Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

Search for Neutrinoless Quadruple-β Decay of ^{150}Nd with the NEMO-3 Detector

We report the results of a first experimental search for lepton number violation by four units in the neutrinoless quadruple-β decay of ^{150}Nd using a total exposure of 0.19 kg yr recorded with the NEMO-3 detector at the Modane Underground Laboratory. We find no evidence of this decay and set lower limits on the half-life in the range T_{1/2}>(1.1-3.2)×10^{21}  yr at the 90% C.L., depending on the model used for the kinematic distributions of the emitted electrons.

Exercise for depression in adolescents: A meta-analysis of randomised controlled trials

Background

The reported lifetime prevalence of depression in adolescents has increased drastically in recent decades. Depression in this population can be particularly damaging and can frequently have a long-lasting adverse impact. The common treatment approach includes psychological therapy and/or anti-depressant medication. However, the efficacy of these approaches, both singularly and combined, is far from conclusive. Recently, there have been an increased number of studies investigating the effect of exercise and physical activity on adolescent depression, however, despite this increased attention, there are no recent reviews and meta-analyses synthesising such studies.

Aim

The review examines the treatment effect of exercise on depression symptoms for adolescents aged 13–17 years of age.

Methods

A systematic search of seven electronic databases identified relevant randomised controlled trials. Screening, data extraction and trial methodological quality were undertaken by two independent researchers. Standardized mean differences were used for pooling post-intervention depressive symptom scores.

Results

Eleven trials met the inclusion criteria, eight of which provided the necessary data for calculation of standardized effect size. Exercise showed a statistically significant moderate overall effect on depressive symptom reduction. Sensitivity analyses were also conducted and will be presented.

Discussion

Exercise and physical activity appear to improve depression symptoms in adolescents, especially in clinical samples, suggesting that exercise may be a useful treatment strategy for adolescents with depression.

Conclusion

Despite the positive findings, large clinical trials that adequately minimise bias are required for firmer conclusions on the effectiveness of exercise as an antidepressant treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Evaluation of patient's versus hematologist/oncologist's office visit agenda

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Background: Few studies have been reported in oncology regarding elements of physician agenda. We aim to compare elements of a doctor office visit agenda between hem/onc physicians (MD) and patients (pts). Methods: Pts and MDs were enrolled to completed a five question survey. Pts were asked: “My doctor” Focuses more on quantity of life and less on quality of life, spends enough time with me, addresses symptoms, addresses chemo side effects, and addresses prognosis. MDs were asked the same questions but worded: "I” spend enough time with pts for example. Answers were recorded on a 5 point scale (1 = highly disagree, 2 = disagree, 3 = neutral, 4 = agree,5 = highly agree) and converted into 2 categories (1,2,3 = neutral/disagree vs 4,5 = agree). Fisher’s exact test with 2 sided p-value was used to compare significance between MD & pts. Results: 1008 pts and 55 MDs were enrolled between 06/2013 - 10/2015. Pt mean age 55 (18-88) with 45% male and 55% female. Racial profile: 16% white, 14% black, 2% Asian/Pacific Islander. Ethnicity: 62% of pts were Hispanic vs. 38% not Hispanic, & 6% other. A significant number of pts feel MDs focus more on quantity of life vs. quality of life (64% pt vs 26% MD p < 0.0001) and MD spend enough time (94% pt vs 82% MD p < 0.05). No differences were seen for symptoms (92% vs 87% p = 0.2), side effects (92% vs 94% p = 1.0), or prognosis (91% vs 96% p = 0.3) pt vs MD respesctively. Conclusions: Pts feel MDs focus more on quantity of life vs. the quality of life. MDs feel they focus more on quality of life vs. quantity of life. Perhaps bridging the gap in what constitutes “quality of life” may improve patient satisfaction. Furthermore MDs underestimate the time spent with their patients. Perhaps MD are spending too much time with some patients resulting in inefficient office visits.

Evaluation of hematologist/oncologist attributes by physicians and patients: A survey study

