34 research outputs found
Phase transition for loop representations of Quantum spin systems on trees
We consider a model of random loops on Galton-Watson trees with an offspring
distribution with high expectation. We give the configurations a weighting of
. For many these models are equivalent to
certain quantum spin systems for various choices of the system parameters. We
find conditions on the offspring distribution that guarantee the occurrence of
a phase transition from finite to infinite loops for the Galton-Watson tree.Comment: 16 pages, 1 figur
Farber disease: clinical presentation, pathogenesis and a new approach to treatment
<p>Abstract</p> <p>Background</p> <p>Farber Disease is an autosomal-recessively inherited, lysosomal storage disorder caused by acid ceramidase deficiency and associated with distinct clinical phenotypes. Children with significant neurological involvement usually die early in infancy, whereas patients without or only mild neurological findings suffer from progressive joint deformation and contractures, subcutaneous nodules, inflammatory, periarticular granulomas, a hoarse voice and finally respiratory insufficiency caused by granuloma formation in the respiratory tract and interstitial pneumonitis leading to death in the third or fourth decade of live. As the inflammatory component of this disorder is caused by some kind of leukocyte dysregulation, allogeneic hematopoietic stem cell transplantation can restore a healthy immune system and thus may provide a curative option in Farber Disease patients without neurological involvement. Previous stem cell transplantations in two children with severe neurological involvement had resulted in a disappointing outcome, as both patients died of progressive deterioration of their neurological status. As a consequence, stem cell transplantation does not appear to be able to abolish or even reduce the neurotoxic effects of the abundant ceramide storage in the brain.</p> <p>Methods</p> <p>After myeloablative, busulfan-based preparative regimens, four Farber Disease patients without neurological involvement received an allogeneic hematopoietic stem cell transplantation from related and unrelated donors. Stem cell source was BM in three patients and PBSC in one patient; GvHD-prophylaxis consisted of CsA and short course MTX.</p> <p>Results and discussion</p> <p>In all patients, HSCT resulted in almost complete resolution of granulomas and joint contractures, considerable improvement of mobility and joint motility without relevant therapy-related morbidities. All patients are alive and well at this point with stabile donor cell chimerism and without evidence of chronic GvHD or other late sequelae of stem cell transplantation.</p> <p>Conclusion</p> <p>Allogeneic hematopoietic stem cell transplantation provides a promising approach for Farber Disease patients without neurological involvement.</p
Expression patterns within the Arabidopsis C/S1 bZIP transcription factor network: availability of heterodimerization partners controls gene expression during stress response and development
Members of the Arabidopsis group C/S1 basic leucine zipper (bZIP) transcription factor (TF) network are proposed to implement transcriptional reprogramming of plant growth in response to energy deprivation and environmental stresses. The four group C and five group S1 members form specific heterodimers and are, therefore, considered to cooperate functionally. For example, the interplay of C/S1 bZIP TFs in regulating seed maturation genes was analyzed by expression studies and target gene regulation in both protoplasts and transgenic plants. The abundance of the heterodimerization partners significantly affects target gene transcription. Therefore, a detailed analysis of the developmental and stress related expression patterns was performed by comparing promoter: GUS and transcription data. The idea that the C/S1 network plays a role in the allocation of nutrients is supported by the defined and partially overlapping expression patterns in sink leaves, seeds and anthers. Accordingly, metabolic signals strongly affect bZIP expression on the transcriptional and/or post-transcriptional level. Sucrose induced repression of translation (SIRT) was demonstrated for all group S1 bZIPs. In particular, transcription of group S1 genes strongly responds to various abiotic stresses, such as salt (AtbZIP1) or cold (AtbZIP44). In summary, heterodimerization and expression data provide a basic framework to further determine the functional impact of the C/S1 network in regulating the plant energy balance and nutrient allocation
Effectiveness of Lumbar Cerebrospinal Fluid Drain Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial.
IMPORTANCE
After aneurysmal subarachnoid hemorrhage, the use of lumbar drains has been suggested to decrease the incidence of delayed cerebral ischemia and improve long-term outcome.
OBJECTIVE
To determine the effectiveness of early lumbar cerebrospinal fluid drainage added to standard of care in patients after aneurysmal subarachnoid hemorrhage.
