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1. Zero Shot Molecular Generation via Similarity Kernels

Author

Elijošius, Rokas, Zills, Fabian, Batatia, Ilyes, Norwood, Sam Walton, Kovács, Dávid Péter, Holm, Christian, and Csányi, Gábor

Subjects
Physics - Chemical Physics, Computer Science - Machine Learning
Abstract

Generative modelling aims to accelerate the discovery of novel chemicals by directly proposing structures with desirable properties. Recently, score-based, or diffusion, generative models have significantly outperformed previous approaches. Key to their success is the close relationship between the score and physical force, allowing the use of powerful equivariant neural networks. However, the behaviour of the learnt score is not yet well understood. Here, we analyse the score by training an energy-based diffusion model for molecular generation. We find that during the generation the score resembles a restorative potential initially and a quantum-mechanical force at the end. In between the two endpoints, it exhibits special properties that enable the building of large molecules. Using insights from the trained model, we present Similarity-based Molecular Generation (SiMGen), a new method for zero shot molecular generation. SiMGen combines a time-dependent similarity kernel with descriptors from a pretrained machine learning force field to generate molecules without any further training. Our approach allows full control over the molecular shape through point cloud priors and supports conditional generation. We also release an interactive web tool that allows users to generate structures with SiMGen online (https://zndraw.icp.uni-stuttgart.de).

Published
2024

2. Adaptive Randomization Methods for Sequential Multiple Assignment Randomized Trials (SMARTs) via Thompson Sampling

Author

Norwood, Peter, Davidian, Marie, and Laber, Eric

Subjects
Statistics - Methodology, 62P10
Abstract

Response-adaptive randomization (RAR) has been studied extensively in conventional, single-stage clinical trials, where it has been shown to yield ethical and statistical benefits, especially in trials with many treatment arms. However, RAR and its potential benefits are understudied in sequential multiple assignment randomized trials (SMARTs), which are the gold-standard trial design for evaluation of multi-stage treatment regimes. We propose a suite of RAR algorithms for SMARTs based on Thompson Sampling (TS), a widely used RAR method in single-stage trials in which treatment randomization probabilities are aligned with the estimated probability that the treatment is optimal. We focus on two common objectives in SMARTs: (i) comparison of the regimes embedded in the trial, and (ii) estimation of an optimal embedded regime. We develop valid post-study inferential procedures for treatment regimes under the proposed algorithms. This is nontrivial, as (even in single-stage settings) RAR can lead to nonnormal limiting distributions of estimators. Our algorithms are the first for RAR in multi-stage trials that account for nonregularity in the estimand. Empirical studies based on real-world SMARTs show that TS can improve in-trial subject outcomes without sacrificing efficiency for post-trial comparisons., Comment: 49 pages, 3 figures

Published
2024

4. Clipping the Positive Lymph Node in Patients with Clinically Node Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: Impact on Axillary Surgery in the ISPY-2 Clinical Trial

Author

Switalla, Kayla M., Boughey, Judy C., Dimitroff, Katrina, Yau, Christina, Ladores, Velle, Yu, Hongmei, Tchou, Julia, Golshan, Mehra, Ahrendt, Gretchen, Postlewait, Lauren M., Piltin, Mara, Reyna, Chantal R., Matsen, Cindy B., Tuttle, Todd M., Wallace, Anne M., Arciero, Cletus A., Lee, Marie Catherine, Tseng, Jennifer, Son, Jennifer, Rao, Roshni, Sauder, Candice, Naik, Arpana, Howard-McNatt, Marissa, Lancaster, Rachael, Norwood, Peter, Esserman, Laura J., and Mukhtar, Rita A.

Published
2024
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5. Internal Mammary Lymphadenopathy Does Not Impact Oncologic Outcomes in Patients Treated with Neoadjuvant Chemotherapy: Results from the I-SPY2 Clinical Trial

Author

Piltin, Mara A., Norwood, Peter, Ladores, Velle, Mukhtar, Rita A., Sauder, Candice A., Golshan, Mehra, Tchou, Julia, Rao, Roshni, Lee, Marie Catherine, Son, Jennifer, Reyna, Chantal, Hewitt, Kelly, Kuerer, Henry, Ahrendt, Gretchen, Greenwalt, Ian, Tseng, Jennifer, Postlewait, Lauren, Howard-McNatt, Marissa, Jaskowiak, Nora, Esserman, Laura J., and Boughey, Judy C.

Published
2024
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6. Responding to the workforce crisis: consensus recommendations from the Second Workforce Summit of the American Society of Pediatric Nephrology

Author

Soranno, Danielle E., Amaral, Sandra, Ashoor, Isa, Atkinson, Meredith A., Barletta, Gina-Marie, Braun, Michael C., Carlson, Joann, Carter, Caitlin, Chua, Annabelle, Dharnidharka, Vikas R., Drake, Keri, Erkan, Elif, Feig, Dan, Goldstein, Stuart L., Hains, David, Harshman, Lyndsay A., Ingulli, Elizabeth, Kula, Alexander J., Leonard, Mary, Mannemuddhu, Sudha, Menon, Shina, Modi, Zubin J., Moxey-Mims, Marva, Nada, Arwa, Norwood, Victoria, Starr, Michelle C., Verghese, Priya S., Weidemann, Darcy, Weinstein, Adam, and Smith, Jodi

Published
2024
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7. Rapid and Ultrasensitive Colorimetric Biosensors for Onsite Detection of Escherichia coli O157:H7 in Fluids

Author

Pan, Bofeng, El-Moghazy, Ahmed Y, Norwood, Makela, Nitin, Nitin, and Sun, Gang

Subjects
Analytical Chemistry, Chemical Sciences, Bioengineering, Infection, Escherichia coli O157, Colorimetry, Biosensing Techniques, foam-based ELISA, Escherichia coli O157:H7, on-site detection, foodborne pathogens, colorimetricbiosensor, colorimetric biosensor, Biomedical Engineering, Nanotechnology, Analytical chemistry, Electronics, sensors and digital hardware
Abstract

This study presents a breakthrough in the field of onsite bacterial detection, offering an innovative, rapid, and ultrasensitive colorimetric biosensor for the detection of Escherichia coli (E. coli) O157:H7, using chemically modified melamine foam (MF). Different from conventional platforms, such as 96-well plates and fiber-based membranes, the modified MF features a macroporous reticulated three-dimensional (3D) framework structure, allowing fast and free movement of large biomolecules and bacteria cells through the MF structure in every direction and ensuring good accessibility of entire active binding sites of the framework structure with the target bacteria, which significantly increased sensitive and volume-responsive detection of whole-cell bacteria. The biosensing platform requires less than 1.5 h to complete the quantitative detection with a sensitivity of 10 cfu/mL, discernible by the naked eye, and an enhanced sensitivity of 5 cfu/mL with the help of a smartphone. Following a short enrichment period of 1 h, the sensitivity was further amplified to 2 cfu/mL. The biosensor material is volume responsive, making the biosensing platform sensitivity increase as the volume of the sample increases, and is highly suitable for testing large-volume fluid samples. This novel material paves the way for the development of volume-flexible biosensing platforms for the record-fast, onsite, selective, and ultrasensitive detection of various pathogenic bacteria in real-world applications.

Published
2024

8. Failure rates of nonoperative management of low-grade splenic injuries with active extravasation: an Eastern Association for the Surgery of Trauma multicenter study.

Author

Spoor, Kristen, Cull, John, Otaibi, Banan, Hazelton, Joshua, Chipko, John, Reynolds, Jessica, Fugate, Sam, Pederson, Claire, Zier, Linda, Jacobson, Lewis, Williams, Jamie, Easterday, Thomas, Byerly, Saskya, Mentzer, Caleb, Hawke, Edward, Cullinane, Daniel, Ontengco, Julianne, Bugaev, Nikolay, LeClair, Madison, Udekwu, Pascal, Josephs, Cooper, Noorbaksh, Matthew, Babowice, James, Velopulos, Catherine, Urban, Shane, Goldenberg, Anna, Ghobrial, Gaby, Pickering, John, Quarfordt, Steven, Aunchman, Alia, LaRiccia, Aimee, Spalding, Chance, Catalano, Richard, Basham, Jordan, Edmundson, Philip, Tay, Erika, Norwood, Scott, Meadows, Katelyn, Wong, Yee, Hardman, Claire, and Nahmias, Jeffry

Subjects
abdominal injuries, spleen, treatment outcome
Abstract

OBJECTIVES: There is little evidence guiding the management of grade I-II traumatic splenic injuries with contrast blush (CB). We aimed to analyze the failure rate of nonoperative management (NOM) of grade I-II splenic injuries with CB in hemodynamically stable patients. METHODS: A multicenter, retrospective cohort study examining all grade I-II splenic injuries with CB was performed at 21 institutions from January 1, 2014, to October 31, 2019. Patients >18 years old with grade I or II splenic injury due to blunt trauma with CB on CT were included. The primary outcome was the failure of NOM requiring angioembolization/operation. We determined the failure rate of NOM for grade I versus grade II splenic injuries. We then performed bivariate comparisons of patients who failed NOM with those who did not. RESULTS: A total of 145 patients were included. Median Injury Severity Score was 17. The combined rate of failure for grade I-II injuries was 20.0%. There was no statistical difference in failure of NOM between grade I and II injuries with CB (18.2% vs 21.1%, p>0.05). Patients who failed NOM had an increased median hospital length of stay (p=0.024) and increased need for blood transfusion (p=0.004) and massive transfusion (p=0.030). Five patients (3.4%) died and 96 (66.2%) were discharged home, with no differences between those who failed and those who did not fail NOM (both p>0.05). CONCLUSION: NOM of grade I-II splenic injuries with CB fails in 20% of patients. LEVEL OF EVIDENCE: IV.

