Elimination of mother- to - child transmission of HIV in South Africa : Rapid scale- up using quality improvement

PKBackground: South Africa (SA) is committed to achieving the goal of eliminating mother-to-child transmission (MTCT) of HIV by 2015. To achieve this, universal coverage of quality antenatal, labour, delivery and postnatal services for all women has to be attained. Over the past decade, the prevention of mother-to-child transmission (PMTCT) programme has been scaled up to reach all healthcare facilities in the country. However, challenges persist in achieving 100% coverage and access to the programme. Objectives: We describe the process undertaken by the National Department of Health (NDoH), in collaboration with partners, to develop, implement and monitor a data-driven intervention to improve facility, district, provincial and national PMTCT-related performance. Methods: Between 2011 and 2013, the NDoH developed and implemented an intervention using data-driven participatory processes to understand facility-level bottlenecks to optimise PMTCT implementation and to scale up priority PMTCT actions nationally. Results: There was remarkable improvement across all key indicators in the PMTCT cascade over the 3 years 2011 - 2013. Simple monitoring tools such as a visual dashboard and data for action reports were successfully used to improve the performance of the PMTCT programme across SA. MTCT has shown a significant downward trend. Conclusions: It is feasible to implement district-level, data-driven quality improvement processes at a national scale to improve the performance of the PMTCT programme at the local level

Search for nonstandard neutrino interactions with IceCube DeepCore

As atmospheric neutrinos propagate through the Earth, vacuumlike oscillations are modified by Standard Model neutral- and charged-current interactions with electrons. Theories beyond the Standard Model introduce heavy, TeV-scale bosons that can produce nonstandard neutrino interactions. These additional interactions may modify the Standard Model matter effect producing a measurable deviation from the prediction for atmospheric neutrino oscillations. The result described in this paper constrains nonstandard interaction parameters, building upon a previous analysis of atmospheric muon-neutrino disappearance with three years of IceCube DeepCore data. The best fit for the muon to tau flavor changing term is εμτ=−0.0005, with a 90% C.L. allowed range of −0.0067<εμτ<0.0081. This result is more restrictive than recent limits from other experiments for εμτ. Furthermore, our result is complementary to a recent constraint on εμτ using another publicly available IceCube high-energy event selection. Together, they constitute the world’s best limits on nonstandard interactions in the μ−τ sector.M.G. Aartsen … G.C. Hill … A. Kyriacou … S. Robertson … A. Wallace … B.J. Whelan … et al. [The IceCube Collaboration

Measurement of atmospheric neutrino oscillations at 6-56 GeV with IceCube DeepCore

We present a measurement of the atmospheric neutrino oscillation parameters using three years of data from the IceCube Neutrino Observatory. The DeepCore infill array in the center of IceCube enables the detection and reconstruction of neutrinos produced by the interaction of cosmic rays in Earth’s atmosphere at energies as low as ∼5  GeV. That energy threshold permits measurements of muon neutrino disappearance, over a range of baselines up to the diameter of the Earth, probing the same range of L/Eν as long-baseline experiments but with substantially higher-energy neutrinos. This analysis uses neutrinos from the full sky with reconstructed energies from 5.6 to 56 GeV. We measure Δm232=2.31+0.11−0.13×10−3  eV2 and sin2θ23=0.51+0.07−0.09, assuming normal neutrino mass ordering. These results are consistent with, and of similar precision to, those from accelerator- and reactor-based experiments.M. G. Aartsen, M. Ackermann, J. Adams, J. A. Aguilar, M. Ahlers … Gary C. Hill … et al

Measurement of atmospheric tau neutrino appearance with IceCube DeepCore

We present a measurement of atmospheric tau neutrino appearance from oscillations with three years of data from the DeepCore subarray of the IceCube Neutrino Observatory. This analysis uses atmospheric neutrinos from the full sky with reconstructed energies between 5.6 and 56 GeV to search for a statistical excess of cascadelike neutrino events which are the signature of ντ interactions. For CC+NC (CC-only) interactions, we measure the tau neutrino normalization to be 0.73⁺·³⁰-.₂₄ (0.57⁺·³⁶-.₃₀) and exclude the absence of tau neutrino oscillations at a significance of 3.2σ (2.0σ) These results are consistent with, and of similar precision to, a confirmatory IceCube analysis also presented, as well as measurements performed by other experiments.M.G. Aartsen … G.C. Hill … A. Kyriacou … A. Wallace … B.J. Whelan … et al. (The IceCube Collaboration

Subjective Distresses of Nasogastric Tube Feeding

Health care professionals assume that tube feeding is an unpleasant, distressing experience for patients, which is only partially substantiated by experience. Thirty patients were interviewed via a tube feeding and hospital experience checklist (a 47–item interview schedule). Common experiences were operationally defined as those felt by at least 50%; subjectively distressful experiences were those identified by patients as causing distress. The most common and most distressful experiences of nasogastric tube feeding were: sensory irritations and sensory deprivation. The psychosensory irritation experiences were: thirst, sore nose or throat, dry mouth, runny nose, a tube in the nose, taking food through a tube, breathing through the mouth, breathing with a tube in the nose, taking food in a treatment type container, and taking food with a different texture and smell than usual. The psychosensory deprivation experiences were: an unsatisfied appetite for certain foods, deprivation of tasting, chewing, swallowing food, and drinking liquids, limited mobility, and deprivation of regular food. Except for burping, gastrointestinal symptoms were not common though they were usually distressful. This information has been used to develop teaching programs which are being tested for effectiveness in reducing distress associated with nasogastric tube feeding.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68702/2/10.1177_014860717900300204.pd

The 2014-2017 outburst of the young star ASASSN-13db: A time-resolved picture of a very low-mass star between EXors and FUors

ASASSN-13db is a M5-type star with a protoplanetary disk, the lowest mass star known to experience accretion outbursts. Since its discovery in 2013, it has experienced two outbursts, the second of which started in November 2014 and lasted until February 2017. We use high- and low-resolution spectroscopy and time-resolved photometry from the ASAS-SN survey, the LCOGT and the Beacon Observatory to study the lightcurve and the dynamical and physical properties of the accretion flow. The 2014-2017 outburst lasted for nearly 800 days. A 4.15d period in the lightcurve likely corresponds to rotational modulation of a star with hot spot(s). The spectra show multiple emission lines with variable inverse P-Cygni profiles and a highly variable blueshifted absorption below the continuum. Line ratios from metallic emission lines (Fe I/Fe II, Ti I/Ti II) suggest temperatures of $\sim$5800-6000 K in the accretion flow. Photometrically and spectroscopically, the 2014-2017 event displays an intermediate behavior between EXors and FUors. The accretion rate (\.{M}=1-3$\times$10$^{-7}$M$_\odot$/yr), about 2 orders of magnitude higher than the accretion rate in quiescence, is not significantly different from the accretion rate observed in 2013. The absorption features in the spectra suggest that the system is viewed at a high angle and drives a powerful, non-axisymmetric wind, maybe related to magnetic reconnection. The properties of ASASSN-13db suggest that temperatures lower than those for solar-type stars are needed for modeling accretion in very low-mass systems. Finally, the rotational modulation during the outburst reveals that accretion-related structures settled after the begining of the outburst and can be relatively stable and long-lived. Our work also demonstrates the power of time-resolved photometry and spectroscopy to explore the properties of variable and outbursting stars. (Abridged)

Dijet Resonance Search with Weak Supervision Using root S=13 TeV pp Collisions in the ATLAS Detector

This Letter describes a search for narrowly resonant new physics using a machine-learning anomaly detection procedure that does not rely on signal simulations for developing the analysis selection. Weakly supervised learning is used to train classifiers directly on data to enhance potential signals. The targeted topology is dijet events and the features used for machine learning are the masses of the two jets. The resulting analysis is essentially a three-dimensional search A → BC, for mA ∼ OðTeVÞ, mB; mC ∼ Oð100 GeVÞ and B, C are reconstructed as large-radius jets, without paying a penalty associated with a large trials factor in the scan of the masses of the two jets. The full run 2 ffiffi s p ¼ 13 TeV pp collision dataset of 139 fb−1 recorded by the ATLAS detector at the Large Hadron Collider is used for the search. There is no significant evidence of a localized excess in the dijet invariant mass spectrum between 1.8 and 8.2 TeV. Cross-section limits for narrow-width A, B, and C particles vary with mA, mB, and mC. For example, when mA ¼ 3 TeV and mB ≳ 200 GeV, a production cross section between 1 and 5 fb is excluded at 95% confidence level, depending on mC. For certain masses, these limits are up to 10 times more sensitive than those obtained by the inclusive dijet search. These results are complementary to the dedicated searches for the case that B and C are standard model boson

