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Sökning: WFRF:(Gustafsson Pia)

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1.
  • Tallberg, Pia, et al. (författare)
  • A longitudinal investigation of cognitive functioning and its relationship to symptom severity and academic functioning in treatment seeking youth with AHDH
  • 2021
  • Ingår i: Scandinavian Journal of Child and Adolescent Psychiatry and Psychology. - : Walter de Gruyter GmbH. - 2245-8875. ; 9, s. 52-63
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Children with ADHD tend to present with poorer cognitive functioning leaving them more vulnerable to a range of negative outcomes. To date, only a handful of longitudinal studies have examined the stability of Wechsler composite scores in children and adolescents with ADHD, and none of them used a more recent version of the Wechsler Intelligence Scales for Children (WISC), than the WISC-III. Objective: The present study investigates the cognitive stability and its longitudinal relationship with the severity of the child's ADHD symptoms and school grades. Method: Cognitive functioning was measured with the fourth editions of the WISC-IV or the Wechsler Adult Intelligence Scales (WAIS-IV) at baseline and at a 3-4-year follow-up in children with ADHD (n = 125, mean age = 11.40 years, SD = 3.27) and a Control group of schoolchildren (n = 59, mean age = 11.97 years, SD = 2.15). The stability of cognitive functioning and the relationship between cognitive functioning, ADHD and grades were evaluated using linear mixed models and logistic regression. Results: Standardized composite scores of Full scale IQ, Verbal Comprehension, and Processing Speed declined between baseline and follow-up in the ADHD group. ADHD symptom scores were associated with Working Memory scores. Together, the severity of concurrent ADHD symptoms and lower scores for verbal comprehension at baseline and follow-up were associated with an increased risk of not achieving grades at follow-up in youth with ADHD. Conclusions: Youth with ADHD often present with cognitive impairments, not improved over time. Together these increase the risk of poorer academic outcomes. Concurrent evaluation of symptom severity and cognitive functions can add potentially useful information in terms of treatment planning, and school supports to prevent school failure.
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  • Bashkanov, M., et al. (författare)
  • Double-Pionic Fusion of Nuclear Systems and the "ABC" Effect : Approaching a Puzzle by Exclusive and Kinematically Complete Measurements
  • 2009
  • Ingår i: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 102:5, s. 052301-
  • Tidskriftsartikel (refereegranskat)abstract
    • The ABC effect-a puzzling low-mass enhancement in the pi pi invariant mass spectrum, first observed by Abashian, Booth, and Crowe-is well known from inclusive measurements of two-pion production in nuclear fusion reactions. Here we report on the first exclusive and kinematically complete measurements of the most basic double-pionic fusion reaction pn -> d pi(0)pi(0) at beam energies of 1.03 and 1.35 GeV. The measurements, which have been carried out at CELSIUS-WASA, reveal the ABC effect to be a (pi pi)(I=L=0) channel phenomenon associated with both a resonancelike energy dependence in the integral cross section and the formation of a Delta Delta system in the intermediate state. A corresponding simple s-channel resonance ansatz provides a surprisingly good description of the data.
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4.
  • Bashkanov, M., et al. (författare)
  • Exclusive measurements of pd -> He-3 pi pi : The ABC effect revisited
  • 2006
  • Ingår i: Physics Letters B. - : Elsevier BV. - 0370-2693 .- 1873-2445. ; 637:4-5, s. 223-228
  • Tidskriftsartikel (refereegranskat)abstract
    • Exclusive measurements of the reactions pd -> He-3 pi(+)7 pi(-) and pd -> He-3 pi(0)pi(0) have been carried out at T-p = 0.893 GeV at the CELSIUS storage ring using the WASA detector. The pi(+)pi(-) channel evidences a pronounced enhancement at low invariant pi pi masses-as anticipated from previous inclusive measurements of the ABC effect. This enhancement is seen to be even much larger in the isoscalar pi(0)pi(0) channel. The differential distributions prove this enhancement to be of scalar-isoscalar nature. Delta Delta calculations give a good description of the data, if a boundstate condition is imposed for the intermediate Delta Delta system.
