Axial T1-weighted imaging of the lumbar spine: a redundancy or an asset?

OBJECTIVE

To determine the diagnostic value of axial T1-weighted imaging for patients suffering from lower back pain.

MATERIALS AND METHODS

In this retrospective study, 100 consecutive lumbar spine MRIs obtained in patients with chronic low back pain were reviewed in two sessions: First, readers viewed core sequences (sagittal T1-weighted, STIR and T2-weighted, and axial T2-weighted) with axial T1-weighted sequences, and second, readers viewed cores sequences alone. Readers recorded the presence of disc degeneration, nerve root compromise, facet joint arthritis, and stenosis at each lumbar spine level as well as the presence of lipoma of filum terminale (LFT), spondylolisthesis, transitional vertebrae, and fractures. The McNemar, Wilcoxon signed-rank, and student T tests were utilized.

RESULTS

For 100 studies, 5 spine levels were evaluated (L1-L2 through L5-S1). There were cases of disc disease (444/500 bulges, 56/500 herniations), nerve root compromise (1/500 nerve enlargement, 36/500 contact only, 20/500 displacement or compression), facet arthritis (438/500), stenosis (58/500 central canal, 64/500 lateral recess, 137/500 neuroforaminal), 6/100 LFTs, and other abnormalities (58/500 spondylolisthesis, 10/100 transitional vertebrae, 10/500 fracture/spondylolysis). There was no difference in diagnostic performance between the interpretation sessions (with and without axial T1-weighted imaging) at any level (p > 0.05), although four small additional LFTs were identified with axial T1-weighted imaging availability.

CONCLUSION

There was no clinically significant difference in the interpretation of lumbar spine MRI viewed with and without axial T1-weighted imaging, suggesting that the axial T1-weighted sequence does not add diagnostic value to routine lumbar spine MRI.

MRI features of benign peripheral nerve sheath tumors: how do sporadic and syndromic tumors differ?

OBJECTIVES

To compare MRI features of sporadic and neurofibromatosis syndrome-related localized schwannomas and neurofibromas.

METHODS

In this retrospective study, our pathology database was searched for "neurofibroma" or "schwannoma" from 2014 to 2019. Exclusion criteria were lack of available MRI and intradural or plexiform tumors. Qualitative and quantitative anatomic (location, size, relationship to nerve, signal, muscle denervation) and functional (arterial enhancement, apparent diffusion-weighted coefficient) MRI features of sporadic and syndrome-related tumors were compared. Statistical significance was assumed for p < 0.05.

RESULTS

A total of 80 patients with 64 schwannomas (sporadic: 42 (65.6%) v. syndrome-related: 22 (34.4%)) and 19 neurofibromas (sporadic: 7 (36.8%) v. syndrome-related: 12 (41.7%)) were included. Only signal heterogeneity (T2W p=0.001, post-contrast p=0.03) and a diffused-weighted imaging target sign (p=0.04) were more frequent with schwannomas than neurofibromas. Sporadic schwannomas were similar in size to syndrome-related schwannomas (2.9±1.2cm vs. 3.7±3.2 cm, p = 0.6), but with greater heterogeneity (T2W p = 0.02, post-contrast p = 0.01). Sporadic neurofibromas were larger (4.6±1.5cm vs. 3.4±2.4 cm, p = 0.03) than syndrome-related neurofibromas, also with greater heterogeneity (T2W p=0.03, post-contrast p=0.04). Additional tumors along an affected nerve were only observed with syndrome-related tumors). There was no difference in apparent diffusion coefficient values or presence of early perfusion between sporadic and syndrome-related tumors (p > 0.05).

CONCLUSIONS

Although syndrome-related and sporadic schwannomas and neurofibromas overlap in their anatomic, diffusion and perfusion features, signal heterogeneity and presence of multiple lesions along a nerve are differentiating characteristics of syndrome-related tumors.

Longitudinal assessment of annular fissures of the cervical spine: overlooked and static

Background

Cervical annular fissures (AFs) have not been studied specifically as to their prevalence, imaging features, and persistence over time. We sought to determine the prevalence and natural history of cervical AFs. We hypothesized that these are static lesions that are not prevalent in the population.

Methods

This was a cross-sectional retrospective study of cervical MRI examinations performed between 2011-2021. We retrospectively reviewed the studies of 115 consecutive patients (63 female, 52 male) who had 2 or more MRI studies of the cervical spine to identify (1) imaging features of cervical AFs on various pulse sequences, (2) the concurrence of disc bulges/herniations, (3) changes in those imaging findings over time (mean follow-up 39.3 months) and (4) rate at which cervical AFs were mentioned in radiology reports. 620 initial and follow-up studies were reviewed.

Results

50/115 (43.5%) patients had cervical AFs; 21 patients had a single AF and 29 patients had multi-level AFs (total 109 AFs). The most common levels affected were C4-C5 (28%, n = 31) and C5-C6 (27%, n = 30). All cervical AFs were hyperintense on T2WI and, over time, 95% (n = 104/109) of the AFs remained hyperintense; 22% (n = 25) showed less hyperintensity, 10% (n = 11) more hyperintensity, and 60% (n = 66) the same hyperintensity. 5 AFs (4%) resolved completely. Only 2 (8%) of 25 cervical AFs enhanced with gadolinium. The rate of concomitant disc bulges and herniations was 71% (n = 78) and 22% (n = 24) respectively. The presence of cervical AFs did not increase the risk of progression to bulges or herniations. None of the cervical AFs were mentioned in the radiology reports.

Conclusions

Cervical AFs occurred in 43.5% of patients but were rarely reported. They usually remained bright on T2W but their brightness could vary over time. Cervical AFs were often associated with disc bulges/herniations and enhanced less frequently (8%) than lumbar disk AFs.

