that 2.3 to 6.4 lakhs undetected cases will already exist in the population by 3rd May.

It has been identified that there are objects where ambient air temperature changes not only as a result of a fire, but also due to the operation of technological equipment and harsh climatic conditions. These changes affect the timing of work for the fire detector. These facilities include boiler rooms, kitchens, dryers, vehicles, etc. The article substantiates the need to develop a heat detector that would change its response parameters and at the same time would not contradict the regulatory requirements for its class. There have been proposed algorithms for the operation of a heat detector which changes the value of the static response temperature and the rate of rise temperature at which it responds. The algorithm of operation analyzes the speed of raising the ambient temperature without information about the operating modes of technological equipment and sets new values of the response based on the analysis.

As the age of the population continues to change, changes in the demographic structure affect the factors of China's real estate prices and such influences are increasingly expanding. This effect reflects the rapid rise in house prices, which has a negative effect on the rise in real estate prices, which has specifically slowed down the rate of rise in high house prices. This research specifically elaborates and analyzes the impact of population aging on real estate prices, and finally proposes comprehensive trends in real estate prices.

Background Concern exists over exponential growth in cardiac imaging in adults, but there is paucity of such data for cardiac imaging trends in pediatric patients. The aims of this study were to determine temporal trends in the use of noninvasive cardiac imaging and compare these with trends in the use of noncardiac imaging and to identify factors influencing those trends using the Pediatric Health Information Service database. Methods Pediatric inpatient encounter data from January 2004 to December 2017 at 35 pediatric hospitals were extracted from the Pediatric Health Information Service database. Temporal imaging utilization trends in cardiac and noncardiac ultrasound or echocardiography, magnetic resonance imaging (MRI), and computed tomography (CT) were assessed using linear mixed-effects models. Models were adjusted for case-mix index, complex chronic conditions, patient age, length of stay, payer source, and cardiac surgical volume. Results A total of 5,869,335 encounters over 14 years were analyzed (median encounters per center per year, 11,411; median patient age, 4 years; median length of stay, 3 days). From 2004 to 2017, the rates of pediatric inpatient cardiac and noncardiac ultrasound and MRI increased, whereas the rate of noncardiac CT decreased. Cardiac CT use increased beginning in 2014 (+0.264 cardiac CT encounters per 1,000 encounters per year), surpassing the rate of rise of cardiac MRI. Case-mix index, cardiac surgical volume, and payer source affected the largest number of imaging trends. Conclusions Among pediatric inpatients, utilization of cardiac and noncardiac ultrasound and MRI has steadily increased. Noncardiac CT use declined and cardiac CT use increased after 2014. Factors influencing imaging trends include case-mix index, cardiac surgical volume, and payer source. This study lays a foundation for investigations of imaging-related resource utilization and outcomes among pediatric inpatients.

Physics letters / B 802, 135199 (2020). doi:10.1016/j.physletb.2020.135199, We analyse the high precision HERA F$_2$ data in the low- x , x, Published by North-Holland Publ., Amsterdam

Records of measurements of sea levels from tide gauges are often &ldquo, segmented&rdquo, i.e., obtained by composing segments originating from the same or different instruments, in the same or different locations, or suffering from other biases that prevent the coupling. A technique is proposed, based on data mining, the application of break-point alignment techniques, and similarity with other segmented and non-segmented records for the same water basin, to quality flag the segmented records. This prevents the inference of incorrect trends for the rate of rise and the acceleration of the sea levels for these segmented records. The technique is applied to the four long-term trend tide gauges of the Indian Ocean, Aden, Karachi, Mumbai, and Fremantle, with three of them segmented.

The application of highly thickened tailings technologies is rapidly increasing due to the perceived benefits with respect to reduction of environmental impacts, water savings and potential reductions in dam size and footprint impoundment. Evaluation of this potential benefits requires that during early design stages an understanding is developed for the range of feasible beach slopes to be achieved during deposition. A comprehensive evaluation of the whole range of factors that influence the beach formation process is paramount to ensure that expected performance during design stages is met throughout operations. This paper presents an integral approach for beach slope estimation, considering a broader range of aspects affecting the beach formation process than those commonly used in current models (rheology and discharge rate of the deposited tailings). The additional aspects considered by this approach are site conditions (site morphology and climate), the rate of rise of the tailings impounded (the relationship between the tailings production rate and the available area for tailings spreading) and the deposition sequence (the configuration of the deposition system and its operation, e.g. thin layer deposition with drying cycles). The approach is supported by a beach slope model based on a dimensionless parameter for non-Newtonian flows, associated with sheet flows on an inclined plane, which directly relates to the tailings beach slope expected to be formed due to sub-aerial disposal. This dimensionless parameter provides a closed expression for estimating tailings beach slopes based on rheological properties and discharge rates, but with the integration of site conditions, rate of rise and deposition sequence. High thickened tailings management facility (TMF) design is well supported by this approach, providing key input as the configuration of the distribution system and the minimum area required to achieve expected performance with respect to desired beach slope, density, degree of saturation and strength.

