The Effects of Previous Experiences of Healthcare Discrimination on HIV Intervention Outcomes

Although several healthcare interventions have been developed to address HIV among young Black/African American men who have sex with men (YBMSM), the HIV epidemic in the United States continues to disproportionately burden this population. The current study examines previous healthcare discrimination and how it affects HIV intervention delivery. One hundred seventy-two YBMSM participated in the Peer Promotion of Wellness and Enhanced Linkage to Resources (PPOWER) project, which used a short, multi-faceted, community-level intervention based on Community Peers Reaching Out and Modeling Intervention Strategies (Community PROMISE). Data were collected at baseline, a 45-day follow up, and a 90-day follow up. Generalized Estimating Equations (GEE) were used to examine the effects of previous healthcare discrimination on outcomes related to HIV testing, alcohol and drug use, and sexual behaviors. Previous healthcare discrimination was found to moderate the relationship between time and intentions to test for HIV, perceptions of sexual risk, problem marijuana use, and problem other drug use, such that those who had experienced more healthcare discrimination showed greater improvements over time compared to those who had experienced less healthcare discrimination. The results of the current study suggest that a community-level peer intervention, in combination with a component to promote cultural competency and address prior experiences of discrimination in healthcare settings, may be highly effective for people who have experienced a barrier in their continuum of care as a result of racial discrimination.

Non-invasive in-utero quantification of vascular reactivity in human placenta

OBJECTIVE

Placental vascular reactivity (PlVR) indicates the ability of the placental vasculature to match blood supply to fetal demand. Many pregnancy disorders alter the characteristics of PlVR, resulting in suboptimal oxygen delivery, although current understanding is limited by the lack of non-invasive, repeatable methods to measure PlVR in utero. Our objective was to quantify PlVR by measuring the placental response to transient changes in maternal carbon dioxide (CO2) using blood-oxygen-level-dependent (BOLD) magnetic resonance imaging (MRI). We hypothesized that PlVR will increase with gestational age to meet the changing demands of a growing fetus, and that PlVR will be driven by a maternal response to changes in CO2 concentration.

METHODS

This was a cross-sectional study of 35 women with a healthy singleton pregnancy, of whom 31 were included in the analysis. The median gestational age was 32.6 (range, 22.6-38.4) weeks. Pregnant women were instructed to follow audiovisual breathing cues during a MRI scan. Maternal end-tidal CO2 (EtCO2) was measured concurrently with resting placental BOLD MRI for a total of 7-8 min. Preprocessing of magnetic resonance images consisted of manual delineation of placental anatomy and motion correction. In each placental voxel, vascular reactivity was computed using a coherence-weighted general linear model between MRI signal and EtCO2 stimulus. Global PlVR was computed as the mean of voxel-wise PlVR values across the placenta.

RESULTS

PlVR, quantified by the placental response to induced, transient changes in maternal CO2, was consistently measured in utero using BOLD MRI. PlVR increased non-linearly with advancing gestational age (P < 0.001) and was higher on the fetal side of the placenta. PlVR was associated positively with fetal brain volume after accounting for gestational age. PlVR did not show any significant associations with maternal characteristics.

CONCLUSIONS

We present, for the first time, a non-invasive paradigm to quantify PlVR in ongoing human pregnancies without the use of exogenous gases or contrast agents. Our findings suggest that PlVR is driven by a fetal response to changes in maternal CO2. Ease of translation to the clinical setting makes PlVR a promising biomarker for the identification and management of high-risk pregnancies. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Statistical Analysis to Determine the Predictors of Liver Segmental Hypertrophy Observed Post-Radiotherapy

PURPOSE/OBJECTIVE(S)

Prediction of liver segment hypertrophy based on radiotherapy (RT) dose is crucial for maximizing functional liver volume and avoiding hepatic failure after RT. We determined predictors associated with liver hypertrophy with stratification based on induction chemo (IC) and tumor location.

MATERIALS/METHODS

RT planning, CT images, and 3-month-followup CTs were analyzed from 148 patients who underwent RT for primary or metastatic liver cancers. A nnUNet based model was trained (train/test = 160/40 CTs) to contour the liver segments (1, 2, 3, 4, 5-8) with accuracy assessed using Dice Similarity Coefficients (DSC). 52 features corresponding to segments 1, 2, 3, 2+3, 4, 5-8, were collected including equivalent dose to 2Gy fractions metrics-mean dose (Dmean), dose received by 95% of the volume (D95), volume spared from x gy (Vx), cancer type, tumor location, and IC status. Descriptive statistics were reported as percentage of segments showing hypertrophy under all stratification. Predictors were compared with 6 response variables using Chi-squared/Fisher-Exact test (CST/FET) and logistic regression (LR) for categorical and numerical predictors.

RESULTS

The nnUNet model had an average DSC of 0.91 across all segments. Overall, segments 1, 4, and 5-8 showed hypertrophy in 35% of cases, and segments 2, 3 and 2+3 showed hypertrophy in 45-49% of patients. Stratification based on tumor location resulted in segment 2+3 hypertrophy in 66% of patients when the tumor was in segments 5-8. For bilobed tumors, segment 2+3 hypertrophy was observed in 34% of patients. CST/FET showed that tumor location, IC, and tumor type were significant predictors of segment 5-8 hypertrophy. Tumor location was also a significant predictor of segments 3 and 2+3 hypertrophy. In LR analysis, all segment-based dose metrics were significant predictors of segment hypertrophy except Dmean in segment 4, and D95 in segment 2 and 4. Overall, the strongest association was obtained for V35 significantly predicting for each segment hypertrophy. The mean dose for segments with hypertrophy was significantly lower (range: 15-30 Gy) than segments with atrophy (p<0.01), except for segment 4 where the mean dose was 10Gy lower but did not reach significance. IC impacts the threshold mean dose that leads to hypertrophy, with more toxic drugs reducing the mean dose threshold.

CONCLUSION

Tumor location and IC significantly impact the response of segments to RT. Dose volume metrics are strong predictors of volumetric response with segment volume spared from 35 Gy being the strongest predictor.

A Community-Defined Approach to Address Trauma Among Cambodian Immigrants and Refugees

Asian American and Pacific Islanders are one of the fastest growing and most diverse groups in the United States. Yet, they are often aggregated as a single group, masking within-group differences in rates of disease and demographic characteristics commonly associated with elevated health risk. While more than four decades have passed since the Khmer Rouge genocide, Cambodians continue to experience trauma-related psychiatric disorders, including post-traumatic stress disorder and major depression. Funded by the California Department of Public Health Office of Health Equity, the Community Wellness Program (CWP) aimed to reduce mental health disparities among Cambodians in Long Beach and Santa Ana, California, using community-defined approaches. The 6-month program comprised community outreach, educational workshops, strengths-based case management, and social and spiritual activities. Our study aimed to examine the effects of the CWP on trauma symptoms. Program evaluation followed an incomplete stepped wedge waitlist design with two study arms. A linear mixed models analysis revealed that participants reported fewer trauma symptoms as a result of participation in the CWP and that participants experienced fewer symptoms over time. This is an especially important finding, as trauma can lead to long-term individual health effects and to social and health repercussions on an entire cultural group by way of intergenerational trauma. As the number of refugees and displaced individuals continues to grow, there is an urgent need for programs such as the CWP to prevent the lasting effects of trauma.

Examining Resident Power Building in a Place-Based Initiative

Rates of diseases and disabilities that are otherwise preventable are higher in low-income communities and communities of color. These disparities are attributed, in large part, to a power imbalance between residents and decision makers, and restoring resident power is necessary to improve health outcomes. A key strategy in many health promotion programs, resident power building is a process by which residents gain necessary skills to improve social conditions through their involvement in community change work. This study is part of a larger evaluation of Building Healthy Communities, a ground-breaking 10-year, $1 billion place-based initiative funded by The California Endowment designed to reverse the historical impact of racial and economic discrimination by advancing statewide policy, changing the narrative around health, and transforming underserved communities to achieve health equity. This article presents the resident power framework and identifies five domains that contributed to resident power building: continuity, culture, context, concrete action, and capacity. Continuity and culture mattered most to residents' ability to organize and to their ability to exercise their voice, respectively. While this study examined resident power building within the context of a large-scale place-based initiative, the domains that the authors identified are salient across health promotion programs that use power building as a key strategy to achieve program outcomes. The domains serve as opportunities to modify power-building strategies and allow program staff to allocate resources to specific activities to achieve program outcomes.

Incisional hernia following colorectal cancer surgery according to suture technique: Hughes Abdominal Repair Randomized Trial (HART)

BACKGROUND

Incisional hernias cause morbidity and may require further surgery. HART (Hughes Abdominal Repair Trial) assessed the effect of an alternative suture method on the incidence of incisional hernia following colorectal cancer surgery.

METHODS

A pragmatic multicentre single-blind RCT allocated patients undergoing midline incision for colorectal cancer to either Hughes closure (double far-near-near-far sutures of 1 nylon suture at 2-cm intervals along the fascia combined with conventional mass closure) or the surgeon's standard closure. The primary outcome was the incidence of incisional hernia at 1 year assessed by clinical examination. An intention-to-treat analysis was performed.

RESULTS

Between August 2014 and February 2018, 802 patients were randomized to either Hughes closure (401) or the standard mass closure group (401). At 1 year after surgery, 672 patients (83.7 per cent) were included in the primary outcome analysis; 50 of 339 patients (14.8 per cent) in the Hughes group and 57 of 333 (17.1 per cent) in the standard closure group had incisional hernia (OR 0.84, 95 per cent c.i. 0.55 to 1.27; P = 0.402). At 2 years, 78 patients (28.7 per cent) in the Hughes repair group and 84 (31.8 per cent) in the standard closure group had incisional hernia (OR 0.86, 0.59 to 1.25; P = 0.429). Adverse events were similar in the two groups, apart from the rate of surgical-site infection, which was higher in the Hughes group (13.2 versus 7.7 per cent; OR 1.82, 1.14 to 2.91; P = 0.011).

CONCLUSION

The incidence of incisional hernia after colorectal cancer surgery is high. There was no statistical difference in incidence between Hughes closure and mass closure at 1 or 2 years.

REGISTRATION NUMBER

ISRCTN25616490 (http://www.controlled-trials.com).

Poor correlation between airway fluoroscopy and rigid bronchoscopic evaluation in paediatric tracheomalacia

INTRODUCTION

Tracheomalacia is a common congenital condition causing stridor in young children. However, the evaluation of these children remains poorly standardised across institutions.

METHODS

We conducted a retrospective review of all children undergoing an elective laryngotracheobronchoscopy at a single tertiary paediatric institution between March 2010 and December 2018. Emergency bronchoscopies and children with tracheostomies were excluded. 1163 children undergoing an elective bronchoscopy were included in this study, and 545 children also had an airway fluoroscopy.