MR imaging of thoracic annular fissures

OBJECTIVE

Annular fissures are common findings on MR studies of the lumbar spine but have not been specifically examined in the thoracic spine. We sought to review the prevalence and stability of MRI imaging features of thoracic annular fissures and the association of thoracic AFs with intervertebral degenerative disk changes.

MATERIALS AND METHODS

We surveyed 10 years of MRI studies in which patients had one or more repeated examinations of the thoracic spine. For every annular fissure, we recorded its imaging features on all pulse sequences and the evolution of those imaging findings across all time periods.

RESULTS

We reviewed 210 patients and discovered that 66 (31.4%) had at least one thoracic annular fissure. The presence of annular fissures was positively correlated with older age and male gender. The initial annular fissure was always hyperintense on T2WI and annular fissures remained hyperintense on T2WI over time in all cases but showed less hyperintensity in 23.9% (n = 39/163) and more hyperintensity in 4.9% (n = 8/163). The rate of concomitant disk bulges was 85.8% (n = 140/163). Of the 71 annular fissures in which gadolinium-enhanced studies were performed, 20 (28.1%) showed enhancement and 14/20 (70%) annular fissures showed persistent enhancement over time (mean follow-up = 39.6 ± 44.1 months).

CONCLUSION

Thoracic annular fissures rarely resolve, remain hyperintense on T2WI, and, if they enhance, that enhancement generally persists.

Is bilateral lung transplantation in pulmonary artery hypertension related to congenital heart disease a real therapeutic option? Experience of a national referral centre

Background

Pulmonary arterial hypertension (PAH) affects almost 10% of patients with congenital heart disease, markedly worsening their prognosis. Bilateral lung or cardiopulmonary transplantation is therefore the last therapeutic option. The presence of underlying congenital heart disease (CHD) leads many of these patients directly to cardiopulmonary transplantation. However, this option is increasingly limited due to the shortage of organs and the high risk of the procedure.

Purpose

Demonstrate that isolated bilateral lung transplantation (BLT) associated with repair of simple heart defects is an option that leads to good prognostic outcomes and adequate positive cardiac chamber remodelling.

Methods

We retrospectively analysed the cases of PAH-CHD in our centre who underwent BLT from September 2010 to January 2022.

Results

During the recorded time 12 of the 135 PAH-CHD patients followed in our unit were considered for transplantation. Six BLT were finally performed. The reasons for rejecting the option of transplantation in patients with congenital heart disease included, in addition to the usual ones (age, histocompatibility, comorbidities, ...) the presence of abundant collateral circulation or repeated thoracic interventions. Of the 6 patients who underwent transplantation of both lungs, the mean age was 39±10 years and 4 were women (66.6%). All of them had previous symptoms of heart failure, 4 of them presented recurrent supraventricular arrhythmias requiring ablation, one of them required stent implantation in the left coronary trunk due to extrinsic compression by the pulmonary artery trunk and another had presented threatening haemoptysis requiring embolization of bronchial branches. Regarding the aetiology of PAH-CHD, two of the patients had residual PAH after previous closure of the intracardiac defect years earlier and the remaining four patients (66.6%) had an incidental intracardiac shunt (2 ASD and 2 VSD). Both incidental ASD were closed in the main intervention. The course of the operation and immediate post-transplantation was similar to other PAH transplants, with a mean ICU stay of 10 days. All patients were discharged home and remain alive to date without recurrence of cardiovascular symptoms. On post-transplant echocardiographic re-evaluation, all patients had normalized right chambers in terms of both size and function (Table 1).

Conclusion

Isolated bilateral lung transplantation is a real option for most cases of pulmonary arterial hypertension associated with congenital heart disease with simple or previously repaired defects. BLT in these patients is not accompanied by a higher rate of complications in the immediate postoperative period and in the long term means the resolution of cardiovascular symptoms with the adequate positive remodelling of the right chambers.

Funding Acknowledgement

Type of funding sources: None.

The patient with Down syndrome and pulmonary arterial hypertension associated with congenital heart disease: from childhood to adulthood

 

Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease (CHD) that significantly affects its prognosis. Down syndrome is a common comorbidity among patients with PAH associated with CHD. Children born in recent years with CHD have benefited from advances in pediatric cardiac surgery that have modified their evolution compared to adults with the same pathologies. Our objective was to know and compare the characteristics of the adult and pediatric population with DS and PAH associated with CHD.

REHAP and REHIPED are Spanish, voluntary, multicenter registries that include patients with PAH associated with CHD. REHAP started in 2007 and includes patients over 18 years of age. Patients diagnosed with PAH after this time were prospectively included, until 2021. Patients who were followed in the participating centers and diagnosed after January 1998 were retrospectively included in the registry. REHIPED started in 2009 and collects patients between 2 months and 18 years of age. Patients diagnosed with PAH after this time were prospectively included, until 2021. Patients who were followed and diagnosed after January 1998 were retrospectively included. 131 adults and 47 children with DS and PAH associated with CHD were analyzed. Their baseline characteristics, hemodynamics, treatment, and 10-year survival were compared.

Adult patients with DS presented more frequently complete atrioventricular canal defect as underlying heart disease and were mostly in Eisenmenger's situation (84%). In pediatric patients the largest group was post-repair PAH (50%). Functional class was similar in both groups, although adults presented significantly greater hemodynamic severity. Regarding medical treatment, no differences were observed between both groups: there was a very low use of prostanoids both at baseline and at follow-up, and a majority use of oral monotherapy. There were no significant differences in survival.

Corrective surgery in patients with DS has become more frequent over the years: adults are mostly in Eisenmenger's situation, while post-repair PAH is the most numerous group in children. Although adults show greater hemodynamic severity, survival is similar in both groups. Medical treatment, which showed no differences between pediatric and adult age, is very conservative, with most patients on oral monotherapy and rare use of prostanoids.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Janssen MSD

An electrocardiographic diagnostic model for differentiating right from left ventricular outflow tract arrythmias origin

Background/Introduction

Several ECG signs have been proposed to discern the focal origin of ventricular outflow tract arrhythmias with a transition ≥V3. Their independent predictive value is unclear.

Purpose

The aim of the study is to establish a predictive model of independent ECG parameters to obtain an acute success in right-sided catheter ablation of isolated premature ventricular contractions (PVCs) or ventricular tachycardia (VT) from the ventricular outflow tract with a transition ≥V3.

Methods

We included 122 patients (62 women, mean age 54±16 years) with documented PVCs or VT showing a lower axis and predominantly negative QRS complexes in V1 and V2 who underwent ablation between January 2014 and June 2020. The achievement of acute ablation success from right endocardial positions was assessed. We performed a predictive model by multivariate logistic regression analysis including the following ECG variables associated with a right origin of the ventricular focus in previous studies: Transitional Zone (TZ) index, V2 transition ratio, V2S / V3R index, R-wave duration index, R/S-wave amplitude index in V2, variable coupling interval, and the presence of QS morphology in lead I.

Results

Two independent predictive ECG variables were identified: the V2S / V3R index (odds ratio 1.223; 95% CI, 1.024–1.460; p=0.026) and a coupling interval variability &gt;60 ms (odds ratio 0.307; 95% CI, 0.129 - 0.731; p=0.008). The area under the curve of this model was 0.733 (Picture 1). Arrhythmias with transition in V3 present a greater electroanatomic overlap and, therefore, a higher probability of right failure (59.3% vs 73.5% in arrhythmias with transitions after V3). In these, the V2 transition ratio is useful to predict the origin of the ectopy.

Conclusion

Two easily identifiable ECG variables (the V2S / V3R index and coupling interval variability &gt;60 ms) predict the acute success of a right-sided approach in the ablation of focal ventricular arrhythmias with predominantly negative QRS complexes in V1 and V2.

Funding Acknowledgement

Type of funding sources: None. Predictive accuracy of the ECG model

Open vs Minimally Invasive Scarf Osteotomy for Hallux Valgus Correction: A Randomized Controlled Trial

BACKGROUND

Minimally invasive (MI) surgery is becoming increasingly popular in the treatment of hallux valgus (HV). The scarf osteotomy is an effective procedure with a track record in open HV surgery. We adapted this effective osteotomy to MI surgery as a novel technique never reported before. The aim of this study was to compare the clinical and radiologic outcomes of patients who underwent open or MI scarf.

METHODS

Between 2017 and 2018, 58 patients were randomized to either open or MI scarf to treat HV deformity. Prospective patient-reported outcome measures and weightbearing radiographs were obtained. Data included the AOFAS score, radiologic angular correction, operative time, fluoroscopy radiation dose, and postoperative pain on visual analog scale (VAS).

RESULTS

The mean follow-up was of 21 (range, 12-38) months. Radiologic measurements (postoperative hallux valgus angle, first-to-second intermetatarsal angle, and distal metaphyseal articular angle) were similar in both groups and showed statistically significant improvement from preoperative measures. The mean operative time for the MI group was 16.7 vs 26.1 minutes in the open group, a statistically significant difference. Radiation exposure was 14 times higher in the MI group when compared to the open group (mean: 34 vs 2.4 mGy/cm², P < .001). There were no major complications in either group.

CONCLUSIONS

The MI scarf provides a clinically and radiologically equivalent outcome to open scarf for the treatment of HV with reduced operative time and immediate postoperative VAS for pain but is associated with a small increase in radiation exposure.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

Five-Minute Five-Sequence Knee MRI Using Combined Simultaneous Multislice and Parallel Imaging Acceleration: Comparison with 10-Minute Parallel Imaging Knee MRI

Background Rapid knee MRI using combined simultaneous multislice (SMS) technique and parallel imaging (PI) acceleration can add value through reduced acquisition time but requires validation of clinical efficacy. Purpose To evaluate the performance of clinical fourfold SMS-PI-accelerated, 5-minute, five-sequence, multicontrast knee MRI protocols compared with standard twofold PI-accelerated, 10-minute knee MRI protocols. Materials and Methods Adults with painful knee conditions were prospectively enrolled from April 2018 to October 2019. Participants underwent fourfold SMS-PI-accelerated, 5-minute, turbo spin-echo (TSE) knee MRI and standard-of-care twofold PI-accelerated, 10-minute, TSE knee MRI at either 1.5 T or 3.0 T. Three radiologists independently evaluated the knee MRI studies for meniscal, tendinous, ligamentous, and osseocartilaginous injuries. Statistical analyses included k-based intermethod agreements and diagnostic performance testing. P < .05 was considered indicative of a statistically significant difference. Results A total of 252 adults were evaluated (mean age ± standard deviation, 47 years ± 17; 134 men). Among the participants, 104 (mean age, 42 years ± 18; 57 women) were in the 1.5-T arm and 148 (mean age, 46 years ± 17; 87 men) were in the 3.0-T arm. Twenty-nine participants (mean age, 38 years ± 12; 15 men) in the 1.5-T arm and 42 (mean age, 41 years ± 16; 24 men) in the 3.0-T arm underwent arthroscopy a mean of 45 days ± 31 and 45 days ± 22 after MRI, respectively. Intermethod agreements were good at 1.5 T (κ >0.71 [95% CI: 0.56, 0.83]) and very good at 3.0 T (κ >0.85 [95% CI: 0.69, 0.96]). The diagnostic performances of corresponding 5-minute and 10-minute MRI protocols were similar for 1.5 T, with areas under the receiver operating characteristic curve (AUCs) greater than 0.78 (95% CI: 0.71, 0.84) (P > .32), and 3.0 T, with AUCs greater than 0.83 (95% CI: 0.78, 0.88) (P > .32). Conclusion Comparisons of 5-minute five-sequence simultaneous multislice- and parallel imaging (PI)-accelerated and 10-minute five-sequence PI-accelerated turbo spin-echo MRI of the knee suggest similar performances at 1.5 and 3.0 T. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Subhas in this issue.

Imaging of non-neurogenic peripheral nerve malignancy-a case series and systematic review

OBJECTIVE

To evaluate the frequency, clinico-pathologic and imaging features of malignant tumors in peripheral nerves which are of non-neurogenic origin (non-neurogenic peripheral nerve malignancy-PNM).

MATERIALS AND METHODS

We retrospectively reviewed our pathology database for malignant peripheral nerve tumors from 07/2014-07/2019 and performed a systematic review. Exclusion criteria were malignant peripheral nerve sheath tumor (MPNST). Clinico-pathologic and imaging features, apparent diffusion coefficient (ADC_min), and standard uptake values (SUV_max) are reported.

RESULTS

After exclusion of all neurogenic tumors (benign = 196, MPNST = 57), our search yielded 19 non-neurogenic PNMs (7%, n = 19/272), due to primary intraneural malignancy (16%, n = 3/19) and secondary perineural invasion from an adjacent malignancy (16%, n = 3/19) or metastatic disease (63%, n = 12/19). Non-neurogenic PNMs were located in the lumbosacral plexus/sciatic nerves (47%, n = 9/19), brachial plexus (32%, n = 6/19), femoral nerve (5%, n = 1/19), tibial nerve (5%, n = 1/19), ulnar nerve (5%, n = 1/19), and radial nerve (5%, n = 1/19). On MRI (n = 14/19), non-neurogenic PNM tended to be small (< 5 cm, n = 10/14), isointense to muscle on T1-W (n = 14/14), hyperintense on T2-WI (n = 12/14), with enhancement (n = 12/12), low ADC_min (0.5-0.7 × 10-3 mm²/s), and variable metabolic activity (SUV_max range 2.1-13.1). A target sign was absent (n = 14/14) and fascicular sign was rarely present (n = 3/14). Systematic review revealed 89 cases of non-neurogenic PNM.

CONCLUSION

Non-neurogenic PNMs account for 7% of PNT in our series and occur due to metastases and primary intraneural malignancy. Although non-neurogenic PNMs exhibit a non-specific MRI appearance, they lack typical signs of neurogenic tumors such as the target sign. Quantitative imaging features identified by DWI (low ADC) and F¹⁸-FDG PET/CT (high SUV) may be helpful clues to the diagnosis.

Determination of skeletal tumor extent: is an isotropic T1-weighted 3D sequence adequate?

OBJECTIVES

To test the hypothesis that an accelerated, T1-weighted 3D CAIPIRINHA SPACE sequence with isotropic voxel size offers a similar performance to conventional T1-weighted 2D TSE (turbo spin echo) for the evaluation of bone tumor extent and characteristics.

METHODS

Thirty-four patients who underwent 3-T MRI with 3DT1 (CAIPIRINHA SPACE TSE) and 2DT1 (TSE) were included. Sequence acquisition time was reported. Two radiologists independently evaluated each technique for tumor location, size/length, tumor-to-joint distance, signal intensity, margin/extraosseous extension, and signal-to-noise (SNR) and contrast-to-noise (CNR) ratios.

RESULTS

Tumors were located in long (20/36, 55.5%) and pelvic (16/36, 44.4%) bones. 3DT1 sequence required an average acquisition time of 235 s (± 42 s, range 156-372), while two plane 2DT1 sequences combined (coronal and axial) had an average acquisition time of 381 s (± 73 s, range 312-523). There was no difference in the measurements of tumor length and tumor-to-joint distance (p = 0.95) between 3DT1 and 2DT1 images. Tumors were hypointense (17/36, 47.2% vs 17/36, 47.2%), isointense (12/36, 33.3% vs 12/36, 33.3%), or hyperintense (7/36, 19.4% vs 7/36, 19.4%) on 3DT1 vs 2DT1, respectively. Assessment of tumor margins and extraosseous extension was similar, and there was no difference in tumor SNR or CNR (p > 0.05).

CONCLUSIONS

An accelerated 3D CAIPIRINHA SPACE T1 sequence provides comparable assessments of intramedullary bone tumor extent and similar tumor characteristics to conventional 2DT1 MRI. For the assessment of bone tumors, the isotropic volume acquisition and multiplanar reformation capability of the 3DT1 datasets can obviate the need for 2DT1 acquisitions in multiple planes.

KEY POINTS

• 3DT1 offers an equivalent performance to 2DT1 for the assessment of bone tumor characteristics, with faster and higher resolution capability, obviating the need for acquiring 2DT1 in multiple planes. • There was no difference in the measurements of tumor length and tumor-to-joint distance obtained on 3DT1 and 2DT1 images. • There was no difference in signal-to-noise ratio (SNR) or contrast-to-noise ratio (CNR) measures between 3DT1 and 2DT1.

Semiconductor laser linewidth reduction by six orders of magnitude via delayed optical feedback

We demonstrate a coherence increase by six orders of magnitude of a standard quantum well semiconductor laser. Using a simple, optical-fiber-based feedback scheme, we stabilize the laser in a high-gain mode of a long external cavity. In a modified self-heterodyne measurement, we mix the high-gain mode with a strongly suppressed side mode and obtain an interference linewidth of only 12.6 Hz, corresponding to a decoherence of (3.1±2.9) Hz. In an independent characterization using an etalon, we deduce an upper limit of 300 Hz for the laser linewidth. The laser stably resides in this mode for tens of seconds. Our results agree with theoretical predictions.

