System size, energy, pseudorapidity, and centrality dependence of elliptic flow

This Letter presents measurements of the elliptic flow of charged particles as a function of pseudorapidity and centrality from Cu-Cu collisions at 62.4 and 200 GeV using the PHOBOS detector at the Relativistic Heavy Ion Collider. The elliptic flow in Cu-Cu collisions is found to be significant even for the most central events. For comparison with the Au-Au results, it is found that the detailed way in which the collision geometry (eccentricity) is estimated is of critical importance when scaling out system-size effects. A new form of eccentricity, called the participant eccentricity, is introduced which yields a scaled elliptic flow in the Cu-Cu system that has the same relative magnitude and qualitative features as that in the Au-Au system.

Large outbreak of E. coli O157 in 2005, Ireland

In October/November 2005, the largest outbreak of verotoxin-producing Escherichia coli (VTEC) ever recorded in Ireland occurred. Eighteen E. coli O157 culture-positive cases, phage type 32, verotoxin 2 positive, were identified in a small rural area of mid-west Ireland. Half of these patients were asymptomatic. Two children were admitted to hospital with haemolytic uraemic syndrome, one of whom required peritoneal dialysis, and both recovered. All 18 culture-positive patients had indistinguishable or closely related pulsed field gel electrophoresis (PFGE) patterns. Nine of the VTEC O157 culture-positive individuals were in preschool children attending two local crèches. Several culture-positive individuals apparently had exposure to a vulnerable private group water scheme (GWS) in an agricultural area. No microbiological evidence of VTEC was found in food or water. One veterinary sample (an animal rectal swab) was positive for E. coli O157 and the PFGE strain was indistinguishable from the outbreak strain. A case control study showed analytical epidemiological evidence of risk related to potential exposure to the GWS but not related to reported consumption of that water. Selection of cases and controls proved challenging. Transmission occurred primarily in childcare and family settings, with significant person-to-person spread. Control measures included voluntary closure of the crèches, exclusion of culture-positive individuals in risk groups until microbiological clearance was achieved and the issuing of a ‘boil water’ advisory for drinking water pending upgrading of disinfection facilities.

Energy dependence of directed flow over a wide range of pseudorapidity in Au + Au collisions at the BNL Relativistic Heavy Ion Collider

We report on measurements of directed flow as a function of pseudorapidity in Au + Au collisions at energies of square root of SNN = 19.6, 62.4, 130 and 200 GeV as measured by the PHOBOS detector at the BNL Relativistic Heavy Ion Collider. These results are particularly valuable because of the extensive, continuous pseudorapidity coverage of the PHOBOS detector. There is no significant indication of structure near midrapidity and the data surprisingly exhibit extended longitudinal scaling similar to that seen for elliptic flow and charged particle pseudorapidity density.

Pediatric Oncology Group (POG) studies of acute myeloid leukemia (AML): a review of four consecutive childhood AML trials conducted between 1981 and 2000

