1,243 research outputs found
Validation of an algorithm-based definition of treatment resistance in patients with schizophrenia
Large-scale pharmacoepidemiological research on treatment resistance relies on accurate identification of people with treatment-resistant schizophrenia (TRS) based on data that are retrievable from administrative registers. This is usually approached by operationalising clinical treatment guidelines by using prescription and hospital admission information. We examined the accuracy of an algorithm-based definition of TRS based on clozapine prescription and/or meeting algorithm-based eligibility criteria for clozapine against a gold standard definition using case notes. We additionally validated a definition entirely based on clozapine prescription. 139 schizophrenia patients aged 18â65 years were followed for a mean of 5 years after first presentation to psychiatric services in South-London, UK. The diagnostic accuracy of the algorithm-based measure against the gold standard was measured with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). A total of 45 (32.4%) schizophrenia patients met the criteria for the gold standard definition of TRS; applying the algorithm-based definition to the same cohort led to 44 (31.7%) patients fulfilling criteria for TRS with sensitivity, specificity, PPV and NPV of 62.2%, 83.0%, 63.6% and 82.1%, respectively. The definition based on lifetime clozapine prescription had sensitivity, specificity, PPV and NPV of 40.0%, 94.7%, 78.3% and 76.7%, respectively. Although a perfect definition of TRS cannot be derived from available prescription and hospital registers, these results indicate that researchers can confidently use registries to identify individuals with TRS for research and clinical practices
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Clozapine use in childhood and adolescent schizophrenia: A nationwide population-based study
Early onset schizophrenia (EOS) begins in childhood or adolescence. EOS is associated with poor treatment response and may benefit from timely use of clozapine. This study aimed to identify the predictors of clozapine use in EOS and characterize the clinical profile and outcome of clozapine-treated youths with schizophrenia. We conducted a nationwide population-based study using linked data from Danish medical registries. We examined all incident cases of EOS (i.e., cases diagnosed prior to their 18th birthday) between December 31st 1994 and December 31st 2006 and characterized their demographic, clinical and treatment profiles. We then used multivariable cox proportional hazard models to identify predictors of clozapine treatment in this patient population. We identified 662 EOS cases (1.9% of all schizophrenia cases), of whom 108 (17.6%) had commenced clozapine by December 31st 2008. Patients had on average 3 antipsychotic trials prior to clozapine initiation. The mean interval between first antipsychotic treatment and clozapine initiation was 3.2 (2.9) years. Older age at diagnosis of schizophrenia [HR=1.2, 95% CI (1.05-1.4), p=0.01], family history of schizophrenia [HR=2.1, 95% CI (1.1-3.04), p=0.02] and attempted suicide [HR=1.8, 95% CI (1.1-3.04), p=0.02] emerged as significant predictors of clozapine use. The majority of patients (n=96, 88.8%) prescribed clozapine appeared to have a favorable clinical response as indicated by continued prescription redemption and improved occupational outcomes. Our findings support current recommendations for the timely use of clozapine in EOS
Hierarchy measure for complex networks
Nature, technology and society are full of complexity arising from the
intricate web of the interactions among the units of the related systems (e.g.,
proteins, computers, people). Consequently, one of the most successful recent
approaches to capturing the fundamental features of the structure and dynamics
of complex systems has been the investigation of the networks associated with
the above units (nodes) together with their relations (edges). Most complex
systems have an inherently hierarchical organization and, correspondingly, the
networks behind them also exhibit hierarchical features. Indeed, several papers
have been devoted to describing this essential aspect of networks, however,
without resulting in a widely accepted, converging concept concerning the
quantitative characterization of the level of their hierarchy. Here we develop
an approach and propose a quantity (measure) which is simple enough to be
widely applicable, reveals a number of universal features of the organization
of real-world networks and, as we demonstrate, is capable of capturing the
essential features of the structure and the degree of hierarchy in a complex
network. The measure we introduce is based on a generalization of the m-reach
centrality, which we first extend to directed/partially directed graphs. Then,
we define the global reaching centrality (GRC), which is the difference between
the maximum and the average value of the generalized reach centralities over
the network. We investigate the behavior of the GRC considering both a
synthetic model with an adjustable level of hierarchy and real networks.
Results for real networks show that our hierarchy measure is related to the
controllability of the given system. We also propose a visualization procedure
for large complex networks that can be used to obtain an overall qualitative
picture about the nature of their hierarchical structure.Comment: 29 pages, 9 figures, 4 table
Effects of the transcutaneous electrode temperature on the accuracy of transcutaneous carbon dioxide tension
Study of boson production in association with beauty and charm
The associated production of a boson with a jet originating from either a
light parton or heavy-flavor quark is studied in the forward region using
proton-proton collisions. The analysis uses data corresponding to integrated
luminosities of 1.0 and collected with the LHCb detector
at center-of-mass energies of 7 and 8 TeV, respectively. The bosons are
reconstructed using the decay and muons with a transverse
momentum, , larger than 20 GeV in the pseudorapidity range
GeV
and . The sum of the muon and jet momenta must satisfy
GeV. The fraction of jet events that originate from beauty
and charm quarks is measured, along with the charge asymmetries of the
and production cross-sections. The ratio of the jet to
jet production cross-sections is also measured using the
decay. All results are in agreement with Standard Model predictions
Study of and decays and determination of the CKM angle
We report a study of the suppressed and favored
decays, where the neutral meson is detected
through its decays to the and CP-even and
final states. The measurement is carried out using a proton-proton
collision data sample collected by the LHCb experiment, corresponding to an
integrated luminosity of 3.0~fb. We observe the first significant
signals in the CP-even final states of the meson for both the suppressed
and favored modes, as well as
in the doubly Cabibbo-suppressed final state of the decay. Evidence for the ADS suppressed decay , with , is also presented. From the observed
yields in the , and their
charge conjugate decay modes, we measure the value of the weak phase to be
. This is one of the most precise
single-measurement determinations of to date.Comment: 22 pages, 9 figures; All figures and tables, along with any
supplementary material and additional information, are available at
https://lhcbproject.web.cern.ch/lhcbproject/Publications/LHCbProjectPublic/LHCb-PAPER-2015-020.htm
Observation of resonances consistent with pentaquark states in decays
Observations of exotic structures in the channel, that we refer to
as pentaquark-charmonium states, in decays are
presented. The data sample corresponds to an integrated luminosity of 3/fb
acquired with the LHCb detector from 7 and 8 TeV pp collisions. An amplitude
analysis is performed on the three-body final-state that reproduces the
two-body mass and angular distributions. To obtain a satisfactory fit of the
structures seen in the mass spectrum, it is necessary to include two
Breit-Wigner amplitudes that each describe a resonant state. The significance
of each of these resonances is more than 9 standard deviations. One has a mass
of MeV and a width of MeV, while the second
is narrower, with a mass of MeV and a width of MeV. The preferred assignments are of opposite parity, with one
state having spin 3/2 and the other 5/2.Comment: 48 pages, 18 figures including the supplementary material, v2 after
referee's comments, now 19 figure
Bose-Einstein correlations of same-sign charged pions in the forward region in pp collisions at âs=7 TeV
Bose-Einstein correlations of same-sign charged pions, produced in protonproton collisions at a 7 TeV centre-of-mass energy, are studied using a data sample collected
by the LHCb experiment. The signature for Bose-Einstein correlations is observed in the
form of an enhancement of pairs of like-sign charged pions with small four-momentum
difference squared. The charged-particle multiplicity dependence of the Bose-Einstein correlation parameters describing the correlation strength and the size of the emitting source
is investigated, determining both the correlation radius and the chaoticity parameter. The
measured correlation radius is found to increase as a function of increasing charged-particle
multiplicity, while the chaoticity parameter is seen to decreas
Search for hidden-sector bosons in decays
A search is presented for hidden-sector bosons, , produced in the decay
, with and
. The search is performed using -collision data
corresponding to 3.0 fb collected with the LHCb detector. No significant
signal is observed in the accessible mass range
MeV, and upper limits are placed on the branching fraction product
as
a function of the mass and lifetime of the boson. These limits are of
the order of for lifetimes less than 100 ps over most of the
range, and place the most stringent constraints to date on many
theories that predict the existence of additional low-mass bosons.Comment: All figures and tables, along with supplementary material, are
available at
https://lhcbproject.web.cern.ch/lhcbproject/Publications/LHCbProjectPublic/LHCb-PAPER-2015-036.htm
Study of charmonium production in b -hadron decays and first evidence for the decay Bs0
Using decays to Ï-meson pairs, the inclusive production of charmonium states in b-hadron decays is studied with pp collision data corresponding to an integrated luminosity of 3.0 fbâ1, collected by the LHCb experiment at centre-of-mass energies of 7 and 8 TeV. Denoting byBC ⥠B(b â C X) Ă B(C â ÏÏ) the inclusive branching fraction of a b hadron to a charmonium state C that decays into a pair of Ï mesons, ratios RC1C2 ⥠BC1 /BC2 are determined as RÏc0ηc(1S) = 0.147 ± 0.023 ± 0.011, RÏc1ηc(1S) =0.073 ± 0.016 ± 0.006, RÏc2ηc(1S) = 0.081 ± 0.013 ± 0.005,RÏc1 Ïc0 = 0.50 ± 0.11 ± 0.01, RÏc2 Ïc0 = 0.56 ± 0.10 ± 0.01and Rηc(2S)ηc(1S) = 0.040 ± 0.011 ± 0.004. Here and below the first uncertainties are statistical and the second systematic.Upper limits at 90% confidence level for the inclusive production of X(3872), X(3915) and Ïc2(2P) states are obtained as RX(3872)Ïc1 < 0.34, RX(3915)Ïc0 < 0.12 andRÏc2(2P)Ïc2 < 0.16. Differential cross-sections as a function of transverse momentum are measured for the ηc(1S) andÏc states. The branching fraction of the decay B0s â ÏÏÏ is measured for the first time, B(B0s â ÏÏÏ) = (2.15±0.54±0.28±0.21B)Ă10â6. Here the third uncertainty is due to the branching fraction of the decay B0s â ÏÏ, which is used for normalization. No evidence for intermediate resonances is seen. A preferentially transverse Ï polarization is observed.The measurements allow the determination of the ratio of the branching fractions for the ηc(1S) decays to ÏÏ and p p asB(ηc(1S)â ÏÏ)/B(ηc(1S)â p p) = 1.79 ± 0.14 ± 0.32
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