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K+K− pairs may be produced in photonuclear collisions, either from the decays of photoproduced ϕ(1020) mesons, or directly as non-resonant K+K− pairs. Measurements of K+K− photoproduction probe the couplings between the ϕ(1020) and charged kaons with photons and nuclear targets. The kaon−proton scattering occurs at energies far above those available elsewhere. We present the first measurement of coherent photoproduction of K+K− pairs on lead ions in ultra-peripheral collisions using the ALICE detector, including the first investigation of direct K+K− production. There is significant K+K− production at low transverse momentum, consistent with coherent photoproduction on lead targets. In the mass range 1.1<MKK<1.4 GeV/c2 above the ϕ(1020) resonance, for rapidity |yKK|<0.8 and pT,KK<0.1 GeV/c, the measured coherent photoproduction cross section is dσ/dy = 3.37 ± 0.61 (stat.) ± 0.15 (syst.) mb. The center-of-mass energy per nucleon of the photon-nucleus (Pb) system WγPb,n ranges from 33 to 188 GeV, far higher than previous measurements on heavy-nucleus targets. The cross section is larger than expected for ϕ(1020) photoproduction alone. The mass spectrum is fit to a cocktail consisting of ϕ(1020) decays, direct K+K− photoproduction, and interference between the two. The confidence regions for the amplitude and relative phase angle for direct K+K− photoproduction are presented.
This Letter presents the measurement of near-side associated per-trigger yields, denoted ridge yields, from the analysis of angular correlations of charged hadrons in proton-proton collisions at s√ = 13 TeV. Long-range ridge yields are extracted for pairs of charged particles with a pseudorapidity difference of 1.4<|Δη|<1.8 and a transverse momentum of 1<pT<2 GeV/c, as a function of the charged-particle multiplicity measured at midrapidity. This study extends the measurements of the ridge yield to the low multiplicity region, where in hadronic collisions it is typically conjectured that a strongly-interacting medium is unlikely to be formed. The precision of the new low multiplicity results allows for the first direct quantitative comparison with the results obtained in e+e− collisions at s√ = 91 GeV and s√ = 183−209 GeV, where initial-state effects such as pre-equilibrium dynamics and collision geometry are not expected to play a role. In the multiplicity range 8≲⟨Nch⟩≲24 where the e+e− results have good precision, the measured ridge yields in pp collisions are substantially larger than the limits set in e+e− annihilations. Consequently, the findings presented in this Letter suggest that the processes involved in e+e− annihilations do not contribute significantly to the emergence of long-range correlations in pp collisions.
The measurements of the inclusive J/ψ yield at midrapidity (|y|<0.9) and forward rapidity (2.5 <y< 4) in Pb−Pb collisions at sNN−−−√=5.02 TeV with the ALICE detector at the LHC are reported. The inclusive J/ψ production yields and nuclear modification factors, RAA, are measured as a function of the collision centrality, J/ψ transverse momentum (pT), and rapidity. The J/ψ average transverse momentum and squared transverse momentum (⟨pT⟩ and ⟨p2T⟩) are evaluated as a function of the centrality at midrapidity. Compared to the previous ALICE publications, here the entire Pb−Pb collisions dataset collected during the LHC Run 2 is used, which improves the precision of the measurements and extends the pT coverage. The pT-integrated RAA shows a hint of an increasing trend towards unity from semicentral to central collisions at midrapidity, while it is flat at forward rapidity. The pT-differential RAA shows a strong suppression at high pT with less suppression at low pT where it reaches a larger value at midrapidity compared to forward rapidity. The ratio of the pT-integrated yields of J/ψ to those of D0 mesons is reported for the first time for the central and semicentral event classes at midrapidity. Model calculations implementing charmonium production via the coalescence of charm quarks and antiquarks during the fireball evolution (transport models) or in a statistical approach with thermal weights are in good agreement with the data at low pT. At higher pT, the data are well described by transport models and a model based on energy loss in the strongly-interacting medium produced in nuclear collisions at the LHC.
The measurements of the inclusive J/ψ yield at midrapidity (|y|<0.9) and forward rapidity (2.5 <y< 4) in Pb−Pb collisions at sNN−−−√=5.02 TeV with the ALICE detector at the LHC are reported. The inclusive J/ψ production yields and nuclear modification factors, RAA, are measured as a function of the collision centrality, J/ψ transverse momentum (pT), and rapidity. The J/ψ average transverse momentum and squared transverse momentum (⟨pT⟩ and ⟨p2T⟩) are evaluated as a function of the centrality at midrapidity. Compared to the previous ALICE publications, here the entire Pb−Pb collisions dataset collected during the LHC Run 2 is used, which improves the precision of the measurements and extends the pT coverage. The pT-integrated RAA shows a hint of an increasing trend towards unity from semicentral to central collisions at midrapidity, while it is flat at forward rapidity. The pT-differential RAA shows a strong suppression at high pT with less suppression at low pT where it reaches a larger value at midrapidity compared to forward rapidity. The ratio of the pT-integrated yields of J/ψ to those of D0 mesons is reported for the first time for the central and semicentral event classes at midrapidity. Model calculations implementing charmonium production via the coalescence of charm quarks and antiquarks during the fireball evolution (transport models) or in a statistical approach with thermal weights are in good agreement with the data at low pT. At higher pT, the data are well described by transport models and a model based on energy loss in the strongly-interacting medium produced in nuclear collisions at the LHC.
Measurements of inclusive charged-particle jet production in pp and p-Pb collisions at center-of-mass energy per nucleon-nucleon collision sNN−−−√=5.02 TeV and the corresponding nuclear modification factor RchjetpPb are presented, using data collected with the ALICE detector at the LHC. Jets are reconstructed in the central rapidity region |ηjet|<0.5 from charged particles using the anti-kT algorithm with resolution parameters R=0.2, 0.3, and 0.4. The pT-differential inclusive production cross section of charged-particle jets, as well as the corresponding cross section ratios, are reported for pp and p-Pb collisions in the transverse momentum range 10<pchT,jet<140 GeV/c and 10<pchT,jet<160 GeV/c, respectively, together with the nuclear modification factor RchjetpPb in the range 10<pchT,jet<140 GeV/c. The analysis extends the pT range of the previously-reported charged-particle jet measurements by the ALICE Collaboration. The nuclear modification factor is found to be consistent with one and independent of the jet resolution parameter with the improved precision of this study, indicating that the possible influence of cold nuclear matter effects on the production cross section of charged-particle jets in p-Pb collisions at sNN−−−√=5.02 TeV is smaller than the current precision. The obtained results are in agreement with other minimum bias jet measurements available for RHIC and LHC energies, and are well reproduced by the NLO perturbative QCD POWHEG calculations with parton shower provided by PYTHIA8 as well as by JETSCAPE simulations.
