Healthcare communication satisfaction and psychosocial outcomes in adolescents and young adults with differences of sex development

OBJECTIVES

We examined: (1) healthcare communication satisfaction and psychosocial outcomes (resilience, QoL, and psychological adjustment) in adolescents and young adults (AYA) with differences of sex development (DSD), (2) differences in psychosocial outcomes between those who were highly satisfied and those who were less satisfied, and (3) group differences between adolescents (ages 12-17) and young adults (ages 18-26) regarding associations with healthcare communication and psychosocial outcomes.

METHODS

AYA with DSD across four study sites reported on satisfaction with healthcare communication and psychosocial outcomes. Analyses included descriptive statistics (aim 1), independent samples t-tests (aim 2), and Pearson's correlations (aim 3).

RESULTS

Participants reported high levels of satisfaction with healthcare communication. Higher healthcare communication satisfaction was associated with greater resilience (p = .01), better QoL (p = .02), and fewer internalizing problems (p = .04). For adolescents, higher healthcare communication satisfaction was associated with better psychosocial outcomes (p values ranging from.01-.04). No significant associations were found in the young adult group.

CONCLUSIONS

Satisfaction with healthcare communication is related to positive psychosocial outcomes in adolescents with DSD.

PRACTICE IMPLICATIONS

These data underscore the importance of optimizing communication with families, engaging AYA in early and ongoing discussions about their care, and including psychosocial providers in DSD care.

Information needs and health status in adolescents and young adults with differences of sex development or sex chromosome aneuploidies

INTRODUCTION

When and how to provide condition-related information to adolescents and young adults (AYAs) with differences of sex development or sex chromosome aneuploidies (DSDs or SCAs) is largely based on anecdotal experience and lacks informed guidance. For AYAs with a DSD or SCA, having accurate information is critical for attaining optimal adjustment and well-being, participating in decision making related to treatment options, and transitioning successfully to adult health care, yet prior studies have focused exclusively on parental perspectives and not on the views of adolescents themselves.

OBJECTIVE

The objective of this study was to describe unmet information needs in AYAs with a DSD or SCA and examine associations with perceived global health.

METHODS

Participants were recruited from specialty clinics at Children's Hospital of Philadelphia (n = 20) and Children's Hospital Colorado (n = 60). AYAs ages 12-21 years with a DSD or SCA and a parent completed a survey assessing perceived information needs across 20 topics, importance of those topics, and global health using the PROMIS Pediatric Global Health questionnaire (PGH-7).

RESULTS

AYAs had diagnoses of Klinefelter syndrome (41%), Turner syndrome (25%), and DSD (26%) and were 16.7 years (SD = 2.56) and 44% female. Parent participants were primarily mothers (81%). AYAs perceived that 48.09% of their information needs were unmet (SD = 25.18, range: 0-100). Parents perceived that 55.31% of AYAs' information needs were unmet (SD = 27.46 range: 5-100). AYAs and parents across conditions reported unmet needs related to information about transition to adult health care, financial support for medical care, and how the condition might affect the AYA's health in the future. While AYA-reported PGH-7 scores were not associated with percentage of AYA unmet information needs, parent-reported PGH-7 scores were (r = -.46, p < .001), such that lower parent-reported global health was associated with higher percentage of AYA unmet information needs.

DISCUSSION/CONCLUSION

On average, parents and AYAs perceived that half of AYAs' information needs were unmet, and a higher percentage of AYA unmet information needs was associated with lower perceived global health. The frequency of unmet needs in this sample of AYAs reflects an opportunity for improvement in clinical care. Future research is needed to understand how education to children and AYAs unfolds as they mature and to develop strategies to address the information needs of AYAs with a DSD or SCA, promote well-being, and facilitate AYA engagement in their own health care.

Instituting Sexual Orientation and Gender Identity Training and Documentation to Increase Inclusivity at a Pediatric Health System

In this mixed-methods quality improvement project, we implemented and evaluated sexual orientation and gender identity (SOGI) form rollout in the electronic medical record. Families in our gender diversity program completed a baseline survey in 2017 (55/328 responded) and follow-up in 2020 (180/721 responded) to evaluate the frequency of affirmed name and pronoun use in the hospital. Survey feedback informed system-wide inclusivity efforts and training. SOGI was implemented in 2020 after 1,662 providers completed an online training and 11,090 team members completed gender and sexual orientation inclusivity training. We recommend similar trainings for health systems utilizing SOGI.

Stigma, Intrusiveness, and Distress in Parents of Children with a Disorder/Difference of Sex Development

OBJECTIVE

The impact of parent-reported stigma due to their child's disorder/difference of sex development (DSD) on parent psychosocial adjustment is poorly understood. In other pediatric populations, perceived interference of medical conditions into daily activities (i.e., illness intrusiveness ) mediates the relationship of stigma to adjustment. This study assessed relationships between parent-focused and child-focused stigma → illness intrusiveness → depressive and anxious symptoms . Exploratory analyses sought to identify patient characteristics associated with stigma.

METHOD

Caregivers (59 women and 43 men) of 63 children diagnosed with a DSD up to age 4 years completed measures of demographics, parent-focused and child-focused stigma, illness intrusiveness, and depressive and anxious symptoms.

RESULTS

Increased parent-focused and child-focused stigma were associated with increased illness intrusiveness, which, in turn, was associated with increased depressive and anxious symptoms for parents nested within dyads. Among children with DSD family histories, parents reported greater child-focused stigma.

CONCLUSION

Parents who experience DSD-related stigma report greater interference of their child's DSD into their daily activities, which is associated with poorer psychosocial adjustment. Findings support developing clinical interventions related to parents' perceptions of stigma and illness intrusiveness to improve parent adjustment.

