First Probe of Sub-GeV Dark Matter beyond the Cosmological Expectation with the COHERENT CsI Detector at the SNS.

The COHERENT Collaboration searched for scalar dark matter particles produced at the Spallation Neutron Source with masses between 1 and 220 MeV/c^{2} using a CsI[Na] scintillation detector sensitive to nuclear recoils above 9 keV_{nr}. No evidence for dark matter is found and we thus place limits on allowed parameter space. With this low-threshold detector, we are sensitive to coherent elastic scattering between dark matter and nuclei. The cross section for this process is orders of magnitude higher than for other processes historically used for accelerator-based direct-detection searches so that our small, 14.6 kg detector significantly improves on past constraints. At peak sensitivity, we reject the flux consistent with the cosmologically observed dark-matter concentration for all coupling constants α_{D}<0.64, assuming a scalar dark-matter particle. We also calculate the sensitivity of future COHERENT detectors to dark-matter signals which will ambitiously test multiple dark-matter spin scenarios.

Measurement of the Coherent Elastic Neutrino-Nucleus Scattering Cross Section on CsI by COHERENT.

We measured the cross section of coherent elastic neutrino-nucleus scattering (CEvNS) using a CsI[Na] scintillating crystal in a high flux of neutrinos produced at the Spallation Neutron Source at Oak Ridge National Laboratory. New data collected before detector decommissioning have more than doubled the dataset since the first observation of CEvNS, achieved with this detector. Systematic uncertainties have also been reduced with an updated quenching model, allowing for improved precision. With these analysis improvements, the COHERENT Collaboration determined the cross section to be (165_{-25}^{+30})×10^{-40} cm^{2}, consistent with the standard model, giving the most precise measurement of CEvNS yet. The timing structure of the neutrino beam has been exploited to compare the CEvNS cross section from scattering of different neutrino flavors. This result places leading constraints on neutrino nonstandard interactions while testing lepton flavor universality and measures the weak mixing angle as sin^{2}θ_{W}=0.220_{-0.026}^{+0.028} at Q^{2}≈(50 MeV)^{2}.

[Validation of Personal Factors in Breast Cancer Rehabilitation - A National Delphi Survey]. / Validierung von Personbezogenen Faktoren im Bereich der onkologischen Brustkrebsrehabilitation ­ eine Delphi-Befragung auf nationaler Ebene.

Objective: In the International Classification of Functioning, Disability and Health (ICF), data on environmental and personal factors, the so-called facilitators or barriers, can be gathered. The World Health Organization (WHO) has not classified personal factors. This is justified with the cultural differences among countries. The German society for social medicine and prevention (DGSMP) has performed pioneering work and has provided a classification draft. The aim of this study is to validate this draft in the context of oncological rehabilitation of breast cancer patients in Germany. Design: 21 experts from 8 rehabilitation centers and 2 breast cancer support groups in Germany were interviewed about personal factors in a 2-round survey using the Delphi technique. The expert group included doctors, nurses, therapists, psychologists with experience in rehabilitation of breast cancer patients and breast cancer patients. The responses of the first round were linked to the DGSMP draft. The degree of fit was calculated by means of the kappa statistic. In the second round, the focus was on the agreement of the personal factors determined in the first round. Results: The experts identified 244 factors out of which 203 (83.2%) were linked to the DGSMP draft. There are 77 categories in the DGSMP draft; 43 of them were included by the experts in the first round and 34 were not mentioned (kappa coefficient 0.776; 95% bootstrapped confidence interval 0.712-0.817). In the second round, 34 of the 43 named DGSMP categories achieved an agreement of at least 75% among the experts. Conclusions: The draft of the DGSMP working group is a comprehensive collection of facilitators and barriers in breast cancer rehabilitation and should be integrated reasonably in rehabilitation. More research on personal facilitators and barriers has to be carried out to show their concrete influence on functioning ability of breast cancer patients.

Heavy-flavour and quarkonium production in the LHC era: from proton-proton to heavy-ion collisions.

