Search

The need for large-scale production of highly accurate simulated event samples for the extensive physics programme of the ATLAS experiment at the Large Hadron Collider motivates the development of new simulation techniques. Building on the recent success of deep learning algorithms, variational autoencoders and generative adversarial networks are investigated for modelling the response of the central region of the ATLAS electromagnetic calorimeter to photons of various energies. The properties of synthesised showers are compared with showers from a full detector simulation using geant4. Both variational autoencoders and generative adversarial networks are capable of quickly simulating electromagnetic showers with correct total energies and stochasticity, though the modelling of some shower shape distributions requires more refinement. This feasibility study demonstrates the potential of using such algorithms for ATLAS fast calorimeter simulation in the future and shows a possible way to complement current simulation techniques.

We describe the development, operation, and application of the 4D Camera-a 576 by 576 pixel active pixel sensor for scanning/transmission electron microscopy which operates at 87,000 Hz. The detector generates data at ∼480 Gbit/s which is captured by dedicated receiver computers with a parallelized software infrastructure that has been implemented to process the resulting 10-700 Gigabyte-sized raw datasets. The back illuminated detector provides the ability to detect single electron events at accelerating voltages from 30 to 300 kV. Through electron counting, the resulting sparse data sets are reduced in size by 10--300× compared to the raw data, and open-source sparsity-based processing algorithms offer rapid data analysis. The high frame rate allows for large and complex scanning diffraction experiments to be accomplished with typical scanning transmission electron microscopy scanning parameters.

The Data Acquisition System (DAQ) for the LUX-ZEPLIN (LZ) dark matter detector is described. The signals from 745 PMTs, distributed across three subsystems, are sampled with 100-MHz 32-channel digitizers (DDC-32s). A basic waveform analysis is carried out on the on-board Field Programmable Gate Arrays (FPGAs) to extract information about the observed scintillation and electroluminescence signals. This information is used to determine if the digitized waveforms should be preserved for offline analysis. The system is designed around the Kintex-7 FPGA. In addition to digitizing the PMT signals and providing basic event selection in real time, the flexibility provided by the use of FPGAs allows us to monitor the performance of the detector and the DAQ in parallel to normal data acquisition. The hardware and software/firmware of this FPGA-based Architecture for Data acquisition and Realtime monitoring (FADR) are discussed and performance measurements are described.

LUX-ZEPLIN (LZ) is a tonne-scale experiment searching for direct dark matter interactions and other rare events. It is located at the Sanford Underground Research Facility (SURF) in Lead, South Dakota, USA. The core of the LZ detector is a dual-phase xenon time projection chamber (TPC), designed with the primary goal of detecting Weakly Interacting Massive Particles (WIMPs) via their induced low energy nuclear recoils. Surrounding the TPC, two veto detectors immersed in an ultra-pure water tank enable reducing background events to enhance the discovery potential. Intricate calibration systems are purposely designed to precisely understand the responses of these three detector volumes to various types of particle interactions and to demonstrate LZ’s ability to discriminate between signals and backgrounds. In this paper, we present a comprehensive discussion of the key features, requirements, and performance of the LZ calibration systems, which play a crucial role in enabling LZ’s WIMP-search and its broad science program. The thorough description of these calibration systems, with an emphasis on their novel aspects, is valuable for future calibration efforts in direct dark matter and other rare-event search experiments.

The Dark Energy Spectroscopic Instrument (DESI) completed its 5 month Survey Validation in 2021 May. Spectra of stellar and extragalactic targets from Survey Validation constitute the first major data sample from the DESI survey. This paper describes the public release of those spectra, the catalogs of derived properties, and the intermediate data products. In total, the public release includes good-quality spectral information from 466,447 objects targeted as part of the Milky Way Survey, 428,758 as part of the Bright Galaxy Survey, 227,318 as part of the Luminous Red Galaxy sample, 437,664 as part of the Emission Line Galaxy sample, and 76,079 as part of the Quasar sample. In addition, the release includes spectral information from 137,148 objects that expand the scope beyond the primary samples as part of a series of secondary programs. Here, we describe the spectral data, data quality, data products, Large-Scale Structure science catalogs, access to the data, and references that provide relevant background to using these spectra.

In photon upconverting core-shell nanoparticles, structure strongly dictates performance. Typical imaging in scanning transmission electron microscopy has sufficient resolution to probe the atomic structure of these nanoparticles, but contrast, dose, and projection limitations make conventional methods insufficient for fully characterizing these structures. Phase retrieval techniques provide a promising alternative imaging mode, and, in particular, multislice electron ptychography can recover depth-dependent information. Here, we study beam-sensitive photon upconverting core-shell nanoparticles with a multislice ptychography approach using a low electron dose to avoid damage. Large strain fields arise in these heterostructures due to the mismatch in lattice parameter between the core and the shell. We reconstruct both a nanoparticle that appears defect-free and one that has a large break in the side and map the distribution of strain in 3D by computing distortion fields from high-resolution potential images of each slice. In the defect-free nanoparticle, we observe twisting of the shell, while in the broken nanoparticle, we measure the 3D position of the crack, the core, and dislocations. These results highlight the advantage of multislice electron ptychography to recover 3D information from a single scan, even under strict electron dose requirements from beam-sensitive samples.

Searches for dark matter with liquid xenon time projection chamber experiments have traditionally focused on the region of the parameter space that is characteristic of weakly interacting massive particles, ranging from a few GeV/c2 to a few TeV/c2. Models of dark matter with a mass much heavier than this are well motivated by early production mechanisms different from the standard thermal freeze-out, but they have generally been less explored experimentally. In this work, we present a reanalysis of the first science run of the LZ experiment, with an exposure of 0.9 tonne×yr, to search for ultraheavy particle dark matter. The signal topology consists of multiple energy deposits in the active region of the detector forming a straight line, from which the velocity of the incoming particle can be reconstructed on an event-by-event basis. Zero events with this topology were observed after applying the data selection calibrated on a simulated sample of signal-like events. New experimental constraints are derived, which rule out previously unexplored regions of the dark matter parameter space of spin-independent interactions beyond a mass of 1017 GeV/c2.

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.

Following the first science results of the LUX-ZEPLIN (LZ) experiment, a dual-phase xenon time projection chamber operating from the Sanford Underground Research Facility in Lead, South Dakota, USA, we report the initial limits on a model-independent nonrelativistic effective field theory describing the complete set of possible interactions of a weakly interacting massive particle (WIMP) with a nucleon. These results utilize the same 5.5 t fiducial mass and 60 live days of exposure collected for the LZ spin-independent and spin-dependent analyses while extending the upper limit of the energy region of interest by a factor of 7.5 to 270 keV. No significant excess in this high energy region is observed. Using a profile-likelihood ratio analysis, we report 90% confidence level exclusion limits on the coupling of each individual nonrelativistic WIMP-nucleon operator for both elastic and inelastic interactions in the isoscalar and isovector bases.

BackgroundThe transition between inpatient and outpatient care for hospitalized people with HIV represents an opportunity for linkage and re-engagement in care. We evaluated whether attendance at a post-hospitalization visit ('discharge clinic') within 1-2 weeks of discharge would reduce readmissions and improve retention in care (RIC) among people with HIV in San Diego, California, USA.MethodsThis was a retrospective cohort study of people with HIV hospitalized between June 2020 and November 2021. Our primary outcome was 30-day readmissions among people with HIV who did or did not attend a discharge clinic visit. Secondary outcomes included the effect of discharge clinic attendance on RIC, along with the impact of attendance at any HIV clinic visit within 30 days of discharge on readmissions and RIC.ResultsWe evaluated 114 people with HIV, of whom 77 (67.5%) and 90 (78.9%) attended a discharge clinic visit or any HIV clinic visit within 30 days of discharge, respectively. Active substance use disorder (SUD) was associated with failing to attend a discharge clinic visit (odds ratio 0.31; 95% confidence interval 0.13-0.77). We observed no significant differences in readmissions between people with HIV who did or did not attend a discharge clinic visit; however, the former had significantly higher 6-month RIC (79.2% vs. 35.1%, p

