New physics searches at kaon and hyperon factories.

Rare meson decays are among the most sensitive probes of both heavy and light new physics. Among them, new physics searches using kaons benefit from their small total decay widths and the availability of very large datasets. On the other hand, useful complementary information is provided by hyperon decay measurements. We summarize the relevant phenomenological models and the status of the searches in a comprehensive list of kaon and hyperon decay channels. We identify new search strategies for under-explored signatures, and demonstrate that the improved sensitivities from current and next-generation experiments could lead to a qualitative leap in the exploration of light dark sectors.

Testing the Sensitivity of the Galactic Center Excess to the Point Source Mask.

The Fermi Large Area Telescope (Fermi-LAT) Collaboration has an updated point source catalog, referred to as 4FGL. We perform the first template fit using a mask based on this new catalog and find that the excess in gamma rays detected at the Galactic Center in Fermi-LAT data persists. On the other hand, we find that a search for point sources is highly sensitive to the use of the 4FGL catalog: no sizable excess of bright pixels is apparent in the inner Galaxy when we mask out 4FGL point sources. Combining these observations restricts the ability of point sources to contribute to the Galactic Center excess. After identifying which bright sources have no known counterpart, we place strong constraints on any point source luminosity function capable of explaining the smooth emission identified in the template fit.

General Solution to the U(1) Anomaly Equations.

The anomaly cancellation equations for the U(1) gauge group can be written as a cubic equation in n-1 integer variables, where n is the number of Weyl fermions carrying the U(1) charge. We solve this Diophantine cubic equation by providing a parametrization of the charges in terms of n-2 integers, and prove that this is the most general solution.

Medication adherence among older adults with schizophrenia.

Older adults with schizophrenia are a growing segment of the population, yet their physical and mental health status is extremely poor. This article presents findings from a qualitative study that explored the understanding older adults with schizophrenia have of their physical health status. The study was conducted among 28 older adults with schizophrenia from a variety of settings using semi-structured interviews and participant observation. Self-management of psychiatric and non-psychiatric medications and its effect on participants' health status was one of the central themes that emerged from the study. Different styles of medication adherence were identified and factors associated with each style are presented. The findings provide insights into the design of clinical interventions aimed at promoting medication adherence among older adults with schizophrenia.

CP violation in B{s} mixing from heavy Higgs boson exchange.

The anomalous dimuon charge asymmetry reported by the D0 Collaboration may be due to the tree-level exchange of some spin-0 particles that mediate CP violation in B{s}-B{s} meson mixing. We show that, for a range of couplings and masses, the heavy neutral states in a two-Higgs doublet model can generate a large charge asymmetry. This range is natural in "uplifted supersymmetry" and may enhance the B{-}→τν and B{s}→µ^{+}µ{-} decay rates. However, we point out that on general grounds the reported central value of the charge asymmetry requires new physics not only in B{s}-B{s} mixing but also in ΔB=1 transitions or in B{d}-B{d} mixing.

Resisting social disenfranchisement: negotiating collective identities and everyday life with memory loss.

Being diagnosed with Alzheimer's disease marks a status passage formally legitimating the incorporation of forgetfulness into daily life. Based on interviews with diagnosed individuals in California, USA, we examine the mechanisms through which an Alzheimer's label is employed to justify forgetfulness, to manage social interactions, and to garner support when deemed necessary, while simultaneously combating the associated demented "master status." For diagnosed individuals, the transition from experience to symptom requires a redefinition of everyday forgetfulness into a medical problem. That is, respondents did not routinely perceive their experiences as pathological but rather were socialised into viewing age-related forgetfulness as symbolic of disease. Support groups sponsored by the Alzheimer's Association and memory clinics have a profound impact not only on the formation of group identity, but also on socialising forgetful individuals into diseased identities. The social disenfranchisement accompanying a diagnosis of dementia transforms forgetful older adults into "Alzheimer's patients," who must manage not only the manifestations of their disease, but also negotiate their interactions and identities. Their adaptation to the "symptoms" of forgetfulness and resultant social relations forms new interactional strategies whereby the diagnosis becomes a resource utilised to get through everyday life. Rather than being passive recipients of a diagnosis, respondents employ the label both as a resource, and as a phenomenon that needs to be incorporated into their self identity.

