Elliptic flow of charged particles in Pb-Pb collisions at 2.76 TeV

We report the first measurement of charged particle elliptic flow in Pb-Pb collisions at 2.76 TeV with the ALICE detector at the CERN Large Hadron Collider. The measurement is performed in the central pseudorapidity region (|$\eta$|<0.8) and transverse momentum range 0.2< $p_{\rm T}$< 5.0 GeV/$c$. The elliptic flow signal v$_2$, measured using the 4-particle correlation method, averaged over transverse momentum and pseudorapidity is 0.087 $\pm$ 0.002 (stat) $\pm$ 0.004 (syst) in the 40-50% centrality class. The differential elliptic flow v$_2(p_{\rm T})$ reaches a maximum of 0.2 near $p_{\rm T}$ = 3 GeV/$c$. Compared to RHIC Au-Au collisions at 200 GeV, the elliptic flow increases by about 30%. Some hydrodynamic model predictions which include viscous corrections are in agreement with the observed increase.Comment: 10 pages, 4 captioned figures, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/389

A randomized open-label phase III trial evaluating the addition of denosumab to standard first-line treatment in advanced NSCLC : the European Thoracic Oncology Platform (ETOP) and European Organisation for Research and Treatment of Cancer (EORTC) SPLENDOUR trial

Introduction Receptor activator of NF-kB ligand stimulates NF-kB–dependent cell signaling and acts as the primary signal for bone resorption. Retrospective analysis of a large trial comparing denosumab versus zoledronic acid in bone metastatic solid tumors suggested significant overall survival (OS) advantage for patients with lung cancer with denosumab (p = 0.01). The randomized open-label phase III SPLENDOUR trial was designed to evaluate whether the addition of denosumab to standard first-line platinum-based doublet chemotherapy improved OS in advanced NSCLC. Methods Patients with stage IV NSCLC were randomized in a 1:1 ratio to either chemotherapy with or without denosumab (120 mg every 3–4 wks), stratified by the presence of bone metastases (at diagnosis), Eastern Cooperative Oncology Group performance status, histology, and region. To detect an OS increase from 9 to 11.25 months (hazard ratio [HR] = 0.80), 847 OS events were required. The trial closed prematurely owing to decreasing accrual rate. Results A total of 514 patients were randomized, with 509 receiving one or more doses of the assigned treatment (chemotherapy: 252, chemotherapy-denosumab: 257). The median age was 66.1 years, 71% were men, and 59% were former smokers. Bone metastases were identified in 275 patients (53%). Median OS (95% confidence interval [CI]) was 8.7 (7.6–11.0) months in the control arm versus 8.2 (7.5–10.4) months in the chemotherapy-denosumab arm (HR = 0.96; 95% CI: 0.78–1.19; one-sided p = 0.36). For patients with bone metastasis, HR was 1.02 (95% CI: 0.77–1.35), whereas for those without, HR was 0.90 (95% CI: 0.66–1.23). Adverse events grade 3 or greater were observed in 40.9%, 5.2%, 8.7% versus 45.5%, 10.9%, 10.5% of patients. Conditional power for OS benefit was less than or equal to 10%. Conclusions Denosumab was well-tolerated without unexpected safety concerns. There was no OS improvement for denosumab when added to chemotherapy in the intention-to-treat population and the subgroups with and without bone metastases. Our data do not provide evidence of a clinical benefit for denosumab in patients with NSCLC without bone metastases

The importance of hospital re-accreditation: improving the timeliness of laboratory critical value reporting

