This article reports world averages of measurements of
b
-hadron,
c
-hadron, and
τ
-lepton properties obtained by the Heavy Flavor Averaging Group using results available through summer 2016. For the ...averaging, common input parameters used in the various analyses are adjusted (rescaled) to common values, and known correlations are taken into account. The averages include branching fractions, lifetimes, neutral meson mixing parameters,
C
P
violation parameters, parameters of semileptonic decays, and Cabbibo–Kobayashi–Maskawa matrix elements.
Septic shock is characterized by dysregulation of the host response to infection, with circulatory, cellular, and metabolic abnormalities. We hypothesized that therapy with hydrocortisone plus ...fludrocortisone or with drotrecogin alfa (activated), which can modulate the host response, would improve the clinical outcomes of patients with septic shock.
In this multicenter, double-blind, randomized trial with a 2-by-2 factorial design, we evaluated the effect of hydrocortisone-plus-fludrocortisone therapy, drotrecogin alfa (activated), the combination of the three drugs, or their respective placebos. The primary outcome was 90-day all-cause mortality. Secondary outcomes included mortality at intensive care unit (ICU) discharge and hospital discharge and at day 28 and day 180 and the number of days alive and free of vasopressors, mechanical ventilation, or organ failure. After drotrecogin alfa (activated) was withdrawn from the market, the trial continued with a two-group parallel design. The analysis compared patients who received hydrocortisone plus fludrocortisone with those who did not (placebo group).
Among the 1241 patients included in the trial, the 90-day mortality was 43.0% (264 of 614 patients) in the hydrocortisone-plus-fludrocortisone group and 49.1% (308 of 627 patients) in the placebo group (P=0.03). The relative risk of death in the hydrocortisone-plus-fludrocortisone group was 0.88 (95% confidence interval, 0.78 to 0.99). Mortality was significantly lower in the hydrocortisone-plus-fludrocortisone group than in the placebo group at ICU discharge (35.4% vs. 41.0%, P=0.04), hospital discharge (39.0% vs. 45.3%, P=0.02), and day 180 (46.6% vs. 52.5%, P=0.04) but not at day 28 (33.7% and 38.9%, respectively; P=0.06). The number of vasopressor-free days to day 28 was significantly higher in the hydrocortisone-plus-fludrocortisone group than in the placebo group (17 vs. 15 days, P<0.001), as was the number of organ-failure-free days (14 vs. 12 days, P=0.003). The number of ventilator-free days was similar in the two groups (11 days in the hydrocortisone-plus-fludrocortisone group and 10 in the placebo group, P=0.07). The rate of serious adverse events did not differ significantly between the two groups, but hyperglycemia was more common in hydrocortisone-plus-fludrocortisone group.
In this trial involving patients with septic shock, 90-day all-cause mortality was lower among those who received hydrocortisone plus fludrocortisone than among those who received placebo. (Funded by Programme Hospitalier de Recherche Clinique 2007 of the French Ministry of Social Affairs and Health; APROCCHSS ClinicalTrials.gov number, NCT00625209 .).
A series of experimental tests were performed to measure the efficiency of volatile iodine trapping on sand bed filters and metallic filters. These filtering media are used in French nuclear power ...plants to mitigate releases in case of severe accident. The results show that molecular iodine is more easily trapped than methyl iodide due to its high chemical affinity with stainless steel or with silver and cesium cations included in the filter medium. For methyl iodide, the trapping efficiency is low.
