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Summary We conducted a prospective comparative study of the effect of teriparatide therapy for preventing vertebral-failure-type PJK after reconstructive surgery for adult spinal deformity. Prophylactic teriparatide improved the volumetric bone mineral density and fine bone structure of the vertebra above the upper-instrumented vertebra and reduced the incidence of vertebral-failure-type PJK. Introduction Proximal junctional kyphosis (PJK) is a complication after corrective surgery for spinal deformity. This study sought to determine whether teriparatide (TP) is an effective prophylactic against PJK type 2 (vertebral fracture) in surgically treated patients with adult spinal deformity (ASD). Methods Forty-three patients who started TP therapy immediately after surgery and 33 patients who did not receive TP were enrolled in this prospective case series. These patients were female, over 50, surgically treated for ASD, and followed for at least 2 years. Preoperative and postoperative standing whole-spine X-rays and dual-energy X-ray absorptiometry scans, and multidetector CT images obtained before and 6 months after surgery were used to analyze the bone strength in the vertebra above the upper-instrumented vertebra (UIV+1). Results Mean age was 67.9 years. After 6 months of treatment, mean hip-bone mineral density (BMD) increased from 0.721 to 0.771 g/cm 2 in the TP group and decreased from 0.759 to 0.729 g/cm 2 in the control group. This percent BMD change between groups was significant ( p  < 0.05). The volumetric BMD (326 to 366 mg/cm 3 ) and bone mineral content (BMC) (553 to 622 mg) at UIV+1 were also significantly increased in TP group. The bone volume/tissue volume ratio increased from 46 to 54 % in the TP group, and the trabecular bone thickness and number increased by 14 and 5 %, respectively. At the 2-year follow-up, the PJK type 2 incidence was significantly lower in the TP group (4.6 %) than in the control group (15.2 %; p  = .02). Conclusions Prophylactic TP treatment improved the volumetric BMD and fine bone structure at UIV+1 and reduced the PJK-type 2 incidence.

Study design: A cross-sectional study. Objectives: Neuropathic pain (NP) after spinal cord injury (SCI) tends to be hard to treat, and its heterogeneous properties make it difficult to identify and characterize. This study was conducted to assess the characteristics of SCI-related NP in detail. Setting: A single hospital for SCI rehabilitation. Methods: This study included 72 patients who were seen at our hospital in 2012 and 2013 and who had sustained SCI at least 3 months before enrollment. The patients completed the Neuropathic Pain Symptom Inventory (NPSI) and the Short Form (SF)-36 Health Inventory. The NPSI score was analyzed for correlations with clinical presentations of SCI and SF-36 subitems. Results: Paresthesia/dysesthesia was the most common subtype of NP after SCI. With regard to location, below-level superficial NP was significantly more intense than at-level pain. Patients who underwent surgery showed significantly less evoked pain compared with patients with non-surgery. Patients reported significantly more severe pain if >1 year had elapsed after the SCI. Patients with an American Spinal Injury Association Impairment Scale grade of B for completeness of injury reported more intense NP than those with other grades. Among the SF-36 subitems, NP correlated significantly with bodily pain, general health and mental health. Conclusion: NP in SCI patients was significantly associated with the location of pain, the time period since the injury, surgery and quality-of-life factors. A more detailed understanding of the characteristics of NP may contribute to better strategies for relieving the pain associated with SCI.

Cefiderocol is a novel siderophore cephalosporin with potent activity against gram-negative bacteria, including multidrug-resistant strains. This Phase I study was conducted to assess the tolerability of single-ascending doses of cefiderocol (part 1) and the effect of cefiderocol on cardiac repolarization, assessed using the electrocardiographic corrected QT interval (QTcF) and other ECG parameters (part 2), in healthy adult subjects. Part 1 was a randomized, double-blind, placebo-controlled, single-ascending dose study in healthy adult male and female subjects. Part 2 was a 4-period crossover study in which subjects received a single 2-g dose of cefiderocol (therapeutic dose), a single 4-g dose of cefiderocol (supratherapeutic dose), or saline (placebo), each infused over 3 hours, and a single oral 400-mg dose of moxifloxacin. In each treatment period, continuous cardiac monitoring was used to assess the effects of cefiderocol on ECG parameters. The QT interval corrected using the Fridericia formula (QTcF) was the primary ECG parameter; the time-matched placebo- and baseline-adjusted (dd)-QTcF interval was the primary end point. The plasma pharmacokinetic properties of cefiderocol were calculated on the basis of concentration–time profiles in all evaluable subjects. All point estimates for the ddQTcF interval were <5 ms and the upper bound of the 90% CIs were <10 ms at each timepoint after the initiation of the cefiderocol 3-hour infusion. Concentration-effect modeling showed a slightly negative slope and predicted modestly negative values of the ddQTcF interval at the Cmax of cefiderocol. Both doses of cefiderocol were well tolerated. All adverse events were mild in severity, with no deaths or serious adverse events reported. Overall, therapeutic and supratherapeutic doses of cefiderocol had no apparent clinically significant effect on the QTcF.