Rahilah Halim,1,* Manveen Kaur,2,* Sharifah Suziah Syed Mokhtar,1 Norliza Chemi,1 Martha Sajatovic,3 Yee Kee Tan,4 Ching Sin Siau,4 Chong Guan Ng2 1Department of Psychiatry and Mental Health, Hospital Kajang, Kajang, Selangor, Malaysia; 2Psychological Medicine Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia; 3Neurological and Behavioral Outcomes Center, University Hospital Cleveland Medical Center & Case Western Reserve University School of Medicine, Cleveland, OH, USA; 4Centre for Community Health Studies (Reach), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia*These authors contributed equally to this workCorrespondence: Manveen Kaur, Psychological Medicine Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia, Email manveen@um.edu.my Ching Sin Siau, Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Wilayah Persekutuan, Malaysia, Email chingsin.siau@ukm.edu.myBackground: Internalized stigma and medication non-adherence pose significant challenges for treating major depressive disorder (MDD), leading to disability, increased suicide risk, and morbidity. Limited data exists on modifiable factors associated with adherence in lower-resourced settings like Malaysia. This study aimed to investigate poor adherence prevalence and the demographic and clinical factors associated with poor medication adherence among patients with MDD.Methods: This cross-sectional survey recruited participants using universal sampling from a major hospital in Selangor, Malaysia. Participants answered questionnaires consisting of demographic and clinical information (medical history, duration of anti-depressant treatment for MDD, psychiatric ward admission history, and any medication side effects experienced), the Internalized Stigma of Mental Illness Scale (comprising alienation, stereotype, perceived discrimination, and social withdrawal), the Multidimensional Scale of Perceived Social Support (comprising family, friend, and significant other support), and the Malaysia Medication Adherence Assessment Tool. Simple and multiple logistic regression and mediation analyses were conducted.Results: Of the 268 participants (69% female), 57.1% were suboptimally or moderately adherent to their medication. Buddhists (adjusted odds ratio [aOR] = 0.280, 95% CI [0.115, 0.679], p = 0.005), higher family support (aOR = 0.753, 95% CI [0.591, 0.960], p = 0.022), a history of ward admissions (aOR = 3.523, 95% CI [1.537, 8.072], p = 0.003), and higher internalized stigma (aOR = 2.828, 95% CI [1.497, 5.344], p = 0.001) were significantly associated with low/moderate medication adherence. The effect of internalized stigma subdomains (alienation, perceived discrimination, and social withdrawal) on medication adherence were partially mediated by family support.Conclusion: More than half of the participants demonstrated low to moderate medication adherence. Those with higher internalized stigma demonstrated higher odds of low/moderate medication adherence, but this effect was attenuated by family support. Therefore, internalized stigma and family support are important points of consideration when assessing patients with MDD in Malaysia.Keywords: medication adherence, MDD, internalized stigma, social support, Malaysia

Katarina Puco,1 Cathrine S Notland,2 Robert Szulkin,3,4 Christian Jonasson,5 Christian Beisland,6,7 Tom B Johannesen,8 Oddvar Solli,9 Jan Oldenburg,10,11 Daniel Heinrich12 1Department of Oncology, Hematology and Palliative Care, Lovisenberg Diaconal Hospital, Oslo, Norway; 2Department of Medical Affairs, Pfizer AS, Oslo, Norway; 3SDS Life Science, Stockholm, Sweden; 4Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden; 5Department of Public Health and Nursing, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; 6Department of Urology, Haukeland University Hospital, Bergen, Norway; 7Department of Clinical Medicine, University of Bergen, Bergen, Norway; 8Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway; 9Health and Value, Pfizer AS, Oslo, Norway; 10Department of Oncology, Akershus University Hospital HF, Lørenskog, Norway; 11Faculty of Medicine, University of Oslo, Oslo, Norway; 12Department of Radiotherapy and Oncology, Innlandet Hospital Trust HF, Division Gjøvik/Lillehammer, NorwayCorrespondence: Katarina Puco, Department of Oncology, Hematology and Palliative Care, Lovisenberg Diaconal Hospital, Oslo, Norway, Tel +47 416 86 298, Email katarina.puco@lds.noPurpose: In Norway, 5-year survival rates of patients with renal cell carcinoma (RCC) are increasing. The objective of this study was to describe the survival of real-world patients with metastatic RCC (mRCC) across Norway and to identify associated factors. The results may provide additional information on the benefits of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) in clinical practice.Patients and Methods: We performed a longitudinal, retrospective, non-interventional cohort study using data from four national registries. The study included adults diagnosed with mRCC between 1 January 1995 and 31 December 2018. Primary endpoint was to evaluate overall survival (OS) in all included patients. Secondary endpoints included further analysis of treatment patterns and possible impact on OS. Secondary endpoint analysis was performed in patients diagnosed with mRCC between 1 January 2008 and 31 December 2018, as complete data on systemic therapies were available from 2008 and onwards.Results: In total, 4078 patients were diagnosed with mRCC in the period from 1995 to 2018. The median OS since initial mRCC diagnosis was 1.17 years. OS appeared to improve over time, 5-year OS was 10% in patients diagnosed in the period 1995– 2001 compared to 25% in 2012– 2015. The secondary analysis included 2338 patients. Fifty-five percent (55%) of the patients received systemic treatment. No differences were observed in the number of treatment lines administered over time or in the number of lines of treatment administered according to tumor histology. Among 343 patients who received ≥ 3 treatment lines, we observed longer OS in patients who received an ICI as a part of their treatment, with a median OS of 4.51 compared to 2.31 years.Conclusion: Provision of information into registries is mandatory in Norway. This retrospective, registry-based study provides real-world evidence on patient outcomes and treatments of the Norwegian patients with mRCC in the period from 1995 to 2018.Keywords: real-world data, immunotherapy, molecular targeted therapy, Norway, renal cell carcinoma

