Adherence to a procalcitonin-guided antibiotic treatment protocol in patients with severe sepsis and septic shock

Background: In randomised controlled trials, procalcitonin (PCT)-guided antibiotic treatment has been proven to significantly reduce length of antibiotic therapy in intensive care unit (ICU) patients. However, concern was raised on low protocol adherence and high rates of overruling, and thus the value of PCT-guided treatment in real clinical life outside study conditions remains unclear. In this study, adherence to a PCT protocol to guide antibiotic treatment in patients with severe sepsis and septic shock was analysed. Methods: From 2012 to 2014, surgical ICU patients with severe sepsis or septic shock were retrospectively screened for PCT measurement series appropriate to make treatment decisions on antibiotic therapy. We compared (1) patients with appropriate PCT measurement series to patients without appropriate series; (2) patients who reached the antibiotic stopping advice threshold (PCT < 0.5 ng/mL and/or decrease to 10% of peak level) to patients who did not reach a stopping advice threshold; and (3) patients who were treated adherently to the PCT protocol to non-adherently treated patients. The groups were compared in terms of antibiotic treatment duration, PCT kinetics, and other clinical outcomes. Results: Of 81 patients with severe sepsis or septic shock, 14 were excluded due to treatment restriction or short course in the ICU. The final analysis was performed on 67 patients. Forty-two patients (62.7%) had appropriate PCT measurement series. In patients with appropriate PCT series, median initial PCT (p = 0.001) and peak PCT levels (p < 0.001) were significantly higher compared to those with non-appropriate series. In 26 patients with appropriate series, PCT levels reached an antibiotic stopping advice. In 8 of 26 patients with stopping advice, antibiotics were discontinued adherently to the PCT protocol (30.8%). Patients with adherently discontinued antibiotics had a shorter antibiotic treatment (7d [IQR 6–9] vs. 12d [IQR 9–16]; p = 0.002). No differences were seen in terms of other clinical outcomes. Conclusion: In patients with severe sepsis and septic shock, procalcitonin testing was irregular and adherence to a local PCT protocol was low in real clinical life. However, adherently treated patients had a shorter duration of antibiotic treatment without negative clinical outcomes. Procalcitonin peak values and kinetics had a clear impact on the regularity of PCT testing

High-quality single InGaAs/GaAs quantum dot growth on a CMOS-compatible silicon substrate for quantum photonic applications

We present the direct heteroepitaxial growth of high-quality InGaAs quantum dots on silicon, enabling scalable, cost-effective quantum photonics devices compatible with CMOS technology. GaAs heterostructures are grown on silicon via a GaP buffer and defect-reducing layers. These epitaxial quantum dots exhibit optical properties akin to those on traditional GaAs substrates, promising vast potential for the heteroepitaxy approach. They demonstrate strong multi-photon suppression with $g^{(2)}(\tau)=(3.7\pm 0.2) \times 10^{-2}$ and high photon indistinguishability $V=(66\pm 19)$% under non-resonance excitation. We achieve up to ($18\pm 1$)% photon extraction efficiency with a backside distributed Bragg mirror, marking a crucial step toward silicon-based quantum nanophotonics

Wigner time delay induced by a single quantum dot

The research leading to these results has received funding from the European Research Council (ERC) under the European Union's Seventh Framework ERC Grant Agreement No. 615613 and from the German Research Foundation Project (DFG) No. RE2974/5-1. A.C. and J.S. gratefully acknowledge the support by the DFG through project B1 of the SFB 910. The Wurzburg group is grateful for support by the State of Bavaria.Resonant scattering of weak coherent laser pulses on a single two-level system (TLS) realized in a semiconductor quantum dot is investigated with respect to a time delay between incoming and scattered light. This type of time delay was predicted by Wigner in 1955 for purely coherent scattering and was confirmed for an atomic system in 2013 [R. Bourgain et al., Opt. Lett. 38, 1963 (2013)]. In the presence of electron-phonon interaction we observe deviations from Wigner’s theory related to incoherent and strongly non-Markovian scattering processes which are hard to quantify via a detuning-independent pure dephasing time. We observe detuning-dependent Wigner delays of up to 530 ps in our experiments which are supported quantitatively by microscopic theory allowing for pure dephasing times of up to 950 ps.PostprintPostprintPeer reviewe

Study of ordered hadron chains with the ATLAS detector

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A search for resonances decaying into a Higgs boson and a new particle X in the XH→qqbb final state with the ATLAS detector

A search for heavy resonances decaying into a Higgs boson ($H$) and a new particle ($X$) is reported, utilizing 36.1 fb$^{-1}$ of proton-proton collision data at $\sqrt{s} =$ 13 TeV collected during 2015 and 2016 with the ATLAS detector at the CERN Large Hadron Collider. The particle $X$ is assumed to decay to a pair of light quarks, and the fully hadronic final state $XH \rightarrow q\bar q'b\bar b$ is analysed. The search considers the regime of high $XH$ resonance masses, where the $X$ and $H$ bosons are both highly Lorentz-boosted and are each reconstructed using a single jet with large radius parameter. A two-dimensional phase space of $XH$ mass versus $X$ mass is scanned for evidence of a signal, over a range of $XH$ resonance mass values between 1 TeV and 4 TeV, and for $X$ particles with masses from 50 GeV to 1000 GeV. All search results are consistent with the expectations for the background due to Standard Model processes, and 95% CL upper limits are set, as a function of $XH$ and $X$ masses, on the production cross-section of the $XH\rightarrow q\bar q'b\bar b$ resonance

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements