Low Withdrawal Rate Research Articles

Is Online Education Working?

This study examines the impact of instruction modality on student learning outcomes, with a focus on disparities observed pre- and post-pandemic. Using administrative data from a public university spanning seven pre-pandemic and five post-pandemic semesters, the analysis controls for endogenous sorting using fixed effects. The findings suggest that face-to-face (FtF) instruction results in better student performance, such as higher grades and a lower withdrawal rate. Additionally, students with greater exposure to FtF instruction are less likely to repeat courses, more likely to graduate on time, and achieve higher Grade Point Averages (GPA). The study also shows that the FtF advantage has been decreasing over time, and the differences are smaller post-pandemic. The results are consistent across student and instructor characteristics, except for Honors and graduate students, where the FtF advantage is either smaller or statistically insignificant.

Liraglutide in the management of obesity: real world data (Portugal).

Overweight and obesity are major public health issues with increasing incidence and prevalence, affecting more than 50% of the population in developed countries. Due to its complex pathophysiology and multifactorial etiology, disease understanding, diagnostic approach and management remain suboptimal. Together with a structured nutritional intervention and physical activity plan, pharmacological treatment has the potential to magnify weight loss and health related benefits. Liraglutide is one of the most effective and frequently prescribed weight loss medication. Its efficacy and safety have been demonstrated in randomized clinical trials, however, real world data in Portugal is scarce. The authors report on the experience of a University Hospital Endocrine Clinic in the management of patients with overweight and obesity with liraglutide on top of lifestyle intervention. The aim of the study was to evaluate the effectiveness of liraglutide in the management of overweight and obesity. Retrospective, longitudinal observational study. Inclusion criteria were adult patients (>18 years old) with obesity (BMI>30 kg/m2) or overweight (≥27 kg/m2) with at least one obesity related co-morbidity (hypertension, dyslipidemia, obstructive sleep apnea, non-alcoholic fatty liver disease) with at least three months of liraglutide treatment. Diabetes diagnosis and prior bariatric surgery were exclusion criteria. Demographic and clinical variables were included and weight was recorded before and after at least 3 months of liraglutide treatment. One hundred forty-eight patients (85.8% females) with a mean age of 48.7±11.9 years were treated with liraglutide. Mean baseline BMI was 33.8±5.2 kg/m2 and median follow-up was 13 months. At the last appointment, 85.8% were still taking liraglutide. Among patients still taking liraglutide, mean weight loss was 7.6 kg (7.9%), with significantly greater losses in patients treated for more than 6 months (8.6kg vs. 6.2 kg, P=0.016). Patients with obesity lost significantly more weight than overweight patients (8.3 kg vs. 4.5 kg, P=0.028), despite similar treatment duration. The reasons for liraglutide withdrawal were gastrointestinal intolerance (7), medication cost (2), inefficacy (10) and physician instructions (1). The present study documents the long-term efficacy of liraglutide in the treatment of patients with overweight and obesity, with a low rate of drug withdrawal. Mean weight loss was significant and more evident from the 6th month of treatment on. Liraglutide, along with lifestyle intervention, is a good option for weight management in the majority of patients with obesity.

Factors Associated With Economics Course Performance at a Large Associate Degree-Granting Institution

Economics courses are often offered at community colleges and other institutions that primarily confer associate degrees. Despite this, little research has been conducted on performance in economics courses focusing on students attending these institutions. I use multinomial logistic models to determine which factors are related to performance in both introductory macroeconomics and introductory microeconomics at a large institution that primarily confers associate degrees and finds several factors associated with performance in these courses. Among the findings are that citizenship status, foreign-born status, and gender are associated with academic performance in economics courses as noncitizens, foreign-born, and male students outperform their citizen, U.S.-born, and female counterparts in certain circumstances. Additional results show that in-person classes are associated with higher pass rates and lower withdrawal rates.

Effect of withdrawal rate on freckle formation of large-size directional solidified nickel-based superalloy blades

The freckle formation and distribution in large-size directional solidified nickel-based superalloy blades at different withdrawal rates were investigated. The microstructure of freckles was analyzed by optical microscope (OM), and scanning electron microscope (SEM). The crystallographic orientation in the freckle regions was characterized by electron backscattered diffraction (EBSD). The solute segregation patterns on the surface of freckle regions were obtained by X-ray fluorescence (XRF). Numerical simulations for the temperature field were performed to analyze the mushy zone evolution during directional solidification. The experimental results indicated that the root region is prone to form freckles. The freckle chains were only distributed on the outward surface of the root region at low and middle withdrawal rates, and the inward side was free of freckles. When a high withdrawal rate was applied, a few freckles occurred on the inward side of the root region. The number and length of freckle chains increased as the withdrawal rate increased. The XRF results indicated that channel segregation formed on the surface of the root region. The segregation channels predicted by the macrosegregation simulation agreed well with the experimental observation. The concave or inclined solidification interface increased the propensity for freckle formation.

New approaches to determine the technological challenged of oil fields at the late stage of development

Background: The main problem of the process of field development in the later stages is the limitation of free funds associated with the decline in production and the corresponding decrease in the profitable part of enterprises. At the same time, the accumulated effect of critical production problems is manifested, for the solution of which in practice a significant amount of capital investments is required in different areas of field development.
 The late stage of development of fields is associated with a number of problems, the main of which are the deterioration of the structure of the reserves and the slow pace of their replenishment, low withdrawal rates and high water cut, frequent failure of ground equipment, technological limitations of the production infrastructure, the quality of construction and completion of wells, a short turnaround time of production wells affecting the wells’ operation coefficient, and insufficient coverage of production processes with digitalization.
 Aim: Considering the large amount of work involved in the oil production process (from geology to onshore infrastructure), an internal benchmarking analytical tool is needed to identify current and most common technological challenges, to focus scientific, technical and production personnel in a certain direction and develop a systematic approach to solving production problems. The purpose of this work is to develop such a tool
 Materials and methods: As the input data, historical data on the production, hydrocarbons reserves, the current technological parameters of underground and surface equipment of 12 oil fields of the group of the NK “Kazmunaygaz” JSC companies were used. 17 basic criteria were formed in the areas of geology, development, oil production, drilling and infrastructure, which served as the basis for internal benchmarking of oil fields.
 Results: As a result of this work, a tool was developed for the diagnosis of key production problems of KMG oil fields. The diagnostic chart is effective for determining zones of the spread of production problems both in one oil field and in all oil fields of KMG. This approach can be scaled to the level of oil fields and horizons.
 Conclusion: The developed internal benchmarking tool serves as the basis for the annual analysis of key problems of the oil fields of the group of the NC “KazMunaygaz” JSC companies and the formation of a long -term plan to solve key production challenges.

Efficacy of Dienogest in Adolescent Endometriosis: A Narrative Review.

Teenage endometriosis is seen as a chronic condition that can worsen if untreated. Treatment objectives include relief of symptoms, prevention of disease development, and preservation of future fertility. In many regions, dienogest (DNG), an oral progestin, has emerged as a key treatment in suppressing endometriosis. The usage of DNG for endometriosis in adolescents was researched in papers published between 2015 and 2022 using PubMed and Google Scholar. Athorough search of all identified studies' reference lists and previously published literature reviews was carried out. The study's nature and geographic scope were not restricted. After reviewing these publications,the authors decided on which oneswere the most pertinent in light of their personal experiences.The final study consisted of14 studies that satisfied inclusion requirements. The trials showed that taking DNG 2 mg daily efficiently lowers endometriotic lesions, eases painful endometriosis symptoms, and improves quality-of-life indicators. In most of these investigations, DNG was shown to be safe and tolerated, with predictable and moderate side effects, good patient compliance rates, and low withdrawal rates. Although endometrioma did not enlarge while receiving treatment, significant regression was not typical. Overall, the studies found that DNG is safe and effective in reducing symptoms of endometriosis in adolescents.

Assessment of the adverse effects of sirolimus versus everolimus in pediatric heart transplant recipients

Literature is limited comparing adverse effects (AEs) of the proliferation signal inhibitors (PSIs) sirolimus (SRL) and everolimus (EVL) in pediatric heart transplant (HTx) recipients. Single-center, observational cohort analysis assessing first use of SRL or EVL in pediatric HTx recipients <21 years of age with up to 2 years follow-up between 2009 and 2020. Eighty-seven patients were included, with 52 (59.8%) receiving EVL and 35 (40.2%) receiving SRL. Tacrolimus with PSI was the most common regimen. Intergroup comparison revealed lower baseline estimated glomerular filtration rate (eGFR) and greater increase in eGFR from baseline to 6 months and latest follow-up in SRL cohort compared to EVL cohort. There was greater increase in HDL cholesterol in SRL cohort compared to EVL cohort. Intragroup analysis revealed eGFR and HDL cholesterol increased significantly within SRL cohort, triglycerides and glycosylated hemoglobin increased in EVL cohort, and LDL cholesterol and total cholesterol increased in both cohorts (all p < .05). There were no differences in hematological indices or rates of aphthous ulcers, effusions, or infections between cohorts. Incidence of proteinuria was not significantly different among those screened within cohorts. Of those included in our analysis, one patient in SRL cohort (2.9%) and two in EVL cohort (3.8%) had PSI withdrawn due to AE. Low-dose PSIs in calcineurin inhibitor minimization regimens appear well-tolerated with low withdrawal rate secondary to AE in pediatric HTx recipients. While incidence of most AE was similar between PSI, our results suggest EVL may be associated with less favorable metabolic impact than SRL in this population.

Project Tool Allows for Continuous Improvements to Business Processes

_ This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 205603, “Reserves and Resources Management: A Continuous Improvement of the Business Processes,” by Aen Nuril Hadi, Stephen Leonardo, and Khairul Anwar, Pertamina, et al. The paper has not been peer reviewed. _ To obtain standardized reserves and resources management of geographically diverse assets, Pertamina has launched a company guideline influenced by the SPE Petroleum Resources Management System (PRMS). A tool called the Project Box enables reserves analysts to map all projects, evaluate portfolios, and monitor progress of the project in the development and exploration phases. Furthermore, in line with a digitalization campaign, the Project Box, all reserves and resources data, and other strategic information are stored and maintained by in‑house software. Introduction As an Indonesian state‑owned energy company, Pertamina has managed more than 800 structures in Indonesia and overseas. In terms of structures, most of the company’s assets are associated with two islands, Sumatra and Java, which collectively contribute more than 75% of these assets. However, in terms of petroleum initial in place (PIIP), the island of Kalimantan is more significant. In terms of operatorship, assets that are scattered throughout the region are managed differently. More than 80% of these assets are operated by the company, while the rest is operated by other companies in the form of participating-interest division and unitization. From 2011 to 2020, because of merger and acquisition activities, the PIIP value continuously increased. In 2018, the acquisition of the Mahakam block led to an addition to PIIP of almost 50%. Subsurface-Asset Performance Heterogeneity Several key performance parameters are used to evaluate the reserves and resource performance of all structures managed by the company. These parameters include the following: - Reserves to production (RTP) indicates the reserves life span of a field or structure in years with the latest annual production. An abnormally high RTP may indicate either that the field or structure is just being put into production or that the reserves are subject to reevaluation. - Maturity is related to project maturity relative to current cumulative production. A maturity close to 100% means that almost all projects are matured into production and nearly approaching end life of the structure or field. - Withdrawal rate indicates the latest annual production performance relative to reserves. A low withdrawal rate may indicate either a petroleum-recovery optimization opportunity or that the reserves are subject to reevaluation. - Reserves replacement ratio (RRR) indicates the annual additional reserves 1P relative to annual production. An RRR equivalent to 100% means that the additional reserves—namely, projects maturing through final investment decision (FID) approval—can make up the produced volume of petroleum in the respective year. - Ultimate recovery factor (RF) indicates the expected recovery of a field or structure through the entire development process. While ultimate RF may seem to be greatly affected by subsurface aspects, it also can be improved through technology breakthroughs.

The association of chiral characteristic with drug withdrawal due to safety: A comparative analysis.

Chirality of drugs might be associated with safety issues through pharmacokinetic or pharmacodynamic variations, interactions, or direct toxicological responses. We aimed to compare chiral status of the available drugs to that of drugs withdrawn due to adverse drug reactions (ADRs). We searched the literature regarding withdrawn drugs due to safety-related issues (n =391) to compare them with all available small-molecule drugs (n =1633). We examined their chiral status and assigned as achiral compound, chiral mixture or pure enantiomer. We compared the mean survival (i.e., nonwithdrawal) time and withdrawal rates of drugs by their chirality, with further stratification by the launch year, ATC-1 (Anatomical Therapeutic Chemical) level and ADR. We identified higher withdrawal rate in achiral drugs (hazard ratio 2.1, 95% CI: 1.6-2.7) and chiral mixtures (hazard ratio 2.6, 95% CI: 1.9-3.5) compared to that in pure enantiomers. Pure enantiomers had the longest mean survival time (62.4±0.8years), followed by achiral drugs (55.4±0.9years, P< .01) and chiral mixtures (52.4±1.4years, P< .01). Pure enantiomers had higher survival rates than chiral mixtures if launched before 1941 (P= .02), in 1961-1980 (P< .001) or 1981-2000 (P< .001). Pure enantiomers had lower withdrawal rate (18.2%) vs. chiral mixtures (35.1%, P= .02) in nervous system drugs. Pure enantiomers had lower withdrawal rate than chiral mixtures in hepatotoxic (P< .01) and cardiovascular ADRs (P< .01). Our study showed lower likelihood of withdrawal for pure enantiomers compared to that in chiral mixtures and achiral drugs, which was more remarkable for those launched in certain time periods and several ADRs, including hepatotoxicity and cardiovascular toxicity.

Capital Preservation and Current Spending with Sovereign Wealth Funds and Endowment Funds: A simulation Study

We simulate the future performance of the Norwegian Government Pension Fund Global as a leading example of sovereign wealth funds intended both to preserve wealth and provide regular budget contributions. Withdrawals are limited to the fund’s expected real returns; however, deviations are allowed to fund automatic stabilizers as well as discretionary fiscal policy. It also allows smoothing to avoid abrupt changes. Except for the fiscal policy part, many endowment funds are subject to similar rules. The main findings are: (i) Even if withdrawals matching expected returns maintain the fund’s value in expectation, the fund will be depleted eventually. (ii) Because the fund is invested in foreign currency, long-run purchasing power parity introduces an element of mean reversion and hence a negative serial correlation in the rates of return, so that the fund’s value is not even preserved in expectation. (iii) The use of the fund for fiscal policy introduces a substantial risk of depletion in finite time. (iv) Smoothing raises the risk of depletion after large negative financial returns, though only modestly so. Risk reduction and withdrawal rates below expected returns are explored as remedies. Risk reduction postpones the eventual depletion but does not eliminate it. Lower withdrawal rates help sustainability more fundamentally, but bounds on fiscal policy are needed for depletion risk to be eliminated.

Microstructure and mechanical properties of twinning induced plasticity steel prepared by optical floating zone method

The three twinning induced plasticity (TWIP) steels were directionally solidified (DS) using the optical floating zone (OFZ) method at the withdrawal rates of 7 (DS7), 15 (DS15), and 30 μm s-1 (DS30) for the first time. The results showed that the relatively low withdrawal rate of 7 μm s-1 was unfavorable to the growth of DS, and the hybrid morphology was observed, which included equiaxed grains, columnar grains, amorphous coarse grains, and a few stray grains. With the increase of withdrawal rate, the volume fraction of columnar grain and dendrite grain increases, and the spacing decreased correspondingly, increasing microhardness and tensile strength. The samples exhibited outstanding plasticity, especially the DS15 had the highest elongation of 96%. This is attributed to the strong TWIP effect with a higher work hardening rate and the strongest ability of uniform plastic deformation at medium to large strains. Compared with the other two samples, the twin structure formed in the DS15 is more homogeneous and prevalent. The interaction between high-density dislocations and increased grain boundaries from the refined columnar grains and dendrites coupled with activated deformation twins, which contributes to the highest work hardening rate in the whole plastic deformation process of DS30.

The impact of online learning tools on student success in college of business core finance classes

The authors examine the impact of a new online learning system on student performance in a core finance course required of all business majors. They find that the online learning system significantly reduces the number of students that withdraw from the course prior to course completion. Additionally, the benefits of a lower withdrawal rate transcend all modalities of course delivery and are greatest for students with declared majors outside of finance. Finally, though use of the online learning system reduces the withdrawal rate of students, it does not appear to result in significant grade inflation among those students completing the course.

System Architecture for "Support Through Mobile Messaging and Digital Health Technology for Diabetes" (SuMMiT-D): Design and Performance in Pilot and Randomized Controlled Feasibility Studies.

BackgroundDiabetes is a highly prevalent long-term condition with high morbidity and mortality rates. People with diabetes commonly worry about their diabetes medicines and do not always take them regularly as prescribed. This can lead to poor diabetes control. The Support Through Mobile Messaging and Digital Health Technology for Diabetes (SuMMiT-D) study aims to deliver brief messages as tailored interventions to support people with type 2 diabetes in better use of their diabetes medicines and to improve treatment adherence and health outcomes.ObjectiveThis paper describes the overall architecture of a tailored intervention delivery system used in the pilot and randomized controlled feasibility studies of SuMMiT-D and reports its performance.MethodsThe SuMMiT-D system includes several platforms and resources to recruit participants and deliver messages as tailored interventions. Its core component is called the clinical system and is responsible for interacting with the participants by receiving and sending SMS text messages from and to them. The personalization and tailoring of brief messages for each participant is based on a list of built-in commands that they can use.ResultsFor the pilot study, a total of 48 participants were recruited; they had a median age of 64 years (first quartile, third quartile [Q1, Q3: 54.5, 69]). For the feasibility study, a total of 209 participants were recruited and randomly assigned to either the control or intervention group; they had a median age of 65 years (Q1, Q3: 56, 71), with 41.1% (86/209) being female. The participants used the SuMMiT-D system for up to 6 months (26 weeks) and had a wide range of different interactions with the SuMMiT-D system while tailored interventions were being delivered. For both studies, we had low withdrawal rates: only 4.2% and 5.3% for the pilot and feasibility studies, respectively.ConclusionsA system was developed to successfully deliver brief messages as tailored health interventions to more than 250 people with type 2 diabetes via SMS text messages. On the basis of the low withdrawal rates and positive feedback received, it can be inferred that the SuMMiT-D system is robust, user-friendly, useful, and positive for most participants. From the two studies, we found that online recruitment was more efficient than recruitment via postal mail; a regular SMS text reminder (eg, every 4 weeks) can potentially increase the participants’ interactions with the system.Trial RegistrationISRCTN Registry ISRCTN13404264; http://www.isrctn.com/ISRCTN13404264

Deceased donors as nondirected donors in kidney paired donation.

As proof of concept, we simulate a revised kidney allocation system that includes deceased donor (DD) kidneys as chain-initiating kidneys (DD-CIK) in a kidney paired donation pool (KPDP), and estimate potential increases in number of transplants. We consider chains of length 2 in which the DD-CIK gives to a candidate in the KPDP, and that candidate's incompatible donor donates to theDD waitlist. In simulations, we vary initial pool size, arrival rates of candidate/donor pairs and (living) nondirected donors (NDDs), and delay time from entry to the KPDP until a candidate is eligible to receive a DD-CIK. Using data on candidate/donor pairs and NDDs from the Alliance for Paired Kidney Donation, and the actual DDs from the Scientific Registry of Transplant Recipients (SRTR) data, simulations extend over 2years. With an initial pool of 400, respective candidate and NDD arrival rates of 2 per day and 3 per month, and delay times for access to DD-CIK of 6months or less, including DD-CIKs increases the number of transplants by at least 447 over 2years, and greatly reduces waiting times of KPDP candidates. Potential effects on waitlist candidates are discussed as are policy and ethical issues.

Measuring Opioid Withdrawal in a Phase 3 Study of a New Analgesic, NKTR-181 (Oxycodegol), in Patients with Moderate to Severe Chronic Low Back Pain

ObjectiveTo evaluate the SUMMIT-07 trial opioid withdrawal results of NKTR-181 (oxycodegol), a new molecular entity mu-opioid receptor agonist.DesignPhase 3, enriched-enrollment, double-blind, randomized-withdrawal study in patients with chronic low back pain (CLBP).SettingConducted in the United States at multiple sites.MethodsSUMMIT-07 was comprised of five periods: screening; NKTR-181 open-label titration (100 to 400 mg twice daily); 12-week randomized, double-blind study drug (NKTR-181 or placebo); one-week study drug taper; and two-week safety follow-up. Permitted rescue medication included hydrocodone 5 mg/acetaminophen 300 mg (two tablets daily) for two weeks after randomization, then acetaminophen 1.0 gm daily for the remainder of the trial. Signs and symptoms of drug withdrawal were evaluated using the Clinical Opiate Withdrawal Scale (COWS); Subjective Opiate Withdrawal Scale (SOWS); Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS); and withdrawal-related adverse events.ResultsOf 1,190 patients entering titration, one patient had moderate withdrawal (COWS score 13/48 maximum) three days after discontinuing NKTR-181. Of 610 patients randomized (N = 309, NKTR-181; N = 301, placebo), no COWS scores indicating withdrawal at a moderate level or greater (i.e., score ≥13) were observed at any time point. At day 8 after randomization, week 12, and the end of tapering, COWS scores indicating mild withdrawal (<13) were observed in seven (2.4%), one (0.4%), and one (0.5%) placebo patients, respectively, and three (1.0%), one (0.4%), and five (2.3%) NKTR-181 patients, respectively. Mean SOWS scores in both arms were ≤2.8 of 64 possible points at all time points. During the randomized period, of 35 events identified by MADDERS, adjudicators identified 20 possible “withdrawal” events (9 [2.9%] NKTR-181 and 11 [3.7%] placebo).ConclusionsNKTR-181 exhibited a low rate and severity of opioid withdrawal in SUMMIT-07 patients with CLBP.

Effects of a Community Health Worker-Led Multimedia Intervention on the Uptake of Cervical Cancer Screening among South Asian Women: A Pilot Randomized Controlled Trial.

The utilization rate of cervical cancer screening services among South Asian women is low. Multimedia interventions conducted by community health workers (CHWs) could potentially enhance the cervical cancer screening uptake among these individuals. This study aimed to investigate the feasibility and preliminary effects of a CHW-led multimedia intervention on cervical cancer screening uptake among this underprivileged group. This pilot study utilized a randomized wait-list controlled trial design. Forty-two South Asian women were recruited at six ethnic minority associations. Randomization of each organization into either the intervention arm or wait-list control arm was then performed. The intervention was conducted by the CHWs from the associations where the participants were recruited. Outcome measures were assessed and compared at baseline and immediately post-intervention. We demonstrated that the intervention was feasible as evidenced by the high consent rate and low withdrawal and attrition rates. The intervention arm showed a statistically significant improvement in perceived benefits (p = 0.001) and perceived barriers (p = 0.02). However, no significant difference was noted in screening uptake and screening intention between arms. Our findings support the feasibility of CHW-led multimedia intervention and provide preliminary evidence of its effectiveness on enhancing the cervical cancer screening beliefs among South Asian women.

Investigation on freckle formation and evolution of single-crystal nickel-based superalloy specimens with different thicknesses and abrupt cross-section changes

The freckle formation and evolution in directionally solidified single-crystal specimens with different thicknesses and abruptly expanding rectangular cross-section were investigated at different withdrawal rates. The microstructure was studied by optical microscope (OP) and scanning electron microscope (SEM), and the crystallographic orientation in freckle areas was characterized by electron backscattered diffraction (EBSD). The experimental results showed that the freckle was the most severe in specimens with a thickness of 10 mm at the same withdrawal rate, and the freckle chain was observed to form below an abruptly expanding cross-section ended at the expanding step. It was found that freckles formed exclusively on the edges of casting facing the central sprue of the shell mould. Findings reveal that freckles tend to form at the highest position of the mushy zone, mainly due to the thermosolutal convection and the radial flow caused by feeding behavior in the mushy zone. The freckle formation is pronounced at a low withdrawal rate, and can further generate stray grains.

