13 research outputs found
Automated columnar microstructure analysis using CoCo (Column Counter): insights from EB-PVD TBCs
No full textThermal barrier coatings (TBCs) are essential for protecting gas turbine components from extreme heat. The columnar microstructures produced by conventional electron beam physical vapour deposition (EB-PVD) provide pathways for the transport of heat and molten calcium–magnesium–alumino–silicates (CMAS), compromising their insulation capability and durability. Modifications to the columnar grain morphology have been shown to improve the performance and durability of EB-PVD TBCs, but replicable quantification of these key morphologic parameters remains elusive. In the present work, we present an automated method for the measurement of column width, Column Counter (CoCo). This method is applied to characterize a wide array of microstructures produced by systematically varying substrate temperature (430–1030 °C) and rotation speed (1–8 rpm). The wide spectrum of novel microstructures produced, ranging from columns with periodic porosity bands to layered architectures, markedly diverge from standard columnar TBCs. The morphological analysis is complemented by advanced characterization via X-ray diffraction (XRD) and electron backscattered diffraction (EBSD), revealing how the deposition parameters control column width, crystallographic texture strength and grain multiplicity within columns. Lower temperatures and slower rotations promote finer, less strongly textured coatings with reduced intercolumnar pathways. The results obtained through CoCo showcase the potential of automated morphological analysis in the tailored design of TBCs for improved performance and durability.The author acknowledges the support from the EPSRC (United Kingdom) grant EP/L016389/1Surface and Coatings Technolog
Pentecostalism: a descriptive history of the origin, growth, and message of a twentieth century religious movement
No full textThesis (Ph.D.)--Boston UniversityPLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at [email protected]. Thank you.The purpose of this dissertation is to present a descriptive history of the origin, growth, and message of Pentecostalism, a twentieth-century religious movement which stresses the belief that a Holy Spirit baptism, accompanied by some sort of charismatic manifestation like glossolalia, ought to be the normative religious experience of all Christians.
However, information about Pentecostalism, which in little more than a half century has emerged from a small decentralized fellowship to an evangelistic movement that today nearly encompasses the globe, has not kept pace with its growth and influence. Most books on church history, religious encyclopedias, and periodical and newspaper indexes have seemingly ignored the movement; therefore, it has been necessary for the author to locate and consult rare collections of Pentecostaliana both here and abroad. Many of these materials-yearbooks, minutes, pamphlets, periodicals, monographs, and tracts-are cited for the first time in what is perhaps the most exhaustive bibliography on Pentecostalism that has yet appeared.
Based on the aforementioned data and supplemented by firsthand observation--attendance at Pentecostal worship services, revivals, camp meetings, national conclaves, and international conferences-this work accomplishes the following: (1) It reviews those characteristics of faith and practice that are unique to Pentecostalism, that set it apart from other types of Protestant Christianity. (2) It traces modern Pentecostalism from its modest beginnings in Topeka, Kansas, in 1901, to its rather rapid expansion throughout the world. (3) It offers reasons for the widespread extension of Pentecostalism during the early decades of this century as well as for the severe opposition which it encountered. (4) It classifies the scores of groups which comprise contemporary Pentecostalism and, at the same time, suggests causes for such frequent proliferation. Furthermore, it provides a country- by-country chronicle of many foreign Pentecostal groups about which little or nothing has been written heretofore. (5) It surveys the most significant trends that have taken place within Pentecostalism since World War II.
The following conclusions have been reached through this study:
1. The teachings which distinguish Pentecostalism from all other religious movements are (a) its declaration that a baptism in the Holy Spirit accompanied by the evidential sign of glossolalia or some other charismatic manifestation ought to be normative to the Christian religious experience, and (b) its emphasis on healing.
2. The present size of Pentecostalism with its world-wide adult membership of more than seven million certainly qualifies it to be called the largest of all the charismatic-healing movements in church history.
