Disorders of Sex Development: Management of Gender Assignment in a Preterm Infant with Intrauterine Growth Restriction

We describe how a gender specialist team managed the case of a disorder of sex development in a preterm infant where definitive diagnosis and gender assignment were delayed due to complications of prematurity, anemia, and severe intrauterine growth restriction

Treatment of Pyonephritis Complicated by Septic Shock Using Extracorporeal Device Polymyxin B-Hemoperfusion

Direct hemoperfusion using polymyxin B-immobilized fiber (PMX-DHP) is an established treatment method for septic shock caused by Gram-negative infections. We report one instance in which PMX-DHP therapy has been used successfully in a 33-year-old woman with septic shock from urosepsis. Although there is lack of recommendations in latest Surviving Sepsis Campaign Guidelines, evidence of PMX-DHP efficacy in this subset of patients is growing

Probing empirical contact networks by simulation of spreading dynamics

Disease, opinions, ideas, gossip, etc. all spread on social networks. How these networks are connected (the network structure) influences the dynamics of the spreading processes. By investigating these relationships one gains understanding both of the spreading itself and the structure and function of the contact network. In this chapter, we will summarize the recent literature using simulation of spreading processes on top of empirical contact data. We will mostly focus on disease simulations on temporal proximity networks -- networks recording who is close to whom, at what time -- but also cover other types of networks and spreading processes. We analyze 29 empirical networks to illustrate the methods

Predictive score using clinical and blood biomarkers in advanced non-small cell lung cancer (aNSCLC) patients treated with immunotherapy

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Exploring the sensitivity of coastal inundation modelling to DEM vertical error

© 2018 Informa UK Limited, trading as Taylor & Francis Group. As sea level is projected to rise throughout the twenty-first century due to climate change, there is a need to ensure that sea level rise (SLR) models accurately and defensibly represent future flood inundation levels to allow for effective coastal zone management. Digital elevation models (DEMs) are integral to SLR modelling, but are subject to error, including in their vertical resolution. Error in DEMs leads to uncertainty in the output of SLR inundation models, which if not considered, may result in poor coastal management decisions. However, DEM error is not usually described in detail by DEM suppliers; commonly only the RMSE is reported. This research explores the impact of stated vertical error in delineating zones of inundation in two locations along the Devon, United Kingdom, coastline (Exe and Otter Estuaries). We explore the consequences of needing to make assumptions about the distribution of error in the absence of detailed error data using a 1 m, publically available composite DEM with a maximum RMSE of 0.15 m, typical of recent LiDAR-derived DEMs. We compare uncertainty using two methods (i) the NOAA inundation uncertainty mapping method which assumes a normal distribution of error and (ii) a hydrologically correct bathtub method where the DEM is uniformly perturbed between the upper and lower bounds of a 95% linear error in 500 Monte Carlo Simulations (HBM+MCS). The NOAA method produced a broader zone of uncertainty (an increase of 134.9% on the HBM+MCS method), which is particularly evident in the flatter topography of the upper estuaries. The HBM+MCS method generates a narrower band of uncertainty for these flatter areas, but very similar extents where shorelines are steeper. The differences in inundation extents produced by the methods relate to a number of underpinning assumptions, and particularly, how the stated RMSE is interpreted and used to represent error in a practical sense. Unlike the NOAA method, the HBM+MCS model is computationally intensive, depending on the areas under consideration and the number of iterations. We therefore used the HBM+ MCS method to derive a regression relationship between elevation and inundation probability for the Exe Estuary. We then apply this to the adjacent Otter Estuary and show that it can defensibly reproduce zones of inundation uncertainty, avoiding the computationally intensive step of the HBM+MCS. The equation-derived zone of uncertainty was 112.1% larger than the HBM+MCS method, compared to the NOAA method which produced an uncertain area 423.9% larger. Each approach has advantages and disadvantages and requires value judgements to be made. Their use underscores the need for transparency in assumptions and communications of outputs. We urge DEM publishers to move beyond provision of a generalised RMSE and provide more detailed estimates of spatial error and complete metadata, including locations of ground control points and associated land cover

Observation of the Baryonic Flavor-Changing Neutral Current Decay Lambda_b -> Lambda mu+ mu-

