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Prompt D meson and non-prompt J/ψ yields are studied as a function of the multiplicity of charged particles produced in inelastic proton-proton collisions at a centre-of-mass energy of s√=7 TeV. The results are reported as a ratio between yields in a given multiplicity interval normalised to the multiplicity-integrated ones (relative yields). They are shown as a function of the multiplicity of charged particles normalised to the average value for inelastic collisions (relative charged-particle multiplicity). D0, D+ and D∗+ mesons are measured in five pT intervals from 1 to 20 GeV/c and for |y|<0.5 via their hadronic decays. The D-meson relative yield is found to increase with increasing charged-particle multiplicity. For events with multiplicity six times higher than the average multiplicity of inelastic collisions, a yield enhancement of a factor about 15 relative to the multiplicity-integrated yield in inelastic collisions is observed. The yield enhancement is independent of transverse momentum within the uncertainties of the measurement. The D0-meson relative yield is also measured as a function of the relative multiplicity at forward pseudorapidity. The non-prompt J/ψ, i.e. the B hadron, contribution to the inclusive J/ψ production is measured in the di-electron decay channel at central rapidity. It is evaluated for pT>1.3 GeV/c and |y|<0.9, and extrapolated to pT>0. The fraction of non-prompt J/ψ in the inclusive J/ψ yields shows no dependence on the charged-particle multiplicity at central rapidity. Charm and beauty hadron relative yields exhibit a similar increase with increasing charged-particle multiplicity. The measurements are compared to PYTHIA 8, EPOS 3 and percolation calculations.
The measurement of the mass differences for systems bound by the strong force has reached a very high precision with protons and anti-protons. The extension of such measurement from (anti-)baryons to (anti-)nuclei allows one to probe any difference in the interactions between nucleons and anti-nucleons encoded in the (anti-)nuclei masses. This force is a remnant of the underlying strong interaction among quarks and gluons and can be described by effective theories, but cannot yet be directly derived from quantum chromodynamics. Here we report a measurement of the difference between the ratios of the mass and charge of deuterons and anti-deuterons, and 3He and 3He¯¯¯¯¯¯ nuclei carried out with the ALICE (A Large Ion Collider Experiment) detector in Pb-Pb collisions at a centre-of-mass energy per nucleon pair of 2.76 TeV. Our direct measurement of the mass-over-charge differences confirm CPT invariance to an unprecedented precision in the sector of light nuclei. This fundamental symmetry of nature, which exchanges particles with anti-particles, implies that all physics laws are the same under the simultaneous reversal of charge(s) (charge conjugation C), reflection of spatial coordinates (parity transformation P) and time inversion (T).
The strength of forward-backward (FB) multiplicity correlations is measured by the ALICE detector in proton-proton (pp) collisions at s√=0.9, 2.76 and 7 TeV. The measurement is performed in the central pseudorapidity region (|η|<0.8) for the transverse momentum pT>0.3 GeV/c. Two separate pseudorapidity windows of width (δη) ranging from 0.2 to 0.8 are chosen symmetrically around η=0. The multiplicity correlation strength (bcor) is studied as a function of the pseudorapidity gap (ηgap) between the two windows as well as the width of these windows. The correlation strength is found to decrease with increasing ηgap and shows a non-linear increase with δη. A sizable increase of the correlation strength with the collision energy, which cannot be explained exclusively by the increase of the mean multiplicity inside the windows, is observed. The correlation coefficient is also measured for multiplicities in different configurations of two azimuthal sectors selected within the symmetric FB η-windows. Two different contributions, the short-range (SR) and the long-range (LR), are observed. The energy dependence of bcor is found to be weak for the SR component while it is strong for the LR component. Moreover, the correlation coefficient is studied for particles belonging to various transverse momentum intervals chosen to have the same mean multiplicity. Both SR and LR contributions to bcor are found to increase with pT in this case. Results are compared to PYTHIA and PHOJET event generators and to a string-based phenomenological model. The observed dependencies of bcor add new constraints on phenomenological models.
The strength of forward-backward (FB) multiplicity correlations is measured by the ALICE detector in proton-proton (pp) collisions at s√=0.9, 2.76 and 7 TeV. The measurement is performed in the central pseudorapidity region (|η|<0.8) for the transverse momentum pT>0.3 GeV/c. Two separate pseudorapidity windows of width (δη) ranging from 0.2 to 0.8 are chosen symmetrically around η=0. The multiplicity correlation strength (bcor) is studied as a function of the pseudorapidity gap (ηgap) between the two windows as well as the width of these windows. The correlation strength is found to decrease with increasing ηgap and shows a non-linear increase with δη. A sizable increase of the correlation strength with the collision energy, which cannot be explained exclusively by the increase of the mean multiplicity inside the windows, is observed. The correlation coefficient is also measured for multiplicities in different configurations of two azimuthal sectors selected within the symmetric FB η-windows. Two different contributions, the short-range (SR) and the long-range (LR), are observed. The energy dependence of bcor is found to be weak for the SR component while it is strong for the LR component. Moreover, the correlation coefficient is studied for particles belonging to various transverse momentum intervals chosen to have the same mean multiplicity. Both SR and LR contributions to bcor are found to increase with pT in this case. Results are compared to PYTHIA and PHOJET event generators and to a string-based phenomenological model. The observed dependencies of bcor add new constraints on phenomenological models.
The strength of forward-backward (FB) multiplicity correlations is measured by the ALICE detector in proton-proton (pp) collisions at s√=0.9, 2.76 and 7 TeV. The measurement is performed in the central pseudorapidity region (|η|<0.8) for the transverse momentum pT>0.3 GeV/c. Two separate pseudorapidity windows of width (δη) ranging from 0.2 to 0.8 are chosen symmetrically around η=0. The multiplicity correlation strength (bcor) is studied as a function of the pseudorapidity gap (ηgap) between the two windows as well as the width of these windows. The correlation strength is found to decrease with increasing ηgap and shows a non-linear increase with δη. A sizable increase of the correlation strength with the collision energy, which cannot be explained exclusively by the increase of the mean multiplicity inside the windows, is observed. The correlation coefficient is also measured for multiplicities in different configurations of two azimuthal sectors selected within the symmetric FB η-windows. Two different contributions, the short-range (SR) and the long-range (LR), are observed. The energy dependence of bcor is found to be weak for the SR component while it is strong for the LR component. Moreover, the correlation coefficient is studied for particles belonging to various transverse momentum intervals chosen to have the same mean multiplicity. Both SR and LR contributions to bcor are found to increase with pT in this case. Results are compared to PYTHIA and PHOJET event generators and to a string-based phenomenological model. The observed dependencies of bcor add new constraints on phenomenological models.
We report the results of the femtoscopic analysis of pairs of identical pions measured in p-Pb collisions at sNN−−−√=5.02 TeV. Femtoscopic radii are determined as a function of event multiplicity and pair momentum in three spatial dimensions. As in the pp collision system, the analysis is complicated by the presence of sizable background correlation structures in addition to the femtoscopic signal. The radii increase with event multiplicity and decrease with pair transverse momentum. When taken at comparable multiplicity, the radii measured in p-Pb collisions, at high multiplicity and low pair transverse momentum, are 10-20% higher than those observed in pp collisions but below those observed in A-A collisions. The results are compared to hydrodynamic predictions at large event multiplicity as well as discussed in the context of calculations based on gluon saturation.
