CURB-65 score predicted mortality in community-acquired pneumonia better than IDSA/ATS minor criteria in a low-mortality-rate setting

The CURB-65 scoring system performs well at identifying patients with pneumonia who have a low risk of death. Whether it predicts mortality in community-acquired pneumonia (CAP) better than the 2007 Infectious Disease Society of America (IDSA)/American Thoracic Society (ATS) minor criteria in low-mortality-rate settings is not clear. The purpose of this study was to determine the hypothesis.A total of 1,230 adult inpatients admitted to our hospital from 2005 to 2009 for CAP were reviewed retrospectively.The hospital mortality was 1.3 %. Percentage mortality increased significantly with CURB-65 score and the increasing number of IDSA/ATS minor criteria present. The number of CURB-65 criteria or IDSA/ATS minor criteria present had significant increased odds ratios for mortality of 7.547 and 2.711, respectively. The sensitivities of a CURB-65 score of ≥ 3 and the presence of ≥ 3 minor criteria in predicting mortality was 25 % and 37.5 %, which increased to 75 % and 62.5 %, while the cut-off values reduced to ≥ 2 criteria, respectively. The area under the receiver operating characteristic curve for CURB-65 was greater than the corresponding area for IDSA/ATS minor criteria in predicting hospital mortality (0.915 vs. 0.805, p = 0.0091).CURB-65 score predicted hospital mortality better than IDSA/ATS minor criteria, and a CURB-65 score of ≥ 2 or the presence of ≥ 2 minor criteria might be more valuable cut-off values for "severe" CAP in a low-mortality-rate setting.

Azimuthal anisotropy of charged particles at high transverse momenta in Pb-Pb collisions at sqrt[s(NN)] = 2.76 TeV

The azimuthal anisotropy of charged particles in Pb-Pb collisions at sqrt[s(NN)]=2.76  TeV is measured with the CMS detector at the LHC over an extended transverse momentum (p(T)) range up to approximately 60  GeV/c. The data cover both the low-p(T) region associated with hydrodynamic flow phenomena and the high-p(T) region where the anisotropies may reflect the path-length dependence of parton energy loss in the created medium. The anisotropy parameter (v2) of the particles is extracted by correlating charged tracks with respect to the event-plane reconstructed by using the energy deposited in forward-angle calorimeters. For the six bins of collision centrality studied, spanning the range of 0-60% most-central events, the observed v2 values are found to first increase with p(T), reaching a maximum around p(T)=3  GeV/c, and then to gradually decrease to almost zero, with the decline persisting up to at least pp(T)=40  GeV/c over the full centrality range measured.

Celecoxib radiosensitizes the human cervical cancer HeLa cell line via a mechanism dependent on reduced cyclo-oxygenase-2 and vascular endothelial growth factor C expression

OBJECTIVE

The effects of celecoxib, a selective cyclo-oxygenase-2 (COX-2) inhibitor, on HeLa cervical cancer cell growth and radiosensitivity were investigated.

METHODS

Cytotoxicity was quantified using a 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyltetrazolium assay and effects on radiosensitivity were assessed using the lethal dose, quasithreshold dose, fraction surviving after 2 Gy irradiation and the radiosensitization ratio (SER, based on average lethal dose) determined using a single-hit multitarget model.

RESULTS

Celecoxib inhibited HeLa cell proliferation in a concentration- and time-dependent manner, with a half-maximal inhibitory concentration at 72 h of 44 μmol/l. Treatment with 20 μmol/l celecoxib for 72 h before irradiation was associated with an SER of 2.01. The SER of irradiated cells was 2.41 when treated with 40 μmol/l celecoxib before irradiation, 1.89 when treated simultaneously and 1.44 when treated after irradiation. Celecoxib downregulated COX-2 and vascular endothelial growth factor C (VEGF-C) expression evaluated immunohistochemically.

CONCLUSION

Celecoxib pretreatment radiosensitizes HeLa cells via a mechanism dependent on down-regulation of COX-2 and VEGF-C.

Candida albicans survival and biofilm formation under starvation conditions

AIM

To investigate the survival and biofilm formation capacity of Candida albicans in starvation and under anaerobic conditions.

METHODOLOGY

Candida albicans growth and survival were monitored in vitro for up to 8 months. Fungal suspensions from late exponential, stationary and starvation phases were incubated on human dentine, polystyrene and glass slides. Scanning electron microscopy (SEM) was used to observe the process of biofilm formation. 2,3-bis(2-Methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxyanilide inner salt (XTT) reduction assay was performed to quantify the biofilm formation capability, and confocal laser scanning microscopy (CLSM) was used to study and make semi-quantitative comparisons of the ultrastructure of biofilms formed on human dentine. 'XTT bioactivity' and 'COMSTAT results' were analysed by two-way analysis of variance (ANOVA) and one-way ANOVA, respectively.

