We study scenarios where loop processes give the dominant contributions to dark matter decay or annihilation despite the presence of tree level channels. We illustrate this possibility in a specific model where dark matter is part of a hidden sector that communicates with the Standard Model sector via a heavy neutrino portal. We explain the underpinning rationale for how loop processes mediated by the portal neutrinos can parametrically dominate over tree level decay channels, and demonstrate that this qualitatively changes the indirect detection signals in positrons, neutrinos, and gamma rays.

Vector leptoquarks can address the lepton flavor universality anomalies in decays associated with the $b \to c \ell u$ and $b \to s \ell \ell$ transitions, as observed in recent years. Generically, these leptoquarks yield new sources of CP violation. In this paper, we explore constraints and discovery potential for electric dipole moments (EDMs) in leptonic and hadronic systems. We provide the most generic expressions for dipole moments induced by vector leptoquarks at one loop. We find that $O(1)$ CP-violating phases in tau and muon couplings can lead to corresponding EDMs within reach of next-generation EDM experiments, and that existing bounds on the electron EDM already put stringent constraints on CP-violating electron couplings.

We present a rare complication of spontaneous thrombus formation on the WATCHMAN delivery system, on both the right- and left-sided systemic circulation. We also describe the multidisciplinary team approach and the use of percutaneous vacuum-assisted aspiration system (AngioVac, AngioDynamics, Latham, New York) for successful thrombus removal. (Level of Difficulty: Intermediate.).

Optimal ergonomics are essential to improving clinical performance and longevity among urologists, as poor ergonomics can contribute to work-related injury and physician burnout. While a majority of urologists experience muscular injury throughout their career, women and trainees are disproportionately affected. These disparities are exacerbated by the lack of formal ergonomics education within urologic training programs. This review provides an overview of practical approaches to optimize ergonomics across working environments for urologists and trainees. We highlight intraoperative techniques and novel devices which have been shown to reduce work-related injury, and we identify knowledge gaps to guide future areas of ergonomic research.

Background

With conflicting evidence regarding the usefulness of intraaortic balloon pump (IABP), reports of IABP use in the United States have been inconsistent. Our objective was to examine trends in IABP usage in percutaneous coronary intervention (PCI) in the United States and to evaluate the association of IABP use with mortality.

Methods

This is a retrospective, observational study using patient data obtained from the Nationwide Inpatient Sample database from 1998 to 2008. Patients undergoing any PCI (1,552,602 procedures) for a primary diagnosis of symptomatic coronary artery disease and acute coronary syndrome, including non-ST-elevation myocardial infarction and ST-elevation myocardial infarction, were evaluated.

Results

The overall use of IABP significantly decreased during the study period from 0.99% in 1998 to 0.36% in 2008 (univariate and multivariate P for trend < .0001). Patients who received IABP had substantially higher rates of shock compared with those who did not receive IABP (38.09% vs 0.70%; P < .0001), which was associated with markedly higher inhospital mortality rates (20.31% vs 0.72%; P < .0001). However, IABP use significantly decreased in patients with shock (36.5%-13.4%) and acute myocardial infarction (2.23%-0.84%) (univariate and multivariate P for trend for both < .0001). A temporal reduction in all-cause PCI-associated mortality from 1.1% in 1998 to 0.86% in 2008 (univariate and multivariate P for trend < .0001) was also observed.

Conclusions

The utilization of IABP associated with PCI significantly decreased between 1998 and 2008 in the United States, even among patients with acute myocardial infarction and shock.