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Apheresis therapies for NMOSD attacks : a retrospective study of 207 therapeutic interventions
(2018)
Objective: To analyze whether 1 of the 2 apheresis techniques, therapeutic plasma exchange (PE) or immunoadsorption (IA), is superior in treating neuromyelitis optica spectrum disorder (NMOSD) attacks and to identify predictive factors for complete remission (CR).
Methods: This retrospective cohort study was based on the registry of the German Neuromyelitis Optica Study Group, a nationwide network established in 2008. It recruited patients with neuromyelitis optica diagnosed according to the 2006 Wingerchuk criteria or with aquaporin-4 (AQP4-ab)-antibody–seropositive NMOSD treated at 6 regional hospitals and 16 tertiary referral centers until March 2013. Besides descriptive data analysis of patient and attack characteristics, generalized estimation equation (GEE) analyses were applied to compare the effectiveness of the 2 apheresis techniques. A GEE model was generated to assess predictors of outcome.
Results: Two hundred and seven attacks in 105 patients (87% AQP4-ab-antibody seropositive) were treated with at least 1 apheresis therapy. Neither PE nor IA was proven superior in the therapy of NMOSD attacks. CR was only achieved with early apheresis therapy. Strong predictors for CR were the use of apheresis therapy as first-line therapy (OR 12.27, 95% CI: 1.04–144.91, p = 0.047), time from onset of attack to start of therapy in days (OR 0.94, 95% CI: 0.89–0.99, p = 0.014), the presence of AQP4-ab-antibodies (OR 33.34, 95% CI: 1.76–631.17, p = 0.019), and monofocal attack manifestation (OR 4.71, 95% CI: 1.03–21.62, p = 0.046).
Conclusions: Our findings suggest early use of an apheresis therapy in NMOSD attacks, particularly in AQP4-ab-seropositive patients. No superiority was shown for one of the 2 apheresis techniques.
Classification of evidence: This study provides Class IV evidence that for patients with NMOSD, neither PE nor IA is superior in the treatment of attacks.
Using 7.33 fb−1 of e+e− collision data collected by the BESIII detector at center-of-mass energies between 4.128 and 4.226~GeV, we observe for the first time the decay D±s→ωπ±η with a statistical significance of 7.6σ. The measured branching fraction of this decay is (0.54±0.12±0.04)%, where the first uncertainty is statistical and the second is systematic.
We report the first measurements of the absolute branching fractions of D0 → K0 Lϕ, D0 → K0Lη, D0 → K0Lω, and D0 → K0Lη0, by analyzing 2.93 fb−1 of eþe− collision data taken at a center-of-mass energy of 3.773 GeV with the BESIII detector. Taking the world averages of the branching fractions of D0 → K0Sϕ, D0 → K0Sη, D0 → K0Sω, and D0 → K0Sη0, the K0S − K0L asymmetries RðD0; XÞ in these decay modes are obtained. The CP asymmetries in these decays are also determined. No significant CP violation is observed
Background: Point of care devices for performing targeted coagulation substitution in patients who are bleeding have become increasingly important in recent years. New on the market is the Quantra. It is a device that uses sonorheometry, a sonic estimation of elasticity via resonance, which is a novel ultrasound-based technology that measures viscoelastic properties of whole blood. Several studies have already shown the comparability of the Quantra with devices already established on the market, such as the rotational thromboelastometry (ROTEM) device.
Objective: In contrast to existing studies, this study is the first prospective interventional study using this new system in a cardiac surgical patient cohort. We will investigate the noninferiority between an already existing coagulation algorithm based on the ROTEM/Multiplate system and a new algorithm based on the Quantra system for the treatment of coagulopathic cardiac surgical patients.
Methods: The study is divided into two phases. In an initial observation phase, whole blood samples of 20 patients obtained at three defined time points (prior to surgery, after completion of cardiopulmonary bypass, and on arrival in the intensive care unit) will be analyzed using both the ROTEM/Multiplate and Quantra systems. The obtained threshold values will be used to develop a novel algorithm for hemotherapy. In a second intervention phase, the new algorithm will be tested for noninferiority against an algorithm used routinely for years in our department.
Results: The main objective of the examination is the cumulative loss of blood within 24 hours after surgery. Statistical calculations based on the literature and in-house data suggest that the new algorithm is not inferior if the difference in cumulative blood loss is <150 mL/24 hours.
Conclusions: Because of the comparability of the Quantra sonorheometry system with the ROTEM measurement methods, the existing hemotherapy treatment algorithm can be adapted to the Quantra device with proof of noninferiority.