DESIGN, SETTING, AND PARTICIPANTS
The EARLYDRAIN trial was a pragmatic, multicenter, parallel-group, open-label randomized clinical trial with blinded end point evaluation conducted at 19 centers in Germany, Switzerland, and Canada. The first patient entered January 31, 2011, and the last on January 24, 2016, after 307 randomizations. Follow-up was completed July 2016. Query and retrieval of data on missing items in the case report forms was completed in September 2020. A total of 20 randomizations were invalid, the main reason being lack of informed consent. No participants meeting all inclusion and exclusion criteria were excluded from the intention-to-treat analysis. Exclusion of patients was only performed in per-protocol sensitivity analysis. A total of 287 adult patients with acute aneurysmal subarachnoid hemorrhage of all clinical grades were analyzable. Aneurysm treatment with clipping or coiling was performed within 48 hours.
INTERVENTION
A total of 144 patients were randomized to receive an additional lumbar drain after aneurysm treatment and 143 patients to standard of care only. Early lumbar drainage with 5 mL per hour was started within 72 hours of the subarachnoid hemorrhage.
MAIN OUTCOMES AND MEASURES
Primary outcome was the rate of unfavorable outcome, defined as modified Rankin Scale score of 3 to 6 (range, 0 to 6), obtained by masked assessors 6 months after hemorrhage.
RESULTS
Of 287 included patients, 197 (68.6%) were female, and the median (IQR) age was 55 (48-63) years. Lumbar drainage started at a median (IQR) of day 2 (1-2) after aneurysmal subarachnoid hemorrhage. At 6 months, 47 patients (32.6%) in the lumbar drain group and 64 patients (44.8%) in the standard of care group had an unfavorable neurological outcome (risk ratio, 0.73; 95% CI, 0.52 to 0.98; absolute risk difference, -0.12; 95% CI, -0.23 to -0.01; Pâ=â.04). Patients treated with a lumbar drain had fewer secondary infarctions at discharge (41 patients [28.5%] vs 57 patients [39.9%]; risk ratio, 0.71; 95% CI, 0.49 to 0.99; absolute risk difference, -0.11; 95% CI, -0.22 to 0; Pâ=â.04).
CONCLUSION AND RELEVANCE
In this trial, prophylactic lumbar drainage after aneurysmal subarachnoid hemorrhage lessened the burden of secondary infarction and decreased the rate of unfavorable outcome at 6 months. These findings support the use of lumbar drains after aneurysmal subarachnoid hemorrhage.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT01258257
Antimicrobial use in pediatric oncology and hematology in Germany and Austria, 2020/2021: a cross-sectional, multi-center point-prevalence study with a multi-step qualitative adjudication process
Background
Due to the high risk of severe infection among pediatric hematology and oncology patients, antimicrobial use is particularly high. With our study, we quantitatively and qualitatively evaluated, based on institutional standards and national guidelines, antimicrobial usage by employing a point-prevalence survey with a multi-step, expert panel approach. We analyzed reasons for inappropriate antimicrobial usage.
Methods
This cross-sectional study was conducted at 30 pediatric hematology and oncology centers in 2020 and 2021. Centers affiliated to the German Society for Pediatric Oncology and Hematology were invited to join, and an existing institutional standard was a prerequisite to participate. We included hematologic/oncologic inpatients under 19 years old, who had a systemic antimicrobial treatment on the day of the point prevalence survey. In addition to a one-day, point-prevalence survey, external experts individually assessed the appropriateness of each therapy. This step was followed by an expert panel adjudication based upon the participating centersâ institutional standards, as well as upon national guidelines. We analyzed antimicrobial prevalence rate, along with the rate of appropriate, inappropriate, and indeterminate antimicrobial therapies with regard to institutional and national guidelines. We compared the results of academic and non-academic centers, and performed a multinomial logistic regression using center- and patient-related data to identify variables that predict inappropriate therapy.
Findings
At the time of the study, a total of 342 patients were hospitalized at 30 hospitals, of whom 320 were included for the calculation of the antimicrobial prevalence rate. The overall antimicrobial prevalence rate was 44.4% (142/320; range 11.1â78.6%) with a median antimicrobial prevalence rate per center of 44.5% (95% confidence interval [CI] 35.9â49.9). Antimicrobial prevalence rate was significantly higher (p < 0.001) at academic centers (median 50.0%; 95% CI 41.2â55.2) compared to non-academic centers (median 20.0%; 95% CI 11.0â32.4). After expert panel adjudication, 33.8% (48/142) of all therapies were labelled inappropriate based upon institutional standards, with a higher rate (47.9% [68/142]) when national guidelines were taken into consideration. The most frequent reasons for inappropriate therapy were incorrect dosage (26.2% [37/141]) and (de-)escalation/spectrum-related errors (20.6% [29/141]). Multinomial, logistic regression yielded the number of antimicrobial drugs (odds ratio, OR, 3.13, 95% CI 1.76â5.54, p < 0.001), the diagnosis febrile neutropenia (OR 0.18, 95% CI 0.06â0.51, p = 0.0015), and an existing pediatric antimicrobial stewardship program (OR 0.35, 95% CI 0.15â0.84, p = 0.019) as predictors of inappropriate therapy. Our analysis revealed no evidence of a difference between academic and non-academic centers regarding appropriate usage.
