Sepsis and septic shock are major causes of mortality during chemotherapy-induced neutropenia for malignancies requiring urgent treatment. Thus, awareness of the presenting characteristics and prompt ...management is most important. Improved management of sepsis during neutropenia may reduce the mortality of cancer therapies. However, optimal management may differ between neutropenic and non-neutropenic patients. The aim of the current guideline is to give evidence-based recommendations for hematologists, oncologists, and intensive care physicians on how to manage adult patients with neutropenia and sepsis.
Introduction
Since the early SARS-CoV-2 pandemic, cancer patients have been assumed to be at higher risk for severe COVID-19. Here, we present an analysis of cancer patients from the LEOSS (Lean ...European Open Survey on SARS-CoV-2 Infected Patients) registry to determine whether cancer patients are at higher risk.
Patients and methods
We retrospectively analyzed a cohort of 435 cancer patients and 2636 non-cancer patients with confirmed SARS-CoV-2 infection, enrolled between March 16 and August 31, 2020. Data on socio-demographics, comorbidities, cancer-related features and infection course were collected. Age-, sex- and comorbidity-adjusted analysis was performed. Primary endpoint was COVID-19-related mortality.
Results
In total, 435 cancer patients were included in our analysis. Commonest age category was 76–85 years (36.5%), and 40.5% were female. Solid tumors were seen in 59% and lymphoma and leukemia in 17.5% and 11% of patients. Of these, 54% had an active malignancy, and 22% had recently received anti-cancer treatments. At detection of SARS-CoV-2, the majority (62.5%) presented with mild symptoms. Progression to severe COVID-19 was seen in 55% and ICU admission in 27.5%. COVID-19-related mortality rate was 22.5%. Male sex, advanced age, and active malignancy were associated with higher death rates. Comparing cancer and non-cancer patients, age distribution and comorbidity differed significantly, as did mortality (14% vs 22.5%,
p
value < 0.001). After adjustments for other risk factors, mortality was comparable.
Conclusion
Comparing cancer and non-cancer patients, outcome of COVID-19 was comparable after adjusting for age, sex, and comorbidity. However, our results emphasize that cancer patients as a group are at higher risk due to advanced age and pre-existing conditions.
The concentration of sulfur in Hanford low‐activity waste (LAW) glass melter feed will be maintained below the point where the salt accumulates on the melt surface. The allowable concentrations may ...range from near zero to over 2.05 wt% (of SO3 on a calcined oxide basis) depending on the composition of the melter feed and processing conditions. If the amount of sulfur exceeds the melt tolerance level, a molten salt will accumulate which may upset melter operations and potentially shorten the useful life of the melter. At the Hanford site, relatively conservative limits have traditionally been placed on sulfur loading in melter feed, which in turn significantly increases the amount of LAW glass that will be produced. Crucible‐scale sulfur solubility data and scaled melter sulfur tolerance data have been collected on simulated Hanford waste glasses over the last 15 years. These data were compiled and analyzed. An empirical model was developed to predict the solubility of SO3 in glass based on 253 simulated Hanford LAW glass compositions. This model represents the data well, accounting for over 85% of the variation in data, and was well validated. The model was also found to accurately predict the maximum amount of sulfur in melter feed that did not form a salt layer in 13 scaled melter tests of simulated LAW glasses. The model can be used to help estimate glass volumes and make informed decisions on process options (e.g., scale of supplemental LAW treatment facility, and pretreatment facility performance requirements). The model also gives quantitative estimates of component concentration effects on sulfur solubility. The components that increase sulfur solubility most are Li2O > V2O5 > CaO ≈ P2O5 > Na2O ≈ B2O3 > K2O. The components that decrease sulfur solubility most are Cl > Cr2O3 > Al2O3 > ZrO2 ≈ SnO2 > Others (i.e., the sum of minor components) ≈SiO2. The order of component effects is similar to previous literature data, in most cases.
Aims
We sought to evaluate the effects of Bacillus species, low surface concentrations, and surface material on recovery efficiency (RE), false‐negative rate (FNR) and limit of detection for ...recovering Bacillus spores using a validated macrofoam‐swab sampling procedure.
Methods and Results
The performance of a macrofoam‐swab sampling method was evaluated using Bacillus anthracis Sterne (BAS) and Bacillus atrophaeus Nakamura (BG) spores applied at nine low target surface concentrations (2 to 500 CFU per plate or coupon) to positive‐control plates and test coupons (25·8064 cm2) of four surface materials (glass, stainless steel, vinyl tile and plastic). The Bacillus species and surface material had statistically significant effects on RE, but surface concentration did not. Mean REs were the lowest for vinyl tile (50·8% with BAS and 40·2% with BG) and the highest for glass (92·8% with BAS and 71·4% with BG). FNR values (which ranged from 0 to 0·833 for BAS and from 0 to 0·806 for BG) increased as surface concentration decreased in the range tested. Surface material also had a statistically significant effect on FNR, with FNR the lowest for glass and highest for vinyl tile. Finally, FNR tended to be higher for BG than for BAS at lower surface concentrations, especially for glass.
Conclusions
Concentration and surface material had significant effects on FNR, with Bacillus species having a small effect. Species and surface material had significant effects on RE, with surface concentration having a nonsignificant effect.
Significance and Impact of the Study
The results provide valuable information on the performance of the macrofoam‐swab method for low surface concentrations of Bacillus spores, which can be adapted to assess the likelihood that there is no contamination when all macrofoam‐swab samples fail to detect B. anthracis.
A mixture experiment (ME) combines components in various proportions and observes the values of one or more responses for each mixture. The proportions of the q components in each mixture must sum to ...1.0. Two statistical approaches for modeling MEs have been discussed in the literature. The slack-variable (SV) approach uses proportions of all but one (q − 1) of the components varied in a mixture (the SV). The component-proportion (CP) approach uses the relative proportions of all q components varied in a mixture. Several articles have claimed advantages and recommended the SV modeling approach over the CP modeling approach. In contrast, a 2009 article recommended the CP modeling approach for several reasons. Our article reviews the literature, evaluates the literature justifications for using the SV modeling approach, and uses literature examples to compare the CP and SV modeling approaches. Recommendations regarding when to use the CP and SV modeling approaches are provided.
Statistical models based on classical calibration and inverse calibration statistical methods were developed using high-temperature data reported in the literature for sodium-alumino-silicate ...glasses. Within the composition and temperature regimes for which the models were developed, the predicted values for temperature and glass composition agree very well with the actual values. R exp 2 values for the classical and inverse calibration approaches were 0.951 and 0.982, respectively, for melt temperature, and 0.990 and 0.995, respectively, for glass composition (Al sub 2 O sub 3 concentration). Based on the results of the Phase I work, an OMMS composed of a high-temperature Raman spectrometer and statistical models involving mathematical functions of Raman parameters, melt temperature, and melt composition appears to be feasible for on-line glass process control. The combination of improved, high-temperature Raman spectroscopy technology and reliable statistical models is envisioned to have potential applications for next-generation, integrated, on-line process control systems for commercial glass and radioactive waste glass vitrification facilities.
PDF
