Mediating pathways that link adverse childhood experiences with cardiovascular disease

OBJECTIVES

There is uncertainty about which factors mediate the association between adverse childhood experiences (ACEs) and cardiovascular disease (CVD). This could inform secondary prevention targets.

STUDY DESIGN

Mediation analysis of a prospective cohort study.

METHODS

English Longitudinal Study of Ageing (ELSA) wave 3 data (2006/7) were used to measure retrospective exposure to 12 individual ACEs and waves 2 to 4 (2004/5 to 2008/9) data to measure current exposure to potential mediators [smoking, physical activity, alcohol consumption, body mass index, depression, and C-reactive protein (CRP)]. Waves 4 to 9 ELSA data (2008/9 to 2018/19) were used to measure incident CVD. Cumulative ACE exposure was categorised into experiencing 0, 1 to 3, or ≥4 individual ACEs. Associations were tested between ACE categories, potential mediators, and incident CVD, to inform which variables were analysed in causal mediation models.

RESULTS

The analytical cohort consisted of 4547 participants (56% women), with a mean age of 64 years (standard deviation = 9 years). At least one ACE had been experienced by 45% of the cohort, and 24% developed incident CVD over a median follow-up period of 9.7 years (interquartile range: 5.3-11.4 years). After adjusting for potential confounders, experiencing ≥4 ACEs compared with none was associated with incident CVD [odds ratio (OR): 1.55; 95% confidence interval (CI): 1.10, 2.17], and the association of one to three ACEs compared with none was non-significant (OR: 1.08; 95% CI: 0.93, 1.24). There were two statistically significant mediators of the association between ≥4 ACEs and incident CVD: CRP and depression, which accounted for 10.7% and 10.8% of the association, respectively.

CONCLUSIONS

Inflammation and depression partially mediated the association between ACEs and CVD. Targeting these factors may reduce the future incidence of CVD.

The adjunct use of descending neurogenic-evoked potentials when transcranial motor-evoked potentials degrade into warning criteria in pediatric spinal deformity surgery: minimizing false-positive events

PURPOSE

This studies objective was to evaluate the utility of descending neurogenic-evoked potentials (DNEPs) in the setting of transcranial motor-evoked potentials (TCeMEPs) degradation into warning criteria during pediatric spinal deformity surgery.

METHODS

An institutional spinal cord monitoring database was queried to identify all primary and revision pediatric spinal deformity cases, < / = 21 years of age performed from 1/2006 to 12/2021, in which TCeMEPs were the primary motor tract assessment modality which degraded into warning criteria, with subsequent initiation of adjunct DNEPs.

RESULTS

Fourteen surgical cases (0.42%; 3351 total cases) in fourteen patients met inclusion criteria. Mean age was 13.2 years (7.5-21.3).

DIAGNOSES

syndromic (n = 7), kyphosis (n = 3), congenital (n = 2), and idiopathic (n = 2). Three-column osteotomies (3CO)were done in eight patients. TCeMEPs degraded into warning criteria during screw placement (n = 7), 3CO performance/closure (n = 4), or deformity correction (n = 3). DNEPs were present in all cases of warning-criteria TCeMEPs and one case had degradation of DNEPs. Intraoperative Stagnara wake-up tests were performed in only 2/14 cases, with one transient new neurologic deficit (NND). In this specific scenario, DNEPs sensitivity was 50%, specificity 100%, positive predictive value 100%, and negative predictive value 92% to detect aNND.

CONCLUSION

DNEPs were useful in assessing spinal cord function in the setting of TCeMEP data degradation in complex pediatric deformity surgeries. DNEPs demonstrated a higher specificity and positive predictive value in this clinical setting than TCeMEPs when assessing long-term neurologic function after surgery. Based on this small cohort, DNEPs appear to be a useful adjunct modality to TCeMEPs, in this challenging clinical scenario.

Exploring views of members of the public and policymakers on the acceptability of population level dietary and active-travel policies: a qualitative study

BACKGROUND

There is limited evidence on what shapes the acceptability of population level dietary and active-travel policies in England. This information would be useful in the decision-making process about which policies should be implemented and how to increase their effectiveness and sustainability. To fill this gap, we explored public and policymakers' views about factors that influence public acceptability of dietary and active-travel policies and how to increase public acceptability for these policies.

METHODS

We conducted online, semi-structured interviews with 20 members of the public and 20 policymakers in England. A purposive sampling frame was used to recruit members of the public via a recruitment agency, based on age, sex, socioeconomic status and ethnicity. Policymakers were recruited from existing contacts within our research collaborations and via snowball sampling. We explored different dietary and active-travel policies that varied in their scope and focus. Interviews were transcribed verbatim and analysed using thematic reflexive analysis with both inductive and deductive coding.

RESULTS

We identified four themes that informed public acceptability of dietary and active-travel policies: (1) perceived policy effectiveness, i.e., policies that included believable mechanisms of action, addressed valued co-benefits and barriers to engage in the behaviour; (2) perceived policy fairness, i.e., policies that provided everyone with an opportunity to benefit (mentioned only by the public), equally considered the needs of various population subgroups and rewarded 'healthy' behaviours rather than only penalising 'unhealthy' behaviours; (3) communication of policies, i.e., policies that were visible and had consistent and positive messages from the media (mentioned only by policymakers) and (4) how to improve policy support, with the main suggestion being an integrated strategy addressing multiple aspects of these behaviours, inclusive policies that consider everyone's needs and use of appropriate channels and messages in policy communication.

CONCLUSIONS

Our findings highlight that members' of the public and policymakers' support for dietary and active-travel policies can be shaped by the perceived effectiveness, fairness and communication of policies and provide suggestions on how to improve policy support. This information can inform the design of acceptable policies but can also be used to help communicate existing and future policies to maximise their adoption and sustainability.

How can we achieve impact from public health research? A meta-ethnography of case studies

BACKGROUND

Generation of public health impact from research is challenging. Research of similar quality often has differential uptake and there is considerable lag time between initiation and uptake of research. Improving understanding of how research impact can be achieved may identify areas stakeholders could target.