We report the results of the femtoscopic analysis of pairs of identical pions measured in p-Pb collisions at sNN−−−√=5.02 TeV. Femtoscopic radii are determined as a function of event multiplicity and pair momentum in three spatial dimensions. As in the pp collision system, the analysis is complicated by the presence of sizable background correlation structures in addition to the femtoscopic signal. The radii increase with event multiplicity and decrease with pair transverse momentum. When taken at comparable multiplicity, the radii measured in p-Pb collisions, at high multiplicity and low pair transverse momentum, are 10-20% higher than those observed in pp collisions but below those observed in A-A collisions. The results are compared to hydrodynamic predictions at large event multiplicity as well as discussed in the context of calculations based on gluon saturation.
We report the results of the femtoscopic analysis of pairs of identical pions measured in p-Pb collisions at sNN−−−√=5.02 TeV. Femtoscopic radii are determined as a function of event multiplicity and pair momentum in three spatial dimensions. As in the pp collision system, the analysis is complicated by the presence of sizable background correlation structures in addition to the femtoscopic signal. The radii increase with event multiplicity and decrease with pair transverse momentum. When taken at comparable multiplicity, the radii measured in p-Pb collisions, at high multiplicity and low pair transverse momentum, are 10-20% higher than those observed in pp collisions but below those observed in A-A collisions. The results are compared to hydrodynamic predictions at large event multiplicity as well as discussed in the context of calculations based on gluon saturation.
The transverse momentum (pT) spectrum and nuclear modification factor (RAA) of reconstructed jets in 0-10% and 10-30% central Pb-Pb collisions at sNN−−−√=2.76 TeV were measured. Jets were reconstructed from charged and neutral particles, utilizing the ALICE tracking detectors and Electromagnetic Calorimeter (EMCal), with the anti-kT jet algorithm with a resolution parameter of R=0.2. The jet pT spectra are reported in the pseudorapidity interval of |ηjet|<0.5 for 40<pT,jet<120 GeV/c in 0-10% and for 30<pT,jet<100 GeV/c in 10-30% collisions. Reconstructed jets were required to contain a leading charged particle with pT>5 GeV/c to suppress jets constructed from the combinatorial background in Pb-Pb collisions. The effect of the leading charged particle requirement has been studied in both pp and Pb-Pb collisions and has been shown to have negligible effects on the RAA within the uncertainties of the measurement. The nuclear modification factor is obtained by dividing the jet spectrum measured in Pb-Pb by that in pp collisions scaled by the number of independent nucleon-nucleon collisions estimated using a Glauber model. RAA is found to be 0.28±0.04 in 0-10% and 0.35±0.04 in 10-30% collisions, independent of pT,jet within the uncertainties of the measurement. The observed suppression is in fair agreement with expectations from two model calculations with different approaches to jet quenching.
The transverse momentum (pT) spectrum and nuclear modification factor (RAA) of reconstructed jets in 0-10% and 10-30% central Pb-Pb collisions at sNN−−−√=2.76 TeV were measured. Jets were reconstructed from charged and neutral particles, utilizing the ALICE tracking detectors and Electromagnetic Calorimeter (EMCal), with the anti-kT jet algorithm with a resolution parameter of R=0.2. The jet pT spectra are reported in the pseudorapidity interval of |ηjet|<0.5 for 40<pT,jet<120 GeV/c in 0-10% and for 30<pT,jet<100 GeV/c in 10-30% collisions. Reconstructed jets were required to contain a leading charged particle with pT>5 GeV/c to suppress jets constructed from the combinatorial background in Pb-Pb collisions. The effect of the leading charged particle requirement has been studied in both pp and Pb-Pb collisions and has been shown to have negligible effects on the RAA within the uncertainties of the measurement. The nuclear modification factor is obtained by dividing the jet spectrum measured in Pb-Pb by that in pp collisions scaled by the number of independent nucleon-nucleon collisions estimated using a Glauber model. RAA is found to be 0.28±0.04 in 0-10% and 0.35±0.04 in 10-30% collisions, independent of pT,jet within the uncertainties of the measurement. The observed suppression is in fair agreement with expectations from two model calculations with different approaches to jet quenching.
The production of (anti-)deuteron and (anti-)3He nuclei in Pb-Pb collisions at sNN−−−√ = 2.76 TeV has been studied using the ALICE detector at the LHC. The spectra exhibit a significant hardening with increasing centrality. Combined blast-wave fits of several particles support the interpretation that this behavior is caused by an increase of radial flow. The integrated particle yields are discussed in the context of coalescence and thermal-statistical model expectations. The particle ratios, 3He/d and 3He/p, in Pb-Pb collisions are found to be in agreement with a common chemical freeze-out temperature of Tchem≈156 MeV. These ratios do not vary with centrality which is in agreement with the thermal-statistical model. In a coalescence approach, it excludes models in which nucleus production is proportional to the particle multiplicity and favors those in which it is proportional to the particle density instead. In addition, the observation of 31 anti-tritons in Pb-Pb collisions is reported. For comparison, the deuteron spectrum in pp collisions at s√=7 TeV is also presented. While the p/π ratio is similar in pp and Pb-Pb collisions, the d/p ratio in pp collisions is found to be lower by a factor of 2.2 than in Pb-Pb collisions.
The production of (anti-)deuteron and (anti-)3He nuclei in Pb-Pb collisions at sNN−−−√ = 2.76 TeV has been studied using the ALICE detector at the LHC. The spectra exhibit a significant hardening with increasing centrality. Combined blast-wave fits of several particles support the interpretation that this behavior is caused by an increase of radial flow. The integrated particle yields are discussed in the context of coalescence and thermal-statistical model expectations. The particle ratios, 3He/d and 3He/p, in Pb-Pb collisions are found to be in agreement with a common chemical freeze-out temperature of Tchem≈156 MeV. These ratios do not vary with centrality which is in agreement with the thermal-statistical model. In a coalescence approach, it excludes models in which nucleus production is proportional to the particle multiplicity and favors those in which it is proportional to the particle density instead. In addition, the observation of 31 anti-tritons in Pb-Pb collisions is reported. For comparison, the deuteron spectrum in pp collisions at s√=7 TeV is also presented. While the p/π ratio is similar in pp and Pb-Pb collisions, the d/p ratio in pp collisions is found to be lower by a factor of 2.2 than in Pb-Pb collisions.
