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Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs.
Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel.
Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1–25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0–88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE- syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%—subcutaneous; 29%—intravenous; 1%—unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy.
Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.
Bei Investigator Initiated Trials (IITs) werden alternative risikoadaptierte Monitoring-Strategien in Abhängigkeit vom individuellen Studiendesign und dem Risikoprofil diskutiert, um bei oft restriktiven Ressourcen eine den gesetzlichen Vorgaben genügende Qualität der Studiendurchführung und der Daten zu gewährleisten. Aufgrund einer Literaturanalyse sollten in der vorliegenden Arbeit Untersuchungen ausgewertet werden, in denen quantitative Aussagen zu Datenqualität und Prüfplan-Compliance in klinischen Prüfungen gemacht wurden. Bei der Interpretation der Ergebnisse sollten die implementierten Qualitätssicherungsmaßnahmen berücksichtigt werden. Aufgrund einer systematischen Recherche in MEDLINE konnten 21 Publikationen identifiziert werden, bei denen die Daten- und Prozessqualität in klinischen Prüfungen untersucht, die Qualität durch Überprüfungen mit Source Data Verification vor Ort oder Überprüfung übermittelter Quelldaten in der Studienzentrale ermittelt wurde und quantitative Informationen zu den Bereichen Datenqualität, Protokoll-Compliance oder Defizite bei Einwilligungserklärungen vorlagen. Die Mehrzahl der Untersuchungen ist drei Organisationen zuzuordnen: European Organization für Research and Treatment of Cancer (EORTC) (n=7), National Cancer Institute (NCI) (n=7) und Untersuchungen der Trans-Tasman Radiation Oncology Group (TROG) (n=4). Darüber hinaus wurden drei Untersuchungen weiterer Studiengruppen identifiziert. Die Untersuchungen wurden im Zeitraum von 1981 bis 2003 publiziert. Überwiegend wurden in der Literatur onkologische Studien betrachtet (n=19), wobei die Radiotherapie im Vordergrund stand (n=8). Für die EORTC-Studien wurde in der Regel eine gute Datenqualität berichtet (80-90% korrekte Daten). Punktuelle Probleme wurden im Hinblick auf die Protokoll-Compliance und das Berichten von Nebenwirkungen/schwerwiegenden unerwünschten Ereignissen festgestellt. Eine gute Qualität wurde ebenfalls bzgl. des korrekten Einschlusses von Patienten beobachtet. Durch das NCI wurde ein standardisiertes Audit-System eingeführt und innerhalb von kooperativen Studiengruppen implementiert. Im Rahmen dieser Audits wurden verschiedene Kriterien überprüft und eine überwiegend gute Datenqualität und Protokoll-Compliance festgestellt. Mängel wurden in ca. 5% der Fälle im Hinblick auf die Einwilligungserklärung, die korrekte Anwendung der Einschlusskriterien, Protokollverletzungen, bei der Ermittlung des Zielkriteriums, der Erfassung der Toxizität, der adäquaten Datenlieferung und bei der Datenverifikation beobachtet. In einzelnen Untersuchungen ergaben sich Probleme mit der Behandlungscompliance (10-20%), bei Protokollabweichungen im Hinblick auf die Arzneimitteldosis (10%) und bei der Drug Accountability (15%). Von der TROG wurde ein Qualitätssicherungsprozess implementiert, der auf zentralem Monitoring von kopierten Quelldaten basiert. Durch den Qualitätssicherungsansatz der TROG konnten schwerwiegende Probleme mit der Protokoll-Compliance unter 10% gesenkt werden, ebenso konnte eine gute Datenqualität mit einer Fehlerrate unter 5% erreicht werden. Die korrekte Handhabung von Ein- und Ausschlusskriterien stellte in Einzelfällen ein Problem dar. Zusammenfassend kann festgestellt werden, dass die in dem Review erfassten Studiengruppen von einer guten Datenqualität und einer guten bis moderaten Protokoll-Compliance berichten. Diese basiert nach Aussage der Autoren im wesentlichen auf etablierten Qualitätssicherungs-Prozeduren, wobei das durchgeführte Audit ebenfalls einen potentiellen Einflussfaktor darstellt. Geringe Probleme wurden in der Regel