Genomic loci associated with performance limiting equine overriding spinous processes (kissing spines)

Commonly known as "Kissing Spines" (KS), the pathological mechanisms underlying impingement and overriding of spinous processes (ORSPs) in horses are poorly understood. Thoroughbreds, Warmbloods, and stock-type breeds, including Paint Horses and Quarter Horses are at increased risk for developing clinical signs of KS. A total of 155 stock-type and Warmblood horses presented at collaborating veterinary clinics and hospitals were examined using a strict clinical and radiographical phenotyping scheme to grade each horse from 0 for unaffected controls to 4 for severe KS. Following genotyping with the Illumina Equine SNP70 array (Illumina, Inc.) a Genome Wide Association Study (GWAS) using 61,229 filtered individual Single Nucleotide Polymorphisms (SNPs) was performed to the KS grade phenotype. Two significantly associated SNPs (BIEC2-668062 and BIEC2-668013) on chromosome 25 defined a ~1.4 Gb candidate region containing approximately 17 coding genes (EquCab3) and 195 ENSEMBL annotated variants. Investigation of the best associated SNP (BIEC2-668062) on chr25 demonstrates a significant correlation with an increase in one KS grade, on average, per A allele in this population. A significant effect of breed group, age, height or sex was not observed in this population. These preliminary results demonstrate the potential for KS diagnosis and preventative measures for WB/ST individuals supported by increased genetic risk for more severe KS grade. We propose further research including other affected breeds and evaluating causative variants, as well as the effect of BIEC2-668062 in these populations.

A data-centric approach to generative modelling for 3D-printed steel

The emergence of additive manufacture (AM) for metallic material enables components of near arbitrary complexity to be produced. This has potential to disrupt traditional engineering approaches. However, metallic AM components exhibit greater levels of variation in their geometric and mechanical properties compared to standard components, which is not yet well understood. This uncertainty poses a fundamental barrier to potential users of the material, since extensive post-manufacture testing is currently required to ensure safety standards are met. Taking an interdisciplinary approach that combines probabilistic mechanics and uncertainty quantification, we demonstrate that intrinsic variation in AM steel can be well described by a generative statistical model that enables the quality of a design to be predicted before manufacture. Specifically, the geometric variation in the material can be described by an anisotropic spatial random field with oscillatory covariance structure, and the mechanical behaviour by a stochastic anisotropic elasto-plastic material model. The fitted generative model is validated on a held-out experimental dataset and our results underscore the need to combine both statistical and physics-based modelling in the characterization of new AM steel products.

Behavioral Health Diagnoses in Youth with Gender Dysphoria Compared with Controls: A PEDSnet Study

OBJECTIVE

To assess the odds of a psychiatric or neurodevelopmental diagnosis among youth with a diagnosis of gender dysphoria compared with matched controls in a large electronic health record dataset from 6 pediatric health systems, PEDSnet. We hypothesized that youth with gender dysphoria would have higher odds of having psychiatric and neurodevelopmental diagnoses than controls.

STUDY DESIGN

All youth with a diagnosis of gender dysphoria (n = 4173 age at last visit 16.2 ± 3.4) and at least 1 outpatient encounter were extracted from the PEDSnet database and propensity-score matched on 8 variables to controls without gender dysphoria (n = 16 648, age at last visit 16.2 ± 4.8) using multivariable logistic regression. The odds of having psychiatric and neurodevelopmental diagnoses were examined using generalized estimating equations.

RESULTS

Youth with gender dysphoria had higher odds of psychiatric (OR 4.0 [95% CI 3.8, 4.3] P < .0001) and neurodevelopmental diagnoses (1.9 [1.7, 2.0], P < .0001). Youth with gender dysphoria were more likely to have a diagnosis across all psychiatric disorder subcategories, with particularly high odds of mood disorder (7.3 [6.8, 7.9], P < .0001) and anxiety (5.5 [5.1, 5.9], P < .0001). Youth with gender dysphoria had a greater odds of autism spectrum disorder (2.6, [2.2, 3.0], P < .0001).

CONCLUSIONS

Youth with gender dysphoria at large pediatric health systems have greater odds of psychiatric and several neurodevelopmental diagnoses compared with youth without gender dysphoria. Further studies are needed to evaluate changes in mental health over time with access to gender affirming care.

Factor Analysis of the Stigma Scale-Parent Version in Pediatric Disorders/Differences of Sex Development

Stigma is a salient experience for both caregivers/parents and individuals with Disorders/Differences of Sex Development (DSD) as evidenced through qualitative and preliminary quantitative reports. However, few validated measures of associative stigma (i.e., vicarious stigma experienced through close association with someone who is socially stigmatized) for parents of children with DSD exist. The present study aims to (1) determine the factor structure of the adapted Stigma Scale - Parent, and (2) examine convergent validity of the factor structure with measures of parent psychosocial adjustment. Confirmatory factor analytic results revealed two factors: a parent-focused factor and a child-focused factor. The parent-focused factor demonstrated convergent validity with parent adjustment measures, but the child-focused factor did not. Together, these results indicate that parent-focused and child-focused stigma are distinct factors, with parent-focused associative stigma being related to parent adjustment following DSD diagnosis. Future research should further refine this measure to determine predictive validity and clinical value.

Providers' perspectives on substance use among solid organ transplant candidates in a pediatric hospital

INTRODUCTION

Substance use is prevalent among youth and often leads to impairment in multiple domains. Additionally, substance use may pose adverse health issues post-transplant. Yet, practices related to substance use among pediatric patients who require organ transplant remain inconsistent. In this study, providers were surveyed for their perspectives on substance use among solid organ transplant candidates within a pediatric hospital.

METHODS

An online survey was administered to providers on the heart, kidney, and liver transplant teams at one tertiary pediatric care center located in the intermountain region of the United States (N = 50, 42% response rate). Providers answered questions about the need for a hospital-wide policy across heart, liver, and kidney transplant teams within this transplant center, timing of substance use evaluation, types of substances eliciting concerns based on organ, and recommended interventions. Data were analyzed using descriptive statistics.

RESULTS

Providers felt strongly about the need for a policy to guide recommendations for substance use among transplant candidates. Providers wanted a hospital-wide substance use policy (84%) and a standardized measure for assessing substance use (98%). Respondents (98%) indicated that substance use should be assessed during the pretransplant evaluation. Respondents expressed varied concerns based on substance and organ type, and recommended interventions for patients to cease substance use prior to transplant listing.

CONCLUSIONS

This study highlights the need for a clear, directive, hospital-wide policy and standardized procedure for evaluating substance use among adolescent solid organ transplant candidates nationally across pediatric transplant centers.

Parent experience with volunteers and support groups in a multidisciplinary DSD clinic

Objective

Despite recommendations that clinics for children with a difference of sex development (DSD) should include peer support, information on how to provide this support is lacking. We utilized a mixed-methods program evaluation to evaluate family satisfaction with our clinic-based volunteers (who either have DSD themselves or are a parent of a child with DSD) and to understand the experience of these volunteers.

Methods

Parents (n=29) of a child with DSD completed an electronic survey. Interviews were conducted with three clinic volunteers.

Results

Most participants (72%) met with a clinic volunteer and majority (81%) rated their interaction as helpful. Most common topics discussed between parents and volunteers included: connecting to support groups (81%), their child's future (62%), and learning about their child's diagnosis (48%). Half of parents (48%) attended an after-clinic support group lunch, and 43% of these attendees rated the lunch session as helpful. Parents who attended a lunch liked the experience because they met other families with a child with a similar medical condition (100%), met volunteers with a similar medical condition (64%), and it helped them think more positively about their child's future (64%). Those who did not attend a lunch cited logistical reasons for not attending.

Conclusions

Incorporating clinic volunteers into a multidisciplinary DSD clinic is associated with high reported rates of satisfaction by families and volunteers.

Medication adherence among adolescent solid-organ transplant recipients: A survey of healthcare providers

The aim of this study was to assess healthcare provider perspectives on barriers to medication adherence and to discover recommendations for interventions among providers of pediatric solid-organ transplant patients. An anonymous online survey was administered to a multidisciplinary pool of pediatric transplant providers from February 2015 to March 2016. It consisted of 15 questions regarding transplant providers' attitudes, clinical practice, and beliefs pertaining to medication adherence among teenage solid-organ transplant recipients. Data were analyzed using descriptive statistics. Responses to open-ended questions were coded and categorized into themes. One hundred ten surveys were completed by providers specializing in pediatric heart, kidney, liver, lung, and/or intestinal transplantation. Commonly cited reasons for poor adherence were forgetting/poor planning (94%), the desire to be normal (86%), lack of support (86%), and poor parental monitoring (79%). Suggestions to improve adherence included increasing peer and family support, providing education, and incorporating technology into adherence regimens. Barriers to adherence in transplant patients are recognized by providers and are both similar to and disparate from patient and family identified barriers published in the literature. Providers recognize the importance of education, social support, and technologically driven interventions on improving outcomes in the transplant population.

'When you are homeless, you are not thinking about your medication, but your food, shelter or heat for the night': behavioural determinants of homeless patients' adherence to prescribed medicines

OBJECTIVES

This study aimed to explore behavioural determinants of homeless patients' adherence to prescribed medicines using Theoretical Domains Framework (TDF).

STUDY DESIGN

A qualitative study using semi-structured, face-to-face interviews.

METHODS

Participants were recruited from a homelessness primary healthcare centre in Aberdeen, United Kingdom (UK). Face-to-face interviews were audio-recorded and transcribed verbatim. Thematic analysis of the interview data was conducted using the Framework Approach based on the Theoretical Domains Framework. National Health Service ethical and Research and Development (R&D) approval was obtained.

RESULTS

Twenty-five patients were interviewed, at which point data saturation was achieved. A total of 13 out of 14 Theoretical Domains Framework domains were identified that explained the determinants of adherence or non-adherence to prescribed medicines. These included: 'beliefs about consequences' (e.g. non-adherence leading to poor health); 'goals' of therapy (e.g. being a 'normal' person with particular reference to methadone adherence); and 'environmental context and resources' (e.g. stolen medicines and the lack of secure storage). Obtaining food and shelter was higher priority than access and adherence to prescribed medicines while being homeless.

CONCLUSIONS

Behavioural determinants of non-adherence identified in this study were mostly related to participants' homelessness and associated lifestyle. Results are relevant to developing behaviour change interventions targeting non-adherent homeless patients and to the education of healthcare professionals serving this vulnerable population.

