Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs

Direct photon elliptic flow in Pb-Pb collisions at root s(NN)=2.76 TeV

The elliptic flow of inclusive and direct photons was measured at mid-rapidity in two centrality classes 0-20% and 20-40% in Pb-Pb collisions at root s(NN) = 2.76 TeV by ALICE. Photons were detected with the highly segmented electromagnetic calorimeter PHOS and via conversions in the detector material with the e(broken vertical bar)e pairs reconstructed in the central tracking system. The results of the two methods were combined and the direct-photon elliptic flow was extracted in the transverse momentum range 0.9 < p(T) < 6.2 GeV/c. A comparison to RHIC data shows a similar magnitude of the measured direct-photon elliptic flow. Hydrodynamic and transport model calculations are systematically lower than the data, but are found to be compatible. (C) 2018 The Author. Published by Elsevier B.V.Peer reviewe

Increasing the Astrophysical Reach of the Advanced Virgo Detector via the Application of Squeezed Vacuum States of Light

Current interferometric gravitational-wave detectors are limited by quantum noise over a wide range of their measurement bandwidth. One method to overcome the quantum limit is the injection of squeezed vacuum states of light into the interferometer’s dark port. Here, we report on the successful application of this quantum technology to improve the shot noise limited sensitivity of the Advanced Virgo gravitational-wave detector. A sensitivity enhancement of up to 3.2±0.1  dB beyond the shot noise limit is achieved. This nonclassical improvement corresponds to a 5%–8% increase of the binary neutron star horizon. The squeezing injection was fully automated and over the first 5 months of the third joint LIGO-Virgo observation run O3 squeezing was applied for more than 99% of the science time. During this period several gravitational-wave candidates have been recorded

Wses Jerusalem Guidelines For Diagnosis And Treatment Of Acute Appendicitis

Acute appendicitis (AA) is among the most common cause of acute abdominal pain. Diagnosis of AA is challenging; a variable combination of clinical signs and symptoms has been used together with laboratory findings in several scoring systems proposed for suggesting the probability of AA and the possible subsequent management pathway. The role of imaging in the diagnosis of AA is still debated, with variable use of US, CT and MRI in different settings worldwide. Up to date, comprehensive clinical guidelines for diagnosis and management of AA have never been issued. In July 2015, during the 3rd World Congress of the WSES, held in Jerusalem (Israel), a panel of experts including an Organizational Committee and Scientific Committee and Scientific Secretariat, participated to a Consensus Conference where eight panelists presented a number of statements developed for each of the eight main questions about diagnosis and management of AA. The statements were then voted, eventually modified and finally approved by the participants to The Consensus Conference and lately by the board of co-authors. The current paper is reporting the definitive Guidelines Statements on each of the following topics: 1) Diagnostic efficiency of clinical scoring systems, 2) Role of Imaging, 3) Non-operative treatment for uncomplicated appendicitis, 4) Timing of appendectomy and in-hospital delay, 5) Surgical treatment 6) Scoring systems for intra-operative grading of appendicitis and their clinical usefulness 7) Non-surgical treatment for complicated appendicitis: abscess or phlegmon 8) Pre-operative and post-operative antibiotics.1

Study of B Meson Production in p plus Pb Collisions at root s(NN)=5.02 TeV Using Exclusive Hadronic Decays

Peer reviewe

Measuring (KSK +/-)-K-0 interactions using pp collisions at root s=7 TeV

We present the first measurements of femtoscopic correlations between the K-S(0) and K-+/- particles in pp collisions at root s = 7 TeV measured by the ALICE experiment. The observed femtoscopic correlations are consistent with final-state interactions proceeding solely via the a(0)(980) resonance. The extracted kaon source radius and correlation strength parameters for (KSK-)-K-0 are found to be equal within the experimental uncertainties to those for (KSK+)-K-0. Results of the present study are compared with those from identical-kaon femtoscopic studies also performed with pp collisions at root s = 7 TeV by ALICE and with a (KSK +/-)-K-0 measurement in Pb-Pb collisions at root s(NN) = 2.76 TeV. Combined with the Pb-Pb results, our pp analysis is found to be compatible with the interpretation of the a (980) having a tetraquark structure instead of that of a diquark. (C) 2018 Published by Elsevier B.V.Peer reviewe

String Synchronizing Sets: Sublinear-Time BWT Construction and Optimal LCE Data Structure