Published
2024

9. A foundation model for atomistic materials chemistry

Author

Batatia, Ilyes, Benner, Philipp, Chiang, Yuan, Elena, Alin M., Kovács, Dávid P., Riebesell, Janosh, Advincula, Xavier R., Asta, Mark, Avaylon, Matthew, Baldwin, William J., Berger, Fabian, Bernstein, Noam, Bhowmik, Arghya, Blau, Samuel M., Cărare, Vlad, Darby, James P., De, Sandip, Della Pia, Flaviano, Deringer, Volker L., Elijošius, Rokas, El-Machachi, Zakariya, Falcioni, Fabio, Fako, Edvin, Ferrari, Andrea C., Genreith-Schriever, Annalena, George, Janine, Goodall, Rhys E. A., Grey, Clare P., Grigorev, Petr, Han, Shuang, Handley, Will, Heenen, Hendrik H., Hermansson, Kersti, Holm, Christian, Jaafar, Jad, Hofmann, Stephan, Jakob, Konstantin S., Jung, Hyunwook, Kapil, Venkat, Kaplan, Aaron D., Karimitari, Nima, Kermode, James R., Kroupa, Namu, Kullgren, Jolla, Kuner, Matthew C., Kuryla, Domantas, Liepuoniute, Guoda, Margraf, Johannes T., Magdău, Ioan-Bogdan, Michaelides, Angelos, Moore, J. Harry, Naik, Aakash A., Niblett, Samuel P., Norwood, Sam Walton, O'Neill, Niamh, Ortner, Christoph, Persson, Kristin A., Reuter, Karsten, Rosen, Andrew S., Schaaf, Lars L., Schran, Christoph, Shi, Benjamin X., Sivonxay, Eric, Stenczel, Tamás K., Svahn, Viktor, Sutton, Christopher, Swinburne, Thomas D., Tilly, Jules, van der Oord, Cas, Varga-Umbrich, Eszter, Vegge, Tejs, Vondrák, Martin, Wang, Yangshuai, Witt, William C., Zills, Fabian, and Csányi, Gábor

Subjects
Physics - Chemical Physics, Condensed Matter - Materials Science
Abstract

Machine-learned force fields have transformed the atomistic modelling of materials by enabling simulations of ab initio quality on unprecedented time and length scales. However, they are currently limited by: (i) the significant computational and human effort that must go into development and validation of potentials for each particular system of interest; and (ii) a general lack of transferability from one chemical system to the next. Here, using the state-of-the-art MACE architecture we introduce a single general-purpose ML model, trained on a public database of 150k inorganic crystals, that is capable of running stable molecular dynamics on molecules and materials. We demonstrate the power of the MACE-MP-0 model - and its qualitative and at times quantitative accuracy - on a diverse set problems in the physical sciences, including the properties of solids, liquids, gases, chemical reactions, interfaces and even the dynamics of a small protein. The model can be applied out of the box and as a starting or "foundation model" for any atomistic system of interest and is thus a step towards democratising the revolution of ML force fields by lowering the barriers to entry., Comment: 119 pages, 63 figures, 37MB PDF

Published
2023

12. Search for UHE Photons from Gravitational Wave Sources with the Pierre Auger Observatory

Author

The Pierre Auger Collaboration, Halim, A. Abdul, Abreu, P., Aglietta, M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Bwembya, A., Caballero-Mora, K. S., Caccianiga, L., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Conte, M., Contreras, F., Convenga, F., Santos, D. Correia dos, Costa, P. J., Covault, C. E., Cristinziani, M., Sanchez, C. S. Cruz, Dasso, S., Daumiller, K., Dawson, B. R., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Ebr, J., Emam, M., Engel, R., Epicoco, I., Erdmann, M., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fernandes, A., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Flaggs, B., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Majercakova, M., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Martins, M. A., Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Meinert, J., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Müller, A. L., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Pereira, L. A. S., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Platino, M., Pont, B., Pothast, M., Shavar, M. Pourmohammad, Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shivashankara, S. U., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Straub, M., Streich, A., Suárez-Durán, M., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., and Zavrtanik, M.

Subjects
Astrophysics - High Energy Astrophysical Phenomena, General Relativity and Quantum Cosmology
Abstract

A search for time-directional coincidences of ultra-high-energy (UHE) photons above 10 EeV with gravitational wave (GW) events from the LIGO/Virgo runs O1 to O3 is conducted with the Pierre Auger Observatory. Due to the distinctive properties of photon interactions and to the background expected from hadronic showers, a subset of the most interesting GW events is selected based on their localization quality and distance. Time periods of 1000 s around and 1 day after the GW events are analyzed. No coincidences are observed. Upper limits on the UHE photon fluence from a GW event are derived that are typically at $\sim$7 MeV cm$^{-2}$ (time period 1000~s) and $\sim$35 MeV cm$^{-2}$ (time period 1 day). Due to the proximity of the binary neutron star merger GW170817, the energy of the source transferred into UHE photons above 40 EeV is constrained to be less than 20% of its total gravitational wave energy. These are the first limits on UHE photons from GW sources., Comment: 15 pages

Published
2023
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13. ASO Visual Abstract: Clipping the Positive Lymph Node in Patients with Clinically Node-Positive Breast Cancer Treated with Neoadjuvant Chemotherapy: Impact on Axillary Surgery in the ISPY-2 Clinical Trial

Author

Switalla, Kayla M., Boughey, Judy C., Dimitroff, Katrina, Yau, Christina, Ladores, Velle, Yu, Hongmei, Tchou, Julia, Golshan, Mehra, Ahrendt, Gretchen, Postlewait, Lauren M., Piltin, Mara, Reyna, Chantal R., Matsen, Cindy B., Tuttle, Todd, Wallace, Anne M., Arciero, Cletus A., Lee, Marie Catherine, Tseng, Jennifer, Son, Jennifer, Rao, Roshni, Sauder, Candice, Naik, Arpana, Howard-McNatt, Marissa, Lancaster, Rachael, Norwood, Peter, Esserman, Laura J., and Mukhtar, Rita A.

Published
2024
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14. ASO Visual Abstract: Internal Mammary Lymphadenopathy Does Not Impact Oncologic Outcomes in Patients Treated with Neoadjuvant Chemotherapy—Results from the I-SPY2 Clinical Trial

Author

Piltin, Mara A., Norwood, Peter, Ladores, Velle, Mukhtar, Rita A., Sauder, Candice A., Golshan, Mehra, Tchou, Julia, Rao, Roshni, Lee, Marie Catherine, Son, Jennifer, Reyna, Chantal, Hewitt, Kelly, Kuerer, Henry, Ahrendt, Gretchen, Greenwalt, Ian, Tseng, Jennifer, Postlewait, Lauren, Howard-McNatt, Marissa, Jaskowiak, Nora, Esserman, Laura J., and Boughey, Judy C.

Published
2024
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15. Grade V renal trauma management: results from the multi-institutional genito-urinary trauma study.

Author

Hakam, Nizar, Keihani, Sorena, Shaw, Nathan M, Abbasi, Behzad, Jones, Charles P, Rogers, Douglas, Wang, Sherry S, Gross, Joel A, Joyce, Ryan P, Hagedorn, Judith C, Selph, J Patrick, Sensenig, Rachel L, Moses, Rachel A, Dodgion, Christopher M, Gupta, Shubham, Mukherjee, Kaushik, Majercik, Sarah, Smith, Brian P, Broghammer, Joshua A, Schwartz, Ian, Baradaran, Nima, Zakaluzny, Scott A, Erickson, Bradley A, Miller, Brandi D, Askari, Reza, Carrick, Matthew M, Burks, Frank N, Norwood, Scott, Myers, Jeremy B, Breyer, Benjamin N, and Multi-institutional Genito-Urinary Trauma Study Group (MiGUTS)

Subjects
Multi-institutional Genito-Urinary Trauma Study Group, Urogenital System, Kidney, Humans, Multiple Trauma, Nephrectomy, Injury Severity Score, Retrospective Studies, Adult, Middle Aged, Trauma Centers, Kidney trauma, Nonoperative management, Urologic trauma, Kidney Disease, Physical Injury - Accidents and Adverse Effects, Patient Safety, 6.4 Surgery, Evaluation of treatments and therapeutic interventions, Clinical Sciences, Urology & Nephrology
Abstract

PurposeTo investigate management trends for American Association for the Surgery of Trauma (AAST) grade V renal trauma with focus on non-operative management.MethodsWe used prospectively collected data as part of the Multi-institutional Genito-Urinary Trauma Study (MiGUTS). We included patients with grade V renal trauma according to the AAST Injury Scoring Scale 2018 update. All cases submitted by participating centers with radiology images available were independently reviewed to confirm renal trauma grade. Management was classified as expectant, conservative (minimally invasive, endoscopic or percutaneous procedures), or operative (renal-related surgery).ResultsEighty patients were included, 25 of whom had complete imaging and had independent confirmation of AAST grade V renal trauma. Median age was 35 years (Interquartile range (IQR) 25-50) and 23 (92%) had blunt trauma. Ten patients (40%) were managed operatively with nephrectomy. Conservative management was used in nine patients (36%) of which six received angioembolization and three had a stent or drainage tube placed. Expectant management was followed in six (24%) patients. Transfusion requirements were progressively higher with groups requiring more aggressive treatment, and injury characteristics differed significantly across management groups in terms of hematoma size and laceration size. Vascular contrast extravasation was more likely in operatively managed patients though a statistically significant association was not found.ConclusionSuccessful use of nonoperative management for grade V injuries is used for a substantial subset of patients. Lower transfusion requirement and less severe injury radiologic phenotype appear to be important characteristics delineating this group.

