Bloodstream infections following different types of surgery in a Finnish tertiary care hospital, 2009-2014

The risk and outcome of bloodstream infections (BSIs) were evaluated following surgery. BSIs were identified in Helsinki University Hospital during 2009-2014 as part of the national surveillance. Of 711 BSIs identified, 51% were secondary and 49% primary. The rate was highest after cardiovascular surgery (8.7 per 1000 procedures) and lowest after gynaecologic (1.0 per 1000). Surgical site infection was the most frequent source of secondary BSIs (34%) and 45% of primary BSIs were central-line-associated. The 28-day case fatality ranged from zero in gynaecology/obstetrics to 21% in cardiovascular surgery. Besides BSIs related to surgical site infections, half of BSIs were primary, providing additional foci for prevention. (C) 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.Peer reviewe

A search for the presence of magnetic fields in the two Supergiant Fast X-ray Transients IGR J08408-4503 and IGR J11215-5952

A significant fraction of high-mass X-ray binaries are supergiant fast X-ray transients (SFXTs). The prime model for the physics governing their X-ray behaviour suggests that the winds of donor OB supergiants are magnetized. To investigate if magnetic fields are indeed present in the optical counterparts of such systems, we acquired low-resolution spectropolarimetric observations of the two optically brightest SFXTs, IGR J08408-4503 and IGR J11215-5952 with the ESO FORS2 instrument during two different observing runs. No field detection at a significance level of 3sigma was achieved for IGR J08408-4503. For IGR J11215-5952, we obtain 3.2sigma and 3.8sigma detections (_hydr = -978+-308G and _hydr = 416+-110G) on two different nights in 2016. These results indicate that the model involving the interaction of a magnetized stellar wind with the neutron star magnetosphere can indeed be considered to characterize the behaviour of SFXTs. We detected long-term spectral variability in IGR J11215-5952, while for IGR J08408-4503 we find an indication of the presence of short-term variability on a time scale of minutes.Comment: 5 pages, 1 table, 7 figures, accepted for publication in MNRA

Treatment of keloid scars with intralesional triamcinolone and 5-fluorouracil injections - a randomized controlled trial

Keloids have high recurrence rates. Current first-line therapy is triamcinolone (TAC) injection, but it has been suggested that approximately 50% of keloids are steroid resistant. We compared the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinalone injections in a double-blind randomized controlled trial. Forty-three patients with 50 keloid scars were treated with either intralesional TAC or 5-FU-injections over 6 months. There was no statistically significant difference in the remission rate at 6 months between the 5-FU and TAC groups (46% vs 60%, respectively). Local adverse effects were higher in the TAC group compared to the 5-FU group. Occurrence of skin atrophy in TAC group was 44% and in the 5-FU group 8% (p <0.05). Also the occurrence of telangiectasia in the TAC group was 50% and in the 5-FU 21% (p <0.05). Vascularity of the keloids, assessed by spectral imaging and immunohistochemical staining for blood vessels, after treatment decreased in the TAC group, but not in the 5-FU group (p <0.05). Fibroblast proliferation evaluated by Ki-67 staining significantly decreased in the TAC group (p <0.05) but increased in the 5-FU group (p <0.05). TAC and 5-FU injections did not differ in their clinical effectivity in this randomized study, but 5-FU injections lead to increased proliferation rate and did not affect vascular density in histological assessment. Due to the greater number of adverse effects observed after TAC treatment, 5-FU injections may be preferable for cosmetically sensitive skin areas. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Extreme Technicolor & The Walking Critical Temperature

We map the phase diagram of gauge theories of fundamental interactions in the flavor-temperature plane using chiral perturbation theory to estimate the relation between the pion decaying constant and the critical temperature above which chiral symmetry is restored. We then investigate the impact of our results on models of dynamical electroweak symmetry breaking and therefore on the electroweak early universe phase transition.Comment: RevTeX, 18 pages, 3 figure

