Search for: All records

Abstract Effective communication is critical for equitable healthcare delivery. In situations where there is language discordance between patients and providers, with one person speaking a shared language more proficiently, communication challenges may exacerbate disparities, particularly for racially or ethnically minoritized patients. Even when patients and providers are both fluent enough in English to not need interpretation, communication challenges intensify when patients are required to use their second language (L2) to interact with a native English (L1) speaking healthcare provider. Communication accommodation encompasses speech adjustments used to mitigate these barriers. Because communication accommodation strategies are not explicitly taught in healthcare training, it is unknown how healthcare providers adjust and the role a patient’s English proficiency plays in guiding provider language choices. This experimental study tested how L1 physician assistant students modify their communication during intake interviews with Latine L2 avatar patients of varying English proficiency, using the mixed-reality simulation platform Mursion. Data from 41 physician assistant students in 2023–2024 were analyzed for acoustic (i.e., speech rate, pitch modulation) and lexical adjustments (i.e., word frequency, contextual diversity). Results revealed significant accommodations: students reduced their speech rate, narrowed their pitch range, and used higher-frequency vocabulary when interacting with lower-proficiency L2 avatars. The results demonstrate that communication accommodation occurs and could be a potential mechanism for the widening or narrowing of healthcare disparities in patient outcomes. Future work should consider identifying which accommodations improve patients’ comprehension of medical advice and their relationships with healthcare providers. 

Abstract Salient aspects of the commissioning, calibration, and performance of the CMS silicon strip tracker are discussed, drawing on experience during operation with proton-proton collisions delivered by the CERN LHC. The data were obtained with a variety of luminosities. The operating temperature of the strip tracker was changed several times during this period and results are shown as a function of temperature in several cases. Details of the system performance are presented, including occupancy, signal-to-noise ratio, Lorentz angle, and single-hit spatial resolution. Saturation effects in the APV25 readout chip preamplifier observed during early Run 2 are presented, showing the effect on various observables and the subsequent remedy. Studies of radiation effects on the strip tracker are presented both for the optical readout links and the silicon sensors. The observed effects are compared to simulation, where available, and they generally agree well with expectations. 

Abstract The Short Strip ASIC (SSA) is one of the four front-end chips designed for the upgrade of the CMS Outer Tracker for the High Luminosity LHC. Together with the Macro-Pixel ASIC (MPA) it will instrument modules containing a strip and a macro-pixel sensor stacked on top of each other. The SSA provides both full readout of the strip hit information when triggered, and, together with the MPA, correlated clusters called stubs from the two sensors for use by the CMS Level-1 (L1) trigger system. Results from the first prototype module consisting of a sensor and two SSA chips are presented. The prototype module has been characterized at the Fermilab Test Beam Facility using a 120 GeV proton beam. 

Abstract The CMS Inner Tracker, made of silicon pixel modules, will be entirely replaced prior to the start of the High Luminosity LHC period. One of the crucial components of the new Inner Tracker system is the readout chip, being developed by the RD53 Collaboration, and in particular its analogue front-end, which receives the signal from the sensor and digitizes it. Three different analogue front-ends (Synchronous, Linear, and Differential) were designed and implemented in the RD53A demonstrator chip. A dedicated evaluation program was carried out to select the most suitable design to build a radiation tolerant pixel detector able to sustain high particle rates with high efficiency and a small fraction of spurious pixel hits. The test results showed that all three analogue front-ends presented strong points, but also limitations. The Differential front-end demonstrated very low noise, but the threshold tuning became problematic after irradiation. Moreover, a saturation in the preamplifier feedback loop affected the return of the signal to baseline and thus increased the dead time. The Synchronous front-end showed very good timing performance, but also higher noise. For the Linear front-end all of the parameters were within specification, although this design had the largest time walk. This limitation was addressed and mitigated in an improved design. The analysis of the advantages and disadvantages of the three front-ends in the context of the CMS Inner Tracker operation requirements led to the selection of the improved design Linear front-end for integration in the final CMS readout chip. 

Abstract During the operation of the CMS experiment at the High-Luminosity LHC the silicon sensors of the Phase-2 Outer Tracker will be exposed to radiation levels that could potentially deteriorate their performance. Previous studies had determined that planar float zone silicon with n-doped strips on a p-doped substrate was preferred over p-doped strips on an n-doped substrate. The last step in evaluating the optimal design for the mass production of about 200 m 2 of silicon sensors was to compare sensors of baseline thickness (about 300 μm) to thinned sensors (about 240 μm), which promised several benefits at high radiation levels because of the higher electric fields at the same bias voltage. This study provides a direct comparison of these two thicknesses in terms of sensor characteristics as well as charge collection and hit efficiency for fluences up to 1.5 × 10 15 n eq /cm 2 . The measurement results demonstrate that sensors with about 300 μm thickness will ensure excellent tracking performance even at the highest considered fluence levels expected for the Phase-2 Outer Tracker. 

Two additions impacting tables 3 and 4 in ref. [1] are presented in the following. No significant impact is found for other results or figures in ref. [1].