This report reviews the study of open heavy-flavour and quarkonium production in high-energy hadronic collisions, as tools to investigate fundamental aspects of Quantum Chromodynamics, from the proton and nucleus structure at high energy to deconfinement and the properties of the Quark-Gluon Plasma. Emphasis is given to the lessons learnt from LHC Run 1 results, which are reviewed in a global picture with the results from SPS and RHIC at lower energies, as well as to the questions to be addressed in the future. The report covers heavy flavour and quarkonium production in proton-proton, proton-nucleus and nucleus-nucleus collisions. This includes discussion of the effects of hot and cold strongly interacting matter, quarkonium photoproduction in nucleus-nucleus collisions and perspectives on the study of heavy flavour and quarkonium with upgrades of existing experiments and new experiments. The report results from the activity of the SaporeGravis network of the I3 Hadron Physics programme of the European Union 7[Formula: see text] Framework Programme.

On the ferromagnetic structure of the intermetallic borocarbide TbCo(2)B(2)C.

Based on magnetization, specific heat, magnetostriction and neutron-diffraction studies on single-crystal TbCo(2)B(2)C, it is found out that the paramagnetic properties, down to liquid nitrogen temperatures, are well described by a Curie-Weiss behavior of the Tb(3+) moments. Furthermore, below T(c) = 6.3 K, the Tb sublattice undergoes a ferromagnetic (FM) phase transition with the easy axis being along the (100) direction and, concomitantly, the unit cell undergoes a tetragonal-to-orthorhombic distortion. The manifestation of an FM state in TbCo(2)B(2)C is unique among all other isomorphous borocarbides, in particular TbNi(2)B(2)C (T(N) = 15 K, incommensurate modulated magnetic state) even though the Tb ions in both isomorphs have almost the same crystalline electric field properties. The difference among the magnetic modes of these Tb-based isomorphs is attributed to a difference in their exchange couplings which are in turn caused by a variation in their lattice parameters and in the position of their Fermi levels.

Nonperturbative heavy-quark diffusion in the quark-gluon plasma.

We evaluate heavy-quark (HQ) transport properties in a quark-gluon plasma (QGP) within a Brueckner many-body scheme employing interaction potentials extracted from thermal lattice QCD. The in-medium T matrices for elastic charm- and bottom-quark scattering off light quarks in the QGP are dominated by attractive meson and diquark channels which support resonance states up to temperatures of ~1.5T(c). The resulting drag coefficient increases with decreasing temperature, contrary to expectations based on perturbative QCD scattering. Employing relativistic Langevin simulations we compute HQ spectra and elliptic flow in sqrt[s(NN)]=200 GeV Au-Au collisions. A good agreement with electron decay data supports our nonperturbative computation of HQ diffusion, indicative for a strongly coupled QGP.

Low-temperature magnetic and transport properties of single-crystal CeCoGe.

The low-temperature properties of single-crystal CeCoGe were investigated by specific heat C(T,H), magnetoresistivity ρ(T,H), and differential susceptibility measurements χ(T,H). The zero-field low-temperature specific heat evolves as C = γT+ßT(3) = 42T+23.5T(3) mJ mol(-1) K(-1). On comparing its γ = 42 mJ mol(-1) K(-1) with that of LaCoGe (12 mJ mol(-1) K(-2)) it is inferred that both 3d (Co) and 4f (Ce) orbitals contribute to the density of states at the Fermi level. Assuming that its phonic contribution to the specific heat is similar to LaCoGe (ß = 0.5 mJ mol(-1) K(-4)), then the extra cubic term in the specific heat (23T(3) mJ mol(-1) K(-1)) must be due to magnon excitation within the antiferromagnetically ordered state, T

Case management for persons with substance use disorders.