The production of (anti-)deuteron and (anti-)3He nuclei in Pb-Pb collisions at sNN−−−√ = 2.76 TeV has been studied using the ALICE detector at the LHC. The spectra exhibit a significant hardening with increasing centrality. Combined blast-wave fits of several particles support the interpretation that this behavior is caused by an increase of radial flow. The integrated particle yields are discussed in the context of coalescence and thermal-statistical model expectations. The particle ratios, 3He/d and 3He/p, in Pb-Pb collisions are found to be in agreement with a common chemical freeze-out temperature of Tchem≈156 MeV. These ratios do not vary with centrality which is in agreement with the thermal-statistical model. In a coalescence approach, it excludes models in which nucleus production is proportional to the particle multiplicity and favors those in which it is proportional to the particle density instead. In addition, the observation of 31 anti-tritons in Pb-Pb collisions is reported. For comparison, the deuteron spectrum in pp collisions at s√=7 TeV is also presented. While the p/π ratio is similar in pp and Pb-Pb collisions, the d/p ratio in pp collisions is found to be lower by a factor of 2.2 than in Pb-Pb collisions.
The production of (anti-)deuteron and (anti-)3He nuclei in Pb-Pb collisions at sNN−−−√ = 2.76 TeV has been studied using the ALICE detector at the LHC. The spectra exhibit a significant hardening with increasing centrality. Combined blast-wave fits of several particles support the interpretation that this behavior is caused by an increase of radial flow. The integrated particle yields are discussed in the context of coalescence and thermal-statistical model expectations. The particle ratios, 3He/d and 3He/p, in Pb-Pb collisions are found to be in agreement with a common chemical freeze-out temperature of Tchem≈156 MeV. These ratios do not vary with centrality which is in agreement with the thermal-statistical model. In a coalescence approach, it excludes models in which nucleus production is proportional to the particle multiplicity and favors those in which it is proportional to the particle density instead. In addition, the observation of 31 anti-tritons in Pb-Pb collisions is reported. For comparison, the deuteron spectrum in pp collisions at s√=7 TeV is also presented. While the p/π ratio is similar in pp and Pb-Pb collisions, the d/p ratio in pp collisions is found to be lower by a factor of 2.2 than in Pb-Pb collisions.
The measurement of primary π±, K±, p and p¯¯¯ production at mid-rapidity (|y|< 0.5) in proton-proton collisions at s√=7 TeV performed with ALICE (A Large Ion Collider Experiment) at the Large Hadron Collider (LHC) is reported. Particle identification is performed using the specific ionization energy loss and time-of-flight information, the ring-imaging Cherenkov technique and the kink-topology identification of weak decays of charged kaons. Transverse momentum spectra are measured from 0.1 up to 3 GeV/c for pions, from 0.2 up to 6 GeV/c for kaons and from 0.3 up to 6 GeV/c for protons. The measured spectra and particle ratios are compared with QCD-inspired models, tuned to reproduce also the earlier measurements performed at the LHC. Furthermore, the integrated particle yields and ratios as well as the average transverse momenta are compared with results at lower collision energies.
The measurement of primary π±, K±, p and p¯¯¯ production at mid-rapidity (|y|< 0.5) in proton-proton collisions at s√=7 TeV performed with ALICE (A Large Ion Collider Experiment) at the Large Hadron Collider (LHC) is reported. Particle identification is performed using the specific ionization energy loss and time-of-flight information, the ring-imaging Cherenkov technique and the kink-topology identification of weak decays of charged kaons. Transverse momentum spectra are measured from 0.1 up to 3 GeV/c for pions, from 0.2 up to 6 GeV/c for kaons and from 0.3 up to 6 GeV/c for protons. The measured spectra and particle ratios are compared with QCD-inspired models, tuned to reproduce also the earlier measurements performed at the LHC. Furthermore, the integrated particle yields and ratios as well as the average transverse momenta are compared with results at lower collision energies.
The measurement of primary π±, K±, p and p¯¯¯ production at mid-rapidity (|y|< 0.5) in proton-proton collisions at s√=7 TeV performed with ALICE (A Large Ion Collider Experiment) at the Large Hadron Collider (LHC) is reported. Particle identification is performed using the specific ionization energy loss and time-of-flight information, the ring-imaging Cherenkov technique and the kink-topology identification of weak decays of charged kaons. Transverse momentum spectra are measured from 0.1 up to 3 GeV/c for pions, from 0.2 up to 6 GeV/c for kaons and from 0.3 up to 6 GeV/c for protons. The measured spectra and particle ratios are compared with QCD-inspired models, tuned to reproduce also the earlier measurements performed at the LHC. Furthermore, the integrated particle yields and ratios as well as the average transverse momenta are compared with results at lower collision energies.
We present results of a search for two hypothetical strange dibaryon states, i.e. the H-dibaryon and the possible Λn¯ bound state. The search is performed with the ALICE detector in central (0-10%) Pb-Pb collisions at sNN−−−√=2.76 TeV, by invariant mass analysis in the decay modes Λn¯→d¯π+ and H-dibaryon →Λpπ−. No evidence for these bound states is observed. Upper limits are determined at 99% confidence level for a wide range of lifetimes and for the full range of branching ratios. The results are compared to thermal, coalescence and hybrid UrQMD model expectations, which describe correctly the production of other loosely bound states, like the deuteron and the hypertriton.
We present results of a search for two hypothetical strange dibaryon states, i.e. the H-dibaryon and the possible Λn¯¯¯¯¯¯ bound state. The search is performed with the ALICE detector in central (0-10%) Pb-Pb collisions at sNN−−−√=2.76 TeV, by invariant mass analysis in the decay modes Λn¯¯¯¯¯¯→d¯¯¯π+ and H-dibaryon →Λpπ−. No evidence for these bound states is observed. Upper limits are determined at 99% confidence level for a wide range of lifetimes and for the full range of branching ratios. The results are compared to thermal, coalescence and hybrid UrQMD model expectations, which describe correctly the production of other loosely bound states, like the deuteron and the hypertriton.
Transverse momentum spectra of π±, K± and p(p¯) up to pT = 20 GeV/c at mid-rapidity in pp and Pb-Pb collisions at sNN−−−√= 2.76 TeV have been measured using the ALICE detector at the Large Hadron Collider. The proton-to-pion and the kaon-to-pion ratios both show a distinct peak at pT≈3GeV/c in central Pb-Pb collisions. Below the peak, pT < 3 GeV/c, both ratios are in good agreement with hydrodynamical calculations, suggesting that the peak itself is dominantly the result of radial flow rather than anomalous hadronization processes. For pT > 10 GeV/c particle ratios in pp and Pb-Pb collisions are in agreement and the nuclear modification factors for π±, K± and p(p¯) indicate that, within the systematic and statistical uncertainties, the suppression is the same. This suggests that the chemical composition of leading particles from jets in the medium is similar to that of vacuum jets.
The pT-differential production cross section of electrons from semileptonic decays of heavy-flavor hadrons has been measured at mid-rapidity in proton-proton collisions at s√=2.76 TeV in the transverse momentum range 0.5 < pT < 12 GeV/c with the ALICE detector at the LHC. The analysis was performed using minimum bias events and events triggered by the electromagnetic calorimeter. Predictions from perturbative QCD calculations agree with the data within the theoretical and experimental uncertainties.
