The effect of psychiatric decision unit services on inpatient admissions and mental health presentations in emergency departments: an interrupted time series analysis from two cities and one rural area in England

AIMS

High-quality evidence is lacking for the impact on healthcare utilisation of short-stay alternatives to psychiatric inpatient services for people experiencing acute and/or complex mental health crises (known in England as psychiatric decision units [PDUs]). We assessed the extent to which changes in psychiatric hospital and emergency department (ED) activity were explained by implementation of PDUs in England using a quasi-experimental approach.

METHODS

We conducted an interrupted time series (ITS) analysis of weekly aggregated data pre- and post-PDU implementation in one rural and two urban sites using segmented regression, adjusting for temporal and seasonal trends. Primary outcomes were changes in the number of voluntary inpatient admissions to (acute) adult psychiatric wards and number of ED adult mental health-related attendances in the 24 months post-PDU implementation compared to that in the 24 months pre-PDU implementation.

RESULTS

The two PDUs (one urban and one rural) with longer (average) stays and high staff-to-patient ratios observed post-PDU decreases in the pattern of weekly voluntary psychiatric admissions relative to pre-PDU trend (Rural: -0.45%/week, 95% confidence interval [CI] = -0.78%, -0.12%; Urban: -0.49%/week, 95% CI = -0.73%, -0.25%); PDU implementation in each was associated with an estimated 35-38% reduction in total voluntary admissions in the post-PDU period. The (urban) PDU with the highest throughput, lowest staff-to-patient ratio and shortest average stay observed a 20% (-20.4%, CI = -29.7%, -10.0%) level reduction in mental health-related ED attendances post-PDU, although there was little impact on long-term trend. Pooled analyses across sites indicated a significant reduction in the number of voluntary admissions following PDU implementation (-16.6%, 95% CI = -23.9%, -8.5%) but no significant (long-term) trend change (-0.20%/week, 95% CI = -0.74%, 0.34%) and no short- (-2.8%, 95% CI = -19.3%, 17.0%) or long-term (0.08%/week, 95% CI = -0.13, 0.28%) effects on mental health-related ED attendances. Findings were largely unchanged in secondary (ITS) analyses that considered the introduction of other service initiatives in the study period.

CONCLUSIONS

The introduction of PDUs was associated with an immediate reduction of voluntary psychiatric inpatient admissions. The extent to which PDUs change long-term trends of voluntary psychiatric admissions or impact on psychiatric presentations at ED may be linked to their configuration. PDUs with a large capacity, short length of stay and low staff-to-patient ratio can positively impact ED mental health presentations, while PDUs with longer length of stay and higher staff-to-patient ratios have potential to reduce voluntary psychiatric admissions over an extended period. Taken as a whole, our analyses suggest that when establishing a PDU, consideration of the primary crisis-care need that underlies the creation of the unit is key.

Search for Evidence of Baryogenesis and Dark Matter in B^{+}→ψ_{D}+p Decays at BABAR

A new dark sector antibaryon, denoted ψ_{D}, could be produced in decays of B mesons. This Letter presents a search for B^{+}→ψ_{D}+p (and the charge conjugate) decays in e^{+}e^{-} annihilations at 10.58 GeV, using data collected in the BABAR experiment. Data corresponding to an integrated luminosity of 398  fb^{-1} are analyzed. No evidence for a signal is observed. Branching fraction upper limits in the range from 10^{-7}-10^{-5} are obtained at 90% confidence level for masses of 1.0 Collapse

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Morphology-Voltage-P-wave duration (MVP) score in prediction of incident atrial fibrillation in an elderly epidemiologic cohort

Background

Interatrial block (IAB) on electrocardiography (ECG) and reduced P wave voltage reflect atrial abnormalities which may contribute to development of atrial fibrillation (AF).

Purpose

We aimed to assess the value of a recently proposed ECG risk score that combines the morphology, voltage and length of the P wave (MVP score) for prediction of incident AF in a prospective population-based setting.

Material and methods

The study population is based on the large, prospective Malmö Preventative Project (MPP) cohort. We included subjects without a history of AF, with a readable ECG in sinus rhythm and an echocardiography performed in 2002–2006 (n=983, mean age 70±5 years, 38% females). Median follow-up was 4.2 (IQR 3.7–4.8) years. ECGs were digitally processed using the Glasgow algorithm. Advanced IAB (aIAB) was defined as a P-wave ≥120 ms and biphasic morphology (+/−) in inferior leads, partial IAB (pIAB) as P-wave ≥120 ms and a monophasic positive morphoology in inferior leads. MVP score was calculated based on the P-wave morphology in inferior leads, voltage in lead 1, and P-wave duration (Table 1).Incident AF events (n=66, 7%) were obtained from the Swedish Hospital Discharge Register and Cause of Death Register. Cox regression analysis and Kaplan Meier curve analysis were used to study the association of echocardiographic and P-wave characteristics with the risk of new onset AF.

Results

At baseline the mean MVP score was 1±1, none of the subjects had MVP score above 4. MVP score correlated with left atrial (LA) area: Pearson r=0.192, p<0.001. After adjustment for age, gender and LA enlargement expressed as LA area >20 cm2, new onset AF was associated with MVP score 4 (HR 6.17, 95% CI 1.76–21.64 compared to those with MVP score <4, Figure 1). Neither aIAB (univariate HR 1.93 CI 95% 0.82–4.56), nor pIAB (univariate HR 1.16 CI 95% 0.52–2.55) predicted incident AF.

Conclusion

In a population-based elderly epidemiological cohort, the ECG-based MVP score was significantly associated with incident AF, independently of LA enlargement.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The Swedish Heart-Lung Foundation

Left ventricular kinetic energy across heart failure subgroups and subclinical diastolic dysfunction

Background

Diastolic dysfunction is a common finding in heart failure with preserved ejection fraction (HFpEF) and is considered a key mechanism for limiting exercise performance. Meanwhile, subclinical diastolic dysfunction (SDD) without heart failure is a growing concern and may be common in the general population [1,5[. The kinetic energy (KE) of intracardiac blood flow reflects the work spent on accelerating blood [3] and may provide a novel window into diastolic filling dynamics [2,4]. Our aim was therefore to quantify left ventricular KE in HFpEF patients and compare with healthy controls, subjects with SDD, and heart failure patients with moderately reduced (HFmrEF) or reduced ejection fraction (HFrEF).

Methods

We studied 12 healthy controls, 22 healthy subjects with 1–2 echocardiographic criteria of diastolic dysfunction (SDD), 16 HFpEF, 9 HFmrEF, and 16 HFrEF patients. All subjects underwent CMR imaging at 1.5T with acquisition of anatomical cines and 4D flow from a box covering the heart. The LV was delineated over the cardiac cycle and KE inside the segmentation calculated as 0.5 × m × v2, where v is the instantaneous velocity vector magnitude and m is blood mass. Group comparisons of peak and average values were performed using Kruskal-Wallis test with Dunn's uncorrected post hoc test. Significance was assigned at p<0.05. Median values are given.

