Analysis of changes in the association of income and the utilization of curative health services in Mexico between 2000 and 2006

<p>Abstract</p> <p>Background</p> <p>A common characteristic of health systems in most developing countries is unequal access to health services. As a result, members of the poorest population groups often do not receive formal attention for health services, because they cannot afford it. In 2001 in Mexico, to address income-related differences in the use of health services, the government launched a major healthcare reform, which includes a health insurance program called <it>Seguro Popular</it>, aimed at improving healthcare access among poor, uninsured residents. This paper analyzes the before and after changes in the demand for curative ambulatory health services focusing on the association of income-related characteristics and the utilization of formal healthcare providers vs. no healthcare service utilization.</p> <p>Methods</p> <p>By using two nationally representative health surveys (ENSA-2000 and ENSANUT-2006), we modeled an individual's decision when experiencing an illness to use services provided by the (1) Ministry of Health (MoH), (2) social security, (3) private entities, or (4) to not use formal services (no healthcare service utilization).</p> <p>Results</p> <p>Poorer individuals were more likely in 2006 than in 2000 to respond to an illness by using formal healthcare providers. Trends in provider selection differed, however. The probability of using public services from the MoH increased among the poorest population, while the findings indicated an increase in utilization of private health services among members of low- and middle-income groups. No significant change was seen among formal workers -covered by social security services-, regardless of socioeconomic status.</p> <p>Conclusions</p> <p>Overall, for 2006 the Mexican population appears less differentiated in using healthcare across economic groups than in 2000. This may be related, in part, to the implementation of <it>Seguro Popular</it>, which seems to be stimulating healthcare demand among the poorest and previously uninsured segment of the population. Still, public health authorities need to address the remaining income-related healthcare utilization differences, the differences in quality between public and private health services, and the general perception that MoH facilities offer inferior services.</p

Constraints on the χ_(c1) versus χ_(c2) polarizations in proton-proton collisions at √s = 8 TeV

The polarizations of promptly produced χ_(c1) and χ_(c2) mesons are studied using data collected by the CMS experiment at the LHC, in proton-proton collisions at √s=8  TeV. The χ_c states are reconstructed via their radiative decays χ_c → J/ψγ, with the photons being measured through conversions to e⁺e⁻, which allows the two states to be well resolved. The polarizations are measured in the helicity frame, through the analysis of the χ_(c2) to χ_(c1) yield ratio as a function of the polar or azimuthal angle of the positive muon emitted in the J/ψ → μ⁺μ⁻ decay, in three bins of J/ψ transverse momentum. While no differences are seen between the two states in terms of azimuthal decay angle distributions, they are observed to have significantly different polar anisotropies. The measurement favors a scenario where at least one of the two states is strongly polarized along the helicity quantization axis, in agreement with nonrelativistic quantum chromodynamics predictions. This is the first measurement of significantly polarized quarkonia produced at high transverse momentum

Effect of SGLT2 inhibitors on stroke and atrial fibrillation in diabetic kidney disease: Results from the CREDENCE trial and meta-analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-Analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus. METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-Analysis. RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: Total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]). CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms

Search for a vector-like quark T′ → tH via the diphoton decay mode of the Higgs boson in proton-proton collisions at s \sqrt{s} = 13 TeV

A search for the electroweak production of a vector-like quark T′, decaying to a top quark and a Higgs boson is presented. The search is based on a sample of proton-proton collision events recorded at the LHC at = 13 TeV, corresponding to an integrated luminosity of 138 fb−1. This is the first T′ search that exploits the Higgs boson decay to a pair of photons. For narrow isospin singlet T′ states with masses up to 1.1 TeV, the excellent diphoton invariant mass resolution of 1–2% results in an increased sensitivity compared to previous searches based on the same production mechanism. The electroweak production of a T′ quark with mass up to 960 GeV is excluded at 95% confidence level, assuming a coupling strength κT = 0.25 and a relative decay width Γ/MT′ < 5%

Search for physics beyond the standard model in events with jets and two same-sign or at least three charged leptons in proton-proton collisions at s=13 TeV\sqrt{s}=13\,{\text {TeV}}

A data sample of events from proton-proton collisions with at least two jets, and two isolated same-sign or three or more charged leptons, is studied in a search for signatures of new physics phenomena. The data correspond to an integrated luminosity of 137fb$^{-1}$ at a center-of-mass energy of 13TeV, collected in 2016–2018 by the CMS experiment at the LHC. The search is performed using a total of 168 signal regions defined using several kinematic variables. The properties of the events are found to be consistent with the expectations from standard model processes. Exclusion limits at 95% confidence level are set on cross sections for the pair production of gluinos or squarks for various decay scenarios in the context of supersymmetric models conserving or violating R parity. The observed lower mass limits are as large as 2.1TeV for gluinos and 0.9TeV for top and bottom squarks. To facilitate reinterpretations, model-independent limits are provided in a set of simplified signal regions