METHODS

This work uses meta-ethnography to synthesize 21 case studies exploring how researchers have generated public health policy impact.

RESULTS

Eight constructs were identified: expertise; motivation; practical solutions to important problems; support structure and funding; collaboration; wide dissemination and use of media to contribute ideas to the wider narrative; understanding the policy realm; and models of impact. The constructs were combined in a lines-of-argument synthesis, producing a model that seeks to illustrate the diffuse, complex and dynamic nature of the process of generating impact from research.

CONCLUSION

Achieving research impact involves seeking to shape wider debates, building relationships with policy makers, becoming a trusted collaborator and being available to provide relevant and practical solutions to questions of concern to policy makers at the appropriate time.

The relation between the social and the biological and COVID-19

Social factors have been linked to disease severity and mortality in COVID-19. These social factors are ethnicity, social disadvantage, age, gender and occupation. Pre-existing medical conditions have also been identified as an increasing risk. This paper explores the relationship between these social and biological factors using a syndemic frame of reference. The paper argues that although the associations have been very well documented, the mechanisms linking the social factors and disease outcomes are not well understood. An approach that seeks to find commensurability between the social and the biological, is suggested.

Evidence-based medicine meets democracy: the role of evidence-based public health guidelines in local government

Background

In 2013, many public health functions transferred from the National Health Service to local government in England. From 2006 NICE had produced public health guidelines based on the principles of evidence-based medicine. This study explores how the guidelines were received in the new environment in local government and related issues raised relating to the use of evidence in local authoritites.

Methods

In depth, interviews with 31 elected members and officers, including Directors of Public Health, from four very different local government organizations (‘local authorities’).

Results

Participants reported that (i) there were tensions between evidence-based, and political decision-making; (ii) there were differences in views about what constituted ‘good’ evidence and (iii) that organizational life is an important mediator in the way evidence is used.

Conclusions

Democratic political decision-making does not necessarily naturally align with decision-making based on evidence from the international scientific literature, and local knowledge and local evidence are very important in the ways that public health decisions are made.

From the National Health Service to local government: perceptions of public health transition in England

OBJECTIVES

In England, in 2013, responsibility for some public health (PH) functions transferred from the National Health Service (NHS) to local government. This moved PH from a health-focussed into a broader and more politically oriented context. This article reports on the perceptions of those involved in this transition about how the PH function was changing as it transited to local government.

STUDY DESIGN

This is a cross-sectional interview study.

METHODS

The study included semi-structured interviews with 31 local government councillors, directors and deputy directors of PH, PH team members and members of clinical commissioning groups. Interviews and data analysis were informed by a theoretical framework, COM-B and an inductive and deductive approach was taken to identify relevant themes.

RESULTS

There was a mixed picture of perceived gains and losses for PH. The transition from NHS to local government was seen by some as a 'homecoming', providing the opportunity for PH to have further reach through influence and collaboration with departments like housing, transport and planning. The opportunity to promote evidence-based practice across local government was also seen as a positive aspect of the transition. However, professional roles of PH and individual PH practitioners were perceived to have less influence and autonomy than in the NHS, with some uncertainty about roles within local government. PH practitioners perceived the need to develop other skills to fulfil their roles in local government. Shorter timescales for action and pressure for faster responses were reported to be the reason for less emphasis on using PH evidence to inform policy and decision-making than hitherto in the NHS.

CONCLUSION

This study illustrates a variety of consequences of transitioning from NHS to local government. There were perceived benefits afforded by proximity to related local government departments but at the costs of reduction in status for PH practitioners and working to a timescale which in some cases reduced drawing on scientific evidence.

Moving beyond individual choice in policies to reduce health inequalities: the integration of dynamic with individual explanations

Background

A strong focus on individual choice and behaviour informs interventions designed to reduce health inequalities in the UK. We review evidence for wider mechanisms from a range of disciplines, demonstrate that they are not yet impacting on programmes, and argue for their systematic inclusion in policy and research.

Methods

We identified potential mechanisms relevant to health inequalities and their amelioration from different disciplines and analysed six policy documents published between 1976 and 2010 using Bacchi's 'What's the problem represented to be?' framework for policy analysis.

Results

We found substantial evidence of supra-individualistic and relational mechanisms relevant to health inequalities from sociology, history, biology, neuroscience, philosophy and psychology. Policy documents sometimes expressed these mechanisms in policy rhetoric but rarely in policy recommendations, which continue to focus on individual behaviour.

Discussion

Current evidence points to the potential of systematically applying broader thinking about causal mechanisms, beyond individual choice and responsibility, to the design, implementation and evaluation of policies to reduce health inequalities. We provide a set of questions designed to enable critique of policy discussions and programmes to ensure that these wider mechanisms are considered.

PDE11A negatively regulates lithium responsivity

Lithium responsivity in patients with bipolar disorder has been genetically associated with Phosphodiesterase 11A (PDE11A), and lithium decreases PDE11A mRNA in induced pluripotent stem cell-derived hippocampal neurons originating from lithium-responsive patients. PDE11 is an enzyme uniquely enriched in the hippocampus that breaks down cyclic AMP and cyclic GMP. Here we determined whether decreasing PDE11A expression is sufficient to increase lithium responsivity in mice. In dorsal hippocampus and ventral hippocampus (VHIPP), lithium-responsive C57BL/6J and 129S6/SvEvTac mice show decreased PDE11A4 protein expression relative to lithium-unresponsive BALB/cJ mice. In VHIPP, C57BL/6J mice also show differences in PDE11A4 compartmentalization relative to BALB/cJ mice. In contrast, neither PDE2A nor PDE10A expression differ among the strains. The compartment-specific differences in PDE11A4 protein expression are explained by a coding single-nucleotide polymorphism (SNP) at amino acid 499, which falls within the GAF-B homodimerization domain. Relative to the BALB/cJ 499T, the C57BL/6J 499A decreases PDE11A4 homodimerization, which removes PDE11A4 from the membrane. Consistent with the observation that lower PDE11A4 expression correlates with better lithium responsiveness, we found that Pde11a knockout mice (KO) given 0.4% lithium chow for 3+ weeks exhibit greater lithium responsivity relative to wild-type (WT) littermates in tail suspension, an antidepressant-predictive assay, and amphetamine hyperlocomotion, an anti-manic predictive assay. Reduced PDE11A4 expression may represent a lithium-sensitive pathophysiology, because both C57BL/6J and Pde11a KO mice show increased expression of the pro-inflammatory cytokine interleukin-6 (IL-6) relative to BALB/cJ and PDE11A WT mice, respectively. Our finding that PDE11A4 negatively regulates lithium responsivity in mice suggests that the PDE11A SNPs identified in patients may be functionally relevant.

Amphetamine sensitization in mice is sufficient to produce both manic- and depressive-related behaviors as well as changes in the functional connectivity of corticolimbic structures

It has been suggested that amphetamine abuse and withdrawal mimics the diverse nature of bipolar disorder symptomatology in humans. Here, we determined if a single paradigm of amphetamine sensitization would be sufficient to produce both manic- and depressive-related behaviors in mice. CD-1 mice were subcutaneously dosed for 5 days with 1.8 mg/kg d-amphetamine or vehicle. On days 6-31 of withdrawal, amphetamine-sensitized (AS) mice were compared to vehicle-treated (VT) mice on a range of behavioral and biochemical endpoints. AS mice demonstrated reliable mania- and depression-related behaviors from day 7 to day 28 of withdrawal. Relative to VT mice, AS mice exhibited long-lasting mania-like hyperactivity following either an acute 30-min restraint stress or a low-dose 1 mg/kg d-amphetamine challenge, which was attenuated by the mood-stabilizers lithium and quetiapine. In absence of any challenge, AS mice showed anhedonia-like decreases in sucrose preference and depression-like impairments in the off-line consolidation of motor memory, as reflected by the lack of spontaneous improvement across days of training on the rotarod. AS mice also demonstrated a functional impairment in nest building, an ethologically-relevant activity of daily living. Western blot analyses revealed a significant increase in methylation of histone 3 at lysine 9 (H3K9), but not lysine 4 (H3K4), in hippocampus of AS mice relative to VT mice. In situ hybridization for the immediate-early gene activity-regulated cytoskeleton-associated protein (Arc) further revealed heightened activation of corticolimbic structures, decreased functional connectivity between frontal cortex and striatum, and increased functional connectivity between the amygdala and hippocampus of AS mice. The effects of amphetamine sensitization were blunted in C57BL/6J mice relative to CD-1 mice. These results show that a single amphetamine sensitization protocol is sufficient to produce behavioral, functional, and biochemical phenotypes in mice that are relevant to bipolar disorder.

The appraisal of public health interventions: an overview

BACKGROUND

The approach currently used to appraise public health interventions is close to that of health technology appraisal for drugs. This approach is not appropriate for many public health interventions, however, when extremely small individual level benefits are delivered to extremely large populations. In many such situations, randomized controlled trials with sufficient size and power to determine individual level effects are impractical. Such interventions may be cost-effective, even in the absence of traditional evidence to demonstrate this.

METHODS

We outline an alternative approach based on decision theory. We apply it to cases where prior beliefs are sufficiently strong and well grounded to allow decision-makers to assume the direction of change of the intervention's outcome, within the context of a transparent and deliberative decision-making process. Decision theory also assumes that decision-makers are risk neutral, implying that they should make decisions based on an intervention's mean cost-effectiveness, and should therefore disregard variance except when deciding to wait for more information. However, they must allow for biases.

RESULTS

A framework is presented which has the potential to achieve large health gains at no additional cost.

CONCLUSIONS

This analysis provides a rigorous theoretical framework for decision-makers in public health. The implied paradigm shift also applies to some clinically based areas.

Transcriptional regulation of neurodevelopmental and metabolic pathways by NPAS3

The basic helix-loop-helix PAS (Per, Arnt, Sim) domain transcription factor gene NPAS3 is a replicated genetic risk factor for psychiatric disorders. A knockout (KO) mouse model exhibits behavioral and adult neurogenesis deficits consistent with human illness. To define the location and mechanism of NPAS3 etiopathology, we combined immunofluorescent, transcriptomic and metabonomic approaches. Intense Npas3 immunoreactivity was observed in the hippocampal subgranular zone-the site of adult neurogenesis--but was restricted to maturing, rather than proliferating, neuronal precursor cells. Microarray analysis of a HEK293 cell line over-expressing NPAS3 showed that transcriptional targets varied according to circadian rhythm context and C-terminal deletion. The most highly up-regulated NPAS3 target gene, VGF, encodes secretory peptides with established roles in neurogenesis, depression and schizophrenia. VGF was just one of many NPAS3 target genes also regulated by the SOX family of transcription factors, suggesting an overlap in neurodevelopmental function. The parallel repression of multiple glycolysis genes by NPAS3 reveals a second role in the regulation of glucose metabolism. Comparison of wild-type and Npas3 KO metabolite composition using high-resolution mass spectrometry confirmed these transcriptional findings. KO brain tissue contained significantly altered levels of NAD(+), glycolysis metabolites (such as dihydroxyacetone phosphate and fructose-1,6-bisphosphate), pentose phosphate pathway components and Kreb's cycle intermediates (succinate and α-ketoglutarate). The dual neurodevelopmental and metabolic aspects of NPAS3 activity described here increase our understanding of mental illness etiology, and may provide a mechanism for innate and medication-induced susceptibility to diabetes commonly reported in psychiatric patients.

Synthesizing diverse evidence: the use of primary qualitative data analysis methods and logic models in public health reviews

OBJECTIVES

The nature of public health evidence presents challenges for conventional systematic review processes, with increasing recognition of the need to include a broader range of work including observational studies and qualitative research, yet with methods to combine diverse sources remaining underdeveloped. The objective of this paper is to report the application of a new approach for review of evidence in the public health sphere. The method enables a diverse range of evidence types to be synthesized in order to examine potential relationships between a public health environment and outcomes.