im Hinblick auf die Einwilligungserklärung, die korrekte Handhabung der Ein- und Ausschlusskriterien und die Datenqualität beobachtet. In einzelnen Studien gab es jedoch Probleme mit der Protokoll-Compliance. Insgesamt hängen Anzahl und Art der Mängel von dem Studientyp, dem Qualitätsmanagement und der Organisation der Studiengruppe ab. Wissenschaftsbetrug wurde nur in sehr wenigen Fällen durch die Audits festgestellt. Die vorgelegten Informationen beziehen sich nahezu ausschließlich auf etablierte Studiengruppen; bezüglich Datenqualität und Protokoll-Compliance außerhalb der Studiengruppen liegen kaum Informationen in der Literatur vor. Bei der Bewertung der Ergebnisse sollte berücksichtigt werden, dass es sich zum Teil um Eigenauswertungen der Studiengruppen und nicht um unabhängige externe Prüfungen (z.B. externe Audits) handelt. Inwieweit die Ergebnisse einer konsequenten Überprüfung nach derzeitigen Good Clinical Practice (GCP) – Regeln standhalten würden, kann aus der Analyse nicht beantwortet werden. Aus der vorliegenden Literaturanalyse ergeben sich Konsequenzen für die Planung einer prospektiven kontrollierten Studie zum Vergleich unterschiedlicher Monitoring-Strategien. Wesentlicher Einflussfaktor für die Datenqualität und Protokollcompliance in einer klinischen Studie ist das Qualitätsmanagement. Dieses Qualitätsmanagement umfasst neben Monitoring zahlreiche andere Maßnahmen. Um zu einer Bewertung von Monitoringstrategien kommen zu können, müssen daher alle Qualitätssicherungsmaßnahmen im Rahmen einer Studie berücksichtigt werden. Für den Vergleich unterschiedlicher Monitoringstrategien sind geeignete Zielparameter zu definieren (z.B. schwerwiegende Defizite bzgl. Ein- und Ausschlusskriterien, Sicherheit). Die vorliegende Analyse ergibt, dass bei gutem Qualitätsmanagement ohne umfassendes vor Ort Monitoring schwerwiegende Fehler nur mit relativ niedriger Häufigkeit festgestellt wurden. Unterschiede zwischen Monitoringstrategien könnten, gegeben ein funktionierendes Qualitätsmanagementssystem, sich als quantitativ gering erweisen. Testet man auf Äquivalenz von Monitoringstrategien, sind nur niedrige Differenzen zu akzeptieren, was wiederum eine Auswirkung auf die Fallzahlplanung hat. Weiterhin muss berücksichtigt werden, dass zur Feststellung der Auswirkung unterschiedlicher Monitoringstrategien auf die Sicherheit der Patienten und die Validität der Daten im Rahmen einer kontrollierten Untersuchung ein unabhängiges Audit notwendig ist. Dabei ist zu berücksichtigen, dass ein Audit bereits einen möglichen Einflussfaktor für die Datenqualität und Protokoll-Compliance darstellen kann, und damit eine Bewertung des Nutzens einer Monitoringstrategie erschwert werden könnte. Schlüsselwörter: systematisches Review, Datenqualität, Protokoll-Compliance, klinische Studie
A measurement of the transverse momentum spectra of jets in Pb-Pb collisions at sNN−−−√=2.76 TeV is reported. Jets are reconstructed from charged particles using the anti-kT jet algorithm with jet resolution parameters R of 0.2 and 0.3 in pseudo-rapidity |η|<0.5. The transverse momentum pT of charged particles is measured down to 0.15 GeV/c which gives access to the low pT fragments of the jet. Jets found in heavy-ion collisions are corrected event-by-event for average background density and on an inclusive basis (via unfolding) for residual background fluctuations and detector effects. A strong suppression of jet production in central events with respect to peripheral events is observed. The suppression is found to be similar to the suppression of charged hadrons, which suggests that substantial energy is radiated at angles larger than the jet resolution parameter R=0.3 considered in the analysis. The fragmentation bias introduced by selecting jets with a high pT leading particle, which rejects jets with a soft fragmentation pattern, has a similar effect on the jet yield for central and peripheral events. The ratio of jet spectra with R=0.2 and R=0.3 is found to be similar in Pb-Pb and simulated PYTHIA pp events, indicating no strong broadening of the radial jet structure in the reconstructed jets with R<0.3.