Published
2023

17. Increased expression of CD70 in relapsed acute myeloid leukemia after hypomethylating agents

Author

Marques-Piubelli, Mario L., Kumar, Bijender, Basar, Rafet, Panowski, Siler, Srinivasan, Surabhi, Norwood, Kevin, Prashad, Sacha, Szenes, Victoria, Balakumaran, Arun, Arandhya, Akanksha, Lu, Wei, Khan, Khaja, Duenas, Daniela, McAllen, Salome, Gomez, Javier A, Burks, Jared K., Acharyal, Sunil, Borthakur, Gautam, Wang, Wei-Lien, Wang, Wei, Wang, Sa, Solis, Luisa M., Marin, David, Rezvani, Katayoun, Daher, May, and Vega, Francisco

Published
2024
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19. H-Wave® Device Stimulation for Chronic Neck Pain: A Patient-Reported Outcome Measures (PROMs) Study

Author

Ashim Gupta, David Han, and Stephen M. Norwood

Subjects
Chronic pain, Neck pain, Electrical stimulation, H-Wave®, H-Wave device stimulation, Patient-reported outcome measures, Anesthesiology, RD78.3-87.3
Abstract

Abstract Introduction Chronic neck pain (cNP) is one of the leading causes of disability worldwide, often being refractory to conventional forms of treatment. Various forms of electrical stimulation have been proposed to decrease pain and improve function. Patient-reported outcome measures (PROMs) for treatment of cNP have rarely been published. Methods An independent retrospective statistical analysis of PROMs data for users of H-Wave® device stimulation (HWDS), prospectively collected by the device manufacturer over a 4-year period, was conducted. Final surveys for 34,192 pain management patients were filtered for pain chronicity limited to 3–24 months and device use of 22–365 days, resulting in 11,503 patients with “all diagnoses”; this number was further reduced to 1482 patients with cNP, sprain, or strain. Results Neck pain was reduced by 3.13 points (0–10 pain scale), with significant (≥ 20%) relief in 86.6%. Function/activities of daily living (ADL) improved in 96.19%, while improved work performance was reported in 84.76%. Medication use decreased or stopped in 65.42% and sleep improved in 60.39%. Over 95% reported having expectations met or exceeded, service satisfaction, and confidence in device use, while no adverse events were reported. Subgroup analyses found positive benefit associations with longer duration of device use. Conclusion Near-equivalent outcomes were self-reported by cNP HWDS patients as for (previously published) chronic low back pain (cLBP) patients. HWDS provided effective and safe cNP relief, improvements in function and ADL, along with additional benefits including decreased medication use, better sleep, and improved work performance.

Published
2024
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20. Exploring US Internal Medicine Resident Career Preferences: A Q-Methodology Study

Author

Roberts, John K., Schub, Micah, Singhal, Surbhi, Norwood, Jamison, Cassini, Thomas, Hudler, Andi, Ramadurai, Deepa, Smith, Christopher C., Desai, Sima S., Weintraub, Jennifer, Hasler, Scott H., Schwiesow, Tyler M., Connors, Geoffrey R., Didwania, Aashish, Hargett, Charles W., and Wolf, Myles

Abstract

Career selection in medicine is a complex and underexplored process. Most medical career studies performed in the U.S. focused on the effect of demographic variables and medical education debt on career choice. Considering ongoing U.S. physician workforce shortages and the trilateral adaptive model of career decision making, a robust assessment of professional attitudes and work-life preferences is necessary. The objective of this study was to explore and define the dominant viewpoints related to career choice selection in a cohort of U.S. IM residents. We administered an electronic Q-sort in which 218 IM residents sorted 50 statements reflecting the spectrum of opinions that influence postgraduate career choice decisions. Participants provided comments that explained the reasoning behind their individual responses. In the final year of residency training, we ascertained participating residents' chosen career. Factor analysis grouped similar sorts and revealed four distinct viewpoints. We characterized the viewpoints as "Fellowship-Bound-Academic," "Altruistic-Longitudinal-Generalist," "Inpatient-Burnout-Aware," and "Lifestyle-Focused-Consultant." There is concordance between residents who loaded significantly onto a viewpoint and their ultimate career choice. Four dominant career choice viewpoints were found among contemporary U.S. IM residents. These viewpoints reflect the intersection of competing priorities, personal interests, professional identity, socio-economic factors, and work/life satisfaction. Better appreciation of determinants of IM residents' career choices may help address workforce shortages and enhance professional satisfaction.

Published
2023
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21. Achieving Health Equity and Continuity of Care for Black and Latinx People Living With HIV.

Author

Loeb, Tamra Burns, Banks, Devin, Ramm, Kate, Viducich, Isabella, Beasley, Quonta, Barron, Juan, Chen, Elizabeth Lee, Norwood-Scott, Enricka, Fuentes, Kimberly, Zhang, Muyu, Brown, Arleen F, Wyatt, Gail E, and Hamilton, Alison B

Subjects
Biomedical and Clinical Sciences, Health Sciences, Humans, Continuity of Patient Care, Health Equity, Health Services Accessibility, Hispanic or Latino, HIV Infections, Black or African American, Medical and Health Sciences, Public Health, Biomedical and clinical sciences, Health sciences
Published
2023

22. Maternal depression, alcohol use, and transient effects of perinatal paraprofessional home visiting in South Africa: Eight-year follow-up of a cluster randomized controlled trial

Author

Rotheram-Borus, Mary Jane, Tomlinson, Mark, Worthman, Carol M, Norwood, Peter, le Roux, Ingrid, and O'Connor, Mary J

Subjects
Midwifery, Public Health, Health Sciences, Brain Disorders, Health Disparities, Pediatric, Prevention, Women's Health, Clinical Trials and Supportive Activities, Behavioral and Social Science, Mental Illness, Maternal Health, Depression, Infectious Diseases, Social Determinants of Health, Sexually Transmitted Infections, HIV/AIDS, Alcoholism, Alcohol Use and Health, Substance Misuse, Clinical Research, Mental Health, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, Reproductive health and childbirth, Good Health and Well Being, Child, Female, Pregnancy, Humans, South Africa, Acquired Immunodeficiency Syndrome, Bayes Theorem, Follow-Up Studies, Mothers, House Calls, Maternal depression, Alcohol use, Problematic alcohol abuse, HIV, AIDS, Home visiting, Community health worker, Cultural beliefs, Cultural values, Medical and Health Sciences, Economics, Studies in Human Society, Health sciences, Human society
Abstract

BackgroundSouth African mothers confront synergistic challenges from depression, alcohol use, and HIV/AIDS. The importance of maternal functioning for child development motivates interventions, yet long-term outcomes seldom are tracked. Furthermore, little is known about trajectories and the role of social-cultural factors in maternal depression and alcohol use across parenthood in low- and middle-income countries.MethodsWe examined maternal outcomes at 5- and 8-years' post-birth, from the Philani Intervention Program (PIP), a randomized controlled trial of a prenatally-initiated home visiting intervention lasting through 6 months' post-birth which yielded some benefits for children and mothers through 3 years. Longitudinal Bayesian mixed-effects models assessed intervention effects for maternal depression and alcohol use from pre-birth through 8 years post-birth. We plotted trajectories of depression and alcohol use and analyzed their relationship over time.ResultsMaternal benefits appeared limited and intervention outcomes differed at 5 and 8 years. Reduced depression in PIP versus standard care (SC) mothers at 3 years disappeared by 5 and 8 years. Depression prevalence declined from 35.1% prenatally to 5.5% at 8 years, independent of intervention or alcohol use. Alcohol use in both groups rebounded from a post-birth nadir; fewer PIP than SC mothers drank alcohol and reported problematic use at 5 but not 8 years. HIV+ prevalence did not differ by condition and increased from 26% to 45% over the reported period.ConclusionsDissipation of early child benefits from home visiting by age 8 years likely reflects lack of durable change in maternal behaviors compounded by social-cultural factors and cumulative effects of community deprivation. High prenatal rates warrant screening and treatment for depression in standard antenatal care. Low-and-middle income countries may need sustained interventions, including alcohol use reduction, to capitalize on initial gains from targeted interventions and address community social-cultural factors. HIV/AIDS continues to spread in this population.

Published
2023

23. A Catalog of the Highest-Energy Cosmic Rays Recorded During Phase I of Operation of the Pierre Auger Observatory

Author

The Pierre Auger Collaboration, Halim, A. Abdul, Abreu, P., Aglietta, M., Allekotte, I., Allison, P., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Ave, M., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Beatty, J., Bellido, J. A., Berat, C., Bertaina, M. E., Bertou, X., Bhatta, G., Biermann, P. L., Billoir, P., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Bwembya, A., Caballero-Mora, K. S., Caccianiga, L., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Cester, R., Chinellato, J. A., Chirinos, J., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Cristinziani, M., Sanchez, C. S. Cruz, Dasso, S., Daumiller, K., Dawson, B. R., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Dorofeev, A., Anjos, R. C. dos, Ebr, J., Eman, M., Engel, R., Epicoco, I., Erdmann, M., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Flaggs, B., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harton, J., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Knapp, J., Kunka, N., Lachaud, C., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Martins, M. A., Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Meinert, J., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Müller, A. L., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Platino, M., Pont, B., Pothast, M., Shavar, M. Pourmohammad, Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shivashankara, S. U., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Straub, M., Streich, A., Suárez-Durán, M., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Cendejas, L. M. Villaseñor, Vink, J., Vorobiov, S., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Younk, P., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., and Zavrtanik, M.