BACKGROUND: Patients with alcohol and other drug use disorders (AOD) frequently have multiple social, physical, and mental health treatment needs, yet have difficulty accessing community services, including drug abuse treatment. One strategy for linking patients with AOD with relevant services is case management, where a single case manager is responsible for linking patients with multiple relevant services. OBJECTIVES: To conduct a systematic review of all RCTs on the use of case management for helping drug abusers in or out of treatment. Outcome criteria included successful linkage with other services, illicit drug use outcomes, and a range of related outcomes. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register (Cochrane Library, issue 4, 2006), MEDLINE (1966 - 2006), EMBASE (1980 - 2006), LILACS (1982 - 2006), PsycINFO (1973 - 2006), Biological Abstracts (1982 t- 2000). Reference searching; personal communication; conference abstracts; book chapters on case management. SELECTION CRITERIA: Randomized controlled studies that compared a specific model of case management with either treatment as usual or another treatment model, included only patients with at least one alcohol or drug related problem. DATA COLLECTION AND ANALYSIS: Two groups of reviewers extracted the data independently . Standardized mean difference was estimated. MAIN RESULTS: In total, we could extract results from 15 studies. Outcome on illicit drug use was reported from 7 studies with 2391 patients. The effect size for illicit drug use was not significant, and small (standardized mean difference (SMD)=0.12, confidence interval=-0.09,0.29, p=0.20). Substantial heterogeneity was found (I(2)=69.9%). Linkage to other treatment services was reported in 10 studies with 3132 patients. The effect size for linkage was moderate (SMD=0.42, 95% confidence interval=0.21 to 0.62, p<0.001), but substantial heterogeneity was found (I(2)=85.2%). Moderator analyses suggested that a part of the heterogeneity found in linkage studies could be explained by the presence or absence of a treatment manual for case management. A single, large trial of case management with two arms, showed that case management was superior to psychoeducation and drug counselling in reducing drug use. AUTHORS' CONCLUSIONS: There is current evidence supporting that case management can enhance linkage with other services. However, evidence that case management reduces drug use or produce other beneficial outcome is not conclusive.

[Radio and microwave frequency radiation and health--an analysis of the literature]. / Hochfrequente Strahlung und Gesundheit--eine Literaturanalyse.

This paper gives an overview of present scientific knowledge in health research on the effects from radio and microwave frequency radiation, at levels to which the general population is typically exposed. The review is based on human experimental and epidemiological studies investigating the effects of radiation in the frequency range between 100 kHz and 10 GHz. The relevant studies were identified via systematic searches of the databases Medline and ISI Web of Science. The review concludes that the existing scientific knowledge base is too limited to draw final conclusions on the health risk from exposure in the low-dose range. Only few studies have investigated the effect of long-term exposure on the general population in the normal environment. Accordingly, little can be predicted regarding long-term health risks. Various studies observed an increased risk for tumours in the hematopoietic and lymphatic tissue of people living in the proximity of TV and radio broadcast transmitters. However, methodological limitations to these studies have been identified and their findings are controversial. In studies of a possible association between brain tumours and mobile phone use, the average period mobile phones use was short compared to the known latency period of brain tumours. Although these studies did not establish an overall increased risk of brain tumours associated with mobile phone use, there were some indications of an association. Immediate effects associated with mobile phone use have been observed in human experimental studies that cannot be explained by conventional thermal mechanisms. The observed effects are within the normal physiological range and are therefore hard to interpret with respect to an increased risk to health. However, it can be concluded that mechanisms other than the established thermal mechanisms exist. Because of the present fragmentary scientific database, a precautionary approach when dealing with radio and microwave frequency radiation is recommended for the individual and the general population.

Measuring readiness for change among crack cocaine users: a descriptive analysis.

This study examines the utility of the University of Rhode Island Change Assessment Scale (URICA) in assessing stages of change status with a group of 235 crack/cocaine users who had received treatment for their drug use. Cluster analyses were performed and three subgroups representing differing levels of readiness to change were identified. The three clusters demonstrated no significant differences on most demographic characteristics and other areas of functioning assessed by the Addiction Severity Index (ASI). The three clusters also showed similar improvements between the intake and six-month follow-up in these ASI life domains. The implications of these findings are discussed.

Strengths-based case management: individuals' perspectives on strengths and the case manager relationship.

