Search

A search for high-mass resonances decaying into a Formula Presented-lepton and a neutrino using proton-proton collisions at a center-of-mass energy of Formula Presented is presented. The full run 2 data sample corresponding to an integrated luminosity of Formula Presented recorded by the ATLAS experiment in the years 2015-2018 is analyzed. The Formula Presented-lepton is reconstructed in its hadronic decay modes and the total transverse momentum carried out by neutrinos is inferred from the reconstructed missing transverse momentum. The search for new physics is performed on the transverse mass between the Formula Presented-lepton and the missing transverse momentum. No excess of events above the Standard Model expectation is observed and upper exclusion limits are set on the Formula Presented production cross section. Heavy Formula Presented vector bosons with masses up to 5.0 TeV are excluded at 95% confidence level, assuming that they have the same couplings as the Standard Model Formula Presented boson. For nonuniversal couplings, Formula Presented bosons are excluded for masses less than 3.5-5.0 TeV, depending on the model parameters. In addition, model-independent limits on the visible cross section times branching ratio are determined as a function of the lower threshold on the transverse mass of the Formula Presented-lepton and missing transverse momentum.

A search for quantum black holes in electron + jet and muon + jet invariant mass spectra is performed with 140 fb-1 of data collected by the ATLAS detector in proton-proton collisions at √s = 13 TeV at the Large Hadron Collider. The observed invariant mass spectrum of lepton + jet pairs is consistent with Standard Model expectations. Upper limits are set at 95% confidence level on the production cross section times branching fractions for quantum black holes decaying into a lepton and a quark in a search region with invariant mass above 2.0 TeV. The resulting quantum black hole lower mass threshold limit is 9.2 TeV in the Arkani-Hamed-Dimopoulos-Dvali model, and 6.8 TeV in the Randall-Sundrum model.

Abstract Peritoneal washing cytology (CY) in patients with pancreatic cancer is mainly used for staging; however, it may also be used to evaluate the intraperitoneal status to predict a more accurate prognosis. Here, we investigated the potential of deep learning of CY specimen images for predicting the 1-year prognosis of pancreatic cancer in CY-positive patients. CY specimens from 88 patients with prognostic information were retrospectively analyzed. CY specimens scanned by the whole slide imaging device were segmented and subjected to deep learning with a Vision Transformer (ViT) and a Convolutional Neural Network (CNN). The results indicated that ViT and CNN predicted the 1-year prognosis from scanned images with accuracies of 0.8056 and 0.8009 in the area under the curve of the receiver operating characteristic curves, respectively. Patients predicted to survive 1 year or more by ViT showed significantly longer survivals by Kaplan–Meier analyses. The cell nuclei found to have a negative prognostic impact by ViT appeared to be neutrophils. Our results indicate that AI-mediated analysis of CY specimens can successfully predict the 1-year prognosis of patients with pancreatic cancer positive for CY. Intraperitoneal neutrophils may be a novel prognostic marker and therapeutic target for CY-positive patients with pancreatic cancer.

Abstract Background Prolonged laparoscopic nephroureterectomy (LNU) for upper tract urothelial cancer (UTUC) can increase the frequency of intravesical recurrence after surgery. Therefore, it is important for urological surgeons to have knowledge on preoperative risk factors for prolonged LNU. However, few studies have investigated the risk factors for prolonged LNU. We hypothesized that the quantity of perirenal fat affects the pneumoretroperitoneum time (PRT) of retroperitoneal LNU (rLNU). This study aimed to investigate the preoperative risk factors for prolonged PRT during rLNU. Methods We reviewed the data of 115 patients who underwent rLNU for UTUC between 2013 and 2021. The perirenal fat thickness (PFT) observed on preoperative computed tomography (CT) images was used to evaluate the perinephric fat quantity. Preoperative risk factors for PRT during rLNU were analyzed using logistic regression models. The cutoff value for PRT was determined based on the median time.The cutoff values for fat-related factors influencing PRT were defined according to receiver operating characteristic curve analysis. Results The median PRT for rLNU was 182 min (interquartile range, 155–230 min). The cutoff values of posterior, lateral, and anterior PFTs were 15 mm, 24 mm, and 6 mm, respectively. Multivariate analysis revealed that a posterior PFT ≥ 15 mm (odds ratio [OR], 2.72; 95% confidence interval, 1.04–7.08; p = 0.0410) was an independent risk factor for prolonged PRT. Conclusions Thick posterior PFT is a preoperative risk factor for prolonged PRT during rLNU. For patients with UTUC and thick posterior PFT, surgeons should develop optimal surgical strategies, including the selecting an expert surgeon as a primary surgeon and the selecting transperitoneal approach to surgery or open surgery.

A search for the pair-production of vector-like quarks optimized for decays into a Z boson and a third-generation Standard Model quark is presented, using the full Run 2 dataset corresponding to 139fb−1 of pp collisions at s=13TeV, collected in 2015–2018 with the ATLAS detector at the Large Hadron Collider. The targeted final state is characterized by the presence of a Z boson with high transverse momentum, reconstructed from a pair of same-flavour leptons with opposite-sign charges, as well as by the presence of b-tagged jets and high-transverse-momentum large-radius jets reconstructed from calibrated smaller-radius jets. Events with exactly two or at least three leptons are used, which are further categorized by the presence of boosted W, Z, and Higgs bosons and top quarks. The categorization is performed using a neural-network-based boosted object tagger to enhance the sensitivity to signal relative to the background. No significant excess above the background expectation is observed and exclusion limits at 95% confidence level are set on the masses of the vector-like partners T and B of the top and bottom quarks, respectively. The limits depend on the branching ratio configurations and, in the case of 100% branching ratio for T→Zt and 100% branching ratio for B→Zb, this search sets the most stringent limits to date, allowing mT>1.60TeV and mB>1.42TeV, respectively.

A search for flavor-changing neutral-current couplings between a top quark, an up or charm quark, and a Formula Presented boson is presented, using proton-proton collision data at Formula Presented collected by the ATLAS detector at the Large Hadron Collider. The analyzed data set corresponds to an integrated luminosity of Formula Presented. The search targets both single-top-quark events produced as Formula Presented (with Formula Presented, Formula Presented) and top-quark-pair events, with one top quark decaying through the Formula Presented channel. The analysis considers events with three leptons (electrons or muons), a Formula Presented-tagged jet, possible additional jets, and missing transverse momentum. The data are found to be consistent with the background-only hypothesis and 95% confidence-level limits on the Formula Presented branching ratios, assuming only tensor operators of the Standard Model effective field theory framework contribute to the Formula Presented vertices. These are Formula Presented (Formula Presented) for Formula Presented (Formula Presented) for a left-handed Formula Presented coupling, and Formula Presented (Formula Presented) in the case of a right-handed coupling. These results are interpreted as 95% CL upper limits on the strength of the corresponding couplings, yielding limits for Formula Presented and Formula Presented (Formula Presented and Formula Presented) of 0.15 (0.16), and limits for Formula Presented and Formula Presented (Formula Presented and Formula Presented) of 0.22 (0.21), assuming a new-physics energy scale Formula Presented of 1 TeV.

A search for the charged-lepton-flavor-violating process Formula Presented is presented, using Formula Presented of Formula Presented Formula Presented collision data collected by the ATLAS experiment at the LHC. An excess in the Formula Presented invariant mass spectrum near the Formula Presented boson mass would be a striking signature of new physics. No excess is observed, and an upper limit Formula Presented is placed on the branching fraction at 95% confidence level, which is the most stringent limit to date.

