NOD2 mutations and anti-Saccharomyces cerevisiae antibodies are risk factors for Crohn's disease in African Americans

OBJECTIVES

NOD2 mutations and anti-Saccharomyces cerevisiae antibodies (ASCAs) are established risk factors of Crohn's disease (CD) in whites but have not been assessed in African-American (AA) adults with CD.

METHODS

AAs with CD and controls were recruited by the Mid-Atlantic African-American IBD Study as part of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) IBD Genetics Consortium. Genotyping for the three common CD NOD2 mutations (Leu1007fsinsC, G908R/2722g>c, and R702W/2104c>t) and ASCA enzyme-linked immunosorbent assays were performed in 183 AA CD patients and in 143 controls. Logistic regression was used to calculate adjusted odds ratios (ORs) for the association between ASCA and disease phenotype.

RESULTS

ASCA sensitivity and specificity values were 70.5 and 70.4%, respectively. On univariate analysis, ASCA was significantly associated with younger age at diagnosis, ileal involvement, and complicated (stricturing/penetrating) behavior. On multivariate analysis, ASCA titer (per 25 Units) was associated with ileal involvement (OR 1.18, 95% confidence interval (CI): 1.04-1.34), complicated behavior (OR 1.13, 95% CI: 1.01-1.28), and surgery (hazard ratio: 1.11, 95% CI: 1.02-1.21). Cigarette smoking and CD family history were also significantly associated with surgery. NOD2 carriers (all heterozygotes) were more common among CD cases than controls (8.2 vs. 2.1%; OR 4.17%, 95% CI: 1.18-14.69). The NOD2 mutation population attributable risk was 6.2%.

CONCLUSIONS

In comparison with whites, ASCA in AAs has a similar sensitivity but a lower specificity for CD. ASCA is associated with ileal involvement, complicated behavior, and surgery in AAs with CD. NOD2 is a risk gene for AA CD, although mutation frequency and population attributable risk are much lower than in whites.

Search for supersymmetry with gauge-mediated breaking in diphoton events with missing transverse energy at CDF II

We present the results of a search for supersymmetry with gauge-mediated breaking and chi(1)(0) --> gammaG in the gammagamma + missing transverse energy final state. In 2.6+/-0.2 fb(-1) of pp collisions at square root(s) = 1.96 TeV recorded by the CDF II detector we observe no candidate events, consistent with a standard model background expectation of 1.4+/-0.4 events. We set limits on the cross section at the 95% C.L. and place the world's best limit of 149 GeV/c2 on the chi(1)(0) mass at tau(chi(1)(0)) << 1 ns. We also exclude regions in the chi(1)(0) mass-lifetime plane for tau(chi(1)(0)) approximately < 2 ns.

Safety profile of IBD: lymphoma risks

This article describes the cancer risks of commonly used inflammatory bowel disease (IBD) medications, with an emphasis on hematologic malignancy risks. The increasing use of immunosuppressant therapies in the treatment of IBD has raised this question to an even greater importance. Studies evaluating these medications are complicated due to varying disease severity and concomitant use of other immunosuppressant medication. The potential risks of all therapies must be weighed against the benefits these therapies can offer these patients.

Safety profile of IBD: lymphoma risks

This article describes the cancer risks of commonly used inflammatory bowel disease (IBD) medications, with an emphasis on hematologic malignancy risks. The increasing use of immunosuppressant therapies in the treatment of IBD has raised this question to an even greater importance. Studies evaluating these medications are complicated due to varying disease severity and concomitant use of other immunosuppressant medication. The potential risks of all therapies must be weighed against the benefits these therapies can offer these patients.