Pediatric Ureteroscopy.

In recent years, the incidence of nephrolithiasis in the pediatric population appears to be increasing. 1 This has placed a new emphasis on surgical management of stones in children. In the past, extracorporeal shockwave lithotripsy was the preferred management technique for stones in children. 2 More recently, though, advances in endoscopy have allowed ureteroscopy to be adapted to the pediatric population and this approach has become more frequently utilized not just for lower ureteral calculi but also for proximal ureteral and renal stones.

Continent Catheterizable Vesicostomy: An Alternative Surgical Modality for Pediatric Patients With Large Bladder Capacity.

OBJECTIVE: To present a modified technique and early outcomes of a continent catheterizable vesicostomy in pediatric patients with either flaccid neurogenic bladder or intractable voiding dysfunction and large capacity bladder. METHODS: Six patients underwent the procedure from October 2014 to December 2015. A 4-cm Pfannenstiel incision was made, avoiding intraperitoneal dissection. After adequate mobilization, a 2-cm vertical flap at the dome of the bladder was identified and tubularized over a 12Fr catheter with 4-0 vicryl suture. The tubularized flap was then intussuscepted into the bladder with four 4-0 polydioxanone sutures, creating a continent mechanism. The catheterizable channel was then tunneled to the umbilicus, the channel ostomy matured, and the cystotomy closed in two layers. RESULTS: The median patient age was 8 (interquartile range [IQR] 12) years. All patients had urinary dysfunction requiring drainage from etiologies that included Eagle-Barrett syndrome (n = 2), Noonan syndrome (n = 1), Lennox-Gastaut syndrome (n = 1), and Spina bifida (n = 2). Median hospital length of stay was 8 (IQR 3) days. One patient had a superficial wound infection treated with antibiotics, and 1 patient required balloon dilation of the catheterizable channel at 3 months postoperatively, secondary to difficulty self-catheterizing. Five patients were successfully self-catheterizing at last follow-up. Median follow-up was 6 (IQR 5) months and there were no intra- or perioperative complications. CONCLUSION: Continent catheterizable vesicostomy is a novel technique for urinary drainage in patients with large bladder capacity that spares use of the appendix or ileum. Early results are encouraging, providing a catheterizable channel through the umbilicus without urinary leakage between catheterization.

Characteristics associated with physician discipline: a case-control study.

BACKGROUND: There has been increasing attention devoted to patient safety. However, the focus has been on system improvements rather than individual physician performance issues. The purpose of this study was to determine if there is an association between certain physician characteristics and the likelihood of medical board-imposed discipline. METHODS: Unmatched, case-control study of 890 physicians disciplined by the Medical Board of California between July 1, 1998, and June 30, 2001, compared with 2981 randomly selected, nondisciplined controls. Odds ratios (ORs) were calculated for physician discipline with respect to age, sex, board certification, international medical school education, and specialty. RESULTS: Male sex (OR, 2.76; P<.001), lack of board certification (OR, 2.22; P<.001), increasing age (OR, 1.64; P<.001), and international medical school education (OR, 1.36; P<.001) were associated with an elevated risk for disciplinary action that included license revocation, practice suspension, probation, and public reprimand. The following specialties had an increased risk for discipline compared with internal medicine: family practice (OR, 1.68; P =.002); general practice (OR, 1.97, P =.001); obstetrics and gynecology (OR, 2.25; P<.001); and psychiatry (OR, 1.87; P<.001). Physicians in pediatrics (OR, 0.62; P =.001) and radiology (OR, 0.36; P<.001) were less likely to receive discipline compared with those in internal medicine. CONCLUSION: Certain physician characteristics and medical specialties are associated with an increased likelihood of discipline.

A Paratesticular Serous Borderline Tumor in a Pediatric Patient With Proteus Syndrome.

Proteus syndrome is a rare disorder of asymmetric overgrowth of various tissues of the body and is associated with specific tumors appearing before the second decade. Although there have been reports of lesions of the genitourinary tract associated with Proteus syndrome, a case of serous borderline tumor of the paratestis has not been previously recorded. We report the first such case in a 20-month-old child who presented with a left-sided testicular mass that was found on histology to be a serous borderline tumor of the paratestis. Surgical management included a left inguinal radical orchiectomy and surveillance follow-up.