3. Whereas most American denominations are the result of the migration of sectarian groups from Europe, Pentecostalism is almost wholly American in origin.
4. Pentecostalism has been experiencing changes, slowly but nonetheless perceptibly during its brief history. Charismatic spontaneity has been replaced by a modified institutionalism; the adherence of many groups to a rigorous puritan ethic has abated somewhat; the principle of independency has been replaced by a belief in local, national, and even international organization.
5. It is difficult to classify the entire movement either as a sect, or a cult, or a denomination because of its eclecticism and diversity in matters of faith, liturgy, and organization.
6. American Pentecostalism appears to be segregative. Although Negroes contributed greatly to the early development of the movement, Negro leaders and Negro groups like the massive Church of God in Christ are today conspicuously absent from associations like the Pentecostal Fellowship of North America.
7. Reports that adherents to Pentecostalism have been excessively fanatical or grossly immoral appear to be greatly exaggerated.
8. Pentecostalism has emerged as the leading "Third Forcen group in Christendom. It needs to be reckoned with rather than ignored.2999-01-0
Scaling up hepatitis B vaccination with the support of GAVI in China : lessons learned for introduction of new vaccines and for the future of hepatitis B control
No full textBackground: Hepatitis B virus (HBV) infection is a leading cause of illness and death in China. In 1992, 60% of the population had a history of HBV infection and 9.8% were chronically infected with HBV. Each year, an estimated 263,000 persons died from HBV-related hepatocellular carcinoma or cirrhosis, accounting for 37%-50% of HBV-related deaths worldwide before 1992. In 1992, the Ministry of Health introduced hepatitis B vaccine into the management system of the Expanded Programme on Immunization (EPI) as a cost-effective way to prevent HBV infection. The schedule included a timely birth dose (within 24 hours of birth, to prevent perinatal infections that are most strongly associated with long term chronic infections and adverse outcomes) and subsequent doses at one month and six months. However, this introduction into the EPI management system only meant that the Government took responsibility over administration and coverage monitoring, but not funding support: The cost of vaccination was covered out of pocket. As a result, coverage was lower in rural areas, in Western provinces (low economic status) and among females. In 2002, the Ministry of Health fully integrated free hepatitis B vaccine into EPI with funding from the Global Alliance for Vaccines and Immunization (GAVI). The GAVI China project financially supported vaccine and auto-disable syringes in Western provinces and poverty-affected counties of Central provinces (Chapter 1). As the GAVI China project was completed in 2010, we compiled all evaluation work conducted to understand how input and process lead to output and outcomes that impacted the heavy HBV associated burden in China.
Methods: We compiled data from GAVI China project areas between 2002 and 2009, reviewed cross-sectional studies conducted in 2004 and 2006 and conducted a final evaluation survey in 2010. These investigations covered input (funds invested into the project for vaccine and AD syringes), process (integration of the vaccine in EPI, increase in institutional births, introduction of auto-disable syringes for vaccination and training), output (immunization coverage for third dose and timely birth dose, use of auto-disable syringes for immunization), outcome (immunity in the population, safe injection practices) and impact (prevalence of HBV surface antigen among children included in the vaccination cohort).
Results: With respect to hepatitis B immunization, input included 27 million USD provided by the GAVI China project to funds hepatitis B vaccine between 2002 and 2007. These funds came from the international GAVI Alliance (50%) and the Government of China (50%). In addition, the Chinese government provided an additional 21.5 million USD in government co-funding of subsidies from central to provincial to health care workers in provinces between 2007 and 2009 so that the vaccine could be administered without user fees. The health system efficiently processed these resources. First, in GAVI-supported areas, the increase in the HepB3/DPT3 ratio (increased from 57% in 2002 to 94% in 2009), indicated indicating that EPI absorbed well the new vaccine. Second, institutionalized deliveries increased to reach 96% nationwide in 2009, indicating that maternal and child health services created conditions to maximize coverage of the timely birth dose. As a result, from 2002 to 2009, the national three-dose hepatitis B vaccine coverage progressed from 71% to 93% (Chapter 5) and the timely birth dose coverage progressed from 60% to 91% (Chapter 7) with a reduction of inequities between Eastern and Western areas. Both of these resulted in immunity among vaccinated cohorts (85% of anti-HBs among children 12 to 23 months of age in the national 2006 serological survey) (Chapter 2). One key factor strongly associated with being HBsAg negative is receiving timely birth dose of hepatitis B vaccine as early as possible (Chapter 4).
