Intracranial bleeding in patients with traumatic brain injury: A prognostic study

BACKGROUND: Intracranial bleeding (IB) is a common and serious consequence of traumatic brain injury (TBI). IB can be classified according to the location into: epidural haemorrhage (EDH) subdural haemorrhage (SDH) intraparenchymal haemorrhage (IPH) and subarachnoid haemorrhage (SAH). Studies involving repeated CT scanning of TBI patients have found that IB can develop or expand in the 48 hours after injury. If IB enlarges after hospital admission and larger bleeds have a worse prognosis, this would provide a therapeutic rationale for treatments to prevent increase in the extent of bleeding. We analysed data from the Trauma Audit & Research Network (TARN), a large European trauma registry, to evaluate the association between the size of IB and mortality in patients with TBI. METHODS: We analysed 13,962 patients presenting to TARN participating hospitals between 2001 and 2008 with a Glasgow Coma Score (GCS) less than 15 at presentation or any head injury with Abbreviated Injury Scale (AIS) severity code 3 and above. The extent of intracranial bleeding was determined by the AIS code. Potential confounders were age, presenting Glasgow Coma Score, mechanism of injury, presence and nature of other brain injuries, and presence of extra-cranial injuries. The outcomes were in-hospital mortality and haematoma evacuation. We conducted a multivariable logistic regression analysis to evaluate the independent effect of large and small size of IB, in comparison with no bleeding, on patient outcomes. We also conducted a multivariable logistic regression analysis to assess the independent effect on mortality of large IB in comparison with small IB. RESULTS: Almost 46% of patients had at some type of IB. Subdural haemorrhages were present in 30% of the patients, with epidural and intraparenchymal present in approximately 22% each. After adjusting for potential confounders, we found that large IB, wherever located, was associated with increased mortality in comparison with no bleeding. We also found that large IB was associated with an increased risk of mortality in comparison with small IB. The odds ratio for mortality for large SDH, IPH and EDH, in comparison with small bleeds, were: 3.41 (95% CI: 2.684.33), 3.47 (95% CI: 2.265.33) and 2.86 (95% CI: 1.864.38) respectively. CONCLUSION: Large EDH, SDH and IPH are associated with a substantially higher probability of hospital mortality in comparison with small IB. However, the limitations of our data, such as the large proportion of missing data and lack of data on other confounding factors, such as localization of the bleeding, make the results of this report only explanatory. Future studies should also evaluate the effect of IB size on functional outcomes

Peptide exchange on MHC-I by TAPBPR is driven by a negative allostery release cycle.

Chaperones TAPBPR and tapasin associate with class I major histocompatibility complexes (MHC-I) to promote optimization (editing) of peptide cargo. Here, we use solution NMR to investigate the mechanism of peptide exchange. We identify TAPBPR-induced conformational changes on conserved MHC-I molecular surfaces, consistent with our independently determined X-ray structure of the complex. Dynamics present in the empty MHC-I are stabilized by TAPBPR and become progressively dampened with increasing peptide occupancy. Incoming peptides are recognized according to the global stability of the final pMHC-I product and anneal in a native-like conformation to be edited by TAPBPR. Our results demonstrate an inverse relationship between MHC-I peptide occupancy and TAPBPR binding affinity, wherein the lifetime and structural features of transiently bound peptides control the regulation of a conformational switch located near the TAPBPR binding site, which triggers TAPBPR release. These results suggest a similar mechanism for the function of tapasin in the peptide-loading complex

Observation of Cabibbo-suppressed and W-exchange Lambda_c^+ baryon decays

We present measurements of the Cabibbo-suppressed decays Lambda_c^+ --> Lambda0 K+ and Lambda_c^+ --> Sigma0 K+ (both first observations), Lambda_c^+ --> Sigma+ K+ pi- (seen with large statistics for the first time), Lambda_c^+ --> p K+ K- and Lambda_c^+ --> p phi (measured with improved accuracy). Improved branching ratio measurements for the decays Lambda_c^+ --> Sigma+ K+ K- and Lambda_c^+ --> Sigma+ phi, which are attributed to W-exchange diagrams, are shown. We also present the first evidence for Lambda_c^+ --> Xi(1690)^0 K+ and set an upper limit on the non-resonant decay Lambda_c^+ --> Sigma+ K+ K-. This analysis was performed using 32.6 fb^{-1} of data collected by the Belle detector at the asymmetric e+ e- collider KEKB.Comment: Submitted to Phys. Lett. B. v2: A small correction to the Authorlist was made. An earlier version of this analysis was released as BELLE-CONF-0130, hep-ex/010800

Observation of Large CP Violation in the Neutral B Meson System

We present a measurement of the Standard Model CP violation parameter sin 2phi_1 based on a 29.1 fb^{-1} data sample collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric-energy e+e- collider. One neutral B meson is fully reconstructed as a J/psi Ks, psi(2S) Ks, chi_c1 Ks, eta_c Ks, J/psi K_L or J/psi K^{*0} decay and the flavor of the accompanying B meson is identified from its decay products. From the asymmetry in the distribution of the time intervals between the two B meson decay points, we determine sin 2phi_1 = 0.99 +- 0.14(stat) +- 0.06(syst). We conclude that we have observed CP violation in the neutral B meson system.Comment: 4 figures, to appear in Phys. Rev. Letter

