Absence of IgE neosensitization in house dust mite allergic patients following sublingual immunotherapy

BACKGROUND

The impact of sublingual immunotherapy (SLIT) on IgE neosensitization remains to be evaluated in large cohorts of patients.

OBJECTIVES

The aim of this study was to assess the dynamics of antibody responses induced in patients with allergic rhinitis during a 12-month treatment with sublingual tablets of house dust mites (HDM) allergen extracts.

METHODS

Antibody responses were assessed in relationship with neosensitization and clinical benefit in sera from 509 European house dust mite-allergic patients before and after 1 year of daily sublingual immunotherapy, using tablets containing Dermatophagoides pteronyssinus plus D farinae extracts or placebo (ClinicalTrials.gov NCT00674700). Patients were followed for one additional year after treatment cessation. IgE and IgG4 antibodies specific for mite extracts or purified group 1, 2 and 10 allergens were assessed using Immulite, Immunocap and ISAC assays.

RESULTS

After 1 year of SLIT, mite-specific IgE and IgG4 titres increased by 1.5-fold and fourfold, respectively, in the active, but not in the placebo group. A strong IgG4 induction occurred in a subgroup (i.e. 10-15%) of "immunoreactive" patients, without any correlation with improvement in the average adjusted symptom score. Pre-existing IgE levels to purified mite allergens were not impacted during immunotherapy, and no de novo IgE responses to group 1, 2, 10 allergens were induced in patients who were unsensitized prior to immunotherapy. Similarly, no IgE neosensitization to wheat germ or yeast components used in the mite culture medium was observed.

CONCLUSIONS AND CLINICAL RELEVANCE

We document in a cohort of 509 patients followed over a 2-year period that SLIT does not induce any IgE neosensitization to allergens contained in the vaccine, such as groups 1, 2 as well as the food-related group 10 allergen. This observation further corroborates the safer safety profile of SLIT over SCIT.

Search for pair production of third-generation leptoquarks and top squarks in pp collisions at sqrt[s] = 7 TeV

Results are presented from a search for the pair production of third-generation scalar and vector leptoquarks, as well as for top squarks in R-parity-violating supersymmetric models. In either scenario, the new, heavy particle decays into a τ lepton and a b quark. The search is based on a data sample of pp collisions at sqrt[s] = 7 TeV, which is collected by the CMS detector at the LHC and corresponds to an integrated luminosity of 4.8 fb(-1). The number of observed events is found to be in agreement with the standard model prediction, and exclusion limits on mass parameters are obtained at the 95% confidence level. Vector leptoquarks with masses below 760 GeV are excluded and, if the branching fraction of the scalar leptoquark decay to a τ lepton and a b quark is assumed to be unity, third-generation scalar leptoquarks with masses below 525 GeV are ruled out. Top squarks with masses below 453 GeV are excluded for a typical benchmark scenario, and limits on the coupling between the top squark, τ lepton, and b quark, λ(333)(') are obtained. These results are the most stringent for these scenarios to date.

Measurement of the Υ1S, Υ2S, and Υ3S polarizations in pp collisions at sqrt[s] = 7 TeV

The polarizations of the Υ(1S), Υ(2S), and Υ(3S) mesons are measured in proton-proton collisions at sqrt[s] = 7 TeV, using a data sample of Υ(nS) → μ +μ- decays collected by the CMS experiment, corresponding to an integrated luminosity of 4.9 fb(-1). The dimuon decay angular distributions are analyzed in three different polarization frames. The polarization parameters λ[symbol see text], λ(φ), and λ([symbol see text]φ), as well as the frame-invariant quantity λ, are presented as a function of the Υ(nS) transverse momentum between 10 and 50 GeV, in the rapidity ranges |y|<0.6 and 0.6<|y|<1.2. No evidence of large transverse or longitudinal polarizations is seen in the explored kinematic region.

Study of the mass and spin-parity of the Higgs boson candidate via its decays to Z boson pairs

A study is presented of the mass and spin-parity of the new boson recently observed at the LHC at a mass near 125 GeV. An integrated luminosity of 17.3 fb(-1), collected by the CMS experiment in proton-proton collisions at center-of-mass energies of 7 and 8 TeV, is used. The measured mass in the ZZ channel, where both Z bosons decay to e or μ pairs, is 126.2 ± 0.6(stat) ± 0.2(syst) GeV. The angular distributions of the lepton pairs in this channel are sensitive to the spin-parity of the boson. Under the assumption of spin 0, the present data are consistent with the pure scalar hypothesis, while disfavoring the pure pseudoscalar hypothesis.

Measurement of the sum of WW and WZ production with W+dijet events in pp collisions at [Formula: see text]

A measurement of the inclusive WW+WZ diboson production cross section in proton-proton collisions is reported, based on events containing a leptonically decaying W boson and exactly two jets. The data sample, collected at [Formula: see text] with the CMS detector at the LHC, corresponds to an integrated luminosity of 5.0 fb-1. The measured value of the sum of the inclusive WW and WZ cross sections is σ(pp→WW+WZ)=68.9±8.7 (stat.)±9.7 (syst.)±1.5 (lum.) pb, consistent with the standard model prediction of 65.6±2.2 pb. This is the first measurement of WW+WZ production in pp collisions using this signature. No evidence for anomalous triple gauge couplings is found and upper limits are set on their magnitudes.

Measurement of the azimuthal anisotropy of neutral pions in Pb-Pb collisions at sqrt[s](NN)] = 2.76 TeV

First measurements of the azimuthal anisotropy of neutral pions produced in Pb-Pb collisions at a center-of-mass energy of sqrt[s(NN)] = 2.76 TeV are presented. The amplitudes of the second Fourier component (v(2)) of the π(0) azimuthal distributions are extracted using an event-plane technique. The values of v(2) are studied as a function of the neutral pion transverse momentum (p(T)) for different classes of collision centrality in the kinematic range 1.6<p(T) <8.0 GeV/c, within the pseudorapidity interval |η|<0.8. The CMS measurements of v(2) (p(T)) are similar to previously reported π(0) azimuthal anisotropy results from sqrt[s(NN)] = 200 GeV Au-Au collisions at RHIC, despite a factor of ∼ 14 increase in the center-of-mass energy. In the momentum range 2.5<p(T)<5.0 GeV/c, the neutral pion anisotropies are found to be smaller than those observed by CMS for inclusive charged particles.

Evidence for associated production of a single top quark and W boson in pp collisions at sqrt[s]=7 TeV

Evidence is presented for the associated production of a single top quark and W boson in pp collisions at sqrt[s]=7  TeV with the CMS experiment at the LHC. The analyzed data correspond to an integrated luminosity of 4.9  fb(-1). The measurement is performed using events with two leptons and a jet originated from a b quark. A multivariate analysis based on kinematic properties is utilized to separate the tt background from the signal. The observed signal has a significance of 4.0σ and corresponds to a cross section of 16(-4)(+5)  pb, in agreement with the standard model expectation of 15.6±0.4(-1.2)(+1.0)  pb.

The Human and Economic Burden of Cervical Cancer in Texas

The goal of this study was to quantify the burden of cervical cancer in Texas and provide information about the health care needs of survivors. Data from multiple sources including the Texas Cancer Registry, Behavioral Risk Factor Surveillance System, and Texas Medicare claims were used in this effort. In 2009, there were over 100,000 cervical cancer survivors in Texas. Our descriptive analysis revealed that these women consumed less fruit and vegetables, were more often smokers, and had worse physical and mental health than women without a history of cancer. Survivors aged 65 and older cost Medicare over $15 million in inpatient, outpatient, and hospice care in 2009 alone, or $9,827 per cervical cancer survivor - nearly a third more than the average Medicare enrollee in Texas that year. Providers and public health practitioners can play an integral role in reducing the human and economic burden of cervical cancer in Texas through smoking cession and healthy lifestyle counseling for survivors, recommending the HPV vaccine to males and females aged 9-26, and continuing to offer cervical cancer screening for women up to age 65.