STUDY DESIGN

The study drew on previous work by the National Institute for Health and Clinical Excellence on conceptual frameworks. It applied and further extended this work to the synthesis of evidence relating to one particular public health area: the enhancement of employee mental well-being in the workplace.

METHODS

The approach utilized thematic analysis techniques from primary research, together with conceptual modelling, to explore potential relationships between factors and outcomes.

RESULTS

The method enabled a logic framework to be built from a diverse document set that illustrates how elements and associations between elements may impact on the well-being of employees.

CONCLUSIONS

Whilst recognizing potential criticisms of the approach, it is suggested that logic models can be a useful way of examining the complexity of relationships between factors and outcomes in public health, and of highlighting potential areas for interventions and further research. The use of techniques from primary qualitative research may also be helpful in synthesizing diverse document types.

A conceptual framework for public health: NICE's emerging approach

This paper outlines the National Institute for Health and Clinical Excellence's (NICE) emerging conceptual framework for public health. This is based on the experience of the first 3 years of producing public health guidance at NICE (2005-2008). The framework has been used to shape the revisions to NICE's public health process and methods manuals for use post 2009, and will inform the public health guidance which NICE will produce from April 2009. The framework is based on the precept that both individual and population patterns of disease have causal mechanisms. These are analytically separate. Explanations of individual diseases involve the interaction between biological, social and related phenomena. Explanations of population patterns involve the same interactions, but also additional interactions between a range of other phenomena working in tandem. These are described. The causal pathways therefore involve the social, economic and political determinants of health, as well as psychological and biological factors. Four vectors of causation are identified: population, environmental, organizational and social. The interaction between the vectors and human behaviour are outlined. The bridge between the wider determinants and individual health outcomes is integration of the life course and the lifeworld.

Acute near-fatal necrotising fasciitis complicating a primary total hip replacement

Necrotising fasciitis is a rapidly spreading, life-threatening condition. We report a case of necrotising fasciitis in a 71-year-old woman after a primary total hip replacement which became deeply infected as a result.

Measurement of branching fractions and mass spectra of B-->Kpipigamma

We present a measurement of the partial branching fractions and mass spectra of the exclusive radiative penguin processes B-->Kpipigamma in the range m(Kpipi)<1.8 GeV/c(2). We reconstruct four final states: K(+)pi(-)pi(+)gamma, K(+)pi(-)pi(0)gamma, K(S)(0)pi(-)pi(+)gamma, and K(S)(0)pi(+)pi(0)gamma, where K(S)(0)-->pi(+)pi(-). Using 232 x 10(6) e(+)e(-)-->BB events recorded by the BABAR experiment at the SLAC PEP-II asymmetric-energy storage ring, we measure the branching fractions B(B(+)-->K(+)pi(-)pi(+)gamma)=[2.95+/-0.13(stat)+/-0.20(syst)] x 10(-5), B(B(0)-->K(+)pi(-)pi(0)gamma)=[4.07+/-0.22(stat)+/-0.31(syst)] x 10(-5), B(B(0)-->K(0)pi(+)pi(-)gamma)=[1.85+/-0.21(stat)+/-0.12(syst)] x 10(-5), and B(B(+)-->K(0)pi(+)pi(0)gamma)=[4.56+/-0.42(stat)+/-0.31(syst)] x 10(-5).

Measurement of the pseudoscalar decay constant fDs using charm-tagged events in e+e- collisions at square root s=10.58 GeV

Using 230.2 fb-1 of e+e- annihilation data collected with the BABAR detector at and near the peak of the Upsilon(4S) resonance, 489+/-55 events containing the pure leptonic decay Ds+-->micro;+numicro have been isolated in charm-tagged events. The ratio of partial widths Gamma(D+-->micro+numicro)/Gamma(Ds+-->phipi+) is measured to be 0.143+/-0.018+/-0.006 allowing a determination of the pseudoscalar decay constant fDs=(283+/-17+/-7+/-14) MeV. The errors are statistical, systematic, and from the Ds+-->phipi+ branching ratio, respectively.

Observation of decays B0-->Ds(*)+ pi- and B0-->Ds(*)- K+

We report the observation of decays B{0}-->D{s}{(*)+}pi- and B{0}-->D{s}{(*)-}K+ in a sample of 230 x 10(6) Upsilon(4S)-->BB[over] events recorded with the BABAR detector at the SLAC PEP-II asymmetric-energy e+ e- storage ring. We measure the branching fractions B(B{0}-->D{s}{+}pi-)=(1.3+/-0.3(stat)+/-0.2(syst))x10(-5), B(B{0}-->D{s}{-} K+)=(2.5+/-0.4(stat)+/-0.4(syst))x10(-5), B(B{0}-->D{s}{*+}pi-)=(2.8+/-0.6(stat)+/-0.5(syst))x10(-5), and B(B{0}-->D{s}{*-}K+)=(2.0+/-0.5(stat)+/-0.4(syst))x10(-5). The significances of the measurements to differ from zero are 5, 9, 6, and 5 standard deviations, respectively. This is the first observation of B{0}-->D{s}{+}pi-, B{0}-->D{s}{*+}pi-, and B{0}-->D{s}{*-}K+ decays.

Observation of a Charmed Baryon Decaying to D;{0}p at a Mass Near 2.94 GeV/c;{2}

A search for charmed baryons decaying to D(0)p reveals two states: the Lambdac(2880)+ baryon and a previously unobserved state at a mass of [2939.8+/-1.3(stat)+/-1.0(syst)] MeV/c2 and with an intrinsic width of [17.5+/-5.2(stat)+/-5.9(syst)] MeV. Consistent and significant signals are observed for the K(-)pi(+) and K(-)pi(+)pi(-)pi(+) decay modes of the D0 in 287 fb(-1) annihilation data recorded by the BABAR detector at a center-of-mass energy of 10.58 GeV. There is no evidence in the D+p spectrum of doubly charged partners. The mass and intrinsic width of the Lambdac(2880)+ baryon and relative yield of the two baryons are also measured.

