Unitary evolution for a two-level quantum system in fractional-time scenario

The time-evolution operator obtained from the fractional-time Schrödinger equation (FTSE) is said to be nonunitary since it does not preserve the norm of the vector state in time. As done in the time-dependent non-Hermitian quantum formalism, for a traceless non-Hermitian two-level quantum system, we demonstrate that it is possible to map the nonunitary time-evolution operator in a unitary one. It is done by considering a dynamical Hilbert space with a time-dependent metric operator, constructed from a Hermitian time-dependent Dyson map, in respect to which the system evolves in a unitary way, and the standard quantum mechanics interpretation can be made properly. To elucidate our approach, we consider three examples of Hamiltonian operators and their corresponding unitary dynamics obtained from the solutions of FTSE, and the respective Dyson maps.

Efficiency of random search with space-dependent diffusivity

We address the problem of random search for a target in an environment with a space-dependent diffusion coefficient D(x). Considering a general form of the diffusion differential operator that includes Itô, Stratonovich, and Hänggi-Klimontovich interpretations of the associated stochastic process, we obtain and analyze the first-passage-time distribution and use it to compute the search efficiency E=〈1/t〉. For the paradigmatic power-law diffusion coefficient D(x)=D_{0}|x|^{α}, where x is the distance from the target and α<2, we show the impact of the different interpretations. For the Stratonovich framework, we obtain a closed-form expression for E, valid for arbitrary diffusion coefficient D(x). This result depends only on the distribution of diffusivity values and not on its spatial organization. Furthermore, the analytical expression predicts that a heterogeneous diffusivity profile leads to a lower efficiency than the homogeneous one with the same average level within the space between the target and the searcher initial position, but this efficiency can be exceeded for other interpretations.

Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late

Diabetic peripheral neuropathy in people with type 2 diabetes is poorly managed because of its insidious onset, delayed diagnosis and more complex aetiology resulting from the contribution of not only hyperglycaemia, but also ageing, hyperlipidaemia, hypertension and obesity. Because there is no US Food and Drug Adminstration-approved disease-modifying therapy for diabetic peripheral neuropathy, the key to ameliorating it in type 2 diabetes has to be through earlier diagnosis and timely multi-factorial risk factor reduction. The management of painful diabetic peripheral neuropathy also requires a detailed appraisal of the choice of therapy, taking into account efficacy, patient wishes, comorbidities, side effect profile and potential for abuse.

Abstract P6-18-16: Ribociclib (RIBO) + letrozole (LET) in older patients with hormone receptor-positive (HR+), human epidermal growth factor receptor-2–negative (HER2–) advanced breast cancer (ABC): Preliminary subgroup results from the phase 3b CompLEEment-1 trial

Background: The cyclin-dependent kinase (CDK)4/6 inhibitor RIBO is approved in combination with an aromatase inhibitor (AI) for HR+, HER2– ABC in postmenopausal women with no prior therapy for ABC, based on the MONALEESA-2 trial (Hortobagyi et al. NEJM 2016). Although a high proportion of patients with HR+, HER2– ABC are &gt;65 years of age, older patients are often under-represented in clinical trials. Furthermore, treatment decisions may be complicated by comorbidities, functional status, and concurrent medications. Here, we report early safety results for patients ≥65 years of age enrolled in CompLEEment-1, an open-label, phase 3b trial evaluating RIBO+LET as first-line endocrine-based therapy in an expanded patient population.

Methods: Patients with HR+, HER2– ABC, ≤1 line of prior chemotherapy (CT), and no prior endocrine therapy for ABC received RIBO (600 mg/day, 3 weeks on/1 week off) + LET (2.5 mg/day); men and premenopausal women received concomitant goserelin (3.6-mg subcutaneous implant every 28 days). The primary outcome was safety and tolerability. A pre-planned interim analysis was conducted ˜15 months after first patient first visit.

Results: Of the first 1,008 patients enrolled who completed 56 days of follow-up or discontinued before the data cut-off date, 377 were ≥65 years of age. Of these, 157 (41.6%) were 65-&lt;70 years, 107 (28.4%) were 70-&lt;75 years, and 113 (30%) were ≥75 years. The majority of patients (94.4%) had an Eastern Cooperative Oncology Group performance status ≤1; 33.2% presented with stage IV disease at diagnosis; 9 patients were male. The most common sites of metastasis were bone (70.0%), lung (44.8%), and lymph nodes (29.7%). The most common all-grade adverse events (AEs) were neutropenia (58.4%), nausea (31.8%), and fatigue (24.1%). The most common grade 3/4 AEs were neutropenia (37.7%) and alanine aminotransferase increase (4.2%). QT prolongation events were mild (majority grade 1/2) and occurred in 6.1% of patients (0.5% grade 3/4). Dose reduction or interruption due to AEs occurred in 54.5% of patients; 6.9% of patients had AEs leading to treatment discontinuation. In the overall patient population, the most frequent grade 3/4 AEs were neutropenia (42.8%), leukopenia (3.4%), and increased alanine aminotransferase (2.9%); QT prolongation occurred in 5.4% of patients (0.5% grade 3/4).