Results

Groups were similar with regard to sex, blood pressure, and body surface area. HFpEF (median 72 years) and HFrEF patients (67 years) were significantly older than subjects with SDD (62 years, p=0.001). Examples of KE are shown in Fig. 1. Systolic peak and average KE did not differ between groups (p=0.81 and p=0.54 respectively, Fig. 2). Diastolic peak KE was higher in all groups of heart failure compared to controls (p<0.03 for all) and diastolic average KE was higher in HFmrEF and HFrEF compared to controls (p<0.02). The standard deviation for SDD was wider than in controls (1.6 mJ vs 0.8 mJ for systolic peaks, 2.7 mJ vs 1.1 mJ for diastolic peaks) and more closely resembled the HFpEF group (2.1 mJ in systole, 2.3 mJ in diastole).

Conclusions

Systolic kinetic energy expenditures are on average similar between controls, subjects with subclinical diastolic dysfunction, and heart failure patients, indicating that cardiac pumping involves approximately the same amount of systolic acceleration for a given afterload. Conversely, diastolic KE was found more dispersed both in heart failure and in asymptomatic individuals with subclinical diastolic dysfunction. Higher peak values of KE were seen in diastole for all types of heart failure including HFpEF, indicating more work is spent filling the ventricle. Measurements of KE in diastole could potentially be a new tool for assessment of heart failure, including early stages of disease development in some individuals with subclinical diastolic dysfunction.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Swedish Heart Lung FoundationRegion of Scania, Sweden

Search for an Axionlike Particle in B Meson Decays

Axionlike particles (ALPs) are predicted in many extensions of the standard model, and their masses can naturally be well below the electroweak scale. In the presence of couplings to electroweak bosons, these particles could be emitted in flavor-changing B meson decays. We report herein a search for an ALP, a, in the reaction B^{±}→K^{±}a, a→γγ using data collected by the BABAR experiment at SLAC. No significant signal is observed, and 90% confidence level upper limits on the ALP coupling to electroweak bosons are derived as a function of ALP mass, improving current constraints by several orders of magnitude in the range 0.175  GeV<m_{a}<4.78  GeV.

Search for Lepton Flavor Violation in ϒ(3S)→e^{±}μ^{∓}

We report on the first search for electron-muon lepton flavor violation (LFV) in the decay of a b quark and b antiquark bound state. We look for the LFV decay ϒ(3S)→e^{±}μ^{∓} in a sample of 118 million ϒ(3S) mesons from 27  fb^{-1} of data collected with the BABAR detector at the SLAC PEP-II e^{+}e^{-} collider operating with a 10.36 GeV center-of-mass energy. No evidence for a signal is found, and we set a limit on the branching fraction B[ϒ(3S)→e^{±}μ^{∓}]<3.6×10^{-7} at 90% C. L. This result can be interpreted as a limit Λ_{NP}/g_{NP}^{2}>80  TeV on the energy scale Λ_{NP} divided by the coupling-squared g_{NP}^{2} of relevant new physics (NP).

Impact of post- transplant diabetes on left ventricular function following heart transplantation

Funding Acknowledgements

Type of funding sources: None.

Background

Orthotopic heart transplantation (OHT) is a standard treatment option for end-stage heart failure (HF). Although post-transplant diabetes (PTDM) is a main complication due to immunosuppressive corticosteroid treatment, its impact on left ventricular (LV) function following OHT has not been described.

Purpose

The purpose of this study was to analyse the possible effect of PTDM on LV function in OHT patients using conventional and speckle tracking echocardiography. Furthermore, this study aimed to compare echocardiographic LV function parameters to clinical parameters, including heart rate, blood pressure, and Hemoglobin A1C (HbA1c) in OHT recipients with or without PTDM.

Methods

We performed a retrospective study including 77 (59 males) OHT patients (PTDM n = 29) using data from the routine 3-year follow-up. The mean age of the study population was 52 ± 14 years. All patients were examined using 2-dimensional transthoracic echocardiography with an ultrasound system equipped with a S5-1 transducer. Systolic-, diastolic blood pressure, heart rate, and HbA1c levels were recorded in conjunction with the TTE examination for each participant.

Results

Participants with PTDM had impaired LV function measured by global longitudinal strain (LVGLS), increased septum diameter, and a lower diastolic EA-ratio compared to the non- PTDM patients. Additionally, a significant correlation between high HbA1c levels and poor LVGLS was detected. 

Conclusion

We found that subtle LV dysfunction, including remodeling of the heart (i.e., increased wall thickness), reduced longitudinal contractile function, and altered diastolic function, was present in OHT patients with PTDM. Our findings suggest that sub-clinical myocardial dysfunction in OHT patients with PTDM is progressive and may evolve to clinical LV dysfunction and HF. Hence, analyzing secondary cardiac effects of PTDM in OHT patients have a therapeutic and prognostic value and may influence long-term patient survival. Abstract Figure.

Search for Darkonium in e^{+}e^{-} Collisions

Collider searches for dark sectors, new particles interacting only feebly with ordinary matter, have largely focused on identifying signatures of new mediators, leaving much of dark sector structures unexplored. In particular, the existence of dark matter bound states (darkonia) remains to be investigated. This possibility could arise in a simple model in which a dark photon (A^{'}) is light enough to generate an attractive force between dark fermions. We report herein a search for a J^{PC}=1^{--} darkonium state, the ϒ_{D}, produced in the reaction e^{+}e^{-}→γϒ_{D}, ϒ_{D}→A^{'}A^{'}A^{'}, where the dark photons subsequently decay into pairs of leptons or pions, using 514  fb^{-1} of data collected with the BABAR detector. No significant signal is observed, and we set bounds on the γ-A^{'} kinetic mixing as a function of the dark sector coupling constant for 0.001<m_{A^{'}}<3.16  GeV and 0.05<m_{ϒ_{D}}<9.5  GeV.

Staff attitudes to completely smoke-free policies and smoking cessation practices in a mental health setting

BACKGROUND

Mental health trusts in England were expected to become completely smoke-free and embed smoking cessation practices by 2018. Such policies are fraught with concerns and have received mixed support from mental health staff. Understanding staff attitudes to these practices prior to enforcement of the policy could help design an effective implementation strategy.

METHODS

A cross-sectional survey was conducted with clinical and non-clinical staff in a Mental Health Trust to understand smoking cessation practices and attitudes to the implementation of a completely smoke-free policy.

RESULTS

There were 631 responses. Most participants disagreed with the policy on wards (59.6%) and throughout all mental health settings (57.4%). Clinicians expressed significantly lower organizational policy support (P = 0.001) than non-clinicians (P = 0.001). Psychiatrists were more supportive of the organizational items than nurses and allied health professionals. Clinicians' attitudes towards smoking cessation practices were less positive for those who were current smokers (P < 0.001), but more positive for clinicians who had received or were interested in attending smoking cessation training (P < 0.001).

CONCLUSIONS

Partial and completely smoke-free policies remain unsupported by staff in mental health settings. Smoking cessation training appears to reinforce rather than alter attitudes towards smoking cessation.

