646 research outputs found
Theoretical study of incoherent phi photoproduction on a deuteron target
We study the photoproduction of phi mesons in deuteron, paying attention to
the modification of the cross section from bound protons to the free ones with
the aim of comparing with recent results at LEPS. For this purpose we take into
account Fermi motion in single scattering and rescattering of the phi to
account for phi absorption on a second nucleon as well as the rescattering of
the proton. We find that the contribution of the double scattering is much
smaller than the typical cross section of gamma p to phi p in free space, which
implies a very small screening of the phi production in deuteron. The
contribution from the proton rescattering, on the other hand, is found to be
not negligible compared to the cross section of gamma p to phi p in free space,
and leads to a moderate reduction of the phi photoproduction cross section on a
deuteron at forward angles if LEPS set up is taken into account. The Fermi
motion allows contribution of the single scattering in regions forbidden by
phase space in the free case. In particular, we find that for momentum
transferred squared close to the maximum value, the Fermi motion changes
drastically the shape of d sigma / dt, to the point that the ratio of this
cross section to the free one becomes very sensitive to the precise value of t
chosen, or the size of the bin used in an experimental analysis. Hence, this
particular region of t does not seem the most indicated to find effects of a
possible phi absorption in the deuteron. This reaction is studied theoretically
as a function of t and the effect of the experimental angular cuts at LEPS is
also discussed, providing guidelines for future experimental analyses of the
reaction.Comment: 17 pages, 16 figure
Mechanisms linking excess adiposity and carcinogenesis promotion
Obesity constitutes one of the most important metabolic diseases being associated to insulin resistance development and increased cardiovascular risk. Association between obesity and cancer has also been well established for several tumor types, such as breast cancer in post-menopausal women, colorectal, and prostate cancer. Cancer is the first death cause in developed countries and the second one in developing countries, with high incidence rates around the world. Furthermore, it has been estimated that 15-20% of all cancer deaths may be attributable to obesity. Tumor growth is regulated by interactions between tumor cells and their tissue microenvironment. In this sense, obesity may lead to cancer development through dysfunctional adipose tissue and altered signaling pathways. In this review, three main pathways relating obesity and cancer development are examined: (i) inflammatory changes leading to macrophage polarization and altered adipokine profile; (ii) insulin resistance development; and (iii) adipose tissue hypoxia. Since obesity and cancer present a high prevalence, the association between these conditions is of great public health significance and studies showing mechanisms by which obesity lead to cancer development and progression are needed to improve prevention and management of these diseases
Intensive care unit discharge to the ward with a tracheostomy cannula as a risk factor for mortality: A prospective, multicenter propensity analysis
To analyze the impact of decannulation before intensive care unit
discharge on ward survival in nonexperimental conditions. DESIGN: Prospective,
observational survey. SETTING: Thirty-one intensive care units throughout Spain.
PATIENTS: All patients admitted from March 1, 2008 to May 31, 2008.
INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: At intensive care unit
discharge, we recorded demographic variables, severity score, and intensive care
unit treatments, with special attention to tracheostomy. After intensive care
unit discharge, we recorded intensive care unit readmission and hospital
survival. STATISTICS: Multivariate analyses for ward mortality, with Cox
proportional hazard ratio adjusted for propensity score for intensive care unit
decannulation. We included 4,132 patients, 1,996 of whom needed mechanical
ventilation. Of these, 260 (13%) were tracheostomized and 59 (23%) died in the
intensive care unit. Of the 201 intensive care unit tracheostomized survivors, 60
were decannulated in the intensive care unit and 141 were discharged to the ward
with cannulae in place. Variables associated with intensive care unit
decannulation (non-neurologic disease [85% vs. 64%], vasoactive drugs [90% vs.