Xiao-Yun Zha, Chang-Shun Wei, Jia-Jia Dong, Jin-Zhi Wu, Liang-Xiao Xie, Ze-Hong Xu, Hua-Qiang Zheng, Duo-Bin Huang, Peng-Bin Lai The First Department of Endocrinology and Metabolism, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, 363000, People’s Republic of ChinaCorrespondence: Peng-Bin Lai, The First Department of Endocrinology and Metabolism, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, 363000, People’s Republic of China, Tel +8613709398727, Email 13709398727@163.comPurpose: This study aims to analyze the impact of serum C-peptide levels in patients with newly diagnosed type 2 diabetes (T2DM) on the 10-year risk of atherosclerotic cardiovascular disease (ASCVD).Patients and Methods: A total of 1923 patients with newly diagnosed T2DM were selected and categorized into four groups based on the interquartile range of fasting C-peptide (FCP) levels: Q1 group (FCP≤ 0.568 ng/mL), Q2 group (0.568 < FCP≤ 0.751 ng/mL), Q3 group (0.751 < FCP≤ 0.980 ng/mL), and Q4 group (FCP > 0.980 ng/mL). Clinical data were collected, and the China-PAR model was employed to evaluate the risk score of ASCVD within 10 years. Additionally, the correlation between FCP levels and the risk of ASCVD was analyzed.Results: As the quartiles of FCP increased, the 10-year ASCVD risk exhibited a gradual increase. The risk score in the FCP > 0.980 ng/mL group was significantly higher than that in the other groups, with noted differences related to gender and weight. Multiple linear regression analysis indicated that, even after adjusting for confounding factors such as gender, age, body mass index (BMI), and glycosylated hemoglobin, FCP levels remained a positive predictor of the 10-year ASCVD risk.Conclusion: High FCP levels are identified as a risk factor for ASCVD within 10 years in patients with newly diagnosed T2DM.Keywords: type 2 diabetes, fasting C-peptide, ASCVD risk

Cheng-Sheng Yu,1– 4,&ast; Jenny L Wu,5,&ast; Chun-Ming Shih,6– 8 Kuan-Lin Chiu,9 Yu-Da Chen,9,10 Tzu-Hao Chang5,11 1Graduate Institute of Data Science, College of Management, Taipei Medical University, New Taipei City, 235603, Taiwan; 2Clinical Data Center, Office of Data Science, Taipei Medical University, New Taipei City, 235603, Taiwan; 3Fintech Innovation Center, Nan Shan Life Insurance Co., Ltd., Taipei, 11049, Taiwan; 4Beyond Lab, Nan Shan Life Insurance Co., Ltd., Taipei, 11049, Taiwan; 5Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, New Taipei City, 235603, Taiwan; 6Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan; 7Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, 11031, Taiwan; 8Taipei Heart Institute, Taipei Medical University, Taipei, 11031, Taiwan; 9Department of Family Medicine, Taipei Medical University Hospital, Taipei, 11031, Taiwan; 10School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan; 11Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, 11031, Taiwan&ast;These authors contributed equally to this workCorrespondence: Tzu-Hao Chang; Yu-Da Chen, Email kevinchang@tmu.edu.tw; 153072@h.tmu.edu.twPurpose: As HF progresses into advanced HF, patients experience a poor quality of life, distressing symptoms, intensive care use, social distress, and eventual hospital death. We aimed to investigate the relationship between morality and potential prognostic factors among in-patient and emergency patients with HF.Patients and Methods: A case series study: Data are collected from in-hospital and emergency care patients from 2014 to 2021, including their international classification of disease at admission, and laboratory data such as blood count, liver and renal functions, lipid profile, and other biochemistry from the hospital’s electrical medical records. After a series of data pre-processing in the electronic medical record system, several machine learning models were used to evaluate predictions of HF mortality. The outcomes of those potential risk factors were visualized by different statistical analyses.Results: In total, 3871 hF patients were enrolled. Logistic regression showed that intensive care unit (ICU) history within 1 week (OR: 9.765, 95% CI: 6.65, 14.34; p-value < 0.001) and prothrombin time (OR: 1.193, 95% CI: 1.098, 1.296; < 0.001) were associated with mortality. Similar results were obtained when we analyzed the data using Cox regression instead of logistic regression. Random forest, support vector machine (SVM), Adaboost, and logistic regression had better overall performances with areas under the receiver operating characteristic curve (AUROCs) of > 0.87. Naïve Bayes was the best in terms of both specificity and precision. With ensemble learning, age, ICU history within 1 week, and respiratory rate (BF) were the top three compelling risk factors affecting mortality due to HF. To improve the explainability of the AI models, Shapley Additive Explanations methods were also conducted.Conclusion: Exploring HF mortality and its patterns related to clinical risk factors by machine learning models can help physicians make appropriate decisions when monitoring HF patients’ health quality in the hospital.Keywords: mortality, risk factor, cardiovascular disease, multivariate statistical analysis, machine learning, artificial intelligence

