Fluid Shear Stress Promotes Osteoblast Proliferation and Suppresses Mitochondrial-Mediated Osteoblast Apoptosis Through the miR-214-3p-ATF4 Signaling Axis

MicroRNAs (miRNAs) play vital roles in bone metabolism and participate in the mechanically induced bone alterations. The underlying molecular mechanisms by which fluid shear stress (FSS) regulate the proliferative and apoptotic phenotypic changes of osteoblasts remain elusive. The study aimed to investigate the regulatory effects of FSS on osteoblast proliferative and apoptotic phenotypes and the roles of miR-214-3p-ATF4 (activating transcription factor 4) signaling axis in the mechanomodulation processes. FSS promoted the proliferative activity of osteoblasts and suppressed mitochondrial-mediated osteoblast apoptosis. FSS decreased miR-214-3p expression and increased ATF4 expression in MC3T3-E1 osteoblasts. MiR-214-3p inhibited osteoblast proliferative activity and promoted mitochondrial-mediated osteoblast apoptosis. Overexpression of miR-214-3p attenuated FSS-enhanced osteoblast proliferation and FSS-suppressed mitochondrial-mediated osteoblast apoptosis. We validated that ATF4 acted as a target gene of miR-214-3p. Moreover, miR-214 3p regulated osteoblast proliferation and apoptosis through targeting ATF4. Taken together, our study proved that FSS could suppress mitochondrial-mediated osteoblast apoptosis and promote osteoblast proliferation through the miR-214-3p-ATF4 signaling axis.

Evidence for Nonlinear Gluon Effects in QCD and Their Mass Number Dependence at STAR

The STAR Collaboration reports measurements of back-to-back azimuthal correlations of di-π^{0}s produced at forward pseudorapidities (2.6<η<4.0) in p+p, p+Al, and p+Au collisions at a center-of-mass energy of 200 GeV. We observe a clear suppression of the correlated yields of back-to-back π^{0} pairs in p+Al and p+Au collisions compared to the p+p data. The observed suppression of back-to-back pairs as a function of transverse momentum suggests nonlinear gluon dynamics arising at high parton densities. The larger suppression found in p+Au relative to p+Al collisions exhibits a dependence of the saturation scale Q_{s}^{2} on the mass number A. A linear scaling of the suppression with A^{1/3} is observed with a slope of -0.09±0.01.

Coherent Picture on the Pure Spin Transport between Ag/Bi and Ferromagnets

In a joint effort of both experiments and first-principles calculations, we resolve a hotly debated controversy and provide a coherent picture on the pure spin transport between Ag/Bi and ferromagnets. We demonstrate a strong inverse Rashba-Edelstein effect (IREE) at the interface in between Ag/Bi with a ferromagnetic metal (FM) but not with a ferromagnetic insulator. This is in sharp contrast to the previously claimed IREE at Ag/Bi interface or inverse spin Hall effect dominated spin transport. A more than one order of magnitude modulation of IREE signal is realized for different Ag/Bi-FM interfaces, casting strong tunability and a new direction for searching efficient spintronics materials.

[A nomogram based on systemic inflammation markers can predict adverse outcomes in patients with heart failure]

OBJECTIVE

To construct a nomogram based on systemic inflammation markers for assessing the risk of adverse outcomes in patients with heart failure (HF).

METHODS

We retrospectively collected the clinical data from 430 patients with HF hospitalized in our hospital from June, 2017 to June, 2019.The patients were randomized into derivation group (n=286) and validation group (n=144) at a 7:3 ratio using R software.The risk factors for adverse prognosis of HF were screened using COX regression analysis to establish the nomogram.The predictive accuracy of the nomogram was assessed using calibration curves.Decision curve analysis (DCA) and Kaplan-Meier curves were used to evaluate the clinical utility of the nomogram.

RESULTS

The results of COX multivariate regression analysis showed that age (P=0.030), body mass index (BMI, P=0.002), New York Heart Association classification (NYHA, P < 0.001), hypertension (P=0.004), lymphocyte count (P < 0.001), platelet-to-lymphocyte ratio (PLR, P=0.007), neutrophil-to-lymphocyte ratio (NLR, P < 0.001) and system inflammation response index (SIRI, P < 0.001) were prognostic factors for HF patients.The nomogram was constructed using these prognostic factors.The C-indexes of the derivation and validation cohorts were 0.719(95%CI: 0.680-0.758) and 0.732(95%CI: 0.693-0.771), respectively.The calibration curves showed a good concordance of the nomogram for predicting adverse outcomes in patients with HF.

CONCLUSION

The nomogram constructed based on the systemic inflammation markers and the conventional risk factors can predict adverse outcomes (mortality and readmission) in patients with HF.

Circadian dysregulation disrupts gut microbe-related bile acid metabolism

Background: Disturbance of circadian rhythm leads to abnormalities in bile acid (BA) and lipid metabolism, and it is of great significance to explore the relationship between them. This study explored the effects of circadian dysregulation on the rhythms of intestinal BA metabolism. Method: Period circadian clock 1/period circadian clock 2 (Per1/Per2) double gene knockout (DKO) and wild-type (WT) male C57BL/6 mice were fed with a control or high-fat diet for 16 weeks. We measure plasma parameters of mice. Pathological changes including those in liver and intestine were detected by hematoxylin and eosin (H&E) and oil O staining. Western blot was used to detect the intestinal core rhythm protein clock circadian regulator (CLOCK), nuclear receptor subfamily 1, group D, member 1 (REV-ERBα), Farnesoid X receptor (FXR), Small heterodimer partner (SHP), and Fibroblast growth factor 15 (FGF15) expressions. We analyzed the bile acid and intestinal flora profile in the mice intestine tissues by BA-targeted metabolomics detection and high-throughput sequencing. Results: Rhythmic chaos affected lipid metabolism and lipid accumulation in mice liver and intestine, and diurnal fluctuations of plasma triglycerides (TGs) were absent in normal-feeding DKO mice. The normal circadian fluctuations of the CLOCK and REV-ERBα observed in wild mice disappeared (normal diet) or were reversed (high-fat diet) in DKO mice. In WT mice intestine, total BA and conjugated BA were affected by circadian rhythm under both normal and high-fat diets, while these circadian fluctuations disappeared in DKO mice. Unconjugated BA seemed to be affected exclusively by diet (significantly increased in the high-fat group) without obvious fluctuations associated with circadian rhythm. Correlation analysis showed that the ratio of conjugated/unconjugated BA was positively correlated with the presence of Bacteroidetes and displayed a circadian rhythm. The expression levels of BA receptor pathway protein FXR, SHP, and FGF15 were affected by the ratio of conjugated/unconjugated BA. Conclusion: Bacteroidetes-related diurnal changes to intestinal ratios of conjugated/unconjugated BA have the potential to regulate diurnal fluctuations in liver BA synthesis via FXR-FGF15. The inverted intestinal circadian rhythm observed in DKO mice fed with a high-fat diet may be an important reason for their abnormal circadian plasma TG rhythms and their susceptibility to lipid metabolism disorders.  

One-pot in-situ hydrothermal synthesis of ternary In2S3/Nb2O5/Nb2C Schottky/S-scheme integrated heterojunction for efficient photocatalytic hydrogen production

MXene-derived photocatalysts continue to fascinate the research community in developing photo-driven green and sustainable fuel production. However, the efficiency of MXene-derived photocatalyst is still low due to the wide bandgap and high recombination rate of photo-excited charge carriers. Here, we have synthesized the Nb₂C MXene-derived ternary photocatalyst via one-pot in-situ hydrothermal method for photocatalytic hydrogen (H₂) evolution. The partial oxidation of Nb₂C MXene into Nb₂O₅ nanorods and coupling with In₂S₃ nanoparticles via in-situ chemical anchoring were the key factors toward high efficiency and long-term stability during photocatalytic H₂ evolution. The optimized ternary photocatalyst composite manifested the highest H₂ evolution efficiency at 68.8 µmol g^-1 h^-1, which was 11 and 7.5 times higher than the Nb₂O₅/Nb₂C (NNC) and pure In₂S₃ photocatalyst, respectively. Moreover, the photocatalytic stability of the optimized ternary photocatalyst composite was analyzed for five consecutive cycles, and above 87% activity retention was observed even after the fifth cycle without any obvious decline. The separation efficiency of photoexcited charge carriers could be attributed to the synergic effect of the In₂S₃/Nb₂O₅ heterojunction and the redox reactions at different sites of the composite. More importantly, the participation of Schottky junction and S-scheme heterojunction charge transfer for the obtained novel ternary photocatalyst was evaluated via ultraviolet photoelectron spectroscopy (UPS) and electron paramagnetic resonance (EPR). This research will provide additional insight into the extended potential of MXene-derived ternary photocatalysts towards efficient H₂ production to meet future global energy demands.

p120 regulates E-cadherin expression in nasal epithelial cells in chronic rhinosinusitis

BACKGROUND

The epithelial barrier plays an important role in the regulation of immune homeostasis. The effect of the immune environment on E-cadherin has been demonstrated in previous studies. This discovery prompted new research on the targeting mechanism of E-cadherin in chronic rhinosinusitis (CRS).

METHODS

E-cadherin and p120 expression was determined by quantitative RT-PCR, and western blot. The interaction between E-cadherin and p120 was assessed by immunofluorescence staining and coimmunoprecipitation assays. Human nasal epithelial cells (HNECs) were cultured with submerged methods and transfected with p120-specific small interfering RNA. In other experiments, HNECs differentiated with the air-liquid interface (ALI) method were stimulated with various cytokines and Toll-like receptor (TLR) agonists. The barrier properties of differentiated HNECs were determined by assessing fluorescent dextran permeability.

RESULTS

E-cadherin and p120 expression was decreased in HNECs from patients with CRS, and the p120 protein expression level was positively correlated with that of E-cadherin. Two isoforms of p120 (p120-1 and p120-3) were expressed in HNECs, with p120-3 being the main isoform. Knocking down p120 in HNECs cultured under submerged conditions significantly reduced the E-cadherin protein expression. The Rac1 inhibitor NSC23766 reversed the protein expression of E-cadherin in p120 knockdown experiments. Inflammatory mediators, including IL-4, TNF-α, TGF- β, LPS and IFN-Î, reduced E-cadherin and p120 protein expression and increased paracellular permeability. Dexamethasone abolished the downregulation of E-cadherin and p120 caused by inflammatory mediators.

CONCLUSIONS

p120 is involved in regulating E-cadherin protein expression in CRS. Dexamethasone may alleviate the reduction in E-cadherin and p120 protein expression caused by inflammatory mediators.

[Genetic characteristics and prognostic analysis of 162 fetal cardiac abnormalities]

Objective: To analyze the type and characteristics of fetal cardiac abnormalities and their relationships with genetic abnormalities and clinical prognosis. Methods: The clinical data of 162 pregnant women with fetal cardiac abnormalities who came to the prenatal diagnosis center of Peking University First Hospital and performed genetic tests from February 2013 to February 2021 were reviewed. Genetic testing methods included chromosome karyotype analysis, array-based comparative genomic hybridization (aCGH) and pathogenic gene detection. Fetuses with isolated cardiac abnormalities and no fatal genetic abnormalities were assessed using the fetal cardiac birth defects clinical outcome score and followed up. Results: (1) Ultrasonography results: among the 162 fetuses, 86 cases (53.1%, 86/162) had isolated cardiac abnormalities, and 76 cases (46.9%, 76/162) had extra-cardiac abnormalities; single cardiac abnormalities were in 84 (51.9%,84/162) cases, and multiple cardiac abnormalities occurred in 78 cases (48.1%,78/162). (2) Genetic examination results: there were 39 cases (24.1%, 39/162) of pathogenic genetic abnormalities, including 35 cases (21.6%, 35/162) of pathogenic chromosome karyotype abnormality, 3 cases (1.9%, 3/162) of pathogenic copy number variant (CNV), and 1 case (0.6%, 1/162) of pathogenic gene variation. The detection rates of pathogenic genetic abnormalities were 16.3% (14/86) in fetuses with isolated cardiac abnormalities and 32.9% (25/76) in fetuses with cardiac abnormalities and extra-cardiac abnormalities, and the difference was statistically significant (χ²=6.094, P=0.014). The detection rate of genetic abnormalities was 28.6% (24/84) in the single cardiac abnormalities, among which ventricular septal defect was 36.7% (11/30), atrioventricular septal defect was 8/13, tetralogy of Fallot was 3/17, persistent trancus arteriosus was 1/1, cardiac tumor was 1/1; no genetic abnormality was detected in the other single cardiac abnormality types (22 cases in total). The main types of pathogenic genetic abnormalities were trisomy 21 (41.7%, 10/24) and trisomy 18 (41.7%, 10/24). (3) Pregnancy outcome and fetal prognosis: among 72 fetuses with isolated heart abnormalities without pathogenic genetic abnormalities, there were 4 cases of grade Ⅰ, all of which continued pregnancy; 39 cases of grade Ⅱ, with 21 cases induced labor, 18 cases continued pregnancy; 26 cases of grade Ⅲ, with 23 cases induced labor, 3 cases continued pregnancy; 3 cases of grade Ⅳ, all of which induced labor. Totally, there were 47 cases induced labor and 25 cases continued pregnancy, 24 cases (96.0%, 24/25) of which were alive. Conclusions: When fetal cardiac abnormalities are detected by prenatal ultrasound, comprehensive cardiac and extra-cardiac ultrasound assessment and further genetic testing are recommended. Fetuses excluded pathogenic genetic abnormalities and extra-cardiac abnormalities should perform clinical prognostic score evaluation through multidisciplinary collaboration, to improve maternal and fetal outcomes.

Combined Application of Virtual Simulation Technology and 3-Dimensional-Printed Computer-Aided Rapid Prototyping in Autotransplantation of a Mature Third Molar

The use of computer-aided rapid prototyping (CARP) models was considered to reduce surgical trauma and improve outcomes when autotransplantation of teeth (ATT) became a viable alternative for dental rehabilitation. However, ATT is considered technique-sensitive due to its series of complicated surgical procedures and unfavorable outcomes in complex cases. This study reported a novel autotransplantation technique of a 28-year-old patient with an unrestorable lower first molar (#36) with double roots. Regardless of a large shape deviation, a lower third molar (#38) with a completely single root formation was used as the donor tooth. ATT was performed with a combined use of virtual simulation, CARP model-based rehearsed surgery, and tooth replica-guided surgery. A 3D virtual model of the donor and recipient site was generated from cone-beam computed tomographic (CBCT) radiographs prior to surgery for direct virtual superimposition simulation and CARP model fabrication. The virtual simulation indicated that it was necessary to retain cervical alveolar bone during the surgical socket preparation, and an intensive surgical rehearsal was performed on the CARP models. The donor tooth replica was used during the procedure to guide precise socket preparation and avoid periodontal ligament injury. Without an additional fitting trial and extra-alveolar storage, the donor tooth settled naturally into the recipient socket within 30 s. The transplanted tooth showed excellent stability and received routine root canal treatment three weeks post-surgery, and the one-year follow-up examination verified the PDL healing outcome and normal functioning. Patient was satisfied with the transplanted tooth. This cutting-edge technology combines virtual simulation, digital surgery planning, and guided surgery implementation to ensure predictable and minimally invasive therapy in complex cases.

Per1/Per2 Disruption Reduces Testosterone Synthesis and Impairs Fertility in Elderly Male Mice

Circadian rhythm disorders caused by genetic or environmental factors lead to decreased male fertility but the mechanisms are poorly understood. The current study reports that the mechanism of Per1/Per2 Double knockout (DKO) reduced the reproductive capacity of elderly male mice. The sperm motility and spermatogenic capacity of male DKO mice were weak. Hormone-targeted metabolomics showed reduced plasma levels of free testosterone in DKO male mice compared with WT male mice. Transcriptomic analysis of testicular tissue showed the down-regulation of testosterone synthesis-related enzymes (Cyp11a1, Cyp17a1, Hsd17b3, Hsd3b1, and Star) in the steroid hormone synthesis pathway. Spermatogenesis genes, Tubd1 and Pafah1b were down-regulated, influencing tubulin dynamics and leading to impaired motility. Seleno-compound metabolic loci, Scly and Sephs2, were up-regulated and Slc7a11 and Selenop were down-regulated. Western-blotting showed that steroid acute regulatory protein (StAR) and p-CREB, PKA and AC1 were reduced in testicular tissue of DKO mice compared to WT. Therefore, Per1/Per2 disruption reduced testosterone synthesis and sperm motility by affecting the PKA-StAR pathway, leading to decreased fertility.

Degradation performance of high-concentration coking wastewater by manganese oxide ore acidic oxidation

The degradation of coking wastewater using a manganese oxide ore acidic oxidation was investigated. This work was performed in three stages. Firstly, the advantageous degradation conditions were measured by the degradation tests, and under the optimal conditions percentage degradation was obtained of 91.6% chemical oxygen demand measured by potassium dichromate oxidation (COD_cr), 94.7% total nitrogen (TN), 98.3% phenols, 98.2% fatty acid, 89.5% tar, and 98.9% sulphide for the oxidized effluent, simultaneously cogenerating a Mn²⁺concentration of 46.2 g/L for Mn-electrolytic stock solution. Secondly, the transformation analysis of the special chemical group of coking wastewater contaminants illustrated that the employment of manganese oxide ore generated the degradation of low and high molecular weight organics, especially causing polymers to break down into oligomers. Thirdly, the electrochemical characteristics of the interface between wastewater and ore revealed that the contaminant degradation of coking wastewater greatly depended on the oxidation capacity of the surface oxide species, involving a simple answer to the MnO₂ oxidation for small-molecule organic materials and a strengthening response to the MnO·OH oxidation for high-weight molecule organic substances. The treatment of coking wastewater using the Mn-oxide ore acidic oxidation process is an effective and value-added method, which is particularly applicable to high-concentration coking wastewater.

Epidemiological Trends of Coronavirus Disease 2019 in Sierra Leone From March 2020 to October 2021

Coronavirus disease 2019 (COVID-19), a serious public health challenge the world over, has led to significant health concerns in Sierra Leone. In the present study, epidemic indices, such as the number of cases, positivity rate, reproduction rate (R0), case fatality rate (CFR), age, and sex, were used to characterize the epidemiological trends of COVID-19. As of October 31, 2021, a total of 6,398 cases and 121 related deaths had been confirmed. The total number of COVID-19 reverse transcription polymerase chain reaction (RT-PCR) tests conducted to October 31, 2021, was 249,534, and the average positivity rate was 2.56%. Three waves of COVID-19 were recorded, occurring during weeks 15–46 in 2020 (2,369 cases), week 47 in 2020 to week 16 in 2021 (1,665 cases), and weeks 17–43 in 2021 (2,364 cases), respectively. Remarkably, there was no increase in the numbers of confirmed COVID-19 cases despite rising test numbers throughout the three waves. Moreover, three high R0 values were observed before each wave. The number of positive cases significantly correlated with positive numbers of international arrivals (P < 0.01), deaths (P < 0.01), and the positivity rate of tested samples (P < 0.01). Moreover, all of the deaths occurred during the peak of the three waves. Our results indicate that there was a low level of COVID-19 epidemic in Sierra Leone and that COVID-19's introduction led to local transmission. It is vital to fight against the spread of SARS-CoV-2 from the source of origin by strengthening testing and management of people entering the country. Our findings will provide important clues for expanding sample screening and will contribute to the reasonable allocation of medical resources.

