Elliptic Flow of Electrons from Beauty-Hadron Decays in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

The elliptic flow of electrons from beauty hadron decays at midrapidity (|y|<0.8) is measured in Pb-Pb collisions at sqrt[s_{NN}]=5.02  TeV with the ALICE detector at the LHC. The azimuthal distribution of the particles produced in the collisions can be parametrized with a Fourier expansion, in which the second harmonic coefficient represents the elliptic flow, v_{2}. The v_{2} coefficient of electrons from beauty hadron decays is measured for the first time in the transverse momentum (p_{T}) range 1.3-6  GeV/c in the centrality class 30%-50%. The measurement of electrons from beauty-hadron decays exploits their larger mean proper decay length cτ≈500  μm compared to that of charm hadrons and most of the other background sources. The v_{2} of electrons from beauty hadron decays at midrapidity is found to be positive with a significance of 3.75  σ. The results provide insights into the degree of thermalization of beauty quarks in the medium. A model assuming full thermalization of beauty quarks is strongly disfavored by the measurement at high p_{T}, but is in agreement with the results at low p_{T}. Transport models including substantial interactions of beauty quarks with an expanding strongly interacting medium describe the measurement within uncertainties.

Do Digital Handover Checklists Influence the Clinical Outcome Parameters of Intensive Care Unit Patients? A Randomized Controlled Pilot Study

Background: Clinical handovers have been identified as high-risk situations for medical treatment errors. It has been shown that handover checklists lead to a reduced rate of medical errors and mortality. However, the influence of handover checklists on essential patient outcomes such as prevalence of sepsis, mortality, and length of hospitalization has not yet been investigated in a randomized controlled trial (RCT).

Objectives: The aim of the present pilot study was to estimate the effect of two different handover checklists on the 48 h sepsis-related organ failure assessment (SOFA) score and the feasibility of a respective clinical RCT.

Methods: Outcome parameters and feasibility were investigated implementing and comparing an intervention with a control checklist.

Design: Single center two-armed cluster randomized prospective crossover pilot study.

Setting: The study took place over three 1-month periods in an intensive care unit (ICU) setting at the University Hospital Aachen.

Patients/Participants: Data from 1,882 patients on seven ICU wards were assessed, of which 1,038 were included in the analysis.

Intervention: A digital standardized handover checklist (ISBAR₃) was compared to a control checklist (VICUR).

Main Outcome Measures: Primary outcome was the 2nd 24 h time window sepsis-related organ failure assessment (SOFA) score. Secondary outcomes were SOFA scores on the 3rd and 5th 24 h time window, mortality, reuptake, and length of stay; handover duration, degree of satisfaction, and compliance as feasibility-related outcomes.

Results: Different sepsis scores were observed only for the 1st 24 h time window after admission to the ICU, with higher values for ISBAR₃. With respect to the patient-centered outcomes, both checklists achieved similar results. Average handover duration was shorter for VICUR, whereas satisfaction and compliance were higher for ISBAR₃. However, overall compliance was low (25.4% for ISBAR₃ and 15.8% for VICUR).

Conclusions: Based on the results, a stratified randomization procedure is recommended for following RCTs, in which medical treatment errors should also be investigated as an additional variable. The use of control checklists is discouraged due to lower acceptance and compliance among healthcare practitioners. Measures should be undertaken to increase compliance with the use of checklists. Clinical outcome parameters should be carefully selected.

Trial Registration:ClinicalTrials.gov, Identifier [NCT03117088]. Registered April 14, 2017.

Outcomes of diagnosed COVID-19 cancer patients: concerning results of a systematic review

Since the outbreak of coronavirus disease 2019 (COVID-19), malignancy was shown to be prevalent in COVID-19 patients. This systematic review's searches were conducted in MEDLINE(R), Embase, Web of Science, and Scopos. Considered for inclusion were all reports on outcomes of cancer patients diagnosed with COVID-19. A total of 1099 references were identified through database searching and manual search. Finally, 17 references comprising 88 cancer patients, diagnosed with COVID-19, were included. Prevalence of cancer patients with COVID-19 was shown to range from 0.9% to 3%. The evidence suggested a severe clinical course of 50.6% in COVID-19 diagnosed cancer patients and a mortality rate of 34.5%. Subgroup analysis according to recent anti-cancer treatment showed a similar pattern, with the most concerning results in patients receiving recent immunotherapy/immunosuppressive treatment. COVID-19 morbidity and mortality among cancer patients should be reduced by consideration of testing asymptomatic COVID-19 cancer patients, reduction of hospital visits, and consideration of anti-cancer treatment.