Information on the species causing Candida peritonitis, their in vitro susceptibility, antifungal strategies in this setting and patient outcome is still scarce. AmarCand was a prospective, ...non-interventional study in 271 adult intensive-care unit (ICU) patients with proven invasive Candida infection who received systemic antifungal therapy (France, 2005–2006). Of these ICU patients, 93 (median age 65 years, simplified acute physiology score II 52) had Candida peritonitis, including 73 nosocomial peritonitis, 53 concomitant bacterial peritoneal infections and 26 candidaemias. Candida species were C. albicans (n = 63/108 isolates, 58%), C. glabrata (n = 22, 20%), C. krusei (n = 9), C. kefyr (n = 5), C. parapsilosis (n = 3), C. tropicalis (n = 3), C. ciferii (n = 2) and C. lusitaniae (n = 1). Of tested isolates, 28% were fluconazole-resistant or susceptible dose-dependent (C. albicans 3/32, C. glabrata 9/14, C. krusei 4/4). Empiric antifungal treatment was started 1 day (median) after peritonitis diagnosis, with fluconazole (n = 72 patients), caspofungin (n = 12), voriconazole (n = 3), amphotericin B (n = 2), or a combination (n = 4). Following susceptibility testing, empiric antifungal treatment was judged inadequate in 9/45 (20%) patients and modified in 30 patients (fluconazole was replaced by caspofungin (n = 14) or voriconazole (n = 4)). Mortality in ICU was 38% (35/93) and was not influenced by type of Candida species, fluconazole susceptibility, time to treatment, candidaemia, nosocomial acquisition, or concomitant bacterial infection. No specific factors for death were identified. In summary, a high proportion of fluconazole-resistant or susceptible dose-dependent strains was cultured. These results confirm the high mortality rates of Candida peritonitis and plead for additional investigation in this population. Antifungal treatment for severe cases of Candida peritonitis in ICU patients remains the standard care.
A 3-D model of a microwave plasma (mwp)-enhanced chemical vapor deposition (PECVD) reactor at 2.45 GHz in argon at low pressure describing self-consistently, the coupling of the microwave energy into ...the plasma is presented. The characteristics of the discharge are simulated using a fluid plasma model which solves the electron and ion continuity equations, electron energy balance equation, and the Poisson's equation by finite element method, using COMSOL Multiphysics software. The physical behavior of the microwave PECVD discharge, such as plasma density, electron temperature, electric field and plasma potential, are simulated and analyzed. The chemical reactions considered in this paper are: elastic, superelastic, excitation, ionization, penning ionization and metastable quenching processes, involving electrons, ions (Ar + ), neutral atoms (Ar), and excited metastable argon atoms (Ar*). The plasma characterization results are studied for a gas temperature of 300 K, a gas pressure of 100 mtorr and a microwave power of 600 W. The effect of varying gas pressure from 50 to 200 mTorr has been studied. The obtained results turn out to be in agreement with previous measurements and show that this kind of model can lead to a better understanding of the physical processes occurring in this kind of microwave reactor and thus allow optimization of this device.
Prosthetic vascular graft infection (PVGI) is a devastating complication, with a mortality rate of up to 75%, which is especially caused by aortic graft infection. The purpose of this study was to ...evaluate factors associated with in-hospital mortality of patients with definite graft infection, and with long-term outcome. We reviewed medical records of 85 patients treated for PVGIs defined by positive bacterial culture of intraoperative specimens or blood samples, and/or clinical, biological and radiological signs of infection. In-hospital patient mortality was defined as any death occurring during the initial treatment of the graft infection. Cure was defined as the absence of evidence of relapsing infection during long-term follow-up (≥1 year). Eighty-five patients (54 aortic and 31 limb graft infections) treated by surgical debridement and removal of the infected prosthesis (n = 41), surgical debridement without removal of prosthesis (n = 34) or antimicrobial treatment without surgery (n = 10) were studied. The only microbiological difference observed between patients with early (occurring within 4 months after surgery) vs. late PVGI and between those with aortic vs. limb PVGI was the incidence of PVGI caused by Staphylococcus aureus, which was greater in patients with limb PVGI. Overall cure was observed in 93.2% of 59 patients with a follow-up of a minimum of 1 year. Overall in-hospital mortality was 16.5% (n = 14). Two variables were independently associated with mortality: age >70 years (OR 9.1, 95% CI 1.83–45.43, p 0.007) and aortic graft infection (OR 5.6, 95% CI 1.1–28.7, p 0.037).
In the frame of severe accident topic for pressurized water reactor, the physical-chemistry of Ru fission products were experimentally studied to better understand their behavior inside the reactor ...coolant system in air or air/steam atmospheres. The tests consisted in vaporizing RuO
2
at 1200 °C and the ruthenium oxides are transported through a controlled thermal gradient tube made of quartz or pre-oxidized stainless steel. Results show that the major part up to 95% is deposited along the tube, the remaining part being transported almost under gaseous form attributed to RuO
4
. Impact of carrier gas, temperature profile and nature of the tube are discussed.
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