Subjects
Astrophysics - High Energy Astrophysical Phenomena, Astrophysics - Instrumentation and Methods for Astrophysics
Abstract

A catalog containing details of the highest-energy cosmic rays recorded through the detection of extensive air-showers at the Pierre Auger Observatory is presented with the aim of opening the data to detailed examination. Descriptions of the 100 showers created by the highest-energy particles recorded between 1 January 2004 and 31 December 2020 are given for cosmic rays that have energies in the range 78 EeV to 166 EeV. Details are also given of a further nine very-energetic events that have been used in the calibration procedure adopted to determine the energy of each primary. A sky plot of the arrival directions of the most energetic particles is shown. No interpretations of the data are offered., Comment: Article accepted for publication in ApJS

Published
2022

24. Constraining the sources of ultra-high-energy cosmic rays across and above the ankle with the spectrum and composition data measured at the Pierre Auger Observatory

Author

The Pierre Auger Collaboration, Halim, A. Abdul, Abreu, P., Aglietta, M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Bwembya, A., Caballero-Mora, K. S., Caccianiga, L., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Conte, M., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Cristinziani, M., Sanchez, C. S. Cruz, Dasso, S., Daumiller, K., Dawson, B. R., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Ebr, J., Eman, M., Engel, R., Epicoco, I., Erdmann, M., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Flaggs, B., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Majercakova, M., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Martins, M. A., Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Meinert, J., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Müller, A. L., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Platino, M., Pont, B., Pothast, M., Shavar, M. Pourmohammad, Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shivashankara, S. U., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Straub, M., Streich, A., Suárez-Durán, M., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., and Zavrtanik, M.

Subjects
Astrophysics - High Energy Astrophysical Phenomena
Abstract

In this work we present the interpretation of the energy spectrum and mass composition data as measured by the Pierre Auger Collaboration above $6 \times 10^{17}$ eV. We use an astrophysical model with two extragalactic source populations to model the hardening of the cosmic-ray flux at around $5\times 10^{18}$ eV (the so-called "ankle" feature) as a transition between these two components. We find our data to be well reproduced if sources above the ankle emit a mixed composition with a hard spectrum and a low rigidity cutoff. The component below the ankle is required to have a very soft spectrum and a mix of protons and intermediate-mass nuclei. The origin of this intermediate-mass component is not well constrained and it could originate from either Galactic or extragalactic sources. To the aim of evaluating our capability to constrain astrophysical models, we discuss the impact on the fit results of the main experimental systematic uncertainties and of the assumptions about quantities affecting the air shower development as well as the propagation and redshift distribution of injected ultra-high-energy cosmic rays (UHECRs)., Comment: Submitted to JCAP

Published
2022
Full Text
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25. Searches for Ultra-High-Energy Photons at the Pierre Auger Observatory

Author

The Pierre Auger Collaboration, Abreu, P., Aglietta, M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Bwembya, A., Caballero-Mora, K. S., Caccianiga, L., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Cristinziani, M., Dasso, S., Daumiller, K., Dawson, B. R., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Ebr, J., Eman, M., Engel, R., Epicoco, I., Erdmann, M., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mancarella, G., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Martins, M. A., Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Müller, A. L., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Platino, M., Pont, B., Pothast, M., Shavar, M. Pourmohammad, Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shivashankara, S. U., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Straub, M., Streich, A., Suárez-Durán, M., Sudholz, T., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., Zavrtanik, M., and Zehrer, L.

Subjects
Astrophysics - High Energy Astrophysical Phenomena
Abstract

The Pierre Auger Observatory, being the largest air-shower experiment in the world, offers an unprecedented exposure to neutral particles at the highest energies. Since the start of data taking more than 18 years ago, various searches for ultra-high-energy (UHE, $E\gtrsim10^{17}\,\text{eV}$) photons have been performed: either for a diffuse flux of UHE photons, for point sources of UHE photons or for UHE photons associated with transient events like gravitational wave events. In the present paper, we summarize these searches and review the current results obtained using the wealth of data collected by the Pierre Auger Observatory., Comment: Review article accepted for publication in Universe (special issue on ultra-high energy photons)

Published
2022
Full Text
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26. The effect of supervision on community health workers’ effectiveness with households in rural South Africa: A cluster randomized controlled trial

Author

Rotheram-Borus, Mary Jane, le Roux, Karl W, Norwood, Peter, Katzen, Linnea Stansert, Snyman, Andre, le Roux, Ingrid, Dippenaar, Elaine, and Tomlinson, Mark

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Clinical Research, Nutrition, Prevention, Clinical Trials and Supportive Activities, Health Services, Behavioral and Social Science, Comparative Effectiveness Research, Pediatric, Reproductive health and childbirth, Generic health relevance, Zero Hunger, Good Health and Well Being, Child, Female, Pregnancy, Humans, Community Health Workers, South Africa, Ambulatory Care Facilities, Anti-Retroviral Agents, Mothers, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

BackgroundCommunity health workers (CHWs) can supplement professional medical providers, especially in rural settings where resources are particularly scarce. Yet, outcomes of studies evaluating CHWs effectiveness have been highly variable and lack impact when scaled nationally. This study examines if child and maternal outcomes are better when existing government CHWs, who are perinatal home visitors, receive ongoing enhanced supervision and monitoring, compared to standard care.Methods and findingsA cluster randomized controlled effectiveness trial was conducted comparing outcomes over 2 years when different supervision and support are provided. Primary health clinics were randomized by clinic to receive monitoring and supervision from either (1) existing supervisors (Standard Care (SC); n = 4 clinics, 23 CHWs, 392 mothers); or (2) supervisors from a nongovernmental organization that provided enhanced monitoring and supervision (Accountable Care [AC]; n = 4 clinic areas, 20 CHWs, 423 mothers). Assessments were conducted during pregnancy and at 3, 6, 15, and 24 months post-birth with high retention rates (76% to 86%). The primary outcome was the number of statistically significant intervention effects among 13 outcomes of interest; this approach allowed us to evaluate the intervention holistically while accounting for correlation among the 13 outcomes and considering multiple comparisons. The observed benefits were not statistically significant and did not show the AC's efficacy over the SC. Only the antiretroviral (ARV) adherence effect met the significance threshold established a priori (SC mean 2.3, AC mean 2.9, p < 0.025; 95% CI = [0.157, 1.576]). However, for 11 of the 13 outcomes, we observed an improvement in the AC compared to the SC. While the observed outcomes were not statistically significant, benefits were observed for 4 outcomes: increasing breastfeeding for 6 months, reducing malnutrition, increasing ARV adherence, and improving developmental milestones. The major study limitation was utilizing existing CHWs and being limited to a sample of 8 clinics. There were no major study-related adverse events.ConclusionsSupervision and monitoring were insufficient to improve CHWs' impact on maternal and child outcomes. Alternative strategies for staff recruitment and narrowing the intervention outcomes to the specific local community problems are needed for consistently high impact.Trial registrationClinicaltrials.gov, NCT02957799.

Published
2023

27. Search for photons above 10$^{19}$ eV with the surface detector of the Pierre Auger Observatory

Author

The Pierre Auger Collaboration, Abreu, P., Aglietta, M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Bwembya, A., Caballero-Mora, K. S., Caccianiga, L., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Cristinziani, M., Dasso, S., Daumiller, K., Dawson, B. R., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Ebr, J., Eman, M., Engel, R., Epicoco, I., Erdmann, M., Escobar, C. O., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Krohm, N., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mancarella, G., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Martins, M. A., Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Müller, A. L., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Papenbreer, P., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Platino, M., Pont, B., Pothast, M., Shavar, M. Pourmohammad, Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shivashankara, S. U., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Straub, M., Streich, A., Suárez-Durán, M., Sudholz, T., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., Zavrtanik, M., and Zehrer, L.

Subjects
Astrophysics - High Energy Astrophysical Phenomena
Abstract

We use the surface detector of the Pierre Auger Observatory to search for air showers initiated by photons with an energy above $10^{19}$ eV. Photons in the zenith angle range from 30$^\circ$ to 60$^\circ$ can be identified in the overwhelming background of showers initiated by charged cosmic rays through the broader time structure of the signals induced in the water-Cherenkov detectors of the array and the steeper lateral distribution of shower particles reaching ground. Applying the search method to data collected between January 2004 and June 2020, upper limits at 95\% CL are set to an $E^{-2}$ diffuse flux of ultra-high energy photons above $10^{19}$ eV, $2{\times}10^{19}$ eV and $4{\times}10^{19}$ eV amounting to $2.11{\times}10^{-3}$, $3.12{\times}10^{-4}$ and $1.72{\times}10^{-4}$ km$^{-2}$ sr$^{-1}$ yr$^{-1}$, respectively. While the sensitivity of the present search around $2 \times 10^{19}$ eV approaches expectations of cosmogenic photon fluxes in the case of a pure-proton composition, it is one order of magnitude above those from more realistic mixed-composition models. The inferred limits have also implications for the search of super-heavy dark matter that are discussed and illustrated., Comment: 21 pages, 8 figures

Published
2022

28. Cosmological implications of photon-flux upper limits at ultra-high energies in scenarios of Planckian-interacting massive particles for dark matter

Author

The Pierre Auger Collaboration, Abreu, P., Aglietta, M., Albury, J. M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Batista, R. Alves, Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Botti, A. M., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Caballero-Mora, K. S., Caccianiga, L., Canfora, F., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Dasso, S., Daumiller, K., Dawson, B. R., Day, J. A., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., del Río, M., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Dova, M. T., Ebr, J., Engel, R., Epicoco, I., Erdmann, M., Escobar, C. O., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Vegas, A. L. Garcia, Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hill, G. C., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mancarella, G., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Mostafá, M., Müller, A. L., Muller, M. A., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Papenbreer, P., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Peña-Rodriguez, J., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Pirronello, V., Platino, M., Pont, B., Pothast, M., Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sarmiento-Cano, C., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shellard, R. C., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Streich, A., Suárez-Durán, M., Sudholz, T., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Wahlberg, H., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., Zavrtanik, M., Zehrer, L., and Aloisio, R.

