Novel Measurement of the Neutron Magnetic Form Factor from A=3 Mirror Nuclei

The electromagnetic form factors of the proton and neutron encode information on the spatial structure of their charge and magnetization distributions. While measurements of the proton are relatively straightforward, the lack of a free neutron target makes measurements of the neutron's electromagnetic structure more challenging and more sensitive to experimental or model-dependent uncertainties. Various experiments have attempted to extract the neutron form factors from scattering from the neutron in deuterium, with different techniques providing different, and sometimes large, systematic uncertainties. We present results from a novel measurement of the neutron magnetic form factor using quasielastic scattering from the mirror nuclei ^{3}H and ^{3}He, where the nuclear effects are larger than for deuterium but expected to largely cancel in the cross-section ratios. We extracted values of the neutron magnetic form factor for low-to-modest momentum transfer, 0.6 Collapse

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Affiliation(s)

S N Santiesteban University of New Hampshire, Durham, New Hampshire 03824, USA
S Li University of New Hampshire, Durham, New Hampshire 03824, USA Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
D Abrams University of Virginia, Charlottesville, Virginia 22904, USA
S Alsalmi Kent State University, Kent, Ohio 44240, USA King Saud University, Riyadh 11451, Kingdom of Saudi Arabia
D Androic University of Zagreb, Zagreb, Croatia
K Aniol California State University, Los Angeles, California 90032, USA
J Arrington Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA Argonne National Laboratory, Lemont, Illinois 60439, USA
T Averett William and Mary, Williamsburg, Virginia 23185, USA
C Ayerbe Gayoso William and Mary, Williamsburg, Virginia 23185, USA
J Bane University of Tennessee, Knoxville, Tennessee 37966, USA
S Barcus William and Mary, Williamsburg, Virginia 23185, USA
J Barrow University of Tennessee, Knoxville, Tennessee 37966, USA Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
A Beck Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
V Bellini INFN Sezione di Catania, Italy
H Bhatt Mississippi State University, Mississippi State, Mississippi 39762, USA
D Bhetuwal Mississippi State University, Mississippi State, Mississippi 39762, USA
D Biswas Hampton University, Hampton, Virginia 23669, USA
A Camsonne Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
J Castellanos Florida International University, Miami, Florida 33199, USA
J Chen William and Mary, Williamsburg, Virginia 23185, USA
J-P Chen Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
D Chrisman Michigan State University, East Lansing, Michigan 48824, USA
M E Christy Hampton University, Hampton, Virginia 23669, USA Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
C Clarke Stony Brook, State University of New York, New York 11794, USA
S Covrig Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
R Cruz-Torres Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
D Day University of Virginia, Charlottesville, Virginia 22904, USA
D Dutta Mississippi State University, Mississippi State, Mississippi 39762, USA
E Fuchey University of Connecticut, Storrs, Connecticut 06269, USA
C Gal University of Virginia, Charlottesville, Virginia 22904, USA
F Garibaldi INFN, Rome, Italy
T N Gautam Hampton University, Hampton, Virginia 23669, USA
T Gogami Tohoku University, Sendai, Japan
J Gomez Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
P Guèye Hampton University, Hampton, Virginia 23669, USA Michigan State University, East Lansing, Michigan 48824, USA
T J Hague Kent State University, Kent, Ohio 44240, USA
J O Hansen Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
F Hauenstein Old Dominion University, Norfolk, Virginia 23529, USA
W Henry Temple University, Philadelphia, Pennsylvania 19122, USA
D W Higinbotham Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
R J Holt Argonne National Laboratory, Lemont, Illinois 60439, USA
C Hyde Old Dominion University, Norfolk, Virginia 23529, USA
K Itabashi Tohoku University, Sendai, Japan
M Kaneta Tohoku University, Sendai, Japan
A Karki Mississippi State University, Mississippi State, Mississippi 39762, USA
A T Katramatou Kent State University, Kent, Ohio 44240, USA
C E Keppel Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
P M King Ohio University, Athens, Ohio 45701, USA
L Kurbany University of New Hampshire, Durham, New Hampshire 03824, USA
T Kutz Stony Brook, State University of New York, New York 11794, USA
N Lashley-Colthirst Hampton University, Hampton, Virginia 23669, USA
W B Li William and Mary, Williamsburg, Virginia 23185, USA
H Liu Columbia University, New York, New York 10027, USA
N Liyanage University of Virginia, Charlottesville, Virginia 22904, USA
E Long University of New Hampshire, Durham, New Hampshire 03824, USA
A Lovato Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA Computational Science Division, Argonne National Laboratory, Argonne, Illinois 60439, USA INFN-TIFPA Trento Institute for Fundamental Physics and Applications, 38123 Trento, Italy
J Mammei University of Manitoba, Winnipeg, MB R3T 2N2, Canada
P Markowitz Florida International University, Miami, Florida 33199, USA
R E McClellan Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
F Meddi INFN, Rome, Italy
D Meekins Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
R Michaels Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
M Mihovilovič Jožef Stefan Institute, 1000 Ljubljana, Slovenia Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana, Slovenia Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, DE-55128 Mainz, Germany
A Moyer Christopher Newport University, Newport News, Virginia 23606, USA
S Nagao Tohoku University, Sendai, Japan
D Nguyen University of Virginia, Charlottesville, Virginia 22904, USA
M Nycz Kent State University, Kent, Ohio 44240, USA
M Olson Saint Norbert College, De Pere, Wisconsin 54115, USA
L Ou Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
V Owen William and Mary, Williamsburg, Virginia 23185, USA
C Palatchi University of Virginia, Charlottesville, Virginia 22904, USA
B Pandey Hampton University, Hampton, Virginia 23669, USA
A Papadopoulou Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
S Park Stony Brook, State University of New York, New York 11794, USA
T Petkovic University of Zagreb, Zagreb, Croatia
S Premathilake University of Virginia, Charlottesville, Virginia 22904, USA
V Punjabi Norfolk State University, Norfolk, Virginia 23529, USA
R D Ransome Rutgers University, New Brunswick, New Jersey 08854, USA
P E Reimer Argonne National Laboratory, Lemont, Illinois 60439, USA
J Reinhold Florida International University, Miami, Florida 33199, USA
S Riordan Argonne National Laboratory, Lemont, Illinois 60439, USA
N Rocco Theoretical Physics Department, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
V M Rodriguez División de Ciencias y Tecnología, Universidad Ana G. Méndez, Recinto de Cupey, San Juan 00926, Puerto Rico
A Schmidt Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
B Schmookler Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
E P Segarra Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
A Shahinyan Yerevan Physics Institute, Yerevan, Armenia
S Širca Jožef Stefan Institute, 1000 Ljubljana, Slovenia Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana, Slovenia
K Slifer University of New Hampshire, Durham, New Hampshire 03824, USA
P Solvignon University of New Hampshire, Durham, New Hampshire 03824, USA
T Su Kent State University, Kent, Ohio 44240, USA
R Suleiman Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
L Tang Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
Y Tian Syracuse University, Syracuse, New York 13244, USA
W Tireman Northern Michigan University, Marquette, Michigan 49855, USA
F Tortorici INFN Sezione di Catania, Italy
Y Toyama Tohoku University, Sendai, Japan
K Uehara Tohoku University, Sendai, Japan
G M Urciuoli INFN, Rome, Italy
D Votaw Michigan State University, East Lansing, Michigan 48824, USA
J Williamson University of Glasgow, Glasgow, G12 8QQ Scotland, United Kingdom
B Wojtsekhowski Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
S Wood Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
Z H Ye Argonne National Laboratory, Lemont, Illinois 60439, USA Tsinghua University, Beijing, China
J Zhang University of Virginia, Charlottesville, Virginia 22904, USA
X Zheng University of Virginia, Charlottesville, Virginia 22904, USA

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First Measurement of η Meson Production in Neutrino Interactions on Argon with MicroBooNE

We present a measurement of η production from neutrino interactions on argon with the MicroBooNE detector. The modeling of resonant neutrino interactions on argon is a critical aspect of the neutrino oscillation physics program being carried out by the DUNE and Short Baseline Neutrino programs. η production in neutrino interactions provides a powerful new probe of resonant interactions, complementary to pion channels, and is particularly suited to the study of higher-order resonances beyond the Δ(1232). We measure a flux-integrated cross section for neutrino-induced η production on argon of 3.22±0.84(stat)±0.86(syst) 10^{-41}  cm^{2}/nucleon. By demonstrating the successful reconstruction of the two photons resulting from η production, this analysis enables a novel calibration technique for electromagnetic showers in GeV accelerator neutrino experiments.

Search for Heavy Neutral Leptons in Electron-Positron and Neutral-Pion Final States with the MicroBooNE Detector

We present the first search for heavy neutral leptons (HNLs) decaying into νe^{+}e^{-} or νπ^{0} final states in a liquid-argon time projection chamber using data collected with the MicroBooNE detector. The data were recorded synchronously with the NuMI neutrino beam from Fermilab's main injector corresponding to a total exposure of 7.01×10^{20} protons on target. We set upper limits at the 90% confidence level on the mixing parameter |U_{μ4}|^{2} in the mass ranges 10≤m_{HNL}≤150  MeV for the νe^{+}e^{-} channel and 150≤m_{HNL}≤245  MeV for the νπ^{0} channel, assuming |U_{e4}|^{2}=|U_{τ4}|^{2}=0. These limits represent the most stringent constraints in the mass range 35 Collapse

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Affiliation(s)

P Abratenko Tufts University, Medford, Massachusetts 02155, USA
O Alterkait Tufts University, Medford, Massachusetts 02155, USA
D Andrade Aldana Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
L Arellano The University of Manchester, Manchester M13 9PL, United Kingdom
J Asaadi University of Texas, Arlington, Texas 76019, USA
A Ashkenazi Tel Aviv University, Tel Aviv, Israel, 69978
S Balasubramanian Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
B Baller Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
G Barr University of Oxford, Oxford OX1 3RH, United Kingdom
D Barrow University of Oxford, Oxford OX1 3RH, United Kingdom
J Barrow Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA Tel Aviv University, Tel Aviv, Israel, 69978
V Basque Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
O Benevides Rodrigues Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
S Berkman Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA Michigan State University, East Lansing, Michigan 48824, USA
A Bhanderi The University of Manchester, Manchester M13 9PL, United Kingdom
A Bhat University of Chicago, Chicago, Illinois 60637, USA
M Bhattacharya Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
M Bishai Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
A Blake Lancaster University, Lancaster LA1 4YW, United Kingdom
B Bogart University of Michigan, Ann Arbor, Michigan 48109, USA
T Bolton Kansas State University (KSU), Manhattan, Kansas 66506, USA
J Y Book Harvard University, Cambridge, Massachusetts 02138, USA
M B Brunetti University of Warwick, Coventry CV4 7AL, United Kingdom
L Camilleri Columbia University, New York, New York 10027, USA
Y Cao The University of Manchester, Manchester M13 9PL, United Kingdom
D Caratelli University of California, Santa Barbara, California 93106, USA
F Cavanna Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
G Cerati Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
A Chappell University of Warwick, Coventry CV4 7AL, United Kingdom
Y Chen SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
J M Conrad Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
M Convery SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
L Cooper-Troendle University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
J I Crespo-Anadón Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT), Madrid E-28040, Spain
R Cross University of Warwick, Coventry CV4 7AL, United Kingdom
M Del Tutto Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
S R Dennis University of Cambridge, Cambridge CB3 0HE, United Kingdom
P Detje University of Cambridge, Cambridge CB3 0HE, United Kingdom
A Devitt Lancaster University, Lancaster LA1 4YW, United Kingdom
R Diurba Universität Bern, Bern CH-3012, Switzerland
Z Djurcic Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
R Dorrill Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
K Duffy University of Oxford, Oxford OX1 3RH, United Kingdom
S Dytman University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
B Eberly University of Southern Maine, Portland, Maine 04104, USA
P Englezos Rutgers University, Piscataway, New Jersey 08854, USA
A Ereditato University of Chicago, Chicago, Illinois 60637, USA Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J J Evans The University of Manchester, Manchester M13 9PL, United Kingdom
R Fine Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
O G Finnerud The University of Manchester, Manchester M13 9PL, United Kingdom
W Foreman Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
B T Fleming University of Chicago, Chicago, Illinois 60637, USA
D Franco University of Chicago, Chicago, Illinois 60637, USA
A P Furmanski University of Minnesota, Minneapolis, Minnesota 55455, USA
F Gao University of California, Santa Barbara, California 93106, USA
D Garcia-Gamez Universidad de Granada, Granada E-18071, Spain
S Gardiner Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
G Ge Columbia University, New York, New York 10027, USA
S Gollapinni Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
E Gramellini The University of Manchester, Manchester M13 9PL, United Kingdom
P Green University of Oxford, Oxford OX1 3RH, United Kingdom
H Greenlee Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
L Gu Lancaster University, Lancaster LA1 4YW, United Kingdom
W Gu Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
R Guenette The University of Manchester, Manchester M13 9PL, United Kingdom
P Guzowski The University of Manchester, Manchester M13 9PL, United Kingdom
L Hagaman University of Chicago, Chicago, Illinois 60637, USA
O Hen Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
C Hilgenberg University of Minnesota, Minneapolis, Minnesota 55455, USA
G A Horton-Smith Kansas State University (KSU), Manhattan, Kansas 66506, USA
Z Imani Tufts University, Medford, Massachusetts 02155, USA
B Irwin University of Minnesota, Minneapolis, Minnesota 55455, USA
M Ismail University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
C James Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
X Ji Nankai University, Nankai District, Tianjin 300071, China
J H Jo Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
R A Johnson University of Cincinnati, Cincinnati, Ohio 45221, USA
Y-J Jwa Columbia University, New York, New York 10027, USA
D Kalra Columbia University, New York, New York 10027, USA
N Kamp Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA
G Karagiorgi Columbia University, New York, New York 10027, USA
W Ketchum Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
M Kirby Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
T Kobilarcik Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
I Kreslo Universität Bern, Bern CH-3012, Switzerland
M B Leibovitch University of California, Santa Barbara, California 93106, USA
I Lepetic Rutgers University, Piscataway, New Jersey 08854, USA
J-Y Li University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
K Li Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
Y Li Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
K Lin Rutgers University, Piscataway, New Jersey 08854, USA
B R Littlejohn Illinois Institute of Technology (IIT), Chicago, Illinois 60616, USA
H Liu Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
W C Louis Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
X Luo University of California, Santa Barbara, California 93106, USA
C Mariani Center for Neutrino Physics, Virginia Tech, Blacksburg, Viriginia 24061, USA
D Marsden The University of Manchester, Manchester M13 9PL, United Kingdom
J Marshall University of Warwick, Coventry CV4 7AL, United Kingdom
N Martinez Kansas State University (KSU), Manhattan, Kansas 66506, USA
D A Martinez Caicedo South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
S Martynenko Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
A Mastbaum Rutgers University, Piscataway, New Jersey 08854, USA
I Mawby University of Warwick, Coventry CV4 7AL, United Kingdom
N McConkey University College London, London WC1E 6BT, United Kingdom
V Meddage Kansas State University (KSU), Manhattan, Kansas 66506, USA
J Micallef Massachusetts Institute of Technology (MIT), Cambridge, Massachusetts 02139, USA Tufts University, Medford, Massachusetts 02155, USA
K Miller University of Chicago, Chicago, Illinois 60637, USA
A Mogan Colorado State University, Fort Collins, Colorado 80523, USA
T Mohayai Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA Indiana University, Bloomington, Indiana 47405, USA
M Mooney Colorado State University, Fort Collins, Colorado 80523, USA
A F Moor University of Cambridge, Cambridge CB3 0HE, United Kingdom
C D Moore Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
L Mora Lepin The University of Manchester, Manchester M13 9PL, United Kingdom
M M Moudgalya The University of Manchester, Manchester M13 9PL, United Kingdom
S Mulleriababu Universität Bern, Bern CH-3012, Switzerland
D Naples University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
A Navrer-Agasson The University of Manchester, Manchester M13 9PL, United Kingdom
N Nayak Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
M Nebot-Guinot University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
J Nowak Lancaster University, Lancaster LA1 4YW, United Kingdom
N Oza Columbia University, New York, New York 10027, USA
O Palamara Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
N Pallat University of Minnesota, Minneapolis, Minnesota 55455, USA
V Paolone University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
A Papadopoulou Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
V Papavassiliou New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
H B Parkinson University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
S F Pate New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
N Patel Lancaster University, Lancaster LA1 4YW, United Kingdom
Z Pavlovic Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
E Piasetzky Tel Aviv University, Tel Aviv, Israel, 69978
I Pophale Lancaster University, Lancaster LA1 4YW, United Kingdom
X Qian Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
J L Raaf Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
V Radeka Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
A Rafique Argonne National Laboratory (ANL), Lemont, Illinois 60439, USA
M Reggiani-Guzzo University of Edinburgh, Edinburgh EH9 3FD, United Kingdom The University of Manchester, Manchester M13 9PL, United Kingdom
L Ren New Mexico State University (NMSU), Las Cruces, New Mexico 88003, USA
L Rochester SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
J Rodriguez Rondon South Dakota School of Mines and Technology (SDSMT), Rapid City, South Dakota 57701, USA
M Rosenberg Tufts University, Medford, Massachusetts 02155, USA
M Ross-Lonergan Los Alamos National Laboratory (LANL), Los Alamos, New Mexico 87545, USA
C Rudolf von Rohr Universität Bern, Bern CH-3012, Switzerland
I Safa Columbia University, New York, New York 10027, USA
G Scanavini Wright Laboratory, Department of Physics, Yale University, New Haven, Connecticut 06520, USA
D W Schmitz University of Chicago, Chicago, Illinois 60637, USA
A Schukraft Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
W Seligman Columbia University, New York, New York 10027, USA
M H Shaevitz Columbia University, New York, New York 10027, USA
R Sharankova Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J Shi University of Cambridge, Cambridge CB3 0HE, United Kingdom
E L Snider Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
M Soderberg Syracuse University, Syracuse, New York 13244, USA
S Söldner-Rembold The University of Manchester, Manchester M13 9PL, United Kingdom
J Spitz University of Michigan, Ann Arbor, Michigan 48109, USA
M Stancari Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J St John Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
T Strauss Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
A M Szelc University of Edinburgh, Edinburgh EH9 3FD, United Kingdom
W Tang University of Tennessee, Knoxville, Tennessee 37996, USA
N Taniuchi University of Cambridge, Cambridge CB3 0HE, United Kingdom
K Terao SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
C Thorpe Lancaster University, Lancaster LA1 4YW, United Kingdom The University of Manchester, Manchester M13 9PL, United Kingdom
D Torbunov Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
D Totani University of California, Santa Barbara, California 93106, USA
M Toups Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
Y-T Tsai SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
J Tyler Kansas State University (KSU), Manhattan, Kansas 66506, USA
M A Uchida University of Cambridge, Cambridge CB3 0HE, United Kingdom
T Usher SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
B Viren Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
M Weber Universität Bern, Bern CH-3012, Switzerland
H Wei Louisiana State University, Baton Rouge, Louisiana 70803, USA
A J White University of Chicago, Chicago, Illinois 60637, USA
S Wolbers Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
T Wongjirad Tufts University, Medford, Massachusetts 02155, USA
M Wospakrik Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
K Wresilo University of Cambridge, Cambridge CB3 0HE, United Kingdom
W Wu University of Pittsburgh, Pittsburgh, Pennsylvania 15260, USA
E Yandel University of California, Santa Barbara, California 93106, USA
T Yang Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
L E Yates Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
H W Yu Brookhaven National Laboratory (BNL), Upton, New York 11973, USA
G P Zeller Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
J Zennamo Fermi National Accelerator Laboratory (FNAL), Batavia, Illinois 60510, USA
C Zhang Brookhaven National Laboratory (BNL), Upton, New York 11973, USA

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Treatment deferral for elevated blood pressure at a dental school clinic

OBJECTIVES

Current guidelines by the American Dental Association (ADA) recommend deferral of elective dental care for elevated blood pressure. However, it is unknown how frequently this impacts dental treatment. The purpose of this study was to evaluate rates of asymptomatic hypertension and treatment deferral at a dental school clinic.

METHODS

This was a retrospective study with data extracted from a chart review of all patients presenting for care at a dental school teaching practice. Differences in dental procedures, the time between visits, and the number of antihypertensive medications were calculated between patients with and without a blood pressure reading exceeding current guidelines for elective treatment.

RESULTS

Among 26,821 individuals, 1265 had a visit with elevated blood pressure. Blood pressure readings at the next visit were significantly lower (systolic blood pressure 137 [95% confidence interval {CI} 135-138] mmHg, diastolic blood pressure 82 [95% CI 81-83 mmHg], p < 0.001), although only 24 patients reported taking a new medication. Only 4.1% of these patients had a procedure deferred; for those that did, the average intervisit time was 88.2 days (95% CI 77.7-98.7 days).

CONCLUSIONS

The majority of patients with blood pressure readings exceeding current ADA recommendations for treatment were treated without evidence of harm. Patients were also unlikely to return to the clinic with new medications for blood pressure after a visit with an elevated blood pressure reading. Oral health providers must weigh the risks and benefits of care deferral and can consider an expanded role in hypertension management in dental settings when caring for patients with elevated blood pressure.

First Double-Differential Measurement of Kinematic Imbalance in Neutrino Interactions with the MicroBooNE Detector

We report the first measurement of flux-integrated double-differential quasielasticlike neutrino-argon cross sections, which have been made using the Booster Neutrino Beam and the MicroBooNE detector at Fermi National Accelerator Laboratory. The data are presented as a function of kinematic imbalance variables which are sensitive to nuclear ground-state distributions and hadronic reinteraction processes. We find that the measured cross sections in different phase-space regions are sensitive to different nuclear effects. Therefore, they enable the impact of specific nuclear effects on the neutrino-nucleus interaction to be isolated more completely than was possible using previous single-differential cross section measurements. Our results provide precision data to help test and improve neutrino-nucleus interaction models. They further support ongoing neutrino-oscillation studies by establishing phase-space regions where precise reaction modeling has already been achieved.

First Measurement of Quasielastic Λ Baryon Production in Muon Antineutrino Interactions in the MicroBooNE Detector

We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×10^{20} protons on target running in neutrino mode, and 4.9×10^{20} protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE's detection thresholds, we obtain a flux averaged cross section of 2.0_{-1.7}^{+2.2}×10^{-40}  cm^{2}/Ar, where statistical and systematic uncertainties are combined.

Partnering for Integrated Care: A Learning Collaborative for Primary Care and Oral Health Teams

PURPOSE

The Teaming and Integrating for Smiles and Health (TISH) Learning Collaborative was developed to help health care organizations accelerate progress in integrating delivery of oral and primary care. By providing expert support and a structure for testing change, the project aimed to improve the early detection of hypertension in the dental setting and of gingivitis in the primary care setting, and to increase the rate of bidirectional referrals between oral and primary care partners. We report its outcomes.

METHODS

A total of 17 primary and oral health care teams were recruited to participate in biweekly virtual calls over 3 months. Participants tested changes to their models of care through Plan-Do-Study-Act cycles between calls. Sites tracked the percentages of patients screened and referred, completed the TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) and Interprofessional Assessment questionnaires, and provided qualitative feedback and updates in storyboard presentations.

RESULTS

On average, with implementation of the TISH Learning Collaborative, sites displayed a nonrandom improvement in the percentages of patients screened for hypertension, referred for hypertension, referred to primary care, and referred for gingivitis. Gingivitis screening and referral to oral health care were not markedly improved. Qualitative responses indicated that teams made progress in screening and referral workflows, improved communication between medical and dental partners, and furthered understanding of the connection between primary care and oral care among staff and patients.

CONCLUSIONS

The TISH project is evidence that a virtual Learning Collaborative is an accessible and productive avenue to improve interprofessional education, further primary care and oral partnerships, and achieve practical progress in integrated care.

First Constraints on Light Sterile Neutrino Oscillations from Combined Appearance and Disappearance Searches with the MicroBooNE Detector

We present a search for eV-scale sterile neutrino oscillations in the MicroBooNE liquid argon detector, simultaneously considering all possible appearance and disappearance effects within the 3+1 active-to-sterile neutrino oscillation framework. We analyze the neutrino candidate events for the recent measurements of charged-current ν_{e} and ν_{μ} interactions in the MicroBooNE detector, using data corresponding to an exposure of 6.37×10^{20} protons on target from the Fermilab booster neutrino beam. We observe no evidence of light sterile neutrino oscillations and derive exclusion contours at the 95% confidence level in the plane of the mass-squared splitting Δm_{41}^{2} and the sterile neutrino mixing angles θ_{μe} and θ_{ee}, excluding part of the parameter space allowed by experimental anomalies. Cancellation of ν_{e} appearance and ν_{e} disappearance effects due to the full 3+1 treatment of the analysis leads to a degeneracy when determining the oscillation parameters, which is discussed in this Letter and will be addressed by future analyses.

BigMouth: development and maintenance of a successful dental data repository

Few clinical datasets exist in dentistry to conduct secondary research. Hence, a novel dental data repository called BigMouth was developed, which has grown to include 11 academic institutions contributing Electronic Health Record data on over 4.5 million patients. The primary purpose for BigMouth is to serve as a high-quality resource for rapidly conducting oral health-related research. BigMouth allows for assessing the oral health status of a diverse US patient population; provides rationale and evidence for new oral health care delivery modes; and embraces the specific oral health research education mission. A data governance framework that encouraged data sharing while controlling contributed data was initially developed. This transformed over time into a mature framework, including a fee schedule for data requests and allowing access to researchers from noncontributing institutions. Adoption of BigMouth helps to foster new collaborations between clinical, epidemiological, statistical, and informatics experts and provides an additional venue for professional development.

Study of Λn FSI with Λ quasi-free productions on the 3H(e, e′K+)X reaction at JLab

Abstract. An nnΛ is a neutral baryon system with no charge. The study of the pure Λ-neutron system such as nnΛ gives us information on the Λn interaction. The nnΛ search experiment (E12-17-003) was performed at JLab Hall A in 2018. In this article, the Λn FSI was investigated by a shape analysis of the 3H(e, e′K+)X missing mass spectrum, and a preliminary result for the Λn FSI study is given.

Cross-section measurement of virtual photoproduction of iso-triplet three-body hypernucleus, Λnn

Missing-mass spectroscopy with the 3H(e, e′K+) reaction was carried out at Jefferson Lab’s (JLab) Hall A in Oct–Nov, 2018. The differential cross section for the 3H(γ∗, K+)Λnn was deduced at ω = Ee − Ee′ = 2.102 GeV and at the forward K+-scattering angle (0° ≤ θγ∗K ≤ 5°) in the laboratory frame. Given typical predicted energies and decay widths, which are (BΛ, Γ) = (−0.25, 0.8) and (−0.55, 4.7) MeV, the cross sections were found to be 11.2 ± 4.8(stat.)+4.1−2.1(sys.) and 18.1 ± 6.8(stat.)+4.2−2.9(sys.) nb/sr, respectively. The obtained result would impose a constraint for interaction models particularly between Λ and neutron by comparing to theoretical calculations.

Study of the Λ/Σ0 electroproduction in the low-Q2 region at JLab

We performed an experiment using tritium and hydrogen cryogenic gas targets at Thomas Jefferson National Accelerator Facility (JLab) in 2018 (E12-17-003)[1, 2]. In this article, we discuss the Λ/Σ0 hyperon electroproduction from hydrogen target. Elementary Λ/Σ0 hyperon production processes are important not only for an absolute mass scale calibration in our experiment, but also for the study of the electroproduction mechanisms themselves. In this article, we reported the results of the differential cross section for the p(e, e’K+)Λ/Σ0 reaction at Q2 ∼ 0.5 (GeV/c)2.

Dental care utilization in Massachusetts before and after initiation of medication for opioid use disorder: A cross-sectional study of a state all-payer claims database

BACKGROUND

Individuals with opioid use disorder (OUD) are at higher risk of poor oral health. Medication for opioid use disorder (MOUD) has been shown to improve outcomes for patients with OUD, but it is unknown how initiation of MOUD affects access to oral health services.

METHODS

This was a retrospective analysis of all individuals in the Massachusetts All-Payer Claims Database prescribed oral buprenorphine-naloxone or injectable naltrexone from 2013 to 2016. We evaluated dental utilization in the year before and after beginning MOUD. A logistic regression predicting dental utilization was conducted.

RESULTS

Among the 54,791 individuals, rates of dental utilization were low both before and after MOUD (10.5% and 10% with a dental visit, respectively). Of those who did not have a dental visit in the year before starting MOUD, 95.1% did not have a dental visit in the year after. Rates of various procedure types were comparable before and after MOUD. In a logistic regression, a prior dental visit was associated with 9.82 times the odds (95% CI 9.14-10.55) of having a dental visit after starting MOUD; increasing age, being prescribed naltrexone, having a mood disorder or HIV, year of initiation or being on Medicaid were also associated with having a dental visit. Male patients and those with Medicare or private insurance were less likely to have a dental visit.

CONCLUSIONS

Initiating MOUD did not substantially result in increased dental access or substantial changes in dental procedures received. Patients receiving treatment for OUD may require additional support to access dental care.

Oral Health Stakeholders: A Time for Alignment and Action

Policy Points Since the Surgeon General's report in 2000, multiple stakeholder groups have engaged in advocacy to expand access to oral health coverage, integrate medicine and dentistry, and to improve the dental workforce. Using a stakeholder map across these three policy priorities, we describe how stakeholder groups are shaping the oral health policy landscape in this century. While the stakeholders are numerous, policy has changed little despite invested efforts and resources. To achieve change, multiple movements must coalesce around common goals and messages and a champion must emerge to lead the way. The ongoing COVID-19 pandemic and political changes due to the 2020 elections can open a window of opportunity to unite stakeholders to achieve comprehensive policy change.

Developing a Standard Set of Patient-centred Outcomes for Adult Oral Health - An International, Cross-disciplinary Consensus

Objective

To develop a minimum Adult Oral Health Standard Set (AOHSS) for use in clinical practice, research, advocacy and population health.

Materials and methods

An international oral health working group (OHWG) was established, of patient advocates, researchers, clinicians and public health experts to develop an AOHSS. PubMed was searched for oral health clinical and patient-reported measures and case-mix variables related to caries and periodontal disease. The selected patient-reported outcome measures focused on general oral health, and oral health-related quality of life tools. A consensus was reached via Delphi with parallel consultation of subject matter content experts. Finally, comments and input were elicited from oral health stakeholders globally, including patients/consumers.

Results

The literature search yielded 1,453 results. After inclusion/exclusion criteria, 959 abstracts generated potential outcomes and case-mix variables. Delphi rounds resulted in a consensus-based selection of 80 individual items capturing 31 outcome and case-mix concepts. Global reviews generated 347 responses from 87 countries, and the patient/consumer validation survey elicited 129 responses. This AOHSS includes 25 items directed towards patients (including demographics, the impact of their oral health on oral function, a record of pain and oral hygiene practices, and financial implications of care) and items for clinicians to complete, including medical history, a record of caries and periodontal disease activity, and types of dental treatment delivered.

Conclusion

In conclusion, utilising a robust methodology, a standardised core set of oral health outcome measures for adults, with a particular emphasis on caries and periodontal disease, was developed.

A definition of global oral health: An expert consensus approach by the Consortium of Universities for Global Health's Global Oral Health Interest Group

Definitions can generate actionable consensus for a given subject matter by resolving important differences in philosophy and best practices and by streamlining activities for a stronger strategic direction. Interest in the global dimensions of oral health, a generally neglected area of global health, is growing; yet, no previously published research has defined the term 'global oral health.' As such, the Global Oral Health Interest Group of the Consortium of Universities for Global Health determined a need for an introductory definition of 'global oral health' to guide program planning, implementation, and evaluation. With the oversight of an expert senior Task Force for the Definition of Global Oral Health, we employed a mixed-methods approach using the more common expert consensus-building Delphi technique combined with the lesser utilized Q methodology. This approach allowed us to identify the interconnectedness of global oral health themes and integrate multiple, seemingly disparate, topics into a single streamlined concept. Our resulting definition is as follows: Global Oral Health aims for optimal oral health for all people and elimination of global health inequities through health promotion, disease prevention, and appropriate oral care approaches that consider common determinants and solutions and acknowledge oral health as part of overall health. The purpose of this short communication is to generate a narrative around our proposed definition of global oral health to support establishing guidelines and developing best practices for academic global oral health programs, policies, and practices that aim to achieve a goal of oral health globally.

Interprofessional value-based health care: Nurse practitioner-dentist model

OBJECTIVES

The United States health system is challenged to improve patient and population health, enhance patients' experience of care, and reduce health care costs. Value-based health care (VBHC) models are proposed to address these issues. Medical health systems are making strides toward VBHC, whereas dental care systems lag behind. The aims of this paper are to a) present study findings of an interprofessional practice model integrating oral health and primary care in a dental practice setting, and b) discuss practice and research implications for advancing VBHC approaches in oral health.

METHODS

A nonexperimental research method was employed to evaluate the Nurse Practitioner-Dentist Model for Primary Care (NPD Model) at the Harvard Dental Center. Pretest/post-test design was used to assess clinical patient outcomes for a convenience cohort of Medicare beneficiaries (n = 31) with a reported diagnosis of hypertension and/or type 2 diabetes. Clinical outcome measures included: blood pressure, weight, body mass index (BMI), and Hemoglobin A1c.

RESULTS

Positive and significant improvements in biometrics (blood pressure, body weight, BMI, HbA1c) were found.

CONCLUSIONS

The NPD Model is an early prototype for interprofessional VBHC in oral health and holds promise for improving patient and population health outcomes. Integration of interprofessional VBHC in oral health is an imperative for achieving the Triple Aim to improve the overall health of our nation.