Burrows-Wheeler transform (BWT) is an invertible text transformation that, given a text $T$ of length $n$, permutes its symbols according to the lexicographic order of suffixes of $T$. BWT is one of the most heavily studied algorithms in data compression with numerous applications in indexing, sequence analysis, and bioinformatics. Its construction is a bottleneck in many scenarios, and settling the complexity of this task is one of the most important unsolved problems in sequence analysis that has remained open for 25 years. Given a binary string of length $n$, occupying $O(n/\log n)$ machine words, the BWT construction algorithm due to Hon et al. (SIAM J. Comput., 2009) runs in $O(n)$ time and $O(n/\log n)$ space. Recent advancements (Belazzougui, STOC 2014, and Munro et al., SODA 2017) focus on removing the alphabet-size dependency in the time complexity, but they still require $\Omega(n)$ time. In this paper, we propose the first algorithm that breaks the $O(n)$-time barrier for BWT construction. Given a binary string of length $n$, our procedure builds the Burrows-Wheeler transform in $O(n/\sqrt{\log n})$ time and $O(n/\log n)$ space. We complement this result with a conditional lower bound proving that any further progress in the time complexity of BWT construction would yield faster algorithms for the very well studied problem of counting inversions: it would improve the state-of-the-art $O(m\sqrt{\log m})$-time solution by Chan and P\v{a}tra\c{s}cu (SODA 2010). Our algorithm is based on a novel concept of string synchronizing sets, which is of independent interest. As one of the applications, we show that this technique lets us design a data structure of the optimal size $O(n/\log n)$ that answers Longest Common Extension queries (LCE queries) in $O(1)$ time and, furthermore, can be deterministically constructed in the optimal $O(n/\log n)$ time.Comment: Full version of a paper accepted to STOC 201

Improved Distributed Algorithms for Exact Shortest Paths

Computing shortest paths is one of the central problems in the theory of distributed computing. For the last few years, substantial progress has been made on the approximate single source shortest paths problem, culminating in an algorithm of Becker et al. [DISC'17] which deterministically computes $(1+o(1))$-approximate shortest paths in $\tilde O(D+\sqrt n)$ time, where $D$ is the hop-diameter of the graph. Up to logarithmic factors, this time complexity is optimal, matching the lower bound of Elkin [STOC'04]. The question of exact shortest paths however saw no algorithmic progress for decades, until the recent breakthrough of Elkin [STOC'17], which established a sublinear-time algorithm for exact single source shortest paths on undirected graphs. Shortly after, Huang et al. [FOCS'17] provided improved algorithms for exact all pairs shortest paths problem on directed graphs. In this paper, we present a new single-source shortest path algorithm with complexity $\tilde O(n^{3/4}D^{1/4})$. For polylogarithmic $D$, this improves on Elkin's $\tilde{O}(n^{5/6})$ bound and gets closer to the $\tilde{\Omega}(n^{1/2})$ lower bound of Elkin [STOC'04]. For larger values of $D$, we present an improved variant of our algorithm which achieves complexity $\tilde{O}\left( n^{3/4+o(1)}+ \min\{ n^{3/4}D^{1/6},n^{6/7}\}+D\right)$, and thus compares favorably with Elkin's bound of $\tilde{O}(n^{5/6} + n^{2/3}D^{1/3} + D )$ in essentially the entire range of parameters. This algorithm provides also a qualitative improvement, because it works for the more challenging case of directed graphs (i.e., graphs where the two directions of an edge can have different weights), constituting the first sublinear-time algorithm for directed graphs. Our algorithm also extends to the case of exact $\kappa$-source shortest paths...Comment: 26 page

Approximate Near Neighbors for General Symmetric Norms

We show that every symmetric normed space admits an efficient nearest neighbor search data structure with doubly-logarithmic approximation. Specifically, for every $n$, $d = n^{o(1)}$, and every $d$-dimensional symmetric norm $\|\cdot\|$, there exists a data structure for $\mathrm{poly}(\log \log n)$-approximate nearest neighbor search over $\|\cdot\|$ for $n$-point datasets achieving $n^{o(1)}$ query time and $n^{1+o(1)}$ space. The main technical ingredient of the algorithm is a low-distortion embedding of a symmetric norm into a low-dimensional iterated product of top-$k$ norms. We also show that our techniques cannot be extended to general norms.Comment: 27 pages, 1 figur

Reasons for initiating long-acting antipsychotics in psychiatric practice: findings from the STAR Network Depot Study

Background: Long Acting Injectable (LAI) antipsychotics have been claimed to ensure treatment adherence and possibly reduce the daily burden of oral formulations. So far, only surveys investigating the theoretical prescribing attitudes of clinicians have been employed. On this basis, we aimed to investigate reasons for prescribing LAIs in a real- world, unselected sample of patients. Methods: The STAR Network Depot Study is an observational, multicentre study consecutively enrolling adults initiating a LAI over a 12-months period. Clinical severity was assessed with the Brief Psychiatric Rating Scale, and patient\u2019s attitude toward medications with the Drug Attitude Inventory 10 items. Psychiatrists recorded reasons for LAI prescribing for each study participant. Responses were grouped into six non- mutually exclusive categories: aggressiveness, patient engagement, ease of drug taking, side-effects, stigma, adherence. Results: Of the 451 patients included, two-thirds suffered from chronic psychoses. Improving patient engagement with the outpatient psychiatric service was the most common reason for prescribing LAIs (almost 80% of participants), followed by increasing treatment adherence (57%), decreasing aggressiveness (54%), and improving ease of drug taking (52%). After adjusting for confounders, logistic regression analyses showed that reasons for LAI use were associated with LAI choice (e.g. first-generation LAIs for reducing aggressiveness). Conclusions: Despite the wide availability of novel LAI formulation and the emphasis on their wider use, our data suggest that the main reasons for LAI use have remained substantially unchanged over the years, focusing mostly on improving patient\u2019s engagement. Further, clinicians follow implicit prescribing patterns when choosing LAIs, and this may generate hypotheses for future experimental studies