With respect to injection safety, input included 14 million USD of GAVI funds to supply auto-disable syringes, safety boxes and needle cutters. In 2009, auto-disable syringes and safety boxes were used in 78% and 79% facilities in GAVI supported areas of the Western areas, respectively (Chapter 6). In terms of output, sterilizable injection devices disappeared and attempts to re-use disposable injection equipment became rare (0% in the 2010 final evaluation). However, no data regarding the incidence of injection-associated infections were available to evaluate the outcome of the progress in injection safety.
With respect to social mobilization and training, 10 million USD were assigned to training between 2002 and 2009. Most of those were not directly funded by GAVI China. These funds were provided by the Government because of the leverage effect of the GAVI China project. These were used in 28,753 training workshops for health care workers that resulted in better knowledge among health care workers (In 2010, 98% of them knew that hepatitis B virus can be transmitted from mother to child) and guardians (In 2010, 89% of them knew that the first dose of hepatitis B vaccine had to be given in the first 24 hours of life). This higher level of knowledge also contributed to higher immunization coverage and safer injections.
Ultimately, the elements of the GAVI China project combined at the impact level to prevent HBV infections. The 2006 national serological survey documented these achievements and pointed to 1% prevalence of HBsAg among children under five years of age, a decrease of 90% from the 9.8% prevalence in the same age group in 1992 (Chapter 3). These infections prevented will lead to the future prevention of cirrhosis, hepatocellular carcinoma. Those should result in early deaths prevented and benefits in terms of disability-adjusted life years (DALYs). However, in 2010, it was too early to measure these longer term effects and the final impact of the project on HBsAg prevalence had not yet been quantified.
Conclusion: The introduction of hepatitis B vaccine into the national immunization programme was successful and the strategies and policy used for the GAVI China project provided a successful case study for the introduction of other new vaccines in China. The determinants of the success of the GAVI China included (1) a well documented disease burden, (2) a good collaboration between the government of China and the international GAVI Alliance that resulted in a strong national GAVI China project, (3) local production of vaccine and AD syringes, (4) solid processes for implementation and (5) leverage of additional support through national and provincial levels co-funding. Remaining challenges include (1) the persistence of an estimated 80,000 perinatal HBV infections each year in China, (2) the lack of homogeneous regulations to harmonize injection practices, (3) the absence of a scaled implementation for the national policy that recommends vaccination of health care workers, (4) the weak specificity and sensitivity of acute hepatitis B surveillance and (5) the absence of policy and plans for the management of chronic hepatitis B infection. We recommended that China (1) maintain universal hepatitis B infant vaccination, with a high priority to reach all infants, especially for those living in remote, mountain areas (2) make additional efforts to strengthen the health system and further improve hospital delivery rates to increase timely birth dose coverage and decrease perinatal HBV transmission, (3) develop clear surveillance guidelines to monitor acute hepatitis B rates (4) immunize health care workers, with an emphasis on pre-service delivery (5) collect manage sharps waste in a way that is safe for the health care workers, the community and the environment, and (6) screen pregnant women to administer adapted immuno-prophylaxis (including hepatitis B immune globulin, HBIG) for children born to those HBsAg positive. These should prepare the country for the next phase of a policy for the prevention and control of hepatitis B, which should ultimately include screening and treatment of patients with chronic infections, particularly those of older age cohorts who were born before the era of universal immunizatio
The multi-societal European consensus on the terminology, diagnosis and management of patients with synchronous colorectal cancer and liver metastases: an E-AHPBA consensus in partnership with ESSO, ESCP, ESGAR, and CIRSE
No full textBackground: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases with a focus on terminology, diagnosis and management. Methods: This project was a multi-organisational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis and management. Statements were refined during an online Delphi process and those with 70% agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising twelve key statements. Results: Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term "early metachronous metastases" applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour with "late metachronous metastases" applied to those detected after 12 months. Disappearing metastases applies to lesions which are no longer detectable on MR scan after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways including systemic chemotherapy, synchronous surgery and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusions: The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases
Recurrence patterns and post-recurrence survival of patients with bilobar colorectal liver metastases: international multicentre retrospective study
No full textMultisocietal European consensus on the terminology, diagnosis, and management of patients with synchronous colorectal cancer and liver metastases: an E-AHPBA consensus in partnership with ESSO, ESCP, ESGAR, and CIRSE
No full textBackground: Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management. Methods: This project was a multiorganizational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis, and management. Statements were refined during an online Delphi process, and those with 70 per cent agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising 12 key statements. Results: Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term 'early metachronous metastases' applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour, the term 'late metachronous metastases' applies to those detected after 12 months. 'Disappearing metastases' applies to lesions that are no longer detectable on MRI after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards, and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways, including systemic chemotherapy, synchronous surgery, and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusion: The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases
Recurrence patterns and post-recurrence survival of patients with bilobar colorectal liver metastases : international multicentre retrospective study
No full textSparsentan in patients with IgA nephropathy: a prespecified interim analysis from a randomised, double-blind, active-controlled clinical trial
No full textBackground: Sparsentan is a novel, non-immunosuppressive, single-molecule, dual endothelin and angiotensin receptor antagonist being examined in an ongoing phase 3 trial in adults with IgA nephropathy. We report the prespecified interim analysis of the primary proteinuria efficacy endpoint, and safety. Methods: PROTECT is an international, randomised, double-blind, active-controlled study, being conducted in 134 clinical practice sites in 18 countries. The study examines sparsentan versus irbesartan in adults (aged ≥18 years) with biopsy-proven IgA nephropathy and proteinuria of 1·0 g/day or higher despite maximised renin-angiotensin system inhibitor treatment for at least 12 weeks. Participants were randomly assigned in a 1:1 ratio to receive sparsentan 400 mg once daily or irbesartan 300 mg once daily, stratified by estimated glomerular filtration rate at screening (30 to 1·75 g/day). The primary efficacy endpoint was change from baseline to week 36 in urine protein-creatinine ratio based on a 24-h urine sample, assessed using mixed model repeated measures. Treatment-emergent adverse events (TEAEs) were safety endpoints. All endpoints were examined in all participants who received at least one dose of randomised treatment. The study is ongoing and is registered with ClinicalTrials.gov, NCT03762850. Findings: Between Dec 20, 2018, and May 26, 2021, 404 participants were randomly assigned to sparsentan (n=202) or irbesartan (n=202) and received treatment. At week 36, the geometric least squares mean percent change from baseline in urine protein-creatinine ratio was statistically significantly greater in the sparsentan group (-49·8%) than the irbesartan group (-15·1%), resulting in a between-group relative reduction of 41% (least squares mean ratio=0·59; 95% CI 0·51-0·69; p<0·0001). TEAEs with sparsentan were similar to irbesartan. There were no cases of severe oedema, heart failure, hepatotoxicity, or oedema-related discontinuations. Bodyweight changes from baseline were not different between the sparsentan and irbesartan groups. Interpretation: Once-daily treatment with sparsentan produced meaningful reduction in proteinuria compared with irbesartan in adults with IgA nephropathy. Safety of sparsentan was similar to irbesartan. Future analyses after completion of the 2-year double-blind period will show whether these beneficial effects translate into a long-term nephroprotective potential of sparsentan. Funding: Travere Therapeutics