RESULTS

Candida albicans survived for over six months. SEM demonstrated that starving C. albicans produced mature biofilms on different substrata. C. albicans of the same growth phase incubated on human dentine displayed significantly higher biofilm formation capability than on polystyrene or glass slides (P < 0.05). Biofilm formation capability by starving cells was significantly lower than that in exponential or stationary phases (P < 0.05). CLSM revealed that biofilms formed by starvation-phase cells were less complex, had a higher roughness coefficient and surface/volume ratio (P < 0.05).

CONCLUSIONS

Candida albicans cells can survive and form biofilms in anaerobic and nutrient-limited conditions and may pose a treatment challenge.

An apoptosis-independent role of SMAC in tumor suppression

Reduced expression of the pro-apoptotic protein SMAC (second mitochondria-derived activator of caspase) has been reported to correlate with cancer progression, while its significance and underlying mechanisms are poorly understood. In this study, we investigated the role of SMAC in intestinal tumorigenesis using both human samples and animal models. Decreased SMAC expression was found to correlate with increased cIAP2 expression and higher grades of human colon cancer. In mice, SMAC deficiency significantly increased the incidence and size of colon tumors induced by azoxymethane (AOM)/dextran sulfate sodium salt (DSS), and highly enriched β-catenin hot spot mutations. SMAC deficiency also significantly increased the incidence of spontaneous intestinal polyps in APC(Min/+) mice. Loss of SMAC in mice led to elevated levels of cIAP1 and cIAP2, increased proliferation and activation of the NF-κB p65 subunit in normal and tumor tissues. Unexpectedly, SMAC deficiency had little effect on the incidence of precursor lesions, or apoptosis induced by AOM or DSS, or in established tumors in mice. Furthermore, SMAC knockout enhanced TNFα-mediated NF-κB activation via cIAP2 in HCT 116 colon cancer cells. These results demonstrate an essential and apoptosis-independent function of SMAC in tumor suppression and provide new insights into the biology and targeting of colon cancer.

Search for supersymmetry in events with three leptons and missing transverse momentum in √[s]=7 TeV pp collisions with the ATLAS detector

A search for the weak production of charginos and neutralinos decaying to a final state with three leptons (electrons or muons) and missing transverse momentum is presented. The analysis uses 2.06 fb(-1) of √[s]=7 TeV proton-proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with standard model expectations in two signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric and simplified models. For the simplified models, degenerate lightest chargino and next-to-lightest neutralino masses up to 300 GeV are excluded for mass differences from the lightest neutralino up to 300 GeV.

Search for violation of Lorentz invariance in top quark pair production and decay

Using data collected with the D0 detector at the Fermilab Tevatron Collider, corresponding to 5.3 fb(-1) of integrated luminosity, we search for violation of Lorentz invariance by examining the tt[over ¯] production cross section in lepton+jets final states. We quantify this violation using the standard-model extension framework, which predicts a dependence of the tt[over ¯] production cross section on sidereal time as the orientation of the detector changes with the rotation of the Earth. Within this framework, we measure components of the matrices (c(Q))(μν33) and (c(U))(μν33) containing coefficients used to parametrize violation of Lorentz invariance in the top quark sector. Within uncertainties, these coefficients are found to be consistent with zero.

Search for dark matter and large extra dimensions in pp collisions yielding a photon and missing transverse energy

Results are presented from a search for new physics in the final state containing a photon (γ) and missing transverse energy (E[combininb /](T)). The data correspond to an integrated luminosity of 5.0 fb(-1) collected in pp collisions at √[s]=7 TeV by the CMS experiment. The observed event yield agrees with standard-model expectations for the γ+E[combininb /](T) events. Using models for the production of dark-matter particles (χ), we set 90% confidence level (C.L.) upper limits of 13.6-15.4 fb on χ production in the γ+E[combininb /](T) state. These provide the most sensitive upper limits for spin-dependent χ-nucleon scattering for χ masses (M(χ)) between 1 and 100 GeV. For spin-independent contributions, the present limits are extended to M(χ)<3.5 GeV. For models with 3-6 large extra dimensions, our data exclude extra-dimensional Planck scales between 1.64 and 1.73 TeV at 95% C.L.