We present results on transverse momentum (pT) and rapidity (y) differential production cross sections, mean transverse momentum and mean transverse momentum square of inclusive J/ψ and ψ(2S) at forward rapidity (2.5 < y < 4) as well as ψ(2S)-to-J/ψ cross section ratios. These quantities are measured in pp collisions at center of mass energies s√=5.02 and 13 TeV with the ALICE detector. Both charmonium states are reconstructed in the dimuon decay channel, using the muon spectrometer. A comprehensive comparison to inclusive charmonium cross sections measured at s√=2.76, 7 and 8 TeV is performed. A comparison to non-relativistic quantum chromodynamics and fixed-order next-to-leading logarithm calculations, which describe prompt and non-prompt charmonium production respectively, is also presented. A good description of the data is obtained over the full pT range, provided that both contributions are summed. In particular, it is found that for pT > 15 GeV/c the non-prompt contribution reaches up to 50% of the total charmonium yield.
The production of K∗(892)0 and ϕ(1020) mesons has been measured in p–Pb collisions at √sNN = 5.02 TeV. K∗0 and ϕ are reconstructed via their decay into charged hadrons with the ALICE detector in the rapidity range - 0.5 < y < 0. The transverse momentum spectra, measured as a function of the multiplicity, have a pT range from 0 to 15 GeV/c for K∗0 and from 0.3 to 21 GeV/c for ϕ. Integrated yields, mean transverse momenta and particle ratios are reported and compared with results in pp collisions at √s = 7 TeV and Pb–Pb collisions at √sNN = 2.76 TeV. In Pb–Pb and p–Pb collisions, K∗0 and ϕ probe the hadronic phase of the system and contribute to the study of particle formation mechanisms by comparison with other identified hadrons. For this purpose, the mean transverse momenta and the differential proton-to-ϕ ratio are discussed as a function of the multiplicity of the event. The short-lived K∗0 is measured to investigate re-scattering effects, believed to be related to the size of the system and to the lifetime of the hadronic phase.
A measurement of the production of prompt +c baryons in Pb–Pb collisions at √sNN = 5.02 TeV with the ALICE detector at the LHC is reported. The +c and − c were reconstructed at midrapidity (|y| < 0.5) via the hadronic decay channel +c → pK0 S (and charge conjugate) in the transverse momentum and centrality intervals 6 < pT < 12 GeV/c and 0–80%. The +c /D0 ratio, which is sensitive to the charm quark hadronisation mechanisms in the medium, is measured and found to be larger than the ratio measured in minimum-bias pp collisions at √s = 7 TeV and in p–Pb collisions at √sNN = 5.02 TeV. In particular, the values in p–Pb and Pb–Pb collisions differ by about two standard deviations of the combined statistical and systematic uncertainties in the common pT interval covered by the measurements in the two collision systems. The + c /D0 ratio is also compared with model calculations including different implementations of charm quark hadronisation. The measured ratio is reproduced by models implementing a pure coalescence scenario, while adding a fragmentation contribution leads to an underestimation. The + c nuclear modification factor, RAA, is also presented. The measured values of the RAA of + c , D+ s and non-strange D mesons are compatible within the combined statistical and systematic uncertainties. They show, however, a hint of a hierarchy (RD0 AA < RD+ s AA < R+ c AA ), conceivable with a contribution from coalescence mechanisms to charm hadron formation in the medium.
The first measurement of e+e− pair production at mid-rapidity (|ηe| < 0.8) in pp collisions at s√=7 TeV with ALICE at the LHC is presented. The dielectron production is studied as a function of the invariant mass (mee < 3.3 GeV/c2), the pair transverse momentum (pT,ee < 8 GeV/c), and the pair transverse impact parameter (DCAee), i.e., the average distance of closest approach of the reconstructed electron and positron tracks to the collision vertex, normalised to its resolution. The results are compared with the expectations from a cocktail of known hadronic sources and are well described when PYTHIA is used to generate the heavy-flavour contributions. In the low-mass region (0.14 < mee < 1.1 GeV/c2), prompt and non-prompt e+e− sources can be separated via the DCAee. In the intermediate-mass region (1.1 < mee < 2.7 GeV/c2), a double-differential fit to the data in mee and pT,ee and a fit of the DCAee distribution allow the total cc¯¯ and bb¯¯¯ cross sections to be extracted. Two different event generators, PYTHIA and POWHEG, can reproduce the shape of the two-dimensional mee and pT,ee spectra, as well as the shape of the DCAee distribution, reasonably well. However, differences in the cc¯¯ and bb¯¯¯ cross sections are observed when using the generators to extrapolate to full phase space. Finally, the ratio of inclusive to decay photons is studied via the measurement of virtual direct photons in the transverse-momentum range 1 < pT < 8 GeV/c. This is found to be unity within the statistical and systematic uncertainties and consistent with expectations from next-to-leading order perturbative quantum chromodynamic calculations.