RESULTS

The median age at bronchoscopy was 17 months, and the majority of children were male. Tracheomalacia was diagnosed in 21.6% of children at bronchoscopy, of these 48.5% had tracheomalacia diagnosed on a previous airway fluoroscopy. Overall, airway fluoroscopy had a low sensitivity (62.3%) and a low specificity (67.5%) for diagnosis of tracheomalacia when compared with bronchoscopy. Increasing severity of tracheomalacia on airway screen significantly predicted a diagnosis of tracheomalacia on bronchoscopy.

CONCLUSIONS

Airway fluoroscopy has a low sensitivity and specificity in diagnosis of tracheomalacia and should be used judiciously rather than as a screening tool for children with stridor. However, this imaging technique may be beneficial in investigating children with severe symptoms who have had other conditions such as laryngomalacia excluded.

Erratum: Azimuthal Anisotropy of K_{S}^{0} and Λ+Λ[over ¯] Production at Midrapidity from Au+Au Collisions at sqrt[s]_{NN}=130 GeV [Phys. Rev. Lett. 89, 132301 (2002)]

This corrects the article DOI: 10.1103/PhysRevLett.89.132301.

Erratum: Azimuthal Anisotropy at the Relativistic Heavy Ion Collider: The First and Fourth Harmonics [Phys. Rev. Lett. 92, 062301 (2004)]

This corrects the article DOI: 10.1103/PhysRevLett.92.062301.

Epithelioid hemangioendothelioma, an ultra-rare cancer: a consensus paper from the community of experts

Epithelioid hemangioendothelioma (EHE) is an ultra-rare, translocated, vascular sarcoma. EHE clinical behavior is variable, ranging from that of a low-grade malignancy to that of a high-grade sarcoma and it is marked by a high propensity for systemic involvement. No active systemic agents are currently approved specifically for EHE, which is typically refractory to the antitumor drugs used in sarcomas. The degree of uncertainty in selecting the most appropriate therapy for EHE patients and the lack of guidelines on the clinical management of the disease make the adoption of new treatments inconsistent across the world, resulting in suboptimal outcomes for many EHE patients. To address the shortcoming, a global consensus meeting was organized in December 2020 under the umbrella of the European Society for Medical Oncology (ESMO) involving >80 experts from several disciplines from Europe, North America and Asia, together with a patient representative from the EHE Group, a global, disease-specific patient advocacy group, and Sarcoma Patient EuroNet (SPAEN). The meeting was aimed at defining, by consensus, evidence-based best practices for the optimal approach to primary and metastatic EHE. The consensus achieved during that meeting is the subject of the present publication.

•

This consensus paper provides key recommendations on the management of epithelioid hemangioendothelioma (EHE).

•

Recommendations followed a consensus meeting between experts and a representative of the EHE advocacy group and SPAEN.

•

Authorship includes a multidisciplinary group of experts from different institutions from Europe, North America and Asia.

Energy-Spread Preservation and High Efficiency in a Plasma-Wakefield Accelerator

Energy-efficient plasma-wakefield acceleration of particle bunches with low energy spread is a promising path to realizing compact free-electron lasers and particle colliders. High efficiency and low energy spread can be achieved simultaneously by strong beam loading of plasma wakefields when accelerating bunches with carefully tailored current profiles [M. Tzoufras et al., Phys. Rev. Lett. 101, 145002 (2008)PRLTAO0031-900710.1103/PhysRevLett.101.145002]. We experimentally demonstrate such optimal beam loading in a nonlinear electron-driven plasma accelerator. Bunches with an initial energy of 1 GeV were accelerated by 45 MeV with an energy-transfer efficiency of (42±4)% at a gradient of 1.3  GV/m while preserving per-mille energy spreads with full charge coupling, demonstrating wakefield flattening at the few-percent level.

Measurement of single-diffractive dijet production in proton-proton collisions at s = 8 Te with the CMS and TOTEM experiments

Measurements are presented of the single-diffractive dijet cross section and the diffractive cross section as a function of the proton fractional momentum loss ξ and the four-momentum transfer squared t. Both processesp p → p X andp p → X p , i.e. with the proton scattering to either side of the interaction point, are measured, whereX includes at least two jets; the results of the two processes are averaged. The analyses are based on data collected simultaneously with the CMS and TOTEM detectors at the LHC in proton-proton collisions ats = 8 Te during a dedicated run withβ ∗ = 90 m at low instantaneous luminosity and correspond to an integrated luminosity of 37.5 nb - 1 . The single-diffractive dijet cross section σ jj p X , in the kinematic region ξ < 0.1 ,0.03 < | t | < 1 Ge 2 , with at least two jets with transverse momentump T > 40 Ge , and pseudorapidity | η | < 4.4 , is 21.7 ± 0.9 (stat) - 3.3 + 3.0 (syst) ± 0.9 (lumi) nb . The ratio of the single-diffractive to inclusive dijet yields, normalised per unit of ξ , is presented as a function of x, the longitudinal momentum fraction of the proton carried by the struck parton. The ratio in the kinematic region defined above, for x values in the range - 2.9 ≤ log 10 x ≤ - 1.6 , is R = ( σ jj p X / Δ ξ ) / σ jj = 0.025 ± 0.001 (stat) ± 0.003 (syst) , where σ jj p X and σ jj are the single-diffractive and inclusive dijet cross sections, respectively. The results are compared with predictions from models of diffractive and nondiffractive interactions. Monte Carlo predictions based on the HERA diffractive parton distribution functions agree well with the data when corrected for the effect of soft rescattering between the spectator partons.

Measurement of single-diffractive dijet production in proton-proton collisions at s = 8 Te with the CMS and TOTEM experiments

Measurements are presented of the single-diffractive dijet cross section and the diffractive cross section as a function of the proton fractional momentum loss ξ and the four-momentum transfer squared t. Both processes p p → p X and p p → X p , i.e. with the proton scattering to either side of the interaction point, are measured, where X includes at least two jets; the results of the two processes are averaged. The analyses are based on data collected simultaneously with the CMS and TOTEM detectors at the LHC in proton-proton collisions at s = 8 Te during a dedicated run with β ∗ = 90 m at low instantaneous luminosity and correspond to an integrated luminosity of 37.5 nb - 1 . The single-diffractive dijet cross section σ jj p X , in the kinematic region ξ < 0.1 , 0.03 < | t | < 1 Ge 2 , with at least two jets with transverse momentum p T > 40 Ge , and pseudorapidity | η | < 4.4 , is 21.7 ± 0.9 (stat) - 3.3 + 3.0 (syst) ± 0.9 (lumi) nb . The ratio of the single-diffractive to inclusive dijet yields, normalised per unit of ξ , is presented as a function of x, the longitudinal momentum fraction of the proton carried by the struck parton. The ratio in the kinematic region defined above, for x values in the range - 2.9 ≤ log 10 x ≤ - 1.6 , is R = ( σ jj p X / Δ ξ ) / σ jj = 0.025 ± 0.001 (stat) ± 0.003 (syst) , where σ jj p X and σ jj are the single-diffractive and inclusive dijet cross sections, respectively. The results are compared with predictions from models of diffractive and nondiffractive interactions. Monte Carlo predictions based on the HERA diffractive parton distribution functions agree well with the data when corrected for the effect of soft rescattering between the spectator partons.

Marijuana Use and Sexual Risk Behavior Among Young Black Men Who Have Sex with Men in California

Young black men who have sex with men (YBMSM) are disproportionately affected by HIV and continue to experience higher rates of new HIV infections when compared to other population groups. As part of the Peer Promotion of Wellness and Enhanced Linkage to Resources Project, we examined problem marijuana use and the overall sexual risk profile of 250 YBMSM. Eighty percent reported prior use of marijuana in their lifetime (n = 200). Among those, problem marijuana use was correlated with problem use of alcohol (r = 0.51, p < 0.001) and other drugs (r = 0.29, p < 0.001); lower household income (r = - .22, p < .01); homelessness (r = 0.15, p < 0.05); incarceration (r = 0.16, p < 0.05); exchanging sex for money, drugs, or shelter (r = 0.18, p < 0.05); having sex with someone known or suspected of having HIV and/or an STI (r = 0.20, p < 0.01); having sex with someone known or suspected of being an injector (r = 0.24, p < 0.01); and having unprotected sex while under the influence of alcohol or drugs (r = 0.32, p < 0.001). The complex relationship between marijuana and sexual risk behavior was examined while accounting for the possible moderating effects of alcohol or other drugs. Problem marijuana, alcohol, and other drug use each made unique contributions to predicting risky sex behavior. A significant marijuana and other drug interaction was found to predict sexual risk behaviors. Future efforts should include holistic intervention approaches for YBMSM that consider factors facilitating high-risk sexual behaviors.

Characteristics of the Diffuse Astrophysical Electron and Tau Neutrino Flux with Six Years of IceCube High Energy Cascade Data

We report on the first measurement of the astrophysical neutrino flux using particle showers (cascades) in IceCube data from 2010-2015. Assuming standard oscillations, the astrophysical neutrinos in this dedicated cascade sample are dominated (∼90%) by electron and tau flavors. The flux, observed in the sensitive energy range from 16 TeV to 2.6 PeV, is consistent with a single power-law model as expected from Fermi-type acceleration of high energy particles at astrophysical sources. We find the flux spectral index to be γ=2.53±0.07 and a flux normalization for each neutrino flavor of ϕ_{astro}=1.66_{-0.27}^{+0.25} at E_{0}=100  TeV, in agreement with IceCube's complementary muon neutrino results and with all-neutrino flavor fit results. In the measured energy range we reject spectral indices γ≤2.28 at ≥3σ significance level. Because of high neutrino energy resolution and low atmospheric neutrino backgrounds, this analysis provides the most detailed characterization of the neutrino flux at energies below ∼100  TeV compared to previous IceCube results. Results from fits assuming more complex neutrino flux models suggest a flux softening at high energies and a flux hardening at low energies (p value ≥0.06). The sizable and smooth flux measured below ∼100  TeV remains a puzzle. In order to not violate the isotropic diffuse gamma-ray background as measured by the Fermi Large Area Telescope, it suggests the existence of astrophysical neutrino sources characterized by dense environments which are opaque to gamma rays.

