Detector developments for the hypernuclear programme at PANDA

The technical design of the PANDA experiment at the future FAIR facility next to GSI is progressing. At the proposed anti-proton storage ring the spectroscopy of double Lambda hypernuclei is one of the four main topics which will be addressed by the Collaboration. The hypernuclear experiments require (i) a dedicated internal target, (ii) an active secondary target of alternating silicon and absorber material layers, (iii) high purity germanium (HPGe) detectors, and (iv) a good particle identification system for low momentum kaons. All systems need to operate in the presence of a high magnetic field and a large hadronic background. The status of the detector developments for this programme is summarized.Comment: Contributed to 2008 IEEE Nuclear Science Symposium, 19-25 October 2008, Dresden, German

Observation of Lambda H-4 hyperhydrogen by decay-pion spectroscopy in electron scattering

At the Mainz Microtron MAMI, the first high-resolution pion spectroscopy from decays of strange systems was performed by electron scattering off a Be-9 target in order to study the ground-state masses of Lambda-hypernuclei. Positively charged kaons were detected by a short-orbit spectrometer with a broad momentum acceptance at zero degree forward angles with respect to the beam, efficiently tagging the production of strangeness in the target nucleus. In coincidence, negatively charged decay-pions were detected by two independent high-resolution spectrometers. About 10^3 pionic weak decays of hyperfragments and hyperons were observed. The pion momentum distribution shows a monochromatic peak at p_pi ~ 133 MeV/c, corresponding to the unique signature for the two-body decay of hyperhydrogen Lambda H-4 -> He-4 + pi-, stopped inside the target. Its binding energy was determined to be B_Lambda = 2.12 +- 0.01 (stat.) +- 0.09 (syst.) MeV with respect to the H-3 + Lambda mass

New detectors for the kaon and hypernuclear experiments with KaoS at MAMI and with PANDA at GSI

The KaoS spectrometer at the Mainz Microtron MAMI, Germany, is perceived as the ideal candidate for a dedicated spectrometer in kaon and hypernuclei electroproduction. KaoS will be equipped with new read-out electronics, a completely new focal plane detector package consisting of scintillating fibres, and a new trigger system. First prototypes of the fibre detectors and the associated new front-end electronics are shown in this contribution. The Mainz hypernuclei research program will complement the hypernuclear experiments at the planned FAIR facility at GSI, Germany. At the proposed antiproton storage ring the spectroscopy of double Lambda hypernuclei is one of the four main topics which will be addressed by the PANDA Collaboration. The experiments require the operation of high purity germanium (HPGe) detectors in high magnetic fields (B= 1T) in the presence of a large hadronic background. The performance of high resolution Ge detectors in such an environment has been investigated.Comment: Presentation at International Symposium on the Development of Detectors for Particle, Astroparticle and Synchrotron Radiation Experiments, Stanford, Ca (SNIC06), 6 pages, LaTeX, 11 eps figure

Silicon Detector Telescope for proton detection in electron scattering reactions at MAMI

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A new measurement of the structure functions PLL−PTT/epsilonP_{LL}-P_{TT}/epsilon and PLTP_{LT} in virtual Compton scattering at Q2=Q^2= 0.33 (GeV/c)2^2

The cross section of the $ep \to e' p' \gamma$ reaction has been measured at $Q^2 = 0.33$ (GeV/c)$^2$. The experiment was performed using the electron beam of the MAMI accelerator and the standard detector setup of the A1 Collaboration. The cross section is analyzed using the low-energy theorem for virtual Compton scattering, yielding a new determination of the two structure functions P_LL}-P_{TT}/epsilon and $P_{LT}$ which are linear combinations of the generalized polarizabilities of the proton. We find somewhat larger values than in the previous investigation at the same $Q^2$. This difference, however, is purely due to our more refined analysis of the data. The results tend to confirm the non-trivial $Q^2$-evolution of the generalized polarizabilities and call for more measurements in the low-$Q^2$ region ($\le$ 1 (GeV/c)$^2$).Comment: 9 pages, 10 figures. EPJA version. slight revisions in the text and figure

EVALUASI RETRIBUSI PARKIR DAN KONTRIBUSINYA TERHADAP PENDAPATAN ASLI DAERAH KABUPATEN KARANGANYAR (Periode Tahun 2001 - 2004)

A measurement of beam helicity asymmetries in the reaction 3He→(e→, e′n)pp is performed at the Mainz Microtron in quasielastic kinematics to determine the electric to magnetic form factor ratio of the neutron GEn/GMn at a four-momentum transfer Q2=1.58  GeV2. Longitudinally polarized electrons are scattered on a highly polarized 3He gas target. The scattered electrons are detected with a high-resolution magnetic spectrometer, and the ejected neutrons are detected with a dedicated neutron detector composed of scintillator bars. To reduce systematic errors, data are taken for four different target polarization orientations allowing the determination of GEn/GMn from a double ratio. We find μnGEn/GMn=0.250±0.058(stat)±0.017(syst)

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes