Subsequent Refilling Research Articles

Experimental, computational, and analytical investigation of cooktop thermosyphon heat transport device for its feasibility in indoor solar cooking system

Cooking is a key contributor to worldwide energy usage and subsequent greenhouse gas emissions. Given this, clean and green energy-based cooking technologies are being explored globally. Though many solar cooker designs are being researched, the social acceptance rate is low due to operational, financial, and accessibility aspects. Hence in the present study, an indoor solar cooking system has been proposed, which has a cooktop Thermosyphon heat transport device (THTD) as an integral part. It transports heat from the outdoor receiver to the indoor kitchen through natural circulation (buoyancy-driven flow) of a heat transfer fluid (HTF). For the first time, different aspects of cooktop THTD are explored through experimental, analytical, and computational approaches. Based on the recommendations from a previous study, the flat design of cooktop THTD was constructed and tested with Therminol-VP1 as the HTF for both steady-state and transient performance. The steady-state results predicted by analytical and computational models were in good agreement with the experimental outcome. The HTF flow in the system is unidirectional, except in the cooktop region, where a combination of radial flow maldistribution and localized recirculation loops are seen (from velcoty contours and vectors) due to a larger flow passage. However, such flow anomalies vanish once the flow gap is reduced. Further, the transient tests witnessed a longer time for boiling (41–68 min) one litre of water in the first trial, which was reduced to 18–27 min with subsequent refills. An important observation is the increment in boiling time with increase in hot leg length. The rise in HTF flow rate (due to increased center-line elevation) and subsequent reduction in the bulk average temperature of HTF in the THTD was the reason for it. Further, the cooktop THTD could cook 315 g of rice in 40–45 min against 35–40 min using an electric induction stove, which justifies the proposed system’s efficacy. The study also demonstrated the criticality of thermal contact resistance between the cooktop surface and the surface of the cooking vessel. Hence devising an efficient and practically viable method (other than thermal paste) is essential. Also, due diligence is required while selecting the HTF as viscous fluid leads to a poor transient performance due to reduced flow rate. Hence, the transient behavior (practically the boiling time) of cooktop THTD is a trade-off between the bulk average temperature of the HTF and its flow rate.

Long-term study of phytoplankton dynamics in a supply reservoir reveals signs of trophic state shift linked to changes in hydrodynamics associated with flow management and extreme events

This study analyses over a decade (2009–2022) of monitoring data to understand the impact of hydrological characteristics on water quality and phytoplankton dynamics in Prospect Reservoir, a critical water supply for Greater Sydney, Australia, known for its excellent water quality. Water quality and phytoplankton dynamics were related to hydrodynamics, linked to flow management and the water quality of inflows. Phytoplankton biovolume increased after a prolonged drawdown and subsequent refill event, mainly driven by dinoflagellates, and corresponded to increases in total phosphorus and water temperature. The hydrological period following the 2019/2020 summer bushfires (post-bushfire) that impacted connected reservoirs, was marked by increased flow activity and nutrient loading, leading to significant shifts in the phytoplankton community. Functional group classification and ordination analysis indicated a transition from taxa typically dominant in oligotrophic conditions to meso‑eutrophic. This transition correlated with elevated nutrient levels and chlorophyll-a (Chl-a), and reduced Secchi depth and dissolved oxygen, providing evidence of eutrophication. Q index indicated good water quality post-bushfire, contrasting with a eutrophic status assessment using Chl-a. Our findings highlight the importance of analysing long-term datasets encompassing varied hydroclimatological conditions for a deeper understanding of reservoir behaviour. A comprehensive approach to water quality assessment is recommended, combining functional group classification, Q index and Chl-a measurements for effective reservoir health assessment. This research provides novel insights into the effects of disturbances such as bushfires, on water quality and phytoplankton dynamics in an underrepresented geographic region, offering valuable knowledge for managing water resources amidst growing climate variability.

