The immune reconstitution inflammatory syndrome (IRIS) has emerged as an important early complication of antiretroviral therapy (ART) in resource-limited settings, especially in patients with tuberculosis. However, there are no consensus case definitions for IRIS or tuberculosisassociated IRIS. Moreover, previously proposed case definitions are not readily applicable in settings where laboratory resources are limited. As a result, existing studies on tuberculosisassociated IRIS have used a variety of non-standardised general case definitions. To rectify this problem, around 100 researchers, including microbiologists, immunologists, clinicians, epidemiologists, clinical trialists, and public-health specialists from 16 countries met in Kampala, Uganda, in November, 2006. At this meeting, consensus case definitions for paradoxical tuberculosis-associated IRIS, ART-associated tuberculosis, and unmasking tuberculosis-associated IRIS were derived, which can be used in high-income and resource-limited settings. It is
Basic design rules are developed for the use of metallic nanostructures to realize broadband absorption enhancements in thin-film solar cells. They are applied to a relevant and physically intuitive model system consisting of a two-dimensional, periodic array of Ag strips on a silica-coated Si film supported by a silica substrate. We illustrate how one can simultaneously take advantage of 1) the high near-fields surrounding the nanostructures close to their surface plasmon resonance frequency and 2) the effective coupling to waveguide modes supported by the thin Si film through an optimization of the array properties. Following this approach, we can attain a 43% enhancement in the short circuit current as compared to a cell without metallic structures. It is suggested that 3-dimensional nanoparticle arrays with even larger boosts in short circuit current can also be generated using the presented framework.Photovoltaic (PV) cells can provide virtually unlimited amounts of energy by effectively converting sunlight into clean electrical power. Silicon has been the material of choice for PV cells due to low cost, earth abundance, non-toxicity, and the availability of a very mature processing technology. The cost of current PV modules still needs to be significantly reduced and efficiency substantially increased to enable large scale implementation. Thin-film, second-generation Si solar cells may provide a viable pathway towards this goal because of their low materials and processing costs. [1] Unfortunately the materials quality and resulting energy conversion efficiencies of such cells are still substantially lower than crystalline, wafer-based cells. This is a direct result of the large mismatch between electronic and photonic length scales in these devices; the absorption depth of light in Si is significantly longer than the electronic (minority carrier) diffusion length in deposited thin-film materials for photon energies close to the band-gap. As a result, charge extraction from optically thick cells is challenging due to carrier recombination in the bulk of the semiconductor.If light absorption could be improved in ultra-thin layers of active material it would lead directly to lower recombination currents, higher open circuit voltages, and higher conversion efficiencies. Conventional, planar anti-reflection (AR) coatings do not provide high transmission efficiencies over the entire solar spectrum and do not enable effective light trapping to increase absorption. Light trapping schemes using diffusely scattering surface textures were first suggested in the 1980s and are by now fairly-well understood. [2,3] Texturing surfaces of thin film cells is not ideal as it leads to enhanced surface recombination. For this reason, some interesting alternative trapping configurations have been proposed that utilize structuring at length-scales orders of magnitude larger than the cell thickness. [4] More than a decade ago, it was first proposed to use the unique optical properties of metallic (i.e., plasmonic) structures to b...
A technical review of the physical, mechanical, and metallurgical variables that have influenced performance of Al-Li based alloys over the last 50 years is presented. First, the historic evolution of different alloys is discussed. Then, the microstructural features responsible for different mechanical properties are identified and discussed. The role of alloying additions is discussed. The shortcomings of a 2nd generation Al-Li alloys are introduced and the key alloy design principles used to overcome these are discussed. Finally, the performance parameters that play a major role in sizing several aircraft and space craft components are reviewed in a chronological perspective and compared with 3rd-generation Al-Li alloys. It is concluded that significant improvements have been made to position Al-Li alloys to enable improved performance of next generation of air and space craft.
IMPORTANCE Atopic dermatitis (AD) is a chronic, recurrent, inflammatory skin disease with an unmet need for treatments that provide rapid and high levels of skin clearance and itch improvement.OBJECTIVE To assess the safety and efficacy of upadacitinib vs dupilumab in adults with moderate-to-severe AD.DESIGN, SETTING, AND PARTICIPANTS Heads Up was a 24-week, head-to-head, phase 3b, multicenter, randomized, double-blinded, double-dummy, active-controlled clinical trial comparing the safety and efficacy of upadacitinib with dupilumab among 692 adults with moderate-to-severe AD who were candidates for systemic therapy. The study was conducted from February 21, 2019, to December 9, 2020, at 129 centers located in 22 countries across Europe, North and South America, Oceania, and the Asia-Pacific region. Efficacy analyses were conducted in the intent-to-treat population.INTERVENTIONS Patients were randomized 1:1 and treated with oral upadacitinib, 30 mg once daily, or subcutaneous dupilumab, 300 mg every other week. MAIN OUTCOMES AND MEASURESThe primary end point was achievement of 75% improvement in the Eczema Area and Severity Index (EASI75) at week 16. Secondary end points were percentage change from baseline in the Worst Pruritus Numerical Rating Scale (NRS) (weekly average), proportion of patients achieving EASI100 and EASI90 at week 16, percentage change from baseline in Worst Pruritus NRS at week 4, proportion of patients achieving EASI75 at week 2, percentage change from baseline in Worst Pruritus NRS (weekly average) at week 1, and Worst Pruritus NRS (weekly average) improvement of 4 points or more at week 16. End points at week 24 included EASI75, EASI90, EASI100, and improvement of 4 points or more in Worst Pruritus NRS from baseline (weekly average). Safety was assessed as treatment-emergent adverse events in all patients receiving 1 or more dose of either drug. RESULTSOf 924 patients screened, 348 (183 men [52.6%]; mean [SD] age, 36.6 [14.6] years) were randomized to receive upadacitinib and 344 were randomized to receive dupilumab (194 men [56.4%]; mean [SD] age, 36.9 [14.1] years); demographic and disease characteristics were balanced among treatment groups. At week 16, 247 patients receiving upadacitinib (71.0%) and 210 patients receiving dupilumab (61.1%) achieved EASI75 (P = .006). All ranked secondary end points also demonstrated the superiority of upadacitinib vs dupilumab, including improvement in Worst Pruritus NRS as early as week 1 (mean [SE], 31.4% [1.7%] vs 8.8% [1.8%]; P < .001), achievement of EASI75 as early as week 2 (152 [43.7%] vs 60 [17.4%]; P < .001), and achievement of EASI100 at week 16 (97 [27.9%] vs 26 [7.6%]; P < .001). Rates of serious infection, eczema herpeticum, herpes zoster, and laboratory-related adverse events were higher for patients who received upadacitinib, whereas rates of conjunctivitis and injection-site reactions were higher for patients who received dupilumab.CONCLUSIONS AND RELEVANCE During 16 weeks of treatment, upadacitinib demonstrated superior efficacy vs dup...
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