A suggested local regions in the Southern Gulf of Mexico using a diatom database (1979-2002) and oceanic hidrographic features

A diatom data-base of 255 species obtained from 14 oceanographic cruises (14801 entries of 647 sampling sites) together with the analysis of oceanic features were used to establish four local regions in the southern Gulf of Mexico. In addition, common species for each region were designated. This study is based on the application of cluster analysis and the species frequency data. Material for this undertaking consisted of water and net samples obtained between June 1979 and December 2002. Results show that the most frequent species (> 40%) were: Asterionellopsis glacialis, Bacteriastrum delicatulum, B. hyalinum, Chaetoceros affinis, C. coarctatus, C. compresus, C. curvisetus, C. danicus, C. decipiens, C. diversus, C. lorenzianus, C. pelagicus, C. peruvianus, Coscinodiscus radiatus, Cylindrotheca closterium, Guinardia flaccida, Hemiaulus hauckii, H. membranaceus, H. sinensis, Leptocylindrus danicus, Neocalyptrella robusta, Nitzschia bicapitata, Pleurosigma diverse-striatum, Proboscia alata, Pseudo-nitzschia pungens, Pseudosolenia calcar-avis, Rhizosolenia imbricata, R. setigera, Skeletonema costatum, Thalassionema bacillare, T frauenfeldii, T nitzschioides and Thalassiosira eccentrica. The species composition for each region and season are discussed. Itis concluded that sampling site assemblages are related to oceanographic conditions. A total list of species composition is given, forty-seven species taxa being new records for this area.

Search for charged higgs bosons decaying into top and bottom quarks in pp[over ] collisions

We describe a search for production of a charged Higgs boson, qq[over ];{'}-->H;{+}, reconstructed in the tb[over ] final state in the mass range 180< or =M_{H;{+}}< or =300 GeV. The search was undertaken at the Fermilab Tevatron collider with a center-of-mass energy sqrt[s]=1.96 TeV and uses 0.9 fb;{-1} of data collected with the D0 detector. We find no evidence for charged Higgs boson production and set upper limits on the production cross section in the types I, II, and III two-Higgs-doublet models (2HDMs). An excluded region in the (M_{H;{+}}, tanbeta) plane for type I 2HDM is presented.

Measurement of the lifetime of the Bc+/- meson in the semileptonic decay channel

Using approximately 1.3 fb(-1) of data collected by the D0 detector between 2002 and 2006, we measure the lifetime of the Bc+/- meson in the Bc-/+-->J/psimicro+/-+X final state. A simultaneous unbinned likelihood fit to the J/psi+micro invariant mass and lifetime distributions yields a signal of 881+/-80(stat) candidates and a lifetime measurement of tau(Bc+/-)=0.448(-0.036)(+0.038)(stat)+/-0.032(syst) ps.

Search for associated W and Higgs Boson production in pp[over ] collisions at sqrt[s]=1.96 TeV

We present results of a search for WH-->lnubb[over ] production in pp[over ] collisions based on the analysis of 1.05 fb;{-1} of data collected by the D0 experiment at the Fermilab Tevatron, using a neural network for separating the signal from backgrounds. No signal-like excess is observed, and we set 95% C.L. upper limits on the WH production cross section multiplied by the branching ratio for H-->bb[over ] for Higgs boson masses between 100 and 150 GeV. For a mass of 115 GeV, we obtain an observed (expected) limit of 1.5 (1.4) pb, a factor of 11.4 (10.7) times larger than the standard model prediction.

Measurement of the semileptonic branching ratio of B_{s};{0} to an orbitally excited D_{s};{**} state: Br(B_{s};{0}-->D_{s1};{-}(2536)mu;{+}nuX)

In a data sample of approximately 1.3 fb;{-1} collected with the D0 detector between 2002 and 2006, the orbitally excited charm state D_{s1};{+/-}(2536) has been observed with a measured mass of 2535.7+/-0.6(stat)+/-0.5(syst) MeV/c;{2} via the decay mode B_{s};{0}-->D_{s1};{-}(2536)mu;{+}nu_{mu}X. A first measurement is made of the branching ratio product Br(b[over ]-->D_{s1};{-}(2536)mu;{+}nu_{mu}X)xBr(D_{s1};{-}-->D;{*-}K_{S};{0}). Assuming that D_{s1};{-}(2536) production in semileptonic decay is entirely from B_{s};{0}, an extraction of the semileptonic branching ratio Br(B_{s};{0}-->D_{s1};{-}(2536)mu;{+}nu_{mu}X) is made.

Search for the standard model Higgs boson in the missing energy and acoplanar b-jet topology at sqrt[s]=1.96 TeV

We report a search for the standard model Higgs boson in the missing energy and acoplanar b-jet topology, using an integrated luminosity of 0.93 fb;{-1} recorded by the D0 detector at the Fermilab Tevatron pp[over ] Collider. The analysis includes signal contributions from pp[over ]-->ZH-->nunu[over ]bb[over ], as well as from WH production in which the charged lepton from the W boson decay is undetected. Neural networks are used to separate signal from background. In the absence of a signal, we set limits on sigma(pp[over ]-->VH)xB(H-->bb[over ]) at the 95% C.L. of 2.6-2.3 pb, for Higgs boson masses in the range 105-135 GeV, where V=W, Z. The corresponding expected limits range from 2.8 to 2.0 pb.

Search for third generation scalar leptoquarks decaying into taub

We have searched for third generation leptoquarks (LQ3) using 1.05 fb(-1) of data collected with the D0 detector at the Fermilab Tevatron Collider operating at sqrt[s]=1.96 TeV. We set a 95% C.L. lower limit of 210 GeV on the mass of a scalar LQ3 state decaying solely to a b quark and a tau lepton.

Measurement of Bs0 mixing parameters from the flavor-tagged decay Bs0-->J/psiphi

From an analysis of the flavor-tagged decay Bs0-->J/psiphi we obtain the width difference between the Bs0 light and heavy mass eigenstates, DeltaGammas = 0.19+/-0.07(stat)(-0.01)+0.02(syst) ps(-1), and the CP-violating phase, phi s= -0.57(-0.30)+0.24(stat)(-0.02)+0.08(syst). The allowed 90% CL intervals of DeltaGammas and phi s are 0.06 < DeltaGammas < 0.30 ps(-1) and -1.20 < phi s < 0.06, respectively. The data sample corresponds to an integrated luminosity of 2.8 fb(-1) accumulated with the D0 detector at the Fermilab Tevatron collider.

