Clinical findings in relation to mortality in non-tuberculous mycobacterial infections : patients with Mycobacterium avium complex have better survival than patients with other mycobacteria

We compared the clinical findings and survival in patients with Mycobacterium avium complex (MAC) and other non-tuberculous mycobacteria (NTM). A total of 167 adult non-human immunodeficiency virus (HIV) patients with at least one positive culture for NTM were included. Medical records were reviewed. The patients were categorised according to the 2007 American Thoracic Society (ATS) criteria. MAC comprised 59 % of all NTM findings. MAC patients were more often female (70 % vs. 34 %, p <0.001) and had less fatal underlying diseases (23 % vs. 47 %, p = 0.001) as compared to other NTM patients. Symptoms compatible with NTM infection had lasted for less than a year in 34 % of MAC patients but in 54 % of other NTM patients (p = 0.037). Pulmonary MAC patients had a significantly lower risk of death compared to pulmonary other NTM (hazard ratio [HR] 0.50, 95 % confidence interval [CI] 0.33-0.77, p = 0.002) or subgroup of other slowly growing NTM (HR 0.55, 95 % CI 0.31-0.99, p = 0.048) or as rapidly growing NTM (HR 0.47, 95 % CI 0.25-0.87, p = 0.02). The median survival time was 13.0 years (95 % CI 5.9-20.1) for pulmonary MAC but 4.6 years (95 % CI 3.4-5.9) for pulmonary other NTM. Serious underlying diseases (HR 3.21, 95 % CI 2.05-5.01, p <0.001) and age (HR 1.07, 95 % CI 1.04-1.09, p <0.001) were the significant predictors of mortality and female sex was a predictor of survival (HR 0.38, 95 % CI 0.24-0.59, p <0.001) in the multivariate analysis. Pulmonary MAC patients had better prognosis than pulmonary other NTM patients. The symptom onset suggests a fairly rapid disease course.Peer reviewe

The experience of long-term opiate maintenance treatment and reported barriers to recovery: A qualitative systematic review

Background/Aim: To inform understanding of the experience of long-term opiate maintenance and identify barriers to recovery. Methods: A qualitative systematic review. Results: 14 studies in 17 papers, mainly from the USA (65%), met inclusion criteria, involving 1,088 participants. Studies focused on methadone prescribing. Participants reported stability; however, many disliked methadone. Barriers to full recovery were primarily ‘inward focused'. Conclusion: This is the first review of qualitative literature on long-term maintenance, finding that universal service improvements could be made to address reported barriers to recovery, including involving ex-users as positive role models, and increasing access to psychological support. Treatment policies combining harm minimisation and abstinence-orientated approaches may best support individualised recovery

A New Mechanism for Generating a Single Transverse Spin Asymmetry

We propose a new mechanism for generating a single transverse spin asymmetry (STSA) in polarized proton-proton and proton-nucleus collisions in the high-energy scattering approximation. In this framework the STSA originates from the q->q G splitting in the projectile (proton) light-cone wave function followed by a perturbative (C-odd) odderon interaction, together with a C-even interaction, between the projectile and the target. We show that some aspects of the obtained expression for the STSA of the produced quarks are in qualitative agreement with experiment: STSA decreases with decreasing projectile x_F and is a non-monotonic function of the transverse momentum k_T. In our framework the STSA peaks at k_T near the saturation scale Q_s. Our mechanism predicts that the quark STSA in proton-nucleus collisions should be much smaller than in proton-proton collisions. We also observe that in our formalism the STSA for prompt photons is zero.Comment: 28 pages, 17 figues; v2: minor corrections, a subsection, discussion and references added; v3: minor corrections and a new figure added; v4: minor corrections; v5: minor corrections in figure

c-erbB2 and topoisomerase IIα protein expression independently predict poor survival in primary human breast cancer: a retrospective study

INTRODUCTION: c-erbB2 (also known as HER-2/neu) and topoisomerase IIα are frequently overexpressed in breast cancer. The aim of the study was to analyze retrospectively whether the expression of c-erbB2 and topoisomerase IIα protein influences the long-term outcome of patients with primary breast cancer. METHODS: In this study c-erbB2 and topoisomerase IIα protein were evaluated by immunohistochemistry in formalin-fixed paraffin-embedded tissue from 225 samples of primary breast cancer, obtained between 1986 and 1998. The prognostic value of these markers was analyzed. RESULTS: Of 225 primary breast tumor samples, 78 (34.7%) showed overexpression of either c-erbB2 (9.8%) or topoisomerase IIα protein (24.9%), whereas in 21 tumors (9.3%) both proteins were found to be overexpressed. Patients lacking both c-erbB2 and topoisomerase IIα overexpression had the best long-term survival. Overexpression of either c-erbB2 or topoisomerase IIα was associated with shortened survival, whereas patients overexpressing both c-erbB2 and topoisomerase IIα showed the worst disease outcome (P < 0.0001). Treatment with anthracyclines was not capable of reversing the negative prognostic impact of topoisomerase IIα or c-erbB2 overexpression. CONCLUSION: The results of this exploratory study suggest that protein expression of c-erbB2 and topoisomerase IIα in primary breast cancer tissues are independent prognostic factors and are not exclusively predictive factors for anthracycline response in patients with primary breast cancer

Comparison of insulin glargine and liraglutide added to oral agents in patients with poorly controlled type 2 diabetes

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Speckle dynamics under ergodicity breaking

Laser speckle contrast imaging (LSCI) is a well-known and versatile approach for the non-invasive visualization of flows and microcirculation localized in turbid scattering media, including biological tissues. In most conventional implementations of LSCI the ergodic regime is typically assumed valid. However, most composite turbid scattering media, especially biological tissues, are non-ergodic, containing a mixture of dynamic and static centers of light scattering. In the current study, we examined the speckle contrast in different dynamic conditions with the aim of assessing limitations in the quantitative interpretation of speckle contrast images. Based on a simple phenomenological approach, we introduced a coefficient of speckle dynamics to quantitatively assess the ratio of the dynamic part of a scattering medium to the static one. The introduced coefficient allows one to distinguish real changes in motion from the mere appearance of static components in the field of view. As examples of systems with static/dynamic transitions, thawing and heating of Intralipid samples were studied by the LSCI approach

Scenario development for D-T operation at JET

The JET exploitation plan foresees D-T operations in 2020 (DTE2). With respect to the first D-T campaign in 1997 (DTE1), when JET was equipped with a carbon wall, the experiments will be conducted in presence of a beryllium-tungsten ITER-like wall and will benefit from an extended and improved set of diagnostics and higher additional heating power (32 MW neutral beam injection + 8 MW ion cyclotron resonance heating). There are several challenges presented by operations with the new wall: a general deterioration of the pedestal confinement; the risk of heavy impurity accumulation in the core, which, if not controlled, can cause the radiative collapse of the discharge; the requirement to protect the divertor from excessive heat loads, which may damage it permanently. Therefore, an intense activity of scenario development has been undertaken at JET during the last three years to overcome these difficulties and prepare the plasmas needed to demonstrate stationary high fusion performance and clear alpha particle effects. The paper describes the status and main achievements of this scenario development activity, both from an operational and plasma physics point of view.Peer reviewe