This Letter reports the first results of a direct dark matter search with the DEAP-3600 single-phase liquid argon (LAr) detector. The experiment was performed 2 km underground at SNOLAB (Sudbury, ...Canada) utilizing a large target mass, with the LAr target contained in a spherical acrylic vessel of 3600 kg capacity. The LAr is viewed by an array of PMTs, which would register scintillation light produced by rare nuclear recoil signals induced by dark matter particle scattering. An analysis of 4.44 live days (fiducial exposure of 9.87 ton day) of data taken during the initial filling phase demonstrates the best electronic recoil rejection using pulse-shape discrimination in argon, with leakage <1.2×10^{-7} (90% C.L.) between 15 and 31 keV_{ee}. No candidate signal events are observed, which results in the leading limit on weakly interacting massive particle (WIMP)-nucleon spin-independent cross section on argon, <1.2×10^{-44} cm^{2} for a 100 GeV/c^{2} WIMP mass (90% C.L.).
DEAP-3600 is a single-phase liquid argon (LAr) direct-detection dark matter experiment, operating 2 km underground at SNOLAB (Sudbury, Canada). The detector consists of 3279 kg of LAr contained in a ...spherical acrylic vessel. This paper reports on the analysis of a 758 tonne·day exposure taken over a period of 231 live-days during the first year of operation. No candidate signal events are observed in the WIMP-search region of interest, which results in the leading limit on the WIMP-nucleon spin-independent cross section on a LAr target of 3.9×10−45 cm2 (1.5×10−44 cm2) for a 100 GeV/c2 (1 TeV/c2) WIMP mass at 90% C.L. In addition to a detailed background model, this analysis demonstrates the best pulse-shape discrimination in LAr at threshold, employs a Bayesian photoelectron-counting technique to improve the energy resolution and discrimination efficiency, and utilizes two position reconstruction algorithms based on the charge and photon detection time distributions observed in each photomultiplier tube.
A multidisciplinary approach combining geological mapping based on seismic and well data with petrographic analyses of core and cuttings samples was used to gain a better understanding of the ...distribution of Upper Permian (Zechstein, Z2) Hauptdolomit platforms and their depositional facies around the Elbow Spit High in the northern Dutch offshore. A detailed understanding of the Hauptdolomit's lateral facies variability is of great importance for assessing its reservoir potential, since both the thickness and reservoir properties of these carbonate platforms greatly depend on local accommodation within different palaeo‐depositional environments. The platforms generally contain the thickest Hauptdolomit sequences and are largely characterised by a mix of oolitic and coated grainstones, as well as by some dolomicrites. Porosities of around 15% are reached at well E02‐02 within the grainstone intervals, and interconnectivity between the pores is generally present. Seismic mapping has indicated a rim of isolated Hauptdolomit platforms, which are up to 10 km wide, around the southern and NW margins of the Elbow Spit High. No Hauptdolomit platforms are present on the NE margin of the High, likely because the palaeo‐ basin margin was too steep and hence lacked accommodation for carbonate growth. Discoveries made in recent years in the UK sector of the southern North Sea have highlighted the importance of the Hauptdolomit hydrocarbon play, and the results of the current study provide a solid base for assessing the reservoir potential of this play in the relatively underexplored northern part of the Dutch offshore.
Objective/Background Critical limb ischemia (CLI) is the most advanced stage of peripheral artery disease (PAD), and many patients with CLI are not eligible for conventional revascularization. In the ...last decade, cell based therapies have been explored as an alternative treatment option for CLI. A meta-analysis was conducted of randomized placebo controlled trials investigating bone marrow (BM) derived cell therapy in patients with CLI. Methods The MEDLINE, Embase, and the Cochrane Controlled Trials Register databases were systematically searched, and all included studies were critically appraised by two independent reviewers. The meta-analysis was performed using a random effects model. Results Ten studies, totaling 499 patients, were included in this meta-analysis. No significant differences were observed in major amputation rates (relative risk RR 0.91; 95% confidence interval CI 0.65–1.27), survival (RR 1.00; 95% CI 0.95–1.06), and amputation free survival (RR 1.03; 95% CI 0.86–1.23) between the cell treated and placebo treated patients. The ankle brachial index (mean difference 0.11; 95% CI 0.07–0.16), transcutaneous oxygen measurements (mean difference 11.88; 95% CI 2.73–21.02), and pain score (mean difference –0.72; 95% CI –1.37 to –0.07) were significantly better in the treatment group than in the placebo group. Conclusions This meta-analysis of placebo controlled trials showed no advantage of stem cell therapy on the primary outcome measures of amputation, survival, and amputation free survival in patients with CLI. The potential benefit of more sophisticated cell based strategies should be explored in future randomized placebo controlled trials.
The Double Chooz Experiment presents an indication of reactor electron antineutrino disappearance consistent with neutrino oscillations. A ratio of 0.944 ± 0.016 (stat) ± 0.040 (syst) observed to ...predicted events was obtained in 101 days of running at the Chooz Nuclear Power Plant in France, with two 4.25 GWth reactors. The results were obtained from a single 10 m3 fiducial volume detector located 1050 m from the two reactor cores. The reactor antineutrino flux prediction used the Bugey4 measurement as an anchor point. The deficit can be interpreted as an indication of a non-zero value of the still unmeasured neutrino mixing parameter sin 22θ13. Analyzing both the rate of the prompt positrons and their energy spectrum we find sin 22θ13 = 0.086 ± 0.041 (stat) ± 0.030 (syst), or, at 90% CL, 0.015 < sin 22θ13 < 0.16.