Correlations in azimuthal angle extending over a long range in pseudorapidity between particles, usually called the "ridge" phenomenon, were discovered in heavy-ion collisions, and later found in pp and p−Pb collisions. In large systems, they are thought to arise from the expansion (collective flow) of the produced particles. Extending these measurements over a wider range in pseudorapidity and final-state particle multiplicity is important to understand better the origin of these long-range correlations in small-collision systems. In this Letter, measurements of the long-range correlations in p−Pb collisions at sNN−−−√=5.02 TeV are extended to a pseudorapidity gap of Δη∼8 between particles using the ALICE, forward multiplicity detectors. After suppressing non-flow correlations, e.g., from jet and resonance decays, the ridge structure is observed to persist up to a very large gap of Δη∼8 for the first time in p−Pb collisions. This shows that the collective flow-like correlations extend over an extensive pseudorapidity range also in small-collision systems such as p−Pb collisions. The pseudorapidity dependence of the second-order anisotropic flow coefficient, v2(η), is extracted from the long-range correlations. The v2(η) results are presented for a wide pseudorapidity range of −3.1<η<4.8 in various centrality classes in p−Pb collisions. To gain a comprehensive understanding of the source of anisotropic flow in small-collision systems, the v2(η) measurements are compared to hydrodynamic and transport model calculations. The comparison suggests that the final-state interactions play a dominant role in developing the anisotropic flow in small-collision systems.
Collective behavior has been observed in high-energy heavy-ion collisions for several decades. Collectivity is driven by the high particle multiplicities that are produced in these collisions. At the CERN Large Hadron Collider (LHC), features of collectivity have also been seen in high-multiplicity proton-proton collisions that can attain particle multiplicities comparable to peripheral Pb-Pb collisions. One of the possible signatures of collective behavior is the decrease of femtoscopic radii extracted from pion and kaon pairs emitted from high-multiplicity collisions with increasing pair transverse momentum. This decrease can be described in terms of an approximate transverse mass scaling. In the present work, femtoscopic analyses are carried out by the ALICE Collaboration on charged pion and kaon pairs produced in pp collisions at s√=13 TeV from the LHC to study possible collectivity in pp collisions. The event-shape analysis method based on transverse sphericity is used to select for spherical versus jet-like events, and the effects of this selection on the femtoscopic radii for both charged pion and kaon pairs are studied. This is the first time this selection method has been applied to charged kaon pairs. An approximate transverse-mass scaling of the radii is found in all multiplicity ranges studied when the difference in the Lorentz boost for pions and kaons is taken into account. This observation does not support the hypothesis of collective expansion of hot and dense matter that should only occur in high-multiplicity events. A possible alternate explanation of the present results is based on a scenario of common emission conditions for pions and kaons in pp collisions for the multiplicity ranges studied.
Study of flavor dependence of the baryon-to-meson ratio in proton–proton collisions at √s = 13 TeV
(2024)
The production cross sections of D0 and Λ+c hadrons originating from beauty-hadron decays (i.e. non-prompt) were measured for the first time at midrapidity (|y|<0.5) by the ALICE Collaboration in proton-proton collisions at a center-of-mass energy s√=13 TeV. They are described within uncertainties by perturbative QCD calculations employing the fragmentation fractions of beauty quarks to baryons measured at forward rapidity by the LHCb Collaboration. The bb¯¯¯ production cross section per unit of rapidity at midrapidity, estimated from these measurements, is dσbb¯¯¯/dy||y|<0.5=83.1±3.5(stat.)±5.4(syst.)+12.3−3.2(extrap.)μb. The baryon-to-meson ratios are computed to investigate the hadronization mechanism of beauty quarks. The non-prompt Λ+c/D0 production ratio has a similar trend to the one measured for the promptly produced charmed particles and to the p/π+ and Λ/K0S ratios, suggesting a similar baryon-formation mechanism among light, strange, charm, and beauty hadrons. The pT-integrated non-prompt Λc/D0 ratio is found to be significantly higher than the one measured in e+e− collisions.
The transverse momentum (pT) and centrality dependence of the nuclear modification factor RAA of prompt and non-prompt J/ψ, the latter originating from the weak decays of beauty hadrons, have been measured by the ALICE collaboration in Pb−Pb collisions at sNN−−−√ = 5.02 TeV. The measurements are carried out through the e+e− decay channel at midrapidity (|y|<0.9) in the transverse momentum region 1.5<pT<10 GeV/c. Both prompt and non-prompt J/ψ measurements indicate a significant suppression for pT> 5 GeV/c, which becomes stronger with increasing collision centrality. The results are consistent with similar LHC measurements in the overlapping pT intervals, and cover the kinematic region down to pT = 1.5 GeV/c at midrapidity, not accessible by other LHC experiments. The suppression of prompt J/ψ in central and semicentral collisions exhibits a decreasing trend towards lower transverse momentum, described within uncertainties by models implementing J/ψ production from recombination of c and c¯¯ quarks produced independently in different partonic scatterings. At high transverse momentum, transport models including quarkonium dissociation are able to describe the suppression for prompt J/ψ. For non-prompt J/ψ, the suppression predicted by models including both collisional and radiative processes for the computation of the beauty-quark energy loss inside the quark−gluon plasma is consistent with measurements within uncertainties.
Study of flavor dependence of the baryon-to-meson ratio in proton–proton collisions at √s = 13 TeV
(2023)
The production cross sections of D0 and Λ+c hadrons originating from beauty-hadron decays (i.e. non-prompt) were measured for the first time at midrapidity (|y|<0.5) by the ALICE Collaboration in proton-proton collisions at a center-of-mass energy s√=13 TeV. They are described within uncertainties by perturbative QCD calculations employing the fragmentation fractions of beauty quarks to baryons measured at forward rapidity by the LHCb Collaboration. The bb¯¯¯ production cross section per unit of rapidity at midrapidity, estimated from these measurements, is dσbb¯¯¯/dy||y|<0.5=83.1±3.5(stat.)±5.4(syst.)+12.3−3.2(extrap.)μb. The baryon-to-meson ratios are computed to investigate the hadronization mechanism of beauty quarks. The non-prompt Λ+c/D0 production ratio has a similar trend to the one measured for the promptly produced charmed particles and to the p/π+ and Λ/K0S ratios, suggesting a similar baryon-formation mechanism among light, strange, charm, and beauty hadrons. The pT-integrated non-prompt Λc/D0 ratio is found to be significantly higher than the one measured in e+e− collisions.
The transverse momentum (pT) and centrality dependence of the nuclear modification factor RAA of prompt and non-prompt J/ψ, the latter originating from the weak decays of beauty hadrons, have been measured by the ALICE collaboration in Pb−Pb collisions at sNN−−−√ = 5.02 TeV. The measurements are carried out through the e+e− decay channel at midrapidity (|y|<0.9) in the transverse momentum region 1.5<pT<10 GeV/c. Both prompt and non-prompt J/ψ measurements indicate a significant suppression for pT> 5 GeV/c, which becomes stronger with increasing collision centrality. The results are consistent with similar LHC measurements in the overlapping pT intervals, and cover the kinematic region down to pT = 1.5 GeV/c at midrapidity, not accessible by other LHC experiments. The suppression of prompt J/ψ in central and semicentral collisions exhibits a decreasing trend towards lower transverse momentum, described within uncertainties by models implementing J/ψ production from recombination of c and c¯¯ quarks produced independently in different partonic scatterings. At high transverse momentum, transport models including quarkonium dissociation are able to describe the suppression for prompt J/ψ. For non-prompt J/ψ, the suppression predicted by models including both collisional and radiative processes for the computation of the beauty-quark energy loss inside the quark−gluon plasma is consistent with measurements within uncertainties.
