Comparison of modern icing cloud instruments

Intercomparison tests with Particle Measuring Systems (PMS) were conducted. Cloud liquid water content (LWC) measurements were also taken with a Johnson and Williams (JW) hot-wire device and an icing rate device (Leigh IDS). Tests include varying cloud LWC (0.5 to 5 au gm), cloud median volume diameter (MVD) (15 to 26 microns), temperature (-29 to 20 C), and air speeds (50 to 285 mph). Comparisons were based upon evaluating probe estimates of cloud LWC and median volume diameter for given tunnel settings. Variations of plus or minus 10% and plus or minus 5% in LWC and MVD, respectively, were determined of spray clouds between test made at given tunnel settings (fixed LWC, MVD, and air speed) indicating cloud conditions were highly reproducible. Although LWC measurements from JW and Leigh devices were consistent with tunnel values, individual probe measurements either consistently over or underestimated tunnel values by factors ranging from about 0.2 to 2. Range amounted to a factor of 6 differences between LWC estimates of probes for given cloud conditions. For given cloud conditions, estimates of cloud MVD between probes were within plus or minus 3 microns and 93% of the test cases. Measurements overestimated tunnel values in the range between 10 to 20 microns. The need for improving currently used calibration procedures was indicated. Establishment of test facility (or facilities) such as an icing tunnel where instruments can be calibrated against known cloud standards would be a logical choice

Outcome with lenalidomide plus dexamethasone followed by early autologous stem cell transplantation in patients with newly diagnosed multiple myeloma on the ECOG-ACRIN E4A03 randomized clinical trial: long-term follow-up

In Eastern Cooperative Oncology Group-ACRIN E4A03, on completion of four cycles of therapy, newly diagnosed multiple myeloma patients had the option of proceeding to autologous peripheral blood stem cell transplant (ASCT) or continuing on their assigned therapy lenalidomide plus low-dose dexamethasone (Ld) or lenalidomide plus high-dose dexamethasone (LD). This landmark analysis compared the outcome of 431 patients surviving their first four cycles of therapy pursuing early ASCT to those continuing on their assigned therapy. Survival distributions were estimated using the Kaplan–Meier method and compared with log-rank test. Ninety patients (21%) opted for early ASCT. The 1-, 2-, 3-, 4- an

The Dynamics of a Meandering River

We present a statistical model of a meandering river on an alluvial plane which is motivated by the physical non-linear dynamics of the river channel migration and by describing heterogeneity of the terrain by noise. We study the dynamics analytically and numerically. The motion of the river channel is unstable and we show that by inclusion of the formation of ox-bow lakes, the system may be stabilised. We then calculate the steady state and show that it is in agreement with simulations and measurements of field data.Comment: Revtex, 12 pages, 2 postscript figure

Change in costs to funders of maternity care over time: an analysis of Queensland births.

Objective To describe change in costs to different funders over time for women giving birth in Queensland between 2012 and 2018. Methods A whole-of-population linked administrative dataset was used that contained all health service use in Queensland for women who gave birth between 1 July 2012 and 30 June 2018 and their babies. Aggregated costs for mother and baby from pregnancy to 12 months postpartum were used to compare the change in costs to funders over time. Results There was an increase in mean total cost to all funders per birth in the public system and private system from 2012 to 2018. North West Hospital and Health Service (HHS) had the highest mean total cost (in Australian dollars) in 2018 (A$42 353), while home births had the lowest (A$6105). For the majority of HHSs the proportion of births with a positive birth outcome (as defined by a composite outcome measure) has remained largely static or declined during this time period. Cairns and Hinterland HHS and Townsville HHS had the largest declines of 15% and 16% respectively, while mean total cost to all funders rose 36.39% and 46.41%, respectively. Conclusions There has been an increase over time across Queensland in the cost of childbirth in public hospitals and in the private system, while the cost of home birth has remained static. For most HHSs this increase in cost is also associated with little change or a decline in the percentage of births with a positive outcome. Increases in cost are therefore not being translated into better outcomes for women and their babies. Routine performance monitoring of cost, quality and safety should be adopted to ensure the provision of high value maternity care in Australia

Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis

Background More than 10 years have elapsed since human papillomavirus (HPV) vaccination was implemented. We did a systematic review and meta-analysis of the population-level impact of vaccinating girls and women against human papillomavirus on HPV infections, anogenital wart diagnoses, and cervical intraepithelial neoplasia grade 2+ (CIN2+)to summarise the most recent evidence about the effectiveness of HPV vaccines in real-world settings and to quantify the impact of multiple age-cohort vaccination.Methods In this updated systematic review and meta-analysis, we used the same search strategy as in our previous paper. We searched MEDLINE and Embase for studies published between Feb 1, 2014, and Oct 11, 2018. Studies were eligible if they compared the frequency (prevalence or incidence) of at least one HPV-related endpoint (genital HPV infections, anogenital wart diagnoses, or histologically confirmed CIN2+) between pre-vaccination and post-vaccination periods among the general population and if they used the same population sources and recruitment methods before and after vaccination. Our primary assessment was the relative risk (RR) comparing the frequency (prevalence or incidence) of HPV-related endpoints between the pre-vaccination and post-vaccination periods. We stratified all analyses by sex, age, and years since introduction of HPV vaccination. We used random-effects models to estimate pooled relative risks.Findings We identified 1702 potentially eligible articles for this systematic review and meta-analysis, and included 65 articles in 14 high-income countries: 23 for HPV infection, 29 for anogenital warts, and 13 for CIN2+.After 5\u20138 years of vaccination, the prevalence of HPV 16 and 18 decreased significantly by 83% (RR 0\ub717, 95% CI 0\ub711\u20130\ub725) among girls aged 13\u201319 years, and decreased significantly by 66% (RR 0\ub734, 95% CI 0\ub723\u20130\ub749) among women aged 20\u201324 years. The prevalence of HPV 31, 33, and 45 decreased significantly by 54% (RR 0\ub746, 95% CI 0\ub733\u20130\ub766) among girls aged 13\u201319 years. Anogenital wart diagnoses decreased significantly by 67% (RR 0\ub733, 95% CI 0\ub724\u20130\ub746) among girls aged 15\u201319 years, decreased significantly by 54% (RR 0\ub746, 95% CI 0.36\u20130.60) among women aged 20\u201324 years, and decreased significantly by 31% (RR 0\ub769, 95% CI 0\ub753\u20130\ub789) among women aged 25\u201329 years. Among boys aged 15\u201319 years anogenital wart diagnoses decreased significantly by 48% (RR 0\ub752, 95% CI 0\ub737\u20130\ub775) and among men aged 20\u201324 years they decreased significantly by 32% (RR 0\ub768, 95% CI 0\ub747\u20130\ub798). After 5\u20139 years of vaccination, CIN2+ decreased significantly by 51% (RR 0\ub749, 95% CI 0\ub742\u20130\ub758) among screened girls aged 15\u201319 years and decreased significantly by 31% (RR 0\ub769, 95% CI 0\ub757\u20130\ub784) among women aged 20\u201324 years.Interpretation This updated systematic review and meta-analysis includes data from 60 million individuals and up to 8 years of post-vaccination follow-up. Our results show compelling evidence of the substantial impact of HPV vaccination programmes on HPV infections and CIN2+ among girls and women, and on anogenital warts diagnoses among girls, women, boys, and men. Additionally, programmes with multi-cohort vaccination and high vaccination coverage had a greater direct impact and herd effects

Sedimentation in an artificial lake -Lake Matahina, Bay of Plenty

Lake Matahina, an 8 km long hydroelectric storage reservoir, is a small (2.5 km2), 50 m deep, warm monomictic, gorge-type lake whose internal circulation is controlled by the inflowing Rangitaiki River which drains a greywacke and acid volcanic catchment. Three major proximal to distal subenvironments are defined for the lake on the basis of surficial sediment character and dominant depositional process: (a) fluvial-glassy, quartzofeld-spathic, and lithic gravel-sand mixtures deposited from contact and saltation loads in less than 3 m depth; (b) (pro-)deltaic-quartzofeldspathic and glassy sand-silt mixtures deposited from graded and uniform suspension loads in 3-20 m depth; and (c) basinal-diatomaceous, argillaceous, and glassy silt-clay mixtures deposited from uniform and pelagic suspension loads in 20-50 m depth. The delta face has been prograding into the lake at a rate of 35-40 m/year and vertical accretion rates in pro-delta areas are 15-20 cm/year. Basinal deposits are fed mainly from river plume dispersion involving overflows, interflows, and underflows, and by pelagic settling, and sedimentation rates behind the dam have averaged about 2 cm/year. Occasional fine sand layers in muds of basinal cores attest to density currents or underflows generated during river flooding flowing the length of the lake along a sublacustrine channel marking the position of the now submerged channel of the Rangitaiki River

Correction to: Options for improving low birthweight and prematurity birth outcomes of Indigenous and culturally and linguistically diverse infants: A systematic review of the literature using the social-ecological model.