Subjects
Astrophysics - High Energy Astrophysical Phenomena, Astrophysics - Cosmology and Nongalactic Astrophysics, High Energy Physics - Phenomenology
Abstract

Using the data of the Pierre Auger Observatory, we report on a search for signatures that would be suggestive of super-heavy particles decaying in the Galactic halo. From the lack of signal, we present upper limits for different energy thresholds above ${\gtrsim}10^8$\,GeV on the secondary by-product fluxes expected from the decay of the particles. Assuming that the energy density of these super-heavy particles matches that of dark matter observed today, we translate the upper bounds on the particle fluxes into tight constraints on the couplings governing the decay process as a function of the particle mass. Instantons, which are non-perturbative solutions to Yang-Mills equations, can give rise to decay channels otherwise forbidden and transform stable particles into meta-stable ones. Assuming such instanton-induced decay processes, we derive a bound on the reduced coupling constant of gauge interactions in the dark sector: $\alpha_X \lesssim 0.09$, for $10^{9} \lesssim M_X/\text{GeV} < 10^{19}$. Conversely, we obtain that, for instance, a reduced coupling constant $\alpha_X = 0.09$ excludes masses $M_X \gtrsim 3\times 10^{13}~$GeV. In the context of dark matter production from gravitational interactions alone during the reheating epoch, we derive constraints on the parameter space that involves, in addition to $M_X$ and $\alpha_X$, the Hubble rate at the end of inflation, the reheating efficiency, and the non-minimal coupling of the Higgs with curvature., Comment: 15 pages, 8 figures, Accompanying paper of arXiv:2203.08854, accepted for publication in Phys. Rev. D

Published
2022

33. Carving in and 'Carving Out' Space

Author

Bridgette Norwood

Subjects
Ethnology. Social and cultural anthropology, GN301-674
Abstract

Skateboarding is a subculture with an ideology that counters normative authority and standards of masculinity. Yet, it continues to uphold persistent misogynistic perspectives and gender discrepancies in participation (Beal 1996; McCarthy 2022). Therefore, it is critical to understand the experiences of marginalized genders in the skateboarding subculture to discover how ideas of authenticity are formed and upheld in the skate subculture and how these standards impact skateboarders of marginalized genders. This qualitative study examines the unexplored skateboard subculture in Halifax, Nova Scotia through an analysis of its symbolic membership and physical and social space. This study identifies a disassociation from ‘typical’ masculinity and outwardly favourable attitudes towards gender diversity within the Halifax skateboard community; however, gender barriers remain within this still hyper-masculine setting disguised through support. Nevertheless, the historically resistant and rebellious attitudes that coincide with skateboarding may provide a space for female and non-binary skaters to counter subcultural and societal gender norms.

Published
2024

34. H-Wave® Device Stimulation for Chronic Low Back Pain: A Patient-Reported Outcome Measures (PROMs) Study

Author

Stephen M. Norwood, David Han, and Ashim Gupta

Subjects
Chronic pain, Low back pain, Electrical stimulation, H-Wave®, H-Wave device stimulation, Patient-reported outcome measures, Anesthesiology, RD78.3-87.3
Abstract

Abstract Introduction Chronic low back pain (cLBP) is a problem globally, creating a tremendous economic burden. Since conventional treatments often fail, various forms of electrical stimulation have been proposed to improve function and decrease pain. Patient-reported outcome measures (PROMs) have not been adequately reported in the electrical stimulation literature. Methods A retrospective independent statistical analysis was conducted on PROMs data for users of H-Wave® device stimulation (HWDS) collected by the device manufacturer over a period of 4 years. Final surveys for 34,192 pain management patients were filtered for pain chronicity limited to 3–24 months and device use of 22–365 days, resulting in 11,503 patients with “all diagnoses”; this number was then reduced to 2711 patients with nonspecific cLBP, sprain, or strain. Results Reported pain was reduced by 3.12 points (0–10 pain scale), with significant (≥ 20%) relief in 85.28%. Function/activities of daily living (ADL) improved in 96.36%, while improved work performance was reported in 81.61%. Medication use decreased or stopped in 64.41% and sleep improved in 59.76%. Over 96% reported having expectations met or exceeded, service satisfaction, and confidence in device use, while no adverse events were reported. Subgroup analyses found positive associations with longer duration of device use, home exercise participation, and working, whereas older age and longer pain chronicity resulted in reduced benefit. Similar analysis of the larger all-diagnoses cohort demonstrated near-equivalent positive outcomes. Conclusion Treatment outcomes directly reported by cLBP HWDS patients demonstrated profound positive effects on function and ADL, robust improvement in pain perception, and additional benefits like decreased medication use, better sleep, and improved work performance, representing compelling new evidence of treatment efficacy.

Published
2024
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35. Arrival Directions of Cosmic Rays above 32 EeV from Phase One of the Pierre Auger Observatory

Author

The Pierre Auger Collaboration, Abreu, P., Aglietta, M., Albury, J. M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Batista, R. Alves, Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Botti, A. M., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Caballero-Mora, K. S., Caccianiga, L., Canfora, F., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Dasso, S., Daumiller, K., Dawson, B. R., Day, J. A., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., del Río, M., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Dova, M. T., Ebr, J., Engel, R., Epicoco, I., Erdmann, M., Escobar, C. O., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hill, G. C., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mancarella, G., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Mostafá, M., Müller, A. L., Muller, M. A., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Papenbreer, P., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Peña-Rodriguez, J., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Pirronello, V., Platino, M., Pont, B., Pothast, M., Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shellard, R. C., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Straub, M., Streich, A., Suárez-Durán, M., Sudholz, T., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Wahlberg, H., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., Zavrtanik, M., and Zehrer, L.

Subjects
Astrophysics - High Energy Astrophysical Phenomena, Astrophysics - Cosmology and Nongalactic Astrophysics
Abstract

A promising energy range to look for angular correlation between cosmic rays of extragalactic origin and their sources is at the highest energies, above few tens of EeV ($1\:{\rm EeV}\equiv 10^{18}\:$eV). Despite the flux of these particles being extremely low, the area of ${\sim}\:3{,}000 \: \text{km}^2$ covered at the Pierre Auger Observatory, and the 17-year data-taking period of the Phase 1 of its operations, have enabled us to measure the arrival directions of more than 2,600 ultra-high energy cosmic rays above $32\:\text{EeV}$. We publish this data set, the largest available at such energies from an integrated exposure of $122{,}000 \: \text{km}^2\:\text{sr}\:\text{yr}$, and search it for anisotropies over the $3.4\pi$ steradians covered with the Observatory. Evidence for a deviation in excess of isotropy at intermediate angular scale, with ${\sim}\:15^\circ$ Gaussian spread or ${\sim}\:25^\circ$ top-hat radius, is obtained at the $4\:\sigma$ significance level for cosmic-ray energies above ${\sim}\:40\:\text{EeV}$., Comment: Published version, 33 pages, 10 figures. Dataset and analysis software available at https://doi.org/10.5281/zenodo.6504276

Published
2022
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36. Investigating Hadronic Interactions at Ultra-High Energies with the Pierre Auger Observatory

Author

Goos, Isabel, Abreu, P., Aglietta, M., Albury, J. M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Batista, R. Alves, Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Botti, A. M., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Caballero-Mora, K. S., Caccianiga, L., Canfora, F., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Dasso, S., Daumiller, K., Dawson, B. R., Day, J. A., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., del Río, M., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Dova, M. T., Ebr, J., Engel, R., Epicoco, I., Erdmann, M., Escobar, C. O., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Vegas, A. L. Garcia, Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hill, G. C., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mancarella, G., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Mostafá, M., Müller, A. L., Muller, M. A., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Papenbreer, P., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Peña-Rodriguez, J., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Pirronello, V., Platino, M., Pont, B., Pothast, M., Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sarmiento-Cano, C., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shellard, R. C., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Streich, A., Suárez-Durán, M., Sudholz, T., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Wahlberg, H., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., Zavrtanik, M., and Zehrer, L.