The first measurements of K∗(892)0 resonance production as a function of charged-particle multiplicity in Xe−Xe collisions at sNN−−−√= 5.44 TeV and pp collisions at s√= 5.02 TeV using the ALICE detector are presented. The resonance is reconstructed at midrapidity (|y|<0.5) using the hadronic decay channel K∗0→K±π∓. Measurements of transverse-momentum integrated yield, mean transverse-momentum, nuclear modification factor of K∗0, and yield ratios of resonance to stable hadron (K∗0/K) are compared across different collision systems (pp, p−Pb, Xe−Xe, and Pb−Pb) at similar collision energies to investigate how the production of K∗0 resonances depends on the size of the system formed in these collisions. The hadronic rescattering effect is found to be independent of the size of colliding systems and mainly driven by the produced charged-particle multiplicity, which is a proxy of the volume of produced matter at the chemical freeze-out. In addition, the production yields of K∗0 in Xe−Xe collisions are utilized to constrain the dependence of the kinetic freeze-out temperature on the system size using the hadron resonance gas in partial chemical equilibrium (HRG-PCE) model.
The first measurements of skewness and kurtosis of mean transverse momentum (⟨pT⟩) fluctuations are reported in Pb−Pb collisions at sNN−−−√ = 5.02 TeV, Xe−Xe collisions at sNN−−−√ = 5.44 TeV and pp collisions at s√=5.02 TeV using the ALICE detector. The measurements are carried out as a function of system size ⟨dNch/dη⟩1/3|η|<0.5, using charged particles with transverse momentum (pT) and pseudorapidity (η), in the range 0.2<pT<3.0 GeV/c and |η|<0.8, respectively. In Pb−Pb and Xe−Xe collisions, positive skewness is observed in the fluctuations of ⟨pT⟩ for all centralities, which is significantly larger than what would be expected in the scenario of independent particle emission. This positive skewness is considered a crucial consequence of the hydrodynamic evolution of the hot and dense nuclear matter created in heavy-ion collisions. Furthermore, similar observations of positive skewness for minimum bias pp collisions are also reported here. Kurtosis of ⟨pT⟩ fluctuations is found to be in good agreement with the kurtosis of Gaussian distribution, for most central Pb−Pb collisions. Hydrodynamic model calculations with MUSIC using Monte Carlo Glauber initial conditions are able to explain the measurements of both skewness and kurtosis qualitatively from semicentral to central collisions in Pb--Pb system. Color reconnection mechanism in PYTHIA8 model seems to play a pivotal role in capturing the qualitative behavior of the same measurements in pp collisions.
The first measurements of skewness and kurtosis of mean transverse momentum (⟨pT⟩) fluctuations are reported in Pb−Pb collisions at sNN−−−√ = 5.02 TeV, Xe−Xe collisions at sNN−−−√ = 5.44 TeV and pp collisions at s√=5.02 TeV using the ALICE detector. The measurements are carried out as a function of system size ⟨dNch/dη⟩1/3|η|<0.5, using charged particles with transverse momentum (pT) and pseudorapidity (η), in the range 0.2<pT<3.0 GeV/c and |η|<0.8, respectively. In Pb−Pb and Xe−Xe collisions, positive skewness is observed in the fluctuations of ⟨pT⟩ for all centralities, which is significantly larger than what would be expected in the scenario of independent particle emission. This positive skewness is considered a crucial consequence of the hydrodynamic evolution of the hot and dense nuclear matter created in heavy-ion collisions. Furthermore, similar observations of positive skewness for minimum bias pp collisions are also reported here. Kurtosis of ⟨pT⟩ fluctuations is found to be in good agreement with the kurtosis of Gaussian distribution, for most central Pb−Pb collisions. Hydrodynamic model calculations with MUSIC using Monte Carlo Glauber initial conditions are able to explain the measurements of both skewness and kurtosis qualitatively from semicentral to central collisions in Pb--Pb system. Color reconnection mechanism in PYTHIA8 model seems to play a pivotal role in capturing the qualitative behavior of the same measurements in pp collisions.
The transverse momentum (pT) and centrality dependence of the nuclear modification factor RAA of prompt and non-prompt J/ψ, the latter originating from the weak decays of beauty hadrons, have been measured by the ALICE collaboration in Pb−Pb collisions at sNN−−−√ = 5.02 TeV. The measurements are carried out through the e+e− decay channel at midrapidity (|y|<0.9) in the transverse momentum region 1.5<pT<10 GeV/c. Both prompt and non-prompt J/ψ measurements indicate a significant suppression for pT> 5 GeV/c, which becomes stronger with increasing collision centrality. The results are consistent with similar LHC measurements in the overlapping pT intervals, and cover the kinematic region down to pT = 1.5 GeV/c at midrapidity, not accessible by other LHC experiments. The suppression of prompt J/ψ in central and semicentral collisions exhibits a decreasing trend towards lower transverse momentum, described within uncertainties by models implementing J/ψ production from recombination of c and c¯¯ quarks produced independently in different partonic scatterings. At high transverse momentum, transport models including quarkonium dissociation are able to describe the suppression for prompt J/ψ. For non-prompt J/ψ, the suppression predicted by models including both collisional and radiative processes for the computation of the beauty-quark energy loss inside the quark−gluon plasma is consistent with measurements within uncertainties.
The first measurements of K∗(892)0 resonance production as a function of charged-particle multiplicity in Xe−Xe collisions at sNN−−−√= 5.44 TeV and pp collisions at s√= 5.02 TeV using the ALICE detector are presented. The resonance is reconstructed at midrapidity (|y|<0.5) using the hadronic decay channel K∗0→K±π∓. Measurements of transverse-momentum integrated yield, mean transverse-momentum, nuclear modification factor of K∗0, and yield ratios of resonance to stable hadron (K∗0/K) are compared across different collision systems (pp, p−Pb, Xe−Xe, and Pb−Pb) at similar collision energies to investigate how the production of K∗0 resonances depends on the size of the system formed in these collisions. The hadronic rescattering effect is found to be independent of the size of colliding systems and mainly driven by the produced charged-particle multiplicity, which is a proxy of the volume of produced matter at the chemical freeze-out. In addition, the production yields of K∗0 in Xe−Xe collisions are utilized to constrain the dependence of the kinetic freeze-out temperature on the system size using the hadron resonance gas in partial chemical equilibrium (HRG-PCE) model.