Exercise training is known to protect the heart from ischemia and improve function during exercise by reducing cardiomyocyte action potential duration (APD) and increasing contractility. The cellular mechanisms involve β-adrenergic regulation and the ATP-sensitive K+(KATP) channel, but how each alters function of the left ventricle and sex specificity is unknown. To address this, female and male Sprague-Dawley rats were randomly assigned to wheel-running (TRN) or sedentary (SED) groups. After 6–8 wk of training, myocytes were isolated from the left ventricle and field stimulated at 1, 2, and 5 Hz. TRN significantly increased cardiomyocyte contractility, the kinetics of the Ca2+transient, and responsiveness to the adrenergic receptor agonist isoproterenol (ISO), as reflected by an increased sarcomere shortening. Importantly, we demonstrated a TRN-induced upregulation of KATPchannels, which was reflected by elevated content, current density, and the channel’s contribution to APD shortening at high activation rates and in the presence of the activator pinacidil. TRN induced increase in KATPcurrent occurred throughout the left ventricle, but channel subunit content showed regional specificity with increases in Kir6.2 in the apex and SUR2A in base regions. In summary, TRN elevated cardiomyocyte cross-bridge kinetics, Ca2+sensitivity, and the responsiveness of contractile function to β-adrenergic receptor stimulation in both sexes. Importantly, upregulation of the KATPchannel accelerates repolarization and shortens APD during stress and exercise. These adaptations have clinical importance, as increased contractility and reduced APD would help protect cardiac output and reduce intracellular Ca2+overload during stresses such as regional ischemia.NEW & NOTEWORTHY Our results demonstrate that regular exercise significantly increased ventricular myocyte shortening and relaxation velocity and the rate of rise in intracellular Ca2+transient and enhanced the response of biomechanics and Ca2+reuptake to β-adrenergic stimulation. Importantly, exercise training upregulated the cardiomyocyte sarcolemma ATP-sensitive K+channel across the left ventricle in both sexes, as reflected by elevated channel subunit content, current density, and the channel’s contribution to reduced action potential duration at high activation rates.

This paper deals with experimental and numerical investigation on thermal stratification phenomenon conducted in a scaled transparent pool using Particle Image Velocimetry (PIV) technique and Computational Fluid Dynamics (CFD) simulations respectively. Experiments were designed to simulate thermal stratification in a pool with an immersed heat exchanger. In general, pools with an immersed heat exchanger tend to get thermally stratified; preventing mixing and participation of the whole pool during the heat removal process. The study presented in the paper, focuses on quantification of thermal stratification in the pool without shrouds and examines the effect of shrouds on suppression of thermal stratification. The installation of three shrouds divides the pool in four compartments and ensures participation of the whole pool inventory in the heat removal process. In all the four compartments, pool water circulation was observed since the beginning of the heat transfer from the heater. In a three-shroud configuration, because of mixing, rate of rise of temperature of water near the top decreases.

Traditionally, soil temperatures at various depths were measured daily at agricultural research stations around the world. Short-term fluctuations are damped at depth, acting as a natural low pass filter on soil surface temperature time series. In the last 20 years, a number of northern hemisphere soil temperature data sets have been analysed for long term trends, but our analysis at four sites in eastern Australian is the first in the southern hemisphere. Soil temperature data at Cowra in New South Wales, Australia was recorded daily at 09.00 at a depth of 1.8 m from 1942 to 2010, together with rainfall and maximum and minimum air temperature data. From 1972 temperatures at some shallower depths were also recorded. We found significant average annual temperature rises in soil and air temperature data, with greater rises in the soil temperatures over this period. We also analysed soil and air temperature data recorded from 1970 at Gunnedah, Inverell and Brigalow in eastern Australia. To standardise for soil temperature measurements taken at various depths, we proposed a model that estimated the rise of the ground surface temperature accounting for the attenuation and delay of the surface temperature signal with depth. We estimated the rise of the soil surface temperature Cowra from about 1970 as 0.06 K year− 1. We found the rate of rise of the average of the daily maximum and minimum air temperatures to be 0.022 K year− 1. For Gunnedah, Inverell, and Brigalow, from 1970 the rates of rise of soil temperatures at 1 m and air temperatures were at around 0.02 K year− 1. These soil temperature data show a clear warming trend overall since about 1970.