Search for physics beyond the standard model in events with jets and two same-sign or at least three charged leptons in proton-proton collisions at √s = 13 TeV

A data sample of events from proton-proton collisions with at least two jets, and two isolated same-sign or three or more charged leptons, is studied in a search for signatures of new physics phenomena. The data correspond to an integrated luminosity of 137 fb⁻¹ at a center-of-mass energy of 13 TeV, collected in 2016–2018 by the CMS experiment at the LHC. The search is performed using a total of 168 signal regions defined using several kinematic variables. The properties of the events are found to be consistent with the expectations from standard model processes. Exclusion limits at 95% confidence level are set on cross sections for the pair production of gluinos or squarks for various decay scenarios in the context of supersymmetric models conserving or violating R parity. The observed lower mass limits are as large as 2.1 TeV for gluinos and 0.9 TeV for top and bottom squarks. To facilitate reinterpretations, model-independent limits are provided in a set of simplified signal regions

Evidence for X(3872) in Pb-Pb Collisions and Studies of its Prompt Production at sNN\sqrt{^{s}NN} =5.02 TeV

The first evidence for X(3872) production in relativistic heavy ion collisions is reported. The X(3872) production is studied in lead-lead (Pb-Pb) collisions at a center-of-mass energy of $\sqrt{^{s}NN}$=5.02 TeV per nucleon pair, using the decay chain X(3872)→J/ψπ$^{+}$ π$^{–}$→μ$^{+}$μ$^{–}$π$^{+}$ π$^{–}$. The data were recorded with the CMS detector in 2018 and correspond to an integrated luminosity of 1.7 nb$^{-1}$. The measurement is performed in the rapidity and transverse momentum ranges |y|<1.6 and 15<pT<50 GeV/c. The significance of the inclusive X(3872) signal is 4.2 standard deviations. The prompt X(3872) to ψ2S yield ratio is found to be ρ$^{Pb-Pb}$=1.08±0.49(stat)±0.52(syst), to be compared with typical values of 0.1 for pp collisions. This result provides a unique experimental input to theoretical models of the X(3872) production mechanism, and of the nature of this exotic state

Determination of the strong coupling constant α_S(m_Z) from measurements of inclusive W± and Z boson production cross sections in proton-proton collisions at √s = 7 and 8 TeV

Twelve measurements of inclusive cross sections of W± and Z boson production, performed in proton-proton collisions at centre-of-mass energies of 7 and 8 TeV, are compared with perturbative quantum chromodynamics calculations at next-to-next- to-leading order (NNLO) accuracy obtained with the CT₁₄, HERAPDF2.0, MMHT₁₄, and NNPDF_(3.0) parton distribution functions (PDFs). Data and theory agree well for all PDF sets, taking into account the experimental and theoretical uncertainties. A novel procedure is employed to extract the strong coupling constant at the Z pole mass from a detailed comparison of all the experimental fiducial cross sections to the corresponding NNLO theoretical predictions, yielding α_S(m_Z) = 0.1163^(+0.0024)_(−0.0031) (CT₁₄), 0.1072^(+0.0043)_(−0.0040) (HERAPDF_(2.0)), 0.1186 ± 0.0025 (MMHT₁₄), and 0.1147 ± 0.0023 (NNPDF_(3.0)). Using the results obtained with the CT₁₄ and MMHT₁₄ PDFs, which yield the most robust and stable α_S(m_Z) extractions, a value α_S(m_Z) = 0.1175^(+0.0025)_(−0.0028) is determined

Measurement of the Y(1S) pair production cross section and search for resonances decaying to Y(1S)μ⁺μ⁻ in proton-proton collisions at √s = 13 TeV

The fiducial cross section for Y(1S) pair production in proton-proton collisions at a center-of-mass energy of 13 TeV in the region where both Y(1S) mesons have an absolute rapidity below 2.0 is measured to be 79±11(stat)±6(syst)±3(B) pb assuming the mesons are produced unpolarized. The last uncertainty corresponds to the uncertainty in the Y(1S) meson dimuon branching fraction. The measurement is performed in the final state with four muons using proton-proton collision data collected in 2016 by the CMS experiment at the LHC, corresponding to an integrated luminosity of 35.9fb⁻¹. This process serves as a standard model reference in a search for narrow resonances decaying to Y(1S)μ⁺μ⁻ in the same final state. Such a resonance could indicate the existence of a tetraquark that is a bound state of two b quarks and two b antiquarks. The tetraquark search is performed for masses in the vicinity of four times the bottom quark mass, between 17.5 and 19.5 GeV, while a generic search for other resonances is performed for masses between 16.5 and 27 GeV. No significant excess of events compatible with a narrow resonance is observed in the data. Limits on the production cross section times branching fraction to four muons via an intermediate Y(1S) resonance are set as a function of the resonance mass