[Investigation and analysis of the implementation status of "Diagnosis and therapy guideline of preterm birth (2014)"]

Objective: To understand the actual situation of the implementation of "Diagnosis and therapy guideline of preterm birth（2014）", "Guideline" for short, by front-line obstetricians, and to provide reference for the further update and supplement of the "Guideline". Methods: This study designed a structured questionnaire for the prominent problems in the prevention and treatment of preterm birth, which was determined by the expert team drafting the "Guideline". In October to November 2021, a cross-sectional survey was conducted among obstetricians, including members of the Perinatal Medicine Branch of Jiangsu Medical Association and the Obstetrics Subgroup,Chinese society of Obstetrics and Gynecology, Chinese Medical Association, on the implementation status of the "Guideline". The recommendations of the "Guideline" were used as standard answers to determine the implementation rate. A total of 328 valid questionnaires were collected. The total score of the questionnaire was 12 points. The questionnaire was divided into low executive ability group (<7 points) and high executive ability group (≥7 points) with a score of 7 as the threshold value, and the differences in baseline information such as hospital grade and professional title between the two groups were compared. Results: The score of 328 obstetricians was (7.6±1.6) points, including 250 (76.2%, 250/328) in the high execution group and 78 (23.8%, 78/328) in the low execution group. The execution rates of "the use of uterine contraction inhibitors for short courses"[97.0% (318/328)], "late umbilical cord breakage after birth of premature infants"[87.8% (288/328)] and "should preterm patients with intact membranes be treated with antibiotics"[86.6% (284/328)] were all over 80%, indicating good implementation. Multiple logistic regression analysis showed that hospital grade and professional title were independent factors influencing the performance of the "Guideline"(all P<0.05), and secondary hospitals had lower scores and worse execution than tertiary hospitals (OR=0.42, 95%CI: 0.23-0.77; P=0.005). Senior titles had higher scores and better execution than junior titles (OR=5.33, 95%CI: 2.35-12.07; P<0.001). When answering the question "gestational week at which premature infants could survive in your hospital", only 3.4% (11/328) answered 22 weeks, and 44.5% (146/328) answered 28 weeks, accounted for the highest proportion. The gestational week of surviving premature infants in tertiary hospitals was earlier than that in secondary hospitals (P<0.05). The gestational week of surviving premature infants answered by senior titles was earlier than that of junior titles (P<0.05). Conclusions: Obstetricians generally have a good implementation of the "Guideline", and their understanding of some recommended clauses in the guidelines needs to be improved. In the future, training of primary hospitals and physicians with junior titles should be strengthened.

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.

Selective Photocatalytic CO2 Reduction to CH4 on Tri-s-triazine-Based Carbon Nitride via Defects and Crystal Regulation: Synergistic Effect of Thermodynamics and Kinetics

Realizing the high selectivity of CH₄ from the photocatalytic CO₂ reduction reaction (CO₂ RR) remains a great challenge owing to the lower efficiency of multi-electron transfer and the similar thermodynamic properties of CH₄ and CO. Herein, nitrogen-deficient carbon nitride two-dimensional (2D) nanosheets were prepared via the high-temperature crystalline phase transformation process. Optimizing crystallinity enhances the in-plane polarization along the a-axis. Owing to the increased electron density of the N defect, the kinetic possibilities of CH₄ production have increased. Furthermore, the potential energy of the mid-gap states introduced by the N defect favors the thermodynamics of CH₄ production. The selectivity values of CH₄ based on yield and electrons are 87.1 and 96.4%. This work unravels the mechanism to selectively produce CH₄ from CO₂ photoreduction through the crystalline phase and defect regulation and provides significant guidance for the rational design of CO₂ reduction photocatalysts for selective CH₄ production.

Comparison of the Utility of High-Resolution CT-DWI and T2WI-DWI Fusion Images for the Localization of Cholesteatoma

BACKGROUND AND PURPOSE

Cholesteatoma is an aggressive disease that may lead to hearing impairment. This study aimed to compare the utility of high-resolution CT and TSE-DWI fusion images with that of T2WI and TSE-DWI fusion images in the localization of middle ear cholesteatoma.

MATERIALS AND METHODS

Seventy-one patients with middle ear cholesteatoma were retrospectively recruited. High-resolution CT, T2WI with fat suppression, and TSE-DWI scans were obtained, and image fusion was performed using a 3D reconstruction postprocessing workstation to form CT-DWI and T2WI-DWI fusion images. The quality of the 2 fused images was subjectively evaluated using a 5-point Likert scale with the horizontal semicircular canal transverse position as the reference. Receiver operating characteristic analysis was performed, and the diagnostic efficacies of CT-DWI and T2WI-DWI fusion images in localizing middle ear cholesteatoma were calculated.

RESULTS

The overall quality of T2WI-DWI fusion images was slightly higher than that of CT-DWI fusion images (P < .001), and the semicircular canal was slightly less clear on T2WI-DWI than on CT-DWI (P < .001). No statistical difference was found in the diagnostic confidence between them. In the localization of middle ear cholesteatoma, the accuracy, sensitivity, and specificity of T2WI-DWI fusion images and CT-DWI fusion images were equivalent for involvement of the attic, tympanic cavity, mastoid antrum, and mastoid process, with no statistically significant differences.

CONCLUSIONS

T2WI-DWI fusion images could replace CT-DWI in the preoperative selection of surgical options for middle ear cholesteatoma.

AB0227 TREATMENT SEQUENCING PATTERNS AND COMPARATIVE EFFICACY IN PATIENTS WITH RHEUMATOID ARTHRITIS FROM A REAL-WORLD SETTING

Background

The European League Against Rheumatism (EULAR)1 recently provided updated guidelines regarding the initiation and modification of disease-modifying antirheumatic drug (DMARD) therapy in patients with Rheumatoid Arthritis (RA). Therefore, real-world evidence studies are warranted to provide insights into first-line DMARD utilization and durability of response in the second-line setting.

Objectives

To analyze RA treatment patterns in real-world data and compare durability of response between second-line DMARDs + anti-TNF (TNFi) therapies vs. TNFi monotherapy.

Methods

Electronic health records (EHRs) from a large health system in the Northeast US were used to identify RA patients. Lines of therapy were defined based on confirmed prescriptions for DMARDs and TNFi therapies. Time to next treatment (TTNT) was the primary outcome to estimate durability of response. Time-to-event analyses were performed using Kaplan-Meier and log-rank test methods. In addition, a Cox Proportional-Hazards (CoxPH) model was used to evaluate covariates as independent predictors of disease progression.

Results

Our study cohort consisted of 8,040 patients who had at least one line of therapy for RA. Conventional synthetic DMARDs (csDMARDs) were the predominant first line of therapy in this dataset (71.3%), followed by TNFi alone (11.1%) or TNFi combined with csDMARD (9.1%) (Figure 1).

For patients who had csDMARD as their first line of therapy, 22.93% progressed to second line treatment. Among them 36.2% patients were TNFi with or without in combination with csDMARDs. In the second-line, TNFi + csDMARDs were associated with a longer TTNT (median time: 13.1 months vs 6.1 months, P < 0.005) compared to TNFi monotherapy. The multiple variable CoxPH model (adjusted for age, gender, and race) demonstrated that second-line TNFi + csDMARDs had a lower hazard rate when compared to TNFi monotherapy (HR = 0.74, 95% CI: 0.36 - 1.12, p < 0.005).

Conclusion

We demonstrated the first comprehensive treatment sequencing patterns in RA from a real-world setting. As a second-line therapy for patients with inadequate response to csDMARDS, the TNFi + csDMARDs combination may improve duration of response when compared to TNFi monotherapy. Results from this study will inform future sequencing strategies to improve patient outcomes.

References

[1]Smolen, Josef S., Robert B. M. Landewé, Johannes W. J. Bijlsma, Gerd R. Burmester, Maxime Dougados, Andreas Kerschbaumer, Iain B. McInnes, et al. 2020. “EULAR Recommendations for the Management of Rheumatoid Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: 2019 Update.” Annals of the Rheumatic Diseases 79 (6): 685–99.

Disclosure of Interests

Lei Ai: None declared, Mitchell Higashi: None declared, Kyeryoung Lee: None declared, Zongzhi Liu: None declared, Lan Jin: None declared, Kalpana Raja: None declared, Yun Mai: None declared, Tomi Jun: None declared, William Oh Consultant of: Janssen

Pfizer, Aviva Beckmann: None declared, Emilio Schadt: None declared, Zachary Schadt: None declared, Rick Wallsten: None declared, Ediz Calay: None declared, Andrew Kasarskis: None declared, Qi Pan: None declared, Eric Schadt Speakers bureau: Eli Lilly, Consultant of: SAB of Eli Lilly

Celgene, Xiaoyan Wang: None declared

Circulating myeloid-derived suppressors cells correlate with clinicopathological characteristics and outcomes undergoing neoadjuvant chemoimmunotherapy in non-small cell lung cancer

PURPOSE

Myeloid-derived suppressors cells (MDSCs) are heterogeneous immunosuppressive cells, closely related to the development, efficacy and prognosis in various tumors. The relationship between clinicopathological characteristics, efficacy of neoadjuvant chemoimmunotherapy (NCIO) and circulating MDSCs in patients with non-small cell lung cancer (NSCLC) was investigated in this study.

METHODS

This study analyzed the clinical data of patients diagnosed at Department of Thoracic Surgery, Beijing Chest Hospital from November 2020 to August 2021. MDSCs and T cells subgroups were measured in fresh peripheral blood mononuclear cells(PBMCs) at baseline. Flow cytometry was used to detect MDSCs and T cells subgroups.

RESULTS

A total of 78 patients with NSCLC and 20 patients with benign nodule underwent direct surgery. 23 patients with NSCLC scheduled to accept NCIO before surgery. NSCLC had elevated levels of total MDSCs, PMN-MDSCs and M-MDSCs compared to patients with benign nodule. MDSCs subgroups were correlated to the pTNM stage in NSCLC patients. The frequency of total MDSCs were moderately positively correlated with regulatory T cells (Tregs)(r = 0.3597, P < 0.01) and negatively correlated with CD4 + T cells(r = 0.2714, P < 0.05). The baseline levels of total MDSCs, PMN-MDSCs and Tregs in pCR patients were significantly decreased than those of non-pCR patients (P < 0.05).

CONCLUSION

Circulating MDSCs were increased in NSCLC patients. MDSC subgroups were related to pTNM stage in NSCLC patients. Total MDSCs were positively correlated with Tregs levels and negatively correlated with CD4 + T cells in peripheral blood. The level of MDSCs and Tregs in peripheral blood may have potential value in predicting pathological response in NSCLC.

[Impact of C2-femoral heads center and sacroiliac fixation on the occurrence of post-operative proximal junctional kyphosis in adults with spinal deformity]

Objective: To analyze the relationship between post-operative proximal junctional kyphosis (PJK) and C₂-femoral heads center (C₂-FH), pelvic fixation in adult spinal deformity (ASD) patients, so as to provide a reference for the preoperative decision-making and the postoperative intervention timely. Methods: It was a retrospective study that analyzed 34 cases of ASD patients who underwent posterior pedicle screw fixation in Nanjing Drum Tower Hospital between January 2017 and May 2017. ASD patients were divided into two groups according to fixation options: the sacroiliac fixation group and the non-sacroiliac fixation group. The spine-pelvis parameters were evaluated on full-length X ray films of spine at preoperatively, 2 weeks postoperatively and the last follow-up, and the incidence of PJK was recorded. Results: A total of 34 ASD patients (3 males and 31 females) were included in this study, with an average age of (58±6) years. The mean follow-up period was (2.9±1.0) years (2.0-4.0 years). The age, follow-up time and various spine-pelvis parameters showed no significant differences between the two groups (all P>0.05). The immediate postoperative C₂-FH in the sacroiliac fixation group was significantly lower than that in the non-sacroiliac fixation group [(-69.46±30.85) mm vs (-31.62±15.31) mm, P<0.001]. The incidence of PJK was as high as 50.0% (8/16) in patients with sacroiliac fixation, but it was only 22% (4/18) in patients without sacroiliac fixation (P=0.016). At the last follow-up, the C₂-FH of both groups were both higher than -20 mm (both were approximately -15 mm, P=0.976), indicating that the C₂-FH was compensated in both groups. Due to the loss of the distal compensation ability, the incidence of PJK in the sacroiliac fixation group was higher than that in the non-sacroiliac fixation group. Due to the fixation of pelvis and most of lumbar spine, no significant differences were found in lumbar lordosis (LL), pelvic tilt (PT) and sacral slope (SS) at the last follow-up in both groups when compared with those after the operation (all P>0.05); while the thoracic kyphosis (TK) and cervical lordosis (CL) increased significantly (both P<0.05) to compensate C₂-FH at the last follow-up. Conclusion: It's demonstrated that C₂-FH< -2 cm and pelvic fixation are high risk factors of PJK in ASD patients. It is suggested that both global sagittal balance and pelvic fixation should be considered in decision-making and corrective surgery, rather than only focusing on spine-pelvic parameters.

[Effect evaluation of "Smoking cessation: Doctor first"program in China]

Objective: To evaluate the effect of "Smoking cessation: Doctor first" program on smoking medical staff. Methods: From December 2016 to September 2019, 1 747 smoking medical staff from 54 units of China Tobacco Cessation Alliance were enrolled into"Smoking cessation: Doctor first"program. Demographic characteristics, smoking characteristics, degree of tobacco dependence, willingness to quit smoking and other related factors were collected during the baseline survey. Multivariate logistic regression model was used to analyze the related factors of willingness to quit. The subjects were given intensive smoking cessation intervention from October 2017 to September 2019, including education on the hazards of smoking, methods of smoking cessation and giving smoking cessation drugs. After intervention, the subjects were investigated about their smoking cessation progress and the effect of the project was evaluated. Results: The subjects were (41±11) years old, 91.9% (1 609/1 747) were male and 62.2% (1 086/1 747) were daily smokers. The main reasons for smoking included the influence of friends [697 (39.9%)], the need for social entertainment [629 (36.0%)], the relief of mental stress [589 (33.7%)] and the refreshment [459 (26.3%)]. At baseline, 52.9% (885/1 672) and 43.2% (755/1 747) smokers had intention to quit smoking and had planned to quit within one year, respectively. Multivariate logistic regression model analysis showed that: low education level [OR (95%CI) of high school and junior high school and below were 2.42 (1.61, 3.63) and 1.57 (1.18, 2.11)], daily smoking [OR (95%CI): 1.38 (1.06, 1.78)], thinking quitting smoking is not important [OR (95%CI): 4.15 (3.33, 5.18)] and having no quitting experience [OR (95%CI): 3.21 (2.53, 4.05)] were associated with no intention to quit smoking. After intensive smoking cessation intervention, 81.0% (1 415/1 747) smokers started to quit and 36.6% (518/1 415) quit smoking with drugs, both higher than the baseline level (all P values<0.001). By the end of the program, 60.2% (852/1 415) of the medical staff had quit smoking successfully. Conclusion: "Smoking cessation: Doctor first"program can improve the willingness to quit and the proportion of using smoking cessation drugs of medical staff.

Measurements of Proton High-Order Cumulants in sqrt[s_{NN}]=3 GeV Au+Au Collisions and Implications for the QCD Critical Point

We report cumulants of the proton multiplicity distribution from dedicated fixed-target Au+Au collisions at sqrt[s_{NN}]=3.0  GeV, measured by the STAR experiment in the kinematic acceptance of rapidity (y) and transverse momentum (p_{T}) within -0.5<y<0 and 0.4<p_{T}<2.0  GeV/c. In the most central 0%-5% collisions, a proton cumulant ratio is measured to be C_{4}/C_{2}=-0.85±0.09 (stat)±0.82 (syst), which is 2σ below the Poisson baseline with respect to both the statistical and systematic uncertainties. The hadronic transport UrQMD model reproduces our C_{4}/C_{2} in the measured acceptance. Compared to higher energy results and the transport model calculations, the suppression in C_{4}/C_{2} is consistent with fluctuations driven by baryon number conservation and indicates an energy regime dominated by hadronic interactions. These data imply that the QCD critical region, if created in heavy-ion collisions, could only exist at energies higher than 3 GeV.

Measurements of _{Λ}^{3}H and _{Λ}^{4}H Lifetimes and Yields in Au+Au Collisions in the High Baryon Density Region

We report precision measurements of hypernuclei _{Λ}^{3}H and _{Λ}^{4}H lifetimes obtained from Au+Au collisions at sqrt[s_{NN}]=3.0  GeV and 7.2 GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider, and the first measurement of _{Λ}^{3}H and _{Λ}^{4}H midrapidity yields in Au+Au collisions at sqrt[s_{NN}]=3.0  GeV. _{Λ}^{3}H and _{Λ}^{4}H, being the two simplest bound states composed of hyperons and nucleons, are cornerstones in the field of hypernuclear physics. Their lifetimes are measured to be 221±15(stat)±19(syst)  ps for _{Λ}^{3}H and 218±6(stat)±13(syst)  ps for _{Λ}^{4}H. The p_{T}-integrated yields of _{Λ}^{3}H and _{Λ}^{4}H are presented in different centrality and rapidity intervals. It is observed that the shape of the rapidity distribution of _{Λ}^{4}H is different for 0%-10% and 10%-50% centrality collisions. Thermal model calculations, using the canonical ensemble for strangeness, describes the _{Λ}^{3}H yield well, while underestimating the _{Λ}^{4}H yield. Transport models, combining baryonic mean-field and coalescence (jam) or utilizing dynamical cluster formation via baryonic interactions (phqmd) for light nuclei and hypernuclei production, approximately describe the measured _{Λ}^{3}H and _{Λ}^{4}H yields. Our measurements provide means to precisely assess our understanding of the fundamental baryonic interactions with strange quarks, which can impact our understanding of more complicated systems involving hyperons, such as the interior of neutron stars or exotic hypernuclei.

[Transoral robotic surgery for treatment of lingual thyroglossal duct cyst]

Objective: To investigate the feasibility, safety and efficacy of transoral robotic surgery (TORS) in the treatment of lingual thyroglossal duct cyst (LTGDC). Methods: The clinical data of 10 patients with LTGDC treated with TORS in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2017 to November 2020 were analyzed retrospectively,including 6 males and 4 females, aged 5-44 years. The cysts were fully exposed, and resection usually started from the cephalic side of lesions. The range of resection was 3 to 5 mm away from the lesions, and partial hyoid bone was removed if necessary. Intra-operative robotic set-up time,operation time and estimated blood loss,and post-operative local bleeding, dyspnea and recovery time for oral intake were analyzed. SPSS 12.0 software was used for statistical analysis. Results: The cysts in all 10 patients were successfully resected by TORS with da Vinci Si surgical system. The mean robotic set-up and exposure time, operation time, estimated intraoperative blood loss and recovery time for oral intake were (15.5±7.1) min, (17.6±7.4) min, (8.9±6.4)ml and (2.3±2.2)days, respectively. No patient required tracheostomy intra-or post-operatively, and no symptoms of airway obstruction, postoperative bleeding, pharyngeal fistula, hoarseness and neurological impairment occurred after operation. The patients were followed up for 5 to 47 months, with median follow-up time of 17 months, and no recurrence was observed. Conclusion: TORS is safe and feasible for resection of LTGDC, with rapid recovery and low recurrence rate.

High quality quasi-parallel x-ray microbeams based on a parabolic capillary

High quality quasi-parallel x-ray microbeams have an appreciable application value in the x-ray diffraction analysis technique, which is currently one of the most significant non-destructive analysis techniques. A simulation of a parabolic single capillary is carried out based on the Monte Carlo simulation toolkit Geant4. The simulation results show that it is feasible to obtain high quality quasi-parallel x-ray microbeams based on a parabolic capillary and a traditional laboratorial x-ray source. We manufacture a parabolic capillary based on the simulation results. The physical parameters of the obtained x-ray beams are characterized by building an x-ray imaging system. The experimental results show that the x-ray beam with submicrometer size and almost zero divergence can be obtained from the traditional laboratorial x-ray source by utilizing a parabolic single capillary as a collimator.

Risk factors for postoperative mortality at 30 days in elderly Chinese patients with hip fractures

Arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery. It is important to improve short-term survival rates by optimizing the respiratory and cardiac function of geriatric patients before they undergo surgery.

INTRODUCTION

This study aims to investigate the 30-day mortality and related risk factors for elderly patients following surgery for hip fractures.

METHODS

This retrospective study examined chart reviews for evaluating associations of gender, age, fracture site, biochemical indicators, pre-surgery comorbidities, number of pre-surgery comorbidities, time to surgery and anesthesia and surgery methods with postoperative 30-day mortality in elderly hip fracture surgery patients.

RESULTS

A total of 1,004 patients were included in the study and 43 (4.3%) patients died within 30 days after surgery. Univariate analysis showed that patients in the non-survival group had a higher mean age, higher leukocyte counts, lower hemoglobin and albumin levels, a higher proportion of arrhythmias, pneumoniae and cardiac insufficiency and number of presurgical comorbidities than the survival group (all P-values < 0.05). Multivariate logistic analysis further confirmed that arrhythmia (OR = 2.033, P = 0.038), pneumonia (OR = 2.246, P = 0.041), cardiac insufficiency (OR = 2.833, P = 0.029), high leukocyte count (OR = 1.139, P = 0.009), and low albumin (OR = 0.925, P = 0.041) were all significant risk factors for mortality 30 days after surgery.

CONCLUSIONS

This study demonstrates that arrhythmia, pneumonia, cardiac insufficiency, a high leukocyte count, and low albumin concentrations were associated with increased 30-day mortality in elderly hip fracture patients after surgery.

Fungal-fungal cocultivation leads to widespread secondary metabolite alteration requiring the partial loss-of-function VeA1 protein

Microbial communication has attracted notable attention as an indicator of microbial interactions that lead to marked alterations of secondary metabolites (SMs) in varied environments. However, the mechanisms responsible for SM regulation are not fully understood, especially in fungal-fungal interactions. Here, cocultivation of an endophytic fungus Epicoccum dendrobii with the model fungus Aspergillus nidulans and several other filamentous fungi triggered widespread alteration of SMs. Multiple silent biosynthetic gene clusters in A. nidulans were activated by transcriptome and metabolome analysis. Unprecedentedly, gene deletion and replacement proved that a partial loss-of-function VeA1 protein, but not VeA, was associated with the widespread SM changes in both A. nidulans and A. fumigatus during cocultivation. VeA1 regulation required the transcription factor SclB and the velvet complex members LaeA and VelB for producing aspernidines as representative formation of SMs in A. nidulans. This study provides new insights into the mechanism that trigger metabolic changes during fungal-fungal interactions.

Odontogenesis by Endocytosis of Peptide Embedding Bioactive Glass Composite

Limited therapeutic options are available for treating deep caries. Those materials with potential of a dual effect to remineralize hard tissue and regenerate defective dentin tissues could be used as a new strategy for deep caries treatment. However, the application of the single component remains a challenge mainly because they lack calcium and phosphorus, are easily degraded, and are difficult to retain in the intricate body fluid environment. Considering the abundant source of calcium and phosphorus as well as the delivery performance of mesoporous bioactive glass (MBG), an amelogenin-derived peptide (QP5), which has a significant role in hard tissue remineralization, was loaded to fabricate a novel composite. After the synthesis of highly ordered MBG using a sol-gel method, the QP5 peptide was loaded increasingly by its extensive porous structure and enhanced electrostatic absorption. When used in an acidic environment, the MBG/QP5 composite presented pH-responsiveness, releasing therapeutic ions and functional peptides in a sequential cascade, and eventually adjusted the pH to a neutral state. The composite was internalized by dental pulp cells through a clathrin-mediated pathway and influenced by cell membrane lipid raft regulation. It could be also transported through the macro-pinocytotic pathway. Compared to the single treatment of peptide QP5 in 48 h, the composite facilitated a higher level of retention of the intracellular peptides. The composite further promoted migration and odontogenesis of dental pulp cells, including the improved activity of alkaline phosphatase, increased formation of mineralized nodules, and upregulated expression of mineralization-related genes compared to using MBG or QP5 alone. The composite further induced the dentin-like layer in a rat pulp capping model. The results suggested that this intelligent material with pH-responsiveness provides a promising alternative treatment method for biomimetic restoration of deep caries.

[Analysis of the associations of chemokine receptors expression on circulating Tfh2 and Th2 cells with sIgE level and disease severity in patients with AR]

Objective: To clarify the chemotactic characteristics of type 2 helper T cells (Th2 cells) and type 2 follicular helper T cells (Tfh2 cells) in peripheral blood of patients with allergic rhinitis (AR), and to explore the associations between the chemokine receptors expression and the levels of antigen-specific IgE (sIgE) and the severity of the disease. Methods: The peripheral blood mononuclear cells of 41 patients with AR (20 males and 21 females, aged 35.0 (24.5, 47.0) years) and 42 healthy controls (24 males and 18 females, aged 35.0 (24.8, 46.5) years) treated in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from April 2017 to February 2018 were isolated. The expressions of chemokine receptor (CCR)2, CCR3, CCR4, CCR5, CCR7, CCR8, chemokine C-X3-C-motif receptor 1 (CX3CR1) and C-X-C motif receptor 4 (CXCR4) in Th2 and Tfh2 cells were explored by fluorescence activated cell sorting (FACs). The relationship between the expression of these chemokine receptors in Th2 cells and Tfh2 cells and the levels of serum sIgE and the scores of visual analogue scale (VAS) was analyzed. Graphpad prism 7.0 software was used for statistical analysis. Results: The significant differences in chemotactic characteristics between Th2 cells and Tfh2 cells in the control group were found: Th2 cells highly expressed chemokine receptors CCR2, CCR3, CCR5, CCR8 and CX3CR1, while Tfh2 cells highly expressed immune cell homing chemokine receptors CCR7 and CXCR4. AR patients, compared to the control, expressed higher levels of CCR2, CCR5 and CX3CR1 on peripheral Th2 cells(all P<0.01). At the same time, the proportion of CCR2⁺and CCR5⁺Th2 cells was positively correlated with VAS score (r value was 0.58 and 0.61, respectively, both P<0.01). In AR patients, higher expression levels of CCR7 on Tfh2 cells were detected (P<0.01), and the proportion of CCR7⁺Tfh2 cells was positively correlated with the level of serum sIgE (r=0.51, P<0.01). Conclusion: The percentage of CCR2⁺ and CCR5⁺ Th2 cells in peripheral of AR patients can reflect the severity of AR to some extent, while the percentage of CCR7⁺ Tfh2 cells is positively correlated with the level of serum sIgE.