Thermally driven state in a spin-1 model with competing interactions

We study a recently proposed spin-1 model with competing antiferromagnetic first-neighbor interaction and a third-neighbor coupling mediated by nonmagnetic states, which reproduces topological features of the phase diagrams of high-T_{c} superconductors [S. A. Cannas and D. A. Stariolo, Phys. Rev. E 99, 042137 (2019)2470-004510.1103/PhysRevE.99.042137]. We employ a cluster mean-field approach to investigate effects of crystal field anisotropy on the phase transitions hosted by this model. At low temperatures, the temperature-crystal field phase diagram exhibits superantiferromagnetic (SAF), antiferromagnetic (AF), and paramagnetic (PM) phases. In addition, we found a thermally driven state between SAF and PM phases. This thermally driven state and the SAF phase appears in the phase diagram as a domelike structure. Our calculations indicate that only second-order phase transitions occur in the PM-AF phase boundary, as suggested by previous Monte Carlo simulations.

Venetoclax and Navitoclax in Combination with Chemotherapy in Patients with Relapsed or Refractory Acute Lymphoblastic Leukemia and Lymphoblastic Lymphoma

Combining venetoclax, a selective BCL2 inhibitor, with low-dose navitoclax, a BCL-X_L/BCL2 inhibitor, may allow targeting of both BCL2 and BCL-X_L without dose-limiting thrombocytopenia associated with navitoclax monotherapy. The safety and preliminary efficacy of venetoclax with low-dose navitoclax and chemotherapy was assessed in this phase I dose-escalation study (NCT03181126) in pediatric and adult patients with relapsed/refractory (R/R) acute lymphoblastic leukemia or lymphoblastic lymphoma. Forty-seven patients received treatment. A recommended phase II dose of 50 mg navitoclax for adults and 25 mg for patients <45 kg with 400 mg adult-equivalent venetoclax was identified. Delayed hematopoietic recovery was the primary safety finding. The complete remission rate was 60%, including responses in patients who had previously received hematopoietic cell transplantation or immunotherapy. Thirteen patients (28%) proceeded to transplantation or CAR T-cell therapy on study. Venetoclax with navitoclax and chemotherapy was well tolerated and had promising efficacy in this heavily pretreated patient population. SIGNIFICANCE: In this phase I study, venetoclax with low-dose navitoclax and chemotherapy was well tolerated and had promising efficacy in patients with relapsed/refractory acute lymphoblastic leukemia or lymphoblastic lymphoma. Responses were observed in patients across histologic and genomic subtypes and in those who failed available therapies including stem cell transplant.See related commentary by Larkin and Byrd, p. 1324.This article is highlighted in the In This Issue feature, p. 1307.

Solvation Effects on the Structure and Stability of Alkali Metal Carbenoids

s‐Block metal carbenoids are carbene synthons and applied in a myriad of organic transformations. They exhibit a strong structure–activity relationship, but this is only poorly understood due to the challenging high reactivity and sensitivity of these reagents. Here, we report on systematic VT and DOSY NMR studies, XRD analyses as well as DFT calculations on a sulfoximinoyl‐substituted model system to explain the pronounced solvent dependency of the carbenoid stability. While the sodium and potassium chloride carbenoids showed high stabilities independent of the solvent, the lithium carbenoid was stable at room temperature in THF but decomposed at −10 °C in toluene. These divergent stabilities could be explained by the different structures formed in solution. In contrast to simple organolithium reagents, the monomeric THF‐solvate was found to be more stable than the dimer in toluene, since the latter more readily forms direct Li/Cl interactions which facilitate decomposition via α‐elimination.

Sediment retention by natural landscapes in the conterminous United States

Soils provide vital ecosystem services, from sequestering carbon to providing food and moderating floods. Soil erosion threatens the provisioning of these services and degrades downstream water quality. Vegetation plays an important role in soil retention: by holding it in place, soil can continue to provide ecosystem goods and services and protect water resources. The aims of this study were to: (1) develop a 30-meter resolution map of erosion in the conterminous United States, and (2) quantify the soil retention service of natural vegetation. Using the Revised Universal Soil Loss Equation and physiographic and remote sensing datasets, we estimated sheet and rill erosion. We also developed a map of sediment delivery ratio to connect erosion to downstream delivery using hydrologic connectivity. The estimated sheet and rill erosion in the conterminous United States was 1.55 Pg yr^-1, of which 0.52 Pg yr^-1 reached waterbodies. Natural land cover prevents 12.3 Pg yr^-1 of sheet and rill erosion and 5.1 Pg yr^-1 in delivery to waterbodies. The value of natural land cover in retaining sediment is a function of the land cover, physiographic characteristics, and spatial context. This study has implications for spatial prioritization of natural land cover preservation and agricultural land management to minimize sediment erosion and delivery.