Scenario development for D-T operation at JET

The JET exploitation plan foresees D-T operations in 2020 (DTE2). With respect to the first D-T campaign in 1997 (DTE1), when JET was equipped with a carbon wall, the experiments will be conducted in presence of a beryllium-tungsten ITER-like wall and will benefit from an extended and improved set of diagnostics and higher additional heating power (32 MW neutral beam injection + 8 MW ion cyclotron resonance heating). There are several challenges presented by operations with the new wall: a general deterioration of the pedestal confinement; the risk of heavy impurity accumulation in the core, which, if not controlled, can cause the radiative collapse of the discharge; the requirement to protect the divertor from excessive heat loads, which may damage it permanently. Therefore, an intense activity of scenario development has been undertaken at JET during the last three years to overcome these difficulties and prepare the plasmas needed to demonstrate stationary high fusion performance and clear alpha particle effects. The paper describes the status and main achievements of this scenario development activity, both from an operational and plasma physics point of view.Peer reviewe

New Insights into Properties of Large-N Holographic Thermal QCD at Finite Gauge Coupling at (the Non-Conformal/Next-to) Leading Order in N

In the context of [1]'s string theoretic dual of large-N thermal QCD-like theories at finite gauge/string coupling (as part of the `MQGP' limit of [2]), we discuss the following. First, up to LO in N, using the results of [3], we show that the local T^3 of [2] is the T^2-invariant sLag of [3] in a resolved conifold. This, together with the results of [4], shows that for a (predominantly resolved or deformed) resolved warped deformed conifold, the local T^3 of [2] in the MQGP limit, is the T^2-invariant sLag of [3] justifying the construction of the delocalized SYZ type IIA mirror of the type IIB background of [1]. Then, using the prescription of [5], we obtain the temperature dependence of the thermal (and electrical) conductivity working up to leading order in N (the number of D3-branes), and upon comparison with [6] show that the results mimic a 1+1-dimensional Luttinger liquid with impurities. Further, including sub-leading non-conformal terms in the metric determined by M (the number of fractional D-branes = the number of colors = 3 in the IR after the end of a Seiberg duality cascade), by looking at respectively the scalar, vector and tensor modes of metric perturbations and using [7]'s prescription of constructing appropriate gauge-invariant perturbations, we obtain respectively the speed of sound, the diffusion constant and the shear viscosity \eta (and \eta/s) including the non-conformal O((g_s M^2) (g_s N_f)/N<<1)-corrections, N_f being the number of flavor D7-branes.Comment: 1+75 pages, LaTeX; Some corrections in Tc-related calculations, results unchange

Beryllium melting and erosion on the upper dump plates in JET during three ITER-like wall campaigns

Data on erosion and melting of beryllium upper limiter tiles, so-called dump plates (DP), are presented for all three campaigns in the JET tokamak with the ITER-like wall. High-resolution images of the upper wall of JET show clear signs of flash melting on the ridge of the roofshaped tiles. The melt layers move in the poloidal direction from the inboard to the outboard tile, ending on the last DP tile with an upward going waterfall-like melt structure. Melting was caused mainly by unmitigated plasma disruptions. During three ILW campaigns, around 15% of all 12376 plasma pulses were catalogued as disruptions. Thermocouple data from the upper dump plates tiles showed a reduction in energy delivered by disruptions with fewer extreme events in the third campaign, ILW-3, in comparison to ILW-1 and ILW-2. The total Be erosion assessed via precision weighing of tiles retrieved from JET during shutdowns indicated the increasing mass loss across campaigns of up to 0.6 g from a single tile. The mass of splashed melted Be on the upper walls was also estimated using the high-resolution images of wall components taken after each campaign. The results agree with the total material loss estimated by tile weighing (similar to 130 g). Morphological and structural analysis performed on Be melt layers revealed a multilayer structure of re-solidified material composed mainly of Be and BeO with some heavy metal impurities Ni, Fe, W. IBA analysis performed across the affected tile ridge in both poloidal and toroidal direction revealed a low D concentration, in the range 1-4 x 10(17) D atoms cm(-2).Peer reviewe

Cavitons and spontaneous hot flow anomalies in a hybrid-Vlasov global magnetospheric simulation