Dario Kohlbrenner,1,2,&ast; Manuel Kuhn,1,2,&ast; Adrian Kläy,1,2 Noriane A Sievi,2 Michal Muszynski,3 Adam Ivankay,3 Christoph S Gross,4 Alina Asisof,4 Thomas Brunschwiler,3 Christian F Clarenbach1,2 1Faculty of Medicine, University of Zurich, Zurich, Switzerland; 2Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland; 3IBM Research - Europe, Zurich, Switzerland; 4Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland&ast;These authors contributed equally to this workCorrespondence: Dario Kohlbrenner, Department of Pulmonology, University Hospital Zurich, Rämistrasse 100, Zurich, 8091, Switzerland, Email dario.kohlbrenner@usz.chObjective: To investigate the effectiveness of 12-weeks hybrid virtual coaching on health-related quality-of-life (HrQoL) in patients with stable COPD.Methods: We equipped all patients with a CAir Desk for telemonitoring, the intervention group additionally received hybrid virtual coaching through the built-in smartphone. The multimodal intervention based on the Living well with COPD programme, containing educational content, physical activity coaching, and home-based exercises. Primary outcome was HrQoL as measured by the SGRQ. Secondary outcomes were symptom burden, physical activity, functional exercise capacity, and lung function. Between-group differences were calculated using linear regression models, controlling for baseline differences.Results: We included 30 participants with COPD (13/17 women/men; 63 [9] years; FEV1 54 [22] % predicted), 24 (80%) completed the study. SGRQ improved in both groups (intervention: − 4.5 [20.1]; control: − 2.7 [7.4] points) without statistically significant or clinically relevant between-group differences (B = − 2.5 points, 95% CI = − 24.3, 19.3, p = 0.81). Physical activity increased only in the intervention group (313 [1561] vs − 364 [2399] steps) without statistically significant but clinically relevant between-group difference (B = 2147 steps, 95% CI = − 86, 4395, p = 0.06). Symptom burden decreased in both groups (− 4.2 [6.7] vs − 1.0 [2.8] points) without statistically significant but clinically relevant between-group difference (B = − 3.0 points, 95% CI = − 10.8, 5.0, p = 0.43).Conclusion: Twelve-weeks hybrid virtual coaching did not improve HrQoL more than telemonitoring only in patients with stable COPD. The intervention group improved their physical activity and symptom burden clinically relevant more than the control group.Keywords: COPD, conversational agent, telemedicine, physical activity