A measurement of the top quark pair-production cross section in the lepton + jets decay channel is presented. It is based on 4.6 fb - 1 of s = 7 TeV p p collision data collected during 2011 by the ATLAS experiment at the CERN Large Hadron Collider. A three-class, multidimensional event classifier based on support vector machines is used to differentiate t t ¯ events from backgrounds. The t t ¯ production cross section is found to be σ t t ¯ = 168.5 ± 0.7 ( stat ) - 5.9 + 6.2 ( syst ) - 3.2 + 3.4 ( lumi ) pb . The result is consistent with the Standard Model prediction based on QCD calculations at next-to-next-to-leading order.

We present measurements of cross sections for production of a leptonically decaying Z boson in association with a large-radius jet in 13 TeV proton-proton collisions at the LHC, using 36 fb - 1 of data from the ATLAS detector. Integrated and differential cross sections are measured at particle level in both a flavor inclusive and a doubly b -tagged fiducial phase space. The large-radius jet mass and transverse momentum, its kinematic relationship to the Z boson, and the angular separation of b -tagged small-radius track jets within the large-radius jet are measured. This measurement constitutes an important test of perturbative quantum chromodynamics in kinematic and flavor configurations relevant to several Higgs boson and beyond-Standard-Model physics analyses. The results highlight issues with modeling of additional hadronic activity in the flavor-inclusive selection, and a distinction between flavor-number schemes in the b -tagged phase space.

Abstract Van-der-Waals magnetic materials can be exfoliated to realize ultrathin sheets or interfaces with highly controllable optical or spintronics responses. In majority, these are collinear ferro-, ferri-, or antiferromagnets, with a particular scarcity of lattice-incommensurate helimagnets of defined left- or right-handed rotation sense, or helicity. Here, we report polarized neutron scattering experiments on DyTe3, whose layered structure has highly metallic tellurium layers separated by double-slabs of dysprosium square nets. We reveal cycloidal (conical) magnetic textures, with coupled commensurate and incommensurate order parameters, and probe the evolution of this ground state in a magnetic field. The observations are well explained by a one-dimensional spin model, with an off-diagonal on-site term that is spatially modulated by DyTe3’s unconventional charge density wave (CDW) order. The CDW-driven term couples to antiferromagnetism, or to the net magnetization in an applied magnetic field, and creates a complex magnetic phase diagram indicative of competing interactions in this easily cleavable van-der-Waals helimagnet.

Abstract Background Index tumors are the most aggressive tumors of the prostate. However, their clinical significance remains unclear. This study aimed to assess the incidence of index tumor location according to the zonal origin and whether these locations affect the prognosis after radical prostatectomy in patients with negative surgical margins. Methods This single-centered, retrospective study evaluated 1,109 consecutive patients who underwent radical prostatectomies. An index tumor was defined as the largest tumor in the prostate gland. We detected these locations based on McNeal's zonal origin using whole-mount sections. Biochemical recurrence (BCR) free survival curves were generated using the Kaplan–Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine the predictive factors for early BCR (within 1-year). Results A total of 621 patients with negative surgical margins who did not receive adjuvant therapy were included in this study. The index tumor were located in the transitional zone in 191 patients (30.8%), the peripheral zone in 399 patients (64.3%), and the central zone in 31 patients (5.0%). In total, 22 of 621 patients (3.5%) experienced early BCR and 70 patients (11.2%) experienced overall BCR at a median follow-up of 61.7 months. According to the index tumor location, the early BCR-free rates were 99.5%, 95.7 %, and 83.3% in the transitional, peripheral, and central zones, respectively. On multivariate analysis, the index tumor in the central zone was an independent predictor of early BCR with negative surgical margins following radical prostatectomy, followed by prostatectomy pathological grade, index tumor in the peripheral zone, and high prostate-specific antigen level. Conclusions We assessed the significance of index tumor location in patients with negative surgical margins following radical prostatectomy. Index tumors located in the central zone, although infrequent, were the strongest predictive factors for early BCR. Our results may allow urologists and patients to reconsider the therapeutic strategies for prostate cancer.

