Phage Therapy of Mycobacterium Infections: Compassionate Use of Phages in 20 Patients With Drug-Resistant Mycobacterial Disease

Background: Nontuberculous Mycobacterium infections, particularly Mycobacterium abscessus, are increasingly common among patients with cystic fibrosis and chronic bronchiectatic lung diseases. Treatment is challenging due to intrinsic antibiotic resistance. Bacteriophage therapy represents a potentially novel approach. Relatively few active lytic phages are available and there is great variation in phage susceptibilities among M. abscessus isolates, requiring personalized phage identification. Methods: Mycobacterium isolates from 200 culture-positive patients with symptomatic disease were screened for phage susceptibilities. One or more lytic phages were identified for 55 isolates. Phages were administered intravenously, by aerosolization, or both to 20 patients on a compassionate use basis and patients were monitored for adverse reactions, clinical and microbiologic responses, the emergence of phage resistance, and phage neutralization in serum, sputum, or bronchoalveolar lavage fluid. Results: No adverse reactions attributed to therapy were seen in any patient regardless of the pathogen, phages administered, or the route of delivery. Favorable clinical or microbiological responses were observed in 11 patients. Neutralizing antibodies were identified in serum after initiation of phage delivery intravenously in 8 patients, potentially contributing to lack of treatment response in 4 cases, but were not consistently associated with unfavorable responses in others. Eleven patients were treated with only a single phage, and no phage resistance was observed in any of these. Conclusions: Phage treatment of Mycobacterium infections is challenging due to the limited repertoire of therapeutically useful phages, but favorable clinical outcomes in patients lacking any other treatment options support continued development of adjunctive phage therapy for some mycobacterial infections

Team dynamics in emergency surgery teams: results from a first international survey

Background: Emergency surgery represents a unique context. Trauma teams are often multidisciplinary and need to operate under extreme stress and time constraints, sometimes with no awareness of the trauma\u2019s causes or the patient\u2019s personal and clinical information. In this perspective, the dynamics of how trauma teams function is fundamental to ensuring the best performance and outcomes. Methods: An online survey was conducted among the World Society of Emergency Surgery members in early 2021. 402 fully filled questionnaires on the topics of knowledge translation dynamics and tools, non-technical skills, and difficulties in teamwork were collected. Data were analyzed using the software R, and reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Findings highlight how several surgeons are still unsure about the meaning and potential of knowledge translation and its mechanisms. Tools like training, clinical guidelines, and non-technical skills are recognized and used in clinical practice. Others, like patients\u2019 and stakeholders\u2019 engagement, are hardly implemented, despite their increasing importance in the modern healthcare scenario. Several difficulties in working as a team are described, including the lack of time, communication, training, trust, and ego. Discussion: Scientific societies should take the lead in offering training and support about the abovementioned topics. Dedicated educational initiatives, practical cases and experiences, workshops and symposia may allow mitigating the difficulties highlighted by the survey\u2019s participants, boosting the performance of emergency teams. Additional investigation of the survey results and its characteristics may lead to more further specific suggestions and potential solutions

A passagem pelo sistema de ensino em três gerações: classe e gênero na segmentação do sistema de ensino The passage of three generations through the schooling system: class and gender in the segmentation of the schooling system

Este artigo analisa os investimentos educativos diferenciados, realizados por três gerações de famílias inseridas em um grupo socialmente privilegiado. A análise centra-se na discussão de como, de uma geração a outra, a passagem pelo sistema de ensino esteve na base dos processos de diferenciação social entre os indivíduos. O material empírico trabalhado foi obtido no quadro de uma pesquisa de doutorado, na qual identifiquei a escola de nível secundário e as trajetórias sócio-profissionais de oitenta e duas mulheres, ex-alunas de três escolas católicas de São Paulo. Discute se modificações estruturais, de longa duração, tais como a expansão do acesso ao ensino, o investimento crescente das meninas nos caminhos da escolarização e a conotação sexual dos percursos escolares. Por meio da comparação sistemática da passagem pelo sistema de ensino e de ingresso no ensino superior é possível verificar a maneira pela qual a ordem social foi transposta para o universo escolar definindo os horizontes possíveis para cada um.<br>This paper analyses the different educational investments made by three generations of families included in a socially privileged group. It discusses how, from one generation to the other, passing through the education system was the basis of the social differentiation processes among individuals. The empirical material studied was obtained as part of a doctoral research, which identified the secondary school level and socio-professional trajectories of eighty-two women who had studied in three Catholic schools. It focuses on the structural long-duration changes, such as the expanding access to education, the increased investment in girls' schooling paths and the survival of the sexual connotation of school courses. By systematically comparing the passage through the education system and the enrollment in higher education, it shows how the social order was transferred into the school environment and how it defines the possible horizons for each person

ϒ production in p–Pb collisions at √s=8.16 TeV

ϒ production in p–Pb interactions is studied at the centre-of-mass energy per nucleon–nucleon collision √sNN = 8.16 TeV with the ALICE detector at the CERN LHC. The measurement is performed reconstructing bottomonium resonances via their dimuon decay channel, in the centre-of-mass rapidity intervals 2.03 < ycms < 3.53 and −4.46 < ycms < −2.96, down to zero transverse momentum. In this work, results on the ϒ(1S) production cross section as a function of rapidity and transverse momentum are presented. The corresponding nuclear modification factor shows a suppression of the ϒ(1S) yields with respect to pp collisions, both at forward and backward rapidity. This suppression is stronger in the low transverse momentum region and shows no significant dependence on the centrality of the interactions. Furthermore, the ϒ(2S) nuclear modification factor is evaluated, suggesting a suppression similar to that of the ϒ(1S). A first measurement of the ϒ(3S) has also been performed. Finally, results are compared with previous ALICE measurements in p–Pb collisions at √sNN = 5.02 TeV and with theoretical calculations.publishedVersio