In this paper we present the first identification of foreshock cavitons and the formation of spontaneous hot flow anomalies (SHFAs) with the Vlasiator global magnetospheric hybrid-Vlasov simulation code. In agreement with previous studies we show that cavitons evolve into SHFAs. In the presented run, this occurs very near the bow shock. We report on SHFAs surviving the shock crossing into the down-stream region and show that the interaction of SHFAs with the bow shock can lead to the formation of a magnetosheath cavity, previously identified in observations and simulations. We report on the first identification of long-term local weakening and erosion of the bow shock, associated with a region of increased foreshock SHFA and caviton formation, and repeated shock crossings by them. We show that SHFAs are linked to an increase in suprathermal particle pitch-angle spreads. The realistic length scales in our simulation allow us to present a statistical study of global caviton and SHFA size distributions, and their comparable size distributions support the theory that SHFAs are formed from cavitons. Virtual spacecraft observations are shown to be in good agreement with observational studies.Peer reviewe

c-erbB2 and topoisomerase IIα protein expression independently predict poor survival in primary human breast cancer: a retrospective study

INTRODUCTION: c-erbB2 (also known as HER-2/neu) and topoisomerase IIα are frequently overexpressed in breast cancer. The aim of the study was to analyze retrospectively whether the expression of c-erbB2 and topoisomerase IIα protein influences the long-term outcome of patients with primary breast cancer. METHODS: In this study c-erbB2 and topoisomerase IIα protein were evaluated by immunohistochemistry in formalin-fixed paraffin-embedded tissue from 225 samples of primary breast cancer, obtained between 1986 and 1998. The prognostic value of these markers was analyzed. RESULTS: Of 225 primary breast tumor samples, 78 (34.7%) showed overexpression of either c-erbB2 (9.8%) or topoisomerase IIα protein (24.9%), whereas in 21 tumors (9.3%) both proteins were found to be overexpressed. Patients lacking both c-erbB2 and topoisomerase IIα overexpression had the best long-term survival. Overexpression of either c-erbB2 or topoisomerase IIα was associated with shortened survival, whereas patients overexpressing both c-erbB2 and topoisomerase IIα showed the worst disease outcome (P < 0.0001). Treatment with anthracyclines was not capable of reversing the negative prognostic impact of topoisomerase IIα or c-erbB2 overexpression. CONCLUSION: The results of this exploratory study suggest that protein expression of c-erbB2 and topoisomerase IIα in primary breast cancer tissues are independent prognostic factors and are not exclusively predictive factors for anthracycline response in patients with primary breast cancer

Role of the pedestal position on the pedestal performance in AUG, JET-ILW and TCV and implications for ITER

The role of the pedestal position on the pedestal performance has been investigated in AUG, JET-ILW and TCV. When the pedestal is peeling-ballooning (PB) limited, the three machines show a similar behaviour. The outward shift of the pedestal density relative to the pedestal temperature can lead to the outward shift of the pedestal pressure which, in turns, reduces the PB stability, degrades the pedestal confinement and reduces the pedestal width. Once the experimental density position is considered, the EPED model is able to correctly predict the pedestal height. An estimate of the impact of the density position on a ITER baseline scenario shows that the maximum reduction in the pedestal height is 10% while the reduction in the fusion power is between 10% and 40% depending on the assumptions for the core transport model usedIn other plasmas, where the pedestal density is shifted even more outwards relative to the pedestal temperature, the pedestal does not seem PB limited and a different behaviour is observed. The outward shift of the density is still empirically correlated with the pedestal degradation but no change in the pressure position is observed and the PB model is not able to correctly predict the pedestal height. On the other hand, the outward shift of the density leads to a significant increase of eta(e) and eta(i) (where eta(e,i) is the ratio of density to temperature scale lengths, eta(e,i) = L-eta e,L-i/L-Te,L-i) which leads to the increase of the growth rate of microinstabilities (mainly ETG and ITG) by 50%. This suggests that, in these plasmas, the increase in the turbulent transport due to the outward shift of the density might play an important role in the decrease of the pedestal performance.Peer reviewe