Following publication of the original article [1], the authors reported an error in Table 1 noting that the ORreported by Kildea et al 2019 [2] is 0.50 (0.31-83), not1.22 (0.80 – 1.86) as previously reported. This changesthe result from not statistically significant, to statistically significant. This has been reflected in the final paragraph of the results section. Additionally, the authors noted that the paper Kildea et al 2012 [3] was not included in the reference list. This has been corrected and can be seen at reference #38. The reported Odds Ratio for this reference was also incorrect. The OR was 0.92 (0.59-1.43), and not 0.92 (0.58-1.46) as I reported. This has been corrected in the table. It does not change the results of the data or conclusions. Additionally, the measure of effect in Table 1 for Kildea et al 2016 [4] was generated from raw data in their paper. The authors have asked that we correct this to the previously published P Value of 0.906 for preterm and 0.122 for low birthweight. This has been corrected in table 1 and the corrections do not change the results of the data or the conclusions

Identifying Longer-Term Health Events and Outcomes and Health Service Use of Low Birthweight CALD Infants in Australia.

INTRODUCTION: Approximately one-third of all births in Australia each year are by culturally and linguistically diverse (CALD) women. CALD women are at an increased risk of adverse pregnancy and birth outcomes including prematurity and low birthweight. Infants born weighing less than 2500 g are susceptible to increased risk of ill health and morbidities such as cognitive defects including cerebral palsy, and neuro-motor functioning. METHODS: An existing linked administrative dataset, Maternity 1000 was utilized for this study which has identified all children born in Queensland (QLD), Australia, between 1st July 2012 to 30th June 2018 from the QLD Perinatal Data Collection. This has then been linked to the QLD Hospital Admitted Patient Data Collection, QLD Hospital Non-Admitted Patient Data Collection, QLD Emergency Department Data Collection, and Medicare Benefits Schedule and Pharmaceutical Benefits Scheme Claims Records between 1 and 2012 to 30th June 2019. RESULTS: Culturally and linguistically diverse infants born with low birthweight had higher mean and standard deviation of all health events and outcomes; potentially preventable hospitalisations, hospital re-admissions, ED presentations without admissions, and development of chronic diseases compared to non-CALD infants born with low birthweight. DISCUSSION: Results from this study highlight the disparities in health service use and health events and outcomes associated with low birthweight infants, between both CALD and Australian born women. This study has responded to the knowledge gap of low birthweight on the Australian economy by identifying that there are significant inequalities in access to health services for CALD women in Australia, as well as increased health events and poor birth outcomes for these infants when compared to those of mothers born in Australia

Intrapartum use of sildenafil citrate to prevent fetal compromise and emergency operative birth in term pregnancies in the United Kingdom and Australia: A preliminary cost-effectiveness analysis.

OBJECTIVE: To compare cost-effectiveness of oral sildenafil citrate, administered after onset of labor, with standard care to health system funders in the UK and Australia. METHODS: We conducted a modeled cost-effectiveness analysis, measuring costs and quality adjusted life years (QALYs), using a decision-analytic model covering onset of labor to 1 month post-birth. The relative risk of emergency cesarean section and operative vaginal birth was taken from a Phase 2 placebo controlled double blinded randomized control trial. RESULTS: Both options of care resulted in the same QALYs gained over the model time period (0.08). Sildenafil citrate was cost-saving compared with standard care, saving £92 per birth in the UK (AU$303 per birth in Australia). Sensitivity analyses did not identify any areas of uncertainty that stopped sildenafil citrate being cost saving compared with standard care. Threshold analysis revealed that sildenafil citrate would be cost saving up to a per birth drug or administration cost of £152.32 in the UK (AU$333.61 in Australia). CONCLUSION: Oral sildenafil citrate may be cost saving compared with standard care; however, the effects on neonatal outcomes still need to be demonstrated in large randomized trials