Clinical characteristics and outcomes of clostridial bacteraemia in cancer patients

AbstractClostridial bacteraemia is usually associated with substantial morbidity and mortality in cancer patients. However, clinical characteristics and risk factors for early mortality in this population are poorly described. We retrospectively studied cancer patients with clostridial bacteraemia treated between January 1996 and December 2011. We compared clinical manifestations between patients with solid tumour and haematological malignancy and assessed risk factors for 7-day mortality. In all, 164 cancer patients developed clostridial bacteraemia during the study period—85 (52%) with solid tumour and 79 (48%) with haematological malignancy. Common isolates were Clostridium perfringens (27%), Clostridium septicum (19%) and Clostridium tertium (14%). Solid tumour malignancy patients were more likely to have a focal gastrointestinal source for bacteraemia and were more likely to undergo subsequent surgery. Haematological malignancy patients were more often neutropenic and more often had no focal source of bacteraemia. Seven-day mortality was 20% (33/164) and did not vary based on malignancy type. The adjusted odds ratio of dying within 7 days of clostridial bacteraemia among patients with hypotension (40/164) was 7.2 (95% CI, 2.9–18.1) and in patients with acute haemolysis (7/164) was 10.5 (95% CI, 1.3–85.2). Clostridial species also impacted mortality; no patient with C. tertium bacteraemia died within 7 days. In conclusion, clinical manifestations of clostridial bacteraemia differed between patients with solid tumour and haematological malignancy, but 7-day mortality was similar. Patients with hypotension and haemolysis at time of bacteraemia were at increased risk for early death

Universality, the QCD critical/tricritical point and the quark number susceptibility

The quark number susceptibility near the QCD critical end-point (CEP), the tricritical point (TCP) and the O(4) critical line at finite temperature and quark chemical potential is investigated. Based on the universality argument and numerical model calculations we propose a possibility that the hidden tricritical point strongly affects the critical phenomena around the critical end-point. We made a semi-quantitative study of the quark number susceptibility near CEP/TCP for several quark masses on the basis of the Cornwall-Jackiw-Tomboulis (CJT) potential for QCD in the improved-ladder approximation. The results show that the susceptibility is enhanced in a wide region around CEP inside which the critical exponent gradually changes from that of CEP to that of TCP, indicating a crossover of different universality classes.Comment: 18 pages, 10 figure

Pulsar-wind nebulae and magnetar outflows: observations at radio, X-ray, and gamma-ray wavelengths

We review observations of several classes of neutron-star-powered outflows: pulsar-wind nebulae (PWNe) inside shell supernova remnants (SNRs), PWNe interacting directly with interstellar medium (ISM), and magnetar-powered outflows. We describe radio, X-ray, and gamma-ray observations of PWNe, focusing first on integrated spectral-energy distributions (SEDs) and global spectral properties. High-resolution X-ray imaging of PWNe shows a bewildering array of morphologies, with jets, trails, and other structures. Several of the 23 so far identified magnetars show evidence for continuous or sporadic emission of material, sometimes associated with giant flares, and a few possible "magnetar-wind nebulae" have been recently identified.Comment: 61 pages, 44 figures (reduced in quality for size reasons). Published in Space Science Reviews, "Jets and Winds in Pulsar Wind Nebulae, Gamma-ray Bursts and Blazars: Physics of Extreme Energy Release

Fitting the integrated Spectral Energy Distributions of Galaxies

Fitting the spectral energy distributions (SEDs) of galaxies is an almost universally used technique that has matured significantly in the last decade. Model predictions and fitting procedures have improved significantly over this time, attempting to keep up with the vastly increased volume and quality of available data. We review here the field of SED fitting, describing the modelling of ultraviolet to infrared galaxy SEDs, the creation of multiwavelength data sets, and the methods used to fit model SEDs to observed galaxy data sets. We touch upon the achievements and challenges in the major ingredients of SED fitting, with a special emphasis on describing the interplay between the quality of the available data, the quality of the available models, and the best fitting technique to use in order to obtain a realistic measurement as well as realistic uncertainties. We conclude that SED fitting can be used effectively to derive a range of physical properties of galaxies, such as redshift, stellar masses, star formation rates, dust masses, and metallicities, with care taken not to over-interpret the available data. Yet there still exist many issues such as estimating the age of the oldest stars in a galaxy, finer details ofdust properties and dust-star geometry, and the influences of poorly understood, luminous stellar types and phases. The challenge for the coming years will be to improve both the models and the observational data sets to resolve these uncertainties. The present review will be made available on an interactive, moderated web page (sedfitting.org), where the community can access and change the text. The intention is to expand the text and keep it up to date over the coming years.Comment: 54 pages, 26 figures, Accepted for publication in Astrophysics & Space Scienc

Sedimentology, stratigraphic context, and implications of Miocene intrashelf bottomset deposits, offshore New Jersey

Drilling of intrashelf Miocene clinothems onshore and offshore New Jersey has provided better understanding of their topset and foreset deposits, but the sedimentology and stratigraphy of their bottomset deposits have not been documented in detail. Three coreholes (Sites M27–M29), collected during Integrated Ocean Drilling Program (IODP) Expedition 313, intersect multiple bottomset deposits, and their analysis helps to refine sequence stratigraphic interpretations and process response models for intrashelf clinothems. At Site M29, the most downdip location, chronostratigraphically well-constrained bottomset deposits follow a repeated stratigraphic motif. Coarse-grained glauconitic quartz sand packages abruptly overlie deeply burrowed surfaces. Typically, these packages coarsen then fine upwards and pass upward into bioturbated siltstones. These coarse sand beds are amalgamated and poorly sorted and contain thin-walled shells, benthic foraminifera, and extrabasinal clasts, consistent with an interpretation of debrites. The sedimentology and mounded seismic character of these packages support interpretation as debrite-dominated lobe complexes. Farther updip, at Site M28, the same chronostratigraphic units are amalgamated, with the absence of bioturbated silts pointing to more erosion in proximal locations. Graded sandstones and dune-scale cross-bedding in the younger sequences in Site M28 indicate deposition from turbidity currents and channelization. The sharp base of each package is interpreted as a sequence boundary, with a period of erosion and sediment bypass evidenced by the burrowed surface, and the coarse-grained debritic and turbiditic deposits representing the lowstand systems tract. The overlying fine-grained deposits are interpreted as the combined transgressive and highstand systems tract deposits and contain the deepwater equivalent of the maximum flooding surface. The variety in thickness and grain-size trends in the coarse-grained bottomset packages point to an autogenic control, through compensational stacking of lobes and lobe complexes. However, the large-scale stratigraphic organization of the bottomset deposits and the coarse-grained immature extrabasinal and reworked glauconitic detritus point to external controls, likely a combination of relative sea-level fall and waxing-and-waning cycles of sediment supply. This study demonstrates that large amounts of sediment gravity-flow deposits can be generated in relatively shallow (~100–200 m deep) and low-gradient (~1°–4°) clinothems that prograded across a deep continental shelf. This physiography likely led to the dominance of debris flow deposits due to the short transport distance limiting transformation to low-concentration turbidity currents

Topological data analysis of coronary plaques demonstrates the natural history of coronary atherosclerosis

OBJECTIVES This study sought to identify distinct patient groups and their association with outcome based on the patient similarity network using quantitative coronary plaque characteristics from coronary computed tomography angiography (CTA).BACKGROUND Coronary CTA can noninvasively assess coronary plaques quantitatively.METHODS Patients who underwent 2 coronary CTAs at a minimum of 24 months' interval were analyzed (n = 1,264). A similarity Mapper network of patients was built by topological data analysis (TDA) based on the whole-heart quantitative coronary plaque analysis on coronary CTA to identify distinct patient groups and their association with outcome.RESULTS Three distinct patient groups were identified by TDA, and the patient similarity network by TDA showed a dosed loop, demonstrating a continuous trend of coronary plaque progression. Group A had the least coronary plaque amount (median 12.4 mm(3) [interquartile range (IQR): 0.0 to 39.6 mm(3)]) in the entire coronary tree. Group B had a moderate coronary plaque amount (31.7 mm(3) [IQR: 0.0 to 127.4 mm(3)]) with relative enrichment of fibrofatty and necrotic core (32.6% [IQR: 16.7% to 46.2%] and 2.7% [IQR: 0.1% to 6.9%] of the total plaque, respectively) components. Group C had the largest coronary plaque amount (187.0 mm(3) [IQR: 96.7 to 306.4 mm(3)]) and was enriched for dense calcium component (46.8% [IQR: 32.0% to 63.7%] of the total plaque). At follow-up, total plaque volume, fibrous, and dense calcium volumes increased in all groups, but the proportion of fibrofatty component decreased in groups B and C, whereas the necrotic core portion decreased in only group B (all p< 0.05). Group B showed a higher acute coronary syndrome incidence than other groups (0.3% vs. 2.6% vs. 0.6%; p= 0.009) but both group B and C had a higher revascularization incidence than group A (3.1% vs. 15.5% vs. 17.8%; p < 0.001). Incorporating group information from TDA demonstrated increase of model fitness for predicting acute coronary syndrome or revascularization compared with that incorporating clinical risk factors, percentage diameter stenosis, and high-risk plaque features.CONCLUSIONS The TDA of quantitative whole-heart coronary plaque characteristics on coronary CTA identified distinct patient groups with different plaque dynamics and clinical outcomes. (Progression of AtheRosclerotic PlAque Determined by Computed TomoGraphic Angiography Imaging [PARADIGM]; NCT02803411) (C) 2021 by the American College of Cardiology Foundation.Cardiolog

Dust in Supernovae and Supernova Remnants II: Processing and survival

Observations have recently shown that supernovae are efficient dust factories, as predicted for a long time by theoretical models. The rapid evolution of their stellar progenitors combined with their efficiency in precipitating refractory elements from the gas phase into dust grains make supernovae the major potential suppliers of dust in the early Universe, where more conventional sources like Asymptotic Giant Branch (AGB) stars did not have time to evolve. However, dust yields inferred from observations of young supernovae or derived from models do not reflect the net amount of supernova-condensed dust able to be expelled from the remnants and reach the interstellar medium. The cavity where the dust is formed and initially resides is crossed by the high velocity reverse shock which is generated by the pressure of the circumstellar material shocked by the expanding supernova blast wave. Depending on grain composition and initial size, processing by the reverse shock may lead to substantial dust erosion and even complete destruction. The goal of this review is to present the state of the art about processing and survival of dust inside supernova remnants, in terms of theoretical modelling and comparison to observations

Age-related effects on cortical thickness patterns of the Rhesus monkey brain

Neuro Imaging Researc