Observation of the doubly strange b baryon Omegab-

We report the observation of the doubly strange b baryon Omegab- in the decay channel Omegab(-)-->J/psiOmega-, with J/psi-->mu+mu(-) and Omega(-)-->LambdaK(-)-->(ppi-)K-, in pp collisions at sqrt[s]=1.96 TeV. Using approximately 1.3 fb(-1) of data collected with the D0 detector at the Fermilab Tevatron Collider, we observe 17.8+/-4.9(stat)+/-0.8(syst) Omegab- signal events at a mass of 6.165+/-0.010(stat)+/-0.013(syst) GeV. The significance of the observed signal is 5.4sigma, corresponding to a probability of 6.7 x 10(-8) of it arising from a background fluctuation.

Search for anomalous Wtb couplings in single top quark production

In 0.9 fb(-1) of pp[over] collisions, the D0 Collaboration presented evidence for single top quark production in events with an isolated lepton, missing transverse momentum, and two to four jets. We examine these data to study the Lorentz structure of the Wtb coupling. The standard model predicts a left-handed vector coupling at the Wtb vertex. The most general lowest dimension, CP-conserving Lagrangian admits right-handed vector and left- or right-handed tensor couplings as well. We find that the data prefer the left-handed vector coupling and set upper limits on the anomalous couplings. These are the first direct constraints on a general Wtb interaction and the first direct limits on left- and right-handed tensor couplings.

Search for neutral Higgs bosons in multi-b-jet events in pp[over] collisions at sqrt[s]=1.96 TeV

Data recorded by the D0 experiment at the Fermilab Tevatron Collider are analyzed to search for neutral Higgs bosons produced in association with b quarks. This production mode can be enhanced in the minimal supersymmetric standard model (MSSM). The search is performed in the three b quark channel using multijet triggered events corresponding to an integrated luminosity of 1 fb(-1). No statistically significant excess of events with respect to the predicted background is observed and limits are set in the MSSM parameter space.

Measurement of the electron charge asymmetry in pp[over ]-->W+X-->enu+X events at sqrt[s]=1.96 TeV

We present a measurement of the electron charge asymmetry in pp[over ]-->W+X-->enu+X events at a center of mass energy of 1.96 TeV using 0.75 fb(-1) of data collected with the D0 detector at the Fermilab Tevatron Collider. The asymmetry is measured as a function of the electron transverse momentum and pseudorapidity in the interval (-3.2, 3.2) and is compared with expectations from next-to-leading order calculations in perturbative quantum chromodynamics. These measurements will allow more accurate determinations of the proton parton distribution functions.

Measurement of the forward-backward charge asymmetry and extraction of sin2thetaWeff in pp-->Z/gamma* + X-->e+e- +X events produced at sqrt[s] = 1.96 TeV

We present a measurement of the forward-backward charge asymmetry (A FB) in pp-->Z/gamma* + X-->e+e(-) + X events at a center-of-mass energy of 1.96 TeV using 1.1 fb(-1) of data collected with the D0 detector at the Fermilab Tevatron collider. A FB is measured as a function of the invariant mass of the electron-positron pair, and found to be consistent with the standard model prediction. We use the A FB measurement to extract the effective weak mixing angle sin2thetaWeff = 0.2326+/-0.0018(stat)+/-0.0006(syst).

Measurement of the polarization of the upsilon(1S) and upsilon(2S) states in pp collisions at square root[s]=1.96 TeV

We present a study of the polarization of the Upsilon(1S) and Upsilon(2S) states using a 1.3 fb;{-1} data sample collected by the D0 experiment in 2002-2006 during run II of the Fermilab Tevatron Collider. We measure the polarization parameter alpha=(sigma_{T}-2sigma_{L})/(sigma_{T}+2sigma_{L}), where sigma_{T} and sigma_{L} are the transversely and longitudinally polarized components of the production cross section, as a function of the transverse momentum (p_{T};{Upsilon}) for the Upsilon(1S) and Upsilon(2S). Significant p_{T};{Upsilon}-dependent longitudinal polarization is observed for the Upsilon(1S). A comparison with theoretical models is presented.

Precise measurement of the top-quark mass from lepton + jets events

We measure the mass of the top quark using top-quark pair candidate events in the lepton+jets channel from data corresponding to 1 fb;{-1} of integrated luminosity collected by the D0 experiment at the Fermilab Tevatron collider. We use a likelihood technique that reduces the jet energy scale uncertainty by combining an in situ jet energy calibration with the independent constraint on the jet energy scale (JES) from the calibration derived using photon+jets and dijet samples. We find the mass of the top quark to be 171.5+/-1.8(stat.+JES)+/-1.1(syst.) GeV.

Observation of ZZ production in p-p collisions at sqrt s=1.96 TeV

We present an observation for ZZ-->l+l-l'+l'- (l, l'=e or mu) production in p[over]p collisions at a center-of-mass energy of sqrt[s]=1.96 TeV. Using 1.7 fb(-1) of data collected by the D0 experiment at the Fermilab Tevatron Collider, we observe three candidate events with an expected background of 0.14(+0.03)_(-0.02) events. The significance of this observation is 5.3 standard deviations. The combination of D0 results in this channel, as well as in ZZ-->l+l- nu[over]nu, yields a significance of 5.7 standard deviations and a combined cross section of sigma(ZZ)=1.60+/-0.63(stat)+0.16_-0.17(syst) pb.

Search for long-lived particles decaying into electron or photon pairs with the D0 detector

In this Letter we report on a search for long-lived particles that decay into final states with two electrons or photons. Such long-lived particles arise in a variety of theoretical models, such as hidden valleys and supersymmetry with gauge-mediated breaking. By precisely reconstructing the direction of the electromagnetic shower we are able to probe much longer lifetimes than previously explored. We see no evidence of the existence of such long-lived particles and interpret this search as a quasi model-independent limit on their production cross section, as well as a limit on a long-lived fourth generation quark.