Precision Measurement of the Ratio B(ϒ(3S)→τ^{+}τ^{-})/B(ϒ(3S)→μ^{+}μ^{-})

We report on a precision measurement of the ratio R_{τμ}^{ϒ(3S)}=B(ϒ(3S)→τ^{+}τ^{-})/B(ϒ(3S)→μ^{+}μ^{-}) using data collected with the BABAR detector at the SLAC PEP-II e^{+}e^{-} collider. The measurement is based on a 28  fb^{-1} data sample collected at a center-of-mass energy of 10.355 GeV corresponding to a sample of 122 million ϒ(3S) mesons. The ratio is measured to be R_{τμ}^{ϒ(3S)}=0.966±0.008_{stat}±0.014_{syst} and is in agreement with the standard model prediction of 0.9948 within 2 standard deviations. The uncertainty in R_{τμ}^{ϒ(3S)} is almost an order of magnitude smaller than the only previous measurement.

Search for a Dark Leptophilic Scalar in e^{+}e^{-} Collisions

Many scenarios of physics beyond the standard model predict the existence of new gauge singlets, which might be substantially lighter than the weak scale. The experimental constraints on additional scalars with masses in the MeV to GeV range could be significantly weakened if they interact predominantly with leptons rather than quarks. At an e^{+}e^{-} collider, such a leptophilic scalar (ϕ_{L}) would be produced predominantly through radiation from a τ lepton. We report herein a search for e^{+}e^{-}→τ^{+}τ^{-}ϕ_{L}, ϕ_{L}→ℓ^{+}ℓ^{-} (ℓ=e, μ) using data collected by the BABAR experiment at SLAC. No significant signal is observed, and we set limits on the ϕ_{L} coupling to leptons in the range 0.04<m_{ϕ_{L}}<7.0  GeV. These bounds significantly improve upon the current constraints, excluding almost entirely the parameter space favored by the observed discrepancy in the muon anomalous magnetic moment below 4 GeV at 90% confidence level.

Enhancing the communication of functional neurological disorder diagnosis: a multidisciplinary education session

BACKGROUND AND PURPOSE

Functional neurological disorder (FND) is a common diagnosis within neurology. Effective communication of the diagnosis is known to be an important part of treatment and can result in reduction or cessation of symptoms, as well as decreased healthcare utilisation. A single group education session, facilitated by professionals commonly involved in the care of patients with FND, was developed to further enhance patients' and relatives' understanding and acceptance of diagnosis.

METHODS

Patients and relatives attending a single education session were asked to complete self-report ratings of understanding of diagnosis, acceptance of diagnosis, belief in treatability and hopefulness regarding recovery, at the beginning and end of the session. Satisfaction data were also collected.

RESULTS

Data were obtained from 193 patients and 153 relatives. Patients had experienced a median duration of symptoms of 4 years, and more than 80% of patients reported more than one functional neurological symptom. There were significant increases in terms of understanding, acceptance, belief in treatability and hopefulness for patients and relatives. Effect sizes ranged from large for improved understanding of FND to small-to-medium for increased agreement with FND diagnosis. High levels of satisfaction were also reported.

CONCLUSIONS

A multidisciplinary, single group education session is an effective and acceptable method of increasing understanding and acceptance of an FND diagnosis, even for patients with a long duration of symptoms and high symptom burden. It could help improve readiness for further treatment.

Preheart failure comorbidities and impact on prognosis in heart failure patients: a nationwide study

BACKGROUND

Data regarding the impact of preheart failure (HF) comorbidities on the prognosis of HF are scarce, especially in the younger HF patients.

OBJECTIVES

To investigate pre-existing comorbidities in HF patients versus matched controls and to assess their impact on mortality.

METHODS

We included all first-time in-hospital and outpatient diagnoses of HF from 1995 to 2017, and comorbidities antedating the HF-diagnosis in the Danish nationwide registries. HF patients were matched with up to five controls. One-year all-cause mortality rates and population attributable risk (PAR) were estimated for three separate age groups (≤50, 51-74 and >74 years).

RESULTS

Totally 280 002 patients with HF and 1 166 773 controls were included. Cardiovascular comorbidities, for example, cerebrovascular disease and ischaemic heart disease were more frequent in the oldest (17.9% and 29.7% in HF vs. 9.8% and 10.7% in controls) compared to the youngest age group (3.9% and 15.2% in HF vs. 0.7% and 0.9% in controls). Amongst patients with HF, 1-year mortality rates (per 100 person-years) were highest amongst those with >1 noncardiovascular comorbidity: ≤50 years (10.4; 9.64-11.3), 51-74 years (23.3; 22.9-23.7), >74 years (58.5; 57.9-59.0); hazard ratios 245.18 (141.45-424.76), 45.85 (42.77-49.15) and 24.5 (23.64-25.68) for those ≤50, 51-74 and >74 years, respectively. For HF patients ≤50 years, PAR was greatest for hypertension (17.8%), cancer (14.1%) and alcohol abuse (8.5%). For those aged >74 years, PAR was greatest for hypertension (23.6%), cerebrovascular disease (6.2%) and cancer (7.2%).

CONCLUSIONS

Heart failure patients had a higher burden of pre-existing comorbidities, compared to controls, which adversely impacted prognosis, especially in the young.

What is the impact of psychiatric decision units on mental health crisis care pathways? Protocol for an interrupted time series analysis with a synthetic control study

BACKGROUND

The UK mental health system is stretched to breaking point. Individuals presenting with mental health problems wait longer at the ED than those presenting with physical concerns and finding a bed when needed is difficult - 91% of psychiatric wards are operating at above the recommended occupancy rate. To address the pressure, a new type of facility - psychiatric decision units (also known as mental health decision units) - have been introduced in some areas. These are short-stay facilities, available upon referral, targeted to help individuals who may be able to avoid an inpatient admission or lengthy ED visit. To advance knowledge about the effectiveness of this service for this purpose, we will examine the effect of the service on the mental health crisis care pathway over a 4-year time period; the 2 years proceeding and following the introduction of the service. We use aggregate service level data of key indicators of the performance of this pathway.

METHODS

Data from four mental health Trusts in England will be analysed using an interrupted time series (ITS) design with the primary outcomes of the rate of (i) ED psychiatric presentations and (ii) voluntary admissions to mental health wards. This will be supplemented with a synthetic control study with the same primary outcomes, in which a comparable control group is generated for each outcome using a donor pool of suitable National Health Service Trusts in England. The methods are well suited to an evaluation of an intervention at a service delivery level targeting population-level health outcome and the randomisation or 'trialability' of the intervention is limited. The synthetic control study controls for national trends over time, increasing our confidence in the results. The study has been designed and will be carried out with the involvement of service users and carers.

DISCUSSION

This will be the first formal evaluation of psychiatric decision units in England. The analysis will provide estimates of the effect of the decision units on a number of important service use indicators, providing much-needed information for those designing service pathways.

TRIAL REGISTRATION

primary registry: isrctn.com Identifying number: ISRCTN77588384 Link: Date of registration in primary registry: 27/02/2020.

PRIMARY SPONSOR

St George's, University of London, Cramner Road, Tooting, SW17 ORE. Primary contact: Joe Montebello.

Measurements of the Absolute Branching Fractions of B^{±}→K^{±}X_{cc[over ¯]}

A study of the two-body decays B^{±}→X_{cc[over ¯]}K^{±}, where X_{cc[over ¯]} refers to one charmonium state, is reported by the BABAR Collaboration using a data sample of 424  fb^{-1}. The absolute determination of branching fractions for these decays are significantly improved compared to previous BABAR measurements. Evidence is found for the decay B^{+}→X(3872)K^{+} at the 3σ level. The absolute branching fraction B[B^{+}→X(3872)K^{+}]=[2.1±0.6(stat)±0.3(syst)]×10^{-4} is measured for the first time. It follows that B[X(3872)→J/ψπ^{+}π^{-}]=(4.1±1.3)%, supporting the hypothesis of a molecular component for this resonance.