A comprehensive study of the sorption mechanism and thermodynamics of f-element sorption onto K-feldspar

The mobility of heavy metal contaminants and radionuclides in the environment is directly controlled by their interactions with charged mineral surfaces, hence an assessment of their potential toxicity, e.g. in the context of radioactive waste disposal sites, requires understanding of sorption processes on the molecular level. Here, we investigate the sorption of a variety of rare earth elements (REE) and trivalent actinides (Am, Cm) on K-feldspar using batch sorption, time-resolved laser-induced fluorescence spectroscopy (TRLFS), and a surface complexation model. Initially, a reliable pK_a for K-feldspar's surface deprotonation reaction was determined as 2.5 ± 0.02 by column titration experiments, in excellent agreement with a measured pH_IEP of 2.8. Batch sorption experiments over a broad range of experimental conditions in terms of mineral grain size, pH, [M³⁺], ionic radius, solid/liquid ratio, ionic strength, and equilibration procedures were carried out to quantify macroscopic retention. The trivalent d-block element Y, early, mid, and late lanthanides (La, Eu, Nd, Lu), as well as two minor actinides (Am, Cm) were used for batch sorption experiments and showed similar pH dependent uptake behavior, underlining their chemical analogy. In parallel, spectroscopic investigations provided insight into surface speciation. Cm TRLFS spectra indicate the formation of three inner-sphere sorption complexes with increasing hydrolysis. Additionally, a ternary K-feldspar/Cm/silicate complex was found for pH > 10, and batch and spectroscopic data at low pH (<4) point to small amounts of outer sphere sorption complexes. Based on TRLFS data, batch sorption, and titration data, a generic geochemical sorption model was developed, that describes sorption edges for all investigated M³⁺/K-feldspar systems satisfactorily. The derived stability constants for the binary sorption complexes (logK_1-4 = -3.6, -7.7, -11.5, and -17.4, respectively) could successfully be used to reproduce literature data. The stability constants obtained for the surface complexes were included into the database for the Smart K_d-concept, which will further improve the safety assessment of potential repositories for radioactive waste.

Measurement of the Low-Energy Antideuteron Inelastic Cross Section

In this Letter, we report the first measurement of the inelastic cross section for antideuteron-nucleus interactions at low particle momenta, covering a range of 0.3≤p<4  GeV/c. The measurement is carried out using p-Pb collisions at a center-of-mass energy per nucleon-nucleon pair of sqrt[s_{NN}]=5.02  TeV, recorded with the ALICE detector at the CERN LHC and utilizing the detector material as an absorber for antideuterons and antiprotons. The extracted raw primary antiparticle-to-particle ratios are compared to the results from detailed ALICE simulations based on the geant4 toolkit for the propagation of (anti)particles through the detector material. The analysis of the raw primary (anti)proton spectra serves as a benchmark for this study, since their hadronic interaction cross sections are well constrained experimentally. The first measurement of the inelastic cross section for antideuteron-nucleus interactions averaged over the ALICE detector material with atomic mass numbers ⟨A⟩=17.4 and 31.8 is obtained. The measured inelastic cross section points to a possible excess with respect to the Glauber model parametrization used in geant4 in the lowest momentum interval of 0.3≤p<0.47  GeV/c up to a factor 2.1. This result is relevant for the understanding of antimatter propagation and the contributions to antinuclei production from cosmic ray interactions within the interstellar medium. In addition, the momentum range covered by this measurement is of particular importance to evaluate signal predictions for indirect dark-matter searches.

Transverse field effects on the competition between antiferromagnetic and cluster spin-glass phases

We investigate a disordered cluster Ising antiferromagnet in the presence of a transverse field. By adopting a replica cluster mean-field framework, we analyze the role of quantum fluctuations in a model with competing short-range antiferromagnetic and intercluster disordered interactions. The model exhibits paramagnetic (PM), antiferromagnetic (AF), and cluster spin-glass (CSG) phases, which are separated by thermal and quantum phase transitions. A scenario of strong competition between AF and CSG unveils a number of interesting phenomena induced by quantum fluctuations, including a quantum PM state and quantum driven criticality. The latter occurs when the thermally driven PM-AF discontinuous phase transition becomes continuous at strong transverse fields. Analogous phenomena have been reported in a number of systems, but a description of underlying mechanisms is still required. Our results indicate that quantum driven criticality can be found in a highly competitive regime of disordered antiferromagnets, which is in consonance with recent findings in spin models with competing interactions.