Risk factors for suboptimal antiretroviral therapy adherence in HIV-infected adolescents in Gaborone, Botswana: a pilot cross-sectional study

OBJECTIVE

Little is known about factors associated with suboptimal antiretroviral treatment (ART) adherence among adolescents in Sub-Saharan Africa. Our objective was to determine the level of ART adherence and predictors of non-adherence among human immunodeficiency virus (HIV)-infected adolescents at the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, Botswana.

METHODS

In a cross-sectional study, 82 HIV-infected adolescents receiving ART and their caregivers were administered a structured questionnaire. The patient's clinical information was retrieved from medical records. Outcome measures included excellent pill count ART adherence (>95%) and virologic suppression (HIV viral load <400 copies/mL). Multivariate logistic regression analysis was performed to identify independent predictors of ART non-adherence.

RESULTS

The overall median (interquartile range) ART adherence was 99% (96.5-100) (N = 82). Seventy-six percent of adolescents had excellent pill count ART adherence levels and 94% achieved virologic suppression. Male adolescents made up 65% of the non-adherent group (P = 0.02). Those who displayed suboptimal ART adherence were more likely to report having ever missed ART doses due to failure to pick up medication at the pharmacy (30.0% versus 9.7%, P = 0.03). In the multivariate logistic regression model, male sex (odds ratio [OR] 3.29, 95% confidence interval [CI] 1.13-9.54; P = 0.03) was the only factor which was independently associated with suboptimal ART adherence.

CONCLUSIONS

A high proportion of HIV-infected adolescents studied had excellent ART adherence and virologic suppression, with male adolescents at higher risk of suboptimal adherence than females. Further research to investigate how sex relates to suboptimal adherence may aid in the design of targeted intervention strategies.

Search for heavy neutrinos and W(R) bosons with right-handed couplings in a left-right symmetric model in pp collisions at sqrt[s]=7 TeV

Results are presented from a search for heavy, right-handed muon neutrinos, N(μ), and right-handed W(R) bosons, which arise in the left-right symmetric extensions of the standard model. The analysis is based on a 5.0  fb(-1) sample of proton-proton collisions at a center-of-mass energy of 7 TeV, collected by the CMS detector at the Large Hadron Collider. No evidence is observed for an excess of events over the standard model expectation. For models with exact left-right symmetry, heavy right-handed neutrinos are excluded at 95% confidence level for a range of neutrino masses below the W(R) mass, dependent on the value of M(W(R)). The excluded region in the two-dimensional (M(W(R)), M(N(μ)) mass plane extends to M(W(R))=2.5  TeV.

Study of the Dijet mass spectrum in pp → W+jets events at sqrt[s] = 7 TeV

We report an investigation of the invariant mass spectrum of the two jets with highest transverse momentum in pp → W+2-jet and W+3-jet events to look for resonant enhancement. The data sample corresponds to an integrated luminosity of 5.0 fb(-1) collected with the CMS detector at sqrt[s] = 7 TeV. We find no evidence for the anomalous structure reported by the CDF Collaboration, and establish an upper limit of 5.0 pb at 95% confidence level on the production cross section for a generic Gaussian signal with mass near 150 GeV. Additionally, we exclude two theoretical models that predict a CDF-like dijet resonance near 150 GeV.

Measurement of the relative prompt production rate of χc2 and χc1 in pp collisions at [Formula: see text]

A measurement is presented of the relative prompt production rate of χc2 and χc1 with 4.6 fb-1 of data collected by the CMS experiment at the LHC in pp collisions at [Formula: see text]. The two states are measured via their radiative decays χc→J/ψ+γ, with the photon converting into an e+e- pair for J/ψ rapidity |y(J/ψ)|<1.0 and photon transverse momentum pT(γ)>0.5 GeV/c. The measurement is given for six intervals of pT(J/ψ) between 7 and 25 GeV/c. The results are compared to theoretical predictions.