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  • Bashkanov, M., et al. (författare)
  • Low-mass pi pi enhancement in baryonic pi pi production : ABC effect revised by exclusive measurements
  • 2007
  • Ingår i: International Journal of Modern Physics A. - 0217-751X .- 1793-656X. ; 22:2-3, s. 625-628
  • Tidskriftsartikel (refereegranskat)abstract
    • The ABC effect - a puzzling threshold enhancement in the ππ invariant mass spectrum of double-pionic fusion to nuclear bound states - has been investigated since 40 years by inclusive measurements without providing a conclusive interpretation. First exclusive measurements to this topic have now been carried out at CELSIUS-WASA. They confirm a huge ππ threshold enhancement, prove it to be of scalar-isoscalar nature, i.e., a σ-channel phenomenon and reveal the theoretically predicted high-mass enhancement in inclusive spectra to be of πππ rather than of ππ nature - falsifying thus corresponding model predictions for the ABC effect. From the kinematically complete data samples we infer that the interaction between the two Δ particles created in this process is of crucial importance.
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  • Bashkanov, M., et al. (författare)
  • Measurement of the slope parameter for the η → 3π0 decay in the pp → ppη reaction
  • 2007
  • Ingår i: Physical Review C. Nuclear Physics. - 0556-2813 .- 1089-490X. ; 76:4, s. 048201-
  • Tidskriftsartikel (refereegranskat)abstract
    • The CELSIUS-WASA setup is used to measure the 3π0 decay of η mesons produced in pp interactions with beam kinetic energies of 1.36 and 1.45 GeV. The efficiency-corrected Dalitz plot and density distributions for this decay are shown, together with a fit of the quadratic slope parameter α yielding α = −0.026 ± 0.010(stat) ± 0.010(syst). This value is compared to recent experimental results and theoretical predictions.
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7.
  • Bastholm Rahmner, Pia, et al. (författare)
  • "Limit work to here and now" : A focus group study on how emergency physicians view their work in relation to patients' drug treatment
  • 2008
  • Ingår i: International Journal of Qualitative Studies on Helath and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 3:3, s. 155-164
  • Tidskriftsartikel (refereegranskat)abstract
    • Patients come to the emergency department (ED) with complex medication and some patients present symptoms of adverse drug effects. Drug treatment is a complex process for physicians to handle. The aim of this study was to explore how a group of ED physicians view their work in relation to patients’ drug treatment. Three semi-structured focus group discussions with 12 physicians in an ED in Sweden were conducted and analysed thematically. The core theme was ‘‘limit work to here and now’’. Three descriptive themes were identified in relation to the main theme; (1) focussing to cope with work; (2) decision making on limited patient-specific information; and (3) actively seeking learning moments. The findings show that the physicians actively seek learning moments in work. Signing their own notes in the computerized medical record is a way of getting feedback on the treatment they have initiated and it was seen as a large part of their clinical education. If we want to support the physicians with new technology for safer drug treatment, such as a computerized drug prescribing support system, the support system should be adapted to the different learning styles and needs.
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  • Bastholm Rahmner, Pia, et al. (författare)
  • Physicians perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system
  • 2004
  • Ingår i: International journal of health care quality assurance incorporating leadership in helath services. - : Emerald. - 1366-0756 .- 2051-3135. ; 17:4, s. 173-179
  • Tidskriftsartikel (refereegranskat)abstract
    • Seeks to identify physicians' perceptions of possibilities and obstacles prior to implementing a computerised drug prescribing support system. Details a descriptive, qualitative study, with semi-structured individual interviews of 21 physicians in the Accident and Emergency Department of South Stockholm General Hospital. Identifies four descriptive categories for possibilities and obstacles. Concludes that gaining access to patient drug history enables physicians to carry out work in a professional way – a need the computerised prescription support system was not developed for and thus cannot fulfil. Alerts and producer-independent drug information are valuable in reducing workload. However, technical prerequisites form the base for a successful implementation. Time must be given to adapt to new ways of working.