Association of initial opioid prescription duration and an opioid refill by pain diagnosis: Evidence from outpatient settings in ten US health systems

ObjectiveThe Centers for Disease Control and Prevention's 2022 Clinical Practice Guideline for Prescribing Opioids for Pain cautioned that inflexible opioid prescription duration limits may harm patients. Information about the relationship between initial opioid prescription duration and a subsequent refill could inform prescribing policies and practices to optimize patient outcomes. We assessed the association between initial opioid duration and an opioid refill prescription. MethodsWe conducted a retrospective cohort study of adults ≥19 years of age in 10 US health systems between 2013 and 2018 from outpatient care with a diagnosis for back pain without radiculopathy, back pain with radiculopathy, neck pain, joint pain, tendonitis/bursitis, mild musculoskeletal pain, severe musculoskeletal pain, urinary calculus, or headache. Generalized additive models were used to estimate the association between opioid days' supply and a refill prescription. ResultsOverall, 220,797 patients were prescribed opioid analgesics upon an outpatient visit for pain. Nearly a quarter (23.5%) of the cohort received an opioid refill prescription during follow-up. The likelihood of a refill generally increased with initial duration for most pain diagnoses. About 1 to 3 fewer patients would receive a refill within 3 months for every 100 patients initially prescribed 3 vs. 7 days of opioids for most pain diagnoses. The lowest likelihood of refill was for a 1-day supply for all pain diagnoses, except for severe musculoskeletal pain (9 days' supply) and headache (3–4 days' supply). ConclusionsLong-term prescription opioid use increased modestly with initial opioid prescription duration for most but not all pain diagnoses examined.

Impact of state opioid laws on prescribing in trauma patients

BackgroundExcessive opioid prescribing has resulted in opioid diversion and misuse. In July 2018, Michigan’s Public Act 251 established a state-wide policy limiting opioid prescriptions for acute pain to a 7-day supply. Traumatic injury increases the risk for new persistent opioid use, yet the impact of prescribing policy in trauma patients remains unknown. To determine the relationship between policy enactment and prescribing in trauma patients, we compared oral morphine equivalents prescribed at discharge before and after implementation of Public Act 251. MethodsIn this cross-sectional study, adult patients who received any oral opioids at discharge from a Level 1 trauma center between January 1, 2016, and June 30, 2021, were identified. The exposure was patients admitted starting July 1, 2018. Inpatient oral morphine equivalents per day 48 hours before discharge and discharge prescription oral morphine equivalents per day were calculated. Student’s t test and an interrupted time series analysis were performed to compare mean oral morphine equivalents per day pre- and post-policy. Multivariable risk adjustment accounted for patient/injury factors and inpatient oral morphine equivalent use. ResultsA total of 3,748 patients were included in the study (pre-policy n = 1,685; post-policy n = 2,063). Implementation of the prescribing policy was associated with a significant decrease in mean discharge oral morphine equivalents per day (34.8 ± 49.5 vs 16.7 ± 32.3, P < .001). After risk adjustment, post-policy discharge prescriptions differed by −19.2 oral morphine equivalents per day (95% CI −21.7 to −16.8, P < .001). The proportion of patients obtaining a refill prescription 30 days post-discharge did not increase after implementation (0.38 ± 0.48 vs 0.37 ± 0.48, P = .7). ConclusionDischarge prescription amounts for opioids in trauma patients decreased by approximately one-half after the implementation of opioid prescribing policies, and there was no compensatory increase in subsequent refill prescriptions. Future work is needed to evaluate the effect of these policies on the adequacy of pain management and functional recovery after injury.

Comparative cardiovascular effects of GLP-1 agonists using real-world data.

There is limited research using real-world data to evaluate protective cardiovascular effects of glucagon-like peptide-1 (GLP-1) agonists among adults with type 2 diabetes (T2D) early in treatment. We conducted a retrospective, active comparator cohort study using 2011-2015 administrative claims data to compare cardiovascular disease (CVD) event rates following initiation of exenatide extended-release (E-ER), exenatide immediate-release (E-IR) or liraglutide in T2D adults who previously received no other antidiabetic medication (ADM) except metformin. The primary outcome was time to first major adverse CVD event (ischaemic heart disease, stroke, congestive heart failure or peripheral arterial disease) after starting GLP-1. Cox proportional hazards regression was used to model the association between index GLP-1 and CVD events, adjusting for baseline patient, prescriber and plan characteristics. Primary analyses included all patients with ≥2 prescription fills for the index GLP-1, regardless of subsequent refill adherence or initiation of other ADM after index date. Compared with liraglutide, neither E-ER nor E-IR was associated with risk of composite major CVD events (hazard ratios [HRs] for E-ER and E-IR: 1.33 [95% C.I. 0.73-2.39] and 1.30 [0.81-2.09]). No associations were observed between event rates for individual CVD components. The HR for an ischaemic event with E-IR relative to liraglutide was 1.85 (95% C.I. 0.97-3.53). Adjusting for time-varying exposure to other ADM and CVD medications after index date produced similar results. Initiating either immediate or extended-release exenatide rather than liraglutide was not associated with significant differences in CVD risk in this observational real-world study.

Improved on-state performance in AlGaN-channel heterojunction field-effect transistors with a quaternary AlGaInN barrier layer and a selectively grown n++-GaN contact layer

Al0.19Ga0.81N-channel metal-insulator-semiconductor heterojunction field-effect transistors (MIS-HFETs) with a quaternary AlGaInN barrier layer and a selectively regrown n++-GaN contact layer were fabricated using the self-alignment selective-area growth (SAG) technique. The self-alignment SAG process was accomplished by the local-area etching process and the subsequent refilling process with a highly-Si-doped n++-GaN layer by metalorganic chemical vapor deposition (MOCVD). It was confirmed that the ohmic contact resistance was drastically reduced from 10.5 Ωmm to 2.5 Ωmm via the self-alignment SAG contacts. Further, fabricated MIS-HFETs with a gate length of 1.5 μm and a drain-to-source length of 9.5 μm exhibited a high drain current density of over 300 mA/mm with a drain-to-source resistance of approximately 25 Ω mm. The fabricated devices also showed a high off-state breakdown voltage of 1220 V at a gate-to-drain length of 10 μm, corresponding to a breakdown field of 122 V/μm.

Estimate of Refractory Reflux Disease in the United States: Economic Burden and Associated Clinical Characteristics.

To update the estimate of the prevalence of refractory gastroesophageal reflux disease (GERD) in the United States, and to assess the clinical and economic differences between patients with and without refractory GERD. GERD affects 18% to 28% of the US population, with nearly 40% of GERD patients presenting with refractory symptoms despite ongoing therapy. Retrospective analysis of the IBM MarketScan databases between January 2011 and June 2018. Inclusion criteria were prescription fill and subsequent refill of a proton pump inhibitor or H2-receptor antagonist (earliest claim=index date), diagnosis of GERD 60 days preceding and/or following index, continuous insurance enrolment for 12 months preceding/following index, and absence of prior GERD diagnosis or GERD medication. We derived refractory GERD symptom scores for all patients on the basis of a previously published algorithm. Health care costs and comorbidities were assessed for all patients and compared between those with and without refractory GERD. In total, 399,017 GERD patients qualified for the study; 103,654 (26%) met our definition of having indications of refractory GERD symptoms. Patients with refractory GERD symptoms reported significantly higher rates of hiatal hernia (25.1% vs. 5.9%), esophagitis (37.3% vs. 11.8%), esophageal stricture (11.3% vs. 1.5%), and dysphagia (26.8% vs. 7.1%; P<0.01 for each). The refractory GERD symptoms cohort incurred ~$10,000 greater health care costs per patient per year compared with patients without refractory GERD symptoms ($26,057±$58,948 vs. $15,285±$39,307; P<0.01). Refractory GERD symptoms were associated with a substantial increase in health care costs. Treatments aimed at improving refractory GERD symptoms may mitigate symptom burden, potentially reducing health care expenditure.

Characteristics of opioid users undergoing surgery for pelvic organ prolapse.