Electroweak symmetry breaking explains the origin of the masses of elementary particles through their interactions with the Higgs field. Besides the measurements of the Higgs boson properties, the study of the scattering of massive vector bosons with spin 1 allows the nature of electroweak symmetry breaking to be probed. Among all processes related to vector-boson scattering, the electroweak production of two jets and a Z-boson pair is a rare and important one. Here we report the observation of this process from proton–proton collision data corresponding to an integrated luminosity of 139 fb−1 recorded at a centre-of-mass energy of 13 TeV with the ATLAS detector at the Large Hadron Collider. We consider two different final states originating from the decays of the Z-boson pair: one containing four charged leptons and another containing two charged leptons and two neutrinos. The hypothesis of no electroweak production is rejected with a statistical significance of 5.7σ, and the measured cross-section for electroweak production is consistent with the Standard Model prediction. In addition, we report cross-sections for inclusive production of a Z-boson pair and two jets for the two final states.

A search is presented for single production of a vector-like B quark decaying into a Standard Model b-quark and a Standard Model Higgs boson, which decays into a (Formula presented.) pair. The search is carried out in 139 fb−1 of (Formula presented.) TeV proton-proton collision data collected by the ATLAS detector at the LHC between 2015 and 2018. No significant deviation from the Standard Model background prediction is observed, and mass-dependent exclusion limits at the 95% confidence level are set on the resonance production cross-section in several theoretical scenarios determined by the couplings cW, cZ and cH between the B quark and the Standard Model W, Z and Higgs bosons, respectively. For a vector-like B occurring as an isospin singlet, the search excludes values of cW greater than 0.45 for a B resonance mass (mB) between 1.0 and 1.2 TeV. For 1.2 TeV < mB< 2.0 TeV, cW values larger than 0.50–0.65 are excluded. If the B occurs as part of a (B, Y) doublet, the smallest excluded cZ coupling values range between 0.3 and 0.5 across the investigated resonance mass range 1.0 TeV < mB< 2.0 TeV.

A search for new phenomena has been performed in final states with at least one isolated high-momentum photon, jets and missing transverse momentum in proton–proton collisions at a centre-of-mass energy of s = 13 TeV. The data, collected by the ATLAS experiment at the CERN LHC, correspond to an integrated luminosity of 139 fb−1. The experimental results are interpreted in a supersymmetric model in which pair-produced gluinos decay into neutralinos, which in turn decay into a gravitino, at least one photon, and jets. No significant deviations from the predictions of the Standard Model are observed. Upper limits are set on the visible cross section due to physics beyond the Standard Model, and lower limits are set on the masses of the gluinos and neutralinos, all at 95% confidence level. Visible cross sections greater than 0.022 fb are excluded and pair-produced gluinos with masses up to 2200 GeV are excluded for most of the NLSP masses investigated. [Figure not available: see fulltext.].

Measurements of single-, double-, and triple-differential cross-sections are presented for boosted top-quark pair-production in 13 TeV proton–proton collisions recorded by the ATLAS detector at the LHC. The top quarks are observed through their hadronic decay and reconstructed as large-radius jets with the leading jet having transverse momentum (pT) greater than 500 GeV. The observed data are unfolded to remove detector effects. The particle-level cross-section, multiplied by the tt¯ → WWbb¯ branching fraction and measured in a fiducial phase space defined by requiring the leading and second-leading jets to have pT> 500 GeV and pT> 350 GeV, respectively, is 331 ± 3(stat.) ± 39(syst.) fb. This is approximately 20% lower than the prediction of 398−49+48 fb by Powheg+Pythia 8 with next-to-leading-order (NLO) accuracy but consistent within the theoretical uncertainties. Results are also presented at the parton level, where the effects of top-quark decay, parton showering, and hadronization are removed such that they can be compared with fixed-order next-to-next-to-leading-order (NNLO) calculations. The parton-level cross-section, measured in a fiducial phase space similar to that at particle level, is 1.94 ± 0.02(stat.) ± 0.25(syst.) pb. This agrees with the NNLO prediction of 1.96−0.17+0.02 pb. Reasonable agreement with the differential cross-sections is found for most NLO models, while the NNLO calculations are generally in better agreement with the data. The differential cross-sections are interpreted using a Standard Model effective field-theory formalism and limits are set on Wilson coefficients of several four-fermion operators. [Figure not available: see fulltext.].