Subjects
Astrophysics - High Energy Astrophysical Phenomena, High Energy Physics - Phenomenology
Abstract

The development of an extensive air shower depends not only on the nature of the primary ultra-high-energy cosmic ray but also on the properties of the hadronic interactions. For energies above those achievable in human-made accelerators, hadronic interactions are only accessible through the studies of extensive air showers, which can be measured at the Pierre Auger Observatory. With its hybrid detector design, the Pierre Auger Observatory measures both the longitudinal development of showers in the atmosphere and the lateral distribution of particles that arrive at the ground. This way, observables that are sensitive to hadronic interactions at ultra-high energies can be obtained. While the hadronic interaction cross-section can be assessed from the longitudinal profiles, the number of muons and their fluctuations measured with the ground detectors are linked to other physical properties. In addition to these direct studies, we discuss here how measurements of the atmospheric depth of the maximum of air-shower profiles and the characteristics of the muon signal at the ground can be used to test the self-consistency of the post-LHC hadronic models., Comment: Proceedings of VHEPU 56th Rencontres de Moriond 2022

Published
2022

37. A search for photons with energies above $2{\times}10^{17}$ eV using hybrid data from the low-energy extensions of the Pierre Auger Observatory

Author

The Pierre Auger Collaboration, Abreu, P., Aglietta, M., Albury, J. M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Batista, R. Alves, Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Botti, A. M., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Caballero-Mora, K. S., Caccianiga, L., Canfora, F., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Dasso, S., Daumiller, K., Dawson, B. R., Day, J. A., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., del Río, M., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Dova, M. T., Ebr, J., Engel, R., Epicoco, I., Erdmann, M., Escobar, C. O., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Vegas, A. L. Garcia, Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hill, G. C., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mancarella, G., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Mostafá, M., Müller, A. L., Muller, M. A., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Papenbreer, P., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Peña-Rodriguez, J., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Pirronello, V., Platino, M., Pont, B., Pothast, M., Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sarmiento-Cano, C., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shellard, R. C., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Streich, A., Suárez-Durán, M., Sudholz, T., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Wahlberg, H., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., Zavrtanik, M., and Zehrer, L.

Subjects
Astrophysics - High Energy Astrophysical Phenomena
Abstract

Ultra-high-energy photons with energies exceeding $10^{17}$ eV offer a wealth of connections to different aspects of cosmic-ray astrophysics as well as to gamma-ray and neutrino astronomy. The recent observations of photons with energies in the $10^{15}$ eV range further motivate searches for even higher-energy photons. In this paper, we present a search for photons with energies exceeding $2{\times}10^{17}$ eV using about 5.5 years of hybrid data from the low-energy extensions of the Pierre Auger Observatory. The upper limits on the integral photon flux derived here are the most stringent ones to date in the energy region between $10^{17}$ and $10^{18}$ eV., Comment: Accepted for publication in ApJ

Published
2022
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38. Comparison between Reading Plus and Business-as-Usual Reading Instruction Outcomes for Grade 4 Students

Author

LeDonnis P. Norwood

Abstract

The problem that was investigated in this study was that despite existing implementation of reading instruction strategies, some students in fourth grade demonstrate reading difficulties prompting the need for additional approaches to reading instruction. The purpose of this quantitative quasi-experimental study was to investigate the difference in fourth graders' reading achievement growth as measured by the i-Ready test between students who participated in the online Reading Plus program and students who participated in business-as-usual reading instruction. The theoretical foundation is applied behavior analysis, which involves using strategies derived from behaviorism theory to improve learning. Aggregated and de-identified i-Ready scores were collected for the 49 fourth grade students at the target school and 43 fourth grade students at the school providing business-as-usual reading instruction. The standardized mean difference was used to determine baseline equivalence between the Reading Plus group and business-as-usual group using the i-Ready scores at the outset of the study. An independent samples t test comparing the two groups on i-Ready scores at the outset and conclusion of the study was calculated to determine differences between scores of the target and business-as-usual students. Cohen's d was used to determine if results show practical significance. Cohen's d was 1.23, which indicates a large, standardized effect size, meaning that the research finding has practical significance. The findings may promote social change by addressing the reading development of many Grade 4 students; the local school has elected to use Reading Plus program for 1 year in hopes of providing additional individualized adaptive instruction for students who struggle with reading. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Published
2023

39. A Proposed Decision-Making Framework for the Translation of In-Person Clinical Care to Digital Care: Tutorial

Author

Anna DeLaRosby, Julie Mulcahy, and Todd Norwood

Subjects
Special aspects of education, LC8-6691, Medicine (General), R5-920
Abstract

AbstractThe continued demand for digital health requires that providers adapt thought processes to enable sound clinical decision-making in digital settings. Providers report that lack of training is a barrier to providing digital health care. Physical examination techniques and hands-on interventions must be adjusted in safe, reliable, and feasible ways to provide digital care, and decision-making may be impacted by modifications made to these techniques. We have proposed a framework to determine whether a procedure can be modified to obtain a comparable result in a digital environment or whether a referral to in-person care is required. The decision-making framework was developed using program outcomes of a digital physical therapy platform and aims to alleviate barriers to delivering digital care that providers may experience. This paper describes the unique considerations a provider must make when collecting background information, selecting and executing procedures, assessing results, and determining whether they can proceed with clinical care in digital settings.

Published
2024
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40. Public preferences and willingness to pay for a net zero NHS: a protocol for a discrete choice experiment in England and Scotland

Author

Verity Watson, Michael Abbott, Patricia Norwood, Mélanie Antunes, and Hangjian Wu

Subjects
Medicine
Abstract

Introduction Climate change poses a major threat to our health, livelihoods and the planet. In 2020, the UK National Health Service (NHS) committed to reducing its Scope 1, 2 and 3 emissions to reach net zero by 2045. Although a net zero NHS would help to limit the consequences of climate change, little is known about the UK general public’s values and preferences for the proposed service changes needed to reach net zero.Methods This study will elicit the public’s preferences for actions to help achieve net zero NHS in England and Scotland using a discrete choice experiment (DCE). The DCE attributes and levels describe actions that can be taken by the NHS across key areas: buildings and estates, outdoor space, travel and transport, provision of care, goods and services and food and catering. The survey was designed using online think-aloud interviews with 17 members of the public. Two versions of the survey will be administered to a sample of up to 2200 respondents. One will include a payment vehicle as income tax increases. We will estimate the relative importance of each attribute and, for the former survey, the monetary trade-offs which individuals are willing to make between attributes. Where possible, we will match both samples to gauge preference robustness with the inclusion of the monetary payment. We will test whether respondents’ preferences differ based on their socioeconomic circumstances and attitudes toward the NHS and climate change.Ethics and dissemination The University of Aberdeen’s School of Medicine, Medical Sciences and Nutrition Ethics Research Board has approved the study (reference: SERB/690090). All participants will provide informed consent. Results will be submitted to peer-reviewed publications and presented at relevant conferences and seminars. A lay summary of the research will be published on the Health Economics Research Unit website.

Published
2024
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41. Failure rates of nonoperative management of low-grade splenic injuries with active extravasation: an Eastern Association for the Surgery of Trauma multicenter study

Author

Nikolay Bugaev, Jeffry Nahmias, Richard D Catalano, Claire Hardman, Daniel C Cullinane, Claire Pederson, Julianne B Ontengco, Anna Goldenberg, Chance Spalding, Lewis E Jacobson, Jamie M Williams, Matthew Noorbaksh, Catherine Garrison Velopulos, Shane Urban, John Chipko, Steven D Quarfordt, Caleb Mentzer, Saskya Byerly, Aimee K LaRiccia, Kristen Spoor, John David Cull, Banan W Otaibi, Joshua P Hazelton, Jessica Reynolds, Sam Fugate, Linda B Zier, Thomas S Easterday, Edward Hawke, Madison LeClair, Pascal Udekwu, Cooper Josephs, James Babowice, Gaby Ghobrial, John M Pickering, Alia F Aunchman, Jordan E Basham, Philip M Edmundson, Erika Tay, Scott H Norwood, Katelyn Meadows, and Yee Wong

Subjects
Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Objectives There is little evidence guiding the management of grade I–II traumatic splenic injuries with contrast blush (CB). We aimed to analyze the failure rate of nonoperative management (NOM) of grade I–II splenic injuries with CB in hemodynamically stable patients.Methods A multicenter, retrospective cohort study examining all grade I–II splenic injuries with CB was performed at 21 institutions from January 1, 2014, to October 31, 2019. Patients >18 years old with grade I or II splenic injury due to blunt trauma with CB on CT were included. The primary outcome was the failure of NOM requiring angioembolization/operation. We determined the failure rate of NOM for grade I versus grade II splenic injuries. We then performed bivariate comparisons of patients who failed NOM with those who did not.Results A total of 145 patients were included. Median Injury Severity Score was 17. The combined rate of failure for grade I–II injuries was 20.0%. There was no statistical difference in failure of NOM between grade I and II injuries with CB (18.2% vs 21.1%, p>0.05). Patients who failed NOM had an increased median hospital length of stay (p=0.024) and increased need for blood transfusion (p=0.004) and massive transfusion (p=0.030). Five patients (3.4%) died and 96 (66.2%) were discharged home, with no differences between those who failed and those who did not fail NOM (both p>0.05).Conclusion NOM of grade I–II splenic injuries with CB fails in 20% of patients.Level of evidence IV.

Published
2024
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42. Identifying social determinants of health in populations exposed to structural inequities: a qualitative study of the COVID-19 pandemic experiences of Black and Latinx people living with HIV and cardiovascular risks

Author

Tamra Burns Loeb, Graciela I. Albarran, Ethan Lee, Jenna Alarcon McEwan, Karen E. Dyer, Michele Cooley-Strickland, Enricka Norwood-Scott, Kate Ramm, David Kesblyan, Aleeja Barnes, Derek Novacek, and Dorothy Chin

Subjects
SDOH, inequities, COVID-19, public health information, vaccine uptake, lived experience, Public aspects of medicine, RA1-1270
Abstract

IntroductionBlack and Latinx communities experience inequities in the social determinants of health (SDOH) and high rates of chronic illnesses [e.g., cardiovascular disease (CVD), HIV]. The COVID-19 pandemic amplified these long-standing SDOH disparities. However, scant attention has been paid to the pandemic-related experiences of populations exposed to structural inequities.MethodsUsing a semi-structured interview guide, 60 in-depth telephone interviews were conducted with Black and Latinx people living with HIV (PLWH) and CVD risks to assess: (1) perceived personal and community risk for COVID-19; (2) knowledge of and access to COVID-19 public health information; (3) barriers to COVID-19 public health recommendations and vaccine uptake; and (4) perceptions of HIV, CVD, and COVID-19. Interviews were professionally transcribed into either English or Spanish. Spanish transcripts were translated into English. Rapid qualitative analysis was used to summarize each transcript into a structured templaicte corresponding to interview guide domains. Summaries were combined into matrices for identification and comparison of themes across domains.ResultsParticipants reported risks for COVID-19 due to being immunocompromised and SDOH, including transportation, exposure to risks conferred by others, living in under-resourced neighborhoods, and housing insecurity. Participants engaged in protective countermeasures by adhering to public health mandates. Relationships with providers, participating in community support groups, and digital inclusion and literacy were salient with respect to dissemination of COVID-19 information and vaccine uptake. Experiences with managing a chronic illness facilitated vaccine acceptance. Participants described language barriers, experiences of discrimination, and a historical lack of trust in medical systems and vaccines.DiscussionThis study provides a real-time narrative from PLWH and CVD risks who were vulnerable during the height of the COVID-19 pandemic. Implications include the need for continuity with providers and established community networks, increasing internet access and digital health literacy, and addressing historical trauma incurred in medical settings. It is critical to understand the impact of traditional SDOH on those living with chronic illness as well as other social determinants that shed light on access to public health information, adherence to public health recommendations, and vaccine uptake among populations exposed to structural inequities.

Published
2024
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43. Effect of Elderly People’s Perceived Value on their Adherence to Outdoor Exercise: The Intermediary Role of Motivation for Active Social Adaptation

Author

Junfeng Yan MS, Shuyuan Fang MSc, Wallace C. Norwood EdD, and Liming Guan PhD

Subjects
Public aspects of medicine, RA1-1270
Abstract

The aim of this study is to investigate the relationship between the perceived value of outdoor activities and exercise persistence among elderly Chinese individuals. Specifically, the study aims to explore whether motivation for active social adaptation mediates this relationship. Three hundred twenty-five subjects were randomly chosen and invited to complete 3 questionnaires about the perceived value of outdoor activity, the motivation for active social adaptation, and the adherence to physical exercise. The results showed that older people’s perception of the value of outdoor activity (function, landscape, and cost) has a statistically significant effect on their adherence to exercise. The mediating role of motivation for active social adaptation was also statistically significant, and the mediating role of active environmental adaptation motivation affected the perceived functional value, perceived landscape value of outdoor activities on adherence to exercise. Hence, it is concluded that older Chinese adults’ perception of the value of outdoor activities promotes their adherence to exercise and reinforces it based on active social adaptation motivation.

Published
2024
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44. Determining Eastern Red Cedar Biochar Soilless Media Supplementation Rates for Potted Ornamental Kale and Chrysanthemum Production

Author

Babita Lamichhane, Bruce L. Dunn, Hardeep Singh, Ajay Kumar, and Bailey Norwood

Subjects
bark, chemical properties, greenhouse production, physical properties, pyrolysis, temperature, Plant culture, SB1-1110
Abstract

The increasing demand for soilless media, sustainability issues with peatmoss, and increasing cost of peatmoss have prompted studies of more environmentally friendly and less expensive substitutes. Biochar, a lightweight black carbon material produced by the pyrolysis of biomass, has gained popularity as a soilless media supplement. The objective of this study was to evaluate Eastern red cedar (ERC) biochar as a supplement to soilless media for the production of chrysanthemum and ornamental kale. Treatments included ERC biochar produced at three different temperature ranges of 300 to 350 °C, 400 to 450 °C, and 500 to 550 °C that were applied at 25%, 50%, and 75% v/v plus a control (100% v/v of standard commercial mix). Additionally, ERC bark was applied at the same rate as biochar. The 300 to 350 °C and 400 to 450 °C temperature ranges increased the bulk density of the media, whereas total porosity was greatest with just bark. Regarding the physical properties of the media, in general, the 75% v/v supplementation rate of ERC bark or biochar at any temperature increased air porosity but decreased the water holding capacity, except for the water holding capacity at 500 to 550 °C. As the biochar production temperature increased, so did the pH and electrical conductivity (EC), whereas volatile matter decreased. Plant height, width, shoot dry weight, root dry weight, number of flowers (chrysanthemum only), flower diameter, and water use efficiency were greatest with the 100% v/v soilless media for both species. In general, chrysanthemum plants grown with 25% v/v biochar supplementation or bark had similar height, width, and shoot dry weight at any temperature compared with those grown with the 100% v/v soilless media. For ornamental kale, the 25% v/v 400 to 450 °C biochar supplementation showed plant height and water use efficiency similar to those of the 100% v/v soilless media. In general, 25% ERC bark performed similar to 25% v/v and 50% v/v biochar at any temperature for plant width, shoot dry weight, root dry weight, water use efficiency, and root-to-shoot ratio. The media nutrient content and EC were greater with 100% v/v soilless media and a lower rate (25% v/v) of ERC bark and biochar than with higher rates. The higher levels of biochar were harmful and reduced the ornamental kale growth and quality. These results suggest that supplemented soilless media with lower rates (25% v/v) of ERC biochar could be recommended for chrysanthemum, but that less than 25% v/v may be necessary for ornamental kale.

Published
2024
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45. Limits to gauge coupling in the dark sector set by the non-observation of instanton-induced decay of Super-Heavy Dark Matter in the Pierre Auger Observatory data