Comparison of in-situ calibration methods for quantifying input to the middle ear

Sound pressure level in-situ measurements are sensitive to standing-wave pressure minima and have the potential to result in over-amplification with risk to residual hearing in hearing-aid fittings. Forward pressure level (FPL) quantifies the pressure traveling toward the tympanic membrane and may be a potential solution as it is insensitive to ear-canal pressure minima. Derivation of FPL is dependent on a Thevenin-equivalent source calibration technique yielding source pressure and impedance. This technique is found to accurately decompose cavity pressure into incident and reflected components in both a hard-walled test cavity and in the human ear canal through the derivation of a second sound-level measure termed integrated pressure level (IPL). IPL is quantified by the sum of incident and reflected pressure amplitudes. FPL and IPL were both investigated as measures of sound-level entering the middle ear. FPL may be a better measure of middle-ear input because IPL is more dependent on middle-ear reflectance and ear-canal conductance. The use of FPL in hearing-aid applications is expected to provide an accurate means of quantifying high-frequency amplification.

Search for the associated production of the standard-model Higgs Boson in the all-hadronic channel

We report on a search for the standard-model Higgs boson in pp collisions at square root(s) = 1.96 TeV using an integrated luminosity of 2.0 fb(-1). We look for production of the Higgs boson decaying to a pair of bottom quarks in association with a vector boson V (W or Z) decaying to quarks, resulting in a four-jet final state. Two of the jets are required to have secondary vertices consistent with B-hadron decays. We set the first 95% confidence level upper limit on the VH production cross section with V(--> qq/qq')H(--> bb) decay for Higgs boson masses of 100-150 GeV/c2 using data from run II at the Fermilab Tevatron. For m(H) = 120 GeV/c2, we exclude cross sections larger than 38 times the standard-model prediction.

Search for Higgs bosons predicted in two-Higgs-doublet models via decays to tau lepton pairs in 1.96 TeV pp collisions

We present the results of a search for Higgs bosons predicted in two-Higgs-doublet models, in the case where the Higgs bosons decay to tau lepton pairs, using 1.8 fb(-1) of integrated luminosity of pp collisions recorded by the CDF II experiment at the Fermilab Tevatron. Studying the mass distribution in events where one or both tau leptons decay leptonically, no evidence for a Higgs boson signal is observed. The result is used to infer exclusion limits in the two-dimensional space of tanbeta versus m(A) (the ratio of the vacuum expectation values of the two Higgs doublets and the mass of the pseudoscalar boson, respectively).

Validity of The Health Improvement Network (THIN) for epidemiologic studies of hepatitis C virus infection

PURPOSE

Before using computerized databases to study hepatitis C virus (HCV) epidemiology, the validity of the diagnosis must be assessed. We determined the accuracy of HCV diagnostic codes within The Health Improvement Network (THIN), an electronic database containing medical record data from general medical practices in the United Kingdom.

METHODS

Patients with initial diagnostic codes for HCV infection and nonspecific viral hepatitis between 2000 and 2007 in the THIN database were identified. Questionnaires were mailed to general practitioners caring for a random sample of 150 of these patients (75 with an HCV code; 75 with a nonspecific viral hepatitis code) to collect information on HCV and other hepatitis diagnoses. We determined the positive predictive value of the database's HCV diagnostic codes and its ability to identify the date of a new HCV diagnosis.

RESULTS

Usable surveys were returned for 146 (97%) patients. Among 74 patients with an HCV code and questionnaire data, HCV was confirmed in 64 (positive predictive value, 86%; 95%CI, 77-93%). In 40 (63%), the first recorded diagnosis in THIN was within 30 days of the date reported in the questionnaire (median difference, 11 days; interquartile range, 0-362 days). Among 72 patients with a nonspecific viral hepatitis code, 16 (22%) had HCV, but manual review of the database's electronic records correctly identified 12/16 (75%).

CONCLUSIONS

In THIN, the HCV-specific diagnostic codes are highly predictive of HCV infection. After manual review, few patients with a nonspecific viral hepatitis code were misclassified as having HCV infection.

First observation of B(s)(0) --> D(s)(+/-)K(-/+) and measurement of the ratio of branching fractions B(B(s)(0) --> D(s)(+/-)K(-/+)/B(B(s)(0) --> D(s)(+)pi(-))

A combined mass and particle identification fit is used to make the first observation of the decay B(s)(0) --> D(s)(+/-)K(-/+) and measure the branching fraction of B(s)(0) --> D(s)(+/-)K(-/+) relative to B(s)(0) --> D(s)(+)pi(-). This analysis uses 1.2 fb(-1) integrated luminosity of pp collisions at square root(s) = 1.96 TeV collected with the CDF II detector at the Fermilab Tevatron collider. We observe a B(s)(0) --> D(s)(+/-)K(-/+) signal with a statistical significance of 8.1 sigma and measure B(B(s)(0) --> D(s)(+/-)K(-/+) /B(B(s)(0) --> D(s)(+)pi(-) 0.097+/-0.018(stat) +/- 0.009(syst).

