The finite temperature QCD using 2+1 flavors of domain wall fermions at N_t = 8

We study the region of the QCD phase transition using 2+1 flavors of domain wall fermions (DWF) and a $16^3 \times 8$ lattice volume with a fifth dimension of $L_s = 32$. The disconnected light quark chiral susceptibility, quark number susceptibility and the Polyakov loop suggest a chiral and deconfining crossover transition lying between 155 and 185 MeV for our choice of quark mass and lattice spacing. In this region the lattice scale deduced from the Sommer parameter $r_0$ is $a^{-1} \approx 1.3$ GeV, the pion mass is $\approx 300$ MeV and the kaon mass is approximately physical. The peak in the chiral susceptibility implies a pseudo critical temperature $T_c = 171(10)(17)$ MeV where the first error is associated with determining the peak location and the second with our unphysical light quark mass and non-zero lattice spacing. The effects of residual chiral symmetry breaking on the chiral condensate and disconnected chiral susceptibility are studied using several values of the valence $L_s$.Comment: 41 pages, 10 tables, 13 figure

Assessment of Symptom, Disability, and Financial Trajectories in Patients Hospitalized for COVID-19 at 6 Months

IMPORTANCE: Individuals who survived COVID-19 often report persistent symptoms, disabilities, and financial consequences. However, national longitudinal estimates of symptom burden remain limited. OBJECTIVE: To measure the incidence and changes over time in symptoms, disability, and financial status after COVID-19-related hospitalization. DESIGN, SETTING, AND PARTICIPANTS: A national US multicenter prospective cohort study with 1-, 3-, and 6-month postdischarge visits was conducted at 44 sites participating in the National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Network\u27s Biology and Longitudinal Epidemiology: COVID-19 Observational (BLUE CORAL) study. Participants included hospitalized English- or Spanish-speaking adults without severe prehospitalization disabilities or cognitive impairment. Participants were enrolled between August 24, 2020, and July 20, 2021, with follow-up occurring through March 30, 2022. EXPOSURE: Hospitalization for COVID-19 as identified with a positive SARS-CoV-2 molecular test. MAIN OUTCOMES AND MEASURES: New or worsened cardiopulmonary symptoms, financial problems, functional impairments, perceived return to baseline health, and quality of life. Logistic regression was used to identify factors associated with new cardiopulmonary symptoms or financial problems at 6 months. RESULTS: A total of 825 adults (444 [54.0%] were male, and 379 [46.0%] were female) met eligibility criteria and completed at least 1 follow-up survey. Median age was 56 (IQR, 43-66) years; 253 (30.7%) participants were Hispanic, 145 (17.6%) were non-Hispanic Black, and 360 (43.6%) were non-Hispanic White. Symptoms, disabilities, and financial problems remained highly prevalent among hospitalization survivors at month 6. Rates increased between months 1 and 6 for cardiopulmonary symptoms (from 67.3% to 75.4%; P = .001) and fatigue (from 40.7% to 50.8%; P \u3c .001). Decreases were noted over the same interval for prevalent financial problems (from 66.1% to 56.4%; P \u3c .001) and functional limitations (from 55.3% to 47.3%; P = .004). Participants not reporting problems at month 1 often reported new symptoms (60.0%), financial problems (23.7%), disabilities (23.8%), or fatigue (41.4%) at month 6. CONCLUSIONS AND RELEVANCE: The findings of this cohort study of people discharged after COVID-19 hospitalization suggest that recovery in symptoms, functional status, and fatigue was limited at 6 months, and some participants reported new problems 6 months after hospital discharge

The chiral transition and U(1)_A symmetry restoration from lattice QCD using Domain Wall Fermions

We present results on both the restoration of the spontaneously broken chiral symmetry and the effective restoration of the anomalously broken U(1)_A symmetry in finite temperature QCD at zero chemical potential using lattice QCD. We employ domain wall fermions on lattices with fixed temporal extent N_\tau = 8 and spatial extent N_\sigma = 16 in a temperature range of T = 139 - 195 MeV, corresponding to lattice spacings of a \approx 0.12 - 0.18 fm. In these calculations, we include two degenerate light quarks and a strange quark at fixed pion mass m_\pi = 200 MeV. The strange quark mass is set near its physical value. We also present results from a second set of finite temperature gauge configurations at the same volume and temporal extent with slightly heavier pion mass. To study chiral symmetry restoration, we calculate the chiral condensate, the disconnected chiral susceptibility, and susceptibilities in several meson channels of different quantum numbers. To study U(1)_A restoration, we calculate spatial correlators in the scalar and pseudo-scalar channels, as well as the corresponding susceptibilities. Furthermore, we also show results for the eigenvalue spectrum of the Dirac operator as a function of temperature, which can be connected to both U(1)_A and chiral symmetry restoration via Banks-Casher relations.Comment: 80 pages, 14 figures, 4 appendice

Lattice QCD and Particle Physics

Contribution from the USQCD Collaboration to the Proceedings of the US Community Study on the Future of Particle Physics (Snowmass 2021)

The association of pregnancy with outcomes among critically ill reproductive-aged women: A propensity-score matched retrospective cohort analysis