We study the robustness against non-magnetic impurities in a three-dimensional topological superconductor, focusing on an effective model (massive Dirac Bogoliubov-de Gennes (BdG) Hamiltonian with s-wave on-site pairing) of CuxBi2Se3 with the parameter set determined by the first-principles calculation. With the use of the self-consistent T- matrix approximation for impurity scattering, we discuss the impurity-concentration dependence of the zero-energy density of states. We show that a single material variable, measuring relativistic effects in the Dirac-BdG Hamiltonian, well characterizes the numerical results. In the nonrelativistic limit, the odd-parity fully-gapped topological superconductivity is fragile against non-magnetic impurities, since this superconductivity can be mapped onto the p-wave superconductivity. On the other hand, in the ultrarelativistic limit, the superconductivity is robust against the non-magnetic impurities, since the effective model has the s-wave superconductivity. We derive the effective Hamiltonian in the both limit.

The relation between the effect and the amount of SiO2 addition on photo-generated hydrophilicity of TiO2 thin film, was investigated by measuring the X-ray diffraction, the microstructure, the specific surface area and the TG-DTA. It was found that the optimum range existed in the amount of SiO2 addition to TiO2, 10–30 mol % SiO2 addition was most effective for contact angle of water. The SiO2 addition less than 30 mol % has a suppressive effect on the transformation of anatase to rutile and on the crystal growth of anatase in calcination, and it has large surface area. With the consequence that the photocatalytic activity of TiO2 and the capability of holding absorbed water which increases during UV irradiation improved.

Carbapenem-resistant Gram-negative bacteria represent the highest priority for addressing global antibiotic resistance. Cefiderocol (S-649266), a new siderophore cephalosporin, has broad activity against Enterobacteriaceae and non-fermenting bacteria, such as Pseudomonas aeruginosa and Acinetobacter baumannii, including carbapenem-resistant strains. We assessed the efficacy and safety of cefiderocol versus imipenem-cilastatin for the treatment of complicated urinary tract infection in patients at risk of multidrug-resistant Gram-negative infections. We did a phase 2, multicentre, double-blind, parallel-group non-inferiority trial at 67 hospitals in 15 countries. Adults (≥18 years) admitted to hospital with a clinical diagnosis of complicated urinary tract infection with or without pyelonephritis or those with acute uncomplicated pyelonephritis were randomly assigned (2:1) by an interactive web or voice response system to receive 1 h intravenous infusions of cefiderocol (2 g) or imipenem-cilastatin (1 g each) three times daily, every 8 h for 7–14 days. Patients were excluded if they had a baseline urine culture with more than two uropathogens, a fungal urinary tract infection, or pathogens known to be carbapenem resistant. The primary endpoint was the composite of clinical and microbiological outcomes at test of cure (ie, 7 days after treatment cessation), which was used to establish non-inferiority (15% and 20% margins) of cefiderocol versus imipenem-cilastatin. The primary efficacy analysis was done on a modified intention-to-treat population, which included all randomly assigned individuals who received at least one dose of study drug and had a qualifying Gram-negative uropathogen (≥1 × 105 colony-forming units [CFU]/mL). Safety was assessed in all randomly assigned individuals who received at least one dose of study drug, according to the treatment they received. This study is registered with ClinicalTrials.gov, number NCT02321800. Between Feb 5, 2015, and Aug 16, 2016, 452 patients were randomly assigned to cefiderocol (n=303) or imipenem-cilastatin (n=149), of whom 448 patients (n=300 in the cefiderocol group; n=148 in the imipenem-cilastatin group) received treatment. 371 patients (n=252 patients in the cefiderocol group; n=119 patients in the imipenem-cilastatin group) had qualifying Gram-negative uropathogen (≥1 × 105 CFU/mL) and were included in the primary efficacy analysis. At test of cure, the primary efficacy endpoint was achieved by 183 (73%) of 252 patients in the cefiderocol group and 65 (55%) of 119 patients in the imipenem-cilastatin group, with an adjusted treatment difference of 18·58% (95% CI 8·23–28·92; p=0·0004), establishing the non-inferiority of cefiderocol. Cefiderocol was well tolerated. Adverse events occurred in 122 (41%) of 300 patients in the cefiderocol group and 76 (51%) of 148 patients in the imipenem-cilastatin group, with gastrointestinal disorders (ie, diarrhoea, constipation, nausea, vomiting, and abdominal pain) the most common adverse events for both treatment groups (35 [12%] patients in the cefiderocol group and 27 [18%] patients in the imipenem-cilastatin group). Intravenous infusion of cefiderocol (2 g) three times daily was non-inferior compared with imipenem-cilastatin (1 g each) for the treatment of complicated urinary tract infection in people with multidrug-resistant Gram-negative infections. The results of this study will provide the basis for submission of a New Drug Application to the US Food and Drug Administration. Clinical trials of hospital-acquired pneumonia and carbapenem-resistant infections are ongoing. Shionogi & Co Ltd, Shionogi Inc.