Timing of myelosuppression during thiopurine therapy for inflammatory bowel disease: implications for monitoring recommendations

BACKGROUND & AIMS

Thiopurines (azathioprine and 6-mercaptopurine) can induce life-threatening myelosuppression. This study determined the frequency, timing, and outcomes of mild and severe myelosuppression after initiation of thiopurine therapy.

METHODS

This retrospective cohort study included patients with inflammatory bowel disease who were new users of thiopurines; those tested for thiopurine methyltransferase levels before therapy were excluded. Patients were followed from their first thiopurine prescription until the earliest of severe leukopenia (white blood cell count, <1.0 x 10(9)/L), severe thrombocytopenia (platelet level, <20 x 10(9)/L), the end of therapy, the first gap in therapy, disenrollment, or December 31, 2006.

RESULTS

Among 1997 new users, the incidence of severe leukopenia per 100 person-months was 0.16 (95% confidence interval [CI], 0.03-0.29; n = 6) in weeks 0 to 8, 0.00 in weeks 9 to 24, and 0.01 (95% CI, 0-0.03; n = 3) after week 26 of therapy. The incidence of severe neutropenia and severe thrombocytopenia per 100 person-months during the first 8 weeks of therapy was 0.51 (95% CI, 0.31-0.80; n = 19) and 0.08 (95% CI, 0.02-0.23; n = 3), respectively. During the first 8 weeks, the median duration from a normal white blood cell count to severe leukopenia was 13 days (range, 8-26 d) and to severe neutropenia was 14 days (range, 7-23 d).

CONCLUSIONS

The high incidence of severe myelosuppression justifies frequent monitoring during the first 8 weeks of therapy. Subsequently, the rate of severe myelosuppression and the proportion of patients who progress from mild to severe myelosuppression decrease, justifying less-frequent monitoring.

Precision measurement of the X(3872) mass in J/psi pi(+) pi(-) decays

We present an analysis of the mass of the X(3872) reconstructed via its decay to J/psi pi(+)pi(-) using 2.4 fb(-1) of integrated luminosity from pp collisions at square root(s)=1.96 TeV, collected with the CDF II detector at the Fermilab Tevatron. The possible existence of two nearby mass states is investigated. Within the limits of our experimental resolution the data are consistent with a single state, and having no evidence for two states we set upper limits on the mass difference between two hypothetical states for different assumed ratios of contributions to the observed peak. For equal contributions, the 95% confidence level upper limit on the mass difference is 3.6 MeV/c(2). Under the single-state model the X(3872) mass is measured to be 3871.61+/-0.16(stat)+/-0.19(syst) MeV/c(2), which is the most precise determination to date.

Search for a standard model Higgs boson in WH --> lvbb in pp collisions at square root s = 1.96 TeV

We present a search for a standard model Higgs boson produced in association with a W boson using 2.7 fb(-1) of integrated luminosity of pp collision data taken at square root s = 1.96 TeV. Limits on the Higgs boson production rate are obtained for masses between 100 and 150 GeV/c(2). Through the use of multivariate techniques, the analysis achieves an observed (expected) 95% confidence level upper limit of 5.6 (4.8) times the theoretically expected production cross section for a standard model Higgs boson with a mass of 115 GeV/c(2).