76%], parenteral nutrition [55% vs. 33%], acute renal failure [37% vs. 23%], and
good prognosis at intensive care unit discharge [40% vs. 18%]) were included in a
propensity score model for decannulation. Crude ward mortality was similar in
decannulated and nondecannulated patients (22% vs. 23%); however, after
adjustment for the propensity score and Sabadell Score, the presence of a
tracheostomy cannula was not associated with any survival disadvantage with an
odds ratio of 0.6 [0.3-1.2] (p=.1). CONCLUSION: In our multicenter setting,
intensive care unit discharge before decannulation is not a risk factor
Prognostic utility of serum free light chain ratios and heavy-light chain ratios in multiple myeloma in three PETHEMA/GEM phase III clinical trials
We investigated the prognostic impact and clinical utility of serum free light chains (sFLC) and serum heavy-light chains (sHLC) in patients with multiple myeloma treated according to the GEM2005MENOS65, GEM2005MAS65, and GEM2010MAS65 PETHEMA/GEM phase III clinical trials. Serum samples collected at diagnosis were retrospectively analyzed for sFLC (n = 623) and sHLC (n = 183). After induction or autologous transplantation, 309 and 89 samples respectively were available for sFLC and sHLC assays. At diagnosis, a highly abnormal (HA) sFLC ratio (sFLCr) (32) was not associated with higher risk of progression. After therapy, persistence of involved-sFLC levels >100 mg/L implied worse survival (overall survival [OS], P = 0.03; progression-free survival [PFS], P = 0.007). Among patients that achieved a complete response, sFLCr normalization did not necessarily indicate a higher quality response. We conducted sHLC investigations for IgG and IgA MM. Absolute sHLC values were correlated with monoclonal protein levels measured with serum protein electrophoresis. At diagnosis, HA-sHLCrs (73) showed a higher risk of progression (P = 0.006). Additionally, involved-sHLC levels >5 g/L after treatment were associated with shorter survival (OS, P = 0.001; PFS, P = 0.018). The HA-sHLCr could have prognostic value at diagnosis; absolute values of involved-sFLC >100 mg/L and involved-sHLC >5 g/L could have prognostic value after treatment
Diastolic shock index and clinical outcomes in patients with septic shock
Background: Loss of vascular tone is a key pathophysiological feature of septic shock. Combination of gradual diastolic hypotension and tachycardia could reflect more serious vasodilatory conditions. We sought to evaluate the relationships between heart rate (HR) to diastolic arterial pressure (DAP) ratios and clinical outcomes during early phases of septic shock. Methods: Diastolic shock index (DSI) was defined as the ratio between HR and DAP. DSI calculated just before starting vasopressors (Pre-VPs/DSI) in a preliminary cohort of 337 patients with septic shock (January 2015 to February 2017) and at vasopressor start (VPs/DSI) in 424 patients with septic shock included in a recent randomized controlled trial (ANDROMEDA-SHOCK; March 2017 to April 2018) was partitioned into five quantiles to estimate the relative risks (RR) of death with respect to the mean risk of each population (assumed to be 1). Matched HR and DAP subsamples were created to evaluate the effect of the individual components of the DSI on RRs. In addition, time-course of DSI and interaction between DSI and vasopressor dose (DSI*NE.dose) were compared between survivors and non-survivors from both populations, while ROC curves were used to identify variables predicting mortality. Finally, as exploratory observation, effect of early start of vasopressors was evaluated at each Pre-VPs/DSI quintile from the preliminary cohort. Results: Risk of death progressively increased at gradual increments of Pre-VPs/DSI or VPs/DSI (One-way ANOVA, p < 0.001). Progressive DAP decrease or HR increase was associated with higher mortality risks only when DSI concomitantly increased. Areas under the ROC curve for Pre-VPs/DSI, SOFA and initial lactate were similar, while mean arterial pressure and systolic shock index showed poor performances to predict mortality. Time-course of DSI and DSI*NE.dose was significantly higher in non-survivors from both populations (repeated-measures ANOVA, p < 0.001). Very early start of vasopressors exhibited an apparent benefit at higher Pre-VPs/DSI quintile. Conclusions: DSI at pre-vasopressor and vasopressor start points might represent a very early identifier of patients at high risk of death. Isolated DAP or HR values do not clearly identify such risk. Usefulness of DSI to trigger or to direct therapeutic interventions in early resuscitation of septic shock need to be addressed in future studies