The differential charged jet cross sections, jet fragmentation distributions, and jet shapes are measured in minimum bias proton-proton collisions at centre-of-mass energy s√=7 TeV using the ALICE detector at the LHC. Jets are reconstructed from charged particle momenta in the mid-rapidity region using the sequential recombination kT and anti-kT as well as the SISCone jet finding algorithms with several resolution parameters in the range R=0.2 to 0.6. Differential jet production cross sections measured with the three jet finders are in agreement in the transverse momentum (pT) interval 20<pjet,chT<100 GeV/c. They are also consistent with prior measurements carried out at the LHC by the ATLAS collaboration. The jet charged particle multiplicity rises monotonically with increasing jet pT, in qualitative agreement with prior observations at lower energies. The transverse profiles of leading jets are investigated using radial momentum density distributions as well as distributions of the average radius containing 80% (⟨R80⟩) of the reconstructed jet pT. The fragmentation of leading jets with R=0.4 using scaled pT spectra of the jet constituents is studied. The measurements are compared to model calculations from event generators (PYTHIA, PHOJET, HERWIG). The measured radial density distributions and ⟨R80⟩ distributions are well described by the PYTHIA model (tune Perugia-2011). The fragmentation distributions are better described by HERWIG.
Event-by-event fluctuations of the mean transverse momentum of charged particles produced in pp collisions at s√ = 0.9, 2.76 and 7 TeV, and Pb-Pb collisions at sNN−−−−√ = 2.76 TeV are studied as a function of the charged-particle multiplicity using the ALICE detector at the LHC. Dynamical fluctuations indicative of correlated particle emission are observed in all systems. The results in pp collisions show little dependence on collision energy. The Monte Carlo event generators PYTHIA and PHOJET are in qualitative agreement with the data. Peripheral Pb-Pb data exhibit a similar multiplicity dependence as that observed in pp. In central Pb-Pb, the results deviate from this trend, featuring a significant reduction of the fluctuation strength. The results in Pb--Pb are in qualitative agreement with previous measurements in Au-Au at lower collision energies and with expectations from models that incorporate collective phenomena.
We report on the production of inclusive Υ(1S) and Υ(2S) in p-Pb collisions at sNN−−−√=5.02 TeV at the LHC. The measurement is performed with the ALICE detector at backward (−4.46<ycms<−2.96) and forward (2.03<ycms<3.53) rapidity down to zero transverse momentum. The production cross sections of the Υ(1S) and Υ(2S) are presented, as well as the nuclear modification factor and the ratio of the forward to backward yields of Υ(1S). A suppression of the inclusive Υ(1S) yield in p-Pb collisions with respect to the yield from pp collisions scaled by the number of binary nucleon-nucleon collisions is observed at forward rapidity but not at backward rapidity. The results are compared to theoretical model calculations including nuclear shadowing or partonic energy loss effects.
We report on the production of inclusive Υ(1S) and Υ(2S) in p-Pb collisions at sNN−−−√=5.02 TeV at the LHC. The measurement is performed with the ALICE detector at backward (−4.46<ycms<−2.96) and forward (2.03<ycms<3.53) rapidity down to zero transverse momentum. The production cross sections of the Υ(1S) and Υ(2S) are presented, as well as the nuclear modification factor and the ratio of the forward to backward yields of Υ(1S). A suppression of the inclusive Υ(1S) yield in p-Pb collisions with respect to the yield from pp collisions scaled by the number of binary nucleon-nucleon collisions is observed at forward rapidity but not at backward rapidity. The results are compared to theoretical model calculations including nuclear shadowing or partonic energy loss effects.
The pT-differential production cross section of electrons from semileptonic decays of heavy-flavor hadrons has been measured at mid-rapidity in proton-proton collisions at s√=2.76 TeV in the transverse momentum range 0.5 < pT < 12 GeV/c with the ALICE detector at the LHC. The analysis was performed using minimum bias events and events triggered by the electromagnetic calorimeter. Predictions from perturbative QCD calculations agree with the data within the theoretical and experimental uncertainties.
The differential charged jet cross sections, jet fragmentation distributions, and jet shapes are measured in minimum bias proton-proton collisions at centre-of-mass energy s√=7 TeV using the ALICE detector at the LHC. Jets are reconstructed from charged particle momenta in the mid-rapidity region using the sequential recombination kT and anti-kT as well as the SISCone jet finding algorithms with several resolution parameters in the range R=0.2 to 0.6. Differential jet production cross sections measured with the three jet finders are in agreement in the transverse momentum (pT) interval 20<pjet,chT<100 GeV/c. They are also consistent with prior measurements carried out at the LHC by the ATLAS collaboration. The jet charged particle multiplicity rises monotonically with increasing jet pT, in qualitative agreement with prior observations at lower energies. The transverse profiles of leading jets are investigated using radial momentum density distributions as well as distributions of the average radius containing 80% (⟨R80⟩) of the reconstructed jet pT. The fragmentation of leading jets with R=0.4 using scaled pT spectra of the jet constituents is studied. The measurements are compared to model calculations from event generators (PYTHIA, PHOJET, HERWIG). The measured radial density distributions and ⟨R80⟩ distributions are well described by the PYTHIA model (tune Perugia-2011). The fragmentation distributions are better described by HERWIG.
Background: Biological psychiatry aims to understand mental disorders in terms of altered neurobiological pathways. However, for one of the most prevalent and disabling mental disorders, Major Depressive Disorder (MDD), patients only marginally differ from healthy individuals on the group-level. Whether Precision Psychiatry can solve this discrepancy and provide specific, reliable biomarkers remains unclear as current Machine Learning (ML) studies suffer from shortcomings pertaining to methods and data, which lead to substantial over-as well as underestimation of true model accuracy.
Methods: Addressing these issues, we quantify classification accuracy on a single-subject level in N=1,801 patients with MDD and healthy controls employing an extensive multivariate approach across a comprehensive range of neuroimaging modalities in a well-curated cohort, including structural and functional Magnetic Resonance Imaging, Diffusion Tensor Imaging as well as a polygenic risk score for depression.
Findings Training and testing a total of 2.4 million ML models, we find accuracies for diagnostic classification between 48.1% and 62.0%. Multimodal data integration of all neuroimaging modalities does not improve model performance. Similarly, training ML models on individuals stratified based on age, sex, or remission status does not lead to better classification. Even under simulated conditions of perfect reliability, performance does not substantially improve. Importantly, model error analysis identifies symptom severity as one potential target for MDD subgroup identification.
Interpretation: Although multivariate neuroimaging markers increase predictive power compared to univariate analyses, single-subject classification – even under conditions of extensive, best-practice Machine Learning optimization in a large, harmonized sample of patients diagnosed using state-of-the-art clinical assessments – does not reach clinically relevant performance. Based on this evidence, we sketch a course of action for Precision Psychiatry and future MDD biomarker research.