Studies of Charm Quark Diffusion inside Jets Using Pb-Pb and pp Collisions at sqrt[s_{NN}]=5.02 TeV

The first study of charm quark diffusion with respect to the jet axis in heavy ion collisions is presented. The measurement is performed using jets with p_{T}^{jet}>60  GeV/c and D^{0} mesons with p_{T}^{D}>4  GeV/c in lead-lead (Pb-Pb) and proton-proton (pp) collisions at a nucleon-nucleon center-of-mass energy of sqrt[s_{NN}]=5.02  TeV, recorded by the CMS detector at the LHC. The radial distribution of D^{0} mesons with respect to the jet axis is sensitive to the production mechanisms of the meson, as well as to the energy loss and diffusion processes undergone by its parent parton inside the strongly interacting medium produced in Pb-Pb collisions. When compared to Monte Carlo event generators, the radial distribution in pp collisions is found to be well described by pythia, while the slope of the distribution predicted by sherpa is steeper than that of the data. In Pb-Pb collisions, compared to the pp results, the D^{0} meson distribution for 4<p_{T}^{D}<20  GeV/c hints at a larger distance on average with respect to the jet axis, reflecting a diffusion of charm quarks in the medium created in heavy ion collisions. At higher p_{T}^{D}, the Pb-Pb and pp radial distributions are found to be similar.

Evaluation of altered environmental conditions as a decontamination approach for nonspore-forming biological agents

AIMS

The purpose of this study was to evaluate the effects of altered environmental conditions on the persistence of Francisella tularensis bacteria and Venezuelan equine encephalitis virus (VEEV), on two material types.

METHODS AND RESULTS

Francisella tularensis (F.t.) and VEEV were inoculated (c. 1 × 108 colony-forming units or PFU), dried onto porous and nonporous fomites (glass and paper), and exposed to combinations of altered environmental conditions ranging from 22 to 60°C and 30 to 75% relative humidity (RH). Viability of test organism was assessed after contact times ranging from 30 min to 10 days. Inactivation rates of F.t. and VEEV increased as both temperature and/or RH were increased. Greater efficacy was observed for paper as compared to glass for both test organisms.

CONCLUSIONS

The use of elevated temperature and RH increased rate of inactivation for both organisms and greater than six log reduction was accomplished in as little as 6 h by elevating temperature to approximately 60°C.

SIGNIFICANCE AND IMPACT OF THE STUDY

These results provide information for inactivation of nonspore-forming select agents using elevated temperature and humidity which may aid incident commanders following a biological contamination incident by providing alternative methods for remediation.

Time-Integrated Neutrino Source Searches with 10 Years of IceCube Data

This Letter presents the results from pointlike neutrino source searches using ten years of IceCube data collected between April 6, 2008 and July 10, 2018. We evaluate the significance of an astrophysical signal from a pointlike source looking for an excess of clustered neutrino events with energies typically above ∼1  TeV among the background of atmospheric muons and neutrinos. We perform a full-sky scan, a search within a selected source catalog, a catalog population study, and three stacked Galactic catalog searches. The most significant point in the northern hemisphere from scanning the sky is coincident with the Seyfert II galaxy NGC 1068, which was included in the source catalog search. The excess at the coordinates of NGC 1068 is inconsistent with background expectations at the level of 2.9σ after accounting for statistical trials from the entire catalog. The combination of this result along with excesses observed at the coordinates of three other sources, including TXS 0506+056, suggests that, collectively, correlations with sources in the northern catalog are inconsistent with background at 3.3σ significance. The southern catalog is consistent with background. These results, all based on searches for a cumulative neutrino signal integrated over the 10 years of available data, motivate further study of these and similar sources, including time-dependent analyses, multimessenger correlations, and the possibility of stronger evidence with coming upgrades to the detector.

Measurement of electroweak production of a W boson in association with two jets in proton-proton collisions at s = 13 Te

A measurement is presented of electroweak (EW) production of a W boson in association with two jets in proton-proton collisions ats = 13 Te . The data sample was recorded by the CMS Collaboration at the LHC and corresponds to an integrated luminosity of 35.9fb - 1 . The measurement is performed for the ℓ ν jj final state (with ℓ ν indicating a lepton-neutrino pair, and j representing the quarks produced in the hard interaction) in a kinematic region defined by invariant massm jj > 120 Ge and transverse momentap T j > 25 Ge . The cross section of the process is measured in the electron and muon channels yieldingσ EW ( W jj ) = 6.23 ± 0.12 (stat) ± 0.61 (syst) pb per channel, in agreement with leading-order standard model predictions. The additional hadronic activity of events in a signal-enriched region is studied, and the measurements are compared with predictions. The final state is also used to perform a search for anomalous trilinear gauge couplings. Limits on anomalous trilinear gauge couplings associated with dimension-six operators are given in the framework of an effective field theory. The corresponding 95% confidence level intervals are - 2.3 < c W W W / Λ 2 < 2.5 Te - 2 , - 8.8 < c W / Λ 2 < 16 Te - 2 , and - 45 < c B / Λ 2 < 46 Te - 2 . These results are combined with the CMS EW Zjj analysis, yielding the constraint on the c W W W coupling: - 1.8 < c W W W / Λ 2 < 2.0 Te - 2 .

Multiple Galactic Sources with Emission Above 56 TeV Detected by HAWC

We present the first catalog of gamma-ray sources emitting above 56 and 100 TeV with data from the High Altitude Water Cherenkov Observatory, a wide field-of-view observatory capable of detecting gamma rays up to a few hundred TeV. Nine sources are observed above 56 TeV, all of which are likely galactic in origin. Three sources continue emitting past 100 TeV, making this the highest-energy gamma-ray source catalog to date. We report the integral flux of each of these objects. We also report spectra for three highest-energy sources and discuss the possibility that they are PeVatrons.

Extraction and validation of a new set of CMS pythia8 tunes from underlying-event measurements

New sets of CMS underlying-event parameters ("tunes") are presented for the pythia8 event generator. These tunes use the NNPDF3.1 parton distribution functions (PDFs) at leading (LO), next-to-leading (NLO), or next-to-next-to-leading (NNLO) orders in perturbative quantum chromodynamics, and the strong coupling evolution at LO or NLO. Measurements of charged-particle multiplicity and transverse momentum densities at various hadron collision energies are fit simultaneously to determine the parameters of the tunes. Comparisons of the predictions of the new tunes are provided for observables sensitive to the event shapes at LEP, global underlying event, soft multiparton interactions, and double-parton scattering contributions. In addition, comparisons are made for observables measured in various specific processes, such as multijet, Drell-Yan, and top quark-antiquark pair production including jet substructure observables. The simulation of the underlying event provided by the new tunes is interfaced to a higher-order matrix-element calculation. For the first time, predictions from pythia8 obtained with tunes based on NLO or NNLO PDFs are shown to reliably describe minimum-bias and underlying-event data with a similar level of agreement to predictions from tunes using LO PDF sets.

Measurements of triple-differential cross sections for inclusive isolated-photon+jet events in p p collisions at s = 8 TeV

Measurements are presented of the triple-differential cross section for inclusive isolated-photon+jet events in p p collisions ats = 8 TeV as a function of photon transverse momentum ( p T γ ), photon pseudorapidity ( η γ ), and jet pseudorapidity ( η jet ). The data correspond to an integrated luminosity of 19.7 fb - 1 that probe a broad range of the available phase space, for| η γ | < 1.44 and1.57 < | η γ | < 2.50 ,| η jet | < 2.5 , 40 < p T γ < 1000 GeV , and jet transverse momentum, p T jet , > 25GeV . The measurements are compared to next-to-leading order perturbative quantum chromodynamics calculations, which reproduce the data within uncertainties.

Search for new physics in top quark production in dilepton final states in proton-proton collisions at s = 13 TeV

A search for new physics in top quark production is performed in proton-proton collisions at 13 TeV . The data set corresponds to an integrated luminosity of 35.9 fb - 1 collected in 2016 with the CMS detector. Events with two opposite-sign isolated leptons (electrons or muons), and b quark jets in the final state are selected. The search is sensitive to new physics in top quark pair production and in single top quark production in association with a W boson. No significant deviation from the standard model expectation is observed. Results are interpreted in the framework of effective field theory and constraints on the relevant effective couplings are set, one at a time, using a dedicated multivariate analysis. This analysis differs from previous searches for new physics in the top quark sector by explicitly separating t W from t t ¯  events and exploiting the specific sensitivity of the t W process to new physics.

A systematic review of cultural orientation and perinatal depression in Latina women: are acculturation, Marianismo, and religiosity risks or protective factors?

Latinas in the USA and Spanish-speaking countries experience elevated rates of perinatal depression (PND) because of high psychosocial stressors. Latinas are heterogeneous and have varying cultural practices. It is unclear whether specific cultural orientations have differential risks for PND. This systematic review aimed to determine whether degree of acculturation, Marianismo, and religiosity are risks or protective factors for PND in Latina women living in the USA, Latin America, and other countries. The review included PubMed, CINAHL, PsycINFO, PsycARTICLES, Academic Search Ultimate (EBSCO), and Social Services Abstracts, and used Boolean combined keywords. English and Spanish language articles were considered. The review was conducted between July 2017 and February 2018, with no boundaries on publication dates. Ten studies were selected for inclusion. Of those, two studies were conducted in Mexico and most studies conducted in the USA included women of Mexican descent. Degree of acculturation (adoption of mainstream values) was inconsistently directly associated with PND; evidence suggest indirect associations. Marianismo, the traditional female role of virtue, passivity, and priority of others over oneself, was inconsistently correlated with risk for depression in pregnancy, but significantly and indirectly associated with postpartum depression. Two of three studies found religiosity to be protective postpartum. Further research on protective and risk factors of specific cultural orientations, particularly degree of acculturation and Marianismo, for PND in Latinas in the USA and abroad is needed. Attention to specific perinatal periods is necessary given the inconsistent findings.

Azimuthal separation in nearly back-to-back jet topologies in inclusive 2- and 3-jet events in pp collisions at s = 13 Te

A measurement for inclusive 2- and 3-jet events of the azimuthal correlation between the two jets with the largest transverse momenta, Δ ϕ 12 , is presented. The measurement considers events where the two leading jets are nearly collinear ("back-to-back") in the transverse plane and is performed for several ranges of the leading jet transverse momentum. Proton-proton collision data collected with the CMS experiment at a center-of-mass energy of 13 Te and corresponding to an integrated luminosity of 35.9 fb - 1 are used. Predictions based on calculations using matrix elements at leading-order and next-to-leading-order accuracy in perturbative quantum chromodynamics supplemented with leading-log parton showers and hadronization are generally in agreement with the measurements. Discrepancies between the measurement and theoretical predictions are as large as 15%, mainly in the region177 ∘ < Δ ϕ 12 < 180 ∘ . The 2- and 3-jet measurements are not simultaneously described by any of models.

Measurement of exclusive ρ 770 0 photoproduction in ultraperipheral pPb collisions at s NN = 5.02 Te

Exclusiveρ 770 0 photoproduction is measured for the first time in ultraperipheral pPb collisions ats NN = 5.02 Te with the CMS detector. The cross section σ ( γ p → ρ 770 0 p ) is 11.0 ± 1.4 (stat) ± 1.0 (syst) μ b at ⟨ W γ p ⟩ = 92.6 Ge for photon-proton centre-of-mass energies W γ p between 29 and 213 Ge . The differential cross section d σ / d | t | is measured in the interval0.025 < | t | < 1 Ge 2 as a function of W γ p , where t is the squared four-momentum transfer at the proton vertex. The results are compared with previous measurements and theoretical predictions. The measured cross section σ ( γ p → ρ 770 0 p ) has a power-law dependence on the photon-proton centre-of-mass, consistent with electron-proton collision measurements performed at HERA. The W γ p dependence of the exponential slope of the differential cross section d σ / d | t | is also measured.

The use of bacteriophage MS2 for the development and application of a virucide decontamination test method for porous and heavily soiled surfaces

AIMS

(i) To develop an analytical method for recovery and quantification of bacteriophage MS2-as a surrogate for foot-and-mouth disease virus-from complex porous surfaces, with and without the presence of laboratory-developed agricultural grime; (ii) to evaluate, with a 4-log dynamic range, the virucidal activity of common biocides for their ability to decontaminate surfaces and hence remediate facilities, following a foreign animal disease contamination incident.

METHODS AND RESULTS

An analytical method was developed and optimized for MS2 recovery from simulated agricultural surfaces. The addition of Dey-Engley neutralizing broth to an extraction buffer improved MS2 viability in liquid extracts, with optimal analytical holding times determined as <8 to ≤24 h, depending on matrix. The recovery of MS2 from surface materials decreased in the order: nonporous reference material >grimed porous materials >nongrimed porous materials. In disinfectant testing, two spray applications of pAB were effective against MS2 (≥4-log reduction) on all operational-scale materials. Two per cent citric acid had limited effectiveness, with a ≥4-log reduction observed on a selected subset of grimed concrete samples.

CONCLUSIONS

Decontamination efficacy test results can be affected by surface characteristics, extraction buffer composition, analytical holding time and surface-specific organism survivability. Efficacy should be evaluated using a test method that reflects the environmental characteristics of the intended application.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of this study demonstrate the importance of analytical method verification tests for disinfectant testing prior to application in complex environments.

Studies of Beauty Suppression via Nonprompt D^{0} Mesons in Pb-Pb Collisions at sqrt[s_{NN}]=5.02 TeV

The transverse momentum spectra of D^{0} mesons from b hadron decays are measured at midrapidity (|y|<1) in pp and Pb-Pb collisions at a nucleon-nucleon center of mass energy of 5.02 TeV with the CMS detector at the LHC. The D^{0} mesons from b hadron decays are distinguished from prompt D^{0} mesons by their decay topologies. In Pb-Pb collisions, the B→D^{0} yield is found to be suppressed in the measured p_{T} range from 2 to 100  GeV/c as compared to pp collisions. The suppression is weaker than that of prompt D^{0} mesons and charged hadrons for p_{T} around 10  GeV/c. While theoretical calculations incorporating partonic energy loss in the quark-gluon plasma can successfully describe the measured B→D^{0} suppression at higher p_{T}, the data show an indication of larger suppression than the model predictions in the range of 2<p_{T}<5  GeV/c.

Search for a heavy pseudoscalar boson decaying to a Z and a Higgs boson at s = 13 Te

A search is presented for a heavy pseudoscalar boson A decaying to a Z  boson and a Higgs boson with mass of 125GeV . In the final state considered, the Higgs boson decays to a bottom quark and antiquark, and the Z  boson decays either into a pair of electrons, muons, or neutrinos. The analysis is performed using a data sample corresponding to an integrated luminosity of 35.9fb - 1 collected in 2016 by the CMS experiment at the LHC from proton-proton collisions at a center-of-mass energy of 13Te . The data are found to be consistent with the background expectations. Exclusion limits are set in the context of two-Higgs-doublet models in the A boson mass range between 225 and 1000GeV .

Predicting postoperative nausea and vomiting in patients undergoing oral and maxillofacial surgery

A common predictive measure of postoperative nausea and vomiting (PONV) is the Apfel score. Although tested in many different operations, it has not been tested extensively in oral and maxillofacial surgery (OMFS). This study was designed to determine whether it applied to OMFS and whether there were other factors in this population that would improve its accuracy. A retrospective chart review was carried out on a randomly selected group of patients who had OMFS during a 10-month period. In addition to the Apfel score risk factors, PONV data were collected in relation to type of anesthetic induction and maintenance, type of surgery, use of maxillomandibular fixation (MMF), use of opioids, and anesthesia and surgery times. One-hundred and sixty-seven patients were included in the analysis; 24% had nausea and 11% had nausea and vomiting. Patients who had orthognathic or temporomandibular joint surgery had the highest rate of PONV. Young age, anesthesia and operation time, and use of MMF were also associated with increased PONV. Adding age, MMF or limited postoperative mouth opening, and surgery type to the Apfel score should make it more predictive in OMFS.