Retention of the patella in total knee arthroplasty for rheumatoid arthritis

AIM

To determine whether retention of the native patella during total knee arthroplasty is appropriate in patients with rheumatoid arthritis.

METHODS

All patients undergoing total knee arthroplasty with a diagnosis of rheumatoid arthritis were identified between January 1997 and December 2000. Subsequently, each individual underwent both radiological and clinical assessments at a designated follow-up clinic.

RESULTS

A total of 30 total knee arthroplasties were studied in 28 patients. Twenty-six patients (93%) were female with a mean age of 74.7 years (range 60-83 years). The average post-operative interval was 59.4 months (range 46-82 months). All individuals were noted to have satisfactory patellar tracking and bone stock at the time of surgery. No patient subsequently underwent revision surgery during follow-up and no episodes of implant sepsis were identified. The mean Patellar Score at final follow-up was 26.2 (range 22-30) with an average anterior knee pain score of 14.2 (range 10-15). The mean Oxford Knee Score was 18.7 (range 16-23) with a mean pain score component of 5.9. Patients were finally assessed with respect to the Knee Society Score. The mean Knee Score was 83.8 (range 71-96) with a mean Function Score of 79.7 (range 40-90).

CONCLUSION

By retaining the native patella we were still able to obtain highly satisfactory medium-term results in terms of pain relief and function. In addition, the potential complications associated with prosthetic replacement of the patella were avoided.

Observation of B0 meson decay to a 1 +/(1260)pi /+

We present a measurement of the branching fraction of the decay B(0)-->a1 (+/)(1260)pi(/+) with a1 (+/)(1260)-->pi(/+)pi(+/)pi(+/). The data sample corresponds to 218 x 10(6) BB[over ] pairs produced in e+e- annihilation through the Upsilon(4S) resonance. We measure the branching fraction Beta(B(0)-->a1(+/)(1260)pi(/+))Beta(a1(+/)(1260)-->pi(/+)pi(+/)pi(+/)) = (16.6+/1.9+/1.5) x 10(-6), where the first error quoted is statistical and the second is systematic.

Search for T, CP, and CPT violation in B0-B0 mixing with inclusive dilepton events

We report the results of a search for T, CP, CPT, and violation in B0-B0 mixing using an inclusive dilepton sample collected by the BABAR experiment at the PEP-II factory. Using a sample of 232 x 10(6) BB pairs, we measure the T and CP violation parameter |q/p| - 1 = (-0.8 +/- 2.7(stat) +/- 1.9(syst) x 10(-3), and the CPT and CP parameters Imz = (13.9 +/- 7.3(stat) +/- 3.2(syst)) x 10(-3) and Delta Gamma x Rez = (7.1 +/- 3.9(stat) +/- 2.0(stat)) x 10(-3) ps(-1). The statistical correlation between the measurements of Imz and Delta Gamma x Rez is 76%.

Search for the rare decay B0-->tau+tau- at BABAR

We present the results of a search for the decay B0-->tau+tau- in a data sample of (232+/-3)x10(6) Upsilon(4S)-->BB decays using the BABAR detector. Certain extensions of the standard model predict measurable levels of this otherwise rare decay. We reconstruct fully one neutral B meson and seek evidence for the signal decay in the rest of the event. We find no evidence for signal events and obtain Beta(B0->tau+tau-)<4.1x10(-3) at the 90% confidence level.

Observation of Upsilon(4S) decays to pi(+)pi(-)Upsilon(1S) and pi(+)pi(-)Upsilon(2S)

Observation of Upsilon(4S) decays to pi(+)pi(-)C and pi(+)pi(-)Upsilon(2S)We present the first measurement of Upsilon(4S) decays to pi(+)pi(-)Upsilon(1S) based on a sample of 230 x 106(4S) mesons collected with the BABAR detector. We measure the product branching fractions Beta(Upsilon(4S) --> pi(+)pi(-)Upsilon(1S)) x BetaUpsilon(1S) --> mu(+)mu(-) = (2.23 +/- 0.25(stat) +/- 0.27(syst))x 10(-6) and Beta(Upsilon(4S) --> pi(+)pi(-)Upsilon(2S) x Beta(Upsilon(2S) --> mu(+)mu(-))=(1.69 +/-0.26(stat) +/- 0.20(syst)) x 10(-)6, from which we derive the partial widths Gamma(Upsilon(4S) --> pi(+)pi(-)Upsilon(1S))=(1.8 +/-0.4) keV and Gamma(Upsilon(4S) --> pi(+)pi(-)Upsilon(2S))=(2.7 +/- 0.8) keV.

Determinations of from inclusive semileptonic decays with reduced model dependence

We report two novel determinations of /|Vub/ with reduced model dependence, based on measurements of the mass distribution of the hadronic system in semileptonic B decays. Events are selected by fully reconstructing the decay of one B meson and identifying a charged lepton from the decay of the other B meson from Upsilon(4S)-->BB events. In one approach, we combine the inclusive B-->Xulambdav rate, integrated up to a maximum hadronic mass mX<1.67 GeV/c2, with a measurement of the inclusive B-->Xsgamma photon energy spectrum. We obtain /Vub/=(4.43+/-0.38stat+/-0.25syst+/-0.29theo) x 10-3. In another approach we measure the total B-->Xulambdav rate over the full phase space and find /Vub/=(3.84+/-0.70stat+/-0.30syst+/-0.10theo) x 10-3.

Measurements of the absolute branching fractions of B+/- --> K+/-X(cc)

We study the two-body decays of B+/- mesons to K+/- and a charmonium state X(cc) in a sample of 210.5 fb(-1) of data from the BABAR experiment. We perform measurements of absolute branching fractions beta(B+/- --> K+/-X(cc)) using a missing mass technique, and report several new or improved results. In particular, the upper limit beta(B+/- --> K+/- X(3872)) < 3.2 x 10(-4) at 90% C.L. and the inferred lower limit beta(X(3872)J/psipi+ pi-) > 4.2% will help in understanding the nature of the recently discovered X(3872).

