Methylphenidate Attenuates Limbic Brain Inhibition after Cocaine-Cues Exposure in Cocaine Abusers

Dopamine (phasic release) is implicated in conditioned responses. Imaging studies in cocaine abusers show decreases in striatal dopamine levels, which we hypothesize may enhance conditioned responses since tonic dopamine levels modulate phasic dopamine release. To test this we assessed the effects of increasing tonic dopamine levels (using oral methylphenidate) on brain activation induced by cocaine-cues in cocaine abusers. Brain metabolism (marker of brain function) was measured with PET and 18FDG in 24 active cocaine abusers tested four times; twice watching a Neutral video (nature scenes) and twice watching a Cocaine-cues video; each video was preceded once by placebo and once by methylphenidate (20 mg). The Cocaine-cues video increased craving to the same extent with placebo (68%) and with methylphenidate (64%). In contrast, SPM analysis of metabolic images revealed that differences between Neutral versus Cocaine-cues conditions were greater with placebo than methylphenidate; whereas with placebo the Cocaine-cues decreased metabolism (p<0.005) in left limbic regions (insula, orbitofrontal, accumbens) and right parahippocampus, with methylphenidate it only decreased in auditory and visual regions, which also occurred with placebo. Decreases in metabolism in these regions were not associated with craving; in contrast the voxel-wise SPM analysis identified significant correlations with craving in anterior orbitofrontal cortex (p<0.005), amygdala, striatum and middle insula (p<0.05). This suggests that methylphenidate's attenuation of brain reactivity to Cocaine-cues is distinct from that involved in craving. Cocaine-cues decreased metabolism in limbic regions (reflects activity over 30 minutes), which contrasts with activations reported by fMRI studies (reflects activity over 2–5 minutes) that may reflect long-lasting limbic inhibition following activation. Studies to evaluate the clinical significance of methylphenidate's blunting of cue-induced limbic inhibition may help identify potential benefits of this medication in cocaine addiction

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods: We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings: In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation: Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment. Funding: Bill & Melinda Gates Foundation

Search for heavy resonances decaying into a pair of Z bosons in the ℓ⁺ ℓ ¯ℓ'⁺ ℓ'¯ and ℓ⁺ ℓ¯ν\bar{ν} states using 139 fb¯¹ of proton–proton collisions at \sqrt{s} = 13 TeV with the ATLAS detector

A search for heavy resonances decaying into a pair of Z bosons leading to \ell ^+\ell ^-\ell '^+\ell '^- and \ell ^+\ell ^-\nu {{\bar{\nu }}} final states, where \ell stands for either an electron or a muon, is presented. The search uses proton–proton collision data at a centre-of-mass energy of 13 TeV collected from 2015 to 2018 that corresponds to the integrated luminosity of 139 \mathrm {fb}^{-1} recorded by the ATLAS detector during Run 2 of the Large Hadron Collider. Different mass ranges spanning 200 GeV to 2000 GeV for the hypothetical resonances are considered, depending on the final state and model. In the absence of a significant observed excess, the results are interpreted as upper limits on the production cross section of a spin-0 or spin-2 resonance. The upper limits for the spin-0 resonance are translated to exclusion contours in the context of Type-I and Type-II two-Higgs-doublet models, and the limits for the spin-2 resonance are used to constrain the Randall–Sundrum model with an extra dimension giving rise to spin-2 graviton excitations

Optimisation of large-radius jet reconstruction for the ATLAS detector in 13 TeV proton–proton collisions

Jet substructure has provided new opportunities for searches and measurements at the LHC, and has seen continuous development since the optimization of the large-radius jet definition used by ATLAS was performed during Run 1. A range of new inputs to jet reconstruction, pile-up mitigation techniques and jet grooming algorithms motivate an optimisation of large-radius jet reconstruction for ATLAS. In this paper, this optimisation procedure is presented, and the performance of a wide range of large-radius jet definitions is compared. The relative performance of these jet definitions is assessed using metrics such as their pileup stability, ability to identify hadronically decaying W bosons and top quarks with large transverse momenta. A new type of jet input object, called a ‘unified flow object’ is introduced which combines calorimeter- and inner-detector-based signals in order to achieve optimal performance across a wide kinematic range. Large-radius jet definitions are identified which significantly improve on the current ATLAS baseline definition, and their modelling is studied using pp collisions recorded by the ATLAS detector at \sqrt{s}=13~\text {TeV} during 2017

Search for pair production of scalar leptoquarks decaying into first- or second-generation leptons and top quarks in proton–proton collisions at \sqrt{s} = 13 TeV with the ATLAS detector