Famílies botàniques de plantes medicinals
No full textFacultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia, Assignatura: Botànica Farmacèutica, Curs: 2013-2014, Coordinadors: Joan Simon, Cèsar Blanché i
Maria Bosch.Els materials que aquí es presenten són els recull de 175 treballs d’una família botànica d’interès medicinal realitzats de manera individual. Els treballs han estat realitzat
per la totalitat dels estudiants dels grups M-2 i M-3 de l’assignatura Botànica Farmacèutica
durant els mesos d’abril i maig del curs 2013-14. Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pel professor de l’assignatura i revisats i finalment co-avaluats entre els propis estudiants. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica
Efficacy and safety of sparsentan versus irbesartan in patients with IgA nephropathy (PROTECT): 2-year results from a randomised, active-controlled, phase 3 trial
No full textBackground: Sparsentan, a novel, non-immunosuppressive, single-molecule, dual endothelin angiotensin receptor antagonist, significantly reduced proteinuria versus irbesartan, an angiotensin II receptor blocker, at 36 weeks (primary endpoint) in patients with immunoglobulin A nephropathy in the phase 3 PROTECT trial's previously reported interim analysis. Here, we report kidney function and outcomes over 110 weeks from the double-blind final analysis.
Methods: PROTECT, a double-blind, randomised, active-controlled, phase 3 study, was done across 134 clinical practice sites in 18 countries throughout the Americas, Asia, and Europe. Patients aged 18 years or older with biopsy-proven primary IgA nephropathy and proteinuria of at least 1·0 g per day despite maximised renin-angiotensin system inhibition for at least 12 weeks were randomly assigned (1:1) to receive sparsentan (target dose 400 mg oral sparsentan once daily) or irbesartan (target dose 300 mg oral irbesartan once daily) based on a permuted-block randomisation method. The primary endpoint was proteinuria change between treatment groups at 36 weeks. Secondary endpoints included rate of change (slope) of the estimated glomerular filtration rate (eGFR), changes in proteinuria, a composite of kidney failure (confirmed 40% eGFR reduction, end-stage kidney disease, or all-cause mortality), and safety and tolerability up to 110 weeks from randomisation. Secondary efficacy outcomes were assessed in the full analysis set and safety was assessed in the safety set, both of which were defined as all patients who were randomly assigned and received at least one dose of randomly assigned study drug. This trial is registered with ClinicalTrials.gov, NCT03762850.
Findings: Between Dec 20, 2018, and May 26, 2021, 203 patients were randomly assigned to the sparsentan group and 203 to the irbesartan group. One patient from each group did not receive the study drug and was excluded from the efficacy and safety analyses (282 [70%] of 404 included patients were male and 272 [67%] were White) . Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6-110) was -2·7 mL/min per 1·73 m2 per year versus -3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2 per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1-week 110) was -2·9 mL/min per 1·73 m2 per year versus -3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI -0·03 to 1·94; p=0·058). The significant reduction in proteinuria at 36 weeks with sparsentan was maintained throughout the study period; at 110 weeks, proteinuria, as determined by the change from baseline in urine protein-to-creatinine ratio, was 40% lower in the sparsentan group than in the irbesartan group (-42·8%, 95% CI -49·8 to -35·0, with sparsentan versus -4·4%, -15·8 to 8·7, with irbesartan; geometric least-squares mean ratio 0·60, 95% CI 0·50 to 0·72). The composite kidney failure endpoint was reached by 18 (9%) of 202 patients in the sparsentan group versus 26 (13%) of 202 patients in the irbesartan group (relative risk 0·7, 95% CI 0·4 to 1·2). Treatment-emergent adverse events were well balanced between sparsentan and irbesartan, with no new safety signals.
Interpretation: Over 110 weeks, treatment with sparsentan versus maximally titrated irbesartan in patients with IgA nephropathy resulted in significant reductions in proteinuria and preservation of kidney function