Modification of charged-particle jets in event-shape engineered Pb–Pb collisions at √sNN = 5.02 TeV
(2024)
Charged-particle jet yields have been measured in semicentral Pb−Pb collisions at center-of-mass energy per nucleon-nucleon collision sNN−−−√=5.02 TeV with the ALICE detector at the LHC. These yields are reported as a function of the jet transverse momentum, and further classified by their angle with respect to the event plane and the event shape, characterized by ellipticity, in an effort to study the path-length dependence of jet quenching. Jets were reconstructed at midrapidity from charged-particle tracks using the anti-kT algorithm with resolution parameters R= 0.2 and 0.4, with event-plane angle and event-shape values determined using information from forward scintillating detectors. The results presented in this letter show that, in semicentral Pb−Pb collisions, there is no significant difference between jet yields in predominantly isotropic and elliptical events. However, out-of-plane jets are observed to be more suppressed than in-plane jets. Further, this relative suppression is greater for low transverse momentum (< 50 GeV/c) R= 0.2 jets produced in elliptical events, with out-of-plane to in-plane jet-yield ratios varying up to 5.2σ between different event-shape classes. These results agree with previous studies indicating that jets experience azimuthally anisotropic suppression when traversing the QGP medium, and can provide additional constraints on the path-length dependence of jet energy loss.
The ALICE Collaboration reports three measurements in ultra-peripheral proton−lead collisions at forward rapidity. The exclusive two-photon process \ggmm and the exclusive photoproduction of J/ψ are studied. J/ψ photoproduction with proton dissociation is measured for the first time at a hadron collider. The cross section for the two-photon process of dimuons in the invariant mass range from 1 to 2.5 GeV/c2 agrees with leading order quantum electrodynamics calculations. The exclusive and dissociative cross sections for J/ψ photoproductions are measured for photon−proton centre-of-mass energies from 27 to 57 GeV. They are in good agreement with HERA results.
The pseudorapidity dependence of elliptic (v2), triangular (v3), and quadrangular (v4) flow coefficients of charged particles measured in Pb-Pb collisions at a centre-of-mass energy per nucleon pair of sNN−−−√=5.02 TeV and in Xe-Xe collisions at sNN−−−√=5.44 TeV with ALICE at the LHC are presented. The measurements are performed in the pseudorapidity range −3.5<η<5 for various centrality intervals using two- and multi-particle cumulants with the subevent method. The flow probability density function (p.d.f.) is studied with the ratio of flow coefficient v2 calculated with four- and two-particle cumulant, and suggests that the variance of flow p.d.f. is independent of pseudorapidity. The decorrelation of the flow vector in the longitudinal direction is probed using two-particle correlations. The results measured with respect to different reference regions in pseudorapidity exhibit differences, argued to be a result of saturating decorrelation effect above a certain pseudorapidity separation, in contrast to previous publications which assign this observation to non-flow effects. The results are compared to 3+1 dimensional hydrodynamic and the AMPT transport model calculations. Neither of the models is able to simultaneously describe the pseudorapidity dependence of measurements of anisotropic flow and its fluctuations. The results presented in this work highlight shortcomings in our current understanding of initial conditions and subsequent system expansion in the longitudinal direction. Therefore, they provide input for its improvement.
The pseudorapidity dependence of elliptic (v2), triangular (v3), and quadrangular (v4) flow coefficients of charged particles measured in Pb-Pb collisions at a centre-of-mass energy per nucleon pair of sNN−−−√=5.02 TeV and in Xe-Xe collisions at sNN−−−√=5.44 TeV with ALICE at the LHC are presented. The measurements are performed in the pseudorapidity range −3.5<η<5 for various centrality intervals using two- and multi-particle cumulants with the subevent method. The flow probability density function (p.d.f.) is studied with the ratio of flow coefficient v2 calculated with four- and two-particle cumulant, and suggests that the variance of flow p.d.f. is independent of pseudorapidity. The decorrelation of the flow vector in the longitudinal direction is probed using two-particle correlations. The results measured with respect to different reference regions in pseudorapidity exhibit differences, argued to be a result of saturating decorrelation effect above a certain pseudorapidity separation, in contrast to previous publications which assign this observation to non-flow effects. The results are compared to 3+1 dimensional hydrodynamic and the AMPT transport model calculations. Neither of the models is able to simultaneously describe the pseudorapidity dependence of measurements of anisotropic flow and its fluctuations. The results presented in this work highlight shortcomings in our current understanding of initial conditions and subsequent system expansion in the longitudinal direction. Therefore, they provide input for its improvement.
Bipolar disorder (BD) is a genetically complex mental illness characterized by severe oscillations of mood and behavior. Genome-wide association studies (GWAS) have identified several risk loci that together account for a small portion of the heritability. To identify additional risk loci, we performed a two-stage meta-analysis of >9 million genetic variants in 9,784 bipolar disorder patients and 30,471 controls, the largest GWAS of BD to date. In this study, to increase power we used ~2,000 lithium-treated cases with a long-term diagnosis of BD from the Consortium on Lithium Genetics, excess controls, and analytic methods optimized for markers on the Xchromosome. In addition to four known loci, results revealed genome-wide significant associations at two novel loci: an intergenic region on 9p21.3 (rs12553324, p = 5.87×10-9; odds ratio = 1.12) and markers within ERBB2 (rs2517959, p = 4.53×10-9; odds ratio = 1.13). No significant X-chromosome associations were detected and X-linked markers explained very little BD heritability. The results add to a growing list of common autosomal variants involved in BD and illustrate the power of comparing well-characterized cases to an excess of controls in GWAS.
Ziele: Das Ziel dieser offiziellen Leitlinie, die von der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) und der Deutschen Krebsgesellschaft (DKG) publiziert und koordiniert wurde, ist es, die Früherkennung, Diagnostik, Therapie und Nachsorge des Mammakarzinoms zu optimieren.
Methoden: Der Aktualisierungsprozess der S3-Leitlinie aus 2012 basierte zum einen auf der Adaptation identifizierter Quellleitlinien und zum anderen auf Evidenzübersichten, die nach Entwicklung von PICO-(Patients/Interventions/Control/Outcome-)Fragen, systematischer Recherche in Literaturdatenbanken sowie Selektion und Bewertung der gefundenen Literatur angefertigt wurden. In den interdisziplinären Arbeitsgruppen wurden auf dieser Grundlage Vorschläge für Empfehlungen und Statements erarbeitet, die im Rahmen von strukturierten Konsensusverfahren modifiziert und graduiert wurden.
Empfehlungen: Der Teil 1 dieser Kurzversion der Leitlinie zeigt Empfehlungen zur Früherkennung, Diagnostik und Nachsorge des Mammakarzinoms: Der Stellenwert des Mammografie-Screenings wird in der aktualisierten Leitlinienversion bestätigt und bildet damit die Grundlage der Früherkennung. Neben den konventionellen Methoden der Karzinomdiagnostik wird die Computertomografie (CT) zum Staging bei höherem Rückfallrisiko empfohlen. Die Nachsorgekonzepte beinhalten Untersuchungsintervalle für die körperliche Untersuchung, Ultraschall und Mammografie, während weiterführende Gerätediagnostik und Tumormarkerbestimmungen bei der metastasierten Erkrankung Anwendung finden.