Challenges of FAIR phase 0
(2018)
After two-year's shutdown, the GSI accelerators plus the latest addition of storage ring CRYRING, will be back into operation in 2018 as the FAIR phase 0 with the goal to fulfill the needs of scientific community and the FAIR accelerators and detector development. Even though GSI has been well known for its operation of a variety of ion beams ranging from proton up to uranium for multi research areas such as nuclear physics, astrophysics, biophysics, material science, the upcoming beam time faces a number of challenges in re-commissioning its existing circular accelerators with brand new control system and upgrade of beam instrumentations, as well as in rising failures of dated components and systems. The cycling synchrotron SIS18 has been undergoing a set of upgrade measures for fulfilling future FAIR operation, among which many measures will also be commissioned during the upcoming beam time. This paper presents the highlights of the challenges such as re-establishing the high intensity heavy ion operation as well as parallel operation mode for serving multi users. The status of preparation including commissioning results will also be reported.
Vögel spielen vor allem aufgrund ihrer Häufigkeit in natürlichen und anthropogenen Habitaten sowie ihrer von anderen Wirbeltieren unübertroffenen Mobilität als natürliche Reservoire von Krankheitserregern eine bedeutende infektionsepidemiologische Rolle. Darüber hinaus können Zugvögel während ihrer Migration Erreger wie Vektoren über hunderte oder tausende von Kilometern transportieren und in ihrer Verbreitung extrem begünstigen. Dass Vögel neben anderen Tiergruppen eine wichtige Wirtsfunktion für Zecken besitzen, ist bekannt. Ebenso wird Vögeln eine Reservoirfunktion für bestimmte Genospezies des Borrelia burgdorferi-Artenkomplexes zugesprochen (GERN et al. 1998; GYLFE et al. 2000). In welchem Maße verschiedene Vogelarten an der geographischen Verbreitung dieser Bakterienarten beteiligt sind, ist jedoch noch weitgehend unklar. In dieser Studie sollte durch die Untersuchung von an Vögeln abgesammelten Zecken (Ixoes ricinus) die Bedeutung von drei Drosselarten (Turdidae) für den Lebenszyklus der Borrelien genauer untersucht werden. Des Weiteren wurde die Reservoirfunktion dieser Vogelarten für vier verschiedene Genospezies des B. burgdorferi-Komplexes geprüft.
Only a few Methyl-[11C]-l-methionine (MET) positron emission tomography (PET) studies have focused on children and young adults with brain neoplasm. Due to radiation exposure, long scan acquisition time, and the need for sedation in young children MET-PET studies should be restricted to this group of patients when a decision for further therapy is not possible from routine diagnostic procedures alone, e.g., structural imaging. We investigated the diagnostic accuracy of MET-PET for the differentiation between tumorous and non-tumorous lesions in this group of patients. Forty eight MET-PET scans from 39 patients aged from 2 to 21 years (mean 15 ± 5.0 years) were analyzed. The MET tumor-uptake relative to a corresponding control region was calculated. A receiver operating characteristic (ROC) was performed to determine the MET-uptake value that best distinguishes tumorous from non-tumorous brain lesions. A differentiation between tumorous (n = 39) and non-tumorous brain lesions (n = 9) was possible at a threshold of 1.48 of relative MET-uptake with a sensitivity of 83% and a specificity of 92%, respectively. A differentiation between high grade malignant lesions (mean MET-uptake = 2.00 ± 0.46) and low grade tumors (mean MET-uptake = 1.84 ± 0.31) was not possible. There was a significant difference in MET-uptake between the histologically homogeneous subgroups of astrocytoma WHO grade II and anaplastic astrocytoma WHO grade III (P = 0.02). MET-PET might be a useful tool to differentiate tumorous from non-tumorous lesions in children and young adults when a decision for further therapy is difficult or impossible from routine structural imaging procedures alone. Keywords Brain tumor - Children - PET - Methionine - Molecular imaging
Observation of enhanced subthreshold K+ production in central collisions between heavy nuclei
(1994)
In the very heavy collision system 197Au+197Au the K+ production process was studied as a function of impact parameter at 1 GeV/nucleon, a beam energy well below the free N-N threshold. The K+ multiplicity increases more than linearly with the number of participant nucleons and the K+/ pi + ratio rises significantly when going from peripheral to central collisions. The measured K+ double differential cross section is enhanced by a factor of 6 compared to microscopic transport calculations if secondary processes (Delta N-->K Lambda N and Delta Delta -->K Lambda N) are ignored.
Quantum Molecular Dynamics (QMD) calculations of central collisions between heavy nuclei are used to study fragment production and the creation of collective flow. It is shown that the final phase space distributions are compatible with the expectations from a thermally equilibrated source, which in addition exhibits a collective transverse expansion. However, the microscopic analyses of the transient states in the intermediate reaction stages show that the event shapes are more complex and that equilibrium is reached only in very special cases but not in event samples which cover a wide range of impact parameters as it is the case in experiments. The basic features of a new molecular dynamics model (UQMD) for heavy ion collisions from the Fermi energy regime up to the highest presently available energies are outlined.
In this paper, the concepts of microscopic transport theory are introduced and the features and shortcomings of the most commonly used ansatzes are discussed. In particular, the Ultrarelativistic Quantum Molecular Dynamics (UrQMD) transport model is described in great detail. Based on the same principles as QMD and RQMD, it incorporates a vastly extended collision term with full baryon-antibaryon symmetry, 55 baryon and 32 meson species. Isospin is explicitly treated for all hadrons. The range of applicability stretches from E lab < 100$ MeV/nucleon up to E lab> 200$ GeV/nucleon, allowing for a consistent calculation of excitation functions from the intermediate energy domain up to ultrarelativistic energies. The main physics topics under discussion are stopping, particle production and collective flow.
The climate system can be regarded as a dynamic nonlinear system. Thus, traditional linear statistical methods fail to model the nonlinearities of such a system. These nonlinearities render it necessary to find alternative statistical techniques. Since artificial neural network models (NNM) represent such a nonlinear statistical method their use in analyzing the climate system has been studied for a couple of years now. Most authors use the standard Backpropagation Network (BPN) for their investigations, although this specific model architecture carries a certain risk of over-/underfitting. Here we use the so called Cauchy Machine (CM) with an implemented Fast Simulated Annealing schedule (FSA) (Szu, 1986) for the purpose of attributing and detecting anthropogenic climate change instead. Under certain conditions the CM-FSA guarantees to find the global minimum of a yet undefined cost function (Geman and Geman, 1986). In addition to potential anthropogenic influences on climate (greenhouse gases (GHG), sulphur dioxide (SO2)) natural influences on near surface air temperature (variations of solar activity, explosive volcanism and the El Nino = Southern Oscillation phenomenon) serve as model inputs. The simulations are carried out on different spatial scales: global and area weighted averages. In addition, a multiple linear regression analysis serves as a linear reference. It is shown that the adaptive nonlinear CM-FSA algorithm captures the dynamics of the climate system to a great extent. However, free parameters of this specific network architecture have to be optimized subjectively. The quality of the simulations obtained by the CM-FSA algorithm exceeds the results of a multiple linear regression model; the simulation quality on the global scale amounts up to 81% explained variance. Furthermore the combined anthropogenic effect corresponds to the observed increase in temperature Jones et al. (1994), updated by Jones (1999a), for the examined period 1856–1998 on all investigated scales. In accordance to recent findings of physical climate models, the CM-FSA succeeds with the detection of anthropogenic induced climate change on a high significance level. Thus, the CMFSA algorithm can be regarded as a suitable nonlinear statistical tool for modeling and diagnosing the climate system.