Neonatal jaundice is observed during 1st week of life in approximately 60% of term infants and 80% of preterm infants. All jaundiced newborns are at potential risk for developing severe hyperbilirubinemia if there is uncontrolled or managed inappropriately. The objective of this study is to compare serum bilirubin level of term and preterm babies. A cross-sectional study was conducted with total of 100 newborns babies who were admitted into neonatal unit, babies from obstetric department and who came for checkup and follow up in neonatal unit of Mymensingh Medical College Hospital, Mymensingh during the period August 2006 to January 2007. In this study, mean gestational age of term babies was 38.9±1.22 weeks and of preterm babies was 34.64±1.05 weeks. Mean bilirubin levels observed in term babies 6.68 and 5.72 mg/dl on day 3 and day 5 respectively. In preterm babies, the mean bilirubin levels were 7.16 and 9.09 mg/dl on day 3 and day 5 respectively. Statistically significant differences were observed in bilirubin level on day 5 in both term and preterm groups (p

Several previous studies have found that interventions by security forces against criminal organisations result in increased violence related to organised crime. However, much less is known about how and why this effect occurs. Our study not only identifies the causal mechanisms that explain this outcome, but also evaluates the empirical validity of these mechanisms. Employing a novel data set, we find that following security-force intervention, the number of criminal organisations increases, and such greater fragmentation in turn raises the incidence of violence among criminal organisations as the relative power of the organisations changes. We employ a mediation model to verify the existence of these causal mechanisms. In addition, we find a decreasing rate of rise in levels of violence as the number of organisations increases.

Background:To assess cardiovascular risk among various hemoglobin (Hb) rates of rise (RoR) in chronic kidney disease (CKD) patients with anemia who have initiated therapy with erythropoiesis stimulating agents (ESAs).Methods:Observational cohort of CKD patients initiating ESA therapy from the Centricity®database, 1990–2011. Proportional hazards models tested the hypothesis that a slower Hb RoR (0 < g/dl/month ⩽ 0.125) is associated with a lower cardiovascular (CV) incidence [composite of fatal/nonfatal myocardial infarction (MI) and stroke] compared with faster RoR (0.125 < g/dl/month ⩽ 2.0, and >2.0 g/dl/month).Results:A total of 9220 patients receiving ESAs were followed for an average of 3.1 years. Slow (group B) RoR versus medium (group C′) and fast (group D′) RoR in Hb, throughout all Hb milestones, was associated with lower risk of the composite endpoint [B (slow) versus D′ (fast) [hazard ratio (HR) = 0.20 (0.11, 0.39), p < 0.0001]; B versus C′ (medium) [HR = 0.34 (0.19, 0.62), p = 0.0004], and C′ versus D′ [HR = 0.60 (0.42, 0.85), p = 0.005]]. Within achieved Hb milestones, HRs were: B versus D′ at milestone ⩾ 14.1 g/dl [HR = 0.17 (0.05, 0.56); p = 0.004] and at milestone 12.6−14.0 [HR = 0.18 (0.07, 0.46), p = 0.0004].Conclusion:Rapid Hb rise is associated with adverse CV outcomes, with markedly lower risk for rates below a threshold trajectory of 0.125 g/dl/month, even with complete correction.

Objective: To evaluate the efficacy of a single intravenous (IV) dose of anti-D in severe thrombocytopenia ( Materials and Methods: An open label, investigator-initiated, randomized interventional study was conducted that included thirty dengue patients (all positive for IgM enzyme-linked immunosorbent assay) with severe thrombocytopenia ( 3 ). Patients were randomized to receive anti-D (50 μg/kg single IV dose) plus supportive therapy or supportive therapy alone. Results: The rate of rise in platelet count was significantly high in the intervention group at 24, 36, and 48 h. At the end of 48 h, 60% patients in the intervention group achieved a platelet count of ≥50,000/mm 3 as compared to 6.7% in the control group ( P = 0.0019). The requirement of the platelet concentrate infusion in the control group was significantly higher, i.e. 342 ml (±193) as compared to the intervention group requiring only 187 ml (±79). The intervention group showed a significant improvement in bleeding manifestations in all the patients by 24 h in Grade 2 bleed ( P = 0.032) and by 48 h in Grade 1 bleed ( P = 0.014). Conclusions: Severe thrombocytopenia (≤20,000/mm 3 ) secondary to DEV infection was rapidly and safely reversed by administration of a single dose of 50 μg/kg (250 IU/kg) anti-D IV.

