Consensus document on controversial issues for the treatment of infections of the central nervous system: bacterial brain abscesses

Summary Background Bacterial brain abscesses remain a serious central nervous system problem despite advances in neurosurgical, neuroimaging, and microbiological techniques and the availability of new antibiotics. The successful treatment of brain abscesses requires surgery, appropriate antibiotic therapy, and eradication of the primary source; nevertheless many controversial issues on the management of this serious infection remain unresolved. Controversial issues The aim of this GISIG (Gruppo Italiano di Studio sulle Infezioni Gravi) working group – a panel of multidisciplinary experts – was to define recommendations for some controversial issues using an evidence-based and analytical approach. The controversial issues were: (1) Which patients with bacterial brain abscesses can be managed safely using medical treatment alone? (1a) What is the efficacy in terms of outcome, tolerability, cost/efficacy, and quality of life of the different antibiotic regimens used to treat bacterial cerebral abscesses? (1b) Which antibiotics have the best pharmacokinetics and/or tissue penetration of brain and/or brain abscess? 2) What is the best surgical approach in terms of outcome in managing bacterial brain abscesses? Results are presented and discussed in detail. Methods A systematic literature search using the MEDLINE database for the period 1988 to 2008 of randomized controlled trials and/or non-randomized studies was performed. A matrix was created to extract evidence from original studies using the CONSORT method to evaluate randomized clinical trials and the Newcastle–Ottawa Quality Assessment Scale for case–control studies, longitudinal cohorts, and retrospective studies. The GRADE method for grading quality of evidence and strength of recommendation was applied

Detection of Viral RNA in Tissues following Plasma Clearance from an Ebola Virus Infected Patient

An unprecedented Ebola virus (EBOV) epidemic occurred in 2013–2016 in West Africa. Over this time the epidemic exponentially grew and moved to Europe and North America, with several imported cases and many Health Care Workers (HCW) infected. Better understanding of EBOV infection patterns in different body compartments is mandatory to develop new countermeasures, as well as to fully comprehend the pathways of human-to-human transmission. We have longitudinally explored the persistence of EBOV-specific negative sense genomic RNA (neg-RNA) and the presence of positive sense RNA (pos-RNA), including both replication intermediate (antigenomic-RNA) and messenger RNA (mRNA) molecules, in the upper and lower respiratory tract, as compared to plasma, in a HCW infected with EBOV in Sierra Leone, who was hospitalized in the high isolation facility of the National Institute for Infectious Diseases “Lazzaro Spallanzani” (INMI), Rome, Italy. We observed persistence of pos-RNA and neg-RNAs in longitudinally collected specimens of the lower respiratory tract, even after viral clearance from plasma, suggesting possible local replication. The purpose of the present study is to enhance the knowledge on the biological features of EBOV that can contribute to the human-to-human transmissibility and to develop effective intervention strategies. However, further investigation is needed in order to better understand the clinical meaning of viral replication and shedding in the respiratory tract

Intrinsic neutron background of nuclear emulsions for directional Dark Matter searches

Recent developments of the nuclear emulsion technology led to the production of films with nanometric silver halide grains suitable to track low energy nuclear recoils with submicrometric length. This improvement opens the way to a directional Dark Matter detection, thus providing an innovative and complementary approach to the on-going WIMP searches. An important background source for these searches is represented by neutron-induced nuclear recoils that can mimic the WIMP signal. In this paper we provide an estimation of the contribution to this background from the intrinsic radioactive contamination of nuclear emulsions. We also report the neutron-induced background as a function of the read-out threshold, by using a GEANT4 simulation of the nuclear emulsion, showing that it amounts to about 0.06 per year per kilogram, fully compatible with the design of a 10 kg × year exposure

Determination of the muon charge sign with the dipolar spectrometers of the OPERA experiment

The OPERA long-baseline neutrino-oscillation experiment has observed the direct appearance of $\nu_\tau$ in the CNGS $\nu_\mu$ beam. Two large muon magnetic spectrometers are used to identify muons produced in the $\tau$ leptonic decay and in $\nu_\mu^{CC}$ interactions by measuring their charge and momentum. Besides the kinematic analysis of the $\tau$ decays, background resulting from the decay of charmed particles produced in $\nu_\mu^{CC}$ interactions is reduced by efficiently identifying the muon track. A new method for the charge sign determination has been applied, via a weighted angular matching of the straight track-segments reconstructed in the different parts of the dipole magnets. Results obtained for Monte Carlo and real data are presented. Comparison with a method where no matching is used shows a significant reduction of up to 40\% of the fraction of wrongly determined charges.Comment: 10 pages. Improvements in the tex

Observation of nu_tau appearance in the CNGS beam with the OPERA experiment

The OPERA experiment is searching for nu_mu -> nu_tau oscillations in appearance mode i.e. via the direct detection of tau leptons in nu_tau charged current interactions. The evidence of nu_mu -> nu_tau appearance has been previously reported with three nu_tau candidate events using a sub-sample of data from the 2008-2012 runs. We report here a fourth nu_tau candidate event, with the tau decaying into a hadron, found after adding the 2012 run events without any muon in the final state to the data sample. Given the number of analysed events and the low background, nu_mu -> nu_tau oscillations are established with a significance of 4.2sigma.Comment: Submitted to Progress of Theoretical and Experimental Physics (PTEP

Evidence for νμ→ντ\nu_\mu \to \nu_\tau appearance in the CNGS neutrino beam with the OPERA experiment

The OPERA experiment is designed to search for $\nu_{\mu} \rightarrow \nu_{\tau}$ oscillations in appearance mode i.e. through the direct observation of the $\tau$ lepton in $\nu_{\tau}$ charged current interactions. The experiment has taken data for five years, since 2008, with the CERN Neutrino to Gran Sasso beam. Previously, two $\nu_{\tau}$ candidates with a $\tau$ decaying into hadrons were observed in a sub-sample of data of the 2008-2011 runs. Here we report the observation of a third $\nu_\tau$ candidate in the $\tau^-\to\mu^-$ decay channel coming from the analysis of a sub-sample of the 2012 run. Taking into account the estimated background, the absence of $\nu_{\mu} \rightarrow \nu_{\tau}$ oscillations is excluded at the 3.4 $\sigma$ level.Comment: 9 pages, 5 figures, 1 table

A facility to Search for Hidden Particles (SHiP) at the CERN SPS

A new general purpose fixed target facility is proposed at the CERN SPS accelerator which is aimed at exploring the domain of hidden particles and make measurements with tau neutrinos. Hidden particles are predicted by a large number of models beyond the Standard Model. The high intensity of the SPS 400~GeV beam allows probing a wide variety of models containing light long-lived exotic particles with masses below ${\cal O}$(10)~GeV/c$^2$, including very weakly interacting low-energy SUSY states. The experimental programme of the proposed facility is capable of being extended in the future, e.g. to include direct searches for Dark Matter and Lepton Flavour Violation.Comment: Technical Proposa