Understanding demographic and opioid utilization patterns of preoperative opioid users compared with opioid-naïve patients undergoing surgical treatment for pelvic organ prolapse (POP) better informs opioid prescribing. A cohort of preoperative opioid users undergoing surgery for POP from 1 January 2012 through 30 May 2017 was identified. Electronic medical records were utilized to obtain pain scores and prescription data. The cohort was organized by surgical approach, number of concomitant procedures, and patient age. These factors were then matched to pain scores, opioid quantity prescribed at discharge, and subsequent refills. Pain scores and opioid use were evaluated for correlation. Results were then compared with similar data previously published for opioid-naïve patients undergoing surgical treatment of POP. Preoperative opioid users were younger (55.5 [14.7] vs 59.5 [12.7]; p= 0.002), of higher body mass index (BMI; 29.2 [5.4] vs 28.6 [10.3]; p= 0.04), and less likely Caucasian (90.3% vs 95.9%; p= 0.002) than opioid-naïve patients. After matching for these differences, opioid users reported higher pain scores (3.5 [2.2] vs 2.6 [1.8]; p = <0.0001), but received similar opioid quantities (324.4 [395] vs 296 [158] oral morphine equivalents [OME]; p= 0.27; 16.8% vs 10.4% refill rates; p= 0.07). In preoperative opioid users, neither surgical approach nor the number of concomitant procedures influenced pain scores. Increasing mean pain scores (1.8 [2.0] to 4.2 [2.4]; p< 0.002) and OME prescribed (226 [170.2] to 541 [902.5] p= 0.056; 0% to 22.2% refill rates; p= 0.02), were seen with decreasing patient age. Pain scores correlated directly with the opioid amount prescribed. Patient age and preoperative opioid utilization should be factored into urogynecological postoperative opioid-prescribing protocols.

Modeling the role of endoplasmic reticulum-mitochondria microdomains in calcium dynamics

Upon inositol trisphosphate (IP3) stimulation of non-excitable cells, including vascular endothelial cells, calcium (Ca2+) shuttling between the endoplasmic reticulum (ER) and mitochondria, facilitated by complexes called Mitochondria-Associated ER Membranes (MAMs), is known to play an important role in the occurrence of cytosolic Ca2+ concentration ([Ca2+]Cyt) oscillations. A mathematical compartmental closed-cell model of Ca2+ dynamics was developed that accounts for ER-mitochondria Ca2+ microdomains as the µd compartment (besides the cytosol, ER and mitochondria), Ca2+ influx to/efflux from each compartment and Ca2+ buffering. Varying the distribution of functional receptors in MAMs vs. the rest of ER/mitochondrial membranes, a parameter called the channel connectivity coefficient (to the µd), allowed for generation of [Ca2+]Cytoscillations driven by distinct mechanisms at various levels of IP3 stimulation. Oscillations could be initiated by the transient opening of IP3 receptors facing either the cytosol or the µd, and subsequent refilling of the respective compartment by Ca2+ efflux from the ER and/or the mitochondria. Only under conditions where the µd became the oscillation-driving compartment, silencing the Mitochondrial Ca2+ Uniporter led to oscillation inhibition. Thus, the model predicts that alternative mechanisms can yield [Ca2+]Cyt oscillations in non-excitable cells, and, under certain conditions, the ER-mitochondria µd can play a regulatory role.

Importance of the Variability of Geocryological Conditions in the Determination of the Significance of the Lakes in the Structure of Regional Water Discharge

The dynamics of the talik zones, associated both with the internal cyclical nature of their development and with climate changes, leads to temporary differences in the volume of water exchange between groundwater and surface water in permafrost areas. Periodic fluctuations in the volumes of lake water are indicative of the unstable dynamics of flows between surface and groundwater. The region of investigation was located around the Chara Depression in Northern Transbaikalia of Russia. During fieldwork and remote sensing studies around the so-called “flickering” lakes on the middle and upper Pleistocene, sediments of end-moraines were identified in the Chara basin. This type of lakes is characterized by considerable fluctuations of water level with alternating complete drainage and subsequent re-filling of the lake depression. Fluctuations of level are not always synchronous in the lakes and do not uniquely depend on the regime of atmospheric precipitation. The authors link it with changes in permafrost conditions.

Engineering Vacancies in Bi2S3yielding Sub‐Bandgap Photoresponse and Highly Sensitive Short‐Wave Infrared Photodetectors

AbstractDefects play an important role in tailoring the optoelectronic properties of materials. Supported by density functional theory (DFT) calculations, herein it is demonstrated that sulphur vacancies are able to engineer sub‐band gap photoresponse in the short‐wave infrared range due to formation of in‐gap states in Bi2S3single crystals. Sulfurization and subsequent refill of the vacancies result in faster response but limit the spectral range to the near infrared as determined by the bandgap of Bi2S3. A facile chemical treatment is then explored to accelerate the speed of sulphur deficient (SD)‐based detectors on the order of 10 ms without sacrificing its spectral coverage of the infrared, while holding a high specific detectivity (D*) close to 1015Jones in the visible–near infrared range and 1012Jones at 1.6 µm. This work also provides new insights into the role sulphur vacancies play in the electronic structure and, as a result, in sub‐bandgap photoresponse enabling ultrasensitive, fast, and broadband photodetectors.

Calcium signaling and secretory granule pool dynamics underlie biphasic insulin secretion and its amplification by glucose: experiments and modeling.

Glucose-stimulated insulin secretion from pancreatic β-cells is controlled by a triggering pathway that culminates in calcium influx and regulated exocytosis of secretory granules, and by a less understood amplifying pathway that augments calcium-induced exocytosis. In response to an abrupt increase in glucose concentration, insulin secretion exhibits a first peak followed by a lower sustained second phase. This biphasic secretion pattern is disturbed in diabetes. It has been attributed to depletion and subsequent refilling of a readily releasable pool of granules or to the phasic cytosolic calcium dynamics induced by glucose. Here, we apply mathematical modeling to experimental data from mouse islets to investigate how calcium and granule pool dynamics interact to control dynamic insulin secretion. Experimental calcium traces are used as inputs in three increasingly complex models of pool dynamics, which are fitted to insulin secretory patterns obtained using a set of protocols of glucose and tolbutamide stimulation. New calcium and secretion data for so-called staircase protocols, in which the glucose concentration is progressively increased, are presented. These data can be reproduced without assuming any heterogeneity in the model, in contrast to previous modeling, because of nontrivial calcium dynamics. We find that amplification by glucose can be explained by increased mobilization and priming of granules. Overall, our results indicate that calcium dynamics contribute substantially to shaping insulin secretion kinetics, which implies that better insight into the events creating phasic calcium changes in human β-cells is needed to understand the cellular mechanisms that disturb biphasic insulin secretion in diabetes.

Laser imaging polarimetry of nacre.

Nacre is a complex biomaterial made of aragonite-tablet bricks and organic mortar that is considerably resilient against breakage. Nacre has been studied with a wide range of laboratory techniques, leading to understanding key fundamentals and informing the creation of bio-inspired materials. In this article, we present an optical polarimetric technique to investigate nacre, taking advantage of the translucence and birefringence of its microcomponents. We focus our study on 3 classes of mollusks that have nacreous shells: bivalve (Pinctada fucata), gastropod (Haliotis asinina and Haliotis rufescens) and cephalopod (Nautilus pompilius). We sent polarized light from a laser through thin samples of nacre and did imaging polarimetry of the transmitted light. We observed clear distinctions between the structures of bivalve and gastropod, due to the spatial variation of their birefringence. The patterns for cephalopod were more similar to bivalve than gastropod. Bleaching of the samples disrupted the transmitted light. Subsequent refilling of the bivalve and gastropod nacre samples with oil produced optical patterns similar to those of unbleached samples. In cephalopod samples, we found that bleaching produced irreversible changes in the optical pattern.

The Effects of an In-office Pharmacy on the Treatment and Management of Hepatitis C

Introduction: The introduction of direct-acting antiviral regimens has revolutionized the treatment of HCV, however many challenges to the treatment of HCV remain including patient adherence, management of complications, and patient access. Methods: An in-office pharmacy played a critical role in solving medication compliance issues. The pharmacist was able to freely contact the practitioner and office staff to accelerate drug approvals. Patients approved for HCV drug therapy were carefully followed by the prescribing office practitioner and the pharmacist to be sure that adverse side effects, office visits, procedures, and labs were completed in a timely fashion. Drug interactions were also evaluated and communicated with the prescriber. Patient assistance was also coordinated. Adverse effects were reported to the pharmacist and/or the practitioner. Refills on the medications were timed to match office visits to minimize costs and maximize convenience. Drug studies typically represent those patients who completed treatment. In clinical practice, most patients often are not consistent in their adherence to medical regimens. It became clear that insurance companies would only pay once for these costly HCV treatments, therefore adherence was imperative. An intensive medication consultation was provided by an experienced pharmacist who was versed in HCV medications. This was a face-to-face consultation at the initial prescription pick-up and with subsequent refills. Results: 52 patients are included in this evaluation. 2 patients died during treatment from complications of end-stage liver disease and 1 patient refused to finish treatment. 1 patient required 2 separate drug regimens to achieve an undetectable viral load. 1 patient in 50 subjects was non-adherent (2%, where N=50). There was a statistically significant improvement in adherence using a collaborative practice approach with practitioner and pharmacist interaction p < 0.001 as compared to other HCV adherence studies where non-adherence percentages were as high as 52%. Conclusion: Patient medication adherence is superior using a collaborative practice model when compared to traditional methods of treatment. Positive outcomes were also noticed in the management of drug interactions, patient side-effects, patient co-pay assistance, and the decreased time required to resolve such issues. Further study is needed to evaluate the benefits of such a collaborative care model.

Impact of Out-of-Pocket Costs on Prescription Fills Among New Initiators of Biologic Therapies for Rheumatoid Arthritis.

Biologic disease-modifying antirheumatic drug (DMARD) therapies are a mainstay of treatment for rheumatoid arthritis (RA), yet high member out-of-pocket (OOP) costs for such therapies may limit patient access to these therapies. To understand whether there is a relationship between OOP costs and the initial fill and subsequent refills of biologic DMARD treatments for RA members. Members of a national Medicare Advantage and Prescription Drug (MAPD) plan with an adjudicated (paid or reversed) claim for a biologic DMARD indicated for RA were identified from July 1, 2007, to December 31, 2012, and followed retrospectively. The first adjudicated claim date was the index date. Members were required to have 180 days of continuous enrollment pre- and post-index and ≥ 1 diagnosis for RA (ICD-9-CM: 714.0 or 714.2) during pre-index or ≤ 30 days post-index. Low-income subsidy and Medicaid-Medicare dual-eligible patients were excluded. The analysis used multivariate regression models to examine associations between initial prescription (Rx) abandonment rates and OOP costs and factors influencing the refill of a biologic DMARD therapy based on pharmacy claims. The final sample size included 864 MAPD members with an adjudicated claim for a biologic DMARD. The majority were female (77.4%) and mean age was 63.5 years (SD = 10.9). Most (78%) had conventional nonbiologic DMARD utilization during pre-index. The overall initial abandonment rate was 18.2% for biologic DMARDs, ranging from 1.3% for the lowest OOP cost group ($0-$250) to 32.7% for the highest OOP cost group (> $550; P < 0.0001 for Cochran-Armitage trend test). ORs for abandonment rose from 18.4 to 32.7 to 41.2 for OOP costs of $250.01-$400.00, $400.01-$550.00, and > $550.00 respectively, relative to OOP costs of ≤ $250.00 (all P < 0.0001). Meeting the catastrophic coverage limit and utilization of a specialty pharmacy for the index claim were both associated with a decreased likelihood of abandoning therapy (OR = 0.29 and OR = 0.14, respectively; both P < 0.05). Among the subset of 533 members with a paid claim, 82.4% had at least 1 refill post-index. The negative association between OOP cost and likelihood of refilling an Rx was highly significant (P < 0.0001). This study suggests that the higher the member OOP cost, the less likely an MAPD member is to initiate or refill a biologic DMARD therapy for RA. Further research is needed to understand reasons for initial Rx abandonment and lack of refills, including benefit design and adverse events.