Search for supersymmetry in events with a photon, jets, b -jets, and missing transverse momentum in proton-proton collisions at 13 Te

A search for supersymmetry is presented based on events with at least one photon, jets, and large missing transverse momentum produced in proton-proton collisions at a center-of-mass energy of 13 Te . The data correspond to an integrated luminosity of 35.9 fb - 1 and were recorded at the LHC with the CMS detector in 2016. The analysis characterizes signal-like events by categorizing the data into various signal regions based on the number of jets, the number of b -tagged jets, and the missing transverse momentum. No significant excess of events is observed with respect to the expectations from standard model processes. Limits are placed on the gluino and top squark pair production cross sections using several simplified models of supersymmetric particle production with gauge-mediated supersymmetry breaking. Depending on the model and the mass of the next-to-lightest supersymmetric particle, the production of gluinos with masses as large as 2120 Ge and the production of top squarks with masses as large as 1230 Ge are excluded at 95% confidence level.

Combined measurements of Higgs boson couplings in proton-proton collisions at s = 13 Te

Combined measurements of the production and decay rates of the Higgs boson, as well as its couplings to vector bosons and fermions, are presented. The analysis uses the LHC proton-proton collision data set recorded with the CMS detector in 2016 ats = 13 Te , corresponding to an integrated luminosity of 35.9fb - 1 . The combination is based on analyses targeting the five main Higgs boson production mechanisms (gluon fusion, vector boson fusion, and associated production with a W or Z boson, or a top quark-antiquark pair) and the following decay modes: H → γ γ , Z Z , W W , τ τ , b b , and μ μ . Searches for invisible Higgs boson decays are also considered. The best-fit ratio of the signal yield to the standard model expectation is measured to be μ = 1.17 ± 0.10 , assuming a Higgs boson mass of 125.09 Ge . Additional results are given for various assumptions on the scaling behavior of the production and decay modes, including generic parametrizations based on ratios of cross sections and branching fractions or couplings. The results are compatible with the standard model predictions in all parametrizations considered. In addition, constraints are placed on various two Higgs doublet models.

Measurement of the t t ¯ production cross section, the top quark mass, and the strong coupling constant using dilepton events in pp collisions at s = 13 Te

A measurement of the top quark-antiquark pair production cross section σ t t ¯ in proton-proton collisions at a centre-of-mass energy of 13Te is presented. The data correspond to an integrated luminosity of 35.9 fb - 1 , recorded by the CMS experiment at the CERN LHC in 2016. Dilepton events ( e ± μ ∓ ,μ + μ - ,e + e - ) are selected and the cross section is measured from a likelihood fit. For a top quark mass parameter in the simulation ofm t MC = 172.5 Ge the fit yields a measured cross sectionσ t t ¯ = 803 ± 2 (stat) ± 25 (syst) ± 20 (lumi) pb , in agreement with the expectation from the standard model calculation at next-to-next-to-leading order. A simultaneous fit of the cross section and the top quark mass parameter in the powheg simulation is performed. The measured value ofm t MC = 172.33 ± 0.14 (stat) - 0.72 + 0.66 (syst) Ge is in good agreement with previous measurements. The resulting cross section is used, together with the theoretical prediction, to determine the top quark mass and to extract a value of the strong coupling constant with different sets of parton distribution functions.

Search for vector-like quarks in events with two oppositely charged leptons and jets in proton-proton collisions at s = 13 Te

A search for the pair production of heavy vector-like partners T and B of the top and bottom quarks has been performed by the CMS experiment at the CERN LHC using proton-proton collisions ats = 13 Te . The data sample was collected in 2016 and corresponds to an integrated luminosity of 35.9fb - 1 . Final states studied for T T ¯ production include those where one of the T quarks decays via T → t Z and the other via T → b W , t Z , or t H , where H is a Higgs boson. For the B B ¯ case, final states include those where one of the B quarks decays via B → b Z and the other B → t W , b Z , or b H . Events with two oppositely charged electrons or muons, consistent with coming from the decay of a Z boson, and jets are investigated. The number of observed events is consistent with standard model background estimations. Lower limits at 95% confidence level are placed on the masses of the T and B quarks for a range of branching fractions. Assuming 100% branching fractions for T → t Z , and B → b Z , T and B quark mass values below 1280 and 1130Ge , respectively, are excluded.

Jet Shapes of Isolated Photon-Tagged Jets in Pb-Pb and pp Collisions at sqrt[s_{NN}]=5.02 TeV

The modification of jet shapes in Pb-Pb collisions, relative to those in pp collisions, is studied for jets associated with an isolated photon. The data were collected with the CMS detector at the LHC at a nucleon-nucleon center-of-mass energy of 5.02 TeV. Jet shapes are constructed from charged particles with track transverse momenta (p_{T}) above 1  GeV/c in annuli around the axes of jets with p_{T}^{jet}>30  GeV/c associated with an isolated photon with p_{T}^{γ}>60  GeV/c. The jet shape distributions are consistent between peripheral Pb-Pb and pp collisions, but are modified for more central Pb-Pb collisions. In these central Pb-Pb events, a larger fraction of the jet momentum is observed at larger distances from the jet axis compared to pp, reflecting the interaction between the partonic medium created in heavy ion collisions and the traversing partons.

Search for W Boson Decays to Three Charged Pions

For the first time, a search for the rare decay of the W boson to three charged pions has been performed. Proton-proton collision data recorded by the CMS experiment at a center-of-mass energy of 13 TeV, corresponding to an integrated luminosity of 77.3  fb^{-1}, have been analyzed. No significant excess is observed above the background expectation. An upper limit of 1.01×10^{-6} is set at 95% confidence level on the branching fraction of the W boson to three charged pions. This provides a strong motivation for theoretical calculations of this branching fraction.