A measurement of the top-quark mass (mt) in the tt¯ → lepton + jets channel is presented, with an experimental technique which exploits semileptonic decays of b-hadrons produced in the top-quark decay chain. The distribution of the invariant mass mℓμ of the lepton, ℓ (with ℓ = e, μ), from the W-boson decay and the muon, μ, originating from the b-hadron decay is reconstructed, and a binned-template profile likelihood fit is performed to extract mt. The measurement is based on data corresponding to an integrated luminosity of 36.1 fb−1 of s = 13 TeV pp collisions provided by the Large Hadron Collider and recorded by the ATLAS detector. The measured value of the top-quark mass is mt = 174.41 ± 0.39 (stat.) ± 0.66 (syst.) ± 0.25 (recoil) GeV, where the third uncertainty arises from changing the Pythia8 parton shower gluon-recoil scheme, used in top-quark decays, to a recently developed setup. [Figure not available: see fulltext.].

A search for Higgs boson pair production in events with two b-jets and two τ-leptons is presented, using a proton–proton collision dataset with an integrated luminosity of 139 fb −1 collected at s = 13 TeV by the ATLAS experiment at the LHC. Higgs boson pairs produced non-resonantly or in the decay of a narrow scalar resonance in the mass range from 251 to 1600 GeV are targeted. Events in which at least one τ-lepton decays hadronically are considered, and multivariate discriminants are used to reject the backgrounds. No significant excess of events above the expected background is observed in the non-resonant search. The largest excess in the resonant search is observed at a resonance mass of 1 TeV, with a local (global) significance of 3.1σ (2.0σ). Observed (expected) 95% confidence-level upper limits are set on the non-resonant Higgs boson pair-production cross-section at 4.7 (3.9) times the Standard Model prediction, assuming Standard Model kinematics, and on the resonant Higgs boson pair-production cross-section at between 21 and 900 fb (12 and 840 fb), depending on the mass of the narrow scalar resonance. [Figure not available: see fulltext.]

A search for high-mass charged and neutral bosons decaying to Wγ and Zγ final states is presented in this paper. The analysis uses a data sample of s = 13 TeV proton-proton collisions with an integrated luminosity of 139 fb −1 collected by the ATLAS detector during LHC Run 2 operation. The sensitivity of the search is determined using models of the production and decay of spin-1 charged bosons and spin-0/2 neutral bosons. The range of resonance masses explored extends from 1.0 TeV to 6.8 TeV. At these high resonance masses, it is beneficial to target the hadronic decays of the W and Z bosons because of their large branching fractions. The decay products of the high-momentum W/Z bosons are strongly collimated and boosted-boson tagging techniques are employed to improve the sensitivity. No evidence of a signal above the Standard Model backgrounds is observed, and upper limits on the production cross-sections of these bosons times their branching fractions to Wγ and Zγ are derived for various boson production models. [Figure not available: see fulltext.].

A search for a charged Higgs boson, H ±, produced in top-quark decays, t → H ± b, is presented. The search targets H ± decays into a bottom and a charm quark, H ± → cb. The analysis focuses on a selection enriched in top-quark pair production, where one top quark decays into a leptonically decaying W boson and a bottom quark, and the other top quark decays into a charged Higgs boson and a bottom quark. This topology leads to a lepton-plus-jets final state, characterised by an isolated electron or muon and at least four jets. The search exploits the high multiplicity of jets containing b-hadrons, and deploys a neural network classifier that uses the kinematic differences between the signal and the background. The search uses a dataset of proton-proton collisions collected at a centre-of-mass energy s = 13 TeV between 2015 and 2018 with the ATLAS detector at CERN’s Large Hadron Collider, amounting to an integrated luminosity of 139 fb −1. Observed (expected) 95% confidence-level upper limits between 0.15% (0.09%) and 0.42% (0.25%) are derived for the product of branching fractions B (t → H ± b) × B(H ± → cb) for charged Higgs boson masses between 60 and 160 GeV, assuming the SM production of the top-quark pairs. [Figure not available: see fulltext.].