This paper proposes a new algorithm for the protection of power transformer depending on the rate of rise of differential currents. In which, all the winding currents of all the phases of power transformer are sensed through current transformer and based on the phasor difference between currents, differential currents of all phases are computed. Based on the value of differential current, abnormal condition is detected and rate of rise of differential currents (RRDC) is calculated. Further peak of the sum of derivative of RRDC function (SDRRDC) of all three phases is calculated and which is used to distinguish between external disturbances (magnetic inrush) and internal faults of transformer. For the validation of proposed protection algorithm, internal faults (symmetrical and asymmetrical) like line-to-ground (LG), line-to-line (LL), line-to-line-to-ground (LLG), line-to-line-to-line (LLL) and line-to-line-to-line-ground (LLLG), magnetic inrush as external disturbance and energisation of faulted transformer events are considered. Several test cases are generated, simulated and verified using PSCAD/EMTDC and MATALB software packages. The proposed scheme precisely discriminates between magnetic inrush and internal faults condition with less response time than the conventional biased differential current protection scheme.

Background Intestinal failure-associated liver disease (IFALD), a multifactorial disease, is common among infants with gastrointestinal surgical disorders (GISDs). Prolonged soy-based intravenous lipid emulsion (S-ILE) intake is associated with IFALD, but preventive studies of limiting S-ILE have been inconclusive. Furthermore, a double-blind, randomized preventive trial (DBRPT) of S-ILE intake has not been performed in infants with GISDs. Our objective was to compare the effect of 1 g/kg/d vs 2 g/kg/d S-ILE intake for 6 weeks on the incidence of IFALD and the rate of rise of direct bilirubin (DB) in infants with GISDs. Methods A DBRPT was conducted in infants with GISDs at ≥34 weeks' gestational age (GA) admitted to the NICU within 72 hours after birth. Infants were randomized in a 1:1 ratio to receive either 1 or 2 g/kg/d S-ILE for 6 weeks. IFALD was defined as DB ≥2 mg/dL. Results Forty infants were studied. The 2 groups had similar clinical characteristics except for GA and blood group incompatibility. Thirty percent of infants in each group developed IFALD (P = .94). However, infants in the group receiving 1 g/kg/d S-ILE (n = 20) had a lower rate of rise of DB compared with infants in the group receiving 2 g/kg/d S-ILE (n = 20). Conclusions Reducing S-ILE intake for 6 weeks in infants with GISD at ≥34 weeks' GA may not prevent IFALD. The extrapolated data on the rate of rise of DB suggest a possible risk of earlier development of IFALD with S-ILE intake of 2 g/kg/d, as compared with 1 g/kg/d, beyond the 6-week study period.

Here I analyze the relative sea level signals from the tide gauges of North America. Linear and parabolic fittings are used to compute relative rates of rise and accelerations. There are 20 long-term-trend (LTT) tide gauges along the (Pacific) West Coast of North America. The average relative rate of rise is −0.38 mm/year, and the average acceleration is +0.0012 mm/year2. There are 33 LTT tide gauges of the (Atlantic) East Coast of North America. The average relative sea level rise is 2.22 mm/year, and the average acceleration is +0.0027 mm/year2.