Author

The Pierre Auger Collaboration, Abreu, P., Aglietta, M., Albury, J. M., Allekotte, I., Cheminant, K. Almeida, Almela, A., Alvarez-Muñiz, J., Batista, R. Alves, Yebra, J. Ammerman, Anastasi, G. A., Anchordoqui, L., Andrada, B., Andringa, S., Aramo, C., Ferreira, P. R. Araújo, Arnone, E., Velázquez, J. C. Arteaga, Asorey, H., Assis, P., Avila, G., Avocone, E., Badescu, A. M., Bakalova, A., Balaceanu, A., Barbato, F., Bellido, J. A., Berat, C., Bertaina, M. E., Bhatta, G., Biermann, P. L., Binet, V., Bismark, K., Bister, T., Biteau, J., Blazek, J., Bleve, C., Blümer, J., Boháčová, M., Boncioli, D., Bonifazi, C., Arbeletche, L. Bonneau, Borodai, N., Botti, A. M., Brack, J., Bretz, T., Orchera, P. G. Brichetto, Briechle, F. L., Buchholz, P., Bueno, A., Buitink, S., Buscemi, M., Büsken, M., Caballero-Mora, K. S., Caccianiga, L., Canfora, F., Caracas, I., Caruso, R., Castellina, A., Catalani, F., Cataldi, G., Cazon, L., Cerda, M., Chinellato, J. A., Chudoba, J., Chytka, L., Clay, R. W., Cerutti, A. C. Cobos, Colalillo, R., Coleman, A., Coluccia, M. R., Conceição, R., Condorelli, A., Consolati, G., Contreras, F., Convenga, F., Santos, D. Correia dos, Covault, C. E., Dasso, S., Daumiller, K., Dawson, B. R., Day, J. A., de Almeida, R. M., de Jesús, J., de Jong, S. J., Neto, J. R. T. de Mello, De Mitri, I., de Oliveira, J., Franco, D. de Oliveira, de Palma, F., de Souza, V., De Vito, E., Del Popolo, A., del Río, M., Deligny, O., Deval, L., di Matteo, A., Dobre, M., Dobrigkeit, C., D'Olivo, J. C., Mendes, L. M. Domingues, Anjos, R. C. dos, Dova, M. T., Ebr, J., Engel, R., Epicoco, I., Erdmann, M., Escobar, C. O., Etchegoyen, A., Falcke, H., Farmer, J., Farrar, G., Fauth, A. C., Fazzini, N., Feldbusch, F., Fenu, F., Fick, B., Figueira, J. M., Filipčič, A., Fitoussi, T., Fodran, T., Fujii, T., Fuster, A., Galea, C., Galelli, C., García, B., Vegas, A. L. Garcia, Gemmeke, H., Gesualdi, F., Gherghel-Lascu, A., Ghia, P. L., Giaccari, U., Giammarchi, M., Glombitza, J., Gobbi, F., Gollan, F., Golup, G., Berisso, M. Gómez, Vitale, P. F. Gómez, Gongora, J. P., González, J. M., González, N., Goos, I., Góra, D., Gorgi, A., Gottowik, M., Grubb, T. D., Guarino, F., Guedes, G. P., Guido, E., Hahn, S., Hamal, P., Hampel, M. R., Hansen, P., Harari, D., Harvey, V. M., Haungs, A., Hebbeker, T., Heck, D., Hill, G. C., Hojvat, C., Hörandel, J. R., Horvath, P., Hrabovský, M., Huege, T., Insolia, A., Isar, P. G., Janecek, P., Johnsen, J. A., Jurysek, J., Kääpä, A., Kampert, K. H., Keilhauer, B., Khakurdikar, A., Covilakam, V. V. Kizakke, Klages, H. O., Kleifges, M., Kleinfeller, J., Knapp, F., Kunka, N., Lago, B. L., Langner, N., de Oliveira, M. A. Leigui, Lenok, V., Letessier-Selvon, A., Lhenry-Yvon, I., Presti, D. Lo, Lopes, L., López, R., Lu, L., Luce, Q., Lundquist, J. P., Payeras, A. Machado, Mancarella, G., Mandat, D., Manning, B. C., Manshanden, J., Mantsch, P., Marafico, S., Mariani, F. M., Mariazzi, A. G., Mariş, I. C., Marsella, G., Martello, D., Martinelli, S., Bravo, O. Martínez, Mastrodicasa, M., Mathes, H. J., Matthews, J., Matthiae, G., Mayotte, E., Mayotte, S., Mazur, P. O., Medina-Tanco, G., Melo, D., Menshikov, A., Michal, S., Micheletti, M. I., Miramonti, L., Mollerach, S., Montanet, F., Morejon, L., Morello, C., Mostafá, M., Müller, A. L., Muller, M. A., Mulrey, K., Mussa, R., Muzio, M., Namasaka, W. M., Nasr-Esfahani, A., Nellen, L., Nicora, G., Niculescu-Oglinzanu, M., Niechciol, M., Nitz, D., Norwood, I., Nosek, D., Novotny, V., Nožka, L., Nucita, A, Núñez, L. A., Oliveira, C., Palatka, M., Pallotta, J., Papenbreer, P., Parente, G., Parra, A., Pawlowsky, J., Pech, M., Pękala, J., Pelayo, R., Peña-Rodriguez, J., Martins, E. E. Pereira, Armand, J. Perez, Bertolli, C. Pérez, Perrone, L., Petrera, S., Petrucci, C., Pierog, T., Pimenta, M., Pirronello, V., Platino, M., Pont, B., Pothast, M., Privitera, P., Prouza, M., Puyleart, A., Querchfeld, S., Rautenberg, J., Ravignani, D., Reininghaus, M., Ridky, J., Riehn, F., Risse, M., Rizi, V., de Carvalho, W. Rodrigues, Rojo, J. Rodriguez, Roncoroni, M. J., Rossoni, S., Roth, M., Roulet, E., Rovero, A. C., Ruehl, P., Saftoiu, A., Saharan, M., Salamida, F., Salazar, H., Salina, G., Gomez, J. D. Sanabria, Sánchez, F., Santos, E. M., Santos, E., Sarazin, F., Sarmento, R., Sarmiento-Cano, C., Sato, R., Savina, P., Schäfer, C. M., Scherini, V., Schieler, H., Schimassek, M., Schimp, M., Schlüter, F., Schmidt, D., Scholten, O., Schoorlemmer, H., Schovánek, P., Schröder, F. G., Schulte, J., Schulz, T., Sciutto, S. J., Scornavacche, M., Segreto, A., Sehgal, S., Shellard, R. C., Sigl, G., Silli, G., Sima, O., Smau, R., Šmída, R., Sommers, P., Soriano, J. F., Squartini, R., Stadelmaier, M., Stanca, D., Stanič, S., Stasielak, J., Stassi, P., Streich, A., Suárez-Durán, M., Sudholz, T., Suomijärvi, T., Supanitsky, A. D., Szadkowski, Z., Tapia, A., Taricco, C., Timmermans, C., Tkachenko, O., Tobiska, P., Peixoto, C. J. Todero, Tomé, B., Torrès, Z., Travaini, A., Travnicek, P., Trimarelli, C., Tueros, M., Ulrich, R., Unger, M., Vaclavek, L., Vacula, M., Galicia, J. F. Valdés, Valore, L., Varela, E., Vásquez-Ramírez, A., Veberič, D., Ventura, C., Quispe, I. D. Vergara, Verzi, V., Vicha, J., Vink, J., Vorobiov, S., Wahlberg, H., Watanabe, C., Watson, A. A., Weindl, A., Wiencke, L., Wilczyński, H., Wittkowski, D., Wundheiler, B., Yushkov, A., Zapparrata, O., Zas, E., Zavrtanik, D., Zavrtanik, M., Zehrer, L., and Aloisio, R.

Subjects
Astrophysics - High Energy Astrophysical Phenomena, Astrophysics - Cosmology and Nongalactic Astrophysics, High Energy Physics - Phenomenology
Abstract

Instantons, which are non-perturbative solutions to Yang-Mills equations, provide a signal for the occurrence of quantum tunneling between distinct classes of vacua. They can give rise to decays of particles otherwise forbidden. Using data collected at the Pierre Auger Observatory, we search for signatures of such instanton-induced processes that would be suggestive of super-heavy particles decaying in the Galactic halo. These particles could have been produced during the post-inflationary epoch and match the relic abundance of dark matter inferred today. The non-observation of the signatures searched for allows us to derive a bound on the reduced coupling constant of gauge interactions in the dark sector: $\alpha_X \lesssim 0.09$, for $10^{9} \lesssim M_X/{\rm GeV} < 10^{19}$. Conversely, we obtain that, for instance, a reduced coupling constant $\alpha_X = 0.09$ excludes masses $M_X \gtrsim 3\times 10^{13}~$GeV. In the context of dark matter production from gravitational interactions alone, we illustrate how these bounds are complementary to those obtained on the Hubble rate at the end of inflation from the non-observation of tensor modes in the cosmological microwave background., Comment: 9 pages, 3 figures, accepted for publication in Phys. Rev. Lett

Published
2022
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49. Immersive virtual reality gameplay detects visuospatial atypicality, including unilateral spatial neglect, following brain injury: a pilot study

Author

David R. Painter, Michael F. Norwood, Chelsea H. Marsh, Trevor Hine, Daniel Harvie, Marilia Libera, Julie Bernhardt, Leslie Gan, and Heidi Zeeman

Subjects
Brain injury, Cognitive assessment, Classification, Immersive virtual reality, Unilateral visuospatial neglect, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Abstract Background In neurorehabilitation, problems with visuospatial attention, including unilateral spatial neglect, are prevalent and routinely assessed by pen-and-paper tests, which are limited in accuracy and sensitivity. Immersive virtual reality (VR), which motivates a much wider (more intuitive) spatial behaviour, promises new futures for identifying visuospatial atypicality in multiple measures, which reflects cognitive and motor diversity across individuals with brain injuries. Methods In this pilot study, we had 9 clinician controls (mean age 43 years; 4 males) and 13 neurorehabilitation inpatients (mean age 59 years; 9 males) recruited a mean of 41 days post-injury play a VR visual search game. Primary injuries included 7 stroke, 4 traumatic brain injury, 2 other acquired brain injury. Three patients were identified as having left sided neglect prior to taking part in the VR. Response accuracy, reaction time, and headset and controller raycast orientation quantified gameplay. Normative modelling identified the typical gameplay bounds, and visuospatial atypicality was defined as gameplay beyond these bounds. Results The study found VR to be feasible, with only minor instances of motion sickness, positive user experiences, and satisfactory system usability. Crucially, the analytical method, which emphasized identifying 'visuospatial atypicality,' proved effective. Visuospatial atypicality was more commonly observed in patients compared to controls and was prevalent in both groups of patients—those with and without neglect. Conclusion Our research indicates that normative modelling of VR gameplay is a promising tool for identifying visuospatial atypicality after acute brain injury. This approach holds potential for a detailed examination of neglect.

Published
2023
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50. Hospitalization and readmission after single-level fall: a population-based sample

Author

Alan Cook, Rebecca Swindall, Katherine Spencer, Carly Wadle, S. Andrew Cage, Musharaf Mohiuddin, Yagnesh Desai, and Scott Norwood

Subjects
Geriatric trauma, Falls, Readmission, Hospitalization, Palliative care, Hospital charges, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Single-level falls (SLFs) in the older US population is a leading cause of hospital admission and rates are increasing. Unscheduled hospital readmission is regarded as a quality-of-care indication and a preventable burden on healthcare systems. We aimed to characterize the predictors of 30-day readmission following admission for SLF injuries among patients 65 years and older. Methods We conducted a retrospective cohort study using the Nationwide Readmission Database from 2018 to 2019. Included patients were 65 and older, admitted emergently following a SLF with a primary injury diagnosis. Hierarchical logit regression was used to model factors associated with readmission within 30 days of discharge. Results Of 1,338,905 trauma patients, 65 years or older, 61.3% had a single-level fall as the mechanism of injury. Among fallers, the average age was 81.1 years and 68.5% were female. SLF patients underwent more major therapeutic procedures (56.3% vs. 48.2%), spent over 2 million days in the hospital and incurred total charges of over $28 billion annually. Over 11% of SLF patients were readmitted within 30 days of discharge. Increasing income had a modest effect, where the highest zip code quartile was 9% less likely to be readmitted. Decreasing population density had a protective effect of readmission of 16%, comparing Non-Urban to Large Metropolitan. Transfer to short-term hospital, brain and vascular injuries were independent predictors of 30-day readmission in multivariable analysis (OR 2.50, 1.31, and 1.42, respectively). Palliative care consultation was protective (OR 0.41). The subsequent hospitalizations among those 30-day readmissions were primarily emergent (92.9%), consumed 260,876 hospital days and a total of $2.75 billion annually. Conclusions SLFs exact costs to patients, health systems, and society. Transfer to short-term hospitals at discharge, along with brain and vascular injuries were strong predictors of 30-day readmission and warrant mitigation strategy development with consideration of expanded palliative care consultation.

Published
2023
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