Adherence to national guidelines for antiemesis prophylaxis in patients undergoing chemotherapy for lung cancer: a population-based study

BACKGROUND

Nausea and vomiting (N/V) during chemotherapy can have profound clinical and economic consequences. Effective antiemetic agents are available for prophylaxis, but barriers may prevent their use. For this population-based study, the authors assessed the rates of antiemetic prophylaxis use, and predictors of such use, among patients who were receiving platinum-based chemotherapy for lung cancer between 2001 and 2007.

METHODS

The authors searched the Texas Cancer Registry-Medicare-linked database for individuals aged >65 years who received platinum-based chemotherapy within 12 months after a first diagnosis of lung cancer from 2001 to 2007; and all patients had continuous Medicare Part A and Part B coverage for the same period. Adherence to recommended regimens for N/V prophylaxis (established by the National Comprehensive Cancer Network) was scored as a binary variable (adherent vs nonadherent) and was calculated as the percentages of treated patients receiving each recommended agent within 1 day of beginning chemotherapy. Logistic regression with stepwise selection was used to examine whether patient characteristics influenced adherence.

RESULTS

Of 4566 selected patients, adherence rates for the receipt of serotonin antagonists (eg, ondansetron) with dexamethasone were 60% to 90% regardless of whether the chemotherapy agent was considered moderately or highly emetogenic. The receipt of substance-P antagonists was much less common (<10%) during any period. On multivariate logistic regression modeling, variables that predicted adherence were older age, white race, higher median income, and concurrent radiation therapy.

CONCLUSIONS

Recommended use of antiemetics for prophylaxis, especially substance-P antagonists, during chemotherapy for lung cancer is suboptimal. Factors that were correlated with adherence suggest socioeconomic barriers in the community.

Rates of bone mineral density measurement in men with prostate cancer starting androgen deprivation therapy

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Background: Men with prostate cancer on androgen deprivation therapy (ADT) are at risk for accelerated bone loss and osteoporotic fractures. Current National Comprehensive Cancer Network (NCCN) guidelines recommend dual-energy X-ray absorptiometry (DXA) scan for risk assessment when starting ADT. Our objective was to determine if DXA scans were performed prior or soon after ADT initiation among men with prostate cancer. Methods: In this claims-based database linkage study, men with prostate cancer were identified fromthe Texas Cancer Registry between 2006-2007 and their records were linked with Medicare databases parts A, B and D to identify claims for ADT using generic names, predefined J codes and ICD codes. Part D claims are currently available for years 2007 and 2008. DXA claims were obtained using CPT/HCPS codes from Medicare part A and part B. Patients were considered to have undergone a DXA exam, useful as a baseline screening test for ADT therapy if a claim could be identified within 2 years before starting ADT therapy, or 6 months afterwards. Multivariate logistic regression models were performed to examine determinants of DXA use. Results: 1,647 men 65 years and older were included in the study. A total of 144 (8.3%) had a DXA scan obtained within 2 years and 6 months after initiation of ADT. Age older than 75 years, history of prior bisphosphonate usage and residence in the metropolitan area were statistically significantly associated with higher likelihood of obtaining DXA. Race, gender, median income, high school percentage, number of ADT claims, and type of ADT used were not associated with DXA usage. Conclusions: Despite the importance of osteoporosis screening, men with prostate cancer and Medicare insurance, in the state of Texas, had very low DXA utilization rates prior, or soon after, the initiation of ADT. Further research is needed to identify barriers to adherence to recommendations for the evaluation of bone health in patients with prostate cancer.

Observation of sequential Υ suppression in PbPb collisions

The suppression of the individual Υ(nS) states in PbPb collisions with respect to their yields in pp data has been measured. The PbPb and pp data sets used in the analysis correspond to integrated luminosities of 150 μb(-1) and 230 nb(-1), respectively, collected in 2011 by the CMS experiment at the LHC, at a center-of-mass energy per nucleon pair of 2.76 TeV. The Υ(nS) yields are measured from the dimuon invariant mass spectra. The suppression of the Υ(nS) yields in PbPb relative to the yields in pp, scaled by the number of nucleon-nucleon collisions, R(AA), is measured as a function of the collision centrality. Integrated over centrality, the R(AA) values are 0.56±0.08(stat)±0.07(syst), 0.12±0.04(stat)±0.02(syst), and lower than 0.10 (at 95% confidence level), for the Υ(1S), Υ(2S), and Υ(3S) states, respectively. The results demonstrate the sequential suppression of the Υ(nS) states in PbPb collisions at LHC energies.

