Clinical Factors Associated with Long-Term Complete Remission versus Poor Response to Chemotherapy in HIV-Infected Children and Adolescents with Kaposi Sarcoma Receiving Bleomycin and Vincristine: A Retrospective Observational Study

Kaposi sarcoma (KS) is the most common HIV-associated malignancy in children and adolescents in Africa. Pediatric KS is distinct from adult disease. We evaluated the clinical characteristics associated with long-term outcomes. We performed a retrospective observational analysis of 70 HIV-infected children and adolescents with KS less than 18 years of age diagnosed between 8/2010 and 6/2013 in Lilongwe, Malawi. Local first-line treatment included bleomycin and vincristine plus nevirapine-based highly active anti-retroviral therapy (HAART). Median age was 8.6 years (range 1.7-17.9); there were 35 females (50%). Most common sites of presentation were: lymph node (74%), skin (59%), subcutaneous nodules (33%), oral (27%), woody edema (24%), and visceral (16%). Eighteen (26%) presented with lymphadenopathy only. Severe CD4 suppression occurred in 28%. At time of KS diagnosis, 49% were already on HAART. Overall, 28% presented with a platelet count \u3c 100 x 109/L and 37% with hemoglobin \u3c 8 g/dL. The 2-year event-free (EFS) and overall survival (OS) were 46% and 58% respectively (median follow-up 29 months, range 15-50). Multivariable analysis of risk of death and failure to achieve EFS demonstrated that visceral disease (odds ratios [OR] 19.08 and 11.61, 95% CI 2.22-163.90 and 1.60-83.95 respectively) and presenting with more than 20 skin/oral lesions (OR 9.57 and 22.90, 95% CI 1.01-90.99 and 1.00-524.13 respectively) were independent risk factors for both. Woody edema was associated with failure to achieve EFS (OR 7.80, 95% CI 1.84-33.08) but not death. Univariable analysis revealed that lymph node involvement was favorable for EFS (OR 0.28, 95% CI 0.08-0.99), while T1 TIS staging criteria, presence of cytopenias, and severe immune suppression were not associated with increased mortality. Long-term complete remission is achievable in pediatric KS, however outcomes vary according to clinical presentation. Based on clinical heterogeneity, treatment according to risk-stratification is necessary to improve overall outcomes

Reciprocity? International Preceptors’ Perceptions of Global Health Elective Learners at African Sites

Background: Short-term global health electives (STGHEs) have become increasingly common, with evidence showing educational and clinical benefits for short-term learners (STLs). Despite increased recognition that STGHEs should be mutually beneficial for host sites and STLs, evidence demonstrating the impact on international host preceptors is lacking. Objectives: To understand international host preceptors’ perceptions regarding benefits and burdens of hosting STLs. Methods: Focus group discussions with a convenience sample of 10 of 18 eligible preceptors were conducted at pediatric STGHE sites in Malawi and Lesotho. Qualitative content analysis was performed to identify themes using a deductive-inductive approach. Findings: Common themes regarding benefits to preceptors included increased knowledge and resources for learning from STLs, broadened differential diagnoses, and the satisfaction of teaching. Regarding burdens, preceptors perceived that supervising STLs decreases efficiency. Preceptors identified the burden of having to intervene in instances that could lead to patient harm. Some preceptors perceived that STLs under-valued preceptors’ clinical decision-making in resource-limited contexts. Conclusions: Our findings emphasize the need for institutions to identify mutuality of benefits between STLs and host sites when developing STGHEs. Host preceptors identified robust pre-departure training for STLs, lengthened duration of STGHEs, and formal preceptor orientation as ways to enhance mutuality of benefits

Routine Inpatient HIV Testing System Increases Access to Pediatric HIV Care in sub-Saharan Africa

Routine HIV testing, called provider-initiated opt-out HIV testing and counseling (PITC), is recommended in African countries with high HIV prevalence. However, it is unknown whether PITC increases access to pediatric HIV care. In 2008 the Baylor International Pediatric AIDS Initiative implemented PITC (BIPAI-PITC) at a Malawian hospital. We sought to evaluate the influence of BIPAI-PITC, compared to non-routine HIV testing (NRT), on pediatric HIV care access

Search for new particles in an extended Higgs sector with four b quarks in the final state at √s = 13 TeV

A search for a massive resonance X decaying to a pair of spin-0 bosons ϕ that themselves decay to pairs of bottom quarks, is presented. The analysis is restricted to the mass ranges from 25 to 100 GeV and from 1 to 3 TeV. For these mass ranges, the decay products of each ϕ boson are expected to merge into a single large-radius jet. Jet substructure and flavor identification techniques are used to identify these jets. The search is based on CERN LHC proton-proton collision data at , collected with the CMS detector in 2016–2018, corresponding to an integrated luminosity of 138 . Model-specific limits, where the two new particles arise from an extended Higgs sector, are set on the product of the production cross section and branching fraction for as a function of the resonances' masses, where both the and branching fractions are assumed to be 100%. These limits are the first of their kind on this process, ranging between 30 and 1 fb at 95% confidence level for the considered mass ranges

Measurement of differential t(t)over-bar production cross sections in the full kinematic range using lepton plus jets events from proton-proton collisions at root s=13 TeV

Measurements of differential and double-differential cross sections of top-quark pair (t (t) over bar) production arc presented in the lepton + jets channels with a single electron or muon and jets in the final state. The analysis combines for the first time signatures of top quarks with low transverse momentum p(T), where the top-quark decay products can be identified as separated jets and isolated leptons, and with high p(T), where the decay products are collimated and overlap. The measurements arc based on proton-proton collision data at is - = 13 TeV collected by the CMS experiment at the LHC, corresponding to an integrated luminosity of 137 fb(-1). The cross sections are presented at the parton and particle levels, where the latter minimizes extrapolations based on theoretical assumptions. Most of the measured differential cross sections are well described by standard model predictions with the exception of some double-differential distributions. The inclusive t (t) over bar production cross section is measured to be sigma(t (t) over bar) = 791 +/- 25 pb, which constitutes the most precise measurement in the lepton + jets channel to date.Peer reviewe

Measurement of the Inclusive and Differential Higgs Boson Production Cross Sections in the Decay Mode to a Pair of τ Leptons in pp Collisions at s =13 TeV

Copyright © 2022 CERN, for the CMS Collaboration. Measurements of the inclusive and differential fiducial cross sections of the Higgs boson are presented, using the τ lepton decay channel. The differential cross sections are measured as functions of the Higgs boson transverse momentum, jet multiplicity, and transverse momentum of the leading jet in the event, if any. The analysis is performed using proton-proton collision data collected with the CMS detector at the LHC at a center-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 138 fb−1. These are the first differential measurements of the Higgs boson cross section in the final state of two τ leptons. In final states with a large jet multiplicity or with a Lorentz-boosted Higgs boson, these measurements constitute a significant improvement over measurements performed in other final states.SCOAP3

Inclusive and differential cross section measurements of single top quark production in association with a Z boson in proton-proton collisions at root s=13 TeV

Inclusive and differential cross sections of single top quark production in association with a Z boson are measured in proton-proton collisions at a center-of-mass energy of 13 TeV with a data sample corresponding to an integrated luminosity of 138 fb−1 recorded by the CMS experiment. Events are selected based on the presence of three leptons, electrons or muons, associated with leptonic Z boson and top quark decays. The measurement yields an inclusive cross section of 87.9+7.5−7.3(stat)+7.3−6.0(syst) fb for a dilepton invariant mass greater than 30 GeV, in agreement with standard model (SM) calculations and represents the most precise determination to date. The ratio between the cross sections for the top quark and the top antiquark production in association with a Z boson is measured as 2.37+0.56−0.42(stat)+0.27−0.13(syst). Differential measurements at parton and particle levels are performed for the first time. Several kinematic observables are considered to study the modeling of the process. Results are compared to theoretical predictions with different assumptions on the source of the initial-state b quark and found to be in agreement, within the uncertainties. Additionally, the spin asymmetry, which is sensitive to the top quark polarization, is determined from the differential distribution of the polarization angle at parton level to be 0.54 ± 0.16 (stat) ± 0.06 (syst), in agreement with SM predictions

Search for resonances decaying to three W bosons in the hadronic final state in proton-proton collisions at ps=13 TeV

A search for Kaluza-Klein excited vector boson resonances, W KK , decaying in cascade to three W bosons via a scalar radion R , W KK → W R → W W W , in a final state containing two or three massive jets is presented. The search is performed with √ s = 13     TeV proton-proton collision data collected by the CMS experiment at the CERN LHC during 2016–2018, corresponding to an integrated luminosity of 138     fb − 1 . Two final states are simultaneously probed, one where the two W bosons produced by the R decay are reconstructed as separate, large-radius, massive jets, and one where they are merged into a single large-radius jet. The observed data are in agreement with the standard model expectations. Limits are set on the product of the W KK resonance cross section and branching fraction to three W bosons in an extended warped extra-dimensional model and are the first of their kind at the LHC