A search for pair production of scalar leptoquarks, each decaying into either an electron or a muon and a top quark, is presented. This is the first leptoquark search using ATLAS data to investigate top-philic cross-generational couplings that could provide explanations for recently observed anomalies in B meson decays. This analysis targets high leptoquark masses which cause the decay products of each resultant top quark to be contained within a single high-p large-radius jet. The full Run 2 dataset is exploited, consisting of 139fb^{-1} of data collected from proton–proton collisions at \sqrt{s} = 13 TeV from 2015 to 2018 with the ATLAS detector at the CERN Large Hadron Collider. In the absence of any significant deviation from the background expectation, lower limits on the leptoquark masses are set at 1480GeV and 1470GeV for the electron and muon channel, respectively

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral

Production of ϒ(nS) mesons in Pb + Pb and pp collisions at 5.02 TeV

A measurement of the production of vector bottomonium states, ϒ(1S), ϒ(2S), and ϒ(3S), in Pb + Pb and pp collisions at a center-of-mass energy per nucleon pair of 5.02 TeV is presented. The data correspond to integrated luminosities of 1.38 nb-1 of Pb + Pb data collected in 2018, 0.44 nb-1 of Pb + Pb data collected in 2015, and 0.26 fb-1 of pp data collected in 2017 by the ATLAS detector at the Large Hadron Collider. The measurements are performed in the dimuon decay channel for transverse momentum pμμT < 30 GeV, absolute rapidity |yμμ| < 1.5, and Pb + Pb event centrality 0-80%. The production rates of the three bottomonium states in Pb + Pb collisions are compared with those in pp collisions to extract the nuclear modification factors as functions of event centrality, pμμT, and |yμμ|. In addition, the suppression of the excited states relative to the ground state is studied. The results are compared with theoretical model calculations

Correlations between flow and transverse momentum in Xe + Xe and Pb + Pb collisions at the LHC with the ATLAS detector: A probe of the heavy-ion initial state and nuclear deformation

The correlations between flow harmonics vn for n = 2, 3, and 4 and mean transverse momentum [pT] in 129Xe + 129Xe and 208Pb + 208Pb collisions at √s = 5.44 and 5.02 TeV, respectively, are measured using charged particles with the ATLAS detector. The correlations are potentially sensitive to the shape and size of the initial geometry, nuclear deformation, and initial momentum anisotropy. The effects from nonflow and centrality fluctuations are minimized, respectively, via a subevent cumulant method and an event-activity selection based on particle production at very forward rapidity. The vn-[pT] correlations show strong dependencies on centrality, harmonic number n, pT, and pseudorapidity range. Current models qualitatively describe the overall centrality- and system-dependent trends but fail to quantitatively reproduce all features of the data. In central collisions, where models generally show good agreement, the v2-[pT] correlations are sensitive to the triaxiality of the quadruple deformation. Comparison of the model with the Pb + Pb and Xe + Xe data confirms that the 129Xe nucleus is a highly deformed triaxial ellipsoid that has neither a prolate nor oblate shape. This provides strong evidence for a triaxial deformation of the 129Xe nucleus from high-energy heavy-ion collisions

Search for Higgs boson production in association with a high-energy photon via vector-boson fusion with decay into bottom quark pairs at \sqrt{s} = 13 TeV with the ATLAS detector

A search is presented for the production of the Standard Model Higgs boson in association with a high-energy photon. With a focus on the vector-boson fusion process and the dominant Higgs boson decay into b-quark pairs, the search benefits from a large reduction of multijet background compared to more inclusive searches. Results are reported from the analysis of 132 fb of pp collision data at s = 13 TeV collected with the ATLAS detector at the LHC. The measured Higgs boson signal yield in this final-state signature is 1.3 ± 1.0 times the Standard Model prediction. The observed significance of the Higgs boson signal above the background is 1.3 standard deviations, compared to an expected significance of 1.0 standard deviations. [Figure not available: see fulltext.] −

Determination of the strong coupling constant from transverse energy-energy correlations in multijet events at \sqrt{s} = 13 TeV with the ATLAS detector

Measurements of transverse energy-energy correlations and their associated azimuthal asymmetries in multijet events are presented. The analysis is performed using a data sample corresponding to 139 fb −1 of proton-proton collisions at a centre-of-mass energy of s = 13 TeV, collected with the ATLAS detector at the Large Hadron Collider. The measurements are presented in bins of the scalar sum of the transverse momenta of the two leading jets and unfolded to particle level. They are then compared to next-to-next-to-leading-order perturbative QCD calculations for the first time, which feature a significant reduction in the theoretical uncertainties estimated using variations of the renormalisation and factorisation scales. The agreement between data and theory is good, thus providing a precision test of QCD at large momentum transfers Q. The strong coupling constant αs is extracted as a function of Q, showing a good agreement with the renormalisation group equation and with previous analyses. A simultaneous fit to all transverse energy-energy correlation distributions across different kinematic regions yields a value of αs(mZ)=0.1175±0.0006(exp.)−0.0017+0.0034(theo.) , while the global fit to the asymmetry distributions yields αs(mZ)=0.1185±0.0009(exp.)−0.0012+0.0025(theo.) . [Figure not available: see fulltext.]