Search for Rare or Forbidden Decays of the D^{0} Meson

We present a search for nine lepton-number-violating and three lepton-flavor-violating neutral charm decays of the type D^{0}→h^{'-}h^{-}ℓ^{'+}ℓ^{+} and D^{0}→h^{'-}h^{+}ℓ^{'±}ℓ^{∓}, where h and h^{'} represent a K or π meson and ℓ and ℓ^{'} an electron or muon. The analysis is based on 468  fb^{-1} of e^{+}e^{-} annihilation data collected at or close to the ϒ(4S) resonance with the BABAR detector at the SLAC National Accelerator Laboratory. No significant signal is observed for any of the twelve modes, and we establish 90% confidence level upper limits on the branching fractions in the range (1.0-30.6)×10^{-7}. The limits are between 1 and 3 orders of magnitude more stringent than previous measurements.

P4667Loss of function in PCSK9, atherogenic lipoprotein concentrations, and calcific aortic valve stenosis

Background

Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition reduces plasma concentrations of most atherogenic lipoproteins such as low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (apoB) and lipoprotein(a) [Lp(a)]. Atherogenic lipoprotein concentrations have also been linked with calcific aortic valve stenosis (CAVS).

Purpose

1) To determine the association between genetic variants in PCSK9 and lipoprotein-lipid levels, 2) to determine whether loss of function (LOF) in PCSK9 is associated with CAVS and 3) to evaluate if PCSK9 could be implicated in aortic valve interstitial cells (VICs) calcification.

Methods

We built a weighted genetic risk score (wGRS) using 10 single nucleotide polymorphisms at the PCSK9 locus associated with LDL-C in the Global Lipids Genetics Consortium. We determined the association between the wGRS and LDL-C, apoB and Lp(a)] in 9692 participants of the EPIC-Norfolk study using linear regression. We investigated the association between the LOF PCSK9 R46L variant and CAVS risk in a meta-analysis of published (three Copenhagen studies, 1463 cases and 101,620 controls) and unpublished studies (UK Biobank, 1350 cases and 349,043 controls, Malmö Diet and Cancer study, 682 cases and 5963 controls and EPIC-Norfolk, 508 cases and 20,421 controls) prospective, population-based studies using logistic regression adjusted for age and sex. We evaluated PCSK9 expression and localization in explanted aortic valves by capillary Western blot and immunohistochemistry in patients with and without CAVS. Von Kossa staining was used to visualize aortic leaflet calcium deposits. We also assessed VICs calcification potential under oxidative stress condition.

Results

In EPIC-Norfolk, the wGRS was significantly associated with TC, LDL-C, and apoB (all p<0.0001), but not with VLDL-C, HDL-C, triglycerides apoA-I, or Lp(a). Carriers of the R46L variant were at lower CAVS risk (odds ratio=0.71 (95% CI, 0.57–0.88, p<0.001)). Aortic valves of patients with aortic sclerosis (n=12) and CAVS (n=8) presented elevated PCSK9 levels (log2 fold change [FC]=+28.6±5.1, p=0.008 and FC=+39.3±15.2, p=0.02, respectively) compared to controls (n=4).In calcified leaflets, PCSK9 expression co-localized with calcium deposits. PCSK9 expression in VICs was induced by oxidative stress (FC=+2.3±0.4, p=0.02), and subsequent increment in calcification potential was observed.

Conclusion

PCSK9LOF variants are associated with lifelong reductions in non-Lp(a) apoB-containing lipoprotein levels and a lower risk of coronary artery disease and CAVS. PCSK9 is abundant in fibrotic and calcified aortic leaflets. Oxidative stress increases PCSK9 expression in VICs. These results support randomized clinical trials of PCSK9 inhibition in the prevention of CAVS.

P2471Adaptation of ventricular function the first year after heart transplantation assessed with echocardiography

Background/Introduction

Echocardiography is commonly used in evaluation patients after heart transplantation (HTx). Detecting discrete changes in ventricular function is important but challenging using standard echocardiographic parameters. Furthermore, interpretation of findings are complicated by the fact that data on early possible adaptation is sparse.

Purpose

We sought to detect alterations in biventricular function primarily using speckle tracking derived strain at four time-points during the first year post HTx.

Methods

Fifty HTx patients (40 males, mean age 50±12 years) were prospectively included. Patients were examined 1, 3, 6 and 12 months after HTx using an iE33 platform with a S5–1 transducer and strain analysis was performed offline with a dedicated software: CMQ, Q-lab 10.3 (Philips Healthcare, Eindhoven, NL). Values were compared using paired t-test and expressed as mean±SD, 95% CI.

Results

Regarding left ventricular (LV) parameters no difference were detected between 1 and 12 months. LV ejection fraction (EF) was 58±5% vs. 58±7%, global longitudinal strain (GLS) was −15±5% vs. −16±4% and global circumferential strain (GCS) was −22±7% vs. −21±6% respectively. Conventional parameters of right ventricular (RV) function: Tricuspid annular plane systolic excursion (TAPSE) improved from 12±2 mm at 1 month to 15±5 mm (p<0.01) at 12 months and tricuspid annular systolic velocity (S') improved from 8.1±1.9 cm/s to 9.5±2.7 cm/s (p<0.01) at 12 months. Fractional area change (FAC) remained unaltered. Strain measurements of RV function improved gradually between 1 and 12 months. RV GLS was −15±3% vs. −17±3% (p<0.01) and strain for the RV lateral wall (RVfree) was −15±3% vs. −18±3% (p<0.001) respectively. Progressive improvement in RV strain is illustrated in Fig 1.

Right ventricular strain post HTx

Conclusion

Our data indicate that clinically stable HTx recipients have reached steady state regarding LV function already 1 month after transplantation. This suggests that alterations in LV function parameters after this time-point can be used to detect adverse events.

On the contrary, right ventricular longitudinal function show significant gradual improvement during the first year following HTx indicating that the RV adaptation-process is extended in comparison to the LV.

We found that measurements of LV function at 1 month and RV function at 12 months post HTx are comparable to previously published normal values in clinically stable HTx patients. Nevertheless, further studies addressing possible continuous improvement in RV function beyond 1 year post HTx would be of interest.

Extraction of form Factors from a Four-Dimensional Angular Analysis of B[over ¯]→D^{*}ℓ^{-}ν[over ¯]_{ℓ}

An angular analysis of the decay B[over ¯]→D^{*}ℓ^{-}ν[over ¯]_{ℓ}, ℓ∈{e,μ}, is reported using the full e^{+}e^{-} collision data set collected by the BABAR experiment at the ϒ(4S) resonance. One B meson from the ϒ(4S)→BB[over ¯] decay is fully reconstructed in a hadronic decay mode, which constrains the kinematics and provides a determination of the neutrino momentum vector. The kinematics of the semileptonic decay is described by the dilepton mass squared, q^{2}, and three angles. The first unbinned fit to the full four-dimensional decay rate in the standard model is performed in the so-called Boyd-Grinstein-Lebed approach, which employs a generic q^{2} parametrization of the underlying form factors based on crossing symmetry, analyticity, and QCD dispersion relations for the amplitudes. A fit using the more model-dependent Caprini-Lellouch-Neubert (CLN) approach is performed as well. Our form factor shapes show deviations from previous fits based on the CLN parametrization. The latest form factors also provide an updated prediction for the branching fraction ratio R(D^{*})≡B(B[over ¯]→D^{*}τ^{-}ν[over ¯]_{τ})/B(B[over ¯]→D^{*}ℓ^{-}ν[over ¯]_{ℓ})=0.253±0.005. Finally, using the well-measured branching fraction for the B[over ¯]→D^{*}ℓ^{-}ν[over ¯]_{ℓ} decay, a value of |V_{cb}|=(38.36±0.90)×10^{-3} is obtained that is consistent with the current world average for exclusive B[over ¯]→D^{(*)}ℓ^{-}ν[over ¯]_{ℓ} decays and remains in tension with the determination from inclusive semileptonic B decays to final states with charm.

Observation of the Decay D^{0}→K^{-}π^{+}e^{+}e^{-}

We report the observation of the rare charm decay D^{0}→K^{-}π^{+}e^{+}e^{-}, based on 468  fb^{-1} of e^{+}e^{-} annihilation data collected at or close to the center-of-mass energy of the ϒ(4S) resonance with the BABAR detector at the SLAC National Accelerator Laboratory. We find the branching fraction in the invariant mass range 0.675<m(e^{+}e^{-})<0.875  GeV/c^{2} of the electron-positron pair to be B(D^{0}→K^{-}π^{+}e^{+}e^{-})=(4.0±0.5±0.2±0.1)×10^{-6}, where the first uncertainty is statistical, the second systematic, and the third due to the uncertainty in the branching fraction of the decay D^{0}→K^{-}π^{+}π^{+}π^{-} used as a normalization mode. The significance of the observation corresponds to 9.7 standard deviations including systematic uncertainties. This result is consistent with the recently reported D^{0}→K^{-}π^{+}μ^{+}μ^{-} branching fraction, measured in the same invariant mass range, and with the value expected in the standard model. In a set of regions of m(e^{+}e^{-}), where long-distance effects are potentially small, we determine a 90% confidence level upper limit on the branching fraction B(D^{0}→K^{-}π^{+}e^{+}e^{-})<3.1×10^{-6}.

Search for a Stable Six-Quark State at BABAR

Recent investigations have suggested that the six-quark combination uuddss could be a deeply bound state (S) that has eluded detection so far, and a potential dark matter candidate. We report the first search for a stable, doubly strange six-quark state in ϒ→SΛ[over ¯]Λ[over ¯] decays based on a sample of 90×10^{6}ϒ(2S) and 110×10^{6}ϒ(3S) decays collected by the BABAR experiment. No signal is observed, and 90% confidence level limits on the combined ϒ(2S,3S)→SΛ[over ¯]Λ[over ¯] branching fraction in the range (1.2-1.4)×10^{-7} are derived for m_{S}<2.05  GeV. These bounds set stringent limits on the existence of such exotic particles.

First Evidence for cos2β>0 and Resolution of the Cabibbo-Kobayashi-Maskawa Quark-Mixing Unitarity Triangle Ambiguity

We present first evidence that the cosine of the CP-violating weak phase 2β is positive, and hence exclude trigonometric multifold solutions of the Cabibbo-Kobayashi-Maskawa (CKM) Unitarity Triangle using a time-dependent Dalitz plot analysis of B^{0}→D^{(*)}h^{0} with D→K_{S}^{0}π^{+}π^{-} decays, where h^{0}∈{π^{0},η,ω} denotes a light unflavored and neutral hadron. The measurement is performed combining the final data sets of the BABAR and Belle experiments collected at the ϒ(4S) resonance at the asymmetric-energy B factories PEP-II at SLAC and KEKB at KEK, respectively. The data samples contain (471±3)×10^{6}BB[over ¯] pairs recorded by the BABAR detector and (772±11)×10^{6}BB[over ¯] pairs recorded by the Belle detector. The results of the measurement are sin2β=0.80±0.14(stat)±0.06(syst)±0.03(model) and cos2β=0.91±0.22(stat)±0.09(syst)±0.07(model). The result for the direct measurement of the angle β of the CKM Unitarity Triangle is β=[22.5±4.4(stat)±1.2(syst)±0.6(model)]°. The measurement assumes no direct CP violation in B^{0}→D^{(*)}h^{0} decays. The quoted model uncertainties are due to the composition of the D^{0}→K_{S}^{0}π^{+}π^{-} decay amplitude model, which is newly established by performing a Dalitz plot amplitude analysis using a high-statistics e^{+}e^{-}→cc[over ¯] data sample. CP violation is observed in B^{0}→D^{(*)}h^{0} decays at the level of 5.1 standard deviations. The significance for cos2β>0 is 3.7 standard deviations. The trigonometric multifold solution π/2-β=(68.1±0.7)° is excluded at the level of 7.3 standard deviations. The measurement resolves an ambiguity in the determination of the apex of the CKM Unitarity Triangle.

Measurement of the D^{*}(2010)^{+}-D^{+} Mass Difference

We measure the mass difference, Δm_{+}, between the D^{*}(2010)^{+} and the D^{+} using the decay chain D^{*}(2010)^{+}→D^{+}π^{0} with D^{+}→K^{-}π^{+}π^{+}. The data were recorded with the BABAR detector at center-of-mass energies at and near the ϒ(4S) resonance, and correspond to an integrated luminosity of approximately 468  fb^{-1}. We measure Δm_{+}=(140 601.0±6.8[stat]±12.9[syst])  keV. We combine this result with a previous BABAR measurement of Δm_{0}≡m(D^{*}(2010)^{+})-m(D^{0}) to obtain Δm_{D}=m(D^{+})-m(D^{0})=(4824.9±6.8[stat]±12.9[syst])  keV. These results are compatible with and approximately five times more precise than the Particle Data Group averages.

Search for Invisible Decays of a Dark Photon Produced in e^{+}e^{-} Collisions at BaBar

We search for single-photon events in 53  fb^{-1} of e^{+}e^{-} collision data collected with the BABAR detector at the PEP-II B-Factory. We look for events with a single high-energy photon and a large missing momentum and energy, consistent with production of a spin-1 particle A^{'} through the process e^{+}e^{-}→γA^{'}; A^{'}→invisible. Such particles, referred to as "dark photons," are motivated by theories applying a U(1) gauge symmetry to dark matter. We find no evidence for such processes and set 90% confidence level upper limits on the coupling strength of A^{'} to e^{+}e^{-} in the mass range m_{A^{'}}≤8  GeV. In particular, our limits exclude the values of the A^{'} coupling suggested by the dark-photon interpretation of the muon (g-2)_{μ} anomaly, as well as a broad range of parameters for the dark-sector models.