Maternal glucose tolerance status influences the risk of macrosomia in male but not in female fetuses

OBJECTIVE

To elucidate whether the risk of macrosomia, large for gestational age (LGA) and small for gestational age (SGA) is influenced by maternal body mass index and glucose tolerance differently in male and female fetuses.

METHODS

A population study was conducted in 16 general hospitals from the Spanish National Health Service that included 9270 consecutive women with singleton pregnancies and without a former diagnosis of diabetes mellitus who delivered 4793 male and 4477 female newborns. Logistic regression analyses were performed to predict the effect of body mass index (BMI) category and glucose tolerance on macrosomia, large for gestational age newborns (LGA) and small for gestational age newborns (SGA) Separate analyses according to foetal sex were carried out for each outcome. The results were adjusted for maternal age, gestational age and pregnancy-induced hypertension.

RESULTS

There were significant differences between males and females in the percentage of infants who had macrosomia, LGA or SGA. Maternal BMI category was positively associated with the risk of macrosomia and LGA in both male and female newborns. In addition, there was a negative association between maternal BMI and SGA that only reached significance in males. In contrast, gestational diabetes was only a predictor of macrosomia exclusively in male fetuses (OR 1.67, 95% CI 1.12 to 2.49)

CONCLUSIONS

There is sexual dimorphism in the risk of abnormal birth weight attributed to maternal glucose tolerance status. A closer surveillance of foetal growth might be warranted in pregnant women with abnormal glucose tolerance carrying a male fetus.

Search for pair production of doubly charged Higgs bosons in the H++H- - -->mu+ mu+ mu- mu- final state

We report the results of a search for pair production of doubly charged Higgs bosons via pp over-->H++H - - X-->mu+ mu+ mu- mu- X at sqrt s=1.96 TeV. We use a data set corresponding to an integrated luminosity of 1.1 fb(-1) collected from 2002 to 2006 by the D0 detector at the Fermilab Tevatron Collider. In the absence of an excess above the standard model background, lower mass limits of M(H L +/- +/-) >150 GeV/c2 and M(H R+/- +/-) >127 GeV/c2 at 95% C.L. are set, respectively, for left-handed and right-handed doubly charged Higgs bosons assuming a 100% branching ratio into muons.

Search for Higgs bosons decaying to tau pairs in pp over collisions with the D0 detector

We present a search for the production of neutral Higgs bosons varphi decaying into tau+tau - final states in pp over collisions at a center-of-mass energy of 1.96 TeV. The data, corresponding to an integrated luminosity of approximately 1 fb(-1), were collected by the D0 experiment at the Fermilab Tevatron Collider. Limits on the production cross section times branching ratio are set. The results are interpreted in the minimal supersymmetric standard model yielding limits that are the most stringent to date at hadron colliders.

Measurement of the inclusive jet cross section in pp[over] collisions at square root [s]=1.96 TeV

We report on a measurement of the inclusive jet cross section in pp[over ] collisions at a center-of-mass energy sqrt[s]=1.96 TeV using data collected by the D0 experiment at the Fermilab Tevatron Collider corresponding to an integrated luminosity of 0.70 fb;{-1}. The data cover jet transverse momenta from 50 to 600 GeV and jet rapidities in the range -2.4 to 2.4. Detailed studies of correlations between systematic uncertainties in transverse momentum and rapidity are presented, and the cross section measurements are found to be in good agreement with next-to-leading order QCD calculations.

Search for decay of a fermiophobic Higgs boson hf-->gammagamma with the D0 detector at sqrt s=1.96 TeV

We report the results of a search for a narrow resonance decaying into two photons in 1.1 fb;{-1} of data collected by the D0 experiment at the Fermilab Tevatron Collider during the period 2002-2006. We find no evidence for such a resonance and set a lower limit on the mass of a fermiophobic Higgs boson of m_{h_{f}}>100 GeV at the 95% C.L. This exclusion limit exceeds those obtained in previous searches at the Fermilab Tevatron and covers a significant region of the parameter space B(h_{f}-->gammagamma) vs m_{h_{f}} which was not accessible at the CERN Large Electron-Positron Collider.

Search for large extra dimensions via single photon plus missing energy final states at sqrt s = 1.96 TeV

We report on a search for large extra dimensions in a data sample of approximately 1 fb(-1) of pp[over] collisions at sqrt s=1.96 TeV. We investigate Kaluza-Klein graviton production with a photon and missing transverse energy in the final state. At the 95% C.L. we set limits on the fundamental mass scale M(D) from 884 to 778 GeV for two to eight extra dimensions.

Observation of the Bc meson in the exclusive decay Bc-->J/psipi

A fully reconstructed Bc-->J/psipi signal is observed with the D0 detector at the Fermilab Tevatron pp[over] collider using 1.3 fb(-1) of integrated luminosity. The signal consists of 54+/-12 candidates with a significance that exceeds 5 standard deviations, and confirms earlier observations of this decay. The measured mass of the Bc meson is 6300+/-14(stat)+/-5(syst) MeV/c2.

First study of the radiation-amplitude zero in Wgamma production and limits on anomalous WWgamma couplings at sqrt[s]=1.96 TeV

We present results from a study of pp-->Wgamma+X events utilizing data corresponding to 0.7 fb{-1} of integrated luminosity at sqrt[s]=1.96 TeV collected by the D0 detector at the Fermilab Tevatron Collider. We set limits on anomalous WWgamma couplings at the 95% C.L. The one-dimensional 95% C.L. limits are 0.49<kappa{gamma}<1.51 and -0.12<lambda{gamma}<0.13. We make the first study of the charge-signed rapidity difference between the lepton and the photon and find it to be indicative of the standard model radiation-amplitude zero in the Wgamma system.

