4 research outputs found

    The unprecedented flaring activities around Mrk 421 in 2012 and 2013: The test for neutrino and UHECR event connection

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    Since its mission, Fermi Collaboration reported the highest flux observed during July - September 2012 for the BL Lac Markarian 421 (Mrk 421). The integrated flux was eight times greater than the average flux reported in the second Fermi catalog. During April 2013, Mrk 421 exhibited the highest TeV γ\gamma-ray and optical fluxes recorded. The Telescope Array (TA) collaboration reported the arrival of 72 ultra-high-energy cosmic rays (UHECRs), two in temporal and positional coincidence with the flaring activity observed in 2012 and one with the flaring activity in 2013. The IceCube collaboration has reported around 100 neutrino events in the High-Energy Starting Events (HESE) catalog. Although no neutrino track-like event has been associated with this source, a neutrino shower-like event (IC31) is in temporal and positional coincidence with the flare in 2012. Describing the broadband spectral energy distribution during the flaring activities exhibited in 2012 and 2013 with one- and two-zone lepto-hadronic scenarios and one-zone SSC model, we study a possible correlation between the neutrino event IC31 and the three UHECRs. We estimate the number of neutrino and UHECR events generated from the proposed models, and show that while the neutrino events are low to associate the event IC31 with Mrk 421, the number of UHECRs are similar to those reported by TA collaboration.Comment: 20 pages, 5 figures, 7 Table

    Global economic burden of unmet surgical need for appendicitis

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    Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and92 492 million using approach 1 and 73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and95 004 million using approach 1 and 75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

    Global economic burden of unmet surgical need for appendicitis

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    Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and92 492 million using approach 1 and 73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and95 004 million using approach 1 and 75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially
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