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  • Bastholm Rahmner, Pia, et al. (författare)
  • Physicians' reported needs of drug information at point of care in Sweden
  • 2012
  • Ingår i: British Journal of Clinical Pharmacology. - : Wiley. - 0306-5251 .- 1365-2125. ; 73:1, s. 115-125
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS Relevant and easily accessible drug information at point-of-care is essential for physicians' decision making when prescribing. However, the information available by using Clinical Decision Support Systems (CDSSs) often does not meet physicians' requirements. The Summary of Product Characteristics (SmPC) is statutory information about drugs. However, the current structure, content and format of SmPCs make it difficult to incorporate them into CDSSs and link them to relevant patient information from the Electronic Health Records. The aim of the study was to evaluate the perceived needs for drug information among physicians in Sweden. METHODS We recruited three focus group discussions with 18 physicians covering different specialities. The information from the groups was combined with a questionnaire administered at the beginning of the group discussions. RESULTS Physicians reported their needs for knowledge databases at the point of drug prescribing. This included more consistent information about existing and new drugs. They also wished to receive automatically generated alerts for severe drug-drug interactions and adverse effects, and to have functions for calculating glomerular filtration rate to enable appropriate dose adjustments to be made for elderly patients and those with impaired renal function. Additionally, features enhancing electronic communication with colleagues and making drug information more searchable were suggested. CONCLUSIONS The results from the current study showed the need for knowledge databases which provide consistent information about new and existing drugs. Most of the required information from physicians appeared to be possible to transfer from current SmPCs to CDSSs. However, inconsistencies in the SmPC information have to be reduced to enhance their utility.
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10.
  • Bastholm Rahmner, Pia, et al. (författare)
  • Variations in understanding the drug-prescribing process : a qualitative study among Swedish GPs
  • 2009
  • Ingår i: Family Practice. - : Oxford University Press (OUP). - 0263-2136 .- 1460-2229. ; 26:2, s. 121-127
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: A majority of doctor-patient meetings result in the patient getting a prescription. This underlines the need for a high-quality prescription process. While studies have been made on single therapeutic drug groups, a complete study of the physicians' general thought process that comprises the prescription of all drugs still remains to be made. OBJECTIVE: To identify variations in ways of understanding drug prescribing among GPs. METHODS: A descriptive qualitative study was conducted with 20 Swedish physicians. Informants were recruited purposively and their understandings about prescribing were studied in semi-structured interviews. Data were analysed using a phenomenographic approach. RESULTS: Five categories were identified as follows: (A) GP prescribed safe, reliable and well-documented drugs for obvious complaints; (B) GP sought to convince the patient of the most effective drug treatment; (C) GP chose the best drug treatment taking into consideration the patient's entire life situation; (D) GP used clinical judgement and close follow-up to minimize unnecessary drug prescribing and (E) GP prescribed drugs which are cheap for society and environmentally friendly. The categories are interrelated, but have different foci: the biomedical, the patient and the society. Each GP had more than one view but none included all five. The findings also indicate that complexity increases when a drug is prescribed for primary or secondary prevention. CONCLUSIONS: GPs understand prescribing differently despite similar external circumstances. The most significant factor to influence prescribing behaviour was the physician's patient relation approach. GPs may need to reflect on difficulties they face while prescribing to enhance their understandings.
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  • Bastholm Rahmner, Pia, et al. (författare)
  • Whose job is it anyway? : Swedish general practitioners' perception of their responsibility for the patient's drug list.