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Background: We aim to compare what attributes are important to hematology/oncology (hem/onc) physicians (MD) and patients (pts). Methods: IRB approval obtained. Pts and MDs at an academic tertiary care medical center were enrolled to complete a survey. Demographics include: age, gender, race, and ethnicity. Clinical info collected: cancer subtype and treating MD. Survey consisted of 5 questions assessing opinions on physician attributes. Patients were asked: “It is important that my doctor” is friendly, is empathetic, is knowledgeable, well dressed, and engaged in research. MDs were asked: “It is important to be” friendly, empathetic, knowledgeable, well dressed, and engaged in research. Answers recorded on a 5 point scale (1 = highly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = highly agree) & converted into 2 categories (1,2,3 = neutral/disagree vs. 4,5 = agree). Fisher’s exact test with 2 sided p-value used to compare significance between MD & pts responses. Results: 1008 pts and 55 MDs enrolled from June 2013 to October 2015. Pt mean age 55, range 18-88 with 45% male & 55% female. 62% of pts were Hispanic vs. 38% not Hispanic. 16% white, 14% black/African American, 2% Asian/Pacific Islander, & 6% other. 21% of pts had hematologic disorders (92% malignant 8% benign) vs. 79% of pts had solid malignancies. Significant difference was seen for research where 93% of pts agree that having a doctor who is engaged in research is important vs. 63% of MDs, p < 0.0001. A majority of pts and MDs agree that friendliness (92% vs. 91% resp., p = 0.6032), empathy (91% vs. 93% resp., p = 1.000), fund of knowledge (95% vs. 94% resp., p = 0.7442), being well dressed (79% vs. 69% resp., p = 0.0901), is important but no significant differences seen. Conclusions: Hem/onc pts and MD agree that friendliness, empathy, fund of knowledge, being well dressed are important attributes in a hem/onc MD. A significantly increased percentage of patients find it important that their hem/onc MD is engaged in research. It is expected that increased hem/onc MD research will not only contribute to society but also it could improve patient satisfaction.

Cell-Specific Transcriptional Profiling of Ciliated Sensory Neurons Reveals Regulators of Behavior and Extracellular Vesicle Biogenesis

Cilia and extracellular vesicles (EVs) are signaling organelles [1]. Cilia act as cellular sensory antennae, with defects resulting in human ciliopathies. Cilia both release and bind to EVs [1]. EVs are sub-micron-sized particles released by cells and function in both short- and long-range intercellular communication. In C. elegans and mammals, the autosomal dominant polycystic kidney disease (ADPKD) gene products polycystin-1 and polycystin-2 localize to both cilia and EVs, act in the same genetic pathway, and function in a sensory capacity, suggesting ancient conservation [2]. A fundamental understanding of EV biology and the relationship between the polycystins, cilia, and EVs is lacking. To define properties of a ciliated EV-releasing cell, we performed RNA-seq on 27 GFP-labeled EV-releasing neurons (EVNs) isolated from adult C. elegans. We identified 335 significantly overrepresented genes, of which 61 were validated by GFP reporters. The EVN transcriptional profile uncovered new pathways controlling EV biogenesis and polycystin signaling and also identified EV cargo, which included an antimicrobial peptide and ASIC channel. Tumor-necrosis-associated factor (TRAF) homologs trf-1 and trf-2 and the p38 mitogen-activated protein kinase (MAPK) pmk-1 acted in polycystin-signaling pathways controlling male mating behaviors. pmk-1 was also required for EV biogenesis, independent of the innate immunity MAPK signaling cascade. This first high-resolution transcriptome profile of a subtype of ciliated sensory neurons isolated from adult animals reveals the functional components of an EVN.

Modulation of aberrant CDK5 signaling rescues impaired neurogenesis in models of Alzheimer's disease

Recent studies show that in Alzheimer's disease (AD), alterations in neurogenesis contribute to the neurodegenerative process. Neurodegeneration in AD has been associated with aberrant signaling through the cyclin-dependent kinase-5 (CDK5) pathway via its activators p35/p25; however, the role of CDK5 in the mechanisms of defective adult neurogenesis in AD is unknown. First, to study AD-like abnormal activation of CDK5 signaling in an in vitro model of neurogenesis, neuronal progenitor cells (NPCs) were infected with a viral vector expressing p35, and exposed to amyloid-β protein (Aβ(1-42)). These conditions resulted in impaired maturation and neurite outgrowth in vitro, and these effects were reversed by pharmacological or genetic inhibition of CDK5. Similarly, neurogenesis was impaired in a transgenic mouse model of AD that expresses high levels of amyloid precursor protein (APP), and this effect was reversed in transgenic mice crossed with a CDK5 heterozygous-deficient mouse line. A similar rescue effect was observed in APP transgenic mice treated with Roscovitine, a pharmacological inhibitor of CDK5. Taken together, these data suggest that the CDK5 signaling pathway has a critical role in maintaining the integrity of NPCs and neuronal maturation in the adult hippocampus. Moreover, potential therapeutic approaches could focus on modulating the aberrant activity of CDK5 to target the neurogenic and neurodegenerative alterations in AD.

Postoperative irradiation: are there long-term effects on nerve regeneration?