Trial Registration: ClinicalTrials.gov NCT03902275; https://clinicaltrials.gov/ct2/show/NCT03902275
International Registered Report Identifier (IRRID): DERR1-10.2196/17206
We search for the semi-leptonic decays Λ + c → Λπ+π−e+νe and Λ + c → pK0 Sπ−e+νe in a sample of 4.5 fb−1 of e+e− annihilation data collected in the center-of-mass energy region between 4.600 GeV and 4.699 GeV by the BESIII detector at the BEPCII. No significant signals are observed, and the upper limits on the decay branching fractions are set to be B(Λ+c → Λπ+π−e+νe ) < 3.9 × 10−4 and B(Λ + c → pK0Sπ−e+νe ) < 3.3 × 10−4 at the 90% confidence level, respectively.
Based on 4.5 fb−1 data taken at seven center-of-mass energies ranging from 4.600 to 4.699 GeV with the BESIII detector at the BEPCII collider, we measure the branching fractions of Λ + c → Σ + + hadrons relative to Λ + c → Σ +π +π −. Combining with the world average branching fraction of Λ + c → Σ +π +π −, their branching fractions are measured to be (0.377 ± 0.042 ± 0.020 ± 0.021)% for Λ + c → Σ +K+K−, (0.200 ± 0.023 ± 0.011 ± 0.011)% for Λ + c → Σ+K+π−, (0.414 ± 0.080 ± 0.030 ± 0.023)% for Λ + c → Σ +φ and (0.197 ± 0.036 ± 0.009 ± 0.011)% for Λ + c → Σ +K+K−(non-φ). In all the above results, the first uncertainties are statistical, the second are systematic and the third are from external input of the branching fraction of Λ + c → Σ +π +π −. Since no signal for Λ + c → Σ +K+π−π 0 is observed, the upper limit of its branching fraction is determined to be 0.13% at the 90% confidence level.
With data samples collected with the BESIII detector at seven energy points at √s = 3.68 − 3.71 GeV, corresponding to an integrated luminosity of 333 pb−1, we present a study of the Λ transverse polarization in the e+e− → ΛΛ¯ reaction. The signifcance of polarization by combining the seven energy points is found to be 2.6σ including the systematic uncertainty, which implies a non-zero phase between the transition amplitudes of the ΛΛ¯ helicity states. The modulus ratio and the relative phase of EM-psionic form factors combined with all energy points are measured to be RΨ = 0.71+0.10−0.10 ± 0.03 and ∆ΦΨ = 23+8.8−8.0 ± 1.6◦, where the frst uncertainties are statistical and the second systematic.
The cross sections of the 𝑒+𝑒−→𝜙𝜂′ process at center-of-mass energies from 3.508 to 4.951 GeV are measured with high precision using 26.1 fb−1 data collected with the BESIII detector operating at the BEPCII storage ring. The cross sections are of the order of a few picobarn and decrease as the center-of-mass energy increases as 𝑠−𝑛/2 with 𝑛=4.35±0.14. This result is in agreement with the Nambu-Jona-Lasinio model prediction of 𝑛=3.5±0.9. In addition, the charmless decay 𝜓(3770)→𝜙𝜂′ is searched for by fitting the measured cross sections, yet no significant signal is observed. The upper limit of ℬ(𝜓(3770)→𝜙𝜂′) at the 90% confidence level is determined to be 2.3×10−5.
Using (1.0087±0.0044)×1010 𝐽/𝜓 events collected by the BESIII detector at the BEPCII collider, we report the first search for the baryon and lepton number violating decays Ξ0→𝐾−𝑒+ with Δ(𝐵−𝐿)=0 and Ξ0→𝐾+𝑒− with |Δ(𝐵−𝐿)|=2, where 𝐵 (𝐿) is the baryon (lepton) number. While no signal is observed, the upper limits on the branching fractions of these two decays are set to ℬ(Ξ0→𝐾−𝑒+)<3.6×10−6 and ℬ(Ξ0→𝐾+𝑒−)<1.9×10−6 at the 90% confidence level, respectively. These results offer a direct probe of baryon number violating interactions involving a strange quark.
The Cabbibo-favored decay Λ+c→Ξ0K+π0 is studied for the first time using 6.1 fb−1 of e+e− collision data at center-of-mass energies between 4.600 and 4.840 GeV, collected with the BESIII detector at the BEPCII collider. With a double-tag method, the branching fraction of the three-body decay Λ+c→Ξ0K+π0 is measured to be (7.79±1.46±0.71)×10−3, where the first and second uncertainties are statistical and systematic, respectively. The branching fraction of the two-body decay Λ+c→Ξ(1530)0K+ is (5.99±1.04±0.29)×10−3, which is consistent with the previous result of (5.02±0.99±0.31)×10−3. In addition, the upper limit on the branching fraction of the doubly Cabbibo-suppressed decay Λ+c→nK+π0 is 7.1×10−4 at the 90% confidence level. The upper limits on the branching fractions of Λ+c→Σ0K+π0 and ΛK+π0 are also determined to be 1.8×10−3 and 2.0×10−3, respectively.
