Rectal Culture-Guided Targeted Antimicrobial Prophylaxis Reduces the Incidence of Post-Operative Infectious Complications in Men at High Risk for Infections Submitted to Transrectal Ultrasound Prostate Biopsy – Results of a Cross-Sectional Study

<div><p>The role of rectal culture-guided antimicrobial prophylaxis (TAP) in reducing infectious complications (IC) after transrectal-ultrasound prostate biopsy (TRUSPBx) is conflicting. We assessed the prevalence of IC in a cohort of men at high risk for IC submitted to TRUSPBx and treated with either TAP or empirical prophylaxis (EAP). Data from 53 patients at high risk for IC undergoing TRUSPBx were collected. Patients who did not receive a rectal swab (RS) were treated with EAP with fluoroquinolones (FQs). Of those who received the RS, patients with FQ-susceptible organisms received ciprofloxacin while those with FQ-resistant organisms received TAP. Office visits were scheduled to investigate the rate of complication at day 7 and 30 after TRUSPBx. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics and logistic regression models detailed the association between clinical parameters and IC rate. Out of 53 men, 17 (32.1%) had RS while 36 (67.9%) did not. All RS cultures were positive for E. Coli and 4 (23.5%) reported FQ-resistant pathogens. Considering risk factors for IC, no difference was found in terms of CCI, rate of diabetes, UTIs or recent antibiotic utilization between groups. Overall, 12 (22.6%) men reported IC, with a greater proportion of them belonging to the group treated with EAP (30.6% vs 5.9%; p = 0.045). Of these, 9 (25.0%) patients, all treated with EAP, developed post biopsy UTIs. E. Coli sustained all UTIs and 7 (77.7%) were FQ resistant. At multivariable analysis, CCI≥1, a history of UTIs/prostatitis and recent antibiotic utilization (all p<0.04) were the most powerful predictors for ICs. In conclusion, we found that compared to EAP, TAP significantly reduces ICs, in men at high risk for post TRUSPBx IC. Patients at risk for IC, especially those with recent antibiotic utilization, CCI≥1 and a history of UTIs/prostatitis before biopsy, could benefit from TAP.</p></div

Protection Scheme Effectiveness Study for the High-Luminosity LHC MBRD Magnet

The MBRD (Main Bending Recombination Dipole, or D2) is one of the magnets in the interaction region of the LHC that needs to be replaced in order to fulfill the requirements of the High-Luminosity upgrade. The magnetic field must be increased up to 4.5 T in an aperture with a diameter of 105 mm and a total length of about 8 m, to reach the target integrated field of 35 T$\cdot$m. The increase of the magnetic field and, consequently, of the cross talk between the two apertures having the same polarity required a brand-new design characterized by asymmetric left-right coils and aluminum rings around the two apertures in order to compensate the repulsive Lorentz forces arising between them. The design was carried out at INFN, while the construction is taking place at the ASG Superconductors (Genova, Italy). The development plan was to initially build a 1.6 m long model, completed and cold tested in summer 2020, a full scale prototype, whose cold tests are now ongoing, followed by a series of six magnets, presently under construction. The test campaign performed on the short model and the one currently underway on the prototype provide very useful information for the magnets of the series, such as the behavior of the protection circuit in case of quenches. During the measurements performed at CERN, several quenches induced by the quench heaters were provoked, and the magnet behavior was recorded for different initial currents. This contribution will focus on the results of such tests and their comparison with the predictions obtained through the simulations with two different codes, Roxie and STEAM-LEDET

The HL-LHC Short Model Recombination D2 Dipole: Cold Test Results and Analysis

The new D2 recombination superconducting dipole is a key two-in-one Nb-Ti magnet with a 105 mm bore aperture for the high luminosity LHC accelerator upgrade project (HL-LHC) at CERN expected in operation from 2024. A short model MBRDS1 magnet of 1.6 m magnetic length has been designed by INFN (Genova), built by ASG Superconductors, and cold tested at CERN within a INFN - CERN collaboration framework. This model magnet features novel magnetic and mechanical design elements, which include the cancellation of unwanted cross-talk field multipoles through asymmetric coils, aluminium alloy collar pack preloading rings and a dedicated axial structure design. The future series of four 8.5 m long full-length dipole magnets shall be installed on both sides of the ATLAS and CMS interaction points with an integral field of 35 T.m and 4.5 T bore magnetic field. This paper presents the first power test results including training, protection, and field quality. Short model results will give a relevant feedback for the prototype construction and the series production

The Development of the Superconducting Dipoles D2 for the High Luminosity Upgrade of LHC

The recombination dipoles D2 (MBRD) for the luminosity upgrade of the Large Hadron Collider (LHC) are double aperture magnets to be placed on each side of ATLAS and CMS experiments, generating 4.5 T along a magnetic length of 7.78 m and a bore diameter of 105 mm. Its development plan foresees the construction of a short model 1.6 m long, followed by a prototype and by the series of 6 magnets. The magnet design was carried out at INFN Genova in a collaboration framework with CERN and the construction is ongoing in the industry (ASG Superconductors, Italy). The short model activities have just been accomplished after a successful power test performed at CERN, while the prototype is in its construction phase. In this contribution, the main features of the D2 magnet will be described, underlining the improvements implemented in the prototype with respect to the short model design. Then, the main results of the power test will be presented, focusing on training performance, protection scheme effectiveness and magnetic measurements

Logistic regression models predicting post TRUSPBx infectious complications in patients who were not submitted to rectal swab (n = 36).

<p>Logistic regression models predicting post TRUSPBx infectious complications in patients who were not submitted to rectal swab (n = 36).</p

Risk factors for post TRUSPBx infectious complications.

<p>Risk factors for post TRUSPBx infectious complications.</p