This study investigates the histomorphologic and functional effects of external-beam irradiation on peripheral nerve regeneration in the rat model. All animals received a 1.5-cm interposition isogeneic nerve graft to the right posterior tibial nerve. Group 1 animals served as controls and Groups 2 and 3 received fractionated postoperative irradiation doses of 66 and 106 Gy, respectively. All animals were evaluated for functional recovery with monthly walking-track analysis. At the end of 8 months, the animals were sacrificed and segments of the grafted and distal nerve were harvested for histomorphologic analysis. A statistically significantly fewer number of axons were found in the distal segment of the irradiated specimens, compared to controls. There was no significant difference in the nerve-fiber density of the grafted or distal segments, compared to controls. Functional evaluation by walking-track analysis showed no difference between the irradiated groups and controls over the length of the study. These results suggest that acute nerve grafting of nerve defects in the face of planned postoperative irradiation is safe.

Multiple-pass cell for very-long-path infrared spectrometry

A multiple-pass cell for mid-IR spectrometry that has been designed to operate in an evacuable environmental chamber is described. Using this new modified White arrangement, we can significantly increase the path length while keeping the spectrometric beam stable. An approximate expression that ties the number of reflections to the optimal signal-to-noise ratio in multiple-reflection cells is derived.

Women and outpatient mental health services: use by black, Hispanic, and white women in a national insured population

Factors affecting ethnic differences in women's use of outpatient mental health services were analyzed to determine whether lower use by black and Hispanic women occurred when socioeconomic and other factors are controlled. Employing the Andersen and Newman model of health use, insurance claims of 1.2 million federal employees insured by Blue Cross/Blue Shield in 1983 were analyzed to identify significant predictors of use. Results revealed that black and Hispanic women had lower probabilities and amounts of use when compared to white women even after controlling for a number of variables. Further research is needed to examine cultural and gender-related factors that may underlie ethnic differences; attitudinal factors and service system barriers are also implicated. Such findings have policy implications in the current climate of health care reform for which efforts are needed to increase access to care for ethnic minority women and other underserved populations.

Folie à deux in forensic setting

OBJECTIVE

This paper is written with the aim of presenting a series of cases of folie à deux, an unusual disorder, occurring in a forensic setting where all the victims suffered a fatal or near-fatal outcome. Similarities in the psychopathology in these cases are drawn and comments are made about their outcome in court. The paper is also written to draw attention to the potential risks involved in this type of case and to accent patterns in psychopathology and in legal outcomes.

CLINICAL PICTURE

Five folie à deux cases are described. All are well known to one of the authors (NK), who has treated them at some stage of their illness, provided medicolegal reports for the trial of cases 3, 4 and 5, and provided expert witness testimony in the trial of case 3. All case notes and other relevant documents were studied in detail and a brief summary is provided for each case.

OUTCOME

The cases appear to conform with the description of folie à deux given in the literature and consist of husband and wife (three cases), mother and daughter (one case) and twin brothers (one case). None of these cases had had any past psychiatric or criminal history, yet all the victims suffered a fatal or near fatal outcome. Additionally, all had shared religious delusions in one form or another.

CONCLUSIONS

Folie à deux cases with shared religious delusions can be a very high risk and could be potentially fatal in a family setting. The authors also highlight the difficulties inherent in a forensic system restricted to McNaughton rules, particularly when a person is on trial having committed, or being alleged to have committed, a serious offence, and who is found to be suffering from a psychotic illness.

Ethnic differences in use of inpatient mental health services by blacks, whites, and Hispanics in a national insured population

OBJECTIVE

We examine whether ethnic differences in use of inpatient mental health services exist when the usually confounding effects of minority status and culture are minimized or controlled.

DATA SOURCES AND STUDY SETTING

Secondary analyses were conducted using a national insurance claims database for 1.2 million federal employees and their dependents insured by the Blue Cross/Blue Shield (BC/BS) Federal Employees Plan (FEP).

STUDY DESIGN

The Andersen-Newman model of health utilization was used to analyze predisposing, enabling, and need variables as predictors of inpatient mental health utilization during 1983. The study design was cross-sectional.

DATA COLLECTION

The study database was made up of BC/BS insurance claims, Office of Personnel Management employee data, and Area Resource File data.

PRINCIPAL FINDINGS

No significant differences were found among blacks, whites, and Hispanics in the probability of a psychiatric hospitalization or in the number of inpatient psychiatric days. Regression analyses revealed younger age and psychiatric treatment of other family members as significant predictors of a hospitalization; region of residence, younger age, hospital bed availability, and high option plan enrollment were significant predictors of the number of treatment days.

CONCLUSIONS

Ethnic differences in use of inpatient mental health services were not significant in this generously insured population. Further research involving primary data collection among large and diverse samples of ethnic individuals is needed to fully examine the effects of cultural and socioeconomic differences on use of mental health services.

Ethnicity and the use of outpatient mental health services in a national insured population

OBJECTIVES

Factors affecting ethnic differences in the use of outpatient mental health services are analyzed in an insured, nonpoor population to determine if lower use by Blacks and Hispanics persists when socioeconomic and other factors are controlled.