  • 2010
  • Ingår i: Annals of Family Medicine. - : Annals of Family Medicine. - 1544-1709 .- 1544-1717. ; 8:1, s. 40-46
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE Information about the patient's current drug list is a prerequisite for safe drug prescribing. The aim of this study was to explore general practitioners' (GPs) understandings of who is responsible for the patient's drug list so that drugs prescribed by different physicians do not interact negatively or even cause harm. The study also sought to clarify how this responsibility was managed. METHODS We conducted a descriptive qualitative study among 20 Swedish physicians. We recruited the informants purposively and captured their view on responsibility by semistructured interviews. Data were analyzed using a phenomenographic approach. RESULTS We found variation in understandings about who is responsible for the patient's drug list and, in particular, how the GPs use different strategies to manage this responsibility. Five categories emerged: (1) imposed responsibility, (2) responsible for own prescriptions, (3) responsible for all drugs, (4) different but shared responsibility, and (5) patient responsible for transferring drug information. The relation between categories is illustrated in an outcome space, which displays how the GPs reason in relation to managing drug lists. CONCLUSIONS The understanding of the GP's responsibility for the patient's drug list varied, which may be a threat to safe patient care. We propose that GPs are made aware of variations in understanding responsibility so that health care quality can be improved.
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  • Berg, Lisa, et al. (författare)
  • Health risk behaviours among migrants by duration of residence : protocol for a systematic review and meta-analysis
  • 2020
  • Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:10
  • Forskningsöversikt (refereegranskat)abstract
    • Introduction International migrants’ health has often been found to deteriorate in new countries, partly due to changes in health risk behaviours such as alcohol consumption, tobacco use, physical inactivity, and poor dietary habits. However, limited efforts have been made to comprehensively evaluate the extent to which migrants adopt unhealthy risk behaviours with longer duration of residence. This systematic review and meta-analysis will summarise evidence on international migrants’ behavioural patterns by duration of residence in multiple country contexts.Methods and analysis PubMed/MEDLINE, Web of Science and ProQuest databases will be searched for quantitative or mixed-method observational studies published in peer-reviewed scientific journals between 1 January 2000 and 31 December 2019. Studies comparing foreign-born individuals by duration of residence will be included. Information on study characteristics, descriptive statistics and measures of effect will be extracted. All included studies will be quality assessed using a modified Newcastle-Ottawa scale. The review will include narrative synthesis and, if sufficient and comparable data are available, random effects meta-analyses. The review will be conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Ethics and dissemination Ethical approval is not required since previously published information from peer-reviewed studies will be assessed. The results of this review will be published in peer-reviewed journals and presented at scientific conferences. Other forms of dissemination will include communication to broader audiences using well-established channels, including through university-based press releases. Progress will be regularly updated on the International Prospective Register of Systematic Reviews to ensure full transparency.
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13.
  • Bergh, Niklas, 1979, et al. (författare)
  • Invasive haemodynamics in de novo everolimus vs. calcineurin inhibitor heart transplant recipients
  • 2020
  • Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 7:2, s. 567-576
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: Invasive haemodynamic profiles at rest and during exercise after heart transplantation (HTx) have never been described in a randomized trial where de novo everolimus (EVR)-based therapy with early calcineurin inhibitor (CNI) withdrawal has been compared with conventional CNI treatment. We report central invasive haemodynamic parameters at rest and exercise during a 3 year follow-up after HTx in a sub-study of the SCandiavian Heart transplant Everolimus De novo stUdy with earLy calcineurin inhibitor avoidancE trial. We hypothesized that the nephroprotective properties, the less development of cardiac allograft vasculopathy (CAV), and the antifibrotic properties of EVR, in comparison with CNI-based immunosuppression, would demonstrate favourable invasive haemodynamic profiles in patients at rest and during exercise. Methods and results: Ninety of 115 HTx recipients randomized to EVR or CNI treatment performed right heart catheterization at rest and 68 performed right heart catheterization at exercise up to 3 years after HTx. Haemodynamic profiles were compared between EVR and CNI treatment groups. Resting haemodynamics improved in both groups from pre-HTx to the first follow-up at 7–11 weeks post-HTx and thereafter remained unchanged up to 3 years of follow-up. During follow-up, cardiac reserve during exercise increased with higher levels of maximum heart rate (118 to 148 b.p.m., P < 0.001), mean arterial pressure (103 to 128 mmHg, P < 0.001), and cardiac output (10.3 to 12.2 l/min, P < 0.001). No significant differences in haemodynamic parameters were observed between the EVR and CNI groups at rest or exercise. Isolated post-capillary pulmonary hypertension (mean pulmonary arterial pressure > 20 mmHg, pulmonary arterial wedge pressure ≥ 15 mmHg, and pulmonary vascular resistance <3) were measured in 11% of the patients at 7–11 weeks, 5% at 12 months, and 6% at 36 months after HTx. The EVR group had significantly better kidney function (76 mL/min/1 vs. 60 mL/min/1, P < 0.001) and reduced CAV (P < 0.01) but an increased rate of early biopsy-proven treated rejections (21.2% vs 5.7%, P < 0.01) compared with the CNI group at any time point. The differences in renal function, CAV, or early biopsy-proven treated acute rejections were not associated with altered haemodynamics. Conclusions: De novo EVR treatment with early CNI withdrawal compared with conventional CNI therapy did not result in differences in haemodynamics at rest or during exercise up to 3 years after HTx despite significant differences in renal function, reduced CAV, and number of early biopsy-proven treated rejections.