Conclusions: Initial safety results from CompLEEment-1, from the first 56 days of follow-up, demonstrate the tolerability of RIBO+LET in older patients, consistent with the overall patient population. NCT02941926.

Citation Format: Ring A, Borstnar S, Ferreira A, Azim HA, Cottu P, Lu J, Martin M, Zamagni C, Beck JT, Zhou K, Wu J, Menon L, De Laurentiis M. Ribociclib (RIBO) + letrozole (LET) in older patients with hormone receptor-positive (HR+), human epidermal growth factor receptor-2–negative (HER2–) advanced breast cancer (ABC): Preliminary subgroup results from the phase 3b CompLEEment-1 trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-16.

Pattern formation in nanoporous titania templates

We have carried out a systematic investigation into the formation of nanoscaled patterns in titania (TiO2) templates under dc anodization of Ti in HF acid. At lower acid concentrations (around 0.5 wt% HF) either pores or tubes form at the surface of anodized titanium foil. The pores or nanotubes are separated from the bottom Ti layer by a thin barrier layer of TiO2. The critical voltage where the transition from pores to tubes occurs has been determined. It is observed that the transition voltage shift towards higher voltages as acid concentration is increased, with pore formation disappearing altogether at high acid concentrations. We have also carried out a systematic investigation into the dependence of pore and tube parameters on the applied dc anodization voltage. Our results indicate that the barrier layer thickness, pore and tube length increase as a function of applied voltage.

Ethnic differences in selective neonatal BCG immunisation: white British children miss out

BACKGROUND

Tuberculosis (TB) is a re-emerging problem, especially in the larger cities of Western Europe. Selective neonatal BCG vaccination is recommended for infants at risk of TB in the UK. Neonatal BCG is safe and effective, with an overall protective value of 75%. This study aimed to assess BCG rates among at risk infants in Cardiff and the Vale of Glamorgan, South Wales in the year 2003.

METHODS

A cohort of infants at risk for TB was identified from demographic data stored on a computerised maternity activity database. A manual search of immunisation records determined overall rates and the rates for infants belonging to various ethnic groups.

RESULTS

Of 5308 infants born in 2003, 514 (9.6%) were at risk of TB; 423 (82.2%) of these infants were referred postnatally for BCG vaccination and 391 received it. Twenty six of the 41 at risk white British infants missed having a BCG vaccination compared with 47 of 288 Asian infants and seven of 39 black African babies. The rate of BCG vaccination among white British infants was 36.5% compared with 83.6% for Asian infants from the Indian subcontinent (chi(2) = 7.25, p<0.01) and 82% for black African infants (chi(2) = 4.48, p<0.05).

CONCLUSIONS

The overall BCG rate among at risk infants in Cardiff was 76% during the study period. The vaccination rate was poor among white British infants compared with other ethnic groups. Enhanced awareness of health professionals to recognise the need for vaccinating certain white children at risk of TB is essential to improve BCG coverage in an increasingly multiethnic population.

Serum interleukin-10 in ICU patients with severe acute central nervous system injuries

RATIONALE

IL-10, the main anti-inflammatory cytokine, may play a pivotal role in cerebral inflammation implicated in the development of brain edema and secondary brain damage after injury.

AIM OF THE STUDY

1) Determining absolute IL-10 serum level and its pattern in critically ill patients with traumatic and non-traumatic acute brain injury. 2) Assessment of prognostic value of serum IL-10 in those patients.

MATERIALS AND METHODS

Serum IL-10 levels in 46 adults (multi-profile ICU, teaching hospital) with traumatic brain injury (TBI, N = 18), nontraumatic intracranial hemorrhage (SAH, N = 11) and polytrauma with concomitant brain injury (POL, N = 17) were measured using ELISA. Relationship of IL-10 and initial diagnosis, clinical state, outcome and risk of infection development was evaluated.

RESULTS

IL-10 was detectable in the serum of all but one patient on ICU admission (56.6 +/- 91.9 pg/ml; mean +/- SD). No statistically significant differences in IL-10 between TBI, SAH and POL groups as well as between survivors and non-survivors on any day were found. No correlation between IL-10 and GCS or SAPS II was seen. Significant fall in serum IL-10 during the first 4 days of injury in patients of all subgroups was observed. Patients with initial serum IL-10 below 77 pg/ml were at significantly higher risk of development of any infection within the first week of injury.