Dental Services Utilization by Rurality Among Privately Insured Children in the United States

Purpose: The purpose of this study was to determine differences in dental services received between rural and urban residents in a national sample of children with private insurance. Methods: This was a retrospective study of deidentified claims data from a major national private insurer. Children younger than 18 years of age enrolled throughout 2018 and who had at least one visit to the dentist that year were included. Differences in the frequency of dental procedures received were determined by chi-square tests. Multilevel logistic regression was used to evaluate the effect of individual-level and ZIP Code-level covariates, including rurality, on the odds of receiving a preventive dental service or having a tooth extracted. Results: A total of 603,064 children, with an average age of 10.2±4.4 (standard deviation) years, visited a dentist, and 6.52 percent lived in a rural area. In a multilevel logistic regression correcting for patient age, patient gender, ZIP Code average income, and dental provider density, rurality was positively associated with receiving a tooth extraction (odds ratio [OR] equals 1.06; P<0.001) and negatively associated with receiving a preventive service (OR equals 0.85; P<0.001). Female gender was a negative predictor of preventive services and a predictor of having a tooth extracted. Conclusion: Children living in rural areas had reduced rates of preventive dental care and higher rates of tooth extraction than their nonrural counterparts.

Variation in dental services by rurality among privately insured adults in the United States

OBJECTIVES

Rurality is associated with reduced dental access and worse oral health outcomes. It is unknown whether there is variation in dental services received by rural adults who visit a dentist.

METHODS

This was a retrospective analysis of claims data from a large private insurer. All individuals who had at least one dental visit in 2018 were included. Patient demographics, whether or not a patient's ZIP code was rural as defined by the Federal Office of Rural Health Policy, as well as ZIP code demographics were collected. Differences in the frequency of dental services received were evaluated using χ² tests. Multilevel logistic regressions were used to evaluate the individual and ZIP code-level correlates of receiving a preventive dental procedure, a tooth extraction, or a denture-related dental procedure.

RESULTS

Rates of preventive, oral and maxillofacial surgery, and denture-related procedures were higher among rural adults. Accounting for individual age and gender, and ZIP code average income and dentist density, rural dwellers were more likely to receive a preventive procedure [odds ratio (OR) 1.15, P < 0.0001] or tooth extraction (OR 1.08, P < 0.0001), and less likely to have a denture-related procedure (OR 0.94, P = 0.015) compared to nonrural dwellers. Female gender was the strongest predictor of receiving a preventive procedure (OR 1.30, P < 0.0001).

CONCLUSIONS

Even among privately insured individuals with known access to dental care, rurality was associated with significant differences in the frequency of various dental procedures. Rural dental patients may have higher needs for oral surgical procedures, even when they have access to preventive care.

Association of income inequality with orthodontic treatment use

BACKGROUND

Income inequality has been associated with worse oral health outcomes and reduced dental care use. It is unknown whether income inequality may motivate people to seek orthodontic treatment.

METHODS

This was a logistic mixed-effects model of deidentified claims from a private insurer in the United States with enrolled members having at least 1 orthodontic visit in the calendar year as the dependent variable. Total number of dental visits, age, and sex were individual-level covariates. Median household income, Gini coefficient, female population proportion, number of practicing dentists and orthodontists, population size, and population density were zip code-level covariates.

RESULTS

A total of 1,860,709 people had at least 1 orthodontic claim. Adjusting for population demographics, the Gini index was significantly positively associated with orthodontic use for children but not for adults (odds ratio, 1.69 for children; P < .0001). Being female was the strongest predictor of orthodontic use for adults and was a significant predictor of use for children (odds ratio, 1.50 and 1.45, respectively; P < .0001).

CONCLUSIONS

The Gini index is associated with orthodontic use in children in a privately insured population. Individual characteristics are more predictive of orthodontic use among privately insured adults.

PRACTICAL IMPLICATIONS

Demographic and economic traits of communities can affect oral health care use; effects on orthodontic use may be more dramatic than on other forms of oral health care.

Developing an Open Access, Competency-Based Global Oral Health Curriculum: A Global Health Starter Kit

Dental education has seen increases in global health and international educational experiences in many dental schools' curricula. In response, the Consortium of Universities for Global Health's Global Oral Health Interest Group aims to develop readily available, open access resources for competency-based global oral health teaching and learning. The aim of this study was to develop and evaluate a Global Health Starter Kit (GHSK), an interdisciplinary, competency-based, open access curriculum for dental faculty members who wish to teach global oral health in their courses. Phase I (2012-17) evaluated longitudinal outcomes from two Harvard School of Dental Medicine pilot global health courses with 32 advanced and 34 predoctoral dental students. In Phase II (2018), the Phase I outcomes informed development, implementation, and evaluation of the open access GHSK (45 enrollees) written by an interdisciplinary, international team of 13 content experts and consisting of five modules: Global Trends, Global Goals, Back to Basics: Primary Care, Social Determinants and Risks, and Ethics and Sustainability. In Phase III (summer and fall 2018), five additional pilot institutions (two U.S. dental schools, one U.S. dental hygiene program, and two dental schools in low- and middle-income countries) participated in an early adoption of the GHSK curriculum. The increase in perceived knowledge scores of students enrolled in the pilot global health courses was similar to those enrolled in the GHSK, suggesting the kit educated students as well or better in nearly all categories than prior course materials. This study found the GHSK led to improvements in learning in the short term and may also contribute to long-term career planning and decision making by providing competency-based global health education.

Oral Health is Health: The Future is Now

Oral disease is strongly affected by social determinants of health, policy, genetics, and other factors. Because of the multifaceted nature of oral health, many members of the health care team can participate in oral care services. Primary care providers (PCPs) are essential team members. Patients often visit PCPs while forgoing dental care. Primary care providers traditionally receive little training in oral health, but that is changing. A thorough, well-organized, systems approach is required to train future providers in oral health. Primary care has 12 disciplines that must be involved in these efforts and coordinated at the highest levels as well as at the grassroots level to affect systems change for didactic and clinical training. Acceptance and sustainability will require new funding mechanisms, innovations in education, patient care, and quality incentives, and evolution in value-based care models and national health organizations. This is achievable with the right champions.

Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda

BACKGROUND

The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda.

METHODS

The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors.

RESULTS

In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions.

CONCLUSION

The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.

Does providing dental services reduce overall health care costs?: A systematic review of the literature

BACKGROUND

The authors conducted a systematic review of the literature to assess the impact of dental treatment on overall health care costs for patients with chronic health conditions and patients who were pregnant.

TYPES OF STUDIES REVIEWED

The authors searched multiple databases including MEDLINE, Embase, Web of Science, and Dentistry & Oral Sciences Source from the earliest date available through May 2017. Two reviewers conducted the initial screening of all retrieved titles and abstracts, read the full text of the eligible studies, and conducted data extraction and quality assessment of included studies.

RESULTS

The authors found only 3 published studies that examined the effect of periodontal treatment on health care costs using medical and dental claims data from different insurance databases. Findings from the qualitative synthesis of those studies were inconclusive as 1 of the 3 studies showed a cost increase, whereas 2 studies showed a decrease.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The small number of studies and their mixed outcomes demonstrate the need for high-quality studies to evaluate the effect of periodontal intervention on overall health care costs.