Observation of a new Ξb baryon

The observation of a new b baryon via its strong decay into Ξ(b)(-) π(+) (plus charge conjugates) is reported. The measurement uses a data sample of pp collisions at sqrt[s] = 7 TeV collected by the CMS experiment at the LHC, corresponding to an integrated luminosity of 5.3 fb(-1). The known Ξ(b)(-) baryon is reconstructed via the decay chain Ξ(b)(-) → J/ψΞ(-) → μ(+) μ(-) Λ(0) π(-), with Λ(0) → pπ(-). A peak is observed in the distribution of the difference between the mass of the Ξ(b)(-) π(+) system and the sum of the masses of the Ξ(b)(-) and π(+), with a significance exceeding 5 standard deviations. The mass difference of the peak is 14.84 ± 0.74(stat) ± 0.28(syst) MeV. The new state most likely corresponds to the J(P) = 3/2(+) companion of the Ξ(b).

Pulse generation without gain-bandwidth limitation in a laser with self-similar evolution

With existing techniques for mode-locking, the bandwidth of ultrashort pulses from a laser is determined primarily by the spectrum of the gain medium. Lasers with self-similar evolution of the pulse in the gain medium can tolerate strong spectral breathing, which is stabilized by nonlinear attraction to the parabolic self-similar pulse. Here we show that this property can be exploited in a fiber laser to eliminate the gain-bandwidth limitation to the pulse duration. Broad (∼200 nm) spectra are generated through passive nonlinear propagation in a normal-dispersion laser, and these can be dechirped to ∼20-fs duration.

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Search for lepton flavour violation in the eμ continuum with the ATLAS detector in [Formula: see text]pp collisions at the LHC

This paper presents a search for the t-channel exchange of an R-parity violating scalar top quark ([Formula: see text]) in the e±μ∓ continuum using 2.1 fb-1 of data collected by the ATLAS detector in [Formula: see text]pp collisions at the Large Hadron Collider. Data are found to be consistent with the expectation from the Standard Model backgrounds. Limits on R-parity-violating couplings at 95 % C.L. are calculated as a function of the scalar top mass ([Formula: see text]). The upper limits on the production cross section for pp→eμX, through the t-channel exchange of a scalar top quark, ranges from 170 fb for [Formula: see text] to 30 fb for [Formula: see text].

Transformation bending device emulated by graded-index waveguide

We demonstrate that a transformation device can be emulated using a gradient-index waveguide. The effective index of the waveguide is spatially varied by tailoring a gradient thickness dielectric waveguide. Based on this technology, we demonstrate a transformation device guiding visible light around a sharp corner, with low scattering loss and reflection loss. The experimental results are in good agreement with the numerical results.

Measurements of the mass and width of the η(c) using the decay ψ(3686)→γη(c)

The mass and width of the lowest-lying S-wave spin singlet charmonium state, the η(c), are measured using a data sample of 1.06×10(8) ψ(3686) decays collected with the BESIII detector at the BEPCII storage ring. We use a model that incorporates full interference between the signal reaction, ψ(3686)→γη(c), and a nonresonant radiative background to describe the line shape of the η(c) successfully. We measure the η(c) mass to be 2984.3±0.6±0.6 MeV/c(2) and the total width to be 32.0±1.2±1.0 MeV, where the first errors are statistical and the second are systematic.

SU-E-T-198: Patient Scheduling Monitor (PSM)-A New Tool for Radiation Therapy Patient Scheduling and Workflow Management in an Increasingly Digital Environment

PURPOSE

To develop an easy-to-use and customizable Patient Scheduling Monitor for 1) active monitoring of radiation therapy workflow from CT simulation to the start of treatment and 2) for optimizing the workflow based on treatment complexity.

METHODS

Microsoft Access database and Visual Basic language were used to create an in-house software application, Patient Scheduling Monitor (PSM). The PSM was designed with three functional modules: a patient schedule calculator, a workflow progress tracker, and a workflow evaluator. The PSM divides the radiation treatment workflow into 6 tasks including image acquisition/fusion, target delineation, dosimetry planning, MD review, physics QA and RTT QA. On the day of CT simulation, the scheduling calculator generates a planned timeline for each task based on the CT-simulation date and the default standard established for each given task and treatment type. Each task within the PSM can also be individualized as needed. After simulation, the progress tracker enables staff to actively monitor the workflow. The workflow evaluator will query the database and analyze the planned versus actual timeline and provide data for future workflow analysis.

RESULTS

We have used the PSM since Nov, 2011 for 186 patients. The PSM has allowed us to provide patient start times at the completion of simulation. It has helped to improve patient satisfaction. The workflow progress tracker enabled us to actively manage the workflow. Currently, for patients managed using the PSM, no rescheduling has been required. The use of PSM has reduced the average CT simulation to treatment start times. It also has improved intradepartmental communications.

CONCLUSIONS

An easy-to-use patient scheduling monitor has been developed. The PSM has been shown to be an efficient and effective tool in managing, assessing and improving the radiation therapy workflow and will be useful in managing the timelines in an increasingly dynamic working environment.