Medium modification of the shape of small-radius jets in central Pb-Pb collisions at √sNN = 2.76 TeV
(2018)
We present the measurement of a new set of jet shape observables for track-based jets in central Pb-Pb collisions at sNN−−−√=2.76 TeV. The set of jet shapes includes the first radial moment or angularity, g; the momentum dispersion, pTD; and the difference between the leading and sub-leading constituent track transverse momentum, LeSub. These observables provide complementary information on the jet fragmentation and can constrain different aspects of the theoretical description of jet-medium interactions. The jet shapes were measured for a small resolution parameter R = 0.2 and were fully corrected to particle level. The observed jet shape modifications indicate that in-medium fragmentation is harder and more collimated than vacuum fragmentation as obtained by PYTHIA calculations, which were validated with the measurements of the jet shapes in proton-proton collisions at s√=7 TeV. The comparison of the measured distributions to templates for quark and gluon-initiated jets indicates that in-medium fragmentation resembles that of quark jets in vacuum. We further argue that the observed modifications are not consistent with a totally coherent energy loss picture where the jet loses energy as a single colour charge, suggesting that the medium resolves the jet structure at the angular scales probed by our measurements (R = 0.2). Furthermore, we observe that small-R jets can help to isolate purely energy loss effects from other effects that contribute to the modifications of the jet shower in medium such as the correlated background or medium response.
The jet radial structure and particle transverse momentum (pT) composition within jets are presented in centrality-selected Pb–Pb collisions at √sNN = 2.76 TeV. Track-based jets, which are also called charged jets, were reconstructed with a resolution parameter of R = 0.3 at midrapidity |ηch jet| < 0.6 for transverse momenta pT, ch jet = 30–120 GeV/c. Jet–hadron correlations in relative azimuth and pseudorapidity space (Δϕ, Δη) are measured to study the distribution of the associated particles around the jet axis for different pT,assoc-ranges between 1 and 20 GeV/c. The data in Pb–Pb collisions are compared to reference distributions for pp collisions, obtained using embedded PYTHIA simulations. The number of high-pT associate particles (4 < pT,assoc < 20 GeV/c) in Pb–Pb collisions is found to be suppressed compared to the reference by 30 to 10% depending on centrality. The radial particle distribution relative to the jet axis shows a moderate modification in Pb–Pb collisions with respect to PYTHIA. High-pT associate particles are slightly more collimated in Pb–Pb collisions compared to the reference, while low-pT associate particles tend to be broadened. The results, which are presented for the first time down to pT, ch jet = 30 GeV/c in Pb–Pb collisions, are compatible with both previous jet–hadron-related measurements from the CMS Collaboration and jet shape measurements from the ALICE Collaboration at higher pT, and add further support for the established picture of in-medium parton energy loss.
Study of the Λ–Λ interaction with femtoscopy correlations in pp and p–Pb collisions at the LHC
(2019)
This work presents new constraints on the existence and the binding energy of a possible – bound state, the H-dibaryon, derived from – femtoscopic measurements by the ALICE collaboration. The results are obtained from a new measurement using the femtoscopy technique in pp collisions at √s = 13 TeV and p–Pb collisions at √sNN = 5.02 TeV, combined with previously published results from pp collisions at √s = 7 TeV. The – scattering parameter space, spanned by the inverse scattering length f −1 0 and the effective range d0, is constrained by comparing the measured – correlation function with calculations obtained within the Lednický model. The data are compatible with hypernuclei results and lattice computations, both predicting a shallow attractive interaction, and permit to test different theoretical approaches describing the – interaction. The region in the (f −1 0 ,d0) plane which would accommodate a – bound state is substantially restricted compared to previous studies. The binding energy of the possible – bound state is estimated within an effective-range expansion approach and is found to be B = 3.2+1.6 −2.4(stat)+1.8 −1.0(syst) MeV.