Search for lepton flavor violation in the decay tau+/--->e+/-gamma

A search for the nonconservation of lepton flavor in the decay tau+/--->e+/-gamma has been performed with 2.07x10(8) e+e--->tau+tau- events collected by the BABAR detector at the SLAC PEP II storage ring at a center-of-mass energy near 10.58 GeV. We find no evidence for a signal and set an upper limit on the branching ratio of Beta(tau+/--->e+/-gamma)<1.1x10(-7) at 90% confidence level.

Measurement of branching fractions and resonance contributions for B0 --> D0K+pi- and search for B0 --> D0K+pi- decays

Using 226 x 10(6) gamma(4S) --> BB events collected with the BABAR detector at the PEP-II e+e- storage ring at the Stanford Linear Accelerator Center, we measure the branching fraction for B0 --> D0K+pi-, excluding B0 --> D*-K+, to be beta(B0 --> D0K+pi-) = (88 +/- 15 +/- 9) x 10(-6). We observe B0 --> D0K*(892)0 and B0 --> D2*(2460)-K+ contributions. The ratio of branching fractions beta(B0 --> D*-K+)/beta(B0 --> D*-pi+) = (7.76 +/- 0.34+/-0.29)% is measured separately. The branching fraction for the suppressed mode B0 --> D0K+pi- is beta(B0 --> D0K+pi-) < 19 x 10(-6) at the 90% confidence level.

Evidence for B+ --> K0K+ and B0 --> K0K0, and measurement of the branching fraction and search for direct CP violation in B+ --> K0pi+

We present evidence for the b --> d penguin-dominated decays B+ --> K0K+ and B0 --> K0K0 in 227 x 10(6) Y(4S) --> BB decays collected with the BABAR detector. We measure the branching fractions B(B+ --> K0K+) = (1.5 +/- 0.5 +/- 0.1) x 10(-6)(< 2.4 x 10(-6)) and B(B0 --> K0K0) = [formula: see text], where the uncertainties are statistical and systematic, respectively. We also present improved measurements of the charge-averaged branching fraction B(B+ --> K0pi+) = (26.0 +/- 1.3 +/- 1.0) x 10(-6) and CP-violating charge asymmetry A(CP) (K0pi+) = -0.09 +/- 0.05 +/- 0.01), where the uncertainties are statistical and systematic, respectively.

Search for lepton-flavor and lepton-number violation in the decay tau(-) -->l-(+)h+(-)h'(-)

A search for lepton-flavor and lepton-number violation in the decay of the tau lepton into one charged lepton and two charged hadrons is performed using 221.4 fb(-1) of data collected at an e+e- center-of-mass energy of 10.58 GeV with the BABAR detector at the SLAC PEP-II storage ring. In all 14 decay modes considered, the observed data are compatible with background expectations, and upper limits are set in the range B(tau-->lhh')<(0.7 - 4.8) x 10(-7) at 90% confidence level.

Measurements of branching fractions and Dalitz distributions for B0 --> D(*)+/-K0pi-/+ decays

We present measurements of the branching fractions for the three-body decays B0 --> D(*)-/+K0pi+/- and their resonant submodes B0 --> D(*)-/+K*+/-using a sample of approximately 88 x 10(6) BB pairs collected by the BABAR detector at the SLAC PEP-II asymmetric energy storage ring. We measure: B(B0 --> D-/+K0pi+/-) = (4.9 +/- 0.7stat +/- 0.5syst) x 10(-4), B(B0 --> D*-/+K0pi+/-) = (3.0 +/- 0.7stat +/- 0.3syst) x 10(-4), B(B0 --> D-/+K*+/-) = (4.6 +/- 0.6stat +/- 0.5syst) x 10(-4), B(B0 --> D*-/+K*+/-) = (3.2 +/- 0.6stat +/- 0.3syst) x 10(-4). From these measurements we determine the fractions of resonant events to be f(B0 --> D-/+K*+/-) = 0.63 +/- 0.08stat +/- 0.04syst and f(B0 --> D*-/+K*+/-) = 0.72 +/- 0.14stat +/-0.05syst.

Measurement of time-dependent CP asymmetries and the CP-odd fraction in the decay B0-->D*+D*-

We present an updated measurement of time-dependent CP asymmetries and the CP-odd fraction in the decay B0-->D*+D*- using 232x10(6)BB pairs collected by the BABAR detector at the SLAC PEP-II B factory. We determine the CP-odd fraction to be 0.125+/-0.044(stat)+/-0.007(syst). The time-dependent CP asymmetry parameters C+ and S+ are determined to be 0.06+/-0.17(stat)+/-0.03(syst) and -0.75+/-0.25(stat)+/-0.03(syst), respectively. The standard model predicts these parameters to be 0 and -sin2beta, respectively, in the absence of penguin amplitude contributions.

Improved measurements of CP-violating asymmetry amplitudes in B0-->pi+pi- decays

We present updated measurements of the CP-violating parameters Spipi and Cpipi in B0-->pi+pi- decays. Using a sample of 227x10(6) Upsilon(4S)-->BB decays collected with the BABAR detector at the PEP-II asymmetric-energy e(+)e(-) collider at SLAC, we observe 467+/-33 signal decays and measure Spipi=-0.30+/-0.17(stat)+/-0.03(syst) and Cpipi=-0.09+/-0.15(stat)+/-0.04(syst).

Production and decay of xi(c)(0) at BABAR

Using 116.1 fb(-1) of data collected by the BABAR detector, we present an analysis of xi(c)(0) production in B decays and from the cc continuum, with the xi(c)(0) decaying into omega- K+ and xi- pi+ final states. We measure the ratio of branching fractions B(xi(c)(0) --> omega- K+)/B(xi(c)(0) --> xi- pi+) spectrum is measured on and 40 MeV below the upsilon(4S) resonance. From these spectra the branching fraction product B(B --> xi(c)(0)X) x B(xi(c)(0) --> xi- pi+) is measured to be (2.11 +/- 0.19 +/- 0.25) x 10(-4), and the cross-section product sigma(e+ e- --> xi(c)(0)X) x B(xi(c)(0) --> xi- pi+) from the continuum is measured to be (388 +/- 39 +/- 41) fb at a center-of-mass energy of 10.58 GeV.