From 1981 to 2000, a total of 1823 children with acute myeloid leukemia (AML) enrolled on four consecutive Pediatric Oncology Group (POG) clinical trials. POG 8101 demonstrated that the induction rate associated with the 3+7+7 combination of daunorubicin, Ara-C, and 6-thioguanine (DAT) was greater than that associated with an induction regimen used to treat acute lymphoblastic leukemia (82 vs 61%; P=0.02). Designed as a pilot study to determine the feasibility of administration of noncross-resistant drug pairs and later modified to assess the effect of dose intensification of Ara-C during the second induction course, POG 8498 confirmed the high initial rate of response to DAT (84.2%) and showed that dose intensification of Ara-C during the second induction course resulted in a trend toward higher event-free survival (EFS) estimates than did standard-dose DAT (2+5) during the second induction course (5 year EFS estimates, 22 vs 27%; P=0.33). Age <2 years and leukocyte count <100 000/mm3 emerged as significantly good prognostic factors. The most significant observation made in the POG 8498 study was the markedly superior outcome of children with Down's syndrome who were treated on the high-dose Ara-C regimen. POG 8821 compared the efficacy of autologous bone marrow transplantation (BMT) with that of intensive consolidation chemotherapy. Intent-to-treat analysis revealed similar 5-year EFS estimates for the group that underwent autologous BMT (36+/-4.7%) and for the group that received only intensive chemotherapy (35+/-4.5%) (P=0.25). There was a high rate of treatment-related mortality in the autologous transplantation group. The study demonstrated superior results of allogeneic BMT for patients with histocompatible related donors (5-year EFS estimate 63+/-5.4%) and of children with Down's syndrome (5-year EFS estimate, 66+/-8.6%). The POG 9421 AML study evaluated high-dose Ara-C as part of the first induction course and the use of the multidrug resistance modulator cyclosporine. Preliminary results showed that patients receiving both high-dose Ara-C for remission induction and the MDR modulator for consolidation had a superior outcome (5-year EFS estimate, 42+/-8.2%) than did patients receiving other treatment; however, the difference was not statistically significant. These four studies demonstrate the importance of dose intensification of Ara-C in the treatment of childhood AML; cytogenetics as the single most prognostic factor and the unique curability of AML in children with Down's syndrome.

Energy dependence of elliptic flow over a large pseudorapidity range in Au+Au collisions at the BNL relativistic heavy ion collider

This Letter describes the measurement of the energy dependence of elliptic flow for charged particles in Au+Au collisions using the PHOBOS detector at the Relativistic Heavy Ion Collider. Data taken at collision energies of square root of s(NN)=19.6, 62.4, 130, and 200 GeV are shown over a wide range in pseudorapidity. These results, when plotted as a function of eta(')=|eta|-y(beam), scale with approximate linearity throughout eta('), implying no sharp changes in the dynamics of particle production as a function of pseudorapidity or increasing beam energy.

Centrality dependence of charged hadron transverse momentum spectra in Au+Au collisions from sqrt[s(NN)]=62.4 to 200 GeV

We have measured transverse momentum distributions of charged hadrons produced in Au+Au collisions at sqrt[s(NN)]=62.4 GeV. The spectra are presented for transverse momenta 0.25<p(T)<4.5 GeV/c, in a pseudorapidity range of 0.2<eta<1.4. The nuclear modification factor R(AA) is calculated relative to p+p data at the same collision energy as a function of collision centrality. For 2<p(T)<4.5 GeV/c, R(AA) is found to be significantly larger than in Au+Au collisions at sqrt[s(NN)]= 130 and 200 GeV. In contrast to the large change in R(AA), we observe a very similar centrality evolution of the p(T) spectra at sqrt[s(NN)]=62.4 and 200 GeV. The dynamical origin of this surprising factorization of energy and centrality dependence of particle production in heavy-ion collisions remains to be understood.

Pseudorapidity distribution of charged particles in d+Au collisions at sqrt[sNN]=200 GeV

The measured pseudorapidity distribution of primary charged particles in minimum-bias d+Au collisions at sqrt[s(NN)]=200 GeV is presented for the first time. This distribution falls off less rapidly in the gold direction as compared to the deuteron direction. The average value of the charged particle pseudorapidity density at midrapidity is <dN(ch)/d eta>|eta|< or =0.6)=9.4+/-0.7(syst) and the integrated primary charged particle multiplicity in the measured region is 82+/-6(syst). Estimates of the total charged particle production, based on extrapolations outside the measured pseudorapidity region, are also presented. The pseudorapidity distribution, normalized to the number of participants in d+Au collisions, is compared to those of Au+Au and p+(-)p systems at the same energy. The d+Au distribution is also compared to the predictions of the parton saturation model, as well as microscopic models.

Quality of Life in Patients Treated with First-Line Antiretroviral Therapy Containing Nevirapine And/Or Efavirenz

Objective

To assess whether differences in safety profiles between nevirapine (NVP) and efavirenz (EFV), as observed in the 2NN study, translated into differences in ‘health related quality of life’ (HRQoL).

Design

A sub-study of the 2NN study, with antiretro-viral-naive patients randomly allocated to NVP (once or twice daily), EFV or NVP+EFV, in addition to stavudine and lamivudine.

Methods

Comparing differences in changes of HRQoL over 48 weeks as measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire, using analysis of variance.

Results

The 2NN study enrolled 1216 patients. No validated questionnaires were available for 244 patients, and 55 patients had no HRQoL data at all, leaving 917 patients eligible for this sub-study. A total of 471 (51%) had HRQoL measurements both at baseline and week 48. The majority (69%) of patients without HRQoL measurements did, however, complete the study. The change in the physical health score (PHS) was 3.9 for NVP, 3.4 for EFV and 2.4 for NVP+EFV ( P=0.712). For the mental health score (MHS) these values were 6.1, 7.0 and 3.9, respectively ( P=0.098). A baseline plasma HIV-1 RNA concentration (pVL) ≥100 000 copies/ml and a decline in pVL (per log10) were independently associated with an increase of PHS. An increase of MHS was only associated with pVL decline. Patients experiencing an adverse event during follow-up had a comparable change in PHS but a significantly smaller change in MHS, compared with those without an adverse event.

Conclusions

First-line ART containing NVP and/or EFV leads to an improvement in HRQoL. The gain in HRQoL was similar for NVP and EFV, but slightly lower for the combination of these drugs.

Centrality dependence of charged-hadron transverse-momentum spectra in d+Au collisions at sqrt[s(NN)]=200 GeV

We have measured transverse momentum distributions of charged hadrons produced in d+Au collisions at sqrt[s(NN)]=200 GeV. The spectra were obtained for transverse momenta 0.25<p(T)<6.0 GeV/c, in a pseudorapidity range of 0.2<eta<1.4 in the deuteron direction. The evolution of the spectra with collision centrality is presented in comparison to p+pmacr; collisions at the same collision energy. With increasing centrality, the yield at high transverse momenta increases more rapidly than the overall particle density, leading to a strong modification of the spectral shape. This change in spectral shape is qualitatively different from observations in Au+Au collisions at the same energy. The results provide important information for discriminating between different models for the suppression of high-p(T) hadrons observed in Au+Au collisions.

Significance of the fragmentation region in ultrarelativistic heavy-ion collisions

We present measurements of the pseudorapidity distribution of primary charged particles produced in Au+Au collisions at three energies, sqrt[s(NN)]=19.6, 130, and 200 GeV, for a range of collision centrali-ties. The distribution narrows for more central collisions and excess particles are produced at high pseudorapidity in peripheral collisions. For a given centrality, however, the distributions are found to scale with energy according to the "limiting fragmentation" hypothesis. The universal fragmentation region described by this scaling grows in pseudorapidity with increasing collision energy, extending well away from the beam rapidity and covering more than half of the pseudorapidity range over which particles are produced. This approach to a universal limiting curve appears to be a dominant feature of the pseudorapidity distribution and therefore of the total particle production in these collisions.

Clinical heterogeneity in childhood acute lymphoblastic leukemia with 11q23 rearrangements

