A multi-element psychosocial intervention for early psychosis (GET UP PIANO TRIAL) conducted in a catchment area of 10 million inhabitants: study protocol for a pragmatic cluster randomized controlled trial

Multi-element interventions for first-episode psychosis (FEP) are promising, but have mostly been conducted in non-epidemiologically representative samples, thereby raising the risk of underestimating the complexities involved in treating FEP in 'real-world' services

The Compact Linear Collider (CLIC) - 2018 Summary Report

The Compact Linear Collider (CLIC) is a TeV-scale high-luminosity linear $e^+e^-$ collider under development at CERN. Following the CLIC conceptual design published in 2012, this report provides an overview of the CLIC project, its current status, and future developments. It presents the CLIC physics potential and reports on design, technology, and implementation aspects of the accelerator and the detector. CLIC is foreseen to be built and operated in stages, at centre-of-mass energies of 380 GeV, 1.5 TeV and 3 TeV, respectively. CLIC uses a two-beam acceleration scheme, in which 12 GHz accelerating structures are powered via a high-current drive beam. For the first stage, an alternative with X-band klystron powering is also considered. CLIC accelerator optimisation, technical developments and system tests have resulted in an increased energy efficiency (power around 170 MW) for the 380 GeV stage, together with a reduced cost estimate at the level of 6 billion CHF. The detector concept has been refined using improved software tools. Significant progress has been made on detector technology developments for the tracking and calorimetry systems. A wide range of CLIC physics studies has been conducted, both through full detector simulations and parametric studies, together providing a broad overview of the CLIC physics potential. Each of the three energy stages adds cornerstones of the full CLIC physics programme, such as Higgs width and couplings, top-quark properties, Higgs self-coupling, direct searches, and many precision electroweak measurements. The interpretation of the combined results gives crucial and accurate insight into new physics, largely complementary to LHC and HL-LHC. The construction of the first CLIC energy stage could start by 2026. First beams would be available by 2035, marking the beginning of a broad CLIC physics programme spanning 25-30 years

The good and evil of flare: flares in hepatitis B virus chronic hepatitis

Treatment of HBeAg-positive chronic hepatitis B with pegylated interferon achieves HBeAg seroconversion in about 30% of patients and retreatment of nonresponders is followed by a low rate of sustained response. Alanine aminotransferase flares occurring after the introduction of interferon are considered a positive predictor of response. Here we described a young patient with active chronic hepatitis B who underwent four different treatment courses developing lamivudine resistance and showing three elevated flares of different origin and with diverse outcome. We discuss the meaning of each flare and their role in treatment response or virus reactivation

INCIDENCE OF ANTI-WRA DETECTION USING WR(A+) ANTIBODY SCREENING CELLS IN PRE-TRANSFUSION TESTING

Background and Objectives Antibodies to low incidence RBC antigens are not rare in candidates to blood transfusion, though the risk of receiving a non-compatible unit is low. Sometimes commercial RBC sets for the screening of irregular antibodies contain Wr(a+) cells: but these cells increase the workload of antibody characterization due to the presence of anti-Wra in recipients. Materials and Methods We have studied both the incidence of Wra antibodies and the effects on routine work of having a Wr(a+) cell in the screening test in an unselected population of 787 patients requiring RBC transfusion and in 151 new blood donors. Results Irregular antibodies were found in 64 sera, 58 of which were specific for Wra , 46 (5,8%) and 12 (7,9%) among patients and donors, respectively. All the positive tested sera contained specific IgM, whereas IgG were also found in 71% of the cases. The use of an antibody screening RBC set, including a Wr(a+) cell, increased the efforts towards the definition of the irregular Abs in the positive screened samples, by three times compared to the previous period. Conclusion A specific anti- Wra IgM component has always been found in positive sera. This component can easily be detected during cross- match procedures. Moreover, the association between anti-Wra and haemolytic transfusion reaction is rare. Therefore, the inclusion of Wr(a+) cells in pre-transfusion screening of blood recipients is not justified by clinical relevance and it causes an undue increase in costs and time to unit release