44 research outputs found
Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial
Background:
Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment.
Methods:
This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal.
Results:
Enrolment began in 2016, and the study is expected to end in 2020.
Conclusions:
This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission.
Clinical trial reference number:
EudraCT 2015-001410-1
Proposed changes to management of lower respiratory tract infections in response to the Clostridium difficile epidemic
Is There a Signalling Role for Public Wages? Evidence for the Euro Area Based on Macro Data
Sub-National Revenue Mobilization in Latin American and Caribbean Countries: The Case of Argentina
A Search for Photons with Energies Above 2X10(17) eV Using Hybrid Data from the Low-Energy Extensions of the Pierre Auger Observatory
Ultra-high-energy photons with energies exceeding 10(17) eV offer a wealth of connections to different aspects of cosmic-ray astrophysics as well as to gamma-ray and neutrino astronomy. The recent observations of photons with energies in the 10(15) eV range further motivate searches for even higher-energy photons. In this paper, we present a search for photons with energies exceeding 2 x 10(17) eV using about 5.5 yr of hybrid data from the low-energy extensions of the Pierre Auger Observatory. The upper limits on the integral photon flux derived here are the most stringent ones to date in the energy region between 10(17) and 10(18) eV
Characterizing the initial conditions of heavy-ion collisions at the LHC with mean transverse momentum and anisotropic flow correlations
Correlations between mean transverse momentum and anisotropic flow coefficients or are measured as a function of centrality in Pb–Pb and Xe–Xe collisions at sqrt(sNN) = 5.02 TeV and 5.44 TeV, respectively, with ALICE. In addition, the recently proposed higher-order correlation between [pt], v2, and v3 is measured for the first time, which shows an anticorrelation for the presented centrality ranges. These measurements are compared with hydrodynamic calculations using IP-Glasma and TRENTO initial-state shapes, the former based on the Color Glass Condensate effective theory with gluon saturation, and the latter a parameterized model with nucleons as the relevant degrees of freedom. The data are better described by the IP-Glasma rather than the TRENTO based calculations. In particular, Trajectum and JETSCAPE predictions, both based on the TRENTO initial state model but with different parameter settings, fail to describe the measurements. As the correlations between [pt] and vn are mainly driven by the correlations of the size and the shape of the system in the initial state, these new studies pave a novel way to characterize the initial state and help pin down the uncertainty of the extracted properties of the quark–gluon plasma recreated in relativistic heavy-ion collisions
Measurement of the non-prompt D-meson fraction as a function of multiplicity in proton-proton collisions at = 13 TeV
The fractions of non-prompt (i.e. originating from beauty-hadron decays) D0
and D+ mesons with respect to the inclusive yield are measured as a function of the
charged-particle multiplicity in proton-proton collisions at a centre-of-mass energy of √s =
13 TeV with the ALICE detector at the LHC. The results are reported in intervals of
transverse momentum (pT) and integrated in the range 1 < pT < 24 GeV/c. The fraction
of non-prompt D0 and D+ mesons is found to increase slightly as a function of pT in
all the measured multiplicity intervals, while no significant dependence on the charged-
particle multiplicity is observed. In order to investigate the production and hadronisation
mechanisms of charm and beauty quarks, the results are compared to PYTHIA 8 as well
as EPOS 3 and EPOS 4 Monte Carlo simulations, and to calculations based on the colour
glass condensate including three-pomeron fusion
General balance functions of identified charged hadron pairs of (pi,K,p) in Pb-Pb collisions at 2.76 TeV
First measurements of balance functions (BFs) of all combinations of identified charged hadron ( π , K, p)
pairs in Pb–Pb collisions at √sNN = 2.76 TeV recorded by the ALICE detector are presented. The BF
measurements are carried out as two-dimensional differential correlators versus the relative rapidity
(delta-y) and azimuthal angle (delta-φ) of hadron pairs, and studied as a function of collision centrality. The delta-φ
dependence of BFs is expected to be sensitive to the light quark diffusivity in the quark–gluon plasma.
While the BF azimuthal widths of all pairs substantially decrease from peripheral to central collisions, the
longitudinal widths exhibit mixed behaviors: BFs of π π and cross-species pairs narrow significantly in
more central collisions, whereas those of KK and pp are found to be independent of collision centrality.
This dichotomy is qualitatively consistent with the presence of strong radial flow effects and the existence
of two stages of quark production in relativistic heavy-ion collisions. Finally, the first measurements of
the collision centrality evolution of BF integrals are presented, with the observation that charge balancing
fractions are nearly independent of collision centrality in Pb–Pb collisions. Overall, the results presented
provide new and challenging constraints for theoretical models of hadron production and transport in
relativistic heavy-ion collisions