Multiplex PCR and Microarray for Detection of Swine Respiratory Pathogens

Porcine respiratory disease complex (PRDC) is one of the most important health concerns for pig producers and can involve multiple viral and bacterial pathogens. No simple, single‐reaction diagnostic test currently exists for the simultaneous detection of major pathogens commonly associated with PRDC. Furthermore, the detection of most of the bacterial pathogens implicated in PRDC currently requires time‐consuming culture‐based methods that can take several days to obtain results. In this study, a novel prototype automated microarray that integrates and automates all steps of post‐PCR microarray processing for the simultaneous detection and typing of eight bacteria and viruses commonly associated with PRDC is described along with associated multiplex reverse transcriptase PCR. The user‐friendly assay detected and differentiated between four viruses [porcine reproductive and respiratory syndrome virus (PRRSV), influenza A virus, porcine circovirus type 2, porcine respiratory corona virus], four bacteria (Mycoplasma hyopneumoniae, Pasteurella multocida, Salmonella enterica serovar Choleraesuis, Streptococcus suis), and further differentiated between type 1 and type 2 PRRSV as well as toxigenic and non‐toxigenic P. multocida. The assay accurately identified and typed a panel of 34 strains representing the eight targeted pathogens and was negative when tested with 34 relevant and/or closely related non‐target bacterial and viral species. All targets were also identified singly or in combination in a panel of clinical lung samples and/or experimentally inoculated biological material.

Insulated Isothermal Reverse Transcriptase PCR (iiRT-PCR) for Rapid and Sensitive Detection of Classical Swine Fever Virus

Classical swine fever (CSF) is an OIE‐listed disease that can have a severe impact on the swine industry. User‐friendly, sensitive, rapid diagnostic tests that utilize low‐cost field‐deployable instruments for CSF diagnosis can be useful for disease surveillance and outbreak monitoring. In this study, we describe validation of a new probe‐based insulated isothermal reverse transcriptase PCR (iiRT‐PCR) assay for rapid detection of classical swine fever virus (CSFV) on a compact, user‐friendly device (POCKIT^™ Nucleic Acid Analyzer) that does not need data interpretation by the user. The assay accurately detected CSFV RNA from a diverse panel of 33 CSFV strains representing all three genotypes plus an additional in vitro‐transcribed RNA from cloned sequences representing a vaccine strain. No cross‐reactivity was observed with a panel of 18 viruses associated with livestock including eight other pestivirus strains (bovine viral diarrhoea virus type 1 and type 2, border disease virus, HoBi atypical pestivirus), African swine fever virus, swine vesicular disease virus, swine influenza virus, porcine respiratory and reproductive syndrome virus, porcine circovirus 1, porcine circovirus 2, porcine respiratory coronavirus, vesicular exanthema of swine virus, bovine herpes virus type 1 and vesicular stomatitis virus. The iiRT‐PCR assay accurately detected CSFV as early as 2 days post‐inoculation in RNA extracted from serum samples of experimentally infected pigs, before appearance of clinical signs. The limit of detection (LOD_95%) calculated by probit regression analysis was 23 copies per reaction. The assay has a sample to answer turnaround time of less than an hour using extracted RNA or diluted or low volume of neat serum. The user‐friendly, compact device that automatically analyses and displays results could potentially be a useful tool for surveillance and monitoring of CSF in a disease outbreak.

Metastasis suppressors: basic and translational advances

Tumor metastasis is a main contributor to death in cancer patients. In the last years, a new class of molecules that reduces the metastatic propensity has been identified: metastasis suppressors. These proteins regulate multiple steps in the metastatic cascade, including cell invasion, survival in the vascular and lymphatic circulation, and colonization of distant organ sites. As a consequence, they are very important therapeutic targets. This review discusses our current understanding of metastasis suppressors and how this knowledge might be useful to improve the treatment of cancer patients.

Glypican-3 reexpression regulates apoptosis in murine adenocarcinoma mammary cells modulating PI3K/Akt and p38MAPK signaling pathways

Glypican-3 (GPC3) is a proteoglycan involved in proliferation and cell survival. Several reports demonstrated that GPC3 is downregulated in some tumors, such as breast cancer. Previously, we determined that GPC3 reexpression in the murine mammary adenocarcinoma LM3 cells induced an impairment of their invasive and metastatic capacities, associated with a decrease of their motility and an increase of their cell death. We demonstrated that GPC3 inhibits canonical Wnt signaling, as well as it activates non canonical pathway. Now, we identified signaling pathways responsible for the pro-apoptotic role of GPC3 in LM3 cells. We found for the first time that GPC3 inhibits the PI3K/Akt anti-apoptotic pathway while it stimulates the p38MAPK stress-activated one. We report a concomitant modulation of CDK inhibitors as well as of pro- and anti-apoptotic molecules. Our results provide new clues regarding the mechanism involved in the modulation induced by GPC3 of mammary tumor cell growth and survival.

Measurement of D{0}-D[-over]{0} mixing from a time-dependent amplitude analysis of D{0}-->K+pi{-}pi{0} decays

We present evidence of D{0}-D[-over ]{0} mixing using a time-dependent amplitude analysis of the decay D{0}-->K+pi{-}pi;{0} in a data sample of 384 fb{-1} collected with the BABAR detector at the PEP-II e+e{-} collider at the Stanford Linear Accelerator Center. Assuming CP conservation, we measure the mixing parameters x{Kpipi{0}}{'}=[2.61{-0.68}{+0.57}(stat)+/-0.39(syst)]%, y{Kpipi;{0}}{'}=[-0.06{-0.64}{+0.55}(stat)+/-0.34(syst)]%. This result is inconsistent with the no-mixing hypothesis with a significance of 3.2 standard deviations. We find no evidence of CP violation in mixing.

Increasing breastfeeding and reducing smoking in pregnancy: a social marketing success improving life chances for children

Aims: The aim of this study is to evaluate an intervention using social marketing principles to increase breastfeeding and reduce smoking during pregnancy in a population to improve life chances for children born in a town in north east England.

Method: Breastfeeding and smoking cessation attendance rates were measured against targets set in a government—local health authority agreement.

Results: Targets were bettered in both breastfeeding and smoking cessation.

Conclusion: This social marketing-based approach is successful.

Evidence for the eta(b)(1S) meson in radiative Upsilon(2S) decay

We have performed a search for the eta_{b}(1S) meson in the radiative decay of the Upsilon(2S) resonance using a sample of 91.6x10(6) Upsilon(2S) events recorded with the BABAR detector at the PEP-II B factory at the SLAC National Accelerator Laboratory. We observe a peak in the photon energy spectrum at Egamma=609.3(-4.5)(+4.6)(stat)+/-1.9(syst) MeV, corresponding to an eta(b)(1S) mass of 9394.2(-4.9)(+4.8)(stat)+/-2.0(syst) MeV/c2. The branching fraction for the decay Upsilon(2S)-->gamma(eta)b(1S) is determined to be [3.9+/-1.1(stat)-0.9+1.1(syst)]x10(-4). We find the ratio of branching fractions B[Upsilon(2S)-->gamma(eta)b(1S)]/B[Upsilon(3S)-->gamma(eta)b(1S)]=0.82+/-0.24(stat)(-0.19)(+0.20)(syst).

Measurement of semileptonic B decays into orbitally excited charmed mesons

We present a study of B decays into semileptonic final states containing charged and neutral D1(2420) and D_{2};{*}(2460). The analysis is based on a data sample of 208 fb;{-1} collected at the Upsilon(4S) resonance with the BABAR detector at the PEP-II asymmetric-energy B factory at SLAC. With a simultaneous fit to four different decay chains, the semileptonic branching fractions are extracted from measurements of the mass difference Deltam=m(D;{**})-m(D) distributions. Product branching fractions are determined to be B(B;{+}-->D_{1};{0}l;{+}nu_{l})xB(D_{1};{0}-->D;{*+}pi;{-})=(2.97+/-0.17+/-0.17)x10;{-3}, B(B;{+}-->D_{2};{*0}l;{+}nu_{l})xB(D_{2};{*0}-->D;{(*)+}pi;{-})=(2.29+/-0.23+/-0.21)x10;{-3}, B(B;{0}-->D_{1};{-}l;{+}nu_{l})xB(D_{1};{-}-->D;{*0}pi;{-})=(2.78+/-0.24+/-0.25)x10;{-3} and B(B;{0}-->D_{2};{*-}l;{+}nu_{l})xB(D_{2};{*-}-->D;{(*)0}pi;{-})=(1.77+/-0.26+/-0.11)x10;{-3}. In addition we measure the branching ratio Gamma(D_{2};{*}-->Dpi;{-})/Gamma(D_{2};{*}-->D;{(*)}pi;{-})=0.62+/-0.03+/-0.02.

Improved limits on lepton-flavor-violating tau decays to lphi, lrho, lK, and lK

We search for the neutrinoless, lepton-flavor-violating tau decays tau- -->l-}V0, where l is an electron or muon and V0 is a vector meson reconstructed as phi-->K+K-, rho-->pi+pi-, K-->K+pi-, K[over ]-->K-pi+. The analysis has been performed using 451 fb-1 of data collected at an e+e- center-of-mass energy near 10.58 GeV with the BABAR detector at the PEP-II storage rings. The number of events found in the data is compatible with the background expectation, and upper limits on the branching fractions are set in the range (2.6-19)x10-8 at the 90% confidence level.

Measurement of B-->Xgamma decays and determination of |Vtd/Vts|

Using a sample of 383 x 10;{6} BB[over ] events collected by the BABAR experiment, we measure sums of seven exclusive final states B-->X_{d(s)}gamma, where X_{d}(X_{s}) is a nonstrange (strange) charmless hadronic system in the mass range 0.6-1.8 GeV/c;{2}. After correcting for unmeasured decay modes in this mass range, we obtain a branching fraction for b-->dgamma of (7.2+/-2.7(stat)+/-2.3(syst))x10;{-6}. Taking the ratio of X_{d} to X_{s} we find Gamma(b-->dgamma)/Gamma(b-->sgamma)=0.033+/-0.013(stat)+/-0.009(syst), from which we determine |V_{td}/V_{ts}|=0.177+/-0.043.

Improved measurement of B+ --> rho+ rho0 and determination of the quark-mixing phase angle alpha

We present improved measurements of the branching fraction B, the longitudinal polarization fraction f{L}, and the direct CP asymmetry A{CP} in the B meson decay channel B;{+}-->rho;{+}rho;{0}. The data sample was collected with the BABAR detector at SLAC. The results are B(B;{+}-->rho;{+}rho;{0})=(23.7+/-1.4+/-1.4) x 10;{-6}, f{L}=0.950+/-0.015+/-0.006, and A{CP}=-0.054+/-0.055+/-0.010, where the uncertainties are statistical and systematic, respectively. Based on these results, we perform an isospin analysis and determine the Cabibbo-Kobayashi-Maskawa phase angle alpha=arg(-V{td}V{tb};/V{ud}V{ub}) to be (92.4{-6.5};{+6.0}) degrees.

Evidence for X(3872)-->psi(2S)gamma in B(+/-)-->X(3872)K(+/-) decays and a study of B-->cc[over ]gammaK

In a search for B-->cc[over ]gammaK decays with the BABAR detector, where cc[over ] includes J/psi and psi(2S), and K includes K(+/-), K(S)(0), and K(*)(892), we find evidence for X(3872)-->J/psigamma and X(3872)-->psi(2S)gamma with 3.6sigma and 3.5sigma significance, respectively. We measure the product of branching fractions B(B(+/-)-->X(3872)K(+/-))xB(X(3872)-->J/psigamma)=[2.8+/-0.8(stat)+/-0.1(syst)]x10(-6) and B(B(+/-)-->X(3872)K(+/-))xB(X(3872)-->psi(2S)gamma)=[9.5+/-2.7(stat)+/-0.6(syst)]x10(-6).

Direct CP, lepton flavor, and isospin asymmetries in the decays B-->K(*)l+l-

We measure branching fractions and integrated rate asymmetries for the rare decays B-->K(*)l+l-, where l+l- is either e+e- or micro+micro-, using a sample of 384x10(6) BB events collected with the BABAR detector at the PEP-II e+e- collider. We find no evidence for direct CP or lepton-flavor asymmetries. However, for dilepton masses below the J/psi resonance, we find evidence for unexpectedly large isospin asymmetries in both B-->Kl+l- and B-->K*l+l- which differ, respectively, by 3.2sigma and 2.7sigma, including systematic uncertainties, from the standard model expectations.

Measurement of the e;{+}e;{-}-->bb[over ] Cross Section between sqrt[s]=10.54 and 11.20 GeV

We report e;{+}e;{-}-->bb[over ] cross section measurements by the BABAR experiment performed during an energy scan in the range of 10.54 to 11.20 GeV at the SLAC PEP-II e;{+}e;{-} collider. A total relative error of about 5% is reached in more than 300 center-of-mass energy steps, separated by about 5 MeV. These measurements can be used to derive precise information on the parameters of the Upsilon(10860) and Upsilon(11020) resonances. In particular we show that their widths may be smaller than previously measured.

Measurement of the branching fractions of B-->D**(l) nu(l) decays in events tagged by a fully reconstructed B meson

We report a measurement of the branching fractions of B-->D**(l) nu(l), decays based on 417 fb(-1) of data collected at the Y(4S) resonance with the BABAR detector at the PEP-II e+e- storage rings. Events are selected by full reconstructing one of the B mesons in a hadronic decay mode. A fit to the invariant mass differences m(D(*) pi)- m(D(*)) is performed to extract the signal yields of the different D** states. We observe the B-->D**l(-1)nu(l) decay modes corresponding to the four D states predicted by heavy quark symmetry with a significance greater than 5 standard deviations including systematic uncertainties.

Searches for B meson decays to phiphi, phirho, phif_{0}(980), and f_{0}(980)f_{0}(980) final states

We present the results of searches for B decays to charmless final states involving varphi, f_{0}(980), and charged or neutral rho mesons. The data sample corresponds to 384x10;{6} BB[over ] pairs collected with the BABAR detector operating at the PEP-II asymmetric-energy e;{+}e;{-} collider at SLAC. We find no significant signals and determine the following 90% confidence level upper limits on the branching fractions, including systematic uncertainties: B(B;{0}-->varphivarphi)<2.0x10;{-7}, B(B;{+}-->varphirho;{+})<30x10;{-7}, B(B;{0}-->varphirho;{0})<3.3x10;{-7}, B[B;{0}-->varphif_{0}(980)]xB[f_{0}(980)-->pi;{+}pi;{-}]<3.8x10;{-7}, and B[B;{0}-->f_{0}(980)f_{0}(980)]xB[f_{0}(980)-->pi;{+}pi;{-}]xB[f_{0}(980)-->K;{+}K;{-}]<2.3x10;{-7}.

Measurement of the CP asymmetry in b-->sgamma using a sum of exclusive final states

We perform a measurement of the CP asymmetry in b-->sgamma decays using a sample of 383 x 10(6) B[over] B events collected by the BABAR detector at the SLAC PEP-II asymmetric B factory. We reconstruct 16 flavor-specific B decay modes containing a high-energy photon and a hadronic system X_(s) containing an s quark. We measure the CP asymmetry to be -0.011+/-0.030(stat)+/-0.014(syst) for a hadronic system mass between 0.6 and 2.8 GeV/c(2).

Observation and polarization measurements of B+/- -->phiK1 +/- and B +/- -->phiK2 *+/-

With the full BABAR data sample of 465 x 10(6) B(over)B pairs, we observe the decays B+/- -->phiK_(1)(1270) +/- and B +/- -->phiK*_(2)(1430)+/-. We measure the branching fractions (6.1+/-1.6+/-1.1) x 10(-6) and (8.4+/-1.8+/-1.0) x 10(-6) and the fractions of longitudinal polarization 0.46 (+0.12+0.06) _(-0.13-0.07) and 0.80(+0.09)_(-0.10)+/-0.03, respectively. We also report on the B+/- -->phiK*_(0)(1430)+/- decay branching fraction of (7.0+/-1.3+/-0.9) x 10(-6) and several parameters sensitive to CP violation and interference in the above three decays. Upper limits are placed on the B+/- decay rates to final states with phi and K_1(1400)+/-, K*(1410)+/-, K2(1770)+/-, or K_2(1820)+/-. Understanding the observed polarization pattern requires amplitude contributions from an uncertain source.

Study of B meson decays with excited eta and eta' mesons

Using 383 x 10(6) BBover pairs from the BABAR data sample, we report results for branching fractions of six charged B-meson decay modes, where a charged kaon recoils against a charmless resonance decaying to KKover* or etapipi final states with mass in the range (1.2-1.8) GeV/c2. We observe a significant enhancement at the low KKover* invariant mass which is interpreted as B+-->eta(1475)K+, find evidence for the decay B+-->eta(1295)K+, and place upper limits on the decays B+-->eta(1405)K+, B+-->f1(1285)K+, B+-->f1(1420)K+, and B+-->phi(1680)K+.