Naeem Mubarak,1 Fatima Rahman Rana,1 Taheer Zahid,2,&ast; Umm-E-Barirah Ijaz,1,&ast; Afshan Shabbir,1,&ast; Ahtesham Ghulam Bari,1,&ast; Bisma Niaz,1,&ast; Sabba Kanwal,1 Nasira Saif-Ur-Rahman,3 Zahid Iqbal,1 Asad Majeed Khan,3 Che Suraya Zin,4 Khalid Mahmood,5 Mohamed Hassan Elnaem,6 Saba Tariq7 1Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences, Lahore, Pakistan; 2Pharmacy Manager, Servaid Pharmacy, 24-M Quaid-E-Azam Industrial Estate, Lahore, Punjab, Pakistan; 3Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences, Lahore, Pakistan; 4Department of Pharmacy Practice, Kulliyyah of Pharmacy, International Islamic University, Kuantan, Malaysia; 5Institute of Information Management, University of the Punjab, Lahore, Punjab, Pakistan; 6School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, UK; 7Pharmacology and Therapeutics, University Medical & Dental College, the University of Faisalabad, University of Birmingham, Birmingham, UK&ast;These authors contributed equally to this workCorrespondence: Saba Tariq, Department of Metabolism and Systems Sciences, School of Medical Sciences, College of Medicine and Health, University of Birmingham, B15 2TT, Birmingham, England, United Kingdom, Email s.tariq@bham.ac.uk Naeem Mubarak, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences, Lahore, Punjab, 54000, Pakistan, Email naeem.mubarak@ubas.edu.pkBackground: The opioid crisis continues to be a public health concern worldwide due to the high rates of misuse and associated mortality. Opioid dispensing competencies are critical for pharmacy graduates to promote the rational use of opioids.Purpose: To evaluate the opioids dispensing competencies among the final year Pharm-D students in Punjab, Pakistan.Design: A multicenter cross-sectional study.Methods: A validated survey was used to evaluate 11 competencies related to opioid use from the final year Pharm-D students from diversely located accredited institutes. On a summative scale, correct response to each survey item was worth a score/point. Descriptive statistics was used for categorical variables while independent t-test computed group differences.Results: A total of n = 661 final year Pharm-D students from 28 institutes (8 public and 20 private) completed the survey with an overall response rate of 78.5%. Comparatively, the students who had either completed a community or hospital internship, or studying in the educational institutions located in the provincial capital demonstrated a significant higher competency score. There was no significant difference in the overall mean competency scores based on gender or system of assessment used in the Pharm-D degree programs. Among eleven opioid competencies, students received the lowest scores for “opioid overdose management”, “opioid monitoring” and “therapeutic uses of opioids”.Conclusion: Pharm-D students in Pakistan require additional training and skills on many of the opioids related competencies to ensure patient’s safety in healthcare settings. There is a need to revise the curriculum and teaching methodologies to improve the competencies of Pharm-D students in opioid dispensing.Plain Language Summary: The study was conducted to assess the opioids dispensing competencies of final-year Pharm-D students in Punjab, Pakistan. These competencies were identified in an Australian study which defined 11 consensus-based core competencies on opioid use and dispensing for pharmacist. Given the ongoing opioid crisis, it is crucial for future pharmacists to acquire the necessary knowledge, skills, and confidence to handle opioid prescriptions, provide patient education, and contribute to harm reduction efforts. The results of the study underscored the importance of continuous education and training for pharmacy students in opioid use and dispensing. Competency in this area is essential for reducing the risk of opioid misuse and overdose, ensuring safe and effective patient care, and supporting broader public health efforts to combat the opioid crisis. The findings suggest that among eleven opioid competencies, students received the lowest scores for “opioid overdose management”, “opioid monitoring” and “therapeutic uses of opioids”.This calls for the development of specialized training programs, policy changes, and enhanced support for pharmacy students in these areas as they prepare to navigate the complexities of opioid dispensing and patient safety in their future careers.Keywords: opioid use, opioid dispensing, opioid competency, pharmacy students, pharmacy education

Penelitian ini bertujuan untuk mengevaluasi pengaruh latihan tendangan menggunakan kaki dalam dan punggung kaki penuh terhadap ketepatan shooting ke gawang pada siswa ekstrakurikuler futsal SMA Negeri 3 Sentani. Populasi terdiri dari 60 orang dan sampel yang digunakan sebanyak 20 orang melalui teknik porposive sample. Variabel penelitian terdiri dari variabel bebas yaitu shooting kaki dalam dan shooting kaki panggung serta variabel terikat yaitu ketepatan shooting ke gawang. Analisis data dilakukan uji normalitas dan uji homogenitas. Hasil penelitian dapat disimpulkan bahwa: (1) ada pengaruh latihan tendangan kaki dalam terhadap ketepatan shooting, karena thitung (3.588) > ttabel (2.093). (2) ada pengaruh latihan tendangan punggung kaki penuh terhadap ketepatan shooting karena thitung (4.178) > ttabel (2.093). (3) latihan shooting menggunakan kaki dalam lebih baik dari pada shooting dengan punggung kaki, karena hasil rata-rata latihan shooting dengan puggung kaki yaitu 15.00 dan 12.90. kesimpulan bahwa untuk pelatih futsal dalam meningkatkan akurasi shooting ke gawang dapat menggunakan latihan tendangan dengan kaki dalam karena lebih efektif dalam ketepatan tendangan ke gawang