Abstract Background The Vesical Imaging Reporting and Data System (VI-RADS) is widely used for predicting muscle-invasive bladder cancer (MIBC). This study aimed to determine the clinicopathological significance of the VI-RADS ≧4 (VI≧4) group. Methods Patients who underwent transurethral resections of bladder tumors during the study period and preoperative magnetic resonance imaging were considered. The patients were pathologically diagnosed with urothelial carcinoma (UC). We first compared the results of patients with VI-RADS scores of 3 and 4 to determine the cut-off score for MIBC; thereafter, the patients were divided into the VI≧4 and VI-RADS ≦3 (VI≦3) groups using VI-RADS. The clinicopathological significance of the VI≧4 group was examined retrospectively by comparing the characteristics of each group. Results In total, 121 cases were examined, of which 28 were pathologically diagnosed with MIBC. Of the 28 MIBC cases, three (10.7%) had a VI-RADS score of ≦3, and 25 (89.3%) had a VI-RADS score of ≧4. Of the 93 NMIBC cases, 86 (92.5%) had a VI-RADS score of ≦3, and seven (7.5%) had a VI-RADS score of ≧4. The diagnostic performance of the VI-RADS with a cut-off score of 4 was 89.3% for sensitivity, 92.5% for specificity, and an area under the curve (AUC) of 0.91. Contrastingly, for a cut-off score of 3, the sensitivity was 89.3%, specificity was 62.0%, and AUC was 0.72. A VI-RADS score of ≥ 4 could predict MIBC. In the VI≧4 group, 30 of 32 (93.8%) patients had high-grade tumors. The VI≧4 group had significantly more high-grade bladder cancers than the VI≦3 group (p

This study presents the enfortumab vedotin (EV) treatment analysis at our institution. We retrospectively analyzed patients with metastatic urothelial cancer (mUC) treated with EV between January 2021 and October 2023. EV was administered at 1.25 mg/kg on days 1, 8, and 15 in a 28-day cycle. Whole-body computed tomography scans were performed to assess the treatment response. Patient characteristics, treatment histories, response rates, progression-free survival, and adverse events were evaluated. Response rates were determined, and adverse events were recorded. Among the 20 patients, 70% were male and 65% had bladder tumors. Most patients had lung (65%) or lymph node (65%) metastases. The median follow-up was 11.2 months, with 45% of the patients succumbing to the disease. The overall response rate was 55%. The median progression-free and median overall survivals were 10.5 and 12.9 months, respectively. Severe adverse events occurred in 35% of patients. In this real-world study, EV demonstrated promising efficacy and manageable safety profiles in Japanese patients with mUC. The study’s results were consistent with previous clinical trials, although a longer follow-up was required. Our findings support EV use as a treatment option for patients with mUC who exhibit disease progression after platinum-based chemotherapy and immune-checkpoint inhibitor therapy.

We report a case of sporotrichosis in an elderly male farmer at the site of a cat scratch scar.An 84-year-old Japanese farmer was scratched by his cat two months before his visit to our hospital.A skin biopsy was performed. Tissue culture revealed the presence of Sporothrix globosa.The patient was treated with oral itraconazole 200 mg/day for 13 months due to a slow healing ulceration, and the symptoms resolved. (71 words).