To assess the clinical heterogeneity among patients with acute lymphoblastic leukemia (ALL) and various 11q23 abnormalities, we analyzed data on 497 infants, children and young adults treated between 1983 and 1995 by 11 cooperative groups and single institutions. The substantial sample size allowed separate analyses according to age younger or older than 12 months for the various cytogenetic subsets. Infants with t(4;11) ALL had an especially dismal prognosis when their disease was characterized by a poor early response to prednisone (P=0.0005 for overall comparison; 5-year event-free survival (EFS), 0 vs 23+/-+/-12% s.e. for those with good response), or age less than 3 months (P=0.0003, 5-year EFS, 5+/-+/-5% vs 23.4+/-+/-4% for those over 3 months). A poor prednisone response also appeared to confer a worse outcome for older children with t(4;11) ALL. Hematopoietic stem cell transplantation failed to improve outcome in either age group. Among patients with t(11;19) ALL, those with a T-lineage immunophenotype, who were all over 1 year of age, had a better outcome than patients over 1 year of age with B-lineage ALL (overall comparison, P=0.065; 5-year EFS, 88+/-+/-13 vs 46+/-14%). In the heterogeneous subgroup with del(11)(q23), National Cancer Institute-Rome risk criteria based on age and leukocyte count had prognostic significance (P=0.04 for overall comparison; 5-year EFS, 64+/-+/-8% (high risk) vs 83+/-+/-6% (standard risk)). This study illustrates the marked clinical heterogeneity among and within subgroups of infants or older children with ALL and specific 11q23 abnormalities, and identifies patients at particularly high risk of failure who may benefit from innovative therapy.

n-p short-range correlations from (p,2p+n) measurements

We studied the 12C(p,2p+n) reaction at beam momenta of 5.9, 8.0, and 9.0 GeV/c. For quasielastic (p,2p) events p(f), the momentum of the knocked-out proton before the reaction, was compared (event by event) with p(n), the coincident neutron momentum. For |p(n)|>k(F)=0.220 GeV/c (the Fermi momentum) a strong back-to-back directional correlation between p(f) and p(n) was observed, indicative of short-range n-p correlations. From p(n) and p(f) we constructed the distributions of c.m. and relative motion in the longitudinal direction for correlated pairs. We also determined that 49+/-13% of events with |p(f)|>k(F) had directionally correlated neutrons with |p(n)|>k(F).

Pseudorapidity and centrality dependence of the collective flow of charged particles in Au+Au collisions at sqrt[s(NN)]=130 GeV

This paper describes the measurement of collective flow for charged particles in Au+Au collisions at sqrt[s(NN)]=130 GeV using the PHOBOS detector at the Relativistic Heavy Ion Collider (RHIC). The measured azimuthal hit anisotropy is presented over a wide range of pseudorapidity (-5.0<eta<5.3) for the first time at this energy. The result, averaged over momenta and particle species, is observed to reach 7% for peripheral collisions at midrapidity, falling off with centrality and increasing |eta|. These results call into question the common assumption of longitudinal boost invariance over a large region of rapidity in RHIC collisions.

Energy dependence of particle multiplicities in central Au+Au collisions

We present the first measurement of the pseudorapidity density of primary charged particles in Au+Au collisions at root square[s(NN)] = 200 GeV. For the 6% most central collisions, we obtain dN(ch)/d(eta)/(/eta/<1) = 650+/-35(syst). Compared to collisions at root square[s(NN)] = 130 GeV, the highest energy studied previously, an increase by a factor of 1.14+/-0.05 at 90% confidence level, is found. The energy dependence of the pseudorapidity density is discussed in comparison with data from proton-induced collisions and theoretical predictions.

Energy dependence of nuclear transparency in C (p,2p) scattering

The transparency of carbon for (p,2p) quasielastic events was measured at beam momenta ranging from 5.9 to 14.5 GeV/c at 90 degrees c.m. The four-momentum transfer squared (Q2) ranged from 4.7 to 12.7 (GeV/c)(2). We present the observed beam momentum dependence of the ratio of the carbon to hydrogen cross sections. We also apply a model for the nuclear momentum distribution of carbon to obtain the nuclear transparency. We find a sharp rise in transparency as the beam momentum is increased to 9 GeV/c and a reduction to approximately the Glauber level at higher energies.