Effects of very early start of norepinephrine in patients with septic shock: a propensity score-based analysis
BACKGROUND: Optimal timing for the start of vasopressors (VP) in septic shock has not been widely studied since it is assumed that fluids must be administered in advance. We sought to evaluate whether a very early start of VP, even without completing the initial fluid loading, might impact clinical outcomes in septic shock. METHODS: A total of 337 patients with sepsis requiring VP support for at least 6 h were initially selected from a prospectively collected database in a 90-bed mixed-ICU during a 24-month period. They were classified into very-early (VE-VPs) or delayed vasopressor start (D-VPs) categories according to whether norepinephrine was initiated or not within/before the next hour of the first resuscitative fluid load. Then, VE-VPs (n = 93) patients were 1:1 propensity matched to D-VPs (n = 93) based on age; source of admission (emergency room, general wards, intensive care unit); chronic and acute comorbidities; and lactate, heart rate, systolic, and diastolic pressure at vasopressor start. A risk-adjusted Cox proportional hazard model was fitted to assess the association between VE-VPs and day 28 mortality. Finally, a sensitivity analysis was performed also including those patients requiring VP support for less than 6 h. RESULTS: Patients subjected to VE-VPs received significantly less resuscitation fluids at vasopressor starting (0[0-510] vs. 1500[650-2300] mL, p < 0.001) and during the first 8 h of resuscitation (1100[500-1900] vs. 2600[1600-3800] mL, p < 0.001), with no significant increase in acute renal failure and/or renal replacement therapy requirements. VE-VPs was related with significant lower net fluid balances 8 and 24 h after VPs. VE-VPs was also associated with a significant reduction in the risk of death compared to D-VPs (HR 0.31, CI95% 0.17-0.57, p < 0.001) at day 28. Such association was maintained after including patients receiving vasopressors for < 6 h. CONCLUSION: A very early start of vasopressor support seems to be safe, might limit the amount of fluids to resuscitate septic shock, and could lead to better clinical outcomes
Coherent electron-phonon coupling and polaron-like transport in molecular wires
We present a technique to calculate the transport properties through
one-dimensional models of molecular wires. The calculations include inelastic
electron scattering due to electron-lattice interaction. The coupling between
the electron and the lattice is crucial to determine the transport properties
in one-dimensional systems subject to Peierls transition since it drives the
transition itself. The electron-phonon coupling is treated as a quantum
coherent process, in the sense that no random dephasing due to electron-phonon
interactions is introduced in the scattering wave functions. We show that
charge carrier injection, even in the tunneling regime, induces lattice
distortions localized around the tunneling electron. The transport in the
molecular wire is due to polaron-like propagation. We show typical examples of
the lattice distortions induced by charge injection into the wire. In the
tunneling regime, the electron transmission is strongly enhanced in comparison
with the case of elastic scattering through the undistorted molecular wire. We
also show that although lattice fluctuations modify the electron transmission
through the wire, the modifications are qualitatively different from those
obtained by the quantum electron-phonon inelastic scattering technique. Our
results should hold in principle for other one-dimensional atomic-scale wires
subject to Peierls transitions.Comment: 21 pages, 8 figures, accepted for publication in Phys. Rev. B (to
appear march 2001
Search for direct production of charginos and neutralinos in events with three leptons and missing transverse momentum in √s = 7 TeV pp collisions with the ATLAS detector
A search for the direct production of charginos and neutralinos in final states with three electrons or muons and missing transverse momentum is presented. The analysis is based on 4.7 fb−1 of proton–proton collision data delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in three signal regions that are either depleted or enriched in Z-boson decays. Upper limits at 95% confidence level are set in R-parity conserving phenomenological minimal supersymmetric models and in simplified models, significantly extending previous results
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