Measurement of the cosmic ray antiproton/proton flux ratio at TeV energies with the ARGO-YBJ detector

Cosmic ray antiprotons provide an important probe to study the cosmic ray propagation in the interstellar space and to investigate the existence of dark matter. Acting the Earth-Moon system as a magnetic spectrometer, paths of primary antiprotons are deflected in the opposite sense with respect to those of the protons in their way to the Earth. This effect allows, in principle, the search for antiparticles in the direction opposite to the observed deficit of cosmic rays due to the Moon (the so-called `Moon shadow'). The ARGO-YBJ experiment, located at the Yangbajing Cosmic Ray Laboratory (Tibet, P.R. China, 4300 m a.s.l., 606 g/cm$^2$), is particularly effective in measuring the cosmic ray antimatter content via the observation of the cosmic rays shadowing effect due to: (1) good angular resolution, pointing accuracy and long-term stability; (2) low energy threshold; (3) real sensitivity to the geomagnetic field. Based on all the data recorded during the period from July 2006 through November 2009 and on a full Monte Carlo simulation, we searched for the existence of the shadow cast by antiprotons in the TeV energy region. No evidence of the existence of antiprotons is found in this energy region. Upper limits to the $\bar{p}/p$ flux ratio are set to 5 % at a median energy of 1.4 TeV and 6 % at 5 TeV with a confidence level of 90%. In the TeV energy range these limits are the lowest available.Comment: Contact authors: G. Di Sciascio ([email protected]) and R. Iuppa ([email protected]), INFN Sezione di Roma Tor Vergata, Roma, Ital

Neurological update: MOG antibody disease

Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOG-AD) is now recognised as a nosological entity with specific clinical and paraclinical features to aid early diagnosis. Although no age group is exempt, median age of onset is within the fourth decade of life, with optic neuritis being the most frequent presenting phenotype. Disease course can be either monophasic or relapsing, with subsequent relapses most commonly involving the optic nerve. Residual disability develops in 50–80% of patients, with transverse myelitis at onset being the most significant predictor of long-term outcome. Recent advances in MOG antibody testing offer improved sensitivity and specificity. To avoid misdiagnosis, MOG antibody testing should be undertaken in selected cases presenting clinical and paraclinical features that are felt to be in keeping with MOG-AD, using a validated cell-based assay. MRI characteristics can help in differentiating MOG-AD from other neuroinflammatory disorders, including multiple sclerosis and neuromyelitis optica. Cerebrospinal fluid oligoclonal bands are uncommon. Randomised control trials are limited, but observational open-label experience suggests a role for high-dose steroids and plasma exchange in the treatment of acute attacks, and for immunosuppressive therapies, such as steroids, oral immunosuppressants and rituximab as maintenance treatment

Clinical outcomes of radiotherapy as initial local therapy for Graves’ ophthalmopathy and predictors of the need for post-radiotherapy decompressive surgery

<p>Abstract</p> <p>Background</p> <p>The optimal initial local treatment for patients with Graves’ ophthalmopathy (GO) is not fully characterized. The purpose of this retrospective study is to describe the clinical outcomes of RT as initial local therapy for GO and define predictors of the need for post-RT salvage bony decompressive surgery.</p> <p>Methods</p> <p>91 patients with active GO and without prior surgery were treated with RT as initial local therapy between 01/1999 and 12/2010, with a median follow-up period of 18.3 months (range 3.7 - 142 months). RT dose was 24 Gy in 12 fractions. 44 patients (48.4%) had prior use of steroids, with 31 (34.1%) being on steroids at the initiation of RT. The most common presenting symptoms were diplopia (79%), proptosis (71%) and soft tissue signs (62%).</p> <p>Results</p> <p>84 patients (92.3%) experienced stabilization or improvement of GO symptoms. 58 patients (64%) experienced improvement in their symptoms. 19 patients (20.9%) underwent salvage post-RT bony decompressive surgery. Smoking status and total symptom score at 4 months were independent predictors of post-RT bony decompression with odds ratios of 3.23 (95% CI 1.03 – 10.2) and 1.59 (95% CI 1.06 – 2.4), respectively. Persistent objective vision loss at 4 months post-RT was the most important symptom type in predicting salvage decompression. Chronic dry eye occurred in 9 patients (9.9%) and cataracts developed in 4 patients (4.4%).</p> <p>Conclusions</p> <p>RT is effective and well tolerated as initial local therapy for active GO, with only 21% of patients requiring decompressive surgery post RT. Most patients experience stabilization or improvement of GO symptoms, but moderate to significant response occurs in the minority of patients. Smoking status and total symptom severity at 4 months, primarily persistent objective vision loss, are the primary determinants of the need for post-RT salvage bony decompression. Patients who smoke or present with predominantly vision loss symptoms should be advised as to their lower likelihood of symptomatic response to RT and their increased likelihood of requiring post-RT decompressive surgery.</p