International consensus on risk management of diabetic ketoacidosis in patients with type 1 diabetes treated with sodium-glucose cotransporter (SGLT) inhibitors

Sodium-glucose cotransporter (SGLT) inhibitors are new oral antidiabetes medications shown to effectively reduce glycated hemoglobin (A1C) and glycemic variability, blood pressure, and body weight without intrinsic properties to cause hypoglycemia in people with type 1 diabetes. However, recent studies, particularly in individuals with type 1 diabetes, have demonstrated increases in the absolute risk of diabetic ketoacidosis (DKA). Some cases presented with near-normal blood glucose levels or mild hyperglycemia, complicating the recognition/diagnosis of DKAand potentially delaying treatment. Several SGLT inhibitors are currently under review by the U.S. Food and Drug Administration and European regulatory agencies as adjuncts to insulin therapy in people with type 1 diabetes. Strategies must be developed and disseminated to the medical community to mitigate the associated DKA risk. This Consensus Report reviews current data regarding SGLT inhibitor use and provides recommendations to enhance the safety of SGLT inhibitors in people with type 1 diabetes

Signatures of muonic activation in the Majorana Demonstrator

Experiments searching for very rare processes such as neutrinoless double-beta decay require a detailed understanding of all sources of background. Signals from radioactive impurities present in construction and detector materials can be suppressed using a number of well-understood techniques. Background from in situ cosmogenic interactions can be reduced by siting an experiment deep underground. However, the next generation of such experiments have unprecedented sensitivity goals of 1028 years half-life with background rates of 10-5cts/(keV kg yr) in the region of interest. To achieve these goals, the remaining cosmogenic background must be well understood. In the work presented here, Majorana Demonstrator data are used to search for decay signatures of metastable germanium isotopes. Contributions to the region of interest in energy and time are estimated using simulations and compared to Demonstrator data. Correlated time-delayed signals are used to identify decay signatures of isotopes produced in the germanium detectors. A good agreement between expected and measured rate is found and different simulation frameworks are used to estimate the uncertainties of the predictions. The simulation campaign is then extended to characterize the background for the LEGEND experiment, a proposed tonne-scale effort searching for neutrinoless double-beta decay in Ge76

Experimental study of C 13 (α,n) O 16 reactions in the Majorana Demonstrator calibration data

Neutron captures and delayed decays of reaction products are common sources of backgrounds in ultrarare event searches. In this work, we studied C13(α,n)O16 reactions induced by α particles emitted within the calibration sources of the Majorana Demonstrator. These sources are thorium-based calibration standards enclosed in carbon-rich materials. The reaction rate was estimated by using the 6129-keV γ rays emitted from the excited O16 states that are populated when the incoming α particles exceed the reaction Q value. Thanks to the excellent energy performance of the Demonstrator's germanium detectors, these characteristic photons can be clearly observed in the calibration data. Facilitated by Geant4 simulations, a comparison between the observed 6129-keV photon rates and predictions by a talys-based software was performed. The measurements and predictions were found to be consistent, albeit with large statistical uncertainties. This agreement provides support for background projections from (α,n) reactions in future double-beta decay search efforts

The Majorana Demonstrator readout electronics system

The Majorana Demonstrator comprises two arrays of high-purity germanium detectors constructed to search for neutrinoless double-beta decay in 76Ge and other physics beyond the Standard Model. Its readout electronics were designed to have low electronic noise, and radioactive backgrounds were minimized by using low-mass components and low-radioactivity materials near the detectors. This paper provides a description of all components of the Majorana Demonstrator readout electronics, spanning the front-end electronics and internal cabling, back-end electronics, digitizer, and power supplies, along with the grounding scheme. The spectroscopic performance achieved with these readout electronics is also demonstrated

Search for Neutrinoless Double- β Decay in Ge 76 with the Majorana Demonstrator

The Majorana Collaboration is operating an array of high purity Ge detectors to search for neutrinoless double-β decay in Ge76. The Majorana Demonstrator comprises 44.1 kg of Ge detectors (29.7 kg enriched in Ge76) split between two modules contained in a low background shield at the Sanford Underground Research Facility in Lead, South Dakota. Here we present results from data taken during construction, commissioning, and the start of full operations. We achieve unprecedented energy resolution of 2.5 keV FWHM at Qββ and a very low background with no observed candidate events in 9.95 kg yr of enriched Ge exposure, resulting in a lower limit on the half-life of 1.9×1025 yr (90% C.L.). This result constrains the effective Majorana neutrino mass to below 240-520 meV, depending on the matrix elements used. In our experimental configuration with the lowest background, the background is 4.0-2.5+3.1 counts/(FWHM t yr)

Bayesian analysis of a future β\beta decay experiment's sensitivity to neutrino mass scale and ordering

International audienceBayesian modeling techniques enable sensitivity analyses that incorporate detailed expectations regarding future experiments. A model-based approach also allows one to evaluate inferences and predicted outcomes, by calibrating (or measuring) the consequences incurred when certain results are reported. We present procedures for calibrating predictions of an experiment's sensitivity to both continuous and discrete parameters. Using these procedures and a new Bayesian model of the β-decay spectrum, we assess a high-precision β-decay experiment's sensitivity to the neutrino mass scale and ordering for one assumed design scenario. We find that such an experiment could measure the electron-weighted neutrino mass within ∼40 meV after 1 year (90% credibility). Neutrino masses >500 meV could be measured within ≈5 meV. Using only β decay and external reactor neutrino data, we find that next-generation β-decay experiments could potentially constrain the mass ordering using a two-neutrino spectral model analysis. By calibrating mass ordering results, we identify reporting criteria that can be tuned to suppress false ordering claims. In some cases, a two-neutrino analysis can reveal that the mass ordering is inverted, an unobtainable result for the traditional one-neutrino analysis approach

Viterbi decoding of CRES signals in Project 8

International audienceCyclotron radiation emission spectroscopy (CRES) is a modern approach for determining charged particle energies via high-precision frequency measurements of the emitted cyclotron radiation. For CRES experiments with gas within the fiducial volume, signal and noise dynamics can be modelled by a hidden Markov model. We introduce a novel application of the Viterbi algorithm in order to derive informational limits on the optimal detection of cyclotron radiation signals in this class of gas-filled CRES experiments, thereby providing concrete limits from which future reconstruction algorithms, as well as detector designs, can be constrained. The validity of the resultant decision rules is confirmed using both Monte Carlo and Project 8 data