Search for Direct CP Violation in B -> K pi Decays

We search for direct CP violation in flavor specific B -> K pi decays by measuring the rate asymmetry between charge conjugate modes. The search is performed on a data sample of 11.1 million B B bar events recorded on the Upsilon(4S) resonance by the Belle experiment at KEKB. We measure 90% confidence intervals in the partial rate asymmetry A_CP of -0.25 < A_CP(K-/+ pi+/-) < 0.37, -0.40 < A_CP(K-/+ pi^0) < 0.36, and -0.53 < A_CP(K^0 pi-/+) < 0.82. By combining the K-/+ pi+/- and K-/+ pi^0 final states, we conclude that -0.22 < A_CP[K-/+(pi+/- + pi^0)] < 0.25 at the 90% confidence level.Comment: Submitted to PRD Rapid Communication

Measurement of the Branching Fraction for B->eta' K and Search for B->eta'pi+

We report measurements for two-body charmless B decays with an eta' meson in the final state. Using 11.1X10^6 BBbar pairs collected with the Belle detector, we find BF(B^+ ->eta'K^+)=(79^+12_-11 +-9)x10^-6 and BF(B^0 -> eta'K^0)=(55^+19_-16 +-8)x10^-6, where the first and second errors are statistical and systematic, respectively. No signal is observed in the mode B^+ -> eta' pi^+, and we set a 90% confidence level upper limit of BF(B^+-> eta'pi^+) eta'K^+- decays is investigated and a limit at 90% confidence level of -0.20<Acp<0.32 is obtained.Comment: Submitted to Physics Letters

Precise Measurement of B Meson Lifetimes with Hadronic Decay Final States

The lifetimes of the B0bar and B- mesons are extracted from 29.1/fb of data collected with the Belle detector at the KEK B-factory. A fit to the decay length differences of neutral and charged B meson pairs, measured in events where one of the B mesons is fully reconstructed in several hadronic modes, yields tau_B0bar = 1.554 +/- 0.030(stat) +/- 0.019(syst) ps, tau_B- = 1.695 +/- 0.026(stat) +/- 0.015(syst) ps, and tau_B-/tau_B0bar = 1.091 +/- 0.023(stat) +/- 0.014(syst).Comment: 10 pages, 2 figures, and 1 table. (To be) published in Phys. Rev. Let

Search for Charmless Two-body Baryonic Decays of B Mesons

We report the results of a search for the rare baryonic decays $B^0 \to p\bar{p}$, $\Lambda\bar{\Lambda}$, and $B^+ \to p\bar{\Lambda}$. The analysis is based on a data set of $31.7\times 10^6 B\bar{B}$ events collected by the Belle detector at the KEKB $e^+e^-$ collider. No statistically significant signals are found, and we set branching fraction upper limits ${\mathcal B}(B^0 \to p\bar{p}) < 1.2 \times 10^{-6}$, ${\mathcal B}(B^0 \to \Lambda\bar{\Lambda}) < 1.0 \times 10^{-6}$, and ${\mathcal B}(B^+ \to p\bar{\Lambda}) < 2.2 \times 10^{-6}$ at the 90% confidence level.Comment: 6 pages, 4 figures and 1 table. Submitted to Phys. Rev. D Rapid Communication

Determination of |Vcb| using the semileptonic decay \bar{B}^0 --> D^{*+}e^-\bar{\nu}

We present a measurement of the Cabibbo-Kobayashi-Maskawa (CKM) matrix element |Vcb| using a 10.2 fb^{-1} data sample recorded at the \Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric e^+e^- storage ring. By extrapolating the differential decay width of the \bar{B}^0 --> D^{*+}e^-\bar{\nu} decay to the kinematic limit at which the D^{*+} is at rest with respect to the \bar{B}^0, we extract the product of |Vcb| with the normalization of the decay form factor F(1), |Vcb |F(1)= (3.54+/-0.19+/-0.18)x10^{-2}, where the first error is statistical and the second is systematic. A value of |Vcb| = (3.88+/-0.21+/-0.20+/-0.19)x10^{-2} is obtained using a theoretical calculation of F(1), where the third error is due to the theoretical uncertainty in the value of F(1). The branching fraction B(\bar{B}^0 --> D^{*+}e^-\bar{\nu}) is measured to be (4.59+/-0.23+/-0.40)x10^{-2}.Comment: 20 pages, 6 figures, elsart.cls, submitted to PL

Observation of Cabibbo suppressed B→D(∗)K−B \to D^{(*)}K^- decays at Belle

Cabibbo-suppressed decays $B \to D^{(*)} K^-$ using a 10.4 fb$^{-1}$ data sample accumulated at the $\Upsilon(4S)$ resonance with the Belle detector at the KEKB $e^+ e^-$ storage ring. The high-momentum particle identification system of Belle is used to isolate signals for $B\to D^0 K^-$, $D^+K^-$, $D^{*0}K^-$ and $D^{*+}K^-$ from the $B\to D^{(*)}\pi^-$ decay processes which have much larger branching fractions. We report ratios of Cabibbo-suppressed to Cabibbo-favored branching fractions of: ${\cal B}(B^- \to D^0 K^-)/{\cal B}(B^- \to D^0\pi^-) = 0.079\pm0.009\pm0.006$; ${\cal B}(\bar{B^0} \to D^+ K^-)/{\cal B}(\bar{B^0} \to D^+\pi^-) = 0.068\pm0.015\pm0.007$; ${\cal B}(B^-\to D^{*0}K^-)/{\cal B}(B^-\to D^{*0}\pi^-) = 0.078 \pm 0.019 \pm 0.009$; and ${\cal B}(\bar{B}^0\to D^{*+}K^-)/{\cal B}(\bar{B}^0\to D^{*+}\pi^-)= 0.074 \pm 0.015 \pm 0.006$. The first error is statistical and the second is systematic. These are the first reported observations of the $B\to D^+K^-$, $D^{*0}K^-$ and $D^{*+}K^-$ decay processes.Comment: LaTeX, 12 pages, 2 figure