Switching among Equivalents in Chronic Cardiovascular Therapies: 'Real World' Data from Italy.

Since August 2012, Italian general practitioners are required to prescribe the generic name of medicines, except for refill of chronic therapy. We evaluated the extent of switching among equivalents in chronic cardiovascular therapies, the influence of the 2012 regulatory intervention and of patient-related or drug-related factors. Prescriptions of off-patent anti-arrhythmics, oral antidiabetics and ACE inhibitors dispensed from August 2011 to August 2013 within the Bologna Local Health Authority (870,000 inhabitants) was collected. The rate of actual switching among equivalents was evaluated monthly. The effect of the regulatory intervention was estimated by interrupted-time-series analysis. Adjusted odds ratios (aORs) of switching were calculated for the following: age, gender, number of different equivalents available for each drug and change in dispensing pharmacy between subsequent refills. The average monthly rates of switches were 9.6%, 16.3% and 16.3% for anti-arrhythmics, antidiabetics and ACE inhibitors, respectively. Values significantly increased soon after the regulatory intervention for ACE inhibitors (+1.81%, p<0.01), anti-arrhythmics (+1.46%, p=0.01) and antidiabetics (+1.09%, p=0.01), and no significant decreasing trends were observed in the following 12months. For all drug classes, odd of switching was higher in case of change in dispensing pharmacy (up to aOR=4.31, 95 CI=4.26-4.35 for ACE inhibitors) and availability of ≥5 different equivalents (up to aOR=7.82, 95 CI=7.39-8.28 for antidiabetics). Switching was lower for age ≥65 for antidiabetics and ACE inhibitors (aOR=0.92, 95 CI=0.90-0.93; 0.87, 0.86-0.88, respectively). The Italian regulatory intervention generated an immediate increase, not sustained in time, in switching among equivalents of cardiovascular therapies. Young age, high number of available equivalents and changes in dispensing pharmacy between subsequent refills were associated with switching.

Monitoring bridge scour using dissolved oxygen probes

Bridge scour is the predominant cause of overwater bridge failures in North America and around the world. Several sensing systems have been developed over the years to detect the extent of scour so that preventative actions can be performed in a timely manner. These sensing systems have drawbacks, such as signal inaccuracy and discontinuity, installation difficulty, and high cost. Therefore, attempts to develop more efficient monitoring schemes continue. In this study, the viability of using optical dissolved oxygen (DO) probes for monitoring scour depths was explored. DO levels are very low in streambed sediments, as compared to the standard level of oxygen in flowing water. Therefore, scour depths can be determined by installing sensors to monitor DO levels at various depths along the buried length of a bridge pier or abutment. The measured DO is negligible when a sensor is buried but would increase significantly once scour occurs and exposes the sensor to flowing water. A set of experiments was conducted in which four dissolved oxygen probes were embedded at different soil depths in the vicinity of a mock bridge pier inside a laboratory flume simulating scour conditions. The results confirmed that DO levels jumped drastically when sensors became exposed during scour hole evolution, thereby providing discrete measurements of the maximum scour depth. Moreover, the DO probes could detect any subsequent refilling of the scour hole through the deposition of sediments. The effect of soil permeability on the sensing response time was also investigated.

Intermittent pool beds are permanent cyclic habitats with distinct wet, moist and dry phases.