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Goerlach U, Grimault C, Bihan ACL, Van Hove P, Asilar E, Beauceron S, Bernet C, Boudoul G, Camen C, Carle A, Chanon N, Contardo D, Depasse P, Mamouni HE, Fay J, Gascon S, Gouzevitch M, Ille B, Jain S, Laktineh IB, Lattaud H, Lesauvage A, Lethuillier M, Mirabito L, Torterotot L, Touquet G, Donckt MV, Viret S, Khvedelidze A, Tsamalaidze Z, Feld L, Klein K, Lipinski M, Meuser D, Pauls A, Preuten M, Rauch MP, Schulz J, Teroerde M, Eliseev D, Erdmann M, Fackeldey P, Fischer B, Ghosh S, Hebbeker T, Hoepfner K, Keller H, Mastrolorenzo L, Merschmeyer M, Meyer A, Mocellin G, Mondal S, Mukherjee S, Noll D, Novak A, Pook T, Pozdnyakov A, Rath Y, Reithler H, Roemer J, Schmidt A, Schuler SC, Sharma A, Wiedenbeck S, Zaleski S, Dziwok C, Flügge G, Ahmad WH, Hlushchenko O, Kress T, Nowack A, Pistone C, Pooth O, Roy D, Sert H, Stahl A, Ziemons T, Petersen HA, Martin MA, Asmuss P, Babounikau I, Baxter S, Behnke O, Martínez AB, Anuar AAB, Borras K, Botta V, Brunner D, Campbell A, Cardini A, Connor P, Rodríguez SC, Danilov V, De Wit A, Defranchis MM, Didukh L, Damiani DD, Eckerlin G, Eckstein D, Eichhorn T, Banos LIE, Gallo E, Geiser A, Giraldi A, Grohsjean A, Guthoff M, Harb A, Jafari A, Jomhari NZ, Jung H, Kasem A, Kasemann M, Kaveh H, Kleinwort C, Knolle J, Krücker D, Lange W, Lenz T, Lidrych J, Lipka K, Lohmann W, Mankel R, Melzer-Pellmann IA, Metwally J, Meyer AB, Meyer M, Missiroli M, Mnich J, Mussgiller A, Myronenko V, Otarid Y, Adán DP, Pflitsch SK, Pitzl D, Raspereza A, Saggio A, Saibel A, Savitskyi M, Scheurer V, Schwanenberger C, Singh A, Ricardo RES, Tonon N, Turkot O, Vagnerini A, Van De Klundert M, Walsh R, Walter D, Wen Y, Wichmann K, Wissing C, Wuchterl S, Zenaiev O, Zlebcik R, Aggleton R, Bein S, Benato L, Benecke A, De Leo K, Dreyer T, Ebrahimi A, Eich M, Feindt F, Fröhlich A, Garbers C, Garutti E, Gunnellini P, Haller J, Hinzmann A, Karavdina A, Kasieczka G, Klanner R, Kogler R, Kutzner V, Lange J, Lange T, Malara A, Niemeyer CEN, Nigamova A, Rodriguez KJP, Rieger O, Schleper P, Schumann S, Schwandt J, Schwarz D, Sonneveld J, Stadie H, Steinbrück G, Vormwald B, Zoi I, Bechtel J, Berger T, Butz E, Caspart R, Chwalek T, De Boer W, Dierlamm A, Droll A, Morabit KE, Faltermann N, Flöh K, Giffels M, Gottmann A, Hartmann F, Heidecker C, Husemann U, Iqbal MA, Katkov I, Keicher P, Koppenhöfer R, Maier S, Metzler M, Mitra S, Müller D, Müller T, Musich M, Quast G, Rabbertz K, Rauser J, Savoiu D, Schäfer D, Schnepf M, Schröder M, Seith D, Shvetsov I, Simonis HJ, Ulrich R, Wassmer M, Weber M, Wolf R, Wozniewski S, Anagnostou G, Asenov P, Daskalakis G, Geralis T, Kyriakis A, Loukas D, Paspalaki G, Stakia A, Diamantopoulou M, Karasavvas D, Karathanasis G, Kontaxakis P, Koraka CK, Manousakis-katsikakis A, Panagiotou A, Papavergou I, Saoulidou N, Theofilatos K, Vellidis K, Vourliotis E, Bakas G, Kousouris K, Papakrivopoulos I, Tsipolitis G, Zacharopoulou A, Evangelou I, Foudas C, Gianneios P, Katsoulis P, Kokkas P, Manitara K, Manthos N, Papadopoulos I, Strologas J, Bartók M, Csanad M, Gadallah MMA, Lökös S, Major P, Mandal K, Mehta A, Pasztor G, Surányi O, Veres GI, Bencze G, Hajdu C, Horvath D, Sikler F, Veszpremi V, Vesztergombi G, Czellar S, Karancsi J, Molnar J, Szillasi Z, Teyssier D, Raics P, Trocsanyi ZL, Ujvari B, Csorgo T, Nemes F, Novak T, Choudhury S, Komaragiri JR, Kumar D, Panwar L, Tiwari PC, Bahinipati S, Dash D, Kar C, Mal P, Mishra T, Bindhu VKMN, Nayak A, Sahoo DK, Sur N, Swain SK, Bansal S, Beri SB, Bhatnagar V, Chaudhary G, Chauhan S, Dhingra N, Gupta R, Kaur A, Kaur S, Kumari P, Meena M, Sandeep K, Sharma S, Singh JB, Virdi AK, Ahmed A, Bhardwaj A, Choudhary BC, Garg RB, Gola M, Keshri S, Kumar A, Naimuddin M, Priyanka P, Ranjan K, Shah A, Bharti M, Bhattacharya R, Bhattacharya S, Bhowmik D, Dutta S, Ghosh S, Gomber B, Maity M, Nandan S, Palit P, Rout PK, Saha G, Sahu B, Sarkar S, Sharan M, Singh B, Thakur S, Behera PK, Behera SC, Kalbhor P, Muhammad A, Pradhan R, Pujahari PR, Sharma A, Sikdar AK, Dutta D, Kumar V, Naskar K, Netrakanti PK, Pant LM, Shukla P, Aziz T, Bhat MA, Dugad S, Verma RK, Mohanty GB, Sarkar U, Banerjee S, Bhattacharya S, Chatterjee S, Chudasama R, Guchait M, Karmakar S, Kumar S, Majumder G, Mazumdar K, Mukherjee S, Roy D, Dube S, Kansal B, Pandey S, Rane A, Rastogi A, Sharma S, Bakhshiansohi H, Zeinali M, Chenarani S, Etesami SM, Khakzad M, Najafabadi MM, Felcini M, Grunewald M, Abbrescia M, Aly R, Aruta C, Colaleo A, Creanza D, De Filippis N, De Palma M, Florio AD, Pilato AD, Elmetenawee W, Fiore L, Gelmi A, Gul M, Iaselli G, Ince M, Lezki S, Maggi G, Maggi M, Margjeka I, Mastrapasqua V, Merlin JA, My S, Nuzzo S, Pompili A, Pugliese G, Ranieri A, Selvaggi G, Silvestris L, Simone FM, Venditti R, Verwilligen P, Abbiendi G, Battilana C, Bonacorsi D, Borgonovi L, Braibant-Giacomelli S, Campanini R, Capiluppi P, Castro A, Cavallo FR, Ciocca C, Cuffiani M, Dallavalle GM, Diotalevi T, Fabbri F, Fanfani A, Fontanesi E, Giacomelli P, Giommi L, Grandi C, Guiducci L, Iemmi F, Meo SL, Marcellini S, Masetti G, Navarria FL, Perrotta A, Primavera F, Rossi AM, Rovelli T, Siroli GP, Tosi N, Albergo S, Costa S, Mattia AD, Potenza R, Tricomi A, Tuve C, Barbagli G, Cassese A, Ceccarelli R, Ciulli V, Civinini C, D’Alessandro R, Fiori F, Focardi E, Latino G, Lenzi P, Lizzo M, Meschini M, Paoletti S, Seidita R, Sguazzoni G, Viliani L, Benussi L, Bianco S, Piccolo D, Bozzo M, Ferro F, Mulargia R, Robutti E, Tosi S, Benaglia A, Beschi A, Brivio F, Cetorelli F, Ciriolo V, De Guio F, Dinardo ME, Dini P, Gennai S, Ghezzi A, Govoni P, Guzzi L, Malberti M, Malvezzi S, Massironi A, Menasce D, Monti F, Moroni L, Paganoni M, Pedrini D, Ragazzi S, de Fatis TT, Valsecchi D, Zuolo D, Buontempo S, Cavallo N, De Iorio A, Fabozzi F, Fienga F, Iorio AOM, Lista L, Meola S, Paolucci P, Rossi B, Sciacca C, Voevodina E, Azzi P, Bacchetta N, Bisello D, Bortignon P, Bragagnolo A, Carlin R, Checchia P, De Castro Manzano P, Dorigo T, Gasparini F, Gasparini U, Hoh SY, Layer L, Margoni M, Meneguzzo AT, Presilla M, Ronchese P, Rossin R, Simonetto F, Strong G, Tosi M, YARAR H, Zanetti M, Zotto P, Zucchetta A, Zumerle G, Aimè C, Braghieri A, Calzaferri S, Fiorina D, Montagna P, Ratti SP, Re V, Ressegotti M, Riccardi C, Salvini P, Vai I, Vitulo P, Biasini M, Bilei GM, Ciangottini D, Fanò L, Lariccia P, Mantovani G, Mariani V, Menichelli M, Moscatelli F, Piccinelli A, Rossi A, Santocchia A, Spiga D, Tedeschi T, Androsov K, Azzurri P, Bagliesi G, Bertacchi V, Bianchini L, Boccali T, Castaldi R, Ciocci MA, Dell’Orso R, Domenico MRD, Donato S, Giannini L, Giassi A, Grippo MT, Ligabue F, Manca E, Mandorli G, Messineo A, Palla F, Ramirez-Sanchez G, Rizzi A, Rolandi G, Chowdhury SR, Scribano A, Shafiei N, Spagnolo P, Tenchini R, Tonelli G, Turini N, Venturi A, Verdini PG, Cavallari F, Cipriani M, Re DD, Marco ED, Diemoz M, Longo E, Meridiani P, Organtini G, Pandolfi F, Paramatti R, Quaranta C, Rahatlou S, Rovelli C, Santanastasio F, Soffi L, Tramontano R, Amapane N, Arcidiacono R, Argiro S, Arneodo M, Bartosik N, Bellan R, Bellora A, Antequera JB, Biino C, Cappati A, Cartiglia N, Cometti S, Costa M, Covarelli R, Demaria N, Kiani B, Legger F, Mariotti C, Maselli S, Migliore E, Monaco V, Monteil E, Monteno M, Obertino MM, Ortona G, Pacher L, Pastrone N, Pelliccioni M, Angioni GLP, Ruspa M, Salvatico R, Siviero F, Sola V, Solano A, Soldi D, Staiano A, Tornago M, Trocino D, Belforte S, Candelise V, Casarsa M, Cossutti F, Da Rold A, Ricca GD, Vazzoler F, Dogra S, Huh C, Kim B, Kim DH, Kim GN, Lee J, Lee SW, Moon CS, Oh YD, Pak SI, Radburn-Smith BC, Sekmen S, Yang YC, Kim H, Moon DH, Francois B, Kim TJ, Park J, Cho S, Choi S, Go Y, Ha S, Hong B, Lee K, Lee KS, Lim J, Park J, Park SK, Yoo J, Goh J, Gurtu A, Kim HS, Kim Y, Almond J, Bhyun JH, Choi J, Jeon S, Kim J, Kim JS, Ko S, Kwon H, Lee H, Lee K, Lee S, Nam K, Oh BH, Oh M, Oh SB, Seo H, Yang UK, Yoon I, Jeon D, Kim JH, Ko B, Lee JSH, Park IC, Roh Y, Song D, Watson IJ, Yoo HD, Choi Y, Hwang C, Jeong Y, Lee H, Lee Y, Yu I, Maghrbi Y, Veckalns V, Juodagalvis A, Rinkevicius A, Tamulaitis G, Vaitkevicius A, Abdullah WATW, Yusli MN, Zolkapli Z, Benitez JF, Hernandez AC, Quijada JAM, Palomo LV, Ayala G, Castilla-Valdez H, De La Cruz-Burelo E, La Cruz IHD, Lopez-Fernandez R, Herrera CAM, Navarro DAP, Sanchez-Hernandez A, Moreno SC, Barrera CO, Ramirez-Garcia M, Valencia FV, Eysermans J, Pedraza I, Ibarguen HAS, Estrada CU, Pineda AM, Mijuskovic J, Raicevic N, Krofcheck D, Bheesette S, Butler PH, Ahmad A, Asghar MI, Awais A, Awan MIM, Hoorani HR, Khan WA, Shah MA, Shoaib M, Waqas M, Avati V, Grzanka L, Malawski M, Bialkowska H, Bluj M, Boimska B, Frueboes T, Górski M, Kazana M, Szleper M, Traczyk P, Zalewski P, Bunkowski K, Doroba K, Kalinowski A, Konecki M, Krolikowski J, Walczak M, Araujo M, Bargassa P, Bastos D, Boletti A, Faccioli P, Gallinaro M, Hollar J, Leonardo N, Niknejad T, Seixas J, Shchelina K, Toldaiev O, Varela J, Baginyan A, Bunin P, Ershov Y, Golunov A, Golutvin I, Gorbounov N, Gorbunov I, Kamenev A, Karjavine V, Lanev A, Malakhov A, Matveev V, Palichik V, Perelygin V, Savina M, Shalaev V, Shmatov S, Teryaev O, Voytishin N, Yuldashev BS, Zarubin