Observation of a broad structure in the pi+ pi- J/psi mass spectrum around 4.26 GeV/c2

We study initial-state radiation events, e+ e- --> gammaISR pi+ pi- J/psi, with data collected with the BABAR detector. We observe an accumulation of events near 4.26 GeV/c2 in the invariant-mass spectrum of pi+ pi- J/psi. Fits to the mass spectrum indicate that a broad resonance with a mass of about 4.26 GeV/c2 is required to describe the observed structure. The presence of additional narrow resonances cannot be excluded. The fitted width of the broad resonance is 50 to 90 MeV/c2, depending on the fit hypothesis.

Measurement of branching fractions and charge asymmetries in B+ decays to eta pi+, eta K+, eta rho+, and eta' pi+, and search for B0 decays to eta K0 and eta omega

We present measurements of branching fractions and charge asymmetries for six B-meson decay modes with an eta or eta(') meson in the final state. The data sample corresponds to 232 x 10(6) BB pairs collected with the BABAR detector at the PEP-II asymmetric-energy e(+)e(-) B Factory at SLAC. We measure the branching fractions (in units of 10(-6)): B(B+ -->eta pi(+))=5.1+/-0.6+/-0.3, B(B+ etaK+)=3.3+/-0.6+/-0.3, B(B0-->etaK0)=1.5+/-0.7+/-0.1 (<2.5 at 90% C.L.), B(B+-->eta rho(+))=8.4+/-1.9+/-1.1, B(B0-->eta omiga)=1.0+/-0.5+/-0.2 (<1.9 at 90% C.L.), and B(B+-->eta(')pi(+))=4.0+/-0.8+/-0.4, where the first uncertainty is statistical and second systematic. For the charged modes we also determine the charge asymmetries, all found to be compatible with zero.

Measurement of time-dependent CP asymmetries in B0-->D(*)+/-D+/- decays

We present a first measurement of CP asymmetries in neutral B decays to D+D-, and updated CP asymmetry measurements in decays to D(*+)D- and D(*-)D+. We use fully reconstructed decays collected in a data sample of (232+/-3) x 10(6) gamma(4S)-->BB events in the BABAR detector at the PEP-II asymmetric-energy B Factory at SLAC. We determine the time-dependent asymmetry parameters to be SD(*+)(D-)=-0.54+/-0.35+/-0.07, CD(*+)(D-)=0.09+/-0.25+/-0.06, SD(*-)(D+)=-0.29+/-0.33+/-0.07, CD(*-)(D+)=0.17+/-0.24+/-0.04, SD+(D-)=-0.29+/-0.63+/-0.06, and CD+(D-)=0.11+/-0.35+/-0.06, where in each case the first error is statistical and the second error is systematic.

Measurement of the Cabibbo-Kobayashi-Maskawa angle gamma in B+/--->D*K+/- decays with a Dalitz analysis of D-->K0(S)pi-pi+

We report on a measurement of the Cabibbo-Kobayashi-Maskawa CP-violating phase gamma through a Dalitz analysis of neutral D decays to K0(S)pi-pi+ in the processes B+/- -->D*K+/-, D*-->Dpi0, Dgamma. Using a sample of 227 x 10(6) BB pairs collected by the BABAR detector, we measure the amplitude ratios r(B)=0.12+/-0.03+/-0.04 and r*(B)=0.17+/-0.10+/-0.03+/-0.03, the relative strong phases delta(B)=(104+/-45(+17+16)(-21-24))degrees and delta*(B)=(-64+/-41(+14)(-12)+/-15) degrees between the amplitudes A(B- -->D*0K-) and A(B- -->D*0)K-), and gamma=(70+/-31(+12+14)(-10-11))degrees. The first error is statistical, the second is the experimental systematic uncertainty, and the third reflects the Dalitz model uncertainty. The results for the strong and weak phases have a twofold ambiguity.

Determination of |Vub| from measurements of the electron and neutrino momenta in inclusive semileptonic B decays

We present a determination of the Cabibbo-Kobayashi-Maskawa matrix element |Vub| based on the analysis of semileptonic B decays from a sample of 88 x 10(6) Gamma(4S) decays collected with the BABAR detector at the SLAC PEP-II e+e- storage ring. Charmless semileptonic B decays are selected using measurements of the electron energy and the invariant mass squared of the electron-neutrino pair. We obtain |Vub| =(3.95 +/- 0.26(+0.58)(-0.42) +/- 0.25) x 10(-3), where the errors represent experimental uncertainties, heavy quark parameter uncertainties, and theoretical uncertainties, respectively.

Improved Measurement of the Cabibbo-Kobayashi-Maskawa angle alpha using B0(B) --> rho+rho- decays

We present results from an analysis of B(0)B(0)--> rho(+)rho(-) using 232 x 10(6) Gamma (4S) --> BB decays collected with the BABAR detector at the PEP-II asymmetric-energy B factory at SLAC. We measure the longitudinal polarization fraction f(L) = 0.978 +/- 0.014(stat) + 0.021 / -0.029(syst) and the CP-violating parameters S(L)= -0.33 +/- 0.24(stat) + 0.08 / -0.14(syst) and C(L)= -0.03 +/- 0.18(stat) +/- 0.09(syst). Using an isospin analysis of B --> rhorho decays, we determine the unitarity triangle parameter alpha. The solution compatible with the standard model is alpha = (100 +/- 13) degrees.

Search for the rare leptonic decay B--->tau-nutau

We present a search for the decay B(-)--> tau(-)nu(tau) in a sample of 88.9 x 10(6) BB pairs recorded with the BABAR detector at the Stanford Linear Accelerator Center B factory. One of the two B mesons from the Gamma(4S) is reconstructed in a hadronic or a semileptonic final state, and the decay products of the other B in the event are analyzed for consistency with a B(-) --> tau(-)nu(tau) decay. We find no evidence of a signal and set an upper limit on the branching fraction of B(B(-) --> tau(-) nu(tau)) < 4.2 x 10(-4) at the 90% confidence level.