Purpose: The aim of this official guideline coordinated and published by the German Society for Gynecology and Obstetrics (DGGG) and the German Cancer Society (DKG) was to optimize the screening, diagnosis, therapy and follow-up care of breast cancer.
Methods: The process of updating the S3 guideline dating from 2012 was based on the adaptation of identified source guidelines which were combined with reviews of evidence compiled using PICO (Patients/Interventions/Control/Outcome) questions and the results of a systematic search of literature databases and the selection and evaluation of the identified literature. The interdisciplinary working groups took the identified materials as their starting point to develop recommendations and statements which were modified and graded in a structured consensus procedure.
Recommendations: Part 1 of this short version of the guideline presents recommendations for the screening, diagnosis and follow-up care of breast cancer. The importance of mammography for screening is confirmed in this updated version of the guideline and forms the basis for all screening. In addition to the conventional methods used to diagnose breast cancer, computed tomography (CT) is recommended for staging in women with a higher risk of recurrence. The follow-up concept includes suggested intervals between physical, ultrasound and mammography examinations, additional high-tech diagnostic procedures, and the determination of tumor markers for the evaluation of metastatic disease.
HLA-DRB1 and HLA-DQB1 genetic diversity modulates response to lithium in bipolar affective disorders
(2021)
Bipolar affective disorder (BD) is a severe psychiatric illness, for which lithium (Li) is the gold standard for acute and maintenance therapies. The therapeutic response to Li in BD is heterogeneous and reliable biomarkers allowing patients stratification are still needed. A GWAS performed by the International Consortium on Lithium Genetics (ConLiGen) has recently identified genetic markers associated with treatment responses to Li in the human leukocyte antigens (HLA) region. To better understand the molecular mechanisms underlying this association, we have genetically imputed the classical alleles of the HLA region in the European patients of the ConLiGen cohort. We found our best signal for amino-acid variants belonging to the HLA-DRB1*11:01 classical allele, associated with a better response to Li (p < 1 × 10−3; FDR < 0.09 in the recessive model). Alanine or Leucine at position 74 of the HLA-DRB1 heavy chain was associated with a good response while Arginine or Glutamic acid with a poor response. As these variants have been implicated in common inflammatory/autoimmune processes, our findings strongly suggest that HLA-mediated low inflammatory background may contribute to the efficient response to Li in BD patients, while an inflammatory status overriding Li anti-inflammatory properties would favor a weak response.
Introduction: Evidence from a number of open-label, uncontrolled studies has suggested that rituximab may benefit patients with autoimmune diseases who are refractory to standard-of-care. The objective of this study was to evaluate the safety and clinical outcomes of rituximab in several standard-of-care-refractory autoimmune diseases (within rheumatology, nephrology, dermatology and neurology) other than rheumatoid arthritis or non-Hodgkin's lymphoma in a real-life clinical setting.
Methods: Patients who received rituximab having shown an inadequate response to standard-of-care had their safety and clinical outcomes data retrospectively analysed as part of the German Registry of Autoimmune Diseases. The main outcome measures were safety and clinical response, as judged at the discretion of the investigators.
Results: A total of 370 patients (299 patient-years) with various autoimmune diseases (23.0% with systemic lupus erythematosus, 15.7% antineutrophil cytoplasmic antibody-associated granulomatous vasculitides, 15.1% multiple sclerosis and 10.0% pemphigus) from 42 centres received a mean dose of 2,440 mg of rituximab over a median (range) of 194 (180 to 1,407) days. The overall rate of serious infections was 5.3 per 100 patient-years during rituximab therapy. Opportunistic infections were infrequent across the whole study population, and mostly occurred in patients with systemic lupus erythematosus. There were 11 deaths (3.0% of patients) after rituximab treatment (mean 11.6 months after first infusion, range 0.8 to 31.3 months), with most of the deaths caused by infections. Overall (n = 293), 13.3% of patients showed no response, 45.1% showed a partial response and 41.6% showed a complete response. Responses were also reflected by reduced use of glucocorticoids and various immunosuppressives during rituximab therapy and follow-up compared with before rituximab. Rituximab generally had a positive effect on patient well-being (physician's visual analogue scale; mean improvement from baseline of 12.1 mm).
Conclusions: Data from this registry indicate that rituximab is a commonly employed, well-tolerated therapy with potential beneficial effects in standard of care-refractory autoimmune diseases, and support the results from other open-label, uncontrolled studies.
Oral presentation from 4th International Conference of cGMP Generators, Effectors and Therapeutic Implications ; Regensburg, Germany. 19–21 June 2009 Background: An exaggerated pain sensitivity is the dominant feature of inflammatory and neuropathic pain both in the clinical setting and in experimental animal models. It manifests as pain in response to normally innocuous stimuli (allodynia), increased response to noxious stimuli (hyperalgesia) or spontaneous pain, and can persist long after the initial injury is resolved. Research over the last decades has revealed that several signaling pathways in the spinal cord essentially contribute to the pain sensitization. To test the contribution of cGMP produced by NO-sensitive guanylyl cyclase (NO-GC) to pain sensitization, we investigated the localization of NO-GC in the spinal cord and in dorsal root ganglia, and we characterized the nociceptive behavior of mice deficient in NO-GC (GC-KO mice). Results: We show that NO-GC (β1 subunit) is distinctly expressed in neurons of the mouse spinal cord, while its distribution in dorsal root ganglia is restricted to non-neuronal cells. GC-KO mice exhibited a considerably reduced nociceptive behavior in models of inflammatory or neuropathic pain, but their responses to acute pain were not impaired. Moreover, GC-KO mice failed to develop pain sensitization induced by spinal administration of drugs releasing NO. Surprisingly, during spinal nociceptive processing cGMP produced by NO-GC may activate signaling pathways different from cGMP-dependent protein kinase I (cGKI), while cGKI can be activated by natriuretic peptide receptor-B (NPR-B) dependent cGMP production. Conclusion: Taken together, our results provide evidence that NO-GC has a dominant role in the development of exaggerated pain sensitivity during inflammatory and neuropathic pain. Furthermore, beside the NO-mediated cGMP synthesis, cGMP produced by NPR-B contributes to pain sensitization by activation of cGKI.
Background: As a multi-targeted anti-angiogenic receptor tyrosine kinase (RTK) inhibitor sunitinib (SUN) has been established for renal cancer and gastrointestinal stromal tumors. In advanced refractory esophagogastric cancer patients, monotherapy with SUN was associated with good tolerability but limited tumor response.
Methods: This double-blind, placebo-controlled, multicenter, phase II clinical trial was conducted to evaluate the efficacy, safety and tolerability of SUN as an adjunct to second and third-line FOLFIRI (NCT01020630). Patients were randomized to receive 6-week cycles including FOLFIRI plus sodium folinate (Na-FOLFIRI) once every two weeks and SUN or placebo (PL) continuously for four weeks followed by a 2-week rest period. The primary study endpoint was progression-free survival (PFS). Preplanned serum analyses of VEGF-A, VEGF-D, VEGFR2 and SDF-1α were performed retrospectively.