A, Zhizhin I, Gavrilov G, Golovtcov V, Ivanov Y, Kim V, Kuznetsova E, Murzin V, Oreshkin V, Smirnov I, Sosnov D, Sulimov V, Uvarov L, Volkov S, Vorobyev A, Andreev Y, Dermenev A, Gninenko S, Golubev N, Karneyeu A, Kirsanov M, Krasnikov N, Pashenkov A, Pivovarov G, Tlisov D, Toropin A, Epshteyn V, Gavrilov V, Lychkovskaya N, Nikitenko A, Popov V, Safronov G, Spiridonov A, Stepennov A, Toms M, Vlasov E, Zhokin A, Aushev T, Chistov R, Danilov M, Oskin A, Parygin P, Polikarpov S, Andreev V, Azarkin M, Dremin I, Kirakosyan M, Terkulov A, Belyaev A, Boos E, Bunichev V, Dubinin M, Dudko L, Gribushin A, Klyukhin V, Kodolova O, Lokhtin I, Obraztsov S, Perfilov M, Petrushanko S, Savrin V, Blinov V, Dimova T, Kardapoltsev L, Ovtin I, Skovpen Y, Azhgirey I, Bayshev I, Kachanov V, Kalinin A, Konstantinov D, Petrov V, Ryutin R, Sobol A, 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Olaiya E, Petyt D, Reis T, Schuh T, Shepherd-Themistocleous CH, Thea A, Tomalin IR, Williams T, Bainbridge R, Bloch P, Bonomally S, Borg J, Breeze S, Buchmuller O, Bundock A, Cepaitis V, Chahal GS, Colling D, Dauncey P, Davies G, Negra MD, Fedi G, Hall G, Iles G, Langford J, Lyons L, Magnan AM, Malik S, Martelli A, Milosevic V, Nash J, Palladino V, Pesaresi M, Raymond DM, Richards A, Rose A, Scott E, Seez C, Shtipliyski A, Stoye M, Tapper A, Uchida K, Virdee T, Wardle N, Webb SN, Winterbottom D, Zecchinelli AG, Cole JE, Hobson PR, Khan A, Kyberd P, Mackay CK, Reid ID, Teodorescu L, Zahid S, Abdullin S, Brinkerhoff A, Call K, Caraway B, Dittmann J, Hatakeyama K, Kanuganti AR, Madrid C, McMaster B, Pastika N, Sawant S, Smith C, Wilson J, Bartek R, Dominguez A, Uniyal R, Hernandez AMV, Buccilli A, Charaf O, Cooper SI, Gleyzer SV, Henderson C, Rumerio P, West C, Akpinar A, Albert A, Arcaro D, Cosby C, Demiragli Z, Gastler D, Rohlf J, Salyer K, Sperka D, Spitzbart D, Suarez I, Yuan S, Zou D, Benelli G, Burkle B, Coubez X, Cutts D, Duh YT, Hadley M, Heintz U, Hogan JM, Kwok KHM, Laird E, Landsberg G, Lau KT, Lee J, Narain M, Sagir S, Syarif R, Usai E, Wong WY, Yu D, Zhang W, Band R, Brainerd C, Breedon R, De La BarcaSanchez MC, Chertok M, Conway J, Conway R, Cox PT, Erbacher R, Flores C, Funk G, Jensen F, Ko W, Kukral O, Lander R, Mulhearn M, Pellett D, Pilot J, Shi M, Taylor D, Tos K, Tripathi M, Yao Y, Zhang F, Bachtis M, Cousins R, Dasgupta A, Hamilton D, Hauser J, Ignatenko M, Lam T, Mccoll N, Nash WA, Regnard S, Saltzberg D, Schnaible C, Stone B, Valuev V, Burt K, Chen Y, Clare R, Gary JW, Hanson G, Karapostoli G, Long OR, Manganelli N, Negrete MO, Paneva MI, Si W, Wimpenny S, Zhang Y, Branson JG, Chang P, Cittolin S, Cooperstein S, Deelen N, Duarte J, Gerosa R, Gilbert D, Krutelyov V, Letts J, Masciovecchio M, May S, Padhi S, Pieri M, Sharma V, Tadel M, Würthwein F, Yagil A, Amin N, Campagnari C, Citron M, Dorsett A, Dutta V, Incandela J, Marsh B, Mei H, Ovcharova A, Qu H, Quinnan M, Richman J, Sarica U, Stuart D, Wang S, Bornheim A, Cerri O, Dutta I, Lawhorn JM, Lu N, Mao J, Newman H, Ngadiuba J, Nguyen TQ, Pata J, Spiropulu M, Vlimant JR, Wang C, Xie S, Zhang Z, Zhu RY, Alison J, Andrews MB, Ferguson T, Mudholkar T, Paulini M, Sun M, Vorobiev I, Cumalat JP, Ford WT, MacDonald E, Mulholland T, Patel R, Perloff A, Stenson K, Ulmer KA, Wagner SR, Alexander J, Cheng Y, Chu J, Cranshaw DJ, Datta A, Frankenthal A, Mcdermott K, Monroy J, Patterson JR, Quach D, Ryd A, Sun W, Tan SM, Tao Z, Thom J, Wittich P, Zientek M, Albrow M, Alyari M, Apollinari G, Apresyan A, Apyan A, Banerjee S, Bauerdick LAT, Beretvas A, Berry D, Berryhill J, Bhat PC, Burkett K, Butler JN, Canepa A, Cerati GB, Cheung HWK, Chlebana F, Cremonesi M, Elvira VD, Freeman J, Gecse Z, Gottschalk E, Gray L, Green D, Grünendahl S, Gutsche O, Harris RM, Hasegawa S, Heller R, Herwig TC, Hirschauer J, Jayatilaka B, Jindariani S, Johnson M, Joshi U, Klabbers P, Klijnsma T, Klima B, Kortelainen MJ, Lammel S, Lincoln D, Lipton R, Liu M, Liu T, Lykken J, Maeshima K, Mason D, McBride P, Merkel P, Mrenna S, Nahn S, O’Dell V, Papadimitriou V, Pedro K, Pena C, Prokofyev O, Ravera F, Hall AR, Ristori L, Schneider B, Sexton-Kennedy E, Smith N, Soha A, Spalding WJ, Spiegel L, Stoynev S, Strait J, Taylor L, Tkaczyk S, Tran NV, Uplegger L, Vaandering EW, Weber HA, Woodard A, Acosta D, Avery P, Bourilkov D, Cadamuro L, Cherepanov V, Errico F, Field RD, Guerrero D, Joshi BM, Kim M, Konigsberg J, Korytov A, Lo KH, Matchev K, Menendez N, Mitselmakher G, Rosenzweig D, Shi K, Sturdy J, Wang J, Wang S, Zuo X, Adams T, Askew A, Diaz D, Habibullah R, Hagopian S, Hagopian V, Johnson KF, Khurana R, Kolberg T, Martinez G, Prosper H, Schiber C, Yohay R, Zhang J, Baarmand MM, Butalla S, Elkafrawy T, Hohlmann M, Noonan D, Rahmani M, Saunders M, Yumiceva F, Adams MR, Apanasevich L, Gonzalez HB, Cavanaugh R, Chen X, Dittmer S, Evdokimov O, Gerber CE, Hangal DA, Hofman DJ, Mills C, Oh G, Roy T, Tonjes MB, Varelas N, Viinikainen J, Wang X, Wu Z, Ye Z, Alhusseini M, Dilsiz K, Durgut S, Gandrajula RP, Haytmyradov M, Khristenko V, Köseyan OK, Merlo JP, Mestvirishvili A, Moeller A, Nachtman J, Ogul H, Onel Y, Ozok F, Penzo A, Snyder C, Tiras E, Wetzel J, Amram O, Blumenfeld B, Corcodilos L, Eminizer M, Gritsan AV, Kyriacou S, Maksimovic P, Mantilla C, Roskes J, Swartz M, Vámi TÁ, Barrera CB, Baringer P, Bean A, Bylinkin A, Isidori T, Khalil S, King J, Krintiras G, Kropivnitskaya A, Lindsey C, Minafra N, Murray M, Rogan C, Royon C, Sanders S, Schmitz E, Takaki JDT, Wang Q, Williams J, Wilson G, Duric S, Ivanov A, Kaadze K, Kim D, Maravin Y, Mitchell T, Modak A, Mohammadi A, Rebassoo F, Wright D, Adams E, Baden A, Baron O, Belloni A, Eno SC, Feng Y, Hadley NJ, Jabeen S, Jeng GY, Kellogg RG, Koeth T, Mignerey AC, Nabili S, Seidel M, Skuja A, Tonwar SC, Wang L, Wong K, Abercrombie D, Allen B, Bi R, Brandt S, Busza W, Cali IA, Chen Y, D’Alfonso M, Ceballos GG, Goncharov M, Harris P, Hsu D, Hu M, Klute M, Kovalskyi D, Krupa J, Lee YJ, Luckey PD, Maier B, Marini AC, Mcginn C, Mironov C, Narayanan S, Niu X, Paus C, Rankin D, Roland C, Roland G, Shi Z, Stephans GSF, Sumorok K, Tatar K, Velicanu D, Wang J, Wang TW, Wang Z, Wyslouch B, Chatterjee RM, Evans A, Hansen P, Hiltbrand J, Jain S, Krohn M, Kubota Y, Lesko Z, Mans J, Revering M, Rusack R, Saradhy R, Schroeder N, Strobbe N, Wadud MA, Acosta JG, Oliveros S, Bloom K, Chauhan S, Claes DR, Fangmeier C, Finco L, Golf F, Fernández JRG, Kravchenko I, Siado JE, Snow GR, Tabb W, Yan F, Agarwal G, Bandyopadhyay H, Harrington C, Hay L, Iashvili I, Kharchilava A, McLean C, Nguyen D, Pekkanen J, Rappoccio S, Roozbahani B, Alverson G, Barberis E, Freer C, Haddad Y, Hortiangtham A, Li J, Madigan G, Marzocchi B, Morse DM, Nguyen V, Orimoto T, Parker A, Skinnari L, Tishelman-Charny A, Wamorkar T, Wang B, Wisecarver A, Wood D, Bhattacharya S, Bueghly J, Chen Z, Gilbert A, Gunter T, Hahn KA, Odell N, Schmitt MH, Sung K, Velasco M, Bucci R, Dev N, Goldouzian R, Hildreth M, Anampa KH, Jessop C, Karmgard DJ, Lannon K, Loukas N, Marinelli N, Mcalister I, Meng F, Mohrman K, Musienko Y, Ruchti R, Siddireddy P, Taroni S, Wayne M, Wightman A, Wolf M, Zygala L, Alimena J, Bylsma B, Cardwell B, Durkin LS, Francis B, Hill C, Lefeld A, Winer BL, Yates BR, Das P, Dezoort G, Elmer P, Greenberg B, Haubrich N, Higginbotham S, Kalogeropoulos A, Kopp G, Kwan S, Lange D, Lucchini MT, Luo J, Marlow D, Mei K, Ojalvo I, Olsen J, Palmer C, Piroué P, Stickland D, Tully C, Malik S, Norberg S, Barnes VE, Chawla R, Das S, Gutay L, Jones M, Jung AW, Negro G, Neumeister N, Peng CC, Piperov S, Purohit A, Qiu H, Schulte JF, Stojanovic M, Trevisani N, Wang F, Wildridge A, Xiao R, Xie W, Cheng T, Dolen J, Parashar N, Baty A, Dildick S, Ecklund KM, Freed S, Geurts FJM, Kilpatrick M, Kumar A, Li W, Padley BP, Redjimi R, Roberts J, Rorie J, Shi W, Leiton AGS, Bodek A, de Barbaro P, Demina R, Dulemba JL, Fallon C, Ferbel T, Galanti M, Garcia-Bellido A, Hindrichs O, Khukhunaishvili A, Ranken E, Taus R, Chiarito B, Chou JP, Gandrakota A, Gershtein Y, Halkiadakis E, Hart A, Heindl M, Hughes E, Kaplan S, Karacheban O, Laflotte I, Lath A, Montalvo R, Nash K, Osherson M, Salur S, Schnetzer S, Somalwar S, Stone R, Thayil SA, Thomas S, Wang H, Acharya H, Delannoy AG, Spanier S, Bouhali O, Dalchenko M, Delgado A, Eusebi R, Gilmore J, Huang T, Kamon T, Kim H, Luo S, Malhotra S, Mueller R, Overton D, Perniè L, Rathjens D, Safonov A, Akchurin N, Damgov J, Hegde V, Kunori S, Lamichhane K, Lee SW, Mengke T, Muthumuni S, Peltola T, Undleeb S, Volobouev I, Wang Z, Whitbeck A, Appelt E, Greene S, Gurrola A, Janjam R, Johns W, Maguire C, Melo A, Ni H, Padeken K, Romeo F, Sheldon P, Tuo S, Velkovska J, Arenton MW, Cox B, Cummings G, Hakala J, Hirosky R, Joyce M, Ledovskoy A, Li A, Neu C, Tannenwald B, Wang Y, Wolfe E, Xia F, Karchin PE, Poudyal N, Thapa P, Black K, Bose T, Buchanan J, Caillol C, Dasu S, De Bruyn I, Everaerts P, Galloni C, He H, Herndon M, Hervé A, Hussain U, Lanaro A, Loeliger A, Loveless R, Sreekala JM, Mallampalli A, Pinna D, Savin A, Shang V, Sharma V, Smith WH, Teague D, Trembath-reichert S, Vetens W. Search for low-mass dilepton resonances in Higgs boson decays to four-lepton final states in proton-proton collisions at s = 13 TeV

