Observation of B0→D¯(0)K(+)K(-) and evidence for B(s)(0)→D¯(0)K(+)K(-)

The first observation of the decay B0→D¯(0)K(+)K(-) is reported from an analysis of 0.62 fb(-1) of pp collision data collected with the LHCb detector. Its branching fraction is measured relative to that of the topologically similar decay B(0)→D ¯(0)π(+)π(-) to be (B(B(0)→D¯(0)K(+)K(-))/B(B(0)→D¯(0)π(+)π(-))=0.056±0.011±0.007,where the first uncertainty is statistical and the second is systematic. The significance of the signal is 5.8σ. Evidence, with 3.8σ significance, for B(s)(0)→D¯(0)K(+)K(-) decays is also presented. The relative branching fraction is measured to be B(B(s)(0)→D¯(0)K(+)K(-))/B(B(0)→D¯(0)K(+)K(-))=0.90±0.27±0.20. These channels are of interest to study the mechanisms behind hadronic B decays, and open new possibilities for CP violation analyses with larger data sets.

Measurement of relative branching fractions of B decays to ψ(2S) and J/ψ mesons

The relative rates of B-meson decays into J/ψ and ψ(2S) mesons are measured for the three decay modes in pp collisions recorded with the LHCb detector. The ratios of branching fractions ([Formula: see text]) are measured to be [Formula: see text] where the third uncertainty is from the ratio of the ψ(2S) and J/ψ branching fractions to μ⁺μ^-.

Measurement of ψ(2S) meson production in pp collisions at [Formula: see text]

The differential cross-section for the inclusive production of ψ(2S) mesons in pp collisions at [Formula: see text] has been measured with the LHCb detector. The data sample corresponds to an integrated luminosity of 36 pb^-1. The ψ(2S) mesons are reconstructed in the decay channels ψ(2S)→μ⁺μ^- and ψ(2S)→J/ψπ⁺π^-, with the J/ψ meson decaying into two muons. Results are presented both for promptly produced ψ(2S) mesons and for those originating from b-hadron decays. In the kinematic range p_T(ψ(2S))≤16 GeV/c and 2<y(ψ(2S))≤4.5 we measure [Formula: see text] where the last uncertainty on the prompt cross-section is due to the unknown ψ(2S) polarization. Recent QCD calculations are found to be in good agreement with our measurements. Combining the present result with the LHCb J/ψ measurements we determine the inclusive branching fraction [Formula: see text] where the last uncertainty is due to the [Formula: see text], [Formula: see text] and [Formula: see text] branching fraction uncertainties.

Donor human milk versus mother's own milk in preterm VLBWIs: a case control study

As for term infants, over the past decades there has been increasing evidence of the benefits of human milk in the feeding of Very Low Birth Weight Infants (VLBWI), influencing not only short-term health outcomes but also long-term neurodevelopmental, metabolic outcomes, and growth. Mother's own milk is the first choice for all neonates including preterm infants, when it is unavailable or in short supply, pasteurized donor breast milk offers a safe alternative and is considered the next best choice. The main aim of this case-control retrospective analysis was to evaluate short term advantages of mother's own milk as a sole diet compared to donor milk as a sole diet, in terms of growth, antiinfectious properties, feeding tolerance, NEC and ROP prevention in a population of VLBWI born in a tertiary center. We did not find significant differences in clinical outcome from mother's own milk compared with pasteurized donor milk. Only a slight and statistically not significant difference in growth could be observed, in favour of maternal milk. We conclude that the maximum effort should always be put in supporting and promoting breastfeeding and donor milk used not only as an alternative to mother's milk but also as a breastfeeding promotion and support strategy.

Critical appraisal of different anthropometric charts to evaluate postnatal growth of preterm infants

Preterm infants' survival has greatly increased in the last few decades thanks to the improvement in obstetrical and neonatal care. The correct evaluation of postnatal growth of these babies is nowadays of primary concern, although the definition of their optimal postnatal growth pattern is still controversial. Concerns have also been raised about the strategies to monitor their growth, specifically in relation to the charts used. At present, the charts available in clinical practice are fetal growth charts, neonatal anthropometric charts and postnatal growth charts for term infants. None of these, for different reasons, is suitable to correctly evaluate preterm infant growth. Recently, an international project has recently started aiming to create prescriptive standard for the evaluation of postnatal growth of preterm infants (INTERGROWTH-21st). Alternatively, at present, while specific charts for evaluating preterm infant postnatal growth are lacking, the best compromise is likely to be as follows: from birth to term neonatal anthropometric charts; International longitudinal charts WHO 2006 or CDC 2002 from term to childhood.

Auxological evaluation of newborns

Auxological evaluation of the newborn should be based on accurate anthropometry at birth and a reliable estimate of gestational age (GA). However, a comprehensive evaluation of the neonate should consider not only anthropometric traits at birth, but also fetal ultrasound biometry and Doppler velocimetry. Many charts have been proposed, but they are hardly comparable with each other, due to numerous methodological problems. The Italian Societies of Neonatology, of Pediatric Endocrinology and Diabetology and the Italian Society of Medical Statistics and Clinical Epidemiology promoted a multicenter survey with the aim to produce an Italian neonatal anthropometric reference (Italian Neonatal Study [INeS] charts) fulfilling the set of the criteria that a reliable neonatal chart should possess. In order to construct an international standard, an international project (INTERGROWTH-21st) has started a study aiming to create a prescriptive standard. Until an international standard is developed, the use of national updated reference charts is recommended.

Nanotechnology and vascular neurosurgery: an in vivo experimental study on microvessels repair using laser photoactivation of a nanostructured hyaluronan solder

Sealing tissues by laser in neurosurgical procedures may overcome problems related to the use of conventional suturing methods which can be associated with various degrees of vascular wall damage. Despite the significant experimental and clinical achievements of the past, a standardized clinical application of laser-welding technology has not yet been implemented. The main problem is related to the use of common organic chromophores. A substantial breakthrough in the laser welding of biological tissues may come from the advent of nanotechnologies. In this paper we describe an experimental study, to confirm the feasibility of an innovative laser-assisted vascular repair (LAVR) technique based on diode laser irradiation and subsequent photoactivation of a hyaluronan solder embedded with near infrared (NIR) absorbing gold nanorods (GNRs), and to analyze the induced closuring effect in a follow-up study performed in animal model. Twenty New Zealand rabbits underwent closure of a 3-mm longitudinal incision performed on the common carotid artery (CCA) by means of 810 nm diode laser irradiation, in conjunction with the topical application of an optimized GNR composite. Effective closure of the arterial wound was accomplished by using very low laser intensity (30 W/cm2). The average CCA occlusion time was as low as 50 sec. Animals underwent different follow-up periods (2, 8, 30 days). After follow-up, they were re-anesthetized, the patency of the treated vessels was tested (Doppler analysis) and then the irradiated vessels were excised and subjected to histological evaluations. Morphological examinations of the samples documented the integrity of the vascular wall. No host reaction to nanoparticles occurred. Collagen and elastic fibers returned to their normal architecture 30 days after treatment. A Scanning Electron Microscopy (SEM) examination and immuno-histochemical analysis demonstrated a full re-endothelization of the vessel walls. We thus confirmed that a laser-based approach is technically easy to perform, and provides several advantages, such as a simplification of the surgical procedure, a reduction in the operative time, and the suppression of bleeding. The use of GNRs improves the selectivity of welding and minimizes the surgical trauma to vessels, resulting in an optimal healing process.

Hyperbilirubinemia and management of breastfeeding

Hyperbilirubinemia and jaundice are natural, physiological phenomena which are only to be expected in the neonatal period, within certain limits. The highest percentage of jaundice in breastfed newborns should be evaluated in connection with inadequate management of breastfeeding rather than a direct effect of breast milk. Breastfeeding is also linked to visible jaundice persisting beyond the first two weeks of life (“breast milk jaundice”), but the appearance of skin jaundice is not a reason for interrupting breastfeeding which can and should continue without any interruption in most cases. There have been numerous contributions to the literature which have rescaled the direct role of breast milk both in early jaundice and in the more severe cases of late jaundice. The reviewed guidelines for detection and management of hyperbilirubinemia underline how prevention of badly managed breastfeeding and early support for the couple mother-child are effective prevention measures against severe early-onset jaundice; furthermore, the breastfeeding interruption is no longer recommended as a diagnostic procedure to identify breast milk jaundice because of its low specificity and the risk to disregarding the detection of a potentially dangerous disease.

Medication and breastfeeding

It is well accepted that the best feeding method for infants is breastfeeding, due to its numerous biological and clinical effects on child and maternal health. The use of medication by the nursing mother and the physician's advice to stop nursing are the most common reasons for the cessation of breastfeeding. The physician plays an extremely delicate role and should be able to assess risks and benefits for both mother and child. The main factors that must be taken into account include pharmacokinetics, the duration of maternal therapy, the age of the infant and the general health of the infant. All physicians should have access to reliable and updated information on medication safety during breastfeeding (reference books, online medical literature). Few drugs have been demonstrated to be absolutely contraindicated during breastfeeding. Nevertheless clear, safe and reliable information is still lacking for most drugs and it would be desirable to improve the knowledge about mechanisms and consequences of infant exposure to drug present in milk.

Relationship between sleep/wakefulness and gastroesophageal reflux in symptomatic newborns

The state of sleep/wakefulness is well known to influence esophageal acid exposure and the number of acid refluxes whereas it is uncertain whether the same is true of the non-acid refluxes that predominate in the newborns. To investigate the relationship between sleep/wakefulness and refluxes 45 newborns with gastroesophageal reflux symptoms were studied with combined multichannel intraluminal impedance and pH monitoring. We found that sleep/wakefulness influenced acid and weakly acidic reflux frequency (awake 2.6+/-0.8; asleep 2.1+/-1.1; p=0.006). A negative correlation was found between sleepness periods and the mean reflux duration for both acid (R=0.55;p < 0.001) and weackly acidic (R=0.51;p < 0.001) refluxes. This finding may raise some concerns about the over-prescription of antacid drugs in newborns.

Metabolism and biological functions of human milk oligosaccharides

It is well known that breastfeeding is beneficial both for its nutritional properties and for the presence of biologically active compounds. Among these, human milk oligosaccharides (HMOs), representing the third largest fraction of human milk, have been assigned important biological functions, such as prebiotic and immunomodulatory and antimicrobial effects. HMOs are synthesized in the mammary gland by glycosyltransferase enzymes and can be divided in core-oligosaccharides, sialo-oligosaccharides, fucosyl-oligosaccharides and sialo-fucosyl-oligosaccharides on the basis of their chemical structure. Glycosyltransferases enzymes are partially regulated by genetic mechanisms; according to the expression of secretory and Lewis' genes, it is possible to classify human milk in 4 different secretory groups. We hereby present a review of the current knowledge concerning HMOs, their metabolism and main biological functions.

First observation of the decay B(c)+ → J/ψπ(+) π- π+

The decay B(c)(+) → J/ψπ(+) π(-) π(+) is observed for the first time, using 0.8 fb(-1) of pp collisions at sqrt[s] = 7 TeV collected by the LHCb experiment. The ratio of branching fractions B(B(c)(+) → J/ψπ(+) π(-) π(+))/B(B(c)(+)→J/ψπ^{+}) is measured to be 2.41 ± 0.30 ± 0.33, where the first uncertainty is statistical and the second is systematic. The result is in agreement with theoretical predictions.

Determination of the sign of the decay width difference in the B(s)(0) system

The interference between the K+ K- S-wave and P-wave amplitudes in B(s)(0) → J/ψK+ K- decays with the K+ K- pairs in the region around the ϕ(1020) resonance is used to determine the variation of the difference of the strong phase between these amplitudes as a function of K+ K- invariant mass. Combined with the results from our CP asymmetry measurement in B(s)(0) → J/ψϕ decays, we conclude that the B(s)(0) mass eigenstate that is almost CP = +1 is lighter and decays faster than the mass eigenstate that is almost CP = -1. This determines the sign of the decay width difference ΔΓ(s) ≡ Γ(L) - Γ(H) to be positive. Our result also resolves the ambiguity in the past measurements of the CP violating phase ϕ(s) to be close to zero rather than π. These conclusions are in agreement with the standard model expectations.

Strong constraints on the rare decays B(s)(0) → μ+ μ- and B0 → μ+ μ-

A search for B(s)(0) → μ+ μ- and B0 → μ+ μ decays is performed using 1.0  fb(-1) of pp collision data collected at sqrt[s] = 7  TeV with the LHCb experiment at the Large Hadron Collider. For both decays, the number of observed events is consistent with expectation from background and standard model signal predictions. Upper limits on the branching fractions are determined to be B(B(s)(0) → μ+ μ-) < 4.5(3.8)×10(-9) and B(B0 → μ+ μ-) < 1.0(0.81)×10(-9) at 95% (90%) confidence level.