Aim of the Study Elevation of the head and thorax (HUP) during cardiopulmonary resuscitation (CPR) has been shown to double brain blood flow with increased cerebral perfusion pressures (CerPP) after active compression-decompression (ACD) CPR with an impedance threshold device (ITD). However, the optimal angle for HUP CPR is unknown. Methods In Study A, different angles were assessed (20°, 30°, 40°), each randomized over 5-min periods of ACD + ITD CPR, after 8 min of untreated ventricular fibrillation in an anesthetized swine model. Based upon Study A, Study B was performed, where animals were randomized to 1 of 2 sequences: 20°, 30°, 40° or 40°, 30°, 20° with a similar protocol. The primary endpoint was CerPP for both studies. Results In Study A, no optimal HUP angle was observed in 18 pigs. CerPPs for 30° and 40° (mmHg, mean ± SD) were equivalent (44 ± 22 and 47 ± 26, p = 0.18). However, CerPP appeared higher when 40° HUP was performed during the last 5-min of CPR, suggestive of a sequence effect. For Study B, after 17 min of CPR, CerPP (mmHg) were higher with the 20°, 30°, 40° sequence: 60 ± 17 versus 33 ± 18 (p = 0.035). Conclusions No optimal HUP CPR angle was observed. However, controlled progressive elevation of the head and thorax during CPR is more beneficial than an absolute angle or height to maximize CerPP. Further studies are needed to determine the optimal rate of rise during HUP ACD + ITD CPR. Institutional Protocol Number 17-06.

Background As compared to term neonates, those < 35 weeks gestation (wks GA) are at greater risk for both acute and chronic bilirubin encephalopathy (ABE, CBE). Among these with postnatal total bilirubin rate of rise, (TB ROR) at age 0 to 72 hours has been observed because of either loss placental elimination system or increased postnatal production due to hemolysis. The ranges are known to vary > 8.5 umol/L/h in neonates with Rh disease to >3.4 umol/L/h at the 95th percentile track of the hour-specific nomogram. TB ROR in healthy term neonates is Objectives To determine the GA ranges on TB ROR to explore predictive TB ROR in preterm neonates who are more vulnerable with each Design/Methods A multi-site observational study to quantify TB ROR in preterm infants between 28 to 35 weeks. 1804 infants born between January 2013- March 2018 at 28–35 wks GA from three canadian perinatal centres were included and those with Rh disease were excluded. Analysis included infants >27 weeks with at least one TB prior to the initiation of treatment for severe hyperbilirubinemia treatment. Feeding patterns, birth history and maternal health conditions were documented. Results The TB ROR were compared by two prematurity GA groups (28–31 weeks and 32–35 weeks) then per individual gestational age in four time periods in hours, 0–24, 24–48, 48–96, and 96 -120 in 1049 preterm infants using 3065 TB samples. Infants Conclusion Though TB ROR were of similar patterns between prematurity groups (28–31 weeks and 32–35 weeks) it was at higher rate of rise between 13–36 hours and decreasing from 36–72 hours, with a plateau after 72 hours of age. There was a significant difference in the magnitude of TB ROR between prematurity groups at 0–24 hours. Additional research into the clinical care impact on the TB ROR should be conducted to study impact of production and elimination.

The storage capacity and rate of rise of a tailings storage facility (TSF) constructed utilising the tailings to form the TSF is dependent on the outer side slopes of the facility. A number of TSFs in South Africa are operated utilising cyclones to construct the outer wall zone of the TSF. The outer slope is dependent on the stacking angle of the cyclone underflow and hence it is critical that the design of the TSF accurately estimates the stacking angle. There are no clear guidelines to make this estimation other than to compare to similar projects. This methodology has resulted in a few TSFs in which the stacking angle was either over or underestimated leading to an inaccurate life assessment. This paper hypothesises that the yield stress of the underflow has the most significant effect on the stacking angle. The hypothesis is tested by measuring various tailings properties on a tailings operation in relation to the stacking angle achieved to attempt to develop a method to predict the stacking angle for future projects.

We show here the presence of significant “coldspot” of sea level rise along the West Coast of the United States and Canada (including Alaska). The 30-years sea level for the area are mostly falling also at subsiding locations as San Francisco and Seattle where subsidence is responsible for a long term positive rate of rise. The 20 long term tide gauges of the area of length exceeding the 60-years length have a naïve average rate of rise −0.729 mm/year in the update 30-Apr-2015, down from −0.624 mm/year in the update 14-Feb-2014. Therefore, along the West Coast of the United States and Canada the sea levels are on average falling, and becoming more and more negative.

A two-channel configured analog microcircuit, intended for applications in optoelectronic devices of space equipment, is created on complementary bipolar transistors. The different combination of microcircuit pins and connection of external RC-elements allow one to create several analog units with specified values of the conversion coefficient of the input signal, bandwidth, rate of rise, and consumed current. The maximal gain of the microcircuit with an open negative feedback loop exceeds 75 dB, and the bandwidth at the 20-fold gain is more than 19.4 MHz. The circuit designs of separate stages of the microcircuit and experimental characteristics are given.