Background: Patient safety is the main issue in healthcare services nowadays. Delaying to inform the critical value of laboratory results is a significant source of harm for the patient. The aim of this study is to compare the timeliness of laboratory critical value reporting before and after re-accreditation as one of the service quality indicators in Hospital X. Methods: This study was done by using observational cross-sectional in Hospital X on January - February 2020 with total sampling method of critical value reporting to the responsible clinician that originated from Intensive Care Unit (ICU), Verlos Kamer (VK), and inpatient ward (IW) 1-6 from January-December 2019. The timeliness of reporting was counted since the laboratory result was obtained until received by the responsible clinician within £ 30 minutes and categorized as "On time" or "Late". Results: During 2019, there were 816 reporting which has been done before re-accreditation (511) and after re-accreditation (305) with 17 kinds of tests. The most reported test was platelet with 349 (before re-accreditation) and 101 (after re-accreditation), whilst SGOT/SGPT and albumin were the fewest one. The lowest timeliness of reporting percentage was 76,00% (February), whilst the highest was 98,48% (November). The timeliness of reporting's percentage was 84,34% (before re-accreditation) and 94,43% (after re-accreditation). The statistical analysis result revealed Pearson Chi-Square correlation was 18,535 with significance 0,000 and 3,145 odds ratio which shows that re-accreditation could significantly increase the timeliness of critical value reporting three times. Conclusion: This result showed that re-accreditation could affect the timeliness of laboratory critical value reporting to the responsible clinicians. Keywords: re-accreditation, critical value, laboratory, patient safety, hospital &nbsp; Abstrak Latar belakang: Keselamatan pasien merupakan isu utama dalam pelayanan kesehatan. Tertundanya komunikasi hasil nilai kritis laboratorium merupakan sumber bahaya yang signifikan terhadap pasien. Penelitian ini bertujuan untuk membandingkan ketepatan waktu pelaporan nilai kritis laboratorium sebelum dan setelah reakreditasi sebagai salah satu indikator mutu di RS X. Metode: Penelitian dilakukan dengan cara observasional dengan metode cross sectional di RS X pada Januari - Februari 2020 dengan total sampling laporan nilai kritis kepada Dokter Penanggung Jawab Pasien (DPJP) yang berasal dari ruang Intensive Care Unit (ICU), Verlos Kamer (VK), dan ruang rawat inap 1 – 6 sejak Januari – Desember 2019. Ketepatan waktu pelaporan dihitung sejak hasil pemeriksaan didapatkan hingga diterima oleh DPJP dalam waktu £ 30 menit dan dinyatakan sebagai "Tepat Waktu" atau "Terlambat". Hasil: Selama tahun 2019, terdapat 816 pelaporan yang dilakukan sebelum akreditasi (511) dan setelahnya (305) dengan 17 jenis pemeriksaan. Pemeriksaan trombosit menjadi yang paling banyak dilaporkan yaitu 349 (sebelum akreditasi) dan 101 (setelah akreditasi), sedangkan SGOT/SGPT dan albumin menjadi yang paling sedikit. Persentase ketepatan waktu pelaporan paling rendah adalah 76,00% (Februari) sedangkan yang paling tinggi adalah 98,48% (November). Persentase ketepatan waktu pelaporan didapatkan 84,34% (sebelum akreditasi) dan 94,43% (setelah akreditasi). Hasil analisis statistik didapatkan korelasi Pearson Chi-Square 18,535 dengan signifikansi 0,000 dan Odds ratio 3,145 menunjukkan re-akreditasi mampu meningkatkan kemungkinan ketepatan waktu pelaporan nilai kritis sebesar tiga kali lipat. Kesimpulan: Hal ini menunjukkan bahwa re-akreditasi mampu mempengaruhi ketepatan waktu pelaporan nilai laboratorium kritis kepada DPJP. Kata kunci: re-akreditasi, nilai kritis, laboratorium, keselamatan pasien, rumah sakit

Complementary feeding in preterm infants: A systematic review

Background: This systematic review summarizes available literature regarding complementary feeding (CF) in preterm infants, with or without comorbidities that may interfere with oral functions. Methods: A literature search was conducted in PubMed and the Cochrane Library. Studies relating to preterm infants (gestational age &lt;37 weeks) were included in the analysis. Retrieved papers were categorized according to their main topic: CF timing and quality; clinical outcome; recommendations; strategies in infants with oral dysfunction. Results: The literature search in PubMed retrieved 6295 papers. Forty met inclusion criteria. The Cochrane search identified four additional study protocols, two related to studies included among PubMed search results, and two ongoing trials. Moreover, among 112 papers dealing with oral feeding, four aiming at managing CF in preterm infants with oral dysfunctions were identified. Conclusions: The available literature does not provide specific guidelines on the management of CF in preterm infants, who are generally weaned earlier than term infants. There is a paucity of data regarding the relationship between CF and growth/quality of growth and health outcomes in preterm infants. It could be suggested to start CF between five and eight months of chronological age if infants have reached three months corrected age and if they have acquired the necessary developmental skills. An individualized multidisciplinary intervention is advisable for preterm infants with oral dysfunctions