9 research outputs found
DARWIN: towards the ultimate dark matter detector
DARk matter WImp search with liquid xenoN (DARWIN) will be an experiment forthe direct detection of dark matter using a multi-ton liquid xenon timeprojection chamber at its core. Its primary goal will be to explore theexperimentally accessible parameter space for Weakly Interacting MassiveParticles (WIMPs) in a wide mass-range, until neutrino interactions with thetarget become an irreducible background. The prompt scintillation light and thecharge signals induced by particle interactions in the xenon will be observedby VUV sensitive, ultra-low background photosensors. Besides its excellentsensitivity to WIMPs above a mass of 5 GeV/c2, such a detector with its largemass, low-energy threshold and ultra-low background level will also besensitive to other rare interactions. It will search for solar axions, galacticaxion-like particles and the neutrinoless double-beta decay of 136-Xe, as wellas measure the low-energy solar neutrino flux with <1% precision, observecoherent neutrino-nucleus interactions, and detect galactic supernovae. Wepresent the concept of the DARWIN detector and discuss its physics reach, themain sources of backgrounds and the ongoing detector design and R&D efforts
Time to treatment with bridging intravenous alteplase before endovascular treatment:subanalysis of the randomized controlled SWIFT-DIRECT trial.
BACKGROUND
We hypothesized that treatment delays might be an effect modifier regarding risks and benefits of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT).
METHODS
We used the dataset of the SWIFT-DIRECT trial, which randomized 408 patients to IVT+MT or MT alone. Potential interactions between assignment to IVT+MT and expected time from onset-to-needle (OTN) as well as expected time from door-to-needle (DTN) were included in regression models. The primary outcome was functional independence (modified Rankin Scale (mRS) 0-2) at 3 months. Secondary outcomes included mRS shift, mortality, recanalization rates, and (symptomatic) intracranial hemorrhage at 24 hours.
RESULTS
We included 408 patients (IVT+MT 207, MT 201, median age 72 years (IQR 64-81), 209 (51.2%) female). The expected median OTN and DTN were 142 min and 54 min in the IVT+MT group and 129 min and 51 min in the MT alone group. Overall, there was no significant interaction between OTN and bridging IVT assignment regarding either the functional (adjusted OR (aOR) 0.76, 95% CI 0.45 to 1.30) and safety outcomes or the recanalization rates. Analysis of in-hospital delays showed no significant interaction between DTN and bridging IVT assignment regarding the dichotomized functional outcome (aOR 0.48, 95% CI 0.14 to 1.62), but the shift and mortality analyses suggested a greater benefit of IVT when in-hospital delays were short.
CONCLUSIONS
We found no evidence that the effect of bridging IVT on functional independence is modified by overall or in-hospital treatment delays. Considering its low power, this subgroup analysis could have missed a clinically important effect, and exploratory analysis of secondary clinical outcomes indicated a potentially favorable effect of IVT with shorter in-hospital delays. Heterogeneity of the IVT effect size before MT should be further analyzed in individual patient meta-analysis of comparable trials.
TRIAL REGISTRATION NUMBER
URL: https://www.
CLINICALTRIALS
gov ; Unique identifier: NCT03192332
Four-Stage Audit Demonstrating Increased Uptake of HIV Testing in Acute Neurology Admissions Using Staged Practical Interventions.
BACKGROUND: UK National Guidelines (UKNG) advise HIV testing in clinically indicated neurological presentations. We audited the impact of our practical strategies to increase uptake of HIV testing at a regional acute neurology admissions unit.
METHODS: We audited HIV testing in 4 periods over 2 years: before we designed a UKNG-based "HIV testing in Neurology" protocol ("pre-protocol"); after dissemination of the protocol alone ("post-protocol"); post-protocol dissemination combined with both a tailored departmental admissions clerking proforma to prompt for HIV testing & consenting, and regular focussed tutorials to doctors on HIV testing in neurological patients ("post-proforma"); and finally one year after the post-proforma period ("+1 year"). We also looked at the total number of HIV tests sent from the unit during the two-year period. We assessed significance using Fisher's exact test.
RESULTS: 47.8% of all acute neurology non-stroke admissions were eligible for HIV testing during all the audit periods. Testing rates were as follows: pre-protocol 21.9%; post-protocol 36.6%; post-proforma 83.3%; and at +1 year 65.4% (p<0.05 for both post-protocol and +1 year when compared to pre-protocol). Documentation of consent for HIV testing improved from 25% to 67.6% with the HIV-tailored clerking proforma. The total number of HIV tests requested from the unit doubled in the post-proforma period compared to pre-protocol (p<0.05).
CONCLUSION: In conclusion: the combination of an HIV testing protocol, a tailored departmental clerking proforma and regular focussed teaching to doctors on indications for HIV testing led to a sustained increase in HIV testing uptake in our regional acute neurology admissions unit
ANTIBIOTICS VERSUS G-CSFS VERSUS A COMBINATION OF BOTH TO PREVENT INFECTIOUS COMPLICATIONS AND DEATHS IN CANCER PATIENTS RECEIVING CHEMOTHERAPY: PRELIMINARY RESULTS OF A NETWORK META-ANALYSIS
Cardiac Resynchronization Therapy (CRT)-Its History, Indication, Usefulness and Problems-
Exclusion of Leptophilic Dark Matter Models using XENON100 Electronic Recoil Data
Laboratory experiments searching for galactic dark matter particles
scattering off nuclei have so far not been able to establish a discovery. We
use data from the XENON100 experiment to search for dark matter interacting
with electrons. With no evidence for a signal above the low background of our
experiment, we exclude a variety of representative dark matter models that
would induce electronic recoils. For axial-vector couplings to electrons, we
exclude cross-sections above 6x10^(-35) cm^2 for particle masses of m_chi = 2
GeV/c^2. Independent of the dark matter halo, we exclude leptophilic models as
explanation for the long-standing DAMA/LIBRA signal, such as couplings to
electrons through axial-vector interactions at a 4.4 sigma confidence level,
mirror dark matter at 3.6 sigma, and luminous dark matter at 4.6 sigma.Comment: 4 pages, 4 figures, with supporting online materia