Cochrane systematic review and meta-analysis of botulinum toxin for the prevention of migraine

ObjectivesTo assess the effects of botulinum toxin for prevention of migraine in adults.DesignSystematic review and meta-analysis.Data sourcesCENTRAL, MEDLINE, Embase and trial registries.Eligibility criteriaWe included randomised controlled trials (RCTs) of botulinum...

Formation of micro-plumes at a planar solid/liquid interface in a temperature gradient

For directional solidification experiments with low withdrawal rates near and even below the constitutional undercooling limit of the corresponding alloy, a sample is needed which reveals a homogeneous concentration along the sample axis. As stirring in samples of a certain length is difficult, homogenization by rapid solidification is very common. Hereby, the liquid sample is rapidly moved from hot to cold and thus fine and long dendrites with segregated inter-dendritic liquid are formed. By subsequently melting and holding the sample in a resting position within a given temperature gradient, diffusion in the liquid and enhanced diffusion in the hot solid diminishes local concentration differences. In this paper, we report on homogenization and solidification experiences with transparent organic model compounds of TRIS-NPG. During one hour of homogenization we observed (i) formation of a coarse grain structure, (ii) liquid film and droplet migration by temperature gradient zone melting, and (iii) formation and eventually disappearance of liquid channels. During solidification experiments we occasionally found liquid channels, which revealed a connection to the solid/liquid interface; liquid that rose in the channel and thus formed micro-plumes at the planar solid/liquid interface. This upwards motion is explained by solutal buoyancy of NPG-rich liquid and a possible feeding through an interconnected network of channels.

Effectiveness and tolerability of methotrexate in pulmonary sarcoidosis: A single center real-world study.

Pulmonary sarcoidosis patients who get disease progression despite corticosteroid treatment or can't tolerate corticosteroid required second-line drug. Methotrexate (MTX) is the most widely used in our clinical practice. Data on its safety and efficacy at different doses are still limited, especially for those without folic acid supplements. To report effectiveness of different MTX dosages and tolerability of MTX in pulmonary sarcoidosis without folic acid supplements. A retrospective study on pulmonary sarcoidosis patients receiving MTX therapy with various dose ≥3 months was conducted. The primary outcome was change in high-resolution computed tomography (HRCT) before and after MTX therapy. Other efficacy parameters included SGRQ score, prednisone dose change, discontinuation and relapse-free survival. Response-linked factors and safety outcomes were also analyzed. Overall, 49 patients (81.7%) were assessed as MTX responders by HRCT and there was no significant difference in clinical response rate among three groups with different doses. The health-related quality of life (HRQL) of the responders improved obviously, which was evidenced by SGRQ score declining from 16.7(IQR: 7.9-26.4) to 10.7(IQR: 4.8-19.3) (P=0.029). The corticosteroids sparing effect was confirmed in "responders" group (P<0.001). When MTX was discontinued in 11 responders with complete improvement, 2 patients experienced relapses within 15.5 (range: 1-30) months (mean follow-up time of these 11 responders: 13.5±13.0 months). No clinical characteristics were found related to MTX effectiveness. Adverse events occurred in 31.7% of the patients, with gastrointestinal-related being the commonest. Drug discontinuation owing to adverse events occupied 6.7% of the subjects. Nearly 80% of the sarcoidosis subjects had well response to MTX. Its effectiveness was irrelevant to the treatment dosages and baseline characteristics. A quite low relapse rate was witnessed in those complete responders discontinuing MTX therapies. The steroid-sparing effect, well drug tolerability and low drug withdrawal rate were observed in these patients even without folic acid supplements in clinical practice.