Search for W' boson resonances decaying to a top quark and a bottom quark

We search for the production of a heavy W' gauge boson that decays to third generation quarks in 0.9 fb-1 of pp collisions at square root(s)=1.96 TeV, collected with the D0 detector at the Fermilab Tevatron collider. We find no significant excess in the final-state invariant mass distribution and set upper limits on the production cross section times branching fraction. For a left-handed W' boson with SM couplings, we set a lower mass limit of 731 GeV. For right-handed W' bosons, we set lower mass limits of 739 GeV if the W' boson decays to both leptons and quarks and 768 GeV if the W' boson decays only to quarks. We also set limits on the coupling of the W' boson to fermions as a function of its mass.

Study of direct CP violation in B(+/-)-->J/psiK(+/-)(pi(+/-)) decays

We present a search for direct CP violation in B(+/-)-->J/psiK(+/-)(pi(+/-)) decays. The event sample is selected from 2.8 fb(-1) of pp collisions recorded by D0 experiment in run II of the Fermilab Tevatron Collider. The charge asymmetry A_(CP)(B(+)-->J/psiK(+))= + 0.0075 +/- 0.0061(stat)+/-0.0030(syst) is obtained using a sample of approximately 40, 000 B(+/-)-->J/psiK(+/-) decays. The achieved precision is of the same level as the expected deviation predicted by some extensions of the standard model. We also measured the charge asymmetry A(CP)(B(+)-->J/psipi(+))=-0.09+/-0.08(stat)+/-0.03(syst).

Simultaneous measurement of the ratio R=B(t --> Wb)/B(t --> Wq) and the top-quark pair production cross section with the D0 detector at sqrt(s) = 1.96 TeV

We present the first simultaneous measurement of the ratio of branching fractions, R=B(t --> Wb)/B(t --> Wq), with q being a d, s, or b quark, and the top-quark pair production cross section sigma(tt[over]) in the lepton plus jets channel using 0.9 fb(-1) of pp[over] collision data at sqrt(s)=1.96 TeV collected with the D0 detector. We extract R and sigma(tt[over]) by analyzing samples of events with 0, 1, and > or =2 identified b jets. We measure R=0.97(+0.09)/(-0.08)(stat+syst) and sigma(tt[over])=8.18(+0.09)(-0.84)(stat+syst) +/- 0.50(lumi) pb, in agreement with the standard model prediction.

Measurement of the tt[over] production cross section in pp[over] collisions at sqrt(s)=1.96 TeV

We measure the tt[over] production cross section in pp[over] collisions at sqrt(s)=1.96 TeV in the lepton + jets channel. Two complementary methods discriminate between signal and background: b tagging and a kinematic likelihood discriminant. Based on 0.9 fb(-1) of data collected by the D0 detector at the Fermilab Tevatron Collider, we measure sigma(tt[over])=7.62+/-0.85 pb, assuming the current world average m(t)=172.6 GeV. We compare our cross section measurement with theory predictions to determine a value for the top-quark mass of 170+/-7 GeV.

Model-independent measurement of the W-boson helicity in top-quark decays at D0

We present the first model-independent measurement of the helicity of W bosons produced in top quark decays, based on a 1 fb(-1) sample of candidate tt events in the dilepton and lepton plus jets channels collected by the D0 detector at the Fermilab Tevatron pp Collider. We reconstruct the angle theta(*) between the momenta of the down-type fermion and the top quark in the W boson rest frame for each top quark decay. A fit of the resulting costheta(*) distribution finds that the fraction of longitudinal W bosons f(0)=0.425+/-0.166(stat)+/-0.102(syst) and the fraction of right-handed W bosons f(+)=0.119+/-0.090(stat)+/-0.053(syst), which is consistent at the 30% C.L. with the standard model.

High levels of genetic variability and inbreeding in two Neotropical dioecious palms with contrasting life histories

We characterized the population genetics of two Neotropical dioecious palm species of Chamaedorea with contrasting life strategies from the region that is both the northernmost extent and most species rich of the genus. Chamaedorea tepejilote is a common, wind-pollinated arboreal understory palm. Although most adult plants reproduce each year, only a few individuals produce the majority of flowers and seeds. Chamaedorea elatior, conversely, is an uncommon climbing subcanopy palm with entomophilous flowers (insect-pollinated characteristics). Most of the mature palms do not reproduce in consecutive years and fruiting is episodic. Isozymes with a total of 107 alleles for 27 loci of 17 enzymes from six populations were assessed. For both species, co-occurrence of high levels of genetic variation and homozygosity was observed (C. tepejilote: He: 0.385-0.442, f: 0.431-0.486; C. elatior: He: 0.278-0.342, f: 0.466-0.535). Genetic differentiation of C. elatior was much lower (theta=0.0315) than that for C. tepejilote (theta=0.152). The contrast in differentiation may be influenced by differences in the spatial scale of the genetic neighborhoods of the two species. The simultaneous maintenance of inbreeding and of a large number of alleles within the populations is attributable to the low and variable number of mating pairs. Demographic studies indicate that this pattern could be explained by low reproductive frequency among individuals and over years in C. elatior and by reproductive dominance in C. tepejilote.

[Prevalence of type 2 diabetes in the preoperative assessment interview]

OBJECTIVES

To determine the prevalence of type 2 diabetes in preoperative anesthetic assessment interviews during May 2004 and to compare the results to prevalences reported in other studies.

PATIENTS AND METHODS

Patients over the age of 20 years who received an assessment interview were included. Type 1 diabetics, pregnant women, and critically ill patients were excluded. We followed the 1997 diagnostic guidelines of the American Diabetes Association.

RESULTS

The prevalence of previously diagnosed type 2 diabetes was 10.3%. Three patients were diabetics unaware of their disease. The overall prevalence of type 2 diabetes was 11% in this population.

CONCLUSIONS

Type 2 diabetes has a high prevalence among surgical patients in our hospital, higher than that reported for the general population based on other studies.