Severe mental illness at ART initiation is associated with worse retention in care among HIV-infected Ugandan adults

OBJECTIVE

The impact of severe mental illness (SMI) on retention in HIV care remains uncertain. We aimed to measure the association between SMI at antiretroviral therapy (ART) initiation and subsequent retention in care in HIV-infected Ugandan adults.

METHOD

We conducted cohort study of 773 patients who initiated ART between January 2005 and July 2009 at the Butabika HIV clinic in Kampala, Uganda. SMI was defined as any clinically diagnosed organic brain syndrome, affective disorder or psychotic disorder. We used Kaplan-Meier and Cox proportional hazards analysis to evaluate the association between SMI and retention in care.

RESULTS

The prevalence of SMI at ART initiation was 23%. Patients with SMI at baseline were similar to those without SMI in terms of age (median [IQR]: 35 [28-40] vs. 35 [30-40], P = 0.03), sex (36% vs. 35% female, P = 0.86) and baseline CD4+ T-cell count (112 [54-175] vs. 120 [48-187] cells/mm3, P = 0.86). At 12 months after ART initiation, Kaplan-Meier estimates of continuous retention in care were 65% (95% confidence interval, CI: 31-39%) among patients without SMI, vs. 47% (95% CI: 39-55%) among those with SMI (P < 0.001). All-cause mortality in the two groups was similar: 1.2% vs. 2.0% (P > 0.05). In multivariable analysis, the only baseline variable independently associated with breakage of continuous care was SMI (HR = 1.58, 95% CI: 1.06─2.33).

CONCLUSIONS

Severe mental illness at ART initiation is associated with worse retention in HIV care in this urban Ugandan referral hospital. As ART is scaled up across sub-Saharan Africa, greater attention must be paid to the burden of mental illness and its impact on retention in care.

Search for new physics in the multijet and missing transverse momentum final state in proton-proton collisions at √s = 7 TeV

A search for physics beyond the standard model is performed in events with at least three jets and large missing transverse momentum produced in proton-proton collisions at a center-of-mass energy of √s=7 TeV. No significant excess of events above the expected backgrounds is observed in 4.98 fb(-1) of data collected with the CMS detector at the Large Hadron Collider. The results are presented in the context of the constrained minimal supersymmetric extension of the standard model and more generically for simplified models. For the simplified models of gluino-gluino and squark-squark production, gluino masses below 1.0 TeV and squark masses below 0.76 TeV are excluded in case the lightest supersymmetric particle mass is below 200 GeV. These results significantly extend previous searches.

Measurement of the pseudorapidity and centrality dependence of the transverse energy density in Pb-Pb collisions at √(s(NN))=2.76 TeV

The transverse energy (E(T)) in Pb-Pb collisions at 2.76 TeV nucleon-nucleon center-of-mass energy (√(s(NN)) has been measured over a broad range of pseudorapidity (η) and collision centrality by using the CMS detector at the LHC. The transverse energy density per unit pseudorapidity (dE(T)/dη) increases faster with collision energy than the charged particle multiplicity. This implies that the mean energy per particle is increasing with collision energy. At all pseudorapidities, the transverse energy per participating nucleon increases with the centrality of the collision. The ratio of transverse energy per unit pseudorapidity in peripheral to central collisions varies significantly as the pseudorapidity increases from η=0 to |η|=5.0. For the 5% most central collisions, the energy density per unit volume is estimated to be about 14 GeV/fm(3) at a time of 1 fm/c after the collision. This is about 100 times larger than normal nuclear matter density and a factor of 2.6 times higher than the energy density reported at √(s(NN))=200 GeV at the Relativistic Heavy Ion Collider.