Results: Overall, 91 patients were randomized, 45 in each group (one patient withdrew). The main grade ≥3 AEs were neutropenia and leucopenia, observed in 56 %/20 % and 27 %/16 % for FOLFIRI + SUN/FOLFIRI + PL, respectively. Median PFS was similar, 3.5 vs. 3.3 months (hazard ratio (HR) 1.11, 95 % CI 0.70–1.74, P = 0.66) for FOLFIRI + SUN vs. FOLFIRI + PL, respectively. For FOLFIRI + SUN, a trend towards longer median overall survival (OS) compared with placebo was observed (10.4 vs. 8.9 months, HR 0.82, 95 % CI 0.50–1.34, one-sided P = 0.21). In subgroup serum analyses, significant changes in VEGF-A (P = 0.017), VEGFR2 (P = 0.012) and VEGF-D (P < 0.001) serum levels were observed.
Conclusions: Although sunitinib combined with FOLFIRI did not improve PFS and response in chemotherapy-resistant gastric cancer, a trend towards better OS was observed. Further biomarker-driven studies with other anti-angiogenic RTK inhibitors are warranted.
Trial registration: This study was registered prospectively in the NCT Clinical Trials Registry (ClinicalTrials.gov) under NCT01020630 on November 23, 2009 after approval by the leading ethics committee of the Medical Association of Rhineland-Palatinate, Mainz, in coordination with the participating ethics committees (see Additional file 2) on September 16, 2009.
The lower wood-feeding Australian termite Mastotermes darwiniensis Froggatt (Fig. 1) is the only living member of the family Mastotermitidae. The complex symbiotic hindgut flora consists of protozoa (formerly named Archaezoa; Cleveland & Grimstone 1964; Brugerolle & al. 1994; Berchtold & König 1995; Fröhlich & König 1999a, b), bacteria (Berchtold & König 1996; Berchtold & al. 1999), archaea (Fröhlich & König 1999a, b) and yeasts (Prillinger & al. 1996; Schäfer & al. 1996). The digestive system of Mastotermes darwiniensis consists of the foregut with the crop and the gizzard, the midgut, and the hindgut (Noirot & Noirot-Timothée 1969; 1995). The hindgut consists of five segments (P1 – P5): the proctodeal segment, the enteric valve, the paunch, the colon and the rectum. The paunch is the main microbial fermentation chamber, but the colon also contains microorganisms. The paunch is subdivided into a dilated thin-walled region (P3a) and a thick walled more tubular region (P3b) (Fig. 1c). In the case of Mastotermes darwiniensis oxygen diffusion gradients could be detected up to 100 μm below the epithelium (Berchtold & al., 1999).
Introduction: Acute lung injury (ALI) is an inflammatory disorder of pulmonary or extrapulmonary origin. We have previously demonstrated that netrin-1 dampens murine ALI, and in an attempt to advance this finding into future clinical practice we evaluated whether netrin-1 would reduce alveolar inflammation during porcine ALI. Methods: This was a controlled in vivo experimental study in pigs. We induced ALI through lipoploysaccharide (LPS) infusion (50 micro g/kg) for 2 hours. Following this, we exposed animals to either vehicle, intravenous netrin-1 (netrin-1 i.v.) or inhaled netrin-1 (netrin-1 inh.). Serum samples and bronchoalveolar lavage (BAL) were obtained to determine levels of tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, interleukin-6 and interleukin-8 at baseline and 6 hours following treatment. Myeloperoxidase activity (MPO) and protein levels were determined in the BAL, and tissue samples were obtained for histological evaluation. Finally, animals were scanned with spiral CT. Results: Following LPS infusion, animals developed acute pulmonary injury. Serum levels of TNF-alpha and IL-6 were significantly reduced in the netrin-1 i.v. group. BAL demonstrated significantly reduced cytokine levels 6 hours post-netrin-1 treatment (TNF-alpha: vehicle 633 ± 172 pg/ml, netrin-1 i.v. 84 ± 5 pg/ml, netrin-1 inh. 168 ± 74 pg/ml; both P < 0.05). MPO activity and protein content were significantly reduced in BAL samples from netrin-1-treated animals. Histological sections confirmed reduced inflammatory changes in the netrin-1-treated animals. Computed tomography corroborated reduced pulmonary damage in both netrin-1-treated groups. Conclusions: We conclude that treatment with the endogenous anti-inflammatory protein netrin-1 reduces pulmonary inflammation during the initial stages of ALI and should be pursued as a future therapeutic option.
Recent work has demonstrated that the formation of platelet neutrophil complexes (PNCs) affects inflammatory tissue injury. Vasodilator-stimulated phosphoprotein (VASP) is crucially involved into the control of PNC formation and myocardial reperfusion injury. Given the clinical importance of hepatic IR injury we pursued the role of VASP during hepatic ischemia followed by reperfusion. We report here that VASP−/− animals demonstrate reduced hepatic IR injury compared to wildtype (WT) controls. This correlated with serum levels of lactate dehydrogenase (LDH), aspartate (AST) and alanine (ALT) aminotransferase and the presence of PNCs within ischemic hepatic tissue and could be confirmed using repression of VASP through siRNA. In studies employing bone marrow chimeric mice we identified hematopoietic VASP to be of crucial importance for the extent of hepatic injury. Phosphorylation of VASP on Ser153 through Prostaglandin E1 or on Ser235 through atrial natriuretic peptide resulted in a significant reduction of hepatic IR injury. This was associated with a reduced presence of PNCs in ischemic hepatic tissue. Taken together, these studies identified VASP and VASP phosphorylation as crucial target for future hepatoprotective strategies.
Sandra Posch, Camilo Aponte-Santamaría, Richard Schwarzl, Andreas Karner, Matthias Radtke, Frauke Gräter, Tobias Obser, Gesa König, Maria A. Brehm, Hermann J. Gruber, Roland R. Netz, Carsten Baldauf, Reinhard Schneppenheim, Robert Tampé, Peter Hinterdorfer
Mutual A domain interactions in the force sensing protein von Willebrand factor
Journal of Structural Biology, Volume 197, Issue 1, January 2017, Pages 57-64. https://doi.org/10.1016/j.jsb.2016.04.012
We here give information for a deeper understanding of single molecule force spectroscopy (SMFS) data through the example of the blood protein von Willebrand factor (VWF). It is also shown, how fitting of rupture forces versus loading rate profiles in the molecular dynamics (MD) loading-rate range can be used to demonstrate the qualitative agreement between SMFS and MD simulations. The recently developed model by Bullerjahn, Sturm, and Kroy (BSK) was used for this demonstration. Further, Brownian dynamics (BD) simulations, which can be utilized to estimate the lifetimes of intramolecular VWF interactions under physiological shear, are described. For interpretation and discussion of the methods and data presented here, we would like to directly point the reader to the related research paper, “Mutual A domain interactions in the force sensing protein von Willebrand Factor” (Posch et al., 2016).