Interpretation
Our study revealed there to be high levels of antimicrobial usage at German and Austrian pediatric oncology and hematology centers with a significant higher number at academic centers. Incorrect dosing was shown to be the most frequent reason for inappropriate usage. Diagnosis of febrile neutropenia and antimicrobial stewardship programs were associated with a lower likelihood of inappropriate therapy. These findings suggest the importance of febrile neutropenia guidelines and guidelines compliance, as well as the need for regular antibiotic stewardship counselling at pediatric oncology and hematology centers.
Funding
European Society of Clinical Microbiology and Infectious Diseases, Deutsche Gesellschaft fßr Pädiatrische Infektiologie, Deutsche Gesellschaft fßr Krankenhaushygiene, Stiftung Kreissparkasse Saarbrßcken
Worldwide variations in artificial skyglow
Despite constituting a widespread and significant environmental change,
understanding of artificial nighttime skyglow is extremely limited. Until now,
published monitoring studies have been local or regional in scope, and
typically of short duration. In this first major international compilation of
monitoring data we answer several key questions about skyglow properties.
Skyglow is observed to vary over four orders of magnitude, a range hundreds of
times larger than was the case before artificial light. Nearly all of the
study sites were polluted by artificial light. A non-linear relationship is
observed between the sky brightness on clear and overcast nights, with a
change in behavior near the rural to urban landuse transition. Overcast skies
ranged from a third darker to almost 18 times brighter than clear. Clear sky
radiances estimated by the World Atlas of Artificial Night Sky Brightness were
found to be overestimated by ~25%; our dataset will play an important role in
the calibration and ground truthing of future skyglow models. Most of the
brightly lit sites darkened as the night progressed, typically by ~5% per
hour. The great variation in skyglow radiance observed from site-to-site and
with changing meteorological conditions underlines the need for a long-term
international monitoring program
The Random Loop Model on Trees
We study the random loop model introduced by Ueltschi as a generalization of probabilistic representations for certain quantum spin systems. Here, loops are subsets of space and time, where space is modeled as a simple graph, and they give rise to the percolation-type question whether there are loops visiting infinitely many vertices.
The random loop model builds upon several parameters that influence the answer to this question. In fact, in many cases it is conjectured that there is a phase transition. This means that there is a critical value for one parameter β beyond which loops are infinite with positive probability, while loops are finite almost surely below this critical parameter.
One difficulty to establish the existence of such a phase transition is the inherent lack of monotonicity for the model on graphs like the d-dimensional cubic lattice. In this thesis we consider the case that the underlying graph is an infinite tree to circumvent this problem. Here, we relate event that a particular loop is infinite to the survival of a stochastic process that is manageable more easily. This allows us to distinguish both phases and to establish a phase transition by evaluating some monotone function of β, yielding the critical parameter as the solution to an implicit equation. Furthermore, from a more careful analysis of this function we obtain an asymptotic expansion for the critical parameter.
A second challenge is that the relevant probability measure depends on the number of loops. On the one hand, this induces highly non-local correlations. On the other hand, we have to start our analysis with finite graphs and then take an infinite-volume limit, where the uniqueness of the limit for the corresponding probability measures is in general not secured. Hence and again for certain trees, we are going to show that such a unique limit exists, enabling our aforementioned investigation of the phase transition and its critical parameter in the first place
Hardware Accelerated Per-Pixel Displacement Mapping
In this paper we present an algorithm capable of rendering a displacement mapped triangle mesh interactively on latest GPUs. The algorithm uses only pixel shaders and does not rely on adaptively adding geometry. All sampling of the displacement map takes place in the pixel shader and bi- or trilinear filtering can be applied to it, and at the same time as the calculations are done per pixel in the shader, the algorithm has automatic level of detail control. The triangles of the base mesh are extruded along the respective normal directions and then the resulting prisms are rendered by casting rays inside and intersecting them with the displaced surface. Two different implementations are discussed in detail