We report the first observation of the baryonic flavor-changing neutral current decay Lambda_b -> Lambda mu+ mu- with 24 signal events and a statistical significance of 5.8 Gaussian standard deviations. This measurement uses ppbar collisions data sample corresponding to 6.8fb-1 at sqrt{s}=1.96TeV collected by the CDF II detector at the Tevatron collider. The total and differential branching ratios for Lambda_b -> Lambda mu+ mu- are measured. We find B(Lambda_b -> Lambda mu+ mu-) = [1.73+-0.42(stat)+-0.55(syst)] x 10^{-6}. We also report the first measurement of the differential branching ratio of B_s -> phi mu+ mu- using 49 signal events. In addition, we report branching ratios for B+ -> K+ mu+ mu-, B0 -> K0 mu+ mu-, and B -> K*(892) mu+ mu- decays.Comment: 8 pages, 2 figures, 4 tables. Submitted to Phys. Rev. Let

Economic evaluation of the treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSIs) from the national payer perspective : introduction of a new treatment to the patient journey. A simulation of three European countries

The aim of this study was to develop a spending predictor model to evaluate the direct costs associated with the management of ABSSSIs from the National health-care provider's perspective of Italy, Romania, and Spain. METHODOLOGY: A decision-analytic model was developed to evaluate the diagnostic and clinical pathways of hospitalized ABSSSI patients based on scientific guidelines and real-world data. A Standard of Care (SoC) scenario was compared with a dalbavancin scenario in which the patients could be discharged early. The epidemiological and cost parameters were extrapolated from national administrative databases (i.e., hospital information system). A probabilistic sensitivity analysis (PSA) and one-way sensitivity analysis (OWA) were performed. RESULTS: Overall, the model estimated an average annual number of patients with ABSSSIs of approximately 50,000 in Italy, Spain, and Romania. On average, the introduction of dalbavancin reduced the length of stay by 3.3 days per ABSSSI patient. From an economic perspective, dalbavancin did not incur any additional cost from the National Healthcare perspective, and the results were consistent among the countries. The PSA and OWA demonstrated the robustness of these results. CONCLUSION: This model represents a useful tool for policymakers by providing information regarding the economic and organizational consequences of an early discharge approach in ABSSSI management

Evidence for t\bar{t}\gamma Production and Measurement of \sigma_t\bar{t}\gamma / \sigma_t\bar{t}

Using data corresponding to 6.0/fb of ppbar collisions at sqrt(s) = 1.96 TeV collected by the CDF II detector, we present a cross section measurement of top-quark pair production with an additional radiated photon. The events are selected by looking for a lepton, a photon, significant transverse momentum imbalance, large total transverse energy, and three or more jets, with at least one identified as containing a b quark. The ttbar+photon sample requires the photon to have 10 GeV or more of transverse energy, and to be in the central region. Using an event selection optimized for the ttbar+photon candidate sample we measure the production cross section of, and the ratio of cross sections of the two samples. Control samples in the dilepton+photon and lepton+photon+\met, channels are constructed to aid in decay product identification and background measurements. We observe 30 ttbar+photon candidate events compared to the standard model expectation of 26.9 +/- 3.4 events. We measure the ttbar+photon cross section to be 0.18+0.08 pb, and the ratio of the cross section of ttbar+photon to ttbar to be 0.024 +/- 0.009. Assuming no ttbar+photon production, we observe a probability of 0.0015 of the background events alone producing 30 events or more, corresponding to 3.0 standard deviations.Comment: 9 pages, 3 figure

Search for the Higgs boson in events with missing transverse energy and b quark jets produced in proton-antiproton collisions at s**(1/2)=1.96 TeV

We search for the standard model Higgs boson produced in association with an electroweak vector boson in events with no identified charged leptons, large imbalance in transverse momentum, and two jets where at least one contains a secondary vertex consistent with the decay of b hadrons. We use ~1 fb-1 integrated luminosity of proton-antiproton collisions at s**(1/2)=1.96 TeV recorded by the CDF II experiment at the Tevatron. We find 268 (16) single (double) b-tagged candidate events, where 248 +/- 43 (14.4 +/- 2.7) are expected from standard model background processes. We place 95% confidence level upper limits on the Higgs boson production cross section for several Higgs boson masses ranging from 110 GeV/c2 to 140 GeV/c2. For a mass of 115 GeV/c2 the observed (expected) limit is 20.4 (14.2) times the standard model prediction.Comment: 8 pages, 2 figures, submitted to Phys. Rev. Let