The von Willebrand factor (VWF) is a glycoprotein in the blood that plays a central role in hemostasis. Among other functions, VWF is responsible for platelet adhesion at sites of injury via its A1 domain. Its adjacent VWF domain A2 exposes a cleavage site under shear to degrade long VWF fibers in order to prevent thrombosis. Recently, it has been shown that VWF A1/A2 interactions inhibit the binding of platelets to VWF domain A1 in a force-dependent manner prior to A2 cleavage. However, whether and how this interaction also takes place in longer VWF fragments as well as the strength of this interaction in the light of typical elongation forces imposed by the shear flow of blood remained elusive. Here, we addressed these questions by using single molecule force spectroscopy (SMFS), Brownian dynamics (BD), and molecular dynamics (MD) simulations. Our SMFS measurements demonstrate that the A2 domain has the ability to bind not only to single A1 domains but also to VWF A1A2 fragments. SMFS experiments of a mutant [A2] domain, containing a disulfide bond which stabilizes the domain against unfolding, enhanced A1 binding. This observation suggests that the mutant adopts a more stable conformation for binding to A1. We found intermolecular A1/A2 interactions to be preferred over intramolecular A1/A2 interactions. Our data are also consistent with the existence of two cooperatively acting binding sites for A2 in the A1 domain. Our SMFS measurements revealed a slip-bond behavior for the A1/A2 interaction and their lifetimes were estimated for forces acting on VWF multimers at physiological shear rates using BD simulations. Complementary fitting of AFM rupture forces in the MD simulation range adequately reproduced the force response of the A1/A2 complex spanning a wide range of loading rates. In conclusion, we here characterized the auto-inhibitory mechanism of the intramolecular A1/A2 bond as a shear dependent safeguard of VWF, which prevents the interaction of VWF with platelets.
Das nachfolgend veröffentlichte Positionspapier "Naturschutz und Fischerei", das von der Ministerin für Raumordnung, Landwirtschaft und Umwelt des Landes Sachsen-Anhalt, Frau Heidecke, dem Präsidenten des Landesfischereiverbandes Sachsen-Anhalt e.V., Herrn Manfred Thiele, dem Präsidenten des Landesanglerverbandes Sachsen-Anhalt e.V., Herrn Hans-Peter Weineck, und dem Präsidenten des VDSF-Landesanglerverbandes Sachsen-Anhalt e.V., Dr. Hans König, unterzeichnet wurde, ist das Ergebnis eines ersten Dialoges zwischen dem Land und den beteiligten Verbänden, um künftig die anstehenden Fragen und Probleme in Umwelt und Naturschutz gemeinsam besser lösen zu können. Das Positionspapier soll sowohl der Umweltverwaltung als auch den Verbänden als Handlungsgrundlage dienen und in der weiteren Arbeit durch Verwaltungsvorschriften, Vereinbarungen und Verträge untersetzt werden. Durch die Frau Ministerin wurde dieses Papier als ein Beispiel für eine öffentlichkeitswirksame Zusammenarbeit hervorgehoben, die weiter fortgesetzt werden soll.
Transfusion of red blood cells (RBC) in patients undergoing major elective cranial surgery is associated with increased morbidity, mortality and prolonged hospital length of stay (LOS). This retrospective single center study aims to identify the clinical outcome of RBC transfusions on skull base and non-skull base meningioma patients including the identification of risk factors for RBC transfusion. Between October 2009 and October 2016, 423 patients underwent primary meningioma resection. Of these, 68 (16.1%) received RBC transfusion and 355 (83.9%) did not receive RBC units. Preoperative anaemia rate was significantly higher in transfused patients (17.7%) compared to patients without RBC transfusion (6.2%; p = 0.0015). In transfused patients, postoperative complications as well as hospital LOS was significantly higher (p < 0.0001) compared to non-transfused patients. After multivariate analyses, risk factors for RBC transfusion were preoperative American Society of Anaesthesiologists (ASA) physical status score (p = 0.0247), tumor size (p = 0.0006), surgical time (p = 0.0018) and intraoperative blood loss (p < 0.0001). Kaplan-Meier curves revealed significant influence on overall survival by preoperative anaemia, RBC transfusion, smoking, cardiovascular disease, preoperative KPS ≤ 60% and age (elderly ≥ 75 years). We concluded that blood loss due to large tumors or localization near large vessels are the main triggers for RBC transfusion in meningioma patients paired with a potential preselection that masks the effect of preoperative anaemia in multivariate analysis. Further studies evaluating the impact of preoperative anaemia management for reduction of RBC transfusion are needed to improve the clinical outcome of meningioma patients.
Recent evidence has demonstrated additional roles for the neuronal guidance protein receptor UNC5B outside the nervous system. Given the fact that ischemia reperfusion injury (IRI) of the liver is a common source of liver dysfunction and the role of UNC5B during an acute inflammatory response we investigated the role of UNC5B on acute hepatic IRI. We report here that UNC5B+/− mice display reduced hepatic IRI and neutrophil (PMN) infiltration compared to WT controls. This correlated with serum levels of lactate dehydrogenase (LDH), aspartate- (AST) and alanine- (ALT) aminotransferase, the presence of PMN within ischemic hepatic tissue, and serum levels of inflammatory cytokines. Moreover, injection of an anti-UNC5B antibody resulted in a significant reduction of hepatic IR injury. This was associated with reduced parameters of liver injury (LDH, ALT, AST) and accumulation of PMN within the injured hepatic tissue. In conclusion our studies demonstrate a significant role for UNC5B in the development of hepatic IRI and identified UNC5B as a potential drug target to prevent liver dysfunction in the future.
Objective: The aim of the study was to analyse the psychometric properties of the EQ-5D in patients with social phobia.
Methods: We used a sample of 445 patients with social phobia with five measurement points over a 30 month period. The discriminative ability of the EQ-5D was analysed by comparing the patients' responses with the general population and between different disease severity levels. For test-retest reliability we assessed the level of agreement in patients' responses over time, when there was no change in the Liebowitz Social Anxiety Scale (LSAS). Construct validity was analysed by identifying correlations of the EQ-5D with more specific instruments. For responsiveness we compared the means of EQ VAS/EQ-5D index anchored on improved (deteriorated) health status and computed effect sizes as well as a receiver operating characteristic (ROC) curve.
Results: Compared to the general population, patients with social phobia reported more problems in the dimensions "usual activities", "pain/discomfort", and "anxiety/depression" and less problems in "mobility" and "self-care". The EQ-5D was able to distinguish between different disease severity levels. The test-retest reliability was moderate (intraclass correlation coefficient > 0.6). Correlations between the EQ-5D and other instruments were mostly small except for correlations with Beck Depression Inventory. The EQ-5D index seemed to be more responsive than the EQ VAS, but with only medium effect sizes (0.5 < effect size < 0.8) in the British EQ-5D index and only significant in patients with improved health status. The ROC analysis revealed no significant results.