Observation of Y(3940) --> J/psiomega in B --> J/psiomegaK at BABAR

We present a study of the decays B;{0,+}-->J/psiomegaK;{0,+} using 383x10;{6} BB[over ] events obtained with the BABAR detector at PEP-II. We observe Y(3940)-->J/psiomega, with mass 3914.6_{-3.4};{+3.8}(stat)+/-2.0(syst) MeV/c;{2}, and width 34_{-8};{+12}(stat)+/-5(syst) MeV. The ratio of B0 and B+ decay to YK is 0.27_{-0.23};{+0.28}(stat)-0.01+0.04(syst), and the relevant B0 and B+ branching fractions are reported.

Measurements of B --> {pi,eta,eta;{'}}lnu_{l} branching fractions and determination of |V_{ub}| with semileptonically tagged B mesons

We report measurements of branching fractions for the decays B-->Plnu_{l}, where P are the pseudoscalar charmless mesons pi;{-}, pi;{0}, eta and eta;{'}, based on 348 fb;{-1} of data collected with the BABAR detector, using B0 and B+ mesons found in the recoil of a second B meson decaying as B-->D;{(*)}lnu_{l}. Assuming isospin symmetry, we combine pionic branching fractions to obtain B(B;{0}-->pi;{-}l;{+}nu_{l})=(1.54+/-0.17_{(stat)}+/-0.09_{(syst)})x10;{-4}; we find 3.2sigma evidence of the decay B;{+}-->etal;{+}nu_{l} and measure its branching fraction to be (0.64+/-0.20_{(stat)}+/-0.03_{(syst)})x10;{-4}, and determine B(B;{+}-->eta;{'}l;{+}nu_{l})<0.47x10;{-4} to 90% confidence level. Using partial branching fractions for the pionic decays in ranges of the momentum transfer and a variety of form factor calculation, we obtain values of the magnitude of the Cabibbo-Kobayashi-Maskawa matrix element |V_{ub}| in ranging from 3.6x10;{-3} to 4.1x10;{-3}.

Observation of the bottomonium ground state in the decay Upsilon(3S)-->gammaetab

We report the results of a search for the bottomonium ground state etab(1S) in the photon energy spectrum with a sample of (109+/-1) million of Upsilon(3S) recorded at the Upsilon(3S) energy with the BABAR detector at the PEP-II B factory at SLAC. We observe a peak in the photon energy spectrum at Egamma=921.2(-2.8)+2.1(stat)+/-2.4(syst) MeV with a significance of 10 standard deviations. We interpret the observed peak as being due to monochromatic photons from the radiative transition Upsilon(3S)-->gammaetab(1S). This photon energy corresponds to an etab(1S) mass of 9388.9(-2.3)+3.1(stat)+/-2.7(syst) MeV/c2. The hyperfine Upsilon(1S)-etab(1S) mass splitting is 71.4(-3.1)+2.3(stat)+/-2.7(syst) MeV/c2. The branching fraction for this radiative Upsilon(3S) decay is estimated to be [4.8+/-0.5(stat)+/-1.2(syst)]x10(-4).

Evidence for CP violation in B0-->J/psipi0 decays

We present measurements of the branching fraction and time-dependent CP asymmetries in B0-->J/psipi0 decays based on 466 x 10(6) Upsilon(4S)-->BB over events collected with the BABAR detector at the SLAC PEP-II asymmetric-energy B factory. We measure the CP asymmetry parameters S= -1.23+/-0.21(stat)+/-0.04(syst) and C= -0.20+/-0.19(stat)+/-0.03(syst), where the measured value of (S, C) is 4.0 standard deviations from (0, 0) including systematic uncertainties. The branching fraction is determined to be B(B0-->J/psipi0)=[1.69+/-0.14(stat)+/-0.07(syst)]x10(-5).

Measurement of the decay B(-) ---> D(*0)e(-)nu[overline](e)

Using 226 x 10(6) BB[overline] events recorded on the Upsilon(4S) resonance with the BABAR detector at the SLAC e(+)e(-) PEP-II storage rings, we reconstruct B(-) ---> D(*0)e(-)nu[overline](e) decays using the decay chain D(*0) --> D(0)pi(0) and D(0)-->K(-)pi(+). From the dependence of their differential rate on w, the dot product of the four velocities of B(-) and D(*0), and using the form factor description by Caprini et al. with the parameters F(1) and rhoA(1)(2), we obtain the results rhoA(1)(2) = 1.16+/-0.06+/-0.08, F(1)|V(cb)|=(35.9+/-0.6+/-1.4) x 10(-3), and B(B(-) --> D(*0)e(-)nu[overline](e))=(5.56+/-0.08+/-0.41)%.

Observation of tree-level B decays with ss production from gluon radiation

We report on our search for decays proceeding via a tree-level b-->c quark transition in which a gluon radiates into an ss[over ] pair. We present observations of the decays B;{-}-->D_{s};{+}K;{-}pi;{-} and B[over ];{0}-->D_{s};{+}K_{S};{0}pi;{-} and evidence for B;{-}-->D_{s};{+}K;{-}K;{-} and set upper limits on the branching fractions for B[over ];{0}-->D_{s};{+}K_{S};{0}pi;{-} and B;{-}-->D_{s};{+}K;{-}K;{-} using 383x10;{6} Upsilon(4S)-->BB[over ] events collected by the BABAR detector at SLAC. We present evidence that the invariant mass distributions of D_{s};{+}K;{-} pairs from B;{-}-->D_{s};{+}K;{-}pi;{-} decays are inconsistent with the phase-space model, suggesting the presence of charm resonances lying below the D_{s};{+}K;{-} threshold.