METHODS

To identify significant predictors of the probability and amount of use, insurance claims data for a population of 1.2 million federal employees insured by Blue Cross/Blue Shield in 1983 were analyzed with the Andersen and Newman model of health service utilization. Logistic and ordinary least squares regression models were estimated for each ethnic group.

RESULTS

Blacks and Hispanics had lower probabilities and amounts of use when compared with Whites after controlling for a number of variables.

CONCLUSIONS

Since ethnic differences in the use of outpatient mental health services exist even in an insured, nonpoor population, factors other than lower socioeconomic status or insurance coverage--for example, cultural or attitudinal factors and service system barriers--are likely responsible. Such findings have policy implications in the current climate of health care reform to increase access to care for the underserved.

The effect of insurance benefit changes on use of child and adolescent outpatient mental health services

Use of outpatient mental health services by dependent children younger than 18 years of age enrolled in the Blue Cross and Blue Shield Federal Employees Plan (FEP) is examined in 1978 and 1983 focusing on a cut in benefits and a shift from high- to low-option plan enrollment between those years. While use rates increased from 2.13% to 2.76% by 1983, the average number of visits decreased from 18.9 to 12.8. High-option plan use exceeded low-option plan use in both years--2.26% versus 0.81% in 1978 and 3.58% versus 1.93% in 1983. In addition to benefit plan, ethnicity, parent's education, type of provider, and type of treatment setting also significantly predicted amount of use. Despite the strong evidence of the effects of benefit coverage, it is likely that need exceeded use even in this insured population of children and adolescents. Implications of the findings are discussed in the context of recent dramatic changes in mental service delivery including privatization, managed care initiatives to cut costs, and growing pressures for national health insurance.

Successful use of the right brachial approach to perform directional atherectomy of the left coronary artery

Although directional coronary atherectomy permits the treatment of complex coronary lesions, its use is limited in patients with peripheral vascular disease by the need to use a large guiding catheter. We describe a patient in whom the right brachial approach was successfully used to perform atherectomy of a semi-protected left main coronary stenosis.

Use of inpatient services by a national population: do benefits make a difference?

This study describes changes in the use of inpatient mental health services by children and adolescents under age 18. The data were insurance claims from the Blue Cross and Blue Shield Federal Employees Program. The study focused on a cut in inpatient benefits that occurred between 1978 and 1983. The rate of inpatient hospitalization dropped significantly, and the average number of days also decreased significantly from 45.8 to 27.0 days. This study is among the first to demonstrate that the rate and amount of inpatient care provided for children and adolescents is responsive to variations in benefit coverage.

Serious physical illness as a stressor: effects on family use of medical services

The purpose of this study was to investigate the effect of stress on the family due to the hospitalization of a family member for a serious chronic illness. The data were the health insurance claims of 3,591 families obtained from the largest U.S.A. insurer of federal employees. It was hypothesized that the nonhospitalized family members would have a stress-related increase in medical expenses for some period of time after the chronically ill person was hospitalized. Multiple regression analysis with adjustments for a number of covariates found increases in mean medical charges of $326 per person (p less than 0.01) (excluding the hospitalized person) in the 3 years following the hospitalization. This finding lends support to the theory that stress--in this case, hospitalization of one family member--affects the entire family system. No significant differences were found in medical charges between families who did and did not receive mental health treatment following the hospitalization.

A new look at evidence about reduced cost of medical utilization following mental health treatment

Meta-analysis of 58 controlled studies and analysis of the claims files for the Blue Cross and Blue Shield Federal Employees Plan for 1974-1978 provide mutually supporting evidence of the cost-offset effects of outpatient mental health treatment. These two complementary resources provide a powerful tool for investigating the nature of associations between mental health services and subsequent reductions in the use of other medical services. The authors found that the reductions in use of medical services are associated with inpatient rather than with outpatient utilization and tend to be larger for persons over 55 years of age.

Mental health treatment and medical care utilization in a fee-for-service system: outpatient mental health treatment following the onset of a chronic disease

Charges for medical services of persons covered by the Blue Cross/Blue Shield Federal Employees Program from 1974 through 1978 who were first diagnosed as having one of four chronic diseases in 1975 and within one year began mental health treatment (MHT) were compared with persons who also were first diagnosed as having one of these diseases in 1975 but had no subsequent MHT. In the third year following the diagnosis, those having seven to 20 MHT visits had medical charges $309 lower and those having over 21 MHT visits had medical charges $284 lower than the comparison group. The savings in medical charges over three years of the group having seven to 20 MHT visits were a function of lower use of inpatient services and roughly equaled the cost of 20 MHT visits. Outpatient mental health treatment can be included in a fee-for-service medical care system to improve the quality and appropriateness of care and, if not extensive, may also serve to lower medical care costs.