The low pressure gas breakdown described by Paschen's law in Townsend theory, i.e. the breakdown voltage as a function of gas pressure p and the electrode distance d, provides an accurate description of breakdown in DC discharges when the ratio between inter-electrode gap distance d and electrode radii R tends to zero. On increasing of the ratio d/R, the Paschen's curves are shifted to the region of higher breakdown voltage and higher pd values. A modified Paschen's law recently proposed is well satisfied in our measurements. However, the value of constant b changes not only due to gas type but also according to electrode gap distance; furthermore, gas breakdown voltages are considerably modified by plasma-wall interactions due to glass tube proximity in the discharge.

Direct deposition of Pt and Pd nanoparticles onto γ-Al2O3 powders was studied by using a pulsed arc plasma process under vacuum to use them as an automotive catalyst. As deposited Pt catalyst exhibited a higher metal dispersion and thus a higher catalytic activity for CO oxidation, compared to the conventional Pt/Al2O3 prepared by wet impregnation. In contrast, Pd/Al2O3 prepared by the arc plasma method was less active because of its metallic state of Pd with a lower dispersion. A weak interaction between precious metals and γ-Al2O3 is not enough for thermal stabilization of as deposited nanoparticles during ageing in a stream of 10% H2O in air at 900 °C.

The electron temperature (Te) and density (ne) at the edge of NOVA-UNICAMP tokamak plasma were determined along the discharge using the concept of particle confinement time (τP) uniqueness and spectroscopic measurements of hydrogen Balmer series emissions. We have used three absolutely intensity calibrated spectrometers with photomultipliers for simultaneous measurements of hydrogen alpha, beta and gamma emissions throughout the discharges. With the use of data from Johnson and Hinnov's table, we have performed an interactive method to find electron temperatures and densities that satisfy the τP uniqueness to obtain the temporal evolution of Te and ne parameters. The results achieved are in agreement with the expected values for these parameters at the edge of the NOVA-UNICAMP tokamak plasma.

It has been recognized that non-ideal MHD effects (Ohmic diffusion, Hall effect, ambipolar diffusion) play crucial roles for the circumstellar disk formation and evolution. Ohmic and ambipolar diffusion decouple the gas and the magnetic field, and significantly reduces the magnetic torque in the disk, which enables the formation of the circumstellar disk (e.g., Tsukamoto et al. 2015b). They set an upper limit to the magnetic field strength of ∼ 0.1 G around the disk (Masson et al. 2016). The Hall effect notably changes the magnetic torques in the envelope around the disk, and strengthens or weakens the magnetic braking depending on the relative orientation of magnetic field and angular momentum. This suggests that the bimodal evolution of the disk size possibly occurs in the early disk evolutionary phase (Tsukamoto et al. 2015a, Tsukamoto et al. 2017). Hall effect and ambipolar diffusion imprint the possibly observable characteristic velocity structures in the envelope of Class 0/I YSOs. Hall effect forms a counter-rotating envelope around the disk. Our simulations show that counter rotating envelope has the size of 100–1000 au and a recent observation actually infers such a structure (Takakuwaet al. 2018). Ambipolar diffusion causes the significant ion-neutral drift in the envelopes. Our simulations show that the drift velocity of ion could become 100-1000 ms–1.