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14.
  • Berlowski, M., et al. (författare)
  • Measurement of eta meson decays into lepton-antilepton pairs
  • 2008
  • Ingår i: Physical Review D. Particles and fields. - : American Physical Society. - 0556-2821 .- 1089-4918. ; 77:3, s. 032004-
  • Tidskriftsartikel (refereegranskat)abstract
    • A search for rare lepton decays of the eta meson was performed using the WASA detector at CELSIUS. Two candidates for double Dalitz decay eta -> e(+)e(-)e(+)e(-) events are reported with a background of 1.3 +/- 0.2 events. This allows to set an upper limit to the branching ratio of 9.7x10(-5) (90% CL). The branching ratio for the decay eta -> e(+)e(-)gamma is determined to (7.8 +/- 0.5(stat)+/- 0.8(syst))x10(-3) in agreement with world average value. An upper limit (90% CL) for the branching ratio for the eta -> e(+)e(-) decay is 2.7x10(-5) and a limit for the sum of the eta ->mu(+)mu(-)mu(+)mu(-) and eta ->pi(+)pi(-)mu(+)mu(-) decays is 3.6x10(-4).
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  • Bloomfield, Kim, et al. (författare)
  • Changes in Alcohol-Related Problems After Alcohol Policy Changes in Denmark, Finland, and Sweden
  • 2010
  • Ingår i: Journal of Studies on Alcohol and Drugs. - New Jersey : Rutgers, the State University of New Jersey. - 1937-1888. ; 71:1, s. 32-40
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: European Union travelers' allowances for alcohol import to Denmark, Sweden, and Finland were abolished in 2004. In addition, excise taxes on alcohol were lowered in 2003 and 2005 in Denmark, and in 2004 in Finland. Using northern Sweden as a control site, this study examines whether levels of reported alcohol problems have changed in Denmark, Finland, and southern Sweden as a consequence of these policy changes. Method: Annual cross-sectional surveys were conducted in Denmark, Finland, and Sweden from 2003 to 2006. Five dependency items and seven extrinsic alcohol-related problems were examined. Changes were analyzed within each country/region with logistic regressions and tested for short- and long-term changes. Differential change was also tested between each country and the control site, northern Sweden. Results: Prevalence of alcohol problems decreased over the study period. Only in selected subgroups did problems increase. This mainly occurred in the samples for northern Sweden and Finland, and mostly among older age groups and men. In relation to the control site, however, no increases in problem prevalence were found. Conclusions: Our findings on a decline in reported alcohol problems largely agree with published reports on alcohol consumption over the same period in the study countries. They do not agree, however, with findings on changes in health and social statistics in Finland and Denmark, where some significant increases in alcohol-related harm have been found.
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18.
  • Brus, Ole, 1982-, et al. (författare)
  • Self-assessed remission rates after electroconvulsive therapy of depressive disorders
  • 2017
  • Ingår i: European Psychiatry. - : Cambridge University Press (CUP). - 0924-9338 .- 1778-3585. ; 45, s. 154-160
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Electroconvulsive therapy (ECT) effectively treats severe depression, but not all patients remit. The aim of the study was to identify clinical factors that associate with ECT-induced remission in a community setting. Methods Depressed patients who underwