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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.
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 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
We present cross sections for the reaction e+e−→K0SK0L at center-of-mass energies ranging from 3.51 GeV to 4.95 GeV using data samples collected in the BESIII experiment, corresponding to a total integrated luminosity of 26.5 fb−1. The ratio of neutral-to-charged kaon form factors at large momentum transfers (12 GeV2<Q2<25 GeV2) is determined to be 0.21±0.01, which indicates a small but significant effect of flavor-SU(3) breaking in the kaon wave function, and consequently excludes the possibility that flavor-SU(3) breaking is the primary reason for the strong experimental violation of the pQCD prediction |F(π±)|/|F(K±)|=f2π/f2K, where F(π±) and F(K±) are the form factors, and fπ and fK are the decay constants of charged pions and kaons, respectively. We also observe a significant signal for the charmless decay ψ(3770)→K0SK0L for the first time. Within a 1σ contour of the likelihood value, the the branching fraction for ψ(3770)→K0SK0L is determined to be B=(2.63+1.40−1.59)×10−5, and the relative phase between the continuum and ψ(3770) amplitudes is ϕ=(−0.39+0.05−0.10)π. The branching fraction is in good agreement with the S- and D-wave charmonia mixing scheme proposed in the interpretation of the "ρπ puzzle" between J/ψ and ψ(3686) decays.
We report a search for a heavier partner of the recently observed Zcs(3985)− state, denoted as Z′−cs, in the process e+e−→K+D∗−sD∗0+c.c., based on e+e− collision data collected at the center-of-mass energies of s√=4.661, 4.682 and 4.699 GeV with the BESIII detector. The Z′−cs is of interest as it is expected to be a candidate for a hidden-charm and open-strange tetraquark. A partial-reconstruction technique is used to isolate K+ recoil-mass spectra, which are probed for a potential contribution from Z′−cs→D∗−sD∗0 (c.c.). We find an excess of Z′−cs→D∗−sD∗0 (c.c.) candidates with a significance of 2.9σ, after considering systematic uncertainties, at a mass of (4123.5±0.7stat.±1.1syst.)MeV/c2. As the data set is limited in size, the upper limits are evaluated at the 90% confidence level on the product of the Born cross section and the branching fraction of Z′−cs→D∗−sD∗0, σBorn⋅B at the three energy points, under different assumptions of the Z′−cs mass from 4.120 to 4.140 MeV and of the width from 10 to 50 MeV. Under various mass and width assumptions, the upper limits of σBorn⋅B are found to lie in the range of 2∼6, 3∼7 and 3∼6 pb at s√=4.661, 4.682 and 4.699 GeV, respectively. The larger data samples that will be collected in the coming years will allow a clearer picture to emerge concerning the existence and nature of the Z′−cs state.
Using e+e− annihilation data sets collected with the BESIII detector, we measure the cross sections of the processes e+e−→e+e− and e+e−→μ+μ− at fifteen center-of-mass energy points in the vicinity of the J/ψ resonance. By a simultaneous fit to the measured, center-of-mass energy dependent cross sections of the two processes, the combined quantities ΓeeΓee/Γtot and ΓeeΓμμ/Γtot are determined to be (0.346±0.009) and (0.335±0.006) keV, respectively, where Γee, Γμμ, and Γtot are the electronic, muonic, and total decay widths of the J/ψ resonance, respectively. Using the resultant ΓeeΓμμ/Γtot and ΓeeΓee/Γtot, the ratio Γee/Γμμ is calculated to be 1.031±0.015, which is consistent with the expectation of lepton universality within about two standard deviations. Assuming lepton universality and using the branching fraction of the J/ψ leptonic decay measured by BESIII in 2013, Γtot and Γll are determined to be (93.0±2.1) and (5.56±0.11) keV, respectively, where Γll is the average leptonic decay width of the J/ψ resonance.
Observation of 𝜒𝑐𝐽→Λ¯Λ𝜂
(2022)
By analyzing (448.1±2.9)×106 𝜓(3686) events collected with the BESIII detector operating at the BEPCII collider, the decays of 𝜒𝑐𝐽→Λ
¯Λ𝜂 (𝐽=0, 1, and 2) are observed for the first time with statistical significances of 13.9𝜎, 6.7𝜎, and 8.2𝜎, respectively. The product branching fractions of 𝜓(3686)→𝛾𝜒𝑐𝐽 and 𝜒𝑐𝐽→Λ¯Λ𝜂 are measured. Dividing by the world averages of the branching fractions of 𝜓(3686)→𝛾𝜒𝑐𝐽, the branching fractions of 𝜒𝑐𝐽→Λ¯Λ𝜂 decays are determined to be (2.31±0.30±0.21)×10−4, (5.86±1.38±0.68)×10−5, and (1.05±0.21±0.15)×10−4 for 𝐽=0, 1 and 2, respectively, where the first uncertainties are statistical and the second systematic.
A light scalar X0 or vector X1 particles have been introduced as a possible explanation for the (g−2)μ anomaly and dark matter phenomena.
Using (8.998±0.039)×109 $\jpsi$ events collected by the BESIII detector, we search for a light muon philic scalar X0 or vector X1 in the processes J/ψ→μ+μ−X0,1 with X0,1 invisible decays. No obvious signal is found, and the upper limits on the coupling g′0,1 between the muon and the X0,1 particles are set to be between 1.1×10−3 and 1.0×10−2 for the X0,1 mass in the range of 1<M(X0,1)<1000~MeV/c2 at 90% confidence level.
Using a data sample corresponding to an integrated luminosity of 11.3 fb−1 collected at center-of-mass energies from 4.23 to 4.70 GeV with the BESIII detector, we observe the process e+e− → π0π0ψ2(3823) for the first time with a statistical significance of 6.0 standard deviations. The ratio of average cross sections for e+e− → π0π0ψ2(3823) and π+π−ψ2(3823) is determined to be R = σ[e+e− → π0π0ψ2(3823)] σ[e+e−→π+π−ψ2(3823)] = 0.57 ± 0.14 ± 0.05, which is consistent with expectations from isospin symmetry. Here and below, the first uncertainties are statistical and the second are systematic. The mass of the ψ2(3823) is measured to be M[ψ2(3823)] = 3824.5±2.4±1.0 MeV/c2. Due to the limited data sample, an upper limit of 18.8 MeV at 90% confidence level is set on the intrinsic width of ψ2(3823).
Using an 𝑒+𝑒− collision data sample of (27.08±0.14)×108 𝜓(3686) events collected by the BESIII detector, we report the first observation of 𝜒𝑐𝐽→Ω−¯Ω+ (𝐽=0, 1, 2) decays with significances of 5.6𝜎, 6.4𝜎, and 18𝜎, respectively, where the 𝜒𝑐𝐽 mesons are produced in the radiative 𝜓(3686) decays. The branching fractions are determined to be ℬ(𝜒𝑐0→Ω−¯Ω+) = (3.51±0.54±0.29)×10−5, ℬ(𝜒𝑐1→Ω−¯Ω+)=(1.49±0.23±0.10)×10−5, and ℬ(𝜒𝑐2→Ω−¯Ω+)=(4.52±0.24±0.18)×10−5, where the first and second uncertainties are statistical and systematic, respectively.
Using e+e− annihilation data corresponding to an integrated luminosity of 2.93 fb−1 taken at the center-of-mass energy s√=3.773~GeV with the BESIII detector, a joint amplitude analysis is performed on the decays D0→π+π−π+π− and D0→π+π−π0π0(non-η). The fit fractions of individual components are obtained, and large interferences among the dominant components of D0→a1(1260)π, D0→π(1300)π, D0→ρ(770)ρ(770) and D0→2(ππ)S are found in both channels. With the obtained amplitude model, the CP-even fractions of D0→π+π−π+π− and D0→π+π−π0π0(non-η) are determined to be (75.2±1.1stat.±1.5syst.)% and (68.9±1.5stat.±2.4syst.)%, respectively. The branching fractions of D0→π+π−π+π− and D0→π+π−π0π0(non-η) are measured to be (0.688±0.010stat.±0.010syst.)% and (0.951±0.025stat.±0.021syst.)%, respectively. The amplitude analysis provides an important model for binning strategy in the measurements of the strong phase parameters of D0→4π when used to determine the CKM angle γ(ϕ3) via the B−→DK− decay.
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.
The absolute branching fraction of the decay Λc(2625)+→Λ+cπ+π− is measured for the first time to be (50.7±5.0stat.±4.9syst.)% with 368.48 pb−1 of e+e− collision data collected by the BESIII detector at the center-of-mass energies of s√=4.918 and 4.950 GeV. This result is lower than the naive prediction of 67\%, obtained from isospin symmetry, by more than 2σ, thereby indicating that the novel mechanism referred to as the \textit{threshold effect}, proposed for the strong decays of Λc(2595)+, also applies to Λc(2625)+. This measurement is necessary to obtain the coupling constants for the transitions between s-wave and p-wave charmed baryons in heavy hadron chiral perturbation theory. In addition, we search for the decay Λc(2595)+→Λ+cπ+π−. No significant signal is observed, and the upper limit on its branching fraction is determined to be 80.8\% at the 90\% confidence level.
Using 15.6 fb−1 of e+e− collision data collected at twenty-four center-of-mass energies from 4.0 to 4.6 GeV with the BESIII detector, the helicity amplitudes of the process e+e−→π+π−ω are analyzed for the first time. Born cross section measurements of two-body intermediate resonance states with statistical significance greater than 5σ are presented, such as f0(500), f0(980), f2(1270), f0(1370), b1(1235)±, and ρ(1450)±. In addition, evidence of a resonance state in e+e−→π+π−ω production is found. The mass of this state obtained by line shape fitting is about 4.2 GeV/c2, which is consistent with the production of ψ(4160) or Y(4220).
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.
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.
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.
The Ξ0 asymmetry parameters are measured using entangled quantum Ξ0 − Ξ¯ 0 pairs from a sample of ð448.1 2.9Þ × 106 ψð3686Þ events collected with the BESIII detector at BEPCII. The relative phase between the transition amplitudes of the Ξ0Ξ¯ 0 helicity states is measured to be ΔΦ ¼ −0.050 0.150 0.020 rad, which implies that there is no obvious polarization at the current level of statistics. The decay parameters of the Ξ0 hyperon ðαΞ0 ; αΞ¯ 0 ; ϕΞ0 ; ϕΞ¯ 0 Þ and the angular distribution parameter ½αψð3686Þ and ΔΦ are measured simultaneously for the first time. In addition, the CP asymmetry observables are determined to be AΞ0 CP ¼ ðαΞ0 þ αΞ¯ 0 Þ=ðαΞ0 − αΞ¯ 0 Þ ¼ −0.007 0.082 0.025 and ΔϕΞ0 CP ¼ ðϕΞ0 þ ϕΞ¯ 0 Þ=2 ¼ −0.079 0.082 0.010 rad, which are consistent with CP conservation.