Fluoroquinolone antibiotics and tendon injury in adolescents

OBJECTIVES: To estimate the association between fluoroquinolone use and tendon injury in adolescents. METHODS: We conducted an active-comparator, new-user cohort study using population-based claims data from 2000 to 2018. We included adolescents (aged 12-18 years) with an outpatient prescription fill for an oral fluoroquinolone or comparator broad-spectrum antibiotic. The primary outcome was Achilles, quadricep, patellar, or tibial tendon rupture identified by diagnosis and procedure codes. Tendinitis was a secondary outcome. We used weighting to adjust for measured confounding and a negative control outcome to assess residual confounding. RESULTS: The cohort included 4.4 million adolescents with 7.6 million fills for fluoroquinolone (275 767 fills) or comparator (7 365 684) antibiotics. In the 90 days after the index antibiotic prescription, there were 842 tendon ruptures and 16 750 tendinitis diagnoses (crude rates 0.47 and 9.34 per 1000 person-years, respectively). The weighted 90-day tendon rupture risks were 13.6 per 100 000 fluoroquinolone-treated adolescents and 11.6 per 100 000 comparator-treated adolescents (fluoroquinolone-associated excess risk: 1.9 per 100 000 adolescents; 95% confidence interval 22.6 to 6.4); the corresponding number needed to treat to harm was 52 632. For tendinitis, the weighted 90-day risks were 200.8 per 100 000 fluoroquinolone-treated adolescents and 178.1 per 100 000 comparator-treated adolescents (excess risk: 22.7 per 100 000; 95% confidence interval 4.1 to 41.3); the number needed to treat to harm was 4405. CONCLUSIONS: The excess risk of tendon rupture associated with fluoroquinolone treatment was extremely small, and these events were rare. The excess risk of tendinitis associated with fluoroquinolone treatment was also small. Other more common potential adverse drug effects may be more important to consider for treatment decision-making, particularly in adolescents without other risk factors for tendon injury

Bayesian solutions to the label switching problem

The label switching problem, the unidentifiability of the permutation of clusters or more generally latent variables, makes interpretation of results computed with MCMC sampling difficult. We introduce a fully Bayesian treatment of the permutations which performs better than alternatives. The method can be used to compute summaries of the posterior samples even for nonparametric Bayesian methods, for which no good solutions exist so far. Although being approximative in this case, the results are very promising. The summaries are intuitively appealing: A summarized cluster is defined as a set of points for which the likelihood of being in the same cluster is maximized

Indocyanine Green as a Navigational Adjunct for Laparoscopic Ablation of Liver Tumors

Background Minimally invasive operative approaches for resection and thermal ablation (eg, microwave, radiofrequency) of hepatocellular carcinoma (HCC) have been successfully implemented over the last two decades, although identifying tumors can be challenging. Successfully performing laparoscopic ablation requires real-time visualization and ultrasonography skills for direct placement of the ablation probe. Methods In this study, we introduce a novel adjunct to ultrasound imaging for tumors located near or on the surface of the liver via intravenous delivery of indocyanine green (ICG) dye. Non-resectable lesion(s) not amenable to percutaneous ablation were considered for laparoscopic microwave ablation. Each patient initially received a dose of .3125 mg ICG via peripheral IV. Results A total of 17 patients were included. There was brisk uptake of ICG throughout the liver parenchyma in under 2 minutes in 15 of 17 patients; the remaining 2 required a second dose of ICG. In 14 cases, a hypo-fluorescent perfusion pattern in the tumor was clearly identified. Discussion Integrating ICG and fluorescent imaging provides a complementary adjunct to ultrasound in identifying HCC nodules. While previous applications of ICG typically require injections several days prior to surgery or segmental injections, this study demonstrates a novel real-time application of ICG to aid surgeons with various experiences in laparoscopic-assisted ablation procedures for HCC

Spatially explicit estimates of N2O emissions from croplands suggest climate mitigation opportunities from improved fertilizer management

With increasing nitrogen (N) application to croplands required to support growing food demand, mitigating N2O emissions from agricultural soils is a global challenge. National greenhouse gas emissions accounting typically estimates N2O emissions at the country scale by aggregating all crops, under the assumption that N2O emissions are linearly related to N application. However, field studies and meta-analyses indicate a nonlinear relationship, in which N2O emissions are relatively greater at higher N application rates. Here we apply a super-linear emissions response model to crop-specific, spatially-explicit synthetic N fertilizer and manure N inputs to provide subnational accounting of global N2O emissions from croplands. We estimate 0.66 Tg of N2O-N direct global emissions circa 2000, with 50% of emissions concentrated in 13% of harvested area. Compared to estimates from the IPCC Tier 1 linear model, our updated N2O emissions range from 20-40% lower throughout Sub-Saharan Africa and Eastern Europe, to >120% greater in some Western European countries. At low N application rates, the weak non-linear response of N2O emissions suggests that relatively large increases in N fertilizer application would generate relatively small increases in N2O emissions. Since aggregated fertilizer data generate underestimation bias in nonlinear models, high-resolution N application data are critical to support accurate N2O emissions estimates

Inelastic electron transport in granular arrays

Transport properties of granular systems are governed by Coulomb blockade effects caused by the discreteness of the electron charge. We show that, in the limit of vanishing mean level spacing on the grains, the low-temperature behavior of 1d and 2d arrays is insulating at any inter-grain coupling (characterized by a dimensionless conductance g.) In 2d and g>>1, there is a sharp Berezinskii-Kosterlitz-Thouless crossover to the conducting phase at a certain temperature, T_{BKT}. These results are obtained by applying an instanton analysis to map the conventional `phase' description of granular arrays onto the dual `charge' representation.Comment: 24 pages, 8 figure

Farming and the geography of nutrient production for human use: a transdisciplinary analysis

Background: Information about the global structure of agriculture and nutrient production and its diversity is essential to improve present understanding of national food production patterns, agricultural livelihoods, and food chains, and their linkages to land use and their associated ecosystems services. Here we provide a plausible breakdown of global agricultural and nutrient production by farm size, and also study the associations between farm size, agricultural diversity, and nutrient production. This analysis is crucial to design interventions that might be appropriately targeted to promote healthy diets and ecosystems in the face of population growth, urbanisation, and climate change. Methods: We used existing spatially-explicit global datasets to estimate the production levels of 41 major crops, seven livestock, and 14 aquaculture and fish products. From overall production estimates, we estimated the production of vitamin A, vitamin B₁₂, folate, iron, zinc, calcium, calories, and protein. We also estimated the relative contribution of farms of different sizes to the production of different agricultural commodities and associated nutrients, as well as how the diversity of food production based on the number of different products grown per geographic pixel and distribution of products within this pixel (Shannon diversity index [H]) changes with different farm sizes. Findings: Globally, small and medium farms (≤50 ha) produce 51–77% of nearly all commodities and nutrients examined here. However, important regional differences exist. Large farms (>50 ha) dominate production in North America, South America, and Australia and New Zealand. In these regions, large farms contribute between 75% and 100% of all cereal, livestock, and fruit production, and the pattern is similar for other commodity groups. By contrast, small farms (≤20 ha) produce more than 75% of most food commodities in sub-Saharan Africa, southeast Asia, south Asia, and China. In Europe, west Asia and north Africa, and central America, medium-size farms (20–50 ha) also contribute substantially to the production of most food commodities. Very small farms (≤2 ha) are important and have local significance in sub-Saharan Africa, southeast Asia, and south Asia, where they contribute to about 30% of most food commodities. The majority of vegetables (81%), roots and tubers (72%), pulses (67%), fruits (66%), fish and livestock products (60%), and cereals (56%) are produced in diverse landscapes (H>1·5). Similarly, the majority of global micronutrients (53–81%) and protein (57%) are also produced in more diverse agricultural landscapes (H>1·5). By contrast, the majority of sugar (73%) and oil crops (57%) are produced in less diverse ones (H≤1·5), which also account for the majority of global calorie production (56%). The diversity of agricultural and nutrient production diminishes as farm size increases. However, areas of the world with higher agricultural diversity produce more nutrients, irrespective of farm size. Interpretation: Our results show that farm size and diversity of agricultural production vary substantially across regions and are key structural determinants of food and nutrient production that need to be considered in plans to meet social, economic, and environmental targets. At the global level, both small and large farms have key roles in food and nutrition security. Efforts to maintain production diversity as farm sizes increase seem to be necessary to maintain the production of diverse nutrients and viable, multifunctional, sustainable landscapes. Funding: Commonwealth Scientific and Industrial Research Organisation, Bill & Melinda Gates Foundation, CGIAR Research Programs on Climate Change, Agriculture and Food Security and on Agriculture for Nutrition and Health funded by the CGIAR Fund Council, Daniel and Nina Carasso Foundation, European Union, International Fund for Agricultural Development, Australian Research Council, National Science Foundation, Gordon and Betty Moore Foundation, and Joint Programming Initiative on Agriculture, Food Security and Climate Change—Belmont Forum

Evidence of Color Coherence Effects in W+jets Events from ppbar Collisions at sqrt(s) = 1.8 TeV

We report the results of a study of color coherence effects in ppbar collisions based on data collected by the D0 detector during the 1994-1995 run of the Fermilab Tevatron Collider, at a center of mass energy sqrt(s) = 1.8 TeV. Initial-to-final state color interference effects are studied by examining particle distribution patterns in events with a W boson and at least one jet. The data are compared to Monte Carlo simulations with different color coherence implementations and to an analytic modified-leading-logarithm perturbative calculation based on the local parton-hadron duality hypothesis.Comment: 13 pages, 6 figures. Submitted to Physics Letters

The vulnerabilities of agricultural land and food production to future water scarcity

Rapidly increasing populations coupled with increased food demand requires either an expansion of agriculturalland or sufficient production gains from current resources. However, in a changing world, reduced wateravailability might undermine improvements in crop and grass productivity and may disproportionately affectdifferent parts of the world. Using multi-model studies, the potential trends, risks and uncertainties to land useand land availability that may arise from reductions in water availability are examined here. In addition, theimpacts of different policy interventions on pressures from emerging risks are examined.Results indicate that globally, approximately 11% and 10% of current crop- and grass-lands could be vul-nerable to reduction in water availability and may lose some productive capacity, with Africa and the MiddleEast, China, Europe and Asia particularly at risk. While uncertainties remain, reduction in agricultural land areaassociated with dietary changes (reduction of food waste and decreased meat consumption) offers the greatestbuffer against land loss and food insecurity

Search for a W' boson decaying to a bottom quark and a top quark in pp collisions at sqrt(s) = 7 TeV

Results are presented from a search for a W' boson using a dataset corresponding to 5.0 inverse femtobarns of integrated luminosity collected during 2011 by the CMS experiment at the LHC in pp collisions at sqrt(s)=7 TeV. The W' boson is modeled as a heavy W boson, but different scenarios for the couplings to fermions are considered, involving both left-handed and right-handed chiral projections of the fermions, as well as an arbitrary mixture of the two. The search is performed in the decay channel W' to t b, leading to a final state signature with a single lepton (e, mu), missing transverse energy, and jets, at least one of which is tagged as a b-jet. A W' boson that couples to fermions with the same coupling constant as the W, but to the right-handed rather than left-handed chiral projections, is excluded for masses below 1.85 TeV at the 95% confidence level. For the first time using LHC data, constraints on the W' gauge coupling for a set of left- and right-handed coupling combinations have been placed. These results represent a significant improvement over previously published limits.Comment: Submitted to Physics Letters B. Replaced with version publishe

Search for the standard model Higgs boson decaying into two photons in pp collisions at sqrt(s)=7 TeV

A search for a Higgs boson decaying into two photons is described. The analysis is performed using a dataset recorded by the CMS experiment at the LHC from pp collisions at a centre-of-mass energy of 7 TeV, which corresponds to an integrated luminosity of 4.8 inverse femtobarns. Limits are set on the cross section of the standard model Higgs boson decaying to two photons. The expected exclusion limit at 95% confidence level is between 1.4 and 2.4 times the standard model cross section in the mass range between 110 and 150 GeV. The analysis of the data excludes, at 95% confidence level, the standard model Higgs boson decaying into two photons in the mass range 128 to 132 GeV. The largest excess of events above the expected standard model background is observed for a Higgs boson mass hypothesis of 124 GeV with a local significance of 3.1 sigma. The global significance of observing an excess with a local significance greater than 3.1 sigma anywhere in the search range 110-150 GeV is estimated to be 1.8 sigma. More data are required to ascertain the origin of this excess.Comment: Submitted to Physics Letters