Background Syncope management is fraught with unnecessary tests and frequent failure to establish a diagnosis. We evaluated the potential of implementing the 2018 European Society of Cardiology (ESC) ...Syncope Guidelines regarding diagnostic yield, accuracy and costs. Methods A multicentre pre-post study in five Dutch hospitals comparing two groups of syncope patients visiting the emergency department: one before intervention (usual care; from March 2017 to February 2019) and one afterwards (from October 2017 to September 2019). The intervention consisted of the simultaneous implementation of the ESC Syncope Guidelines with quick referral routes to a syncope unit when indicated. The primary objective was to compare diagnostic accuracy using logistic regression analysis accounting for the study site. Secondary outcome measures included diagnostic yield, syncope-related healthcare and societal costs. One-year follow-up data were used to define a gold standard reference diagnosis by applying ESC criteria or, if not possible, evaluation by an expert committee. We determined the accuracy by comparing the treating physician's diagnosis with the reference diagnosis. Results We included 521 patients (usual care, n = 275; syncope guidelines intervention, n = 246). The syncope guidelines intervention resulted in a higher diagnostic accuracy in the syncope guidelines group than in the usual care group (86% vs.69%; risk ratio 1.15; 95% CI 1.07 to 1.23) and a higher diagnostic yield (89% vs. 76%, 95% CI of the difference 6 to 19%). Syncope-related healthcare costs did not differ between the groups, yet the syncope guideline implementation resulted in lower total syncope-related societal costs compared to usual care (saving euro908 per patient; 95% CI euro34 to euro1782). Conclusions ESC Syncope Guidelines implementation in the emergency department with quick referral routes to a syncope unit improved diagnostic yield and accuracy and lowered societal costs. Trial registration Netherlands Trial Register, NTR6268 Keywords: Transient loss of consciousness, Healthcare efficiency, Syncope, Epilepsy, Admission, Tilt table testing, QALY
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
We find that it is possible to increase sensitivity to low energy physics in a third or fourth Deep Underground Neutrino Experiment (DUNE)-like module with careful controls over radiopurity ...and targeted modifications to a detector similar to the DUNE Far Detector design. In particular, sensitivity to supernova and solar neutrinos can be enhanced with improved MeV-scale reach. A neutrinoless double beta decay search with
136
Xe loading appears feasible. Furthermore, sensitivity to Weakly-Interacting Massive Particle (WIMP) Dark Matter becomes competitive with the planned world program in such a detector, offering a unique seasonal variation detection that is characteristic of the nature of WIMPs.
Dark matter with Planck-scale mass (≃10^{19} GeV/c^{2}) arises in well-motivated theories and could be produced by several cosmological mechanisms. A search for multiscatter signals from ...supermassive dark matter was performed with a blind analysis of data collected over a 813 d live time with DEAP-3600, a 3.3 t single-phase liquid argon-based detector at SNOLAB. No candidate signals were observed, leading to the first direct detection constraints on Planck-scale mass dark matter. Leading limits constrain dark matter masses between 8.3×10^{6} and 1.2×10^{19} GeV/c^{2}, and ^{40}Ar-scattering cross sections between 1.0×10^{-23} and 2.4×10^{-18} cm^{2}. These results are interpreted as constraints on composite dark matter models with two different nucleon-to-nuclear cross section scalings.
Syncope care is often fragmented and inefficient. Structuring syncope care through implementation of guidelines and Syncope Units has been shown to improve diagnostic yield, reduce costs and improve ...quality of life. We implemented the European Society of Cardiology (ESC) 2018 syncope guidelines at the Emergency Departments (ED) and established Syncope Units in five Dutch hospitals. We evaluated the implementation process by identifying factors that hinder (‘barriers’) and facilitate (‘facilitators’) the implementation.
We conducted, recorded and transcribed semi-structured interviews with 19 specialists and residents involved in syncope care from neurology, cardiology, internal medicine and emergency medicine. Two researchers independently classified the reported barriers and facilitators, according to the framework of qualitative research (Flottorp), which distinguished several separate fields (‘levels’). Software package Atlas.ti was used for analysis.
We identified 31 barriers and 22 facilitators. Most barriers occurred on the level of the individual health care professional (e.g. inexperienced residents having to work with the guideline at the ED) and the organizational context (e.g. specialists not relinquishing preceding procedures). Participants reported most facilitators at the level of innovation (e.g. structured work-flow at the ED). The multidisciplinary Syncope Unit was welcomed as useful solution to a perceived need in clinical practice.
Implementing ESC syncope guidelines at the ED and establishing Syncope Units facilitated a structured multidisciplinary work-up for syncope patients. Most identified barriers related to the individual health care professional and the organizational context. Future implementation of the multidisciplinary guideline should be tailored to address these barriers.
•We evaluated the implementation process of ESC syncope guidelines and identified 31 barriers and 22 facilitators.•Most barriers concerned the individual health care professionaland the organizational context.•Most facilitators were reported at the level of innovation.•The multidisciplinary Syncope Unit was welcomed as useful solution to a perceived need in clinical practice.•These barriers and facilitators should be used to designtailored interventions to impphese
PDF