Mehtap Tatar,1 Cansu Selcan Akdeniz,2 Utku Zeybey,2 Salih &Scedil;ahin,2 Çavlan Çiftçi2 1Vitale Health Economics, Policy and Consultancy, London, UK; 2Demiro&gbreve;lu Bilim University, Istanbul, TurkeyCorrespondence: Mehtap Tatar, Vitale Health Economics, Policy and Consultancy, London, UK, Email mehtap.tatar@vitalehealtheconomics.co.ukPurpose: In cardiovascular surgeries, iron deficiency anemia and transfusion of blood products are associated with mortality and morbidity, prolonged hospital stay and poor patient outcomes. Patient blood management (PBM) is a patient-centered approach based on a ‘three pillar’ model that promotes optimum use of blood and blood products to improve outcomes. This study assessed the potential budget impact of implementing PBM in patients undergoing elective cardiovascular surgery in a private hospital in Turkey.Methods: Two models were developed to estimate the hospital budget impact of PBM. The first model encompassed implementation of the first pillar of PBM, which proposes treatment of iron deficiency anemia before a surgical procedure. The second covered implementation of all three pillars of PBM. Budget impact was estimated from the number of avoided complications after treating iron deficiency anemia and reducing blood transfusions. Rates of complication (sepsis, myocardial infarction, renal failure and stroke) with and without PBM were taken from published meta-analyses. Data on 882 cardiovascular operations performed during 2020– 2022 were taken from the Florence Nightingale Istanbul Hospital. The costs of treating complications were estimated by applying Turkish Social Security Institution prices to a healthcare resource utilization tool for each complication completed by experts.Results: Results from the budget impact analysis showed that, by implementing the first pillar of PBM, the department could have avoided 30 complications and saved 4,189,802 TRY. For the second model based on implementing all three pillars of PBM, 29 complications could have been avoided by reducing the number of transfusions, with budget savings of 6,174,434 TRY. Reducing the length of hospital stay could have enabled 137 additional operations in the given period.Conclusion: Implementation of PBM in patients undergoing elective cardiovascular surgery in private hospitals could be a budget-saving strategy in Turkey and may provide an opportunity to increase revenue.Keywords: patient blood management, budget impact, anemia, cardiovascular surgery, healthcare resource utilization, Turkey

Osman Savran,1 Klaus Bønnelykke,2,3 Charlotte Suppli Ulrik1,2 1Respiratory Research Unit Hvidovre, Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Hvidovre, Denmark; 2Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; 3COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital Gentofte, Gentofte, DenmarkCorrespondence: Osman Savran, Respiratory Research Unit Hvidovre, Department of Respiratory Medicine Copenhagen University Hospital - Hvidovre, Hvidovre, Denmark, Email osmansavran@ymail.comBackground and Aim: Asthma in early life has been linked to subsequent development of COPD and according to GOLD 2023 COPD may be divided into distinct subtypes. We aimed to investigate factors associated with the GOLD classification COPD-A (asthma in childhood) and COPD-C (tobacco exposure) in a cohort of adults with a history of severe childhood asthma.Patients and Methods: In a cohort of Danish adults with a history of severe childhood asthma and a previous 4-month stay during childhood at the asthma care facility in Kongsberg, Norway, we divided participants in a long-term follow-up examination into COPD-A and COPD-C, defined as post-bronchodilator FEV1/FVC < 0.7, and never-smoker or ever-smoker, respectively, and no airflow limitation. Characteristics between groups were analysed.Results: The study cohort comprised 232 adults with a history of severe childhood asthma, of whom 30 (13%) and 23 (10%), respectively, were classified as COPD-A and COPD-C. Compared to those with no airflow limitation, individuals with COPD-A and COPD-C more often had had at least one exacerbation (filled prescription of oral corticosteroid) in the past 12 months (risk ratio [RR] 1.83 and 2.65, respectively). The COPD-C group had a significantly higher Medical Research Council dyspnoea score (p< 0.01) and significantly higher blood eosinophil count (p< 0.01) than those with no airflow limitation. Compared to the COPD-C group, the COPD-A group had higher fractional exhaled nitric oxide (mean 29 [SD 28]) and FEV1%pred (mean 75 [SD 20]). Finally, when comparing participants with COPD-A to both COPD-C and participants without airflow limitation, the proportion of participants with osteoporosis (17%) and depression (10%) was more than twice as high.Conclusion: Our study revealed a high prevalence and unique features of the two COPD subtypes COPD-A and COPD-C in a cohort of adults with a history of severe childhood asthma.Keywords: early life, asthma, etiotypes, adult, Kongsberg cohort