Measurements of partial branching fractions for B-->Xulnu and determination of |Vub|

We present partial branching fractions for inclusive charmless semileptonic B decays B[over ]-->X_{u}lnu[over ], and the determination of the Cabibbo-Kobayashi-Maskawa matrix element |V_{ub}|. The analysis is based on a sample of 383 x 10;{6} Upsilon(4S) decays into BB[over ] pairs collected with the BABAR detector at the SLAC PEP-II e;{+}e;{-} storage rings. We select events using the invariant mass M_{X} of the hadronic system, the invariant mass squared, q;{2}, of the lepton and neutrino pair, the kinematic variable P+, or one of their combinations. We then determine partial branching fractions in limited regions of phase space: DeltaB=(1.18+/-0.09_{stat}+/-0.07_{syst}+/-0.01_{theor})x10;{-3} (M_{X}<1.55 GeV/c;{2}), DeltaB=(0.95+/-0.10_{stat}+/-0.08_{syst}+/-0.01_{theor})x10;{-3} (P+<0.66 GeV/c), and DeltaB=(0.81+/-0.08_{stat}+/-0.07_{syst}+/-0.02_{theor})x10;{-3} (M_{X}<1.7 GeV/c;{2}, q;{2}>8 GeV;{2}/c;{4}). Corresponding values of |V_{ub}| are extracted using several theoretical calculations.

Measurement of the branching fractions of exclusive _B-->D(*)(pi)l-_nu l decays in events with a fully reconstructed B meson

We report a measurement of the branching fractions for _B-->D(*)(pi)l- _nu(l) decays based on 341.1 fb(-1) of data collected at the Upsilon(4S) resonance with the BABAR detector at the SLAC PEP-II e+ e- storage rings. Events are tagged by fully reconstructing one of the B mesons in a hadronic decay mode. We obtain B(B- -->D(0)l-_nu(l)=(2.33+/-0.09(stat)+/-0.09(syst)%, B(B- -->D(*0)l-_nu(l)=(5.83+/-0.15(stat) +/-0.30(syst) %, B(_B(0)-->D+l-_nu(l)=(2.21+/-0.11(stat) +/-0.12(syst)%, B(_B(0)-->D(*)l-_nu(l)=(5.49+/-0.16(stat)+/-0.25(syst)%, B(B- -->D+pi-l-_nu(l)=(0.42+/-0.06(stat)+/-0.03(syst)%, B(B- -->D(*)+pi-l-_nu(l)=(0.59+/-0.05(stat)+/-0.04(syst)%, B(_B(0)-->D(0)pi+l-_nu(l)=(0.43+/-0.08(stat)+/-0.03(syst)%, and B(_B(0)-->D(*0)pi+l-_nu(l)=(0.48+/-0.08(stat)+/-0.04(syst)%.

Search for CPT and lorentz violation in B0-B[over ]0 oscillations with dilepton events

We report results of a search for CPT and Lorentz violation in B(0)-B[over ](0) oscillations using inclusive dilepton events from 232 x 10(6) Upsilon(4S)-->BB[over ] decays recorded by the BABAR detector at the PEP-II B Factory at SLAC. We find 2.8sigma significance, compatible with no signal, for variations in the complex CPT violation parameter z at the Earth's sidereal frequency and extract values for the quantities Deltaa(micro) in the general Lorentz-violating standard-model extension. The spectral powers for variations in z over the frequency range 0.26 yr(-1) to 2.1 solar day(-1) are also compatible with no signal.

Observation of B;{0}-->K;(*0)K[over ](*0) and Search for B;(0)-->K;(*0)K;(*0)

We report the observation of the b-->d penguin-dominated decay B;{0}-->K;{*0}K[over ];{*0} with a sample of 383.2+/-4.2 million BB[over ] pairs collected with the BABAR detector at the PEP-II asymmetric-energy e;{+}e;{-} collider at the Stanford Linear Accelerator Center. The measured branching fraction is B(B;{0}-->K;{*0}K[over ];{*0})=[1.28_{-0.30};{+0.35}+/-0.11]x10;{-6} and the fraction of longitudinal polarization is f_{L}(B;{0}-->K;{*0}K[over ];{*0})=0.80_{-0.12};{+0.10}+/-0.06. The first error quoted is statistical and the second systematic. We also obtain an upper limit at the 90% confidence level on the branching fraction for B(B;{0}-->K;{*0}K;{*0})<0.41x10;{-6}.

Search for lepton flavor violating decays tau+/--->l+/-omega

A search for lepton flavor violating decays of a tau to a lighter-mass charged lepton and an omega vector meson is performed using 384.1 fb(-1) of e(+)e(-) annihilation data collected with the BABAR detector at the Stanford Linear Accelerator Center PEP-II storage ring. No signal is found, and the upper limits on the branching ratios are determined to be B(tau(+/-)-->e;{+/-}omega)<1.1 x10 (-7) and B(tau(+/-)-->micro(+/-)omega)<1.0 x 10(-7) at 90% confidence level.

Search for CP violation in the decays D0 --> K- K+ and D0 --> pi- pi+

We measure time-integrated CP-violating asymmetries of neutral charmed mesons in the modes D0 --> K(-) K(+) and D0 --> pi(-) pi(+) with the highest precision to date by using D0 --> K(-) pi(+) decays to correct detector asymmetries. An analysis of 385.8 fb(-1) of data collected with the BABAR detector yields values of a(CP)(KK)=(0.00+/-0.34(stat)+/-0.13(syst))% and a(CP)(pipi)=(-0.24+/-0.52(stat)+/-0.22(syst))%, which agree with standard model predictions.