Opposite-side flavour tagging of B mesons at the LHCb experiment

The calibration and performance of the opposite-side flavour tagging algorithms used for the measurements of time-dependent asymmetries at the LHCb experiment are described. The algorithms have been developed using simulated events and optimized and calibrated with B⁺→J/ψK⁺, B⁰→J/ψK^∗0 and B⁰→D^∗-μ⁺ν_μ decay modes with 0.37 fb^-1 of data collected in pp collisions at [Formula: see text] during the 2011 physics run. The opposite-side tagging power is determined in the B⁺→J/ψK⁺ channel to be (2.10±0.08±0.24) %, where the first uncertainty is statistical and the second is systematic.

Measurement of production in collisions at [Formula: see text]

The production of ϒ(1S), ϒ(2S) and ϒ(3S) mesons in proton-proton collisions at the centre-of-mass energy of [Formula: see text] is studied with the LHCb detector. The analysis is based on a data sample of 25 pb-1 collected at the Large Hadron Collider. The ϒ mesons are reconstructed in the decay mode ϒ→μ+μ- and the signal yields are extracted from a fit to the μ+μ- invariant mass distributions. The differential production cross-sections times dimuon branching fractions are measured as a function of the ϒ transverse momentum pT and rapidity y, over the range pT <15 GeV/c and 2.0 Collapse

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First evidence of direct CP violation in charmless two-body decays of Bs0 mesons

Using a data sample corresponding to an integrated luminosity of 0.35  fb-1 collected by LHCb in 2011, we report the first evidence of CP violation in the decays of Bs0} mesons to K±π∓ pairs, ACP(Bs0→Kπ)=0.27±0.08(stat)±0.02(syst), with a significance of 3.3σ. Furthermore, we report the most precise measurement of CP violation in the decays of B0 mesons to K±π∓ pairs, ACP(B0→Kπ)=-0.088±0.011(stat)±0.008(syst), with a significance exceeding 6σ.

Differential branching fraction and angular analysis of the decay B0 → K*0 μ+ μ-

The angular distributions and the partial branching fraction of the decay B0 → K*0 μ+ μ- are studied by using an integrated luminosity of 0.37  fb(-1) of data collected with the LHCb detector. The forward-backward asymmetry of the muons, A(FB), the fraction of longitudinal polarization, F(L), and the partial branching fraction dB/dq2 are determined as a function of the dimuon invariant mass. The measurements are in good agreement with the standard model predictions and are the most precise to date. In the dimuon invariant mass squared range 1.00-6.00  GeV2/c4, the results are A(FB)=-0.06(-0.14)(+0.13)±0.04, F(L)=0.55±0.10±0.03, and dB/dq2=(0.42±0.06±0.03)×10(-7)  c4/GeV2. In each case, the first error is statistical and the second systematic.

First observation of the decays B(0) → D(+)K(-)π(+)π(-) and B(-) → D(0)K(-)π(+)π(-)

First observations of the Cabibbo-suppressed decays B(0) → D(+)K(-)π(+)π(-) and B(-) → D(0)K(-)π(+)π(-) are reported using 35 pb(-1) of data collected with the LHCb detector. Their branching fractions are measured with respect to the corresponding Cabibbo-favored decays, from which we obtain B(B(0) → D(+)K(-)π(+)π(-))/B(B(0) → D(+)π(-)π(+)π(-))=(5.9±1.1±0.5)×10(-2) and B(B(-) → D(0)K(-)π(+)π(-))/B(B(-) → D(0)π(-)π(+)π(-))=(9.4±1.3±0.9)×10(-2), where the uncertainties are statistical and systematic, respectively. The B(-) → D(0)K(-)π(+)π(-) decay is particularly interesting, as it can be used in a similar way to B(-) → D(0)K(-) to measure the Cabibbo-Kobayashi-Maskawa phase γ.

Observation of B(s)(0) → J/ψf(2)'(1525) in J/ψK+ K- final states

The decay B(s)(0) → J/ψK+ K- is investigated using 0.16  fb(-1) of data collected with the LHCb detector using 7 TeV pp collisions. Although the J/ψϕ channel is well known, final states at higher K+ K- masses have not previously been studied. In the K+ K- mass spectrum we observe a significant signal in the f(2)'(1525) region as well as a nonresonant component. After subtracting the nonresonant component, we find B(B(s)(0) → J/ψf(2)'(1525))/B(B(s)(0) → J/ψϕ) = (26.4 ± 2.7 ± 2.4)%.