Incorporating Oral Health as Part of Routine Diabetes Care in Ireland

Diabetes mellitus is a common disorder of glucose metabolism that is increasingly prevalent in the Irish population. It is associated with a range of complications leading to substantial morbidity and mortality. A less well-recognized complication of diabetes is periodontal disease. This is a chronic inflammatory disease affecting the periodontium, the specialized group of tissues that surround and support the teeth, including the gingiva (gums) and alveolar bone. Periodontal disease affects patients with diabetes with a greater prevalence and incidence than non-diabetic patients, and can itself exert negative effects on glucose control in people with diabetes. The National Clinical Programme for Diabetes in Ireland aims to reduce the morbidity and mortality associated with diabetes, which includes the development and dissemination of guidelines supporting integrated care. Based on the bidirectional relationship between diabetes mellitus and periodontal disease, we recommend that an oral health evaluation, as well as any necessary onward referral, be incorporated into the Irish recommendations for routine diabetes care, as part of the National Clinical Programme.

Patient-Centered Communication: Exploring the Dentist's Role in the Era of e-Patients and Health 2.0

In today's digital era, people are increasingly relying on the Internet-including social media-to access health information and inform their health decisions. This article describes an exploratory initiative to better understand and define the role of dentists in patient education in the context of e-patients and Health 2.0. This initiative consisted of four phases. In Phase I, an interdisciplinary expert advisory committee was assembled for a roundtable discussion about patients' health information-seeking behaviors online. In Phase II, a pilot case study was conducted, with methods and analysis informed by Phase I recommendations. Phase III consisted of a debriefing conference to outline future areas of research on modernizing health communication strategies. In Phase IV, the findings and working theories were presented to 75 dental students, who then took a survey regarding their perspectives with the objective of guiding potential curriculum design for predoctoral courses. The results of the survey showed that the validity of online content was often secondary to the strength of the network sharing it and that advocacy online could be more effective if it allowed for emotional connections with peers rather than preserving accuracy of the information. Students expressed high interest in learning how to harness modern health communications in their clinical care since the role of the dentist is evolving from giving information to giving personalized guidance against the backdrop of an often contradictory modern information environment. The authors recommend that the dental profession develop patient-centered health communication training for predoctoral students and professional development and continuing education for practicing professionals.

A competency matrix for global oral health

The Lancet Commission on Education of Health Professionals for the 21(st) Century calls for enhancing health education for the needs and challenges of the 21st century to improve health status globally. To complement the Lancet report, this article makes recommendations for including core global health competencies in the education of health care professionals and specific groups of the public who are relevant to oral health in a global context in order to tackle the burden of oral diseases. Experts from various professional backgrounds developed global oral health competencies for four target groups: Group 1 was defined as dental students, residents/trainee specialists (or equivalent), and dentists; Group 2 was community health workers, dental hygienists, and dental therapists (or the equivalent); Group 3 was health professionals such as physicians, physician assistants, nurses, nurse practitioners, and pharmacists; and Group 4 was non-health professionals in the public arena such as parents, teachers, decision makers, key opinion leaders, and health and consumer advocates. Key competencies for members of each of the four target groups are presented in a matrix. The suggested competency matrix shows that many other health professions and groups in society have potentially crucial roles in the prevention, control, and management of oral diseases globally. Workforce models including a wider range of professionals working together as a team will be needed to tackle the burden of oral diseases in an integrated way in the broader context of non-communicable diseases. Further discussion and research should be conducted to validate or improve the competencies proposed here with regard to their relevance, appropriateness, and completeness.

A historical and undergraduate context to inform interprofessional education for global health

Through a case example of fluoride, this paper examines why dental caries and other 21st century challenges require collaborative practice toward improved health that begins with interprofessional education (IPE). We suggest a theoretical framework for expanding the thinking around IPE for global health and recommend beginning at the undergraduate, or "pre-interprofessional," level where students are still undifferentiated by profession. Our theoretical framework can assist in providing a foundation for curriculum alignment and calibration moving forward to the graduate and professional training levels.

Results from a new global oral health course: a case study at one dental school

To channel students' interest in global oral health and prepare them to respond adequately to the health effects of globalization as future practitioners, new courses in dental curricula may be needed. This article documents the results of Harvard School of Dental Medicine (HSDM)'s new course, Global Oral Health: Interdisciplinary Approaches. To the authors' knowledge, this is the first course of its kind in dental education. HSDM developed learning objectives for the course based on the literature, the training and experience of HSDM global health faculty, and the mission of the HSDM Global Health Initiative. Dental residents and public health students enrolled, and some dental students audited. The discussion-based critical thinking course examined the extensive relationship between oral health and global health, and concept development was determined by in-class participation. After taking the course, students' assessments of their global oral health knowledge increased on average 100 percent. Nearly all students reported that they were very likely to use the concepts of global oral health in their careers and that they would definitely recommend the course to others. This course model seems to have met the expectations of students and faculty, and its fundamentals appear to be readily transferrable to other dental schools.

Including oral health training in a health system strengthening program in Rwanda

OBJECTIVE

Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH) Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda.

DESIGN

In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined 'vertical' direct patient care training with 'horizontal' interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability.

RESULTS

The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed.

CONCLUSIONS

Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come.

Purification and Characterization of a Population of EGFP-Expressing Cells from the Developing Pancreas of a Neurogenin3/EGFP Transgenic Mouse

Neurogenin 3 (ngn3) is a basic helix loop helix transcription factor that is transiently expressed in the developing mouse pancreas with peak expression around E15. In mice lacking the ngn3 gene the endocrine cells of the pancreas fail to develop suggesting that the ngn3-positive cell may represent a progenitor cell for the endocrine pancreas. In order to purify and characterize this cell in detail we have generated a transgenic mouse, in which the ngn3 promoter drives expression of enhanced green fluorescent protein (EGFP). In the E15.5 embryo EGFP was expressed in the dorsal and ventral pancreas, the duodenum, and lower intestine as well as in the brain. This pattern of expression was in keeping with the known expression profile of the endogenous ngn3 gene. Within the pancreas EGFP was localized in close proximity to cells that stained positive for ngn3, insulin, and glucagon, but was absent from regions of the pancreas that stained positive for amylase. EGFP was also present in the pancreas at E18.5, although there was no detectable expression of ngn3. At this stage EGFP did not colocalize with any of the hormones or exocrine markers. EGFP(+) cells were FACS purified (96%) from the E15 pancreas yielding approximately 10,000 cells or 1.6% of the total pancreatic cells from one litter. RT/PCR analysis confirmed that the purified cells expressed EGFP, ngn3, insulin, glucagon, somatostatin and pancreatic polypeptide. The ability to purify ngn3(+) cells provides an invaluable source of material for charactering in detail their properties.