Recognition that intermittent pools are a single habitat phase of an intermittent pool bed that cycles between aquatic and terrestrial habitat greatly enhances their usefulness for addressing general questions in ecology. The aquatic phase has served as a model system in many ecological studies, because it has distinct habitat boundaries in space and time and is an excellent experimental system, but the aquatic to terrestrial transition and terrestrial phase remain largely unstudied. We conducted a field experiment within six replicate natural intermittent pool beds to explore macroinvertebrate community dynamics during the transition from aquatic to terrestrial habitat and during the terrestrial phase. We monitored and compared macroinvertebrate communities within leaf packs that i) remained wet, ii) underwent drying (i.e., started wet and then dried), and iii) remained dry. Our results show that i) a diverse macroinvertebrate community inhabits all phases of intermittent pool beds, ii) pool drying involves colonization by an assemblage of macroinvertebrates not recorded in permanently terrestrial leaf packs, iii) the community within dried leaf packs remains distinct from that of permanently terrestrial leaf packs for an extended period following drying (possibly until subsequent refilling), and iv) there are likely to be strong spatial and temporal resource linkages between the aquatic and terrestrial communities. The unique environmental characteristics of intermittent pool beds, which repeatedly cycle from aquatic to terrestrial habitat, should continue to make them valuable study systems.

Analysis of a measurement scheme for ultrafast hole dynamics by few femtosecond resolution X-ray pump-probe Auger spectroscopy.

Ultrafast hole dynamics created in molecular systems as a result of sudden ionisation is the focus of much attention in the field of attosecond science. Using the molecule glycine we show through ab initio simulations that the dynamics of a hole, arising from ionisation in the inner valence region, evolves with a timescale appropriate to be measured using X-ray pulses from the current generation of SASE free electron lasers. The examined pump-probe scheme uses X-rays with photon energy below the K edge of carbon (275-280 eV) that will ionise from the inner valence region. A second probe X-ray at the same energy can excite an electron from the core to fill the vacancy in the inner-valence region. The dynamics of the inner valence hole can be tracked by measuring the Auger electrons produced by the subsequent refilling of the core hole as a function of pump-probe delay. We consider the feasibility of the experiment and include numerical simulation to support this analysis. We discuss the potential for all X-ray pump-X-ray probe Auger spectroscopy measurements for tracking hole migration.

Geochronology and geoarchaeology of Pleistocene fluvial deposits in the Prados-Guatén Depression (Madrid Basin, Central Spain)

This study deals with the geochronological, geoarchaeological, sedimentological and geomorphological analyses of sandy Pleistocene fluvial deposits exposed throughout the Prados-Guatén Depression, occupying the wide drainage divide of the Guadarrama and Jarama rivers draining towards the Tagus River (SW Madrid, Central Spain). Pleistocene fluvial deposits within the depression record two different fluvial systems draining the zone during the Pleistocene. Older fluvial deposits (T1), thick stacked arkosic sand sequences (∼15–17 m) with fossil fauna attributable to the Lower Pleistocene (c. 1.0–0.9 Ma; Mammuthus meridionalis NESTI), exposed at elevations of +15–40 m above the present Guatén stream thalweg. This terrace was deposited by an ancient fluvial system draining the Depression north to south, flowing directly to the Tagus (Paleo-Manzanares). Overlapping the older ones, the younger deposits studied are inset fluvial terraces at +13–16 m (T2) and +8 m (T3). T2 Upper-Middle Pleistocene (500–200 ka) fauna, Equus ferus cf. Mosbachensis, is related with the abandonment of the valley, the onset of a stage of relevant intra-valley dissection, and subsequent refilling linked to the early organization of the present drainage leading to the development of T3. Paleomagnetic data from T2 and T3 terraces display an overall normal “Brunhes” polarity, although anomalous reverse polarities are recorded in the younger terrace (T3). TL and OSL dates range between c. >126–75 ka for T2 (MIS 5) and c. 20–17 ka for T3 (MIS 2), indicating a mainly Upper Pleistocene age for the development of these two more recent terraces. The dates obtained indicate that the establishment of the present divergent fluvial arrangement within the Prados-Guatén Depression started during the Middle-Upper Pleistocene transition, after it was abandoned by the Lower-Middle Pleistocene Paleo-Manzanares fluvial system (T1). T2 contains a variety of Lower to Middle Palaeolithic flint flaking products, indicating chronocultural transition during the Upper Pleistocene in the area, correlated with a drastic change in the fluvial landscape from the end of MIS 5 (<75 ka).