63 research outputs found
Search for electron antineutrino appearance in a long-baseline muon antineutrino beam
Electron antineutrino appearance is measured by the T2K experiment in an accelerator-produced antineutrino beam, using additional neutrino beam operation to constrain parameters of the Pontecorvo-Maki-Nakagawa-Sakata (PMNS) mixing matrix. T2K observes 15 candidate electron antineutrino events with a background expectation of 9.3 events. Including information from the kinematic distribution of observed events, the hypothesis of no electron antineutrino appearance is disfavored with a significance of 2.40Ï and no discrepancy between data and PMNS predictions is found. A complementary analysis that introduces an additional free parameter which allows non-PMNS values of electron neutrino and antineutrino appearance also finds no discrepancy between data and PMNS predictions
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6Â months was conducted. Follow-up lasted 30Â days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, pâ=â0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, pâ=â0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, pâ<â0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, pâ<â0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
The pathogenesis of Chagas' disease: when autoimmune and parasite-specific immune responses meet
Peripheral brain-derived neurotrophic factor (BDNF) as a biomarker in bipolar disorder: a meta-analysis of 52 studies
Search for light sterile neutrinos with the T2K far detector Super-Kamiokande at a baseline of 295 km
We perform a search for light sterile neutrinos using the data from the T2K far detector at a baseline of 295 km, with an exposure of 14.7Ă°7.6Ă Ă 1020 protons on target in neutrino (antineutrino) mode. A selection of neutral-current interaction samples is also used to enhance the sensitivity to sterile mixing.
No evidence of sterile neutrino mixing in the 3 ĂŸ 1 model was found from a simultaneous fit to the charged-current muon, electron and neutral-current neutrino samples. We set the most stringent limit on the sterile oscillation amplitude sin2 Ξ24 for the sterile neutrino mass splitting Îm241 < 3 Ă 10â3 eV2=c4
Search for neutral-current induced single photon production at the ND280 near detector in T2K
Neutrino neutral-current (NC) induced single photon production is a sub-leading order process for accelerator-based neutrino beam experiments including T2K. It is, however, an important process to understand because it is a background for electron (anti)neutrino appearance oscillation experiments. Here, we performed the first search of this process below 1 GeV using the fine-grained detector at the T2K ND280 off-axis near detector. By reconstructing single photon kinematics from electron-positron pairs, we achieved 95% pure gamma ray sample from 5.738 x 10(20) protons-on-targets neutrino mode data. We do not find positive evidence of NC induced single photon production in this sample. We set the model-dependent upper limit on the cross-section for this process, at 0.114 x 10(-38) cm(2) (90% C.L.) per nucleon, using the J-PARC off-axis neutrino beam with an average energy of similar to 0.6 GeV. This is the first limit on this process below 1 GeV which is important for current and future oscillation experiments looking for electron neutrino appearance oscillation signals
Constraint on the matter-antimatter symmetry-violating phase in neutrino oscillations
The charge-conjugation and parity-reversal (CP) symmetry of fundamental particles is a symmetry between matter and antimatter. Violation of this CP symmetry was first observed in 19641, and CP violation in the weak interactions of quarks was soon established2. Sakharov proposed3 that CP violation is necessary to explain the observed imbalance of matter and antimatter abundance in the Universe. However, CP violation in quarks is too small to support this explanation. So far, CP violation has not been observed in non-quark elementary particle systems. It has been shown that CP violation in leptons could generate the matterâantimatter disparity through a process called leptogenesis4. Leptonic mixing, which appears in the standard modelâs charged current interactions5,6, provides a potential source of CP violation through a complex phase ÎŽCP, which is required by some theoretical models of leptogenesis7,8,9. This CP violation can be measured in muon neutrino to electron neutrino oscillations and the corresponding antineutrino oscillations, which are experimentally accessible using accelerator-produced beams as established by the Tokai-to-Kamioka (T2K) and NOvA experiments10,11. Until now, the value of ÎŽCP has not been substantially constrained by neutrino oscillation experiments. Here we report a measurement using long-baseline neutrino and antineutrino oscillations observed by the T2K experiment that shows a large increase in the neutrino oscillation probability, excluding values of ÎŽCP that result in a large increase in the observed antineutrino oscillation probability at three standard deviations (3Ï). The 3Ï confidence interval for ÎŽCP, which is cyclic and repeats every 2Ï, is [â3.41, â0.03] for the so-called normal mass ordering and [â2.54, â0.32] for the inverted mass ordering. Our results indicate CP violation in leptons and our method enables sensitive searches for matterâantimatter asymmetry in neutrino oscillations using accelerator-produced neutrino beams. Future measurements with larger datasets will test whether leptonic CP violation is larger than the CP violation in quarks
Search for heavy neutrinos with the T2K near detector ND280
International audienceThis paper reports on the search for heavy neutrinos with masses in the range 140<MN<493ââMeV/c2 using the off-axis near detector ND280 of the T2K experiment. These particles can be produced from kaon decays in the standard neutrino beam and then subsequently decay in ND280. The decay modes under consideration are Nââα±Ïâ and Nââα+âÎČ-Îœ(â)(α,ÎČ=e,ÎŒ). A search for such events has been made using the Time Projection Chambers of ND280, where the background has been reduced to less than two events in the current dataset in all channels. No excess has been observed in the signal region. A combined Bayesian statistical approach has been applied to extract upper limits on the mixing elements of heavy neutrinos to electron-, muon- and tau- flavored currents (Ue2, UÎŒ2, UÏ2) as a function of the heavy neutrino mass, e.g., Ue2<10-9 at 90% C.L. for a mass of 390ââMeV/c2. These constraints are competitive with previous experiments
The DUNE Far Detector Interim Design Report, Volume 3: Dual-Phase Module
The DUNE IDR describes the proposed physics program and technical designs of the DUNE far detector modules in preparation for the full TDR to be published in 2019. It is intended as an intermediate milestone on the path to a full TDR, justifying the technical choices that flow down from the high-level physics goals through requirements at all levels of the Project. These design choices will enable the DUNE experiment to make the ground-breaking discoveries that will help to answer fundamental physics questions. Volume 3 describes the dual-phase module's subsystems, the technical coordination required for its design, construction, installation, and integration, and its organizational structure
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