Strengths-based practice in social work has a strong theoretical foundation as an effective helping strategy that builds on a person's successes. Although there is growing empirical evidence informing outcomes associated with strengths-based approaches, missing from the literature is an understanding of how individuals who receive these services view their experiences. Qualitative data collection methods were used to gather individuals' experiences of participating in strengths-based case management implemented in a substance abuse aftercare program. The research questions that guided the study were "What are individuals' perceptions of strengths-based case management?" and "How do those perceptions compare and contrast to the key principles of strengths-based case management?" The emerging themes centered on individuals' responses to a focus on strengths (acceptance of strengths; holding on to strengths and deficits simultaneously; and initial mistrust of the approach) and to the relationship with the case manager (acceptance of the relationship; guilt when success is not achieved; and not needing the relationship). Implications for social work practice are discussed.

Levofloxacin failure in a patient with pneumococcal pneumonia.

OBJECTIVE: To report a case of levofloxacin failure in a patient with a penicillin-sensitive Streptococcus pneumoniae pneumonia. CASE SUMMARY: A previously healthy, immunocompetent, 53-year-old white man presented with penicillin-sensitive S. pneumoniae pneumonia. The patient was empirically placed on levofloxacin monotherapy, which was continued due to a local penicillin shortage. When the patient failed to improve, further susceptibility testing was ordered. The organism was found to have a penicillin minimum inhibitory concentration (MIC) of 0.023 microgram/mL and a levofloxacin MIC of 6 micrograms/mL. Effective antimicrobial therapy was delayed, as clinicians did not anticipate fluoroquinolone resistance. DISCUSSION: Newer fluoroquinolones such as levofloxacin have good activity against most S. pneumoniae isolates and are used for the treatment of pneumonia. Although resistance to these agents is rare, it has been reported. Current guidelines from the National Committee for Clinical Laboratory Standards do not recommend initial fluoroquinolone susceptibility testing. CONCLUSIONS: As fluoroquinolone resistance may not be identified by susceptibility patterns to other antibiotics, early fluoroquinolone susceptibility testing and increased awareness of resistance may aid clinicians in their treatment of pneumococcal disease.

Resolving the antibaryon-production puzzle in high-energy heavy-ion collisions.

We argue that the observed antiproton production in heavy-ion collisions at CERN-SPS energies can be understood if (contrary to most sequential scattering approaches) the backward direction in the process pP<-->n(pi) (with n = 5-6) is consistently accounted for within a thermal framework. Employing the standard picture of subsequent chemical and thermal freezeout, which induces an oversaturation of pion number with associated chemical potentials of mu(pi) approximately 60-80 MeV, enhances the backward reaction substantially. The resulting rates turn out to be large enough to maintain an antiproton abundance at thermal freezeout in accordance with the measured p/p ratio in Pb(158A GeV)+Pb collisions.

Short-term variation in air pollution and in average lung function among never-smokers. The Swiss Study on Air Pollution and Lung Diseases in Adults (SAPALDIA).

The present analysis was directed at investigating associations between short-term variations in air pollutant levels (NO2, total suspended particulates [TSP], O3) and cross-sectional lung function (FVC, FEV1, and forced expiratory flow at 25% to 75% of FVC [FEF25-75]) within a random sample of 3,912 adult never-smokers from eight areas of Switzerland (i.e., participants in the Swiss Study on Air Pollution and Lung Diseases in Adults [SAPALDIA] cross-sectional study, 1991). Within each local data set, the logarithms of FVC, FEV1, and FEF25-75 were regressed against the 24-h-means of NO2 and TSP and the 8-h mean of O3 (10:00 A.M. to 6:00 P.M.) on the examination day, with control for subjects' sex, age, height and weight, seasonal fluctuations and weekly cycles and meteorologic factors. On average, a 10-microg/m3 increment in the daily level of NO2, TSP, and O3 was associated with decrements in FEV1 of 0.67% (95% confidence interval [CI]: 0.13% to 1.21%), 0.46% (95% CI: 0.14% to 0.78%), and 0.51% (95% CI: 0.13% to 0.88%), respectively. Moreover, 10-microg/m3 increments in NO2 and TSP were associated with decrements in FVC of 0.73% (95% CI: 0.22% to 1.23%) and 0.36% (95% CI: 0.06% to 0.66%), respectively, and a 10-microg/m3 increment in O(3) was associated with a decrement in FEF25-75 of 1.04% (95% CI: 0.22% to 1.85%). Our results suggest that FVC, FEV1, and FEF25-75 vary with the daily level of NO2, TSP, and O3, but that these measures of lung function do not allow separation of the effects of particulates from those of NO2.

Gender, body, biomedicine: how some feminist concerns dragged reproduction to the center of social theory.

This article tracks the growth of medical anthropology in the United States in the decades since the 1970s, as it has intersected the expansion of feminist activism and scholarship. I argue that feminist attention to embodied inequalities quickly focused on reproduction as a site of investigation and intervention. Medical anthropology has benefited from feminist concern with stratified reproduction, especially its interrogation of nonnormative and stigmatized fertility and childbearing. When reproduction becomes problematic, it provides a lens through which cultural norms, struggles, and transformations can be viewed. Examples drawn from prenatal diagnosis are particularly revelatory of the diverse interests and stakes we all hold in reproduction.

Development of a best-practice model at a university hospital to increase efficiency in the management of patients with community-acquired pneumonia.

An economic evaluation of drug acquisition, nursing care, pharmacy time, laboratory costs, supplies, and ancillary care was conducted as a first step toward developing a pneumonia management plan at the University of Kentucky Medical Center (UKMC). UKMC costs were compared with costs at other hospitals treating pneumonia patients on Medicare. Overall costs for pneumonia at the 25% of hospitals nationwide with the lowest costs for Medicare patients with this condition were determined and compared with costs at UKMC. Against nationwide benchmarks, efficiencies at UKMC for treating simple pneumonia ranged from 45% for pharmacy expenses to 81% for nursing costs. Efficiencies for complicated pneumonia ranged from 47% for laboratory costs to 67% for nursing costs. The most cost-efficient antimicrobial treatment options were promoted and integrated into a pneumonia management plan based on Infectious Diseases Society of America treatment guidelines. A comparison of pneumonia treatment costs at UKMC with those at the 25% of hospitals nationwide with the lowest treatment costs for Medicare patients with pneumonia revealed that UKMC pharmacy costs could be optimized. Strategies for standardizing the care of patients with community-acquired pneumonia (CAP) are being implemented.

Emerging bacterial pathogens: a consensus of the scientific data and the risk for development of multiple organ dysfunction syndrome.

Antibiotic resistance in the hospital setting is continuing to increase, particularly in intensive care units (ICUs) and other areas of the hospital such as oncology units, where the use of empiric broad-spectrum antibiotics is common. The problem of antibiotic resistance is also compounded in the immunocompromised patient. Multi-drug resistance is common among both Gram-positive and -negative bacteria, and becoming more prevalent among fungi (yeast). Two major antibiotic-resistant pathogens include extended-spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL-KP) and vancomycin-resistant enterococci (VRE). When infections occur with ESBL-KP, a carbapenem antibiotic is usually the drug of choice. When infection occurs with VRE, specific therapy is bacteriostatic, and the clinician may have to rely on empirically selected antibiotics or combinations of antibiotics to achieve a positive outcome. Two newly-approved agents, linezolid and quinupristin/dalfopristin can be used to treat infections caused by resistant gram-positive cocci, but the latter is approved for use against VR-E. faecium. Risk factors for the development of ESBL-KP include the use of extended-spectrum cephalosporins such as ceftazidime. Risk factors for the development of VRE include inappropriate use of vancomycin, extended-spectrum cephalosporins, and antianaerobic drug therapy such as clindamycin. Several institutions have documented a reduction in one or both of these resistant pathogens following a decrease in the use of extended-spectrum cephalosporins combined with the increased use of extended-spectrum penicillins/beta-lactamase inhibitor combinations, such as piperacillin/tazobactam, for the empiric therapy of infections. For VRE, a reduction in the inappropriate use of vancomycin is also an important interventional strategy along with improved infection control practice.