Before it is too late: professional responsibilities in late-onset Alzheimer's research and pre-symptomatic prediction.

The development of a wide array of molecular and neuroscientific biomarkers can provide the possibility to visualize the course of Alzheimer's disease (AD) at early stages. Many of these biomarkers are aimed at detecting not only a preclinical, but also a pre-symptomatic state. They are supposed to facilitate clinical trials aiming at treatments that attack the disease at its earliest stage or even prevent it. The increasing number of such biomarkers currently tested and now partly proposed for clinical implementation calls for critical reflection on their aims, social benefits, and risks. This position paper summarizes major challenges and responsibilities. Its focus is on the ethical and social problems involved in the organization and application of dementia research, as well as in healthcare provision from a cross-national point of view. The paper is based on a discussion of leading dementia experts from neuroscience, neurology, social sciences, and bioethics in the United States and Europe. It thus reflects a notable consensus across various disciplines and national backgrounds. We intend to initiate a debate on the need for actions within the researchers' national and international communities.

A randomized trial of a multifaceted intervention to reduce falls among community-dwelling adults.

Using a randomized controlled trial, we tested the efficacy of a fall prevention intervention to reduce falls among adults in a community-based health promotion program. Adults aged 65 and older within two counties were recruited (control n = 257; intervention n = 286). After 12 months, there was a significant decrease in the number of falls in both groups (odds ratio = 0.45, p < .04), but the time by group membership interaction was not significant (χ(2) = 0.15, p < .69). Multivariate analysis did not find significant differences between the control and intervention groups for physical function as measured by a balance test or a sitting/standing test. Further research is needed on effective methods to deliver multifaceted fall interventions to older adults who are already being served by community health promotion programs.

Visible cascade Higgs decays to four photons at hadron colliders.

The presence of a new singlet scalar particle a can open up new decay channels for the Higgs boson, through cascades of the form h --> 2a --> X, possibly making discovery through standard model channels impossible. If a is CP odd, its decays are particularly sensitive to new physics. Quantum effects from heavy fields can naturally make h --> 4 g the dominant decay which is difficult to observe at hadron colliders, and is allowed by CERN LEP for m(h) > 82 GeV. However, there are usually associated decays, either h --> 2g2gamma or h --> 4gamma, which are more promising. The decay h-->4gamma is a clean channel that can discover both a and h. At the CERN LHC with 300 fb(-1) of luminosity, a branching ratio of order 10(-4) is sufficient for discovery for a large range of Higgs boson masses. With total luminosity of approximately 8 fb(-1), discovery at the Fermilab Tevatron requires more than 5 x 10(-3) in branching ratio.

A stress process model of family caregiver service utilization: factors associated with respite and counseling service use.

This study examines whether caregivers' differential utilization of respite and counseling support services is associated with different situational stress processes. A multinomial regression analysis was conducted to compare respite users, counseling users, and those who used neither service, using data collected on a statewide random sample of 1,643 California caregivers providing assistance to individuals aged 50 or older. Compared with caregivers who used neither service, respite service users were more likely to have demanding care situations giving rise to physical symptoms of stress, and were more likely to use community services for the care recipient to augment their care. In contrast, counseling service users were more likely to be managing the meaning of their care situation by seeking out information about services and talking with a confidant about their situation, while coping with both emotional and physical symptoms of stress. Tailoring caregiver interventions to meet the support needs and coping strategies stemming from diverse caregiving situations and caregiver characteristics may increase the likelihood that those interventions will be effective in alleviating or preventing deleterious secondary stress frequently experienced by family caregivers.

Cultural attitudes and caregiver service use: lessons from focus groups with racially and ethnically diverse family caregivers.

Focus groups were conducted with caregivers from eight racial-specific or ethnic-specific populations (African Americans, Chinese, Filipinos, Hispanics, Koreans, Native Americans, Russians, and Vietnamese), to examine cultural variations in caregiving experiences, care-related values and beliefs, care practices, and factors contributing to decisions about the use of caregiver support services. Analysis of focus group transcripts revealed three cross-cutting constructs: familism, group identity, and attitudinal and structural barriers to service use. We discuss these findings in terms of their implications for existing knowledge regarding family responsibility, resource utilization, and program development for racially and ethnically diverse family caregivers.