Attribution and detection of anthropogenic climate change using a backpropagation neural network
(2002)
The climate system can be regarded as a dynamic nonlinear system. Thus traditional linear statistical methods are not suited to describe the nonlinearities of this system which renders it necessary to find alternative statistical techniques to model those nonlinear properties. In addition to an earlier paper on this subject (WALTER et al., 1998), the problem of attribution and detection of the observed climate change is addressed here using a nonlinear Backpropagation Neural Network (BPN). In addition to potential anthropogenic influences on climate (CO2-equivalent concentrations, called greenhouse gases, GHG and SO2 emissions) natural influences on surface air temperature (variations of solar activity, volcanism and the El Niño/Southern Oscillation phenomenon) are integrated into the simulations as well. It is shown that the adaptive BPN algorithm captures the dynamics of the climate system, i.e. global and area weighted mean temperature anomalies, to a great extent. However, free parameters of this network architecture have to be optimized in a time consuming trial-and-error process. The simulation quality obtained by the BPN exceeds the results of those from a linear model by far; the simulation quality on the global scale amounts to 84% explained variance. Additionally the results of the nonlinear algorithm are plausible in a physical sense, i.e. amplitude and time structure. Nevertheless they cover a broad range, e.g. the GHG-signal on the global scale ranges from 0.37 K to 1.65 K warming for the time period 1856-1998. However the simulated amplitudes are situated within the discussed range (HOUGHTON et al., 2001). Additionally the combined anthropogenic effect corresponds to the observed increase in temperature for the examined time period. In addition to that, the BPN succeeds with the detection of anthropogenic induced climate change on a high significance level. Therefore the concept of neural networks can be regarded as a suitable nonlinear statistical tool for modeling and diagnosing the climate system.
Simulation of global temperature variations and signal detection studies using neural networks
(1998)
The concept of neural network models (NNM) is a statistical strategy which can be used if a superposition of any forcing mechanisms leads to any effects and if a sufficient related observational data base is available. In comparison to multiple regression analysis (MRA), the main advantages are that NNM is an appropriate tool also in the case of non-linear cause-effect relations and that interactions of the forcing mechanisms are allowed. In comparison to more sophisticated methods like general circulation models (GCM), the main advantage is that details of the physical background like feedbacks can be unknown. Neural networks learn from observations which reflect feedbacks implicitly. The disadvantage, of course, is that the physical background is neglected. In addition, the results prove to be sensitively dependent from the network architecture like the number of hidden neurons or the initialisation of learning parameters. We used a supervised backpropagation network (BPN) with three neuron layers, an unsupervised Kohonen network (KHN) and a combination of both called counterpropagation network (CPN). These concepts are tested in respect to their ability to simulate the observed global as well as hemispheric mean surface air temperature annual variations 1874 - 1993 if parameter time series of the following forcing mechanisms are incorporated : equivalent CO2 concentrations, tropospheric sulfate aerosol concentrations (both anthropogenic), volcanism, solar activity, and ENSO (all natural). It arises that in this way up to 83% of the observed temperature variance can be explained, significantly more than by MRA. The implication of the North Atlantic Oscillation does not improve these results. On a global average, the greenhouse gas (GHG) signal so far is assessed to be 0.9 - 1.3 K (warming), the sulfate signal 0.2 - 0.4 K (cooling), results which are in close similarity to the GCM findings published in the recent IPCC Report. The related signals of the natural forcing mechanisms considered cover amplitudes of 0.1 - 0.3 K. Our best NNM estimate of the GHG doubling signal amounts to 2.1K, equilibrium, or 1.7 K, transient, respectively.
Antisynthetase syndrome (ASSD) is a rare clinical condition that is characterized by the occurrence of a classic clinical triad, encompassing myositis, arthritis, and interstitial lung disease (ILD), along with specific autoantibodies that are addressed to different aminoacyl tRNA synthetases (ARS). Until now, it has been unknown whether the presence of a different ARS might affect the clinical presentation, evolution, and outcome of ASSD. In this study, we retrospectively recorded the time of onset, characteristics, clustering of triad findings, and survival of 828 ASSD patients (593 anti-Jo1, 95 anti-PL7, 84 anti-PL12, 38 anti-EJ, and 18 anti-OJ), referring to AENEAS (American and European NEtwork of Antisynthetase Syndrome) collaborative group’s cohort. Comparisons were performed first between all ARS cases and then, in the case of significance, while using anti-Jo1 positive patients as the reference group. The characteristics of triad findings were similar and the onset mainly began with a single triad finding in all groups despite some differences in overall prevalence. The “ex-novo” occurrence of triad findings was only reduced in the anti-PL12-positive cohort, however, it occurred in a clinically relevant percentage of patients (30%). Moreover, survival was not influenced by the underlying anti-aminoacyl tRNA synthetase antibodies’ positivity, which confirmed that antisynthetase syndrome is a heterogeneous condition and that antibody specificity only partially influences the clinical presentation and evolution of this condition.
Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a “planned second-look” laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.
A 48 year old patient with dilated cardiomyopathy and chronic acne inversa underwent implantation of a LVAD system (Heartmate II, Thoratec, USA) March 2011. During 2011 and 2012 the patient was repeatedly readmitted for treatment of driveline infection with MRSA. Colonization was controlled with Linezolid and Rifampicin however reoccurred after discontinuation. In August 2012 the LVAD-system was exchanged due to pump dysfunction (HVAD, HeartWare Inc., USA). Postoperatively, the patient presented with ascites which secreted through the driveline exit. Consequently, the abdominal wall was surgically corrected to prevent exit of peritoneal fluid through the driveline, and the patient was discharged with sterile wound swabs. However 6 weeks after discharge the driveline exit wound started secreting pus showing abundant growth of multi resistant staphylococcus aureus (MRSA). With clinical signs of increasing liver failure with regular need for paracentesis, and clinical signs of local infection, a CT scan of the abdomen was performed revealing an enrichment of contrast medium along the driveline and an abscess-like formation on the abdominal wall. Patient was admitted receiving regular dose Daptomycin and Rifampicin. The latter was discontinued after ten days. The abscess, surrounding driveline exit and abdominal wall cavity was excised and vacuum treatment initiated. Total duration of Daptomycin therapy was 3 weeks. While first week skin and wound swabs were still positive for MRSA, all samples were sterile after the second week. Inflammation was monitored by leucocyte count and IL6. The secretion of pus along the driveline ceased, the wound cavity was closed subsequently. After discharge and stop of antibiotics skin and driveline swabs remained negative for MRSA (10 weeks).
Background: Does the dogma of nephron sparing surgery (NSS) still stand for large renal masses? Available studies dealing with that issue are considerably biased often mixing imperative with elective indications for NSS and also including less malignant variants or even benign renal tumors. Here, we analyzed the oncological long-term outcomes of patients undergoing elective NSS or radical tumor nephrectomy (RN) for non-endophytic, large (≥7cm) clear cell renal carcinoma (ccRCC).
Methods: Prospectively acquired, clinical databases from two academic high-volume centers were screened for patients from 1980 to 2010. The query was strictly limited to patients with elective indications. Surgical complications were retrospectively assessed and classified using the Clavien-Dindo-classification system (CDS). Overall survival (OS) and cancer specific survival (CSS) were analyzed using the Kaplan-Meier-method and the log-rank test.
Results: Out of in total 8664 patients in the databases, 123 patients were identified (elective NSS (n = 18) or elective RN (n = 105)) for ≥7cm ccRCC. The median follow-up over all was 102 months (range 3–367 months). Compared to the RN group, the NSS group had a significantly longer median OS (p = 0.014) and median CSS (p = 0.04).
Conclusions: In large renal masses, NSS can be performed safely with acceptable complication rates. In terms of long-term OS and CSS, NSS was at least not inferior to RN. Our findings suggest that NSS should also be performed in patients presenting with renal tumors ≥7cm whenever technically feasible. Limitations include its retrospective nature and the limited availability of data concerning long-term development of renal function in the two groups.
Flächenbezogene Artenzahlen sind besonders im Kontext von Monitoringprojekten grundlegend für die Beurteilung von Veränderungen der Biodiversität. Diese Studie vergleicht die von neun Bearbeitern (5 Einzelbearbeiter, 2 Zweierteams) erfasste Zahl an Gefäßpflanzenarten bei Vegetationserhebungen auf markierten Flächen von 4, 100 und 400 m2 Größe in einem artenreichen Kalkbuchenwald im Göttinger Stadtwald. Dabei wurden Bearbeiter- und Zeiteffekte untersucht, sowie artspezifische Übersehensraten, Fehlbestimmungsraten und Ungenauigkeiten bei der Zuordnung von Pflanzenindividuen zur jeweiligen Aufnahmefläche (Fehlzuordnungsraten) abgeschätzt.
Protokollierte Fragen ließen keine systematischen Unterschiede bei der Vertrautheit der Bearbeiter mit der Vegetation vor Ort erkennen, so dass Ausbildung und Erfahrung für gefundene Unterschiede ausschlaggebend sein dürften. Bei den 4 m2 großen Erhebungseinheiten ergaben sich bei der Artenzahl relative Abweichungen der Bearbeiter vom Erwartungswert von 8 bis 26 % (1 bis 4 Arten absolut). Diese waren bei den 100 m2 großen Erhebungseinheiten mit 9 bis 27 % (2 bis 6 Arten absolut) höher. Mit zunehmender Flächengröße nahm der Flächenidentitätseffekt tendenziell ab und der Bearbeitereffekt signifikant zu. Bei den 100 m2 großen Flächen hatte eine längere Bearbeitungszeit einen positiven Effekt auf die Artenzahl.
Mit Hilfe artbezogener Auswertungen wurden Übersehens-, Fehlbestimmungs- und Fehlzuordnungsraten ermittelt. Nicht eine Art wurde von allen Bearbeitern auf allen Flächen gefunden, auf denen sie jeweils auftrat. Schwer differenzierbare Arten sowie Arten in ungünstigen Entwicklungsstadien wiesen höhere Übersehens-, aber auch höhere Fehlbestimmungsraten auf. Bei morphologisch gut charakterisierten Arten wurde bei Einzelfunden von einer Fehlzuordnung zur Erhebungseinheit ausgegangen.
Die erzielten Ergebnisse sind auch für andere Projekte zur Erfassung der Biodiversität relevant und Bemühungen zur Reduzierung entsprechender Bearbeitereffekte sollten unternommen werden. Eine organisatorische Einbindung entsprechender Bemühungen wird vorgeschlagen.
Background: Treatment complexity rises in line with the number of drugs, single doses, and administration methods, thereby threatening patient adherence. Patients with multimorbidity often need flexible, individualised treatment regimens, but alterations during the course of treatment may further increase complexity. The objective of our study was to explore medication changes in older patients with multimorbidity and polypharmacy in general practice.
Methods: We retrospectively analysed data from the cluster-randomised PRIMUM trial (PRIoritisation of MUltimedication in Multimorbidity) conducted in 72 general practices. We developed an algorithm for active pharmaceutical ingredients (API), strength, dosage, and administration method to assess changes in physician-reported medication data during two intervals (baseline to six-months: ∆1; six- to nine-months: ∆2), analysed them descriptively at prescription and patient levels, and checked for intervention effects.
Results: Of 502 patients (median age 72 years, 52% female), 464 completed the study. Changes occurred in 98.6% of patients (changes were 19% more likely in the intervention group): API changes during ∆1 and ∆2 occurred in 414 (82.5%) and 338 (67.3%) of patients, dosage alterations in 372 (74.1%) and 296 (59.2%), and changes in API strength in 158 (31.5%) and 138 (27.5%) respectively. Administration method changed in 79 (16%) of patients in both ∆1 and ∆2. Simvastatin, metformin and aspirin were most frequently subject to alterations.
Conclusion: Medication regimens in older patients with multimorbidity and polypharmacy changed frequently. These are mostly due to discontinuations and dosage alterations, followed by additions and restarts. These findings cast doubt on the effectiveness of cross-sectional assessments of medication and support longitudinal assessments where possible.
Trial registration: 1. Prospective registration: Trial registration number: NCT01171339; Name of registry: ClinicalTrials.gov; Date of registration: July 27, 2010; Date of enrolment of the first participant to the trial: August 12, 2010.
2. Peer reviewed trial registration: Trial registration number: ISRCTN99526053; Name of registry: Controlled Trials; Date of registration: August 31, 2010; Date of enrolment of the first participant to the trial: August 12, 2010.
The Paleocene-Eocene Thermal Maximum (PETM) offers insight into massive short-term carbon cycle perturbations that caused significant warming during a high-pCO2 world, affecting both marine and terrestrial ecosystems. PETM records from the marine-terrestrial interface (e.g. estuarine swamps and mire deposits) are, therefore, of great interest as their present-day counterparts are highly vulnerable to future climate and sea level change. Here, we assess paleoenvironmental changes of mid-latitudinal Late Paleocene-Early Eocene peat mire records along the paleo-North Sea coast. We provide carbon isotope data of bulk organic matter (δ13CTOC), organic carbon content (%TOC), and palynological data from an extensive peat mire deposited at a mid-latitudinal (ca. 41 °N) coastal site (Schöningen, Germany). The δ13CTOC data show a carbon isotope excursion (CIE) of −1.7 ‰ coeval with a conspicuous Apectodinium acme, calling for the presence of the PETM in this coastal section. Due to the exceptionally large stratigraphic thickness of the PETM at Schöningen (10 m of section) we established a detailed palynological record that indicates only minor changes in paleovegetation leading to and during the PETM. Instead, paleovegetation changes mostly follow natural successions in response to changes along the marine-terrestrial interface. Compared to other available peat mire records (Cobham, UK; Vasterival, France) it appears that wetland deposits around the Paleogene North Sea have a typical CIE magnitude of ca. −1.3 ‰ in δ13CTOC. Moreover, the Schöningen record shares major characteristics with the Cobham Lignite, including evidence for increased fire activity prior to the PETM, minor PETM-related plant species changes, a reduced CIE in δ13CTOC, and drowning of the mire (marine ingressions) during much of the PETM. This suggests that paleoenvironmental conditions during the Late Paleocene-Early Eocene, including the PETM, consistently affected major segments of the paleo-North Sea coast.