Measurements of differential cross-sections in four-lepton events in 13 TeV proton-proton collisions with the ATLAS detector

Measurements of four-lepton differential and integrated fiducial cross-sections in events with two same-flavour, opposite-charge electron or muon pairs are presented. The data correspond to 139 fb−1 of s√ = 13 TeV proton-proton collisions, collected by the ATLAS detector during Run 2 of the Large Hadron Collider (2015–2018). The final state has contributions from a number of interesting Standard Model processes that dominate in different four-lepton invariant mass regions, including single Z boson production, Higgs boson production and on-shell ZZ production, with a complex mix of interference terms, and possible contributions from physics beyond the Standard Model. The differential cross-sections include the four-lepton invariant mass inclusively, in slices of other kinematic variables, and in different lepton flavour categories. Also measured are dilepton invariant masses, transverse momenta, and angular correlation variables, in four regions of four-lepton invariant mass, each dominated by different processes. The measurements are corrected for detector effects and are compared with state-of-the-art Standard Model calculations, which are found to be consistent with the data. The Z → 4ℓ branching fraction is extracted, giving a value of (4.41 ± 0.30) × 10−6. Constraints on effective field theory parameters and a model based on a spontaneously broken B − L gauge symmetry are also evaluated. Further reinterpretations can be performed with the provided information

Search for pair production of third-generation scalar leptoquarks decaying into a top quark and a τ-lepton in pp collisions at s√ = 13 TeV with the ATLAS detector

A search for pair production of third-generation scalar leptoquarks decaying into a top quark and a τ-lepton is presented. The search is based on a dataset of pp collisions at s√ = 13 TeV recorded with the ATLAS detector during Run 2 of the Large Hadron Collider, corresponding to an integrated luminosity of 139 fb−1. Events are selected if they have one light lepton (electron or muon) and at least one hadronically decaying τ -lepton, or at least two light leptons. In addition, two or more jets, at least one of which must be identified as containing b-hadrons, are required. Six final states, defined by the multiplicity and flavour of lepton candidates, are considered in the analysis. Each of them is split into multiple event categories to simultaneously search for the signal and constrain several leading backgrounds. The signal-rich event categories require at least one hadronically decaying τ-lepton candidate and exploit the presence of energetic final-state objects, which is characteristic of signal events. No significant excess above the Standard Model expectation is observed in any of the considered event categories, and 95% CL upper limits are set on the production cross section as a function of the leptoquark mass, for different assumptions about the branching fractions into tτ and bν. Scalar leptoquarks decaying exclusively into tτ are excluded up to masses of 1.43 TeV while, for a branching fraction of 50% into tτ, the lower mass limit is 1.22 TeV

Measurements of Higgs bosons decaying to bottom quarks from vector boson fusion production with the ATLAS experiment at √=13TeV

The paper presents a measurement of the Standard Model Higgs Boson decaying to b-quark pairs in the vector boson fusion (VBF) production mode. A sample corresponding to 126 fb−1 of s√=13TeV proton–proton collision data, collected with the ATLAS experiment at the Large Hadron Collider, is analyzed utilizing an adversarial neural network for event classification. The signal strength, defined as the ratio of the measured signal yield to that predicted by the Standard Model for VBF Higgs production, is measured to be 0.95+0.38−0.36 , corresponding to an observed (expected) significance of 2.6 (2.8) standard deviations from the background only hypothesis. The results are additionally combined with an analysis of Higgs bosons decaying to b-quarks, produced via VBF in association with a photon