Search for strange-pentaquark production in e+e- annihilation at sqrt[s] = 10.58 GeV

We search for strange-pentaquark states that have been previously reported by other experiments--the Theta (1540)(+), Xi(5)(1860)(--), and Xi(5)(1860)(0)--in 123 fb(-1) of data recorded with the BABAR detector at the PEP-II e(+)e(-) storage ring. We find no evidence for these states and set 95% confidence level upper limits on the number of Theta(1540)(+) and Xi(5)(1860)(--) pentaquarks produced per e(+)e(-) annihilation into qq and Gamma(4S) decay. For qq events the Theta(1540)(+) [Xi(5)(1860)(--)] limit is about 8 [4] times lower than the rates measured for ordinary baryons of similar mass.

Search for lepton flavor violation in the decay tau+/- --> mu+ gamma

A search for the nonconservation of lepton flavor number in the decay tau(+/-) --> mu(+/-) has been performed using 2.07 x 10(8) e(+ )e(-) tau(+) tau(-) events produced at a center-of-mass energy near 10.58 GeV with the BABAR detector at the PEP-II storage ring. We find no evidence for a signal and set an upper limit on the branching ratio of Beta(tau(+/-) --> mu(+/-) gamma) < 6.8 x 10(-8) at 90% confidence level.

Measurement of the branching fraction of Gamma(4S) --> B0B0

We report the first measurement of the branching fraction f(00) for Gamma(4S) --> B(0)B(0). The data sample consists of 81.7 fb(-1) collected at the Gamma(4S) resonance with the BABAR detector at the SLAC PEP-II asymmetric-energy e(+)e(-) storage ring. Using partial reconstruction of the decay B(0) --> D(*+) l(-)nu(l) in which only the charged lepton and the soft pion from the decay D(*+) --> D(0)pi(+) are reconstructed, we obtain f(00) = 0.487 +/- 0.010(stat) +/- 0.008(syst). Our result does not depend on the branching fractions of B(0) --> D(*+)l(-)nu(l) and D(*+) --> D(0)pi(+) decays, on the ratio of the charged and neutral B meson lifetimes, nor on the assumption of isospin symmetry.

Branching fraction and CP asymmetries of B0-->K0(S)K0(S)K0(S)

We present measurements of the branching fraction and time-dependent CP-violating asymmetries in B0-->K0(S)K0(S)K0(S) decays based on 227 x 10(6) Upsilon4S-->BB decays collected with the BABAR detector at the PEP-II asymmetric-energy B factory at SLAC. We obtain a branching fraction of (6.9(+0.9)(-0.8)+/-0.6) x 10(-6), and CP asymmetries C=-0.34(+0.28)(-0.25)+/-0.05 and S=-0.71(+0.38)(-0.32)+/-0.04, where the first uncertainties are statistical and the second systematic.

Search for decays of B0-->e+ e-, B0-->mu+ mu-, B0-->e +/- mu-/+

We present a search for the decays B0-->e+ e-, B0-->mu+ mu-, and B0-->e (+/-) mu (-/+) in data collected at the Upsilon(4S) resonance with the BABAR detector at the SLAC B Factory. Using a data set of 111 fb(-1), we find no evidence for a signal in any of the three channels investigated and set the following branching fraction upper limits at the 90% confidence level: B(B0-->e+ e-) < 6.1 x 10(-8), B(B0-->mu+ mu-) < 8.3 x 10(-8), and B(B0-->e (+/-) mu (-/+) )<18 x 10(-8).

Measurements of branching fractions and time-dependent CP-violating asymmetries in B --> eta'K decays

We present measurements of the B --> eta(')K branching fractions; for B(+) --> eta(')K(+) we measure also the time-integrated charge asymmetry Alpha(ch), and for B(0) --> eta(')K(0)(S) the time-dependent CP-violation parameters S and C. The data sample corresponds to 232 x 10(6) BB pairs produced by e(+)e(-) annihilation at the Upsilon (4S). The results are Beta(B --> eta(')K(+)) = (68.9 +/- 2.0 +/- 3.2) x 10(-6), Beta(B(0) --> eta(')K(0)) = (67.4 +/- 3.2) x 10(-6), Alpha(ch) = 0.033 +/- 0.028 +/- 0.005, S = 0.30 +/- 0.140 +/- 0.02, and C = -0.21 +/- 0.10 +/- 0.02, where the first error quoted is statistical and the second is systematic.

Branching fractions and CP asymmetries in B0-->pi0pi0, B+-->pi+pi0, and B+-->K+pi0 decays and isospin analysis of the B-->pipi system

Based on a sample of 227 x 10(6) BB pairs collected by the BABAR detector at the PEP-II asymmetric-energy B Factory at SLAC, we measure the branching fraction B(B0-->pi(0)pi(0))=(1.17+/-0.32+/-0.10)x10(-6), and the asymmetry Cpi(0)(pi(0))=-0.12+/-0.56+/-0.06. The B0-->pi(0)pi(0) signal has a significance of 5.0 sigma. We also measure B(B+-->pi(+)pi(0))=(5.8+/-0.6+/-0.4)x10(-6), B(B+-->K+pi(0))=(12.0+/-0.7+/-0.6)x10(-6), and the charge asymmetries Api(+)(pi(0))=-0.01+/-0.10+/-0.02 and AK+(pi(0))=0.06+/-0.06+/-0.01. Using isospin relations, we find an upper bound on the angle difference |alpha-alpha(eff)| of 35 degrees at the 90% C.L.

Search for factorization-suppressed B-->chi(c)K(*) decays

We search for the factorization-suppressed decays B-->chi(c0)K(*) and B-->chi(c2)K(*), with chi(c0) and chi(c2) decaying into J/psi gamma, using a sample of 124 x 10(6) BB events collected with the BABAR detector at the PEP-II storage ring of the Stanford Linear Accelerator Center. We find no significant signal and set upper bounds for the branching fractions.