Using data samples with an integrated luminosity of 22.42 fb−1 collected by the BESIII detector operating at the BEPCII storage ring, we measure the cross sections of the 𝑒+𝑒−→𝜂𝐽/𝜓 process at center-of-mass energies from 3.808 to 4.951 GeV. Three structures are observed in the line shape of the measured cross sections. A maximum-likelihood fit with 𝜓(4040), two additional resonances, and a nonresonant component are performed. The mass and width of the first additional state are (4219.7±2.5±4.5) MeV/𝑐2 and (80.7±4.4±1.4) MeV, respectively, consistent with the 𝜓(4230). For the second state, the mass and width are (4386±13±17) MeV/𝑐2 and (177±32±13) MeV, respectively, consistent with the 𝜓(4360). The first uncertainties are statistical, and the second ones are systematic. The statistical significance of 𝜓(4040) is 8.0𝜎 and those for 𝜓(4230) and 𝜓(4360) are more than 10.0𝜎.
Evidence for the singly Cabibbo suppressed decay Λ+c→pπ0 is reported for the first time with a statistical significance of 3.7σ based on 6.0 fb−1 of e+e− collision data collected at center-of-mass energies between 4.600 and 4.843 GeV with the BESIII detector at the BEPCII collider. The absolute branching fraction of Λ+c→pπ0 is measured to be (1.56+0.72−0.58±0.20)×10−4, which distinctly exceeds the upper limit measured by Belle experiment. Combining with the branching fraction of Λ+c→nπ+, (6.6±1.3)×10−4, the ratio of the branching fractions of Λ+c→nπ+ and Λ+c→pπ0 is calculated to be 3.2+2.2−1.2. As an important input for the theoretical models describing the decay mechanisms of charmed baryons, our result indicates that the non-factorizable contributions play an essential role and their interference with the factorizable contributions should not be significant. In addition, the absolute branching fraction of Λ+c→pη is measured to be (1.63±0.31stat±0.11syst)×10−3, which is consistent with previous measurements.
Evidence for the singly Cabibbo suppressed decay Λ+c→pπ0 is reported for the first time with a statistical significance of 3.7σ based on 6.0 fb−1 of e+e− collision data collected at center-of-mass energies between 4.600 and 4.843 GeV with the BESIII detector at the BEPCII collider. The absolute branching fraction of Λ+c→pπ0 is measured to be (1.56+0.72−0.58±0.20)×10−4. Combining with the branching fraction of Λ+c→nπ+, (6.6±1.3)×10−4, the ratio of the branching fractions of Λ+c→nπ+ and Λ+c→pπ0 is calculated to be 3.2+2.2−1.2. As an important input for the theoretical models describing the decay mechanisms of charmed baryons, our result indicates that the non-factorizable contributions play an essential role and their interference with the factorizable contributions should not be significant. In addition, the absolute branching fraction of Λ+c→pη is measured to be (1.63±0.31stat±0.11syst)×10−3.
Evidence for the singly Cabibbo suppressed decay Λ+c→pπ0 is reported for the first time with a statistical significance of 3.7σ based on 6.0 fb−1 of e+e− collision data collected at center-of-mass energies between 4.600 and 4.843 GeV with the BESIII detector at the BEPCII collider. The absolute branching fraction of Λ+c→pπ0 is measured to be (1.56+0.72−0.58±0.20)×10−4, which distinctly exceeds the upper limit measured by Belle experiment. Combining with the branching fraction of Λ+c→nπ+, (6.6±1.3)×10−4, the ratio of the branching fractions of Λ+c→nπ+ and Λ+c→pπ0 is calculated to be 3.2+2.2−1.2. As an important input for the theoretical models describing the decay mechanisms of charmed baryons, our result indicates that the non-factorizable contributions play an essential role and their interference with the factorizable contributions should not be significant. In addition, the absolute branching fraction of Λ+c→pη is measured to be (1.63±0.31stat±0.11syst)×10−3, which is consistent with previous measurements.
Using 7.33~fb−1 of e+e− collision data collected by the BESIII detector at center-of-mass energies in the range of s√=4.128−4.226~GeV, we search for the rare decays D+s→h+(h0)e+e−, where h represents a kaon or pion. By requiring the e+e− invariant mass to be consistent with a ϕ(1020), 0.98<M(e+e−)<1.04 ~GeV/c2, the decay D+s→π+ϕ,ϕ→e+e− is observed with a statistical significance of 7.8σ, and evidence for the decay D+s→ρ+ϕ,ϕ→e+e− is found for the first time with a statistical significance of 4.4σ. The decay branching fractions are measured to be B(D+s→π+ϕ,ϕ→e+e−)=(1.17+0.23−0.21±0.03)×10−5, and B(D+s→ρ+ϕ,ϕ→e+e−)=(2.44+0.67−0.62±0.16)×10−5, where the first uncertainties are statistical and the second systematic. No significant signal for the three four-body decays of D+s→π+π0e+e−, D+s→K+π0e+e−, and D+s→K0Sπ+e+e− is observed. For D+s→π+π0e+e−, the ϕ mass region is vetoed to minimize the long-distance effects. The 90% confidence level upper limits set on the branching fractions of these decays are in the range of (7.0−8.1)×10−5.
The Cabbibo-favored decay Λ+c→Ξ0K+π0 is studied for the first time using 6.1 fb−1 of e+e− collision data at center-of-mass energies between 4.600 and 4.840 GeV, collected with the BESIII detector at the BEPCII collider. With a double-tag method, the branching fraction of the three-body decay Λ+c→Ξ0K+π0 is measured to be (7.79±1.46±0.71)×10−3, where the first and second uncertainties are statistical and systematic, respectively. The branching fraction of the two-body decay Λ+c→Ξ(1530)0K+ is (5.99±1.04±0.29)×10−3, which is consistent with the previous result of (5.02±0.99±0.31)×10−3. In addition, the upper limit on the branching fraction of the doubly Cabbibo-suppressed decay Λ+c→nK+π0 is 7.1×10−4 at the 90% confidence level. The upper limits on the branching fractions of Λ+c→Σ0K+π0 and ΛK+π0 are also determined to be 1.8×10−3 and 2.0×10−3, respectively.
Using data samples with an integrated luminosity of 22.42 fb−1 collected by the BESIII detector operating at the BEPCII storage ring, we measure the cross sections of the $e^{+}e^{-}\rightarrow\etaJ/\psi$ process at center-of-mass energies from 3.808 to 4.951 GeV. Three structures are observed in the line shape of the measured cross sections. A maximum-likelihood fit with ψ(4040), two additional resonances, and a non-resonant component is performed. The mass and width of the first additional state are (4219.7±2.5±4.5)MeV/c2 and (80.7±4.4±1.4)MeV, respectively, consistent with the ψ(4230). For the second state, the mass and width are (4386±13±17)MeV/c2 and (177±32±13)MeV, respectively, consistent with the ψ(4360). The first uncertainties are statistical and the second ones are systematic. The statistical significance of ψ(4040) is 8.0σ and those for ψ(4230) and ψ(4360) are more than 10.0σ.
We present the first observation of the singly Cabibbo-suppressed decay Λ+c→ΛK+π0 with a significance of 5.7σ and the first evidence of Λ+c→ΛK+π+π− decay with a significance of 3.1σ, based on e+e− annihilation data recorded by the BESIII detector at the BEPCII collider. The data correspond to an integrated luminosity of 6.4 fb−1, in the center-of-mass energy range from 4.600 GeV to 4.950 GeV. We determine the branching fractions of Λ+c→ΛK+π0 and Λ+c→ΛK+π+π− relative to their Cabibbo-favored counterparts to be B(Λ+c→ΛK+π0)B(Λ+c→Λπ+π0)=(2.09±0.39stat.±0.07syst.)×10−2 and B(Λ+c→ΛK+π+π−)B(Λ+c→Λπ+π+π−)=(1.13±0.41stat.±0.06syst.)×10−2, respectively. Moreover, by combining our measured result with the world average of B(Λ+c→Λπ+π0), we obtain the branching fraction B(Λ+c→ΛK+π0)=(1.49±0.27stat.±0.05syst.±0.08ref.)×10−3. This result significantly departs from theoretical predictions based on quark SU(3) flavor symmetry, which is underpinned by the presumption of meson pair S-wave amplitude dominance.
Using 2.93 fb−1 of e+e− collision data collected with the BESIII detector at the center-of-mass energy 3.773 GeV, we perform the first amplitude analysis of the decay D+ → π+π0π0 and determine the relative magnitudes and phases of different intermediate processes. The absolute branching fraction of D+ → π+π0π0 is measured to be (2.888 ± 0.058stat. ± 0.069syst.)%. The dominant intermediate processes are D+ → a1(1260)+(→ ρ+π0) and D+ → *0ρ+, with branching fractions of (8.66 ± 1.04stat. ± 1.39syst.) × 10−3 and (9.70 ± 0.81stat. ± 0.53syst.) × 10−3, respectively.