The accurate simulation of additional interactions at the ATLAS experiment for the analysis of proton–proton collisions delivered by the Large Hadron Collider presents a significant challenge to the computing resources. During the LHC Run 2 (2015–2018), there were up to 70 inelastic interactions per bunch crossing, which need to be accounted for in Monte Carlo (MC) production. In this document, a new method to account for these additional interactions in the simulation chain is described. Instead of sampling the inelastic interactions and adding their energy deposits to a hard-scatter interaction one-by-one, the inelastic interactions are presampled, independent of the hard scatter, and stored as combined events. Consequently, for each hard-scatter interaction, only one such presampled event needs to be added as part of the simulation chain. For the Run 2 simulation chain, with an average of 35 interactions per bunch crossing, this new method provides a substantial reduction in MC production CPU needs of around 20%, while reproducing the properties of the reconstructed quantities relevant for physics analyses with good accuracy.

The ATLAS experiment at the Large Hadron Collider has a broad physics programme ranging from precision measurements to direct searches for new particles and new interactions, requiring ever larger and ever more accurate datasets of simulated Monte Carlo events. Detector simulation with Geant4 is accurate but requires significant CPU resources. Over the past decade, ATLAS has developed and utilized tools that replace the most CPU-intensive component of the simulation—the calorimeter shower simulation—with faster simulation methods. Here, AtlFast3, the next generation of high-accuracy fast simulation in ATLAS, is introduced. AtlFast3 combines parameterized approaches with machine-learning techniques and is deployed to meet current and future computing challenges, and simulation needs of the ATLAS experiment. With highly accurate performance and significantly improved modelling of substructure within jets, AtlFast3 can simulate large numbers of events for a wide range of physics processes.

Objective: To report a case of bilateral reversible optic neuropathy as the first sign of Waldenström macroglobulinemia (WM).Methods: Observational case report.Results: A 52-year-old man had a sudden loss of vision in the left eye. Examinations revealed the presence of a serum monoclonal immunoglobulin (IgM kappa) in the serum. Even after a session of steroid pulse therapy, optic neuropathy became bilateral and then resolved almost completely after 4 months. The condition progressed to WM with multiorgan lesions years later. There was no evidence of optic neuropathy recurrence. The literature revealed two cases of monoclonal gammopathy (MG): a 64-year-old man with multiple myeloma (MM) with a and a 51-year-old man with MM with IgG kappa. These cases have similar conditions: 1) visual reduction as an initial symptom of MG, 2) bilateral involvement, 3) no sign of central nervous system (CNS) infiltration shown by normal brain magnetic resonance images, and ecovery to a visual acuity of ≥1.0 bilaterally with no reoccurrence. The excessive Igs or B-cell hyperactivity may activate an autoimmune mechanism that reversibly interferes with the bilateral optic nerves.Conclusion: Bilateral optic neuropathy was the initial symptom of WM. There was no evidence of CNS infiltration; it recovered and then did not reoccur. The pathogenesis remained unknown, but two cases of MG were reported in the literature with remarkably similar conditions.

Searches are performed for nonresonant and resonant di-Higgs boson production in the bb¯γγ final state. The dataset used corresponds to an integrated luminosity of 139 fb-1 of proton-proton collisions at a center-of-mass energy of 13 TeV recorded by the ATLAS detector at the CERN Large Hadron Collider. No excess above the expected background is found and upper limits on the di-Higgs boson production cross sections are set. A 95% confidence-level upper limit of 4.2 times the cross section predicted by the Standard Model is set on pp→HH nonresonant production, where the expected limit is 5.7 times the Standard Model predicted value. The expected constraints are obtained for a background hypothesis excluding pp→HH production. The observed (expected) constraints on the Higgs boson trilinear coupling modifier κλ are determined to be [-1.5,6.7] ([-2.4,7.7]) at 95% confidence level, where the expected constraints on κλ are obtained excluding pp→HH production from the background hypothesis. For resonant production of a new hypothetical scalar particle X (X→HH→bb¯γγ), limits on the cross section for pp→X→HH are presented in the narrow-width approximation as a function of mX in the range 251 GeV≤mX≤1000 GeV. The observed (expected) limits on the cross section for pp→X→HH range from 640 fb to 44 fb (391 fb to 46 fb) over the considered mass range.