Single molecule detection of double-stranded DNA in poly(methylmethacrylate) and polycarbonate microfluidic devices

Single photon burst techniques were used to detect double-stranded DNA molecules in poly(methylmethacrylate) (PM MA) and polycarbonate (PC) microfluidic devices. A confocal epi-illumination detection system was constructed to monitor the fluorescence signature from single DNA molecules that were multiply labeled with the mono-intercalating dye, TOPRO-5, which possessed an absorption maximum at 765 nm allowing excitation with a solid-state diode laser and fluorescence monitoring in the near-infrared (IR). Near-IR excitation minimized autofluorescence produced from the polymer substrate, which was found to be significantly greater when excitation was provided in the visible range (488 nm). A solution containing lambda-DNA (48.5 kbp) was electrokinetically transported through the microfluidic devices at different applied voltages and solution pH values to investigate the effects of polymer substrate on the transport rate and detection efficiency of single molecular events. By applying an autocorrelation analysis to the data, we were able to obtain the molecular transit time of the individual molecules as they passed through the 7 microm laser beam. It was observed that the applied voltage for both devices affected the transport rate. However, solution pH did not alter the transit time for PM MA-based devices since the electroosmotic flow of PMMA was independent of solution pH. In addition, efforts were directed toward optimizing the sampling efficiency (number of molecules passing through the probe volume) by using either hydrodynamically focused flows from a sheath generated by electrokinetic pumping from side channels or reducing the channel width of the microfluidic device. Due to the low electroosmotic flows generated by both PMMA and PC, tight focusing of the sample stream was not possible. However, in PMMA devices, flow gating was observed by applying field strengths > -120 V/cm to the sheath flow channels. By narrowing the microchannel width, the number of molecular events detected per unit time was found to be four times higher in channels with 10 microm widths compared to those of 50 microm, indicating improved sampling efficiency for the narrower channels without significantly deteriorating detection efficiency. Attempts were made to do single molecule sizing of lambda-DNA, M13 (7.2 kbp) and pUC19 (2.7 kbp) using photon burst detection. While the average number of photons for each DNA type were different, the standard deviations were large due to the Gaussian intensity profile of the excitation beam. To demonstrate the sensitivity of single molecule analysis in the near-IR using polymer microfluidic devices, the near-IR chromophore, NN382, wasanalyzed using ourconfocal imager. A detection efficiency of 94% for single NN382 molecules was observed in the PC devices.

Barriers to enrollment in a state child health insurance program

OBJECTIVE

To identify barriers to enrollment into Colorado's Child Health Insurance Plan (CHP+) for non-Hispanic (NH), Hispanic (H), and uninsured families.

DESIGN

Telephone survey of 1) random samples of families who requested an application but did not complete it (N = 273 NH, N = 159 H) and 2) families with uninsured children identified by random-digit-dial statewide surveys (N = 165).

RESULTS

Major reasons for not enrolling included 1) got other insurance (NH 16.5%; H 27.2% P <.01), 2) thought household income was too high to qualify (NH 21.0%; H 11.9% P =.01), and 3) paperwork (NH 13.4%; H 14.7%, P = NS). Of those who thought their income was too high (N = 76, 17.6%), 58.5% appeared eligible based on reported income. Of uninsured families, only 41.7% had heard of CHP+. Of those who had never applied, major remediable reasons included not knowing enough about the program (20.9%) and thinking household income was too high (9.3%).

CONCLUSIONS

Effective marketing and education to increase awareness of CHP+ and ensure understanding of eligibility are critical to the success of the program.

Haplotype analysis of hemochromatosis: evaluation of different linkage-disequilibrium approaches and evolution of disease chromosomes

We applied several types of linkage-disequilibrium calculations to analyze the hereditary hemochromatosis (hh) locus. Twenty-four polymorphic markers in the major histocompatibility complex (MHC) class I region were used to haplotype hh and normal chromosomes. A total of 169 hh and 161 normal chromosomes were analyzed. Disequilibrium values were found to be high over an unusually large region beginning 150 kb centromeric of HLA-A and extending nearly 5 Mb telomeric of it. Recombination in this region was approximately 28% of the expected value. This low level of recombination contributes to the unusually broad region of linkage disequilibrium found with hh. The strongest disequilibrium was found at locus HLA-H (delta = .84) and at locus D6S2239 (delta = .85), a marker approximately 10 kb telomeric to HLA-H. All disequilibrium methods employed in this study found peak disequilibrium at HLA-H or D6S2239. The cys282tyr mutation in HLA-H, a candidate gene for hh, was found in 85% of disease chromosomes. A haplotype phylogeny for hh chromosomes was constructed and suggests that the mutation associated with the most common haplotype occurred relatively recently. The age of the hh mutation was estimated to be approximately 60-70 generations. Disequilibrium was maintained over a greater distance for hh-carrying chromosomes, consistent with a recent mutation for hh. Our data provide a reasonable explanation for previous difficulties in localizing the hh locus and provide an evolutionary history for disease chromosomes.

Regulation of the mesocorticolimbic dopamine system by glutamic acid receptor subtypes

Glutamic acid and excitatory amino acids specific for the glutamate receptor subtypes were microinjected into the A10 region of the rat. Glutamate produced an increase in motor behavior that was antagonized by pretreatment with the dopamine D2 receptor antagonist, haloperidol. This motor stimulant effect was produced by kainate, but not by N-methyl-D-aspartate (NMDA) or quisqualic acid. By using in vivo dialysis it was found that dopamine release in the nucleus accumbens and locomotor activity were enhanced by glutamate injection into the A10 region. Whereas glutamate was found to increase the postmortem concentration of dopamine metabolites in the medial prefrontal cortex, nucleus accumbens and A10 region, NMDA selectively increased dopamine metabolism in the prefrontal cortex, and kainate produced increases in the nucleus accumbens and A10 region. When glutamate and the NMDA receptor antagonist, 3-[(+/-)-2-carboxypiperazine-4-yl)propyl-1-phosphonic acid (CPP) were coadministered, CPP selectively abolished the effect of glutamate on medial prefrontal cortical dopamine metabolites. A physiological role for the NMDA receptor modulation of A10 dopamine neurons was shown by intra-A10 pretreatment with CPP antagonism of mild footshock-induced increase in dopamine metabolites in the prefrontal cortex. These data argue that glutamate is a regulatory transmitter of A10 dopamine neurons, and that the NMDA receptor subtype modulates neurons projecting to the prefrontal cortex whereas the kainate subtype modulates mesoaccumbens neurons.

Carcinoma of the bladder presenting as gonococcal cystitis

A patient with gonococcal infection presented with frank haematuria. On subsequent investigation a transitional cell carcinoma was found. Because the haematuria resolved rapidly after treatment with ampicillin no sinister cause for the bleeding was suspected. Since gonorrhoea is rarely associated with gross haematuria, when it does occur a thorough investigation should be undertaken.