Search for charged Higgs bosons in decays of top quarks in pp collisions at square root s = 1.96 TeV

We report on the first direct search for charged Higgs bosons decaying into cs in tt events produced by pp collisions at square root s = 1.96 TeV. The search uses a data sample corresponding to an integrated luminosity of 2.2 fb(-1) collected by the CDF II detector at Fermilab and looks for a resonance in the invariant mass distribution of two jets in the lepton + jets sample of tt candidates. We observe no evidence of charged Higgs bosons in top quark decays. Hence, 95% upper limits on the top quark decay branching ratio are placed at B(t --> H(+)b)< 0.1 to 0.3 for charged Higgs boson masses of 60 to 150 GeV/c(2) assuming B(H(+) --> cs)=1.0. The upper limits on B(t --> H(+)b) are also used as model-independent limits on the decay branching ratio of top quarks to generic scalar charged bosons beyond the standard model.

Observation of electroweak single top-quark production

We report the observation of single top-quark production using 3.2 fb(-1) of pp[over ] collision data with sqrt[s]=1.96 TeV collected by the Collider Detector at Fermilab. The significance of the observed data is 5.0 standard deviations, and the expected sensitivity for standard model production and decay is in excess of 5.9 standard deviations. Assuming m(t) = 175 GeV/c(2), we measure a cross section of 2.3(-0.5);(+0.6)(stat + syst) pb, extract the CKM matrix-element value |V(tb)| = 0.91 + or - 0.11(stat + syst) + or - 0.07(theory), and set the limit |V(tb)| > 0.71 at the 95% C.L.

First observation of vector boson pairs in a hadronic final state at the tevatron collider

We present the first observation in hadronic collisions of the electroweak production of vector boson pairs (VV, V = W, Z) where one boson decays to a dijet final state. The data correspond to 3.5 fb(-1) of integrated luminosity of pp[over ] collisions at sqrt[s] = 1.96 TeV collected by the CDF II detector at the Fermilab Tevatron. We observe 1516 + or - 239(stat) + or - 144(syst) diboson candidate events and measure a cross section sigma(pp[over ]-->VV + X) of 18.0 + or - 2.8(stat) + or - 2.4(syst) + or -1.1(lumi) pb, in agreement with the expectations of the standard model.

Search for a fermiophobic Higgs boson decaying into diphotons in pp[over] collisions at sqrt[s] = 1.96 TeV

A search for a narrow diphoton mass resonance is presented based on data from 3.0 fb;{-1} of integrated luminosity from pp[over ] collisions at sqrt[s] = 1.96 TeV collected by the CDF experiment. No evidence of a resonance in the diphoton mass spectrum is observed, and upper limits are set on the cross section times branching fraction of the resonant state as a function of Higgs boson mass. The resulting limits exclude Higgs bosons with masses below 106 GeV/c;{2} at a 95% Bayesian credibility level for one fermiophobic benchmark model.

Time trends in therapies and outcomes for adult inflammatory bowel disease, Northern California, 1998-2005

BACKGROUND & AIMS

The management of inflammatory bowel disease (IBD) has become increasingly complicated, and it is unknown whether poor outcomes (prolonged steroid use, hospitalizations, and surgery) have declined in the general population.

METHODS

This multilevel study used computerized clinical data. The study comprised 2892 adults with Crohn's disease (CD) and 5895 with ulcerative colitis (UC) who received care at 16 medical centers within an integrated care organization in Northern California between 1998 and 2005.

RESULTS

Time trends included (1) a shift in gastroenterology-related visits from the gastroenterology division to primary care; (2) increased use of IBD-related drugs, except for a 7% decline in use of 5-aminosalicylate in CD and no change in steroid use for CD; (3) for the prevalence of prolonged steroid exposure (120 days of continuous use), a 36% decline for CD with a 27% increase for UC; (4) declines in the hospitalization rates of 33% for CD and 29% for UC; and (5) for the surgery rate, no significant change for CD with a 50% decline for UC.

CONCLUSIONS

Declines in prolonged steroid exposure and the hospitalization rate for CD and in the hospitalization and surgery rate for UC are encouraging; however, the increase in prolonged steroid exposure for UC merits concern and further investigation. The variability in care patterns observed in this study suggests lack of standardization of care and the opportunity to identify targets for quality improvement. These findings should stimulate research to quantify the effect of current trends in IBD management.

Search for the production of narrow tb[over] resonances in 1.9 fb;{-1} of pp[over] collisions at sqrt[s] = 1.96 TeV

We present new limits on resonant tb[over] production in pp[over] collisions at sqrt[s] = 1.96 TeV, using 1.9 fb;{-1} of data recorded with the CDF II detector at the Fermilab Tevatron. We reconstruct a candidate tb[over] mass in events with a lepton, neutrino candidate, and two or three jets, and search for anomalous tb[over] production as modeled by W;{'} --> tb[over]. We set a new limit on a right-handed W;{'} with standard model-like coupling, excluding any mass below 800 GeV/c;{2} at 95% C.L. The cross section for any narrow, resonant tb[over] production between 750 and 950 GeV/c;{2} is found to be less than 0.28 pb at 95% C.L. We also present an exclusion of the W;{'} coupling strength versus W;{'} mass over the range 300-950 GeV/c;{2}.

Observation of new charmless decays of bottom hadrons

We search for new charmless decays of neutral b hadrons to pairs of charged hadrons, using 1 fb(-1) of data collected by the CDF II detector at the Fermilab Tevatron. We report the first observation of the Bs0-->K-pi+ decay and measure B(Bs0-->K-pi+)=(5.0+/-0.7(stat)+/-0.8(syst))x10(-6). We also report the first observation of charmless b-baryon decays, and measure B(Lambdab0-->ppi-)=(3.5+/-0.6(stat)+/-0.9(syst))x10(-6) and B(Lambdab0-->pK-)=(5.6+/-0.8(stat)+/-1.5(syst))x10(-6). No evidence is found for other modes, and we set the limit B(Bs0-->pi+pi;-)<1.2x10(-6) at 90% C.L.

Search for long-lived massive charged particles in 1.96 TeV pp collisions

We performed a signature-based search for long-lived charged massive particles produced in 1.0 fb-1 of pp[over ] collisions at sqrt[s]=1.96 TeV, collected with the CDF II detector using a high transverse-momentum (pT) muon trigger. The search used time of flight to isolate slowly moving, high-pT particles. One event passed our selection cuts with an expected background of 1.9+/-0.2 events. We set an upper bound on the production cross section and, interpreting this result within the context of a stable scalar top-quark model, set a lower limit on the particle mass of 249 GeV/c2 at 95% C.L.

Evidence for a narrow near-threshold structure in the J/psivarphi mass spectrum in B;{+} --> J/psivarphiK;{+} decays

Evidence is reported for a narrow structure near the J/psivarphi threshold in exclusive B;{+} --> J/psivarphiK;{+} decays produced in p[over]p collisions at sqrt[s] = 1.96 TeV. A signal of 14 +/- 5 events, with statistical significance in excess of 3.8 standard deviations, is observed in a data sample corresponding to an integrated luminosity of 2.7 fb;{-1}, collected by the CDF II detector. The mass and natural width of the structure are measured to be 4143.0 +/- 2.9(stat) +/- 1.2(syst) MeV/c;{2} and 11.7_{-5.0};{+8.3}(stat) +/- 3.7(syst) MeV/c;{2}.

Observation of exclusive charmonium production and gammagamma --> micro;{+}micro;{-} in pp[over] collisions at sqrt[s] = 1.96 TeV

In CDF we have observed the reactions p + p[over] --> p + X + p[over], with X being a centrally produced J/psi, psi(2S), or chi_{c0}, and gammagamma-->micro;{+}micro;{-} in pp[over] collisions at sqrt[s] = 1.96 TeV. The event signature requires two oppositely charged central muons, and either no other particles or one additional photon detected. Exclusive vector meson production is as expected for elastic photoproduction, gamma + p --> J/psi(psi(2S)) + p, observed here for the first time in hadron-hadron collisions. We also observe exclusive chi_{c0} --> J/psi + gamma. The cross sections dsigma/dy|_{y = 0} for J/psi, psi(2S), and chi_{c0} are 3.92 +/- 0.25(stat) +/- 0.52(syst) nb, 0.53 +/- 0.09(stat) +/- 0.10(syst) nb, and 76 +/- 10(stat) +/- 10(syst) nb, respectively, and the continuum is consistent with QED. We put an upper limit on the cross section for Odderon exchange in exclusive J/psi production.