The maternal mortality rate in the US is unacceptably high. However, the relative contribution of pregnancy to these outcomes is unknown. Studies comparing outcomes among pregnant versus non-pregnant critically ill patients show mixed results and are limited by small sample sizes. What is the association of pregnancy with critical illness outcomes? We performed a retrospective cohort study of 18-55-year-old women who received invasive mechanical ventilation (MV) on hospital day 0 or 1, or had sepsis present on admission (infection with organ failure) discharged from Premier Healthcare Database hospitals in 2008-2021. The exposure was pregnancy. The primary outcome was in-hospital mortality. We created propensity scores for pregnancy (using patient and hospital characteristics) and performed 1:1 propensity-score matching without replacement within age strata (to ensure exact age matching). We performed multilevel multivariable mixed-effects logistic regression for propensity-matched pairs with pair as a random effect. 3,093 pairs were included in the matched MV cohort, and 13,002 in the sepsis cohort. Cohort characteristics in both were well-balanced (all standard mean differences<0.1). Among matched pairs, unadjusted mortality was 8.0% versus 13.8% for MV and 1.4% versus 2.3% for sepsis, among pregnant and non-pregnant patients, respectively. In adjusted regression, pregnancy was associated with lower odds of in-hospital mortality (MV: odds ratio [OR] 0.50, 95% confidence interval [CI] 0.41-0.60, p<0.001; sepsis: OR 0.52, 95% CI 0.40-0.67, p<0.001). In our large US cohort, critically ill pregnant women receiving MV or with sepsis had better survival than propensity score-matched, non-pregnant women. These findings must be interpreted in the context of likely residual confounding

Influence of the COVID-19 Pandemic on Author Gender and Manuscript Acceptance Rates among Pulmonary and Critical Care Journals

The COVID-19 pandemic has negatively affected women more than men and may influence the publication of non-COVID research. Evaluate whether the COVID-19 pandemic is associated with changes in manuscript acceptance rates among pulmonary/critical care journals, and gender-based disparities in these rates. We analyzed first, senior, and corresponding-author gender (female vs. male, identified by matching first names in a validated Genderize database) of manuscripts submitted to four pulmonary/critical care journals between 1/1/18-12/31/20. We constructed interrupted time series regression models to evaluate whether the proportion of female first and senior authors of non-COVID-19 original research manuscripts changed with the pandemic. Next, we performed multivariable logistic regressions to evaluate the association of author gender with acceptance of original research manuscripts. Among 8,332 original research submissions, women comprised 39.9% and 28.3% of first and senior authors, respectively. We found no change in the proportion of female first or senior-authors of non-COVID-19 or COVID-19-submitted research manuscripts during the COVID-era. Non-COVID-19 manuscripts submitted during the COVID-era had reduced odds of acceptance, regardless of author gender (first-author: adjustedOR [aOR]0.46 [95%CI0.36-0.59]; senior-author: aOR0.46 [95%CI0.37-0.57]). Female senior-authorship was associated with decreased acceptance of non-COVID research manuscripts (crude rates: 14.4% [male] vs 13.2% [female]; aOR0.84, 95%CI0.71-0.99). Although female author submissions were not disproportionately influenced by COVID-19, we found evidence suggesting gender disparities in manuscript acceptance rates. Journals may need to consider strategies to reduce this disparity and academic institutions may need to factor our findings, including lower acceptance rates for non-COVID manuscripts, into promotion decisions

“You’re Socially Distant and Trying Not to Be Emotionally Distant.” Physicians’ Perspectives of Communication and Therapeutic Relationships in the ICU During the COVID-19 Pandemic: A Qualitative Study

OBJECTIVES:. To: 1) characterize how COVID-19–related policies influence patient-clinician communication and relationships in the ICU, with attention to race and ethnicity as factors and 2) identify interventions that may facilitate patient-clinician communication. DESIGN:. We conducted a qualitative study between September 2020 and February 2021 that explored facilitators and barriers to patient-clinician communication and the formation of therapeutic relationships. We used thematic analysis to develop findings describing patient-communication and therapeutic relationships within the ICU early in the COVID-19 pandemic. SETTING:. We purposively selected hospital dyads from regions in the United States that experienced early and/or large surges of patients hospitalized with COVID-19. SUBJECTS:. We recruited a national sample of ICU physicians from Veteran Affairs (VA) Health Care Systems and their associated academic affiliate hospitals. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Twenty-four intensivists from seven VA hospitals and six academic-affiliate hospitals participated. Intensivists noted the disproportionate impact of the pandemic on among people holding minoritized racial and ethnic identities, describing how language barriers and restrictive visitation policies exacerbated institutional mistrust and compromised physicians’ ability to develop therapeutic relationships. We also identified several perceived influences on patient-clinician communication and the establishment of therapeutic relationships. Barriers included physicians’ fear of becoming infected with COVID-19 and use of personal protective equipment, which created obstacles to effective physical and verbal interactions. Facilitators included the presence of on-site interpreters, use of web-based technology to interact with family members outside the ICU, and designation of a care team member or specialist service to provide routine updates to families. CONCLUSIONS:. The COVID-19 pandemic has threatened patient-clinician communication and the development of therapeutic relationships in the ICU, particularly among people holding minoritized racial and ethnic identities and their families. We identified several facilitators to improve patient-clinician communication as perceived by intensivists that may help improve trust and foster therapeutic alliances