Measurements of the Electric and Magnetic Form Factors of the Neutron for Timelike Momentum Transfer

We present the first measurements of the electric and magnetic form factors of the neutron in the timelike (positive q^{2}) region as function of four-momentum transfer. We explored the differential cross sections of the reaction e^{+}e^{-}→n[over ¯]n with data collected with the BESIII detector at the BEPCII accelerator, corresponding to an integrated luminosity of 354.6  pb^{-1} in total at twelve center-of-mass energies between sqrt[s]=2.0-2.95  GeV. A relative uncertainty of 18% and 12% for the electric and magnetic form factors, respectively, is achieved at sqrt[s]=2.3935  GeV. Our results are comparable in accuracy to those from electron scattering in the comparable spacelike region of four-momentum transfer. The electromagnetic form factor ratio R_{em}≡|G_{E}|/|G_{M}| is within the uncertainties close to unity. We compare our result on |G_{E}| and |G_{M}| to recent model predictions, and the measurements in the spacelike region to test the analyticity of electromagnetic form factors.

Observation of Three Charmoniumlike States with J^{PC}=1^{--} in e^{+}e^{-}→D^{*0}D^{*-}π^{+}

The Born cross sections of the process e^{+}e^{-}→D^{*0}D^{*-}π^{+} at center-of-mass energies from 4.189 to 4.951 GeV are measured for the first time. The data samples used correspond to an integrated luminosity of 17.9  fb^{-1} and were collected by the BESIII detector operating at the BEPCII storage ring. Three enhancements around 4.20, 4.47, and 4.67 GeV are visible. The resonances have masses of 4209.6±4.7±5.9  MeV/c^{2}, 4469.1±26.2±3.6  MeV/c^{2}, and 4675.3±29.5±3.5  MeV/c^{2} and widths of 81.6±17.8±9.0  MeV, 246.3±36.7±9.4  MeV, and 218.3±72.9±9.3  MeV, respectively, where the first uncertainties are statistical and the second systematic. The first and third resonances are consistent with the ψ(4230) and ψ(4660) states, respectively, while the second one is compatible with the ψ(4500) observed in the e^{+}e^{-}→K^{+}K^{-}J/ψ process. These three charmoniumlike ψ states are observed in the e^{+}e^{-}→D^{*0}D^{*-}π^{+} process for the first time.

Observation of a Strongly Isospin-Mixed Doublet in ^{26}Si via β-Delayed Two-Proton Decay of ^{26}P

β decay of proton-rich nuclei plays an important role in exploring isospin mixing. The β decay of ^{26}P at the proton drip line is studied using double-sided silicon strip detectors operating in conjunction with high-purity germanium detectors. The T=2 isobaric analog state (IAS) at 13 055 keV and two new high-lying states at 13 380 and 11 912 keV in ^{26}Si are unambiguously identified through β-delayed two-proton emission (β2p). Angular correlations of two protons emitted from ^{26}Si excited states populated by ^{26}P β decay are measured, which suggests that the two protons are emitted mainly sequentially. We report the first observation of a strongly isospin-mixed doublet that deexcites mainly via two-proton decay. The isospin mixing matrix element between the ^{26}Si IAS and the nearby 13 380-keV state is determined to be 130(21) keV, and this result represents the strongest mixing, highest excitation energy, and largest level spacing of a doublet ever observed in β-decay experiments.

Search for Subsolar-Mass Binaries in the First Half of Advanced LIGO's and Advanced Virgo's Third Observing Run

We report on a search for compact binary coalescences where at least one binary component has a mass between 0.2  M_{⊙} and 1.0  M_{⊙} in Advanced LIGO and Advanced Virgo data collected between 1 April 2019 1500 UTC and 1 October 2019 1500 UTC. We extend our previous analyses in two main ways: we include data from the Virgo detector and we allow for more unequal mass systems, with mass ratio q≥0.1. We do not report any gravitational-wave candidates. The most significant trigger has a false alarm rate of 0.14  yr^{-1}. This implies an upper limit on the merger rate of subsolar binaries in the range [220-24200]  Gpc^{-3} yr^{-1}, depending on the chirp mass of the binary. We use this upper limit to derive astrophysical constraints on two phenomenological models that could produce subsolar-mass compact objects. One is an isotropic distribution of equal-mass primordial black holes. Using this model, we find that the fraction of dark matter in primordial black holes in the mass range 0.2  M_{⊙}<m_{PBH}<1.0  M_{⊙} is f_{PBH}≡Ω_{PBH}/Ω_{DM}≲6%. This improves existing constraints on primordial black hole abundance by a factor of ∼3. The other is a dissipative dark matter model, in which fermionic dark matter can collapse and form black holes. The upper limit on the fraction of dark matter black holes depends on the minimum mass of the black holes that can be formed: the most constraining result is obtained at M_{min}=1  M_{⊙}, where f_{DBH}≡Ω_{DBH}/Ω_{DM}≲0.003%. These are the first constraints placed on dissipative dark models by subsolar-mass analyses.

Application of XOLAIR® (Omalizumab) in adolescent refractory chest tightness variant asthma

BACKGROUND

Asthma can manifest in a variety of clinical phenotypes like cough variant asthma, chest tightness variant asthma (CTVA), and masked asthma. Patients with CTVA usually have a singular or primary complaint of chest tightness, which is often overlooked or misdiagnosed due to the lack of characteristic asthma symptoms. We hereby report a case of CTVA managed by omalizumab.

CASE REPORT

A 15-year-old female patient reported to us with repeated coughing persisting for 3 weeks. Initial treatment with standard asthma drugs had minimal effect. Later during the disease, chest tightness became the primary symptom, and she was managed with steroids, β2 receptor agonists, and leukotriene receptor agonists but without complete relief. Based on clinical signs and symptoms, the response to baseline drugs, and results of bronchial provocation test, the diagnosis was revised to CTVA, and the patient was started on Omalizumab in addition to baseline drugs, which significantly improved her condition.

CONCLUSIONS

CTVA is difficult to diagnose due to its insidious symptoms and poor characteristics. Improper treatment can lead to uncontrolled disease, negative psychological issues, and reduced quality of life. Comprehensive assessment of children's airway inflammation level, lung function, bronchial provocation test, and responsiveness to drug therapy should be performed for accurate diagnosis. Omalizumab in combination with standard drugs can significantly improve the outcomes of CTVA.

Probing ^{93m}Mo Isomer Depletion with an Isomer Beam

The isomer depletion of ^{93m}Mo was recently reported [Chiara et al., Nature (London) 554, 216 (2018)NATUAS0028-083610.1038/nature25483] as the first direct observation of nuclear excitation by electron capture (NEEC). However, the measured excitation probability of 1.0(3)% is far beyond the theoretical expectation. In order to understand the inconsistency between theory and experiment, we produce the ^{93m}Mo nuclei using the ^{12}C(^{86}Kr,5n) reaction at a beam energy of 559 MeV and transport the reaction residues to a detection station far away from the target area employing a secondary beam line. The isomer depletion is expected to occur during the slowdown process of the ions in the stopping material. In such a low γ-ray background environment, the signature of isomer depletion is not observed, and an upper limit of 2×10^{-5} is estimated for the excitation probability. This is consistent with the theoretical expectation. Our findings shed doubt on the previously reported NEEC phenomenon and highlight the necessity and feasibility of further experimental investigations for reexamining the isomer depletion under low γ-ray background.

POS1403 CLINICAL CHARACTERISTICS, HEALTH CARE RESOURCE UTILIZATION, AND COSTS ASSOCIATED WITH FLARES IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS IN GERMANY

Background

Longitudinal data describing real-world systemic lupus erythematosus (SLE) disease characteristics, health care resource utilization (HCRU), and costs associated with flares in Germany are limited.

Objectives

To evaluate the clinical characteristics of patients with SLE and estimate the impact of flares on HCRU and costs in a cohort of adults with SLE in Germany.

Methods

CHaracteristics and impact of flares on clinicAl and econoMic OutcoMes In patients with systemic Lupus Erythematosus: a German Claims Database Study (CHAMOMILE) was an observational, retrospective cohort study. Adult patients with SLE were identified from the German Betriebskrankenkassen health insurance fund database between 1 July 2010 and 31 December 2013, and followed for up to 9 years. Baseline period was defined as the first year since the first quarter with the earliest SLE diagnosis during the identification period, including this quarter. Resource utilization measures included number of hospitalizations, duration of stay, and associated costs per person-year (PY) by follow-up year for patient subgroups defined by flare exposure (no, mild, or moderate/severe flares) during baseline. Cost measures included total PY costs in flare-exposure subgroups.

Results

Of 2088 patients included in the study, the mean (SD) age was 51.4 (16.1) years and 1767 (84.6%) were female. The most common SLE manifestations were cutaneous (66.8%), osteoarticular (28.7%), and vascular (23.0%). Patients were receiving treatment with glucocorticoids (54.8%), antimalarials (40.2%), nonsteroidal anti-inflammatory drugs (39.1%), and/or immunosuppressants (32.7%). During the baseline period, 750 patients (35.9%) experienced moderate/severe flares, 622 (29.8%) experienced mild flares, and 716 (34.3%) experienced no flares. Patients with no flares or mild flares during the baseline period had similar costs, and a similar number and duration of hospital stays per PY, which remained consistent from baseline up to 9 years of follow-up. Patients with moderate/severe flares during the baseline period had 2- to 3-fold higher hospital costs, 1- to 2-fold more hospital stays, and hospital stays that were 2-fold longer in duration, compared with the no-flares or mild-flares groups during baseline and each year of follow-up (Table 1). During the baseline period, annual total costs were more than 2-fold greater for patients with moderate/severe flares (€11,048/PY) than patients with mild (€5148/PY) or no flares (€4734/PY). In all subsequent years, costs for patients with moderate/severe flares exceeded costs for patients with mild or no flares. Annual total costs gradually increased over time to €7761/PY for patients with mild and to €7564/PY for patients with no flares at Year 9, whereas costs reduced sharply at follow-up Year 1 to €8801/PY and remained similar to Year 9 for patients with moderate/severe flares (Figure 1).

Table 1.

Mean Costs, Number, and Duration of Hospital Stays per Person-Year by Baseline Flares

Flare-Exposure SubgroupYearBaseline123456789Patients, nNo716716701676658634603526444315Mild622622613596575559534455348239Moderate/severe750750721690669646624503391263Costs of hospital stays, mean, €No1325179822961725223331261759178617952047Mild1779194415451820165222612390197422902451Moderate/severe5517355034032798272529992663369527142977Number of hospital stays, mean, nNo0.490.460.470.440.510.530.440.410.440.45Mild0.460.480.400.500.420.470.470.480.510.43Moderate/severe1.390.850.760.640.620.670.630.760.600.74Duration of hospital stays, mean, daysNo3.514.664.983.915.025.413.984.584.464.73Mild4.554.914.114.413.764.334.134.054.684.19Moderate/severe13.898.187.587.686.887.106.597.896.546.03

Conclusion

Patients with moderate or severe flares following diagnosis place a large burden on the health care system in Germany. Earlier diagnosis and treatment may reduce flare severity and the associated high health care costs.

Acknowledgements

Writing assistance by Rebecca S. Jones, PhD (Fishawack Health). This study was sponsored by AstraZeneca.

Disclosure of Interests

Bo Ding Employee of: AstraZeneca, Marc Pignot: None declared, Elena Garal-Pantaler: None declared, Beate Villinger Paid instructor for: Novartis, Vertex, Boehringer Ingelheim, UCB, Consultant of: Novartis, Vertex, Boehringer Ingelheim, UCB, AstraZeneca, Employee of: Novartis, AstraZeneca, Barnabas Desta Shareholder of: AstraZeneca, Employee of: AstraZeneca, Katharina Schmidt Employee of: AstraZeneca, Sarowar Golam Employee of: AstraZeneca, Heide Stirnadel-Farrant Shareholder of: AstraZeneca, GSK, Employee of: AstraZeneca, Andreas Schwarting Speakers bureau: AstraZeneca, Genentech, Consultant of: GSK, Astra Zeneca, Grant/research support from: GSK, Pfizer, Novartis

N(6)-methyladenosine RNA methyltransferase like 3 inhibits extracellular matrix synthesis of endplate chondrocytes by downregulating sex-determining region Y-Box transcription factor 9 expression under tension

OBJECTIVE

Tension stimulation is an important inducer of endplate cartilage degeneration, but the specific regulatory mechanism remains unclear. This study was the first to reveal the mechanism by which methyltransferase-like 3 (METTL3)-mediated N(6)-methyladenosine (m6A) modification affected the extracellular matrix anabolism by tension-induced endplate chondrocytes.

METHOD

We examined the differences in METTL3 expression and m6A methylation levels in human endplate chondrocytes and human cartilage endplate tissues under in vitro tension. The effect on endplate cartilage degeneration was evaluated by manipulating m6A methylation mediated by METTL3 in vivo and in vitro. The effect of METTL3-mediated m6A methylation on the stability of sex-determining region Y-box transcription factor 9 (SOX9) gene expression was determined experimentally.

RESULTS

METTL3 expression and m6A methylation levels were significantly increased in degenerative human endplate cartilage tissue. Similarly, tension stimulation inhibited the ability of human endplate chondrocytes to synthesize extracellular matrix, which was accompanied by an increase in METTL3-mediated m6A methylation. The ability of endplate chondrocytes to resist tension was significantly enhanced by inhibiting METTL3 expression and subsequently downregulating m6A methylation in vitro and in vivo, thereby reducing intervertebral disc degeneration. Furthermore, METTL3 mediated SOX9 RNA methylation and disrupted SOX9 mRNA stability, thereby inhibiting the gene expression of the downstream collagen type II alpha 1 chain.

CONCLUSION

Tension stimulation downregulated SOX9 expression through METTL3-mediated m6A methylation, thereby inhibiting the synthesis of extracellular matrix in endplate chondrocytes.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Constraints on Cosmic Strings Using Data from the Third Advanced LIGO-Virgo Observing Run

We search for gravitational-wave signals produced by cosmic strings in the Advanced LIGO and Virgo full O3 dataset. Search results are presented for gravitational waves produced by cosmic string loop features such as cusps, kinks, and, for the first time, kink-kink collisions. A template-based search for short-duration transient signals does not yield a detection. We also use the stochastic gravitational-wave background energy density upper limits derived from the O3 data to constrain the cosmic string tension Gμ as a function of the number of kinks, or the number of cusps, for two cosmic string loop distribution models. Additionally, we develop and test a third model that interpolates between these two models. Our results improve upon the previous LIGO-Virgo constraints on Gμ by 1 to 2 orders of magnitude depending on the model that is tested. In particular, for the one-loop distribution model, we set the most competitive constraints to date: Gμ≲4×10^{-15}. In the case of cosmic strings formed at the end of inflation in the context of grand unified theories, these results challenge simple inflationary models.

Interactive effects of vitamins A and K3 on laying performance, egg quality, tibia attributes and antioxidative status of aged Roman Pink laying hens

Extending laying cycle is a tendency in hen breeding, but egg quality declines as laying hens age. The present study was conducted to investigate the interactive effects of vitamins A and K₃ on laying performance, egg and tibia quality, and antioxidative status of aged Roman Pink laying hens. In a 3 × 3 factorial arrangement, 1 080 87-week-old laying hens were allocated to nine groups with eight replicates in each group. Deficient, adequate and excess vitamins A (0, 7 000 and 14 000 IU/kg) and K₃ (0, 2.0 and 4.0 mg/kg) were supplemented into a basal diet with 1 320 IU/kg of vitamin A and 0.5 mg/kg of vitamin K₃. After 2 weeks of adaption to basal diet, hens were fed corresponding diets for 8 weeks. Vitamins A and K₃ did not significantly affect the laying performance. However, they showed interactive effects on yolk ratio at week 93 as well as tibia weight and diameter (P < 0.05), and hens fed deficient vitamins A and K₃ had the highest yolk ratio and tibia weight, but the lowest tibia diameter. Compared with deficient addition, adequate or excess vitamins A and K₃ increased yolk color at weeks 93 and 97 (P < 0.05). Compared with hens fed deficient or excess vitamins, hens fed adequate vitamins A and K₃ had higher eggshell strength at week 93 or 97 (P < 0.05). Increasing vitamin A elevated plasma total superoxide dismutase (T-SOD) activity and decreased hepatic glutathione peroxidase (GSH-Px) activity (P < 0.05). Excess vitamin K₃ increased hepatic T-SOD activity (P < 0.05). Vitamins A and K₃ exhibited interaction on the activities of antioxidative enzymes in eggshell gland (P < 0.05), and adequate or excess vitamins A and K₃ increased the activities of GSH-Px, T-SOD and catalase (CAT). Adequate and excess vitamin A up-regulated the mRNA expression of GSH-Px1, GSH-Px3 and SOD1 in eggshell gland (P < 0.05). Vitamins A and K₃ showed interactive effects on CAT mRNA expression in eggshell gland (P < 0.05) and hens fed adequate vitamins A and K₃ had the highest CAT mRNA levels. In conclusion, dietary addition of vitamins A and K₃ improved the eggshell quality and yolk color as well as antioxidative status in eggshell gland of aged laying hens. Adequate vitamins A and K₃ showed beneficial effects and excess levels did not exhibit superior effects.

Acellular bovine pericardium matrix in immediate breast reconstruction compared with conventional implant-based breast reconstruction

Background

Acellular Bovine Pericardium Matrix (ABPM) is a new material in implant-based breast reconstruction (IBBR). Few studies have reported on its outcome and complications worldwide and most studies were without a control group. Our aim was to compare its use in IBBR with the other two conventional implant-based reconstruction methods.

Methods

A retrospective review of patients undergoing IBBR from January to December 2018 was performed. Patients were assigned to the ABPM-assisted IBBR (group A), latissimus dorsi-assisted IBBR (group B) and two-stage IBBR (group C). Patients’ post-operative complications, cost-effectiveness and Quality of Life were compared.

Results

100 patients with 100 breasts were included in the study. No complications occurred in group C (n = 11). No significant differences were noted between group A (n = 44) and group B (n = 45) in terms of overall complications (9.1% vs 11.1%, p = 0.973). Group B had the longest operative duration (310.8 ± 62.3 min, p<0.001). The cost of hospitalization forthe three groups was $8051.3 ± 849.2, $7566.0 ± 1172.7 and $7896.5 ± 1762.2, respectively (p = 0.128). The postoperative Breast-Q scores  were similar across the three groups.

Conclusions

ABPM demonstrated acceptable complication rates, cost-effectiveness and quality of life outcomes when compared to LD-assisted IBBR and two-stage IBBR.

Translational implications of the interactions between hormones and age-related hearing loss

Provocative research has revealed both positive and negative effects of hormones on hearing as we age; with in some cases, mis-regulation of hormonal levels in instances of medical comorbidities linked to aging, lying at the heart of the problem. Animal model studies have discovered that hormonal fluctuations can sharpen hearing for improved communication and processing of mating calls during reproductive seasons. Sex hormones sometimes have positive effects on auditory processing, as is often the case with estrogen, whereas combinations of estrogen and progesterone, and testosterone, can have negative effects on hearing abilities, particularly in aging subjects. Too much or too little of some hormones can be detrimental, as is the case for aldosterone and thyroid hormones, which generally decline in older individuals. Too little insulin, as in Type 1 diabetics, or poor regulation of insulin, as in Type 2 diabetics, is also harmful to hearing in our aged population. In terms of clinical translational possibilities, hormone therapies can be problematic due to systemic side effects, as has happened for estrogen/progestin combination hormone replacement therapy (HRT) in older women, where the HRT induces a hearing loss. As hormone therapy approaches are further developed, it may be possible to lower needed doses of hormones by combining them with supplements, such as antioxidants. Another option will be to take advantage of emerging technologies for local drug delivery to the inner ear, including biodegradeable, sustained-release hydrogels and micro-pumps which can be implanted in the middle ear near the round window. In closing, exciting research completed to date, summarized in the present report bodes well for emerging biomedical therapies to prevent or treat age-related hearing loss utilizing hormonal strategies.