Objectives: Rising prevalence of multidrug-resistant organisms (MDRO) is a major health problem in patients with liver cirrhosis. The impact of MDRO colonization in liver transplantation (LT) candidates and recipients on mortality has not been determined in detail.
Methods: Patients consecutively evaluated and listed for LT in a tertiary German liver transplant center from 2008 to 2018 underwent screening for MDRO colonization including methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant gram-negative bacteria (MDRGN), and vancomycin-resistant enterococci (VRE). MDRO colonization and infection status were obtained at LT evaluation, planned and unplanned hospitalization, three months upon graft allocation, or at last follow-up on the waiting list.
Results: In total, 351 patients were listed for LT, of whom 164 (47%) underwent LT after a median of 249 (range 0–1662) days. Incidence of MDRO colonization increased during waiting time for LT, and MRDO colonization was associated with increased mortality on the waiting list (HR = 2.57, p<0.0001. One patients was colonized with a carbapenem-resistant strain at listing, 9 patients acquired carbapenem-resistant gram-negative bacteria (CRGN) on the waiting list, and 4 more after LT. In total, 10 of these 14 patients died.
Conclusions: Colonization with MDRO is associated with increased mortality on the waiting list, but not in short-term follow-up after LT. Moreover, colonization with CRGN seems associated with high mortality in liver transplant candidates and recipients.
Immune-modulating therapy is a promising therapy for patients with cholangiocarcinoma (CCA). Microsatellite instability (MSI) might be a favorable predictor for treatment response, but comprehensive data on the prevalence of MSI in CCA are missing. The aim of the current study was to determine the prevalence of MSI in a German tertiary care hospital. Formalin-fixed paraffin-embedded tissue samples, obtained in the study period from 2007 to 2015 from patients with CCA undergoing surgical resection with curative intention at Johann Wolfgang Goethe University hospital, were examined. All samples were investigated immunohistochemically for the presence of MSI (expression of MLH1, PMS2, MSH2, and MSH6) as well as by pentaplex polymerase chain reaction for five quasimonomorphic mononucleotide repeats (BAT-25, BAT-26, NR-21, NR-22, and NR-24). In total, 102 patients were included, presenting intrahepatic (n = 35, 34.3%), perihilar (n = 42, 41.2%), and distal CCA (n = 25, 24.5%). In the immunohistochemical analysis, no loss of expression of DNA repair enzymes was observed. In the PCR-based analysis, one out of 102 patients was found to be MSI-high and one out of 102 was found to be MSI-low. Thus, MSI seems to appear rarely in CCA in Germany. This should be considered when planning immune-modulating therapy trials for patients with CCA.
Cardiac rehabilitation (CR) is a multidisciplinary intervention including patient assessment and medical actions to promote stabilization, management of cardiovascular risk factors, vocational support, psychosocial management, physical activity counselling, and prescription of exercise training. Millions of people with cardiac implantable electronic devices live in Europe and their numbers are progressively increasing, therefore, large subsets of patients admitted in CR facilities have a cardiac implantable electronic device. Patients who are cardiac implantable electronic devices recipients are considered eligible for a CR programme. This is not only related to the underlying heart disease but also to specific issues, such as psychological adaptation to living with an implanted device and, in implantable cardioverter-defibrillator patients, the risk of arrhythmia, syncope, and sudden cardiac death. Therefore, these patients should receive special attention, as their needs may differ from other patients participating in CR. As evidence from studies of CR in patients with cardiac implantable electronic devices is sparse, detailed clinical practice guidelines are lacking. Here, we aim to provide practical recommendations for CR in cardiac implantable electronic devices recipients in order to increase CR implementation, efficacy, and safety in this subset of patients.
Abstract Geant4 is a toolkit for simulating the passage of particles through matter. It includes a complete range of functionality including tracking, geometry, physics models and hits. The physics processes offered cover a comprehensive range, including electromagnetic, hadronic and optical processes, a large set of long-lived particles, materials and elements, over a wide energy range starting, in some cases, from 250 eV and extending in others to the TeV energy range. It has been designed and constructed to expose the physics models utilised, to handle complex geometries, and to enable its easy adaptation for optimal use in different sets of applications. The toolkit is the result of a worldwide collaboration of physicists and software engineers. It has been created exploiting software engineering and object-oriented technology and implemented in the C++ programming language. It has been used in applications in particle physics, nuclear physics, accelerator design, space engineering and medical physics. PACS: 07.05.Tp; 13; 23
Background: The potential anti-cancer effects of mammalian target of rapamycin (mTOR) inhibitors are being intensively studied. To date, however, few randomised clinical trials (RCT) have been performed to demonstrate anti-neoplastic effects in the pure oncology setting, and at present, no oncology endpoint-directed RCT has been reported in the high-malignancy risk population of immunosuppressed transplant recipients. Interestingly, since mTOR inhibitors have both immunosuppressive and anti-cancer effects, they have the potential to simultaneously protect against immunologic graft loss and tumour development. Therefore, we designed a prospective RCT to determine if the mTOR inhibitor sirolimus can improve hepatocellular carcinoma (HCC)-free patient survival in liver transplant (LT) recipients with a pre-transplant diagnosis of HCC. Methods: The study is an open-labelled, randomised, RCT comparing sirolimus-containing versus mTOR-inhibitor-free immunosuppression in patients undergoing LT for HCC. Patients with a histologically confirmed HCC diagnosis are randomised into 2 groups within 4-6 weeks after LT; one arm is maintained on a centre-specific mTOR-inhibitor-free immunosuppressive protocol and the second arm is maintained on a centre-specific mTOR-inhibitor-free immunosuppressive protocol for the first 4-6 weeks, at which time sirolimus is initiated. A 3-year recruitment phase is planned with a 5-year follow-up, testing HCC-free survival as the primary endpoint. Our hypothesis is that sirolimus use in the second arm of the study will improve HCC-free survival. The study is a non-commercial investigator-initiated trial (IIT) sponsored by the University Hospital Regensburg and is endorsed by the European Liver and Intestine Transplant Association; 13 countries within Europe, Canada and Australia are participating. Discussion: If our hypothesis is correct that mTOR inhibition can reduce HCC tumour growth while simultaneously providing immunosuppression to protect the liver allograft from rejection, patients should experience less post-transplant problems with HCC recurrence, and therefore could expect a longer and better quality of life. A positive outcome will likely change the standard of posttransplant immunosuppressive care for LT patients with HCC. (trial registered at www.clinicaltrials.gov: NCT00355862) (EudraCT Number: 2005-005362-36)