A search for low-mass dilepton resonances in Higgs boson decays is conducted in the four-lepton final state. The decay is assumed to proceed via a pair of beyond the standard model particles, or one such particle and a Z boson. The search uses proton-proton collision data collected with the CMS detector at the CERN LHC, corresponding to an integrated luminosity of 137 fb - 1 , at a center-of-mass energy s = 13 TeV . No significant deviation from the standard model expectation is observed. Upper limits at 95% confidence level are set on model-independent Higgs boson decay branching fractions. Additionally, limits on dark photon and axion-like particle production, based on two specific models, are reported.

A nomogram for short-term recurrent pain after percutaneous vertebroplasty for osteoporotic vertebral compression fractures

In clinical practice, it was found that some patients experienced short-term recurrent pain (SRP) in the original site after PVP treatment. This study was designed to develop and validate a nomogram for predicting the potential risks of SRP after PVP, which may help to provide a painless postoperative experience and personalized health management for patients with OVCF.

INTRODUCTION

With the aging of China's population, the incidence of osteoporotic vertebral compression fractures (OVCF) has increased significantly. Percutaneous vertebroplasty (PVP) has been widely accepted due to its minimally invasive, rapid, and effective characteristics. However, it has been found that some patients have short-term recurrent pain (SRP) in the original site after surgery in practical clinical work.

METHODS

We retrospectively reviewed the clinical data of OVCF patients who were treated with PVP in our center from January 1st, 2019, to December 30th, 2020. A total of 296 patients were enrolled in the study cohort, and patients were randomly divided into the training set (70%) and validation set (30%). Univariate and multivariate logistic regression analyses were used to determine the risk factors of SRP, and a nomogram predictive model was established accordingly. The model was evaluated by calibration curve, receiver operation characteristic (ROC) curve, and decision curve analysis (DCA).

RESULTS

Among the 296 patients, 83 (27.85%) patients experienced SRP after surgery. The independent risk factors included fracture segments (OR: 14.148, 95%CI: 1.532-130.661; p < 0.019), number of surgical vertebrae (OR: 7.896, 95%CI: 3.007-20.729; p < 0.001; (OR: 12.563, 95%CI: 2.223-70.993; p = 0.004), and smoking (OR: 3.833, 95%CI: 1.219-12.052; p = 0.022). The AUC of the prediction model was 0.819 in the training set and 0.794 in the validation set. The calibration curve and DCA indicated the good performance of this nomogram.

CONCLUSION

The nomogram prediction model had satisfactory accuracy and clinical utility, which may benefit clinical decision-making for the treatment of OVCF and strengthen patient education.

Reference data and calculators for second-generation HR-pQCT measures of the radius and tibia at anatomically standardized regions in White adults

High-resolution peripheral quantitative computed tomography (HR-pQCT) is a powerful tool to assess bone health. To determine how an individual's or population of interest's HR-pQCT outcomes compare to expected, reference data are required. This study provides reference data for HR-pQCT measures acquired in a population of White adults.

PURPOSE

To provide age- and sex-specific reference data for high-resolution peripheral quantitative computed tomography (HR-pQCT) measures of the distal and diaphyseal radius and tibia acquired using a second-generation scanner and percent-of-length offsets proximal from the end of the bone.

METHODS

Data were acquired in White adults (aged 18-80 years) living in the Midwest region of the USA. HR-pQCT scans were performed at the 4% distal radius, 30% diaphyseal radius, 7.3% distal tibia, and 30% diaphyseal tibia. Centile curves were fit to the data using the LMS approach.

RESULTS

Scans of 867 females and 317 males were included. The fitted centile curves reveal HR-pQCT differences between ages, sexes, and sites. They also indicate differences when compared to data obtained by others using fixed length offsets. Excel-based calculators based on the current data were developed and are provided to enable computation of subject-specific percentiles, z-scores, and t-scores and to plot an individual's outcomes on the fitted curves. In addition, regression equations are provided to convert estimated failure load acquired with the conventional criteria utilized with first-generation scanners and those specifically developed for second-generation scanners.

CONCLUSION

The current study provides unique data and resources. The combination of the reference data and calculators provide clinicians and investigators an ability to assess HR-pQCT outcomes in an individual or population of interest, when using the described scanning and analysis procedure. Ultimately, the expectation is these data will be expanded over time so the wealth of information HR-pQCT provides becomes increasingly interpretable and utilized.

Isotopic and geochemical data from Barry Lake, Canada: A 900-year record of environmental change

The data reported here consist of oxygen and hydrogen isotope compositions for 145 modern water samples, and geochemical measurements for gravity cores of sediment, all collected from Barry Lake, a small kettle lake located in Ontario, Canada. The geochemical measurements for the sediment organic matter include organic carbon and total nitrogen isotope compositions, organic carbon and total nitrogen contents and chlorophyll a content. The carbon and oxygen isotope compositions of marl contained in these sediments are also reported, along with the calcite and quartz contents of the sediment sample. Mass accumulation rates of total organic carbon, total nitrogen, chlorophyll a and calcite are reported. Dating of these sediments shows that they span ∼900 years. The stable isotope compositions of the modern waters and marl are useful to researchers studying how effective moisture (the net of water inputs vs outputs) changed in southern Ontario across the last ∼900 years. Proxies derived from the organic fraction of the lake sediments will be of interest to researchers of small Ontario lakes seeking to contextualize recent increases in primary production related to eutrophication. A discussion of these data, and a comparison of these data to other cores in the Great Lakes Region, is available in “A 900-year record of effective moisture in the Great Lakes Region” (Doyle et al., 2021).

Probing the Gluonic Structure of the Deuteron with J/ψ Photoproduction in d+Au Ultraperipheral Collisions

Understanding gluon density distributions and how they are modified in nuclei are among the most important goals in nuclear physics. In recent years, diffractive vector meson production measured in ultraperipheral collisions (UPCs) at heavy-ion colliders has provided a new tool for probing the gluon density. In this Letter, we report the first measurement of J/ψ photoproduction off the deuteron in UPCs at the center-of-mass energy sqrt[s_{NN}]=200  GeV in d+Au collisions. The differential cross section as a function of momentum transfer -t is measured. In addition, data with a neutron tagged in the deuteron-going zero-degree calorimeter is investigated for the first time, which is found to be consistent with the expectation of incoherent diffractive scattering at low momentum transfer. Theoretical predictions based on the color glass condensate saturation model and the leading twist approximation nuclear shadowing model are compared with the data quantitatively. A better agreement with the saturation model has been observed. With the current measurement, the results are found to be directly sensitive to the gluon density distribution of the deuteron and the deuteron breakup process, which provides insights into the nuclear gluonic structure.