Conclusions: The EQ-5D was moderately reliable and responsive in patients with improved health status. Construct validity was limited.
Trial registration: Current controlled trials ISRCTN53517394.
Background: Bipolar disorder is associated with circadian disruption and a high risk of suicidal behavior. In a previous exploratory study of patients with bipolar I disorder, we found that a history of suicide attempts was associated with differences between winter and summer levels of solar insolation. The purpose of this study was to confirm this finding using international data from 42% more collection sites and 25% more countries. Methods: Data analyzed were from 71 prior and new collection sites in 40 countries at a wide range of latitudes. The analysis included 4876 patients with bipolar I disorder, 45% more data than previously analyzed. Of the patients, 1496 (30.7%) had a history of suicide attempt. Solar insolation data, the amount of the sun’s electromagnetic energy striking the surface of the earth, was obtained for each onset location (479 locations in 64 countries). Results: This analysis confirmed the results of the exploratory study with the same best model and slightly better statistical significance. There was a significant inverse association between a history of suicide attempts and the ratio of mean winter insolation to mean summer insolation (mean winter insolation/mean summer insolation). This ratio is largest near the equator which has little change in solar insolation over the year, and smallest near the poles where the winter insolation is very small compared to the summer insolation. Other variables in the model associated with an increased risk of suicide attempts were a history of alcohol or substance abuse, female gender, and younger birth cohort. The winter/summer insolation ratio was also replaced with the ratio of minimum mean monthly insolation to the maximum mean monthly insolation to accommodate insolation patterns in the tropics, and nearly identical results were found. All estimated coefficients were significant at p < 0.01. Conclusion: A large change in solar insolation, both between winter and summer and between the minimum and maximum monthly values, may increase the risk of suicide attempts in bipolar I disorder. With frequent circadian rhythm dysfunction and suicidal behavior in bipolar disorder, greater understanding of the optimal roles of daylight and electric lighting in circadian entrainment is needed.
Purpose: Molecular diagnostics including next generation gene sequencing are increasingly used to determine options for individualized therapies in brain tumor patients. We aimed to evaluate the decision-making process of molecular targeted therapies and analyze data on tolerability as well as signals for efficacy.
Methods: Via retrospective analysis, we identified primary brain tumor patients who were treated off-label with a targeted therapy at the University Hospital Frankfurt, Goethe University. We analyzed which types of molecular alterations were utilized to guide molecular off-label therapies and the diagnostic procedures for their assessment during the period from 2008 to 2021. Data on tolerability and outcomes were collected.
Results: 413 off-label therapies were identified with an increasing annual number for the interval after 2016. 37 interventions (9%) were targeted therapies based on molecular markers. Glioma and meningioma were the most frequent entities treated with molecular matched targeted therapies. Rare entities comprised e.g. medulloblastoma and papillary craniopharyngeoma. Molecular targeted approaches included checkpoint inhibitors, inhibitors of mTOR, FGFR, ALK, MET, ROS1, PIK3CA, CDK4/6, BRAF/MEK and PARP. Responses in the first follow-up MRI were partial response (13.5%), stable disease (29.7%) and progressive disease (46.0%). There were no new safety signals. Adverse events with fatal outcome (CTCAE grade 5) were not observed. Only, two patients discontinued treatment due to side effects. Median progression-free and overall survival were 9.1/18 months in patients with at least stable disease, and 1.8/3.6 months in those with progressive disease at the first follow-up MRI.
Conclusion: A broad range of actionable alterations was targeted with available molecular therapeutics.
However, efficacy was largely observed in entities with paradigmatic oncogenic drivers, in particular with BRAF mutations. Further research on biomarker-informed molecular matched therapies is urgently necessary.
We present a dataset of free-viewing eye-movement recordings that contains more than 2.7 million fixation locations from 949 observers on more than 1000 images from different categories. This dataset aggregates and harmonizes data from 23 different studies conducted at the Institute of Cognitive Science at Osnabrück University and the University Medical Center in Hamburg-Eppendorf. Trained personnel recorded all studies under standard conditions with homogeneous equipment and parameter settings. All studies allowed for free eye-movements, and differed in the age range of participants (~7–80 years), stimulus sizes, stimulus modifications (phase scrambled, spatial filtering, mirrored), and stimuli categories (natural and urban scenes, web sites, fractal, pink-noise, and ambiguous artistic figures). The size and variability of viewing behavior within this dataset presents a strong opportunity for evaluating and comparing computational models of overt attention, and furthermore, for thoroughly quantifying strategies of viewing behavior. This also makes the dataset a good starting point for investigating whether viewing strategies change in patient groups.
Aus Hessen war Brachypodium rupestre bisher nur von einem Fundort veröffentlicht. Durch gezielte Suche und einen Zufallsfund kamen in den letzten Jahren fünf weitere hinzu. Die Wuchsorte sind anthropogene Böschungen von Straßen und Hochwasserrückhaltebecken, nur in einem Fall wachsen die Pflanzen auf einem naturnahen Standort in einer extensiv bewirtschafteten Stromtalwiese. Die Vorkommen gehen wahrscheinlich alle auf Ansaat zurück, entweder auf direkte Ansaat am Wuchsort oder ausgehend von den Primärpopulationen auf Verdriftung der Diasporen mit Hochwässern. Die Art ist in Hessen als eingebürgerter Neophyt einzustufen.
Background: Transfusion of red blood cells (RBC) in patients undergoing major elective cranial surgery is associated with increased morbidity, mortality and prolonged hospital length of stay (LOS). This retrospective single center study aims to identify the impact of RBC transfusions on skull-base and non-skull-base meningioma patients including the identification of risk factors for RBC transfusion.
Methods: From October 2009 - October 2016 we retrospectively analyzed 423 primary meningioma patients undergoing surgery for primary meningioma resection our department.
Results: Of these 423 patients, 68 (16.1%) received RBC transfusion and 355 (83.9%) did not receive RBC units. Preoperative anaemia rate was significantly higher in transfused patients (17.7%) compared to patients without RBC transfusion (6.2%; p = 0.0015). In transfused patients, postoperative complications as well as hospital LOS was significantly higher (p < 00001) compared to non-transfused patients. After multivariate analyses, risk factors for RBC transfusion were preoperative American Society of Anesthesiologists (ASA) physical status score (p = 0.0247), tumor size (p = 0.0006), surgical time (p = 0.0018) and intraoperative blood loss (p < 0.001). Kaplan-Meier curves revealed significant influence on overall survival by preoperative anaemia, RBC transfusion, smoking, cardiovascular disease, preoperative KPS ≤ 60% and age (elderly ≥ 75 years).
Conclusion: We concluded that blood loss due to large tumors or localization near large vessels are the main triggers for RBC transfusion in meningioma patients paired with a potential preselection that masks the effect of preoperative anaemia in multivariate analysis. Further studies evaluating the impact of preoperative anaemia management for reduction of RBC transfusion are needed to improve clinical outcomes of meningioma patients.