Drug users talk about HIV testing: motivating and deterring factors

Injection drug use plays a critical role in the spread of HIV/AIDS, with an estimated 19,000 drug users infected each year. Counselling and testing services can be an important gateway for engaging HIV-infected individuals into medical care and can positively influence the preventive behaviours of IDUs. This study seeks to document and understand the complexity and range of motivations and deterrents to HIV testing among IDUs. Participants were recruited using a convenience sampling method. Interviews consisted of a qualitative guide and a quantitative survey to collect HIV testing histories, sex and drug risk behaviours, and demographic information. Interview data was coded and content analyzed to identify emerging themes and clarify the processes that drug users employ in deciding whether or not to test. Sixty-six drug users were interviewed. The sample reported a median of four lifetime HIV tests. Participants described a range of motivating and deterring factors to HIV testing across personal, interpersonal and structural categories. Drug users' decision to test is influenced by a complex network of factors. Better understanding of these motivators and deterrents can help providers develop a more holistic approach to targeting this high-risk population for HIV prevention efforts.

Voices from the field: providers discuss HIV counseling and testing programs for drug users

The use of illicit drugs plays a critical role in the spread of HIV, with approximately one-half of all new HIV infections in the United States attributed to this mode of transmission. There is a renewed emphasis on developing special HIV counseling and testing (C&T) programs for drug users. We conducted a qualitative study of C&T providers to identify client-centered and structural barriers to providing HIV C&T to high-risk drug users. Interviews focused on obtaining a detailed description of the services; successful and problematic forms of organization, financing, and service delivery; client access and barriers to C&T services; recommendations for increasing C&T accessibility and utilization by drug users; and linkages between C&T and other HIV-prevention and intervention services. The results of our interviews illustrate that it is tremendously complex and challenging work to provide C&T to populations with multiple and immediate needs within a context of layered constraints on individual behavior, provider resources, and service delivery. Providers clearly understand client-centered and structural barriers and have demonstrated a commitment to overcoming the barriers related to AIDS stigma, confidentiality, material needs, and fear when delivering HIV C&T services.

Ratios of charged antiparticles-to-particles near mid-rapidity in Au + Au collisions at sqrt[s(NN)]=130 GeV

We have measured the ratios of antiparticles to particles for charged pions, kaons, and protons near mid-rapidity in central Au+Au collisions at sqrt[s(NN)] = 130 GeV. We observe <pi(-)>/<pi(+)> = 1.00+/-0.01(stat)+/-0.02(syst), <K->/<K+> = 0.91+/-0.07(stat)+/-0.06(syst), and <p>/<p> = 0.60+/-0.04(stat)+/-0.06(syst). The <K->/<K+> and <p>/<p> ratios give a consistent estimate of the baryo-chemical potential mu(B) of 45 MeV, a factor of 5-6 smaller than in central Pb+Pb collisions at sqrt[s(NN)] = 17.2 GeV.

Charged-particle pseudorapidity density distributions from Au+Au collisions at sqrt[s(NN)]=130 GeV

The charged-particle pseudorapidity density dN(ch)/d eta has been measured for Au+Au collisions at sqrt[s(NN)] = 130 GeV at RHIC, using the PHOBOS apparatus. The total number of charged particles produced for the 3% most-central Au+Au collisions for /eta/<or=5.4 is found to be 4200+/-470. The evolution of dN(ch)/d eta with centrality is discussed, and compared to model calculations and to data from proton-induced collisions. The data show an enhancement in charged-particle production at midrapidity, while in the fragmentation regions, the results are consistent with expectations from pp and pA scattering.

Hand washing for health-care workers in domestic care settings

Hand washing is recognized as the single most important practice in reducing the spread of infection. Infection problems, such as an increase in antibiotic resistant organisms, have now made apparent the need to return to such basic practice. Although optimum facilities and practices for hand washing in an inpatient setting have been described, these are rarely available for health-care workers providing increasingly more complex care to patients and clients in their own homes. Therefore community staff need to adopt a risk assessment approach and strategies to ensure that adequate decontamination of their hands is achieved in order that care can be given with the minimal risk of cross-infection between patients, clients and staff.