CONCLUSIONS

After acute brain injury, serum IL-10 in adults is detectable independent of CNS lesion type. Its systemic release is strongly individualized. Serum IL-10 on ICU admission may have some prognostic value to predict development of infection in patients with CNS lesions.

Magnetic and structural properties of electrochemically self-assembled Fe1-xCox nanowires

Fe1-xCox (0 < or = x < or = 1) nanowires have been self-assembled by electrodeposition in porous alumina films. The crystal structure is bee at the Fe end. With increased addition of Co, the crystal structure remains bcc until about 67% addition of Co. At the Co end, the structure is a mixture of hcp and fcc. Magnetic studies show very high coercivities for the Fe-Co alloys in the bcc phase. For Fe0.67Co0.33 nanowires of diameter 9 nm, the coercivity is about 2900 Oe, whereas for Fe0.33Co0.67 nanowires, it is about 2850 Oe. Temperature and size dependence of magnetic properties show no indication of superparamagnetic effects down to wire diameters of 9 nm.

Pneumocystis carinii pneumonia in human immunodeficiency virus infected patients in Bombay: diagnosed by bronchoalveolar lavage cytology and transbronchial lung biopsy

We report Pneumocystis carinii pneumonia (PCP) diagnosed by bronchoalveolar lavage cytology and transbronchial lung biopsy in three out of five human immunodeficiency virus (HIV) positive adult patients presenting with interstitial pneumonitis. One of these patients was serologically positive for HIV at the time of presentation and the remaining two patients were detected to be HIV positive on follow up after the diagnosis had been established. All the three patients were treated with co-trimoxazole. One patient recovered and was discharged; another patient improved with treatment but died after jugular vein cannulation and the third patient succumbed to cryptosporidial diarrhoea. The remaining two patients with non-specific interstitial pneumonitis treated with prednisolone and bronchodilators were recovered and were discharged from the hospital.

Anti-inflammatory action of steroid inhalers

With mucosal inflammation contributing to the pathogenesis of asthma, it is increasingly accepted that long term steroid inhalers may induce remission in chronic long standing asthmatics. The present study involved 44 stable asthmatics who were randomly given either beclomethasone dipropionate inhaler (50 ug) 2 puffs qds or salbutamol inhaler (100 mcg) 2 puffs tds in addition to their oral bronchodilators. Pulmonary function testing, bronchoalveolar lavage and complete blood count were done at basal and weekly intervals and at the end of the study. The absolute eosinophil count showed a significant drop in the beclomethasone group as compared to the salbutamol group. Serial lung functions showed a significant improvement in the pre-bronchodilator PEFR and the pre-bronchodilator FVC in the beclomethasone group as compared to the salbutamol group. There was no significant change in the lavage eosinophil count pre and post-bronchodilator in both groups. Steroid inhalers are thus useful in long term management of bronchial asthma especially with respect to reducing bronchodilator requirement.

Persistent in vitro survival of coagulase-negative staphylococci adherent to intravascular catheters in the absence of conventional nutrients

The in vitro survival of coagulase-negative staphylococci in media devoid of routine nutritional supplementation was assessed in the presence and absence of catheter materials to evaluate bacterium-device interactions. Strains of slime- and non-slime-producing coagulase-negative staphylococci were suspended in phosphate-buffered saline together with multiple segments of polyvinyl chloride (PVC), Teflon, Silastic, and polyurethane catheters and in control suspensions without catheters. Catheters were removed at 2 min and 24, 48, 72, and 96 h of incubation and washed thoroughly, and semiquantitative roll cultures were performed on blood agar. In addition, after 96 h catheters were introduced into tryptic soy broth (TSB), and roll cultures were performed after 18 h of incubation. Results demonstrated that after 96 h, 6 of 32 catheter specimens (4 PVC) had greater than 10 CFU of coagulase-negative staphylococci per catheter; after TSB addition, 18 of 32 catheter specimens had greater than or equal to 100 CFU per catheter (8 of 8 PVC catheters had greater than 1,000 CFU per catheter). In control suspensions, no growth was seen at 96 h or after TSB addition. No differences in the survival of slime- versus non-slime-producing strains were observed in control or catheter studies. These findings suggest that both slime- and non-slime-producing coagulase-negative staphylococci survive in vitro on catheters (especially PVC) in the absence of conventional nutrients and can proliferate on catheters when nutrients are added. Catheter-adherent coagulase-negative staphylococci appear to possess survival mechanisms under adverse conditions which may relate to the genesis of occult foreign-body-associated infections.