Laparoscopic Splenectomy in Children

BACKGROUND: Laparoscopic splenectomy is being performed more commonly in children, although its advantages are not clear. We sought to determine whether laparoscopic splenectomy was superior to open splenectomy. METHODS: The records of all pediatric patients undergoing splenectomy without significant comorbidities over a 12-year period were examined. The patients were divided into those undergoing laparoscopic splenectomy and those undergoing open splenectomy. Demographics, operative time, estimated blood loss, spleen size, length of stay, and total charges were compared between the groups. RESULTS: Eighty-one (58%) children underwent laparoscopic splenectomy, and 59 (42%) children underwent open splenectomy. The groups were similar in age and sex; hereditary spherocytosis was more common in the LS group. Operating time was longer in the laparoscopic splenectomy group (231 +/- 10 min vs 138 +/- 9 min; P\u3c0.001), but blood loss and complication rates were similar. Twelve (15%) conversions were necessary primarily due to spleen size. Although children undergoing LS had a shorter length of stay (2.4 +/- 0.1 vs 4.1 +/- 0.3 days; P\u3c0.001), they incurred higher charges (dollars 21199 +/- 664 vs dollars 15723 +/- 1737; P\u3c0.002). CONCLUSION: Laparoscopic splenectomy is a safe procedure in children, resulting in shorter hospital stay, which may translate into earlier return to activity and a smaller burden on the child\u27s caretakers

Absorption of high-energy gamma rays in Cygnus X-3

The microquasar Cygnus X-3 was detected at high energies by the gamma-ray space telescopes AGILE and Fermi. The gamma-ray emission is transient, modulated with the orbital period and seems related to major radio flares, i.e. to the relativistic jet. The GeV gamma-ray flux can be substantially attenuated by internal absorption with the ambient X-rays. In this study, we examine quantitatively the effect of pair production in Cygnus X-3 and put constraints on the location of the gamma-ray source. Cygnus X-3 exhibits complex temporal and spectral patterns in X-rays. During gamma-ray flares, the X-ray emission can be approximated by a bright disk black body component and a non-thermal tail extending in hard X-rays, possibly related to a corona above the disk. We calculate numerically the exact optical depth for gamma rays above a standard accretion disk. Emission and absorption in the corona are also investigated. GeV gamma rays are significantly absorbed by soft X-rays emitted from the inner parts of the accretion disk. The absorption pattern is complex and anisotropic. Isotropization of X-rays due to Thomson scattering in the companion star wind tends to increase the gamma-ray opacity. Gamma rays from the corona suffer from strong absorption by photons from the disk and cannot explain the observed high-energy emission, unless the corona is unrealistically extended. The lack of absorption feature in the GeV emission indicates that high-energy gamma rays should be located at a minimum distance ~10^8-10^10 cm from the compact object. The gamma-ray emission is unlikely to have a coronal origin.Comment: 11 pages, 9 figures, accepted for publication in Astronomy and Astrophysic

HST/ACS Multiband Coronagraphic Imaging of the Debris Disk around Beta Pictoris

(Abridged.) We present F435W (B), F606W (Broad V), and F814W (Broad I) coronagraphic images of the debris disk around Beta Pictoris obtained with HST's Advanced Camera for Surveys. We confirm that the previously reported warp in the inner disk is a distinct secondary disk inclined by ~5 deg from the main disk. The main disk's northeast extension is linear from 80 to 250 AU, but the southwest extension is distinctly bowed with an amplitude of ~1 AU over the same region. Both extensions of the secondary disk appear linear, but not collinear, from 80 to 150 AU. Within ~120 AU of the star, the main disk is ~50% thinner than previously reported. The surface-brightness profiles along the spine of the main disk are fitted with four distinct radial power laws between 40 and 250 AU, while those of the secondary disk between 80 and 150 AU are fitted with single power laws. These discrepancies suggest that the two disks have different grain compositions or size distributions. The F606W/F435W and F814W/F435W flux ratios of the composite disk are nonuniform and asymmetric about both projected axes of the disk. Within ~120 AU, the m_F435W-m_F606W and m_F435W-m_F814W colors along the spine of the main disk are ~10% and ~20% redder, respectively, than those of Beta Pic. These colors increasingly redden beyond ~120 AU, becoming 25% and 40% redder, respectively, than the star at 250 AU. We compare the observed red colors within ~120 AU with the simulated colors of non-icy grains having a radial number density ~r^-3 and different compositions, porosities, and minimum grain sizes. The observed colors are consistent with those of compact or moderately porous grains of astronomical silicate and/or graphite with sizes >0.15-0.20 um, but the colors are inconsistent with the blue colors expected from grains with porosities >90%.Comment: 38 pages (including 21 figures and 4 tables) in EmulateApJ format, accepted for publication in The Astronomical Journal. Full-resolution figures and fully processed FITS images (with error maps) are available at http://acs.pha.jhu.edu/~dag/betapic Version 2: Added 4 references and some clarifying text. Basic facts and conclusions are unchange

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe

Measurement of the W gamma Production Cross Section in Proton-Proton Collisions at root s=13 TeV and Constraints on Effective Field Theory Coefficients

A fiducial cross section for W gamma production in proton-proton collisions is measured at a center-of-mass energy of 13 TeV in 137 fb(-1) of data collected using the CMS detector at the LHC. The W -> e nu and mu nu decay modes are used in a maximum-likelihood fit to the lepton-photon invariant mass distribution to extract the combined cross section. The measured cross section is compared with theoretical expectations at next-to-leading order in quantum chromodynamics. In addition, 95% confidence level intervals are reported for anomalous triple-gauge couplings within the framework of effective field theory.Peer reviewe

Search for top squark production in fully hadronic final states in proton-proton collisions at root s=13 TeV

A search for production of the supersymmetric partners of the top quark, top squarks, is presented. The search is based on proton-proton collision events containing multiple jets, no leptons, and large transverse momentum imbalance. The data were collected with the CMS detector at the CERN LHC at a center-of-mass energy of 13 TeV, and correspond to an integrated luminosity of 137 fb(-1). The targeted signal production scenarios are direct and gluino-mediated top squark production, including scenarios in which the top squark and neutralino masses are nearly degenerate. The search utilizes novel algorithms based on deep neural networks that identify hadronically decaying top quarks and W bosons, which are expected in many of the targeted signal models. No statistically significant excess of events is observed relative to the expectation from the standard model, and limits on the top squark production cross section are obtained in the context of simplified supersymmetric models for various production and decay modes. Exclusion limits as high as 1310 GeVare established at the 95% confidence level on the mass of the top squark for direct top squark production models, and as high as 2260 GeV on the mass of the gluino for gluino-mediated top squark production models. These results represent a significant improvement over the results of previous searches for supersymmetry by CMS in the same final state.Peer reviewe