Hui Chen, Jing-Jing Li, Chun-Shuang Guan, Ming Xue, Yu-Xue Xing, Ru-Ming Xie Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Ru-Ming Xie, Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China, Email ch0002018@126.comPurpose: To investigate whole-brain gray matter volume (GMV) changes in human immunodeficiency (HIV)-negative patients with general paresis of the insane (GPI) using voxel-based morphometry (VBM).Patients and Methods: A total of 18 HIV-negative individuals with GPI and 24 healthy control volunteers matched for sex, age, and education were enrolled in this study. 3 D T1-weighted imaging (3D T1WI) structural images of GPI patients and healthy controls were preprocessed using VBM. The GMV was then segmented and compared between the two groups. In addition, the correlation between cortical/subcortical GMVs and neuropsychological/laboratory test results was analyzed.Results: Compared to the normal control group, the GPI group showed a decrease in GMV in multiple regions, including the bilateral frontal cortices (superior frontal gyrus, middle frontal gyrus, orbital gyrus), bilateral temporal/occipital cortices (superior temporal, bilateral inferior temporal, bilateral parahippocampal, bilateral cingulate, left precentral, left fusiform, left posterior superior temporal sulcus, left lateral occipital, right middle temporal, right precuneus, right insular, and right medioventral occipital), and right parietal cortices (right superior parietal, right inferior parietal) (p< 0.01, FDR corrected). Additionally, there was an increase in GMV in the bilateral basal ganglia, right hippocampus, and bilateral thalamus (p< 0.01, FDR corrected). In the GPI group, GMVs of the right rostral hippocampus (r=− 0.524, p=0.026), bilateral dorsal caudate nucleus (r=− 0.604, p=0.008; r=− 0.685, p=0.002), and the right rostral temporal thalamus (r=− 0.560, p=0.016) were negatively correlated with MMSE score.Conclusion: VBM showed that there are structural changes in brain GMV in HIV-negative GPI patients. The use of VBM has the potential to provide a valuable imaging basis for the diagnosis of GPI.Keywords: neurosyphilis, magnetic resonance imaging, general paresis of the insane, voxel-based morphometry, gray matter

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.

The Dark Energy Spectroscopic Instrument (DESI) was designed to conduct a survey covering 14,000 deg2 over 5 yr to constrain the cosmic expansion history through precise measurements of baryon acoustic oscillations (BAO). The scientific program for DESI was evaluated during a 5 month survey validation (SV) campaign before beginning full operations. This program produced deep spectra of tens of thousands of objects from each of the stellar Milky Way Survey (MWS), Bright Galaxy Survey (BGS), luminous red galaxy (LRG), emission line galaxy (ELG), and quasar target classes. These SV spectra were used to optimize redshift distributions, characterize exposure times, determine calibration procedures, and assess observational overheads for the 5 yr program. In this paper, we present the final target selection algorithms, redshift distributions, and projected cosmology constraints resulting from those studies. We also present a One-Percent Survey conducted at the conclusion of SV covering 140 deg2 using the final target selection algorithms with exposures of a depth typical of the main survey. The SV indicates that DESI will be able to complete the full 14,000 deg2 program with spectroscopically confirmed targets from the MWS, BGS, LRG, ELG, and quasar programs with total sample sizes of 7.2, 13.8, 7.46, 15.7, and 2.87 million, respectively. These samples will allow exploration of the Milky Way halo, clustering on all scales, and BAO measurements with a statistical precision of 0.28% over the redshift interval z < 1.1, 0.39% over the redshift interval 1.1 < z < 1.9, and 0.46% over the redshift interval 1.9 < z < 3.5.

The CP properties of the coupling between the Higgs boson and the top quark are investigated using 139 fb−1 of proton–proton collision data recorded by the ATLAS experiment at the LHC at a centre-of-mass energy of s=13 TeV. The CP structure of the top quark–Higgs boson Yukawa coupling is probed in events with a Higgs boson decaying into a pair of b-quarks and produced in association with either a pair of top quarks, tt¯H, or a single top quark, tH. Events containing one or two electrons or muons are used for the measurement. Multivariate techniques are used to select regions enriched in tt¯H and tH events, where dedicated CP-sensitive observables are exploited. In an extension of the Standard Model (SM) with a CP-odd admixture in the top–Higgs Yukawa coupling, the mixing angle between CP-even and CP-odd couplings is measured to be α=11−73∘∘+52∘, compatible with the SM prediction corresponding to α=0.

Weakly interacting massive particles (WIMPs) may interact with a virtual pion that is exchanged between nucleons. This interaction channel is important to consider in models where the spin-independent isoscalar channel is suppressed. Using data from the first science run of the LUX-ZEPLIN dark matter experiment, containing 60 live days of data in a 5.5 tonne fiducial mass of liquid xenon, we report the results on a search for WIMP-pion interactions. We observe no significant excess and set an upper limit of 1.5 × 10−46 cm2 at a 90% confidence level for a WIMP mass of 33 GeV/c2 for this interaction.

Scanning transmission electron microscopy is a common tool used to study the atomic structure of materials. It is an inherently multimodal tool allowing for the simultaneous acquisition of multiple information channels. Despite its versatility, however, experimental workflows currently rely heavily on experienced human operators and can only acquire data from small regions of a sample at a time. Here, we demonstrate a flexible pipeline-based system for high-throughput acquisition of atomic-resolution structural data using an all-piezo sample stage applied to large-scale imaging of nanoparticles and multimodal data acquisition. The system is available as part of the user program of the Molecular Foundry at Lawrence Berkeley National Laboratory.