Evidence for CP violation in time-integrated D0→h(-)h(+) decay rates

A search for time-integrated CP violation in D(0)→h(-)h(+) (h=K, π) decays is presented using 0.62 fb(-1) of data collected by LHCb in 2011. The flavor of the charm meson is determined by the charge of the slow pion in the D(*+)→D(0)π(+) and D(*-)→D[over ¯](0)π(-) decay chains. The difference in CP asymmetry between D(0)→K(-)K(+) and D(0)→π(-)π(+), ΔA(CP)≡A(CP)(K(-)K(+))-A(CP)(π(-)π(+)), is measured to be [-0.82±0.21(stat)±0.11(syst)]%. This differs from the hypothesis of CP conservation by 3.5 standard deviations.

Search for lepton number violating decays B+ → π- μ+ μ+ and B+ → K- μ+ μ+

A search is performed for the lepton number violating decay B+ → h- μ+ μ+, where h- represents a K- or a π-, using an integrated luminosity of 36  pb(-1) of data collected with the LHCb detector. The decay is forbidden in the standard model but allowed in models with a Majorana neutrino. No signal is observed in either channel and limits of B(B+ → K- μ+ μ+) < 5.4×10(-8) and B(B+ → π- μ+ μ+) < 5.8×10(-8) are set at the 95% confidence level. These improve the previous best limits by factors of 40 and 30, respectively.

Measurement of the CP-violating phase ϕ(s) in the decay B(s)(0) → J/ψϕ

We present a measurement of the time-dependent CP-violating asymmetry in B(s)(0) → J/ψϕ decays, using data collected with the LHCb detector at the LHC. The decay time distribution of B(s)(0) → J/ψϕ is characterized by the decay widths Γ(H) and Γ(L) of the heavy and light mass eigenstates, respectively, of the B(s)(0) - B(s)(0) system and by a CP-violating phase ϕ(s). In a sample of about 8500 B(s)(0) → J/ψϕ events isolated from 0.37  fb(-1) of pp collisions at sqrt[s] = 7  TeV, we measure ϕ(s) = 0.15 ± 0.18(stat) ± 0.06(syst)  rad. We also find an average B(s)(0) decay width Γ(s) ≡ (Γ(L) + Γ(H))/2 = 0.657 ± 0.009(stat) ± 0.008(syst)  ps(-1) and a decay width difference ΔΓ(s) ≡ Γ(L) - Γ(H) = 0.123 ± 0.029(stat) ± 0.011(syst)  ps(-1). Our measurement is insensitive to the transformation (ϕ(s),ΔΓ(s)) ↦ (π - ϕ(s), -ΔΓ(s)).

Bone maturity and thyroidal status at birth: role of the ultrasonographic evaluation of the distal femoral epiphysis

PURPOSE

Thyroidal hormones are important for bone development, and ultrasonographic (US) evaluation of the distal femoral epiphysis (DFE) has recently been suggested as a new method for the assessment of skeletal maturity in infants. A delayed bone maturation, expressed by a smaller or absent DFE nucleus (in terms of DFE surface area, sum of the epiphyseal diameters, or DFE height and acetabular size), has been largely demonstrated in diagnosed hypothyroid infants, while no data analyze the role and meaning of the DFE dimensions (in terms of volume) in newborn before knowledge of the congenital neonatal screening results. The aims of the present study were to ultrasonographically evaluate the volume of DFE in newborns, and to determine whether it has any predictive role for the thyroidal status at birth.

MATERIALS AND METHODS

238 newborns (M/F: 121 /117) were evaluated. The gestational age, body weight and length at birth were registered. Neonatal screening for congenital hypothyroidism (CH), based on TSH levels on blood spot, was performed in all on the 3 rd day of life. The DFE volume was ultrasonographically evaluated, taking into account the three diameters of the DFE nucleus, within 48 hours of birth.

RESULTS

No newborn was found to have CH on neonatal screening. The DFE volume ranged between 0.00 cm and 0.61 cm (mean 0.14 ± 0.10 cm, median 0.13 cm). The DFE volume did not differ between males and females, while it was significantly greater in at term babies than in preterm babies. No differences in TSH values at screening were noted among the groups. The DFE volume was significantly related to gestational age, birth weight and length. A significant relationship was found between the DFE volume and TSH concentrations at screening.

CONCLUSION

US evaluation of DFE volume provides a simple method for assessing bone maturity at birth, which is related to gestational age, body weight and length at birth. Nonetheless, it has any predictive role for thyroidal status at birth, being not related to TSH levels on neonatal screening for CH.