Search for B^{+}→K^{+}τ^{+}τ^{-} at the BaBar Experiment

We search for the rare flavor-changing neutral current process B^{+}→K^{+}τ^{+}τ^{-} using data from the BABAR experiment. The data sample, collected at the center-of-mass energy of the ϒ(4S) resonance, corresponds to a total integrated luminosity of 424  fb^{-1} and to 471×10^{6}  BB[over ¯] pairs. We reconstruct one B meson, produced in the ϒ(4S)→B^{+}B^{-} decay, in one of many hadronic decay modes and search for activity compatible with a B^{+}→K^{+}τ^{+}τ^{-} decay in the rest of the event. Each τ lepton is required to decay leptonically into an electron or muon and neutrinos. Comparing the expected number of background events with the data sample after applying the selection criteria, we do not find evidence for a signal. The resulting upper limit, at the 90% confidence level, is B(B^{+}→K^{+}τ^{+}τ^{-})<2.25×10^{-3}.

Synthesis and Properties of Poly(Arylene Ether Pyrazole)S

Poly(arylene ether pyrazole)s containing N–H and N-phenyl groups have been prepared by the aromatic nucleophilic displacement reaction of two new bisphenols containing a pyrazole ring with activated aromatic dihalides in N,N-dimethylacetamide at 155 °C in the presence of anhydrous potassium carbonate. The polymers exhibited glass transition temperatures ( Tg) ranging from 190–296 °C and inherent viscosities from 0.44–1.96 dl g−1. Poly(arylene ether-pyrazole)s containing N–H groups exhibited higher Tg and mechanical properties than the corresponding N-phenyl-containing poly(arylene ether pyrazole)s. The chemistry, physical and mechanical properties of these polymers are discussed.

Controlled molecular weight poly(arylene ether benzimidazole)s endcapped with benzimidazole and ethynyl groups

A series of controlled molecular weight poly(arylene ether benzimidazole)s (PAEBIs) endcapped with either benzimidazole, ethynyl or phenylethynyl groups was prepared and characterized. PAEBIs endcapped with either ethynyl or phenylethynyl groups were thermally cured to provide polymers with improved moisture and solvent resistance and higher glass transition temperature than PAEBIs without reactive endcaps. The synthesis and characterization of a series of PAEBIs endcapped with benzimidazole, ethynyl and phenylethynyl groups prepared at stoichiometric imbalances of 7 and 10 mol% are discussed.

Properties of Imide Oligomers Containing Pendent Phenylethynyl Groups

As part of a programme to develop high-performance/high-temperature structural resins for aeronautical applications, imide oligomers containing pendent phenylethynyl groups were prepared, characterized, thermally cured and the cured resins evaluated as films, mouldings, adhesives and composites matrices. Initially a diamine containing a pendent phenylethynyl group (3, 5-diamino-4′-phenylethynylbenzophenone) was prepared and characterized. This compound was used to make amide acid and subsequently imide oligomers containing pendent phenylethynyl groups. In order to control the distance between reactive sites, the concentration of pendent phenylethynyl groups was varied randomly along the oligomer backbone. The amide acid oligomers in N-methyl-2-pyrrolidinone were processed into thin films, adhesive tape, carbon fibre prepreg and also converted into imide powder. After initial screening work was performed on unoriented thin films, imidized powders and neat resin mouldings to assess glass transition temperature, mechanical properties (tensile properties and fracture toughness), melt flow behaviour and processability, one particular formulation was scaled up for more comprehensive evaluation. This imide oligomer containing pendent phenylethynyl groups was fabricated into adhesive and composite specimens under 1.4 MPa for1hat 350–371 °C. Excellent mechanical properties were obtained at room temperature and 177 °C. The properties of this material are compared with those of a material of similar composition and molecular weight containing only terminal phenylethynyl groups.

Chemistry and Properties of Imide Oligomers from Phenylethynyl-Containing Diamines

As an extension of work on pendent phenylethynyl-containing imide oligomers, three new diamines containing pendent phenylethynyl groups were prepared and characterized. These diamines were used to prepare pendent and pendent and terminal phenylethynyl imide oligomers via the amide acid route in N-methyl-2-pyrrolidinone at a calculated number average molecular weight of 5000 g mol−1. The pendent phenylethynyl groups were randomly distributed along the oligomer backbone and provided a means of controlling the distance between reactive sites. The imide oligomers were characterized and thermally cured, and the cured polymers evaluated as thin films and compared with materials of similar composition prepared from 3,5-diamino-4′-phenylethynylbenzophenone. This work was performed as part of a continuing research effort to develop structural resins for potential aeronautical applications.

Imide Oligomers Containing Pendent and Terminal Phenylethynyl Groups—II

As part of a programme to develop high-performance/high-temperature structural resins for aeronautical applications, imide oligomers containing pendent and terminal phenylethynyl groups were prepared, characterized and the cured resins evaluated as composite matrices. The oligomers were prepared at a calculated number-average molecular weight of 5000 g mol−1 and contained 15–20 mol% pendent phenylethynyl groups. In previous work, an oligomer containing pendent and terminal phenylethynyl groups exhibited a high glass transition temperature (∼313 °C), and laminates therefrom exhibited high compressive properties, but processability, fracture toughness, microcrack resistance and damage tolerance were less than desired. In an attempt to improve these deficiencies, modifications in the oligomeric backbone involving the incorporation of 1,3-bis(3-aminophenoxy)benzene were investigated as a means of improving processability and toughness without detracting from the high glass transition temperature and high compressive properties. The amide acid oligomeric solutions were prepared in N-methyl-2-pyrrolidinone and were subsequently processed into imide powder, thin films, adhesive tape and carbon fibre prepreg. Neat resin plaques were fabricated from imide powder by compression moulding. The maximum processing pressure was 1.4 MPa and the cure temperature ranged from 350 to 371 °C for 1 h for the mouldings, adhesives, films and composites. The properties of the 1,3-bis(3-aminophenoxy)benzene modified cured imide oligomers containing pendent and terminal phenylethynyl groups are compared with those of previously prepared oligomers containing pendent and terminal phenylethynyl groups of similar composition and molecular weight.

Poly(arylene ether)s Containing Phenylphosphine Oxide Groups

As part of a NASA program to develop materials for potential future space applications, poly(arylene ether)s containing phenylphosphine oxide groups were prepared and characterized. The polymers were synthesized by the aromatic nucleophilic displacement reaction of two isomeric bisphenols, 2,5- dihydroxyphenyldiphenylphosphine oxide and bis(4-hydroxyphenyl)phenylphosphine oxide, with activated aromatic difluorides in the presence of anhydrous potassium carbonate in N,N-dimethylacetamide at 155 'C. The polymers exhibited inherent viscosities from 0.35 to 1.00 dL g- 1 and glass transition temperatures from 160 to 249 'C. Thermogravimetric analyses showed 5% weight loss ranging from 382 to 479 'C in air and 377 to 505 'C in nitrogen. Unoriented thin films exhibited tensile strengths, moduli, and break elongations at 23 'C of 49-94 MPa, 2.3-3.4 GPa, and 6-41%, respectively Limiting oxygen indices from 18-32 were calculated based on polymer char residues at 850 'C in nitrogen. The polymers exhibited relatively low solar absorptivities ranging from 0.04 to 0.16 and thermal emissivities ranging from 0.48 to 0.63. The chemistry, physical, and mechanical properties of these polymers are presented herein.

Polyimides Prepared from 4,4′-(2-Diphenylphosphinyl-1,4-Phenylenedioxy)Diphthalic Anhydride for Potential Space Applications

As part of an ongoing materials development activity to produce high performance polymers that are space environmentally stable, phosphine oxide containing polyimides were prepared by reacting a novel aromatic dianhydride, 4,4′-(2-diphenylphosphinyl-1,4-phenylenedioxy)diphthalic anhydride 3, with aromatic diamines. The dianhydride was prepared from 2,5-dihydroxyphenyldiphenylphosphine oxide in three steps in relatively good yield. In general, the polyimides exhibited physical and mechanical properties comparable to other wholly aromatic polyimides. Depending upon the diamine, nearly all of the polyimides formed near colorless to yellow films. The polyimides were amorphous and in most cases soluble in polar aprotic solvents. However, one polymer film prepared using 1,4-phenylenediamine exhibited some degree of ordering when prepared by chemical imidization. The chemistry, physical and mechanical properties of the polymers are discussed.

Chemistry and Properties of a Phenylethynyl-Terminated Imide Blend

As part of an effort to develop a low-volatile, essentially dry, carbon fiber tape from a phenylethynyl-terminated imide for use in heated head automated tow placement, a 70:30 blend of LaRCTM PETI-5 and LaRCTM PETI-IAX was prepared in N-methyl-2-pyrrolidinone by mixing the phenylethynylterminated amide acid solutions together. Solutions of the amide acids and the blend were characterized by size exclusion chromatography after aging at room temperature and at 5 °C over a 30-day period. Thin films were periodically cast from the solutions, thermally cured, and the tensile properties determined. Unoriented thin-film tensile properties were unaffected by aging conditions over the 30-day period whereas the weight average molecular weights of the phenylethynyl-terminated amide acids decreased. Imide oligomers were prepared from the amide acids, characterized, and thermally cured. A low-volatile tape prepared from prepreg of the 70:30 blend was fabricated into composites by processing in a vacuum press. The thin-film tensile and composite properties of the blend generally followed a rule of mixtures.

Thermal Conductivity of UltemTM/Carbon Nanofiller Blends

In an effort to improve polymer thermal conductivity (TC), UltemTM 1000 was compounded with nano-fillers of carbon allotropes. As-received and modified multiwalled carbon nanotubes (MWCNTs), vapor-grown carbon nanofibers (CNF) and expanded graphite (EG) were investigated. Functionalization of MWCNTs was performed to improve the TC compatibility between the resin and MWCNTs. It was postulated that this may provide an improved interface between the MWCNT and the polymer which would result in enhanced TC. The nano-fillers were mixed with UltemTM 1000 inthemeltandinsolution at concentrations ranging from 5 to 40 wt.%. Ribbons were extruded from the blends to form samples where the nano-fillers were aligned to some degree in the extrusion direction. Samples were also fabricated by compression molding resulting in random orientation of the nano-fillers. Thermal properties of the samples were evaluated by differential scanning calorimetry (DSC) and thermal gravimetric analyzer (TGA). Tensile properties of aligned samples were determined at room temperature. As expected, increased filler loading led to increased modulus and decreased elongation with respect to the neat polymer. The degree of dispersion and alignment of the nano-fillers was determined by high-resolution scanning electron microscopy (HRSEM). The HRSEM of the ribbons revealed that the MWCNTs and CNFs were predominantly aligned in the flow direction. The TC of the samples was measured using a NanoflashTM instrument. Since the MWCNTs and CNF are anisotropic, the TC was expected to be different in the longitudinal (parallel to the nanotube and fiber axis) and transverse (perpendicular to the nanotube and fiber axis) directions. The largest TC improvement was achieved for aligned samples when the measurement was performed in the direction of MWCNT and CNF alignment (i.e. longitudinal axis). Unaligned samples also showed a significant improvement in TC and may be potentially useful in applications when it is not possible to align the nano-filler. The results of this study will be presented.

Polyimide Nanocomposites Prepared with a Novel Aromatic Surfactant

Montmorillonite clays modified with 1,5-bis(3-aminophenoxy)-3-oxapentane dihydrochloride (BAOD) were used in the preparation of polyimide/organoclay hybrid films. Organoclays with varying surface charge based upon BAOD were prepared and examined for their dispersion behavior in the polymer matrix. Initial evaluation was performed by preparing high molecular weight poly(amide acid) solutions in the presence of the organoclays at a 3 wt% loading. Films were cast and subsequently heated to 300 °C to cause imidization. The resulting nanocomposite films were characterized by transmission electron microscopy and x-ray diffraction. It was found that the clay's cation exchange capacity (CEC) played a key role in determining the extent of dispersion in the polyimide matrix. Considerable dispersion was observed in nanocomposite films prepared from organoclays possessing medium and high CECs. One organoclay that dispersed well was further evaluated in nanocomposite films at weight loadings of 5 and 8%. The nanocomposite films were characterized by transmission electron microscopy, x-ray diffraction, and thin-film tensile testing. High levels of clay dispersion were achieved even at the higher clay loadings. Mechanical testing of these films showed that the moduli of the materials increased with increasing clay concentration, but the strength and elongation were generally adversely affected.

Measurement of the [Formula: see text] cross section in pp collisions at [Formula: see text] TeVand limits on anomalous gauge couplings

A measurement of the W boson pair production cross section in proton-proton collisions at [Formula: see text] TeV is presented. The data collected with the CMS detector at the LHC correspond to an integrated luminosity of 19.4[Formula: see text]. The [Formula: see text] candidates are selected from events with two charged leptons, electrons or muons, and large missing transverse energy. The measured [Formula: see text] cross section is [Formula: see text], consistent with the standard model prediction. The [Formula: see text] cross sections are also measured in two different fiducial phase space regions. The normalized differential cross section is measured as a function of kinematic variables of the final-state charged leptons and compared with several perturbative QCD predictions. Limits on anomalous gauge couplings associated with dimension-six operators are also given in the framework of an effective field theory. The corresponding 95 % confidence level intervals are [Formula: see text], [Formula: see text], [Formula: see text], in the HISZ basis.

Observation of B→D(*) π^(+)π^(-)ℓ^(-)ν Decays in e^(+)e^(-) Collisions at the Υ(4S) Resonance

We report on measurements of the decays of B¯ mesons into the semileptonic final states B¯→D^(*)π^(+)π^(-)ℓ^(-)ν¯, where D^(*) represents a D or D^(*) meson and ℓ^(-) is an electron or a muon. These measurements are based on 471×10^(6) BB ¯ pairs recorded with the BABAR detector at the SLAC asymmetric B factory PEP-II. We determine the branching fraction ratios R_{π^{+}π^{-}}^{(*)}=B(B[over ¯]→D^{(*)}π^{+}π^{-}ℓ^{-}ν[over ¯])/B(B[over ¯]→D^{(*)}ℓ^{-}ν[over ¯]) using events in which the second B meson is fully reconstructed. We find R_{π^{+}π^{-}}=0.067±0.010±0.008 and R_{π^{+}π^{-}}^{*}=0.019±0.005±0.004, where the first uncertainty is statistical and the second is systematic. Based on these results and assuming isospin invariance, we estimate that B[over ¯]→D^{(*)}ππℓ^{-}ν[over ¯] decays, where π denotes either a π^{±} and π^{0} meson, account for up to half the difference between the measured inclusive semileptonic branching fraction to charm hadrons and the corresponding sum of previously measured exclusive branching fractions.

Measurement of differential cross sections for Higgs boson production in the diphoton decay channel in pp collisions at [Formula: see text]

A measurement is presented of differential cross sections for Higgs boson (H) production in pp collisions at [Formula: see text][Formula: see text]. The analysis exploits the [Formula: see text] decay in data corresponding to an integrated luminosity of 19.7[Formula: see text] collected by the CMS experiment at the LHC. The cross section is measured as a function of the kinematic properties of the diphoton system and of the associated jets. Results corrected for detector effects are compared with predictions at next-to-leading order and next-to-next-to-leading order in perturbative quantum chromodynamics, as well as with predictions beyond the standard model. For isolated photons with pseudorapidities [Formula: see text], and with the photon of largest and next-to-largest transverse momentum ([Formula: see text]) divided by the diphoton mass [Formula: see text] satisfying the respective conditions of [Formula: see text] and [Formula: see text], the total fiducial cross section is [Formula: see text][Formula: see text].

Measurement of the differential cross section for top quark pair production in pp collisions at [Formula: see text]

The normalized differential cross section for top quark pair ([Formula: see text]) production is measured in pp collisions at a centre-of-mass energy of 8[Formula: see text] at the CERN LHC using the CMS detector in data corresponding to an integrated luminosity of 19.7[Formula: see text]. The measurements are performed in the lepton[Formula: see text]jets ([Formula: see text][Formula: see text]jets) and in the dilepton ([Formula: see text], [Formula: see text], and [Formula: see text]) decay channels. The [Formula: see text] cross section is measured as a function of the kinematic properties of the charged leptons, the jets associated to b quarks, the top quarks, and the [Formula: see text] system. The data are compared with several predictions from perturbative quantum chromodynamic up to approximate next-to-next-to-leading-order precision. No significant deviations are observed relative to the standard model predictions.

Measurements of the [Formula: see text][Formula: see text] production cross sections in the [Formula: see text] channel in proton-proton collisions at [Formula: see text] and [Formula: see text] and combined constraints on triple gauge couplings

Measurements of the [Formula: see text][Formula: see text] production cross sections in proton-proton collisions at center-of-mass energies of 7 and 8[Formula: see text] are presented. Candidate events for the leptonic decay mode [Formula: see text], where [Formula: see text] denotes an electron or a muon, are reconstructed and selected from data corresponding to an integrated luminosity of 5.1 (19.6)[Formula: see text] at 7 (8)[Formula: see text] collected with the CMS experiment. The measured cross sections, [Formula: see text] at 7[Formula: see text], and [Formula: see text] at 8[Formula: see text], are in good agreement with the standard model predictions with next-to-leading-order accuracy. The selected data are analyzed to search for anomalous triple gauge couplings involving the [Formula: see text][Formula: see text] final state. In the absence of any deviation from the standard model predictions, limits are set on the relevant parameters. These limits are then combined with the previously published CMS results for [Formula: see text][Formula: see text] in 4[Formula: see text] final states, yielding the most stringent constraints on the anomalous couplings.

First Observation of CP Violation in B[over ¯]^{0}→D_{CP}^{(*)}h^{0} Decays by a Combined Time-Dependent Analysis of BABAR and Belle Data

We report a measurement of the time-dependent CP asymmetry of B[over ¯]^{0}→D_{CP}^{(*)}h^{0} decays, where the light neutral hadron h^{0} is a π^{0}, η, or ω meson, and the neutral D meson is reconstructed in the CP eigenstates K^{+}K^{-}, K_{S}^{0}π^{0}, or K_{S}^{0}ω. The measurement is performed combining the final data samples collected at the ϒ(4S) resonance by the BABAR and Belle experiments at the asymmetric-energy B factories PEP-II at SLAC and KEKB at KEK, respectively. The data samples contain (471±3)×10^{6} BB[over ¯] pairs recorded by the BABAR detector and (772±11)×10^{6} BB[over ¯] pairs recorded by the Belle detector. We measure the CP asymmetry parameters -η_{f}S=+0.66±0.10(stat)±0.06(syst) and C=-0.02±0.07(stat)±0.03(syst). These results correspond to the first observation of CP violation in B[over ¯]^{0}→D_{CP}^{(*)}h^{0} decays. The hypothesis of no mixing-induced CP violation is excluded in these decays at the level of 5.4 standard deviations.

Constraints on the pMSSM, AMSB model and on other models from the search for long-lived charged particles in proton-proton collisions at [Formula: see text]

Stringent limits are set on the long-lived lepton-like sector of the phenomenological minimal supersymmetric standard model (pMSSM) and the anomaly-mediated supersymmetry breaking (AMSB) model. The limits are derived from the results presented in a recent search for long-lived charged particles in proton-proton collisions, based on data collected by the CMS detector at a centre-of-mass energy of 8 TeV at the Large Hadron Collider. In the pMSSM parameter sub-space considered, 95.9 % of the points predicting charginos with a lifetime of at least 10 ns are excluded. These constraints on the pMSSM are the first obtained at the LHC. Charginos with a lifetime greater than 100 ns and masses up to about 800 GeV in the AMSB model are also excluded. The method described can also be used to set constraints on other models.

Evidence for Collective Multiparticle Correlations in p-Pb Collisions

The second-order azimuthal anisotropy Fourier harmonics, v2, are obtained in p-Pb and PbPb collisions over a wide pseudorapidity (η) range based on correlations among six or more charged particles. The p-Pb data, corresponding to an integrated luminosity of 35  nb-1, were collected during the 2013 LHC p-Pb run at a nucleon-nucleon center-of-mass energy of 5.02  TeV by the CMS experiment. A sample of semiperipheral PbPb collision data at √sNN=2.76  TeV, corresponding to an integrated luminosity of 2.5  μb-1 and covering a similar range of particle multiplicities as the p-Pb data, is also analyzed for comparison. The six- and eight-particle cumulant and the Lee-Yang zeros methods are used to extract the v2 coefficients, extending previous studies of two- and four-particle correlations. For both the p-Pb and PbPb systems, the v2 values obtained with correlations among more than four particles are consistent with previously published four-particle results. These data support the interpretation of a collective origin for the previously observed long-range (large Δη) correlations in both systems. The ratios of v2 values corresponding to correlations including different numbers of particles are compared to theoretical predictions that assume a hydrodynamic behavior of a p-Pb system dominated by fluctuations in the positions of participant nucleons. These results provide new insights into the multiparticle dynamics of collision systems with a very small overlapping region.

Distributions of topological observables in inclusive three- and four-jet events in pp collisions at [Formula: see text][Formula: see text]

This paper presents distributions of topological observables in inclusive three- and four-jet events produced in pp collisions at a centre-of-mass energy of 7[Formula: see text] with a data sample collected by the CMS experiment corresponding to a luminosity of 5.1[Formula: see text]. The distributions are corrected for detector effects, and compared with several event generators based on two- and multi-parton matrix elements at leading order. Among the considered calculations, MadGraph interfaced with pythia6 displays the overall best agreement with data.