Measurement of K*(892)(+/-) production in inelastic pp collisions at the LHC

The first results on K⁎(892)± resonance production in inelastic pp collisions at LHC energies of s=5.02, 8, and 13 TeV are presented. The K⁎(892)± has been reconstructed via its hadronic decay channel K⁎(892)→±KS0+π± with the ALICE detector. Measurements of transverse momentum distributions, pT-integrated yields, and mean transverse momenta for charged K⁎(892) are found to be consistent with previous ALICE measurements for neutral K⁎(892) within uncertainties. For pT>1 GeV/c the K⁎(892)± transverse momentum spectra become harder with increasing centre-of-mass energy from 5.02 to 13 TeV, similar to what previously observed for charged kaons and pions. For pT<1 GeV/c the K⁎(892)± yield does not evolve significantly and the abundance of K⁎(892)± relative to K is rather independent of the collision energy. The transverse momentum spectra, measured for K⁎(892)± at midrapidity in the interval 0 < pT<15 GeV/c, are not well described by predictions of different versions of PYTHIA 6, PYTHIA 8 and EPOS-LHC event generators. These generators reproduce the measured pT-integrated K⁎±/K ratios and describe well the momentum dependence for pT<2 GeV/c

Measurement of prompt D-s(+)-meson production and azimuthal anisotropy in Pb-Pb collisions at root s(NN)=5.02 TeV

The production yield and angular anisotropy of prompt Ds+ mesons were measured as a function of transverse momentum (pT) in Pb–Pb collisions at a centre-of-mass energy per nucleon pair sNN=5.02TeV collected with the ALICE detector at the LHC. Ds+ mesons and their charge conjugates were reconstructed at midrapidity (|y|10GeV/c, the measured Ds+-meson nuclear modification factor RAA is consistent with the one of non-strange D mesons within uncertainties, while at lower pT a hint for a Ds+-meson RAA larger than that of non-strange D mesons is seen. The enhanced production of Ds+ relative to non-strange D mesons is also studied by comparing the pT-dependent Ds+/D0 production yield ratios in Pb–Pb and in pp collisions. The ratio measured in Pb–Pb collisions is found to be on average higher than that in pp collisions in the interval 2<pT<8GeV/c with a significance of 2.3σ and 2.4σ for the 0–10% and 30–50% centrality intervals. The azimuthal anisotropy coefficient v2 of prompt Ds+ mesons was measured in Pb–Pb collisions in the 30–50% centrality interval and is found to be compatible with that of non-strange D mesons. The main features of the measured RAA, Ds+/D0 ratio, and v2 as a function of pT are described by theoretical calculations of charm-quark transport in a hydrodynamically expanding quark–gluon plasma including hadronisation via charm-quark recombination with light quarks from the medium. The pT-integrated production yield of Ds+ mesons is compatible with the prediction of the statistical hadronisation model

KS0KS0 and KS0K± femtoscopy in pp collisions at √s=5.02 and 13 TeV

Femtoscopic correlations with the particle pair combinations K0 SK0 S and K0 SK± are studied in pp collisions at √s = 5.02 and 13 TeV by the ALICE experiment. At both energies, boson source parameters are extracted for both pair combinations, by fitting models based on Gaussian size distributions of the sources, to the measured two-particle correlation functions. The interaction model used for the K0 SK0 S analysis includes quantum statistics and strong final-state interactions through the f0(980) and a0(980) resonances. The model used for the K0 SK± analysis includes only the final-state interaction through the a0 resonance. Source parameters extracted in the present work are compared with published values from pp collisions at √s = 7 TeV and the different pair combinations are found to be consistent. From the observation that the strength of the K0 SK0 S correlations is significantly greater than the strength of the K0 SK± correlations, the new results are compatible with the a0 resonance being a tetraquark state of the form (q1, q2, s, s), where q1 and q2 are u or d quarks

Transverse-momentum and event-shape dependence of D-meson flow harmonics in Pb–Pb collisions at √sNN = 5.02 TeV

The elliptic and triangular flow coefficients v2 and v3 of prompt D0, D+, and D∗+ mesons were measured at midrapidity (|y| < 0.8) in Pb–Pb collisions at the centre-of-mass energy per nucleon pair of √sNN = 5.02 TeV with the ALICE detector at the LHC. The D mesons were reconstructed via their hadronic decays in the transverse momentum interval 1 < pT < 36 GeV/c in central (0–10%) and semi-central (30–50%) collisions. Compared to pions, protons, and J/ψ mesons, the average D-meson vn harmonics are compatible within uncertainties with a mass hierarchy for pT 3 GeV/c, and are similar to those of charged pions for higher pT. The coupling of the charm quark to the light quarks in the underlying medium is further investigated with the application of the event-shape engineering (ESE) technique to the D-meson v2 and pT-differential yields. The D-meson v2 is correlated with average bulk elliptic flow in both central and semi-central collisions. Within the current precision, the ratios of per-event Dmeson yields in the ESE-selected and unbiased samples are found to be compatible with unity. All the measurements are found to be reasonably well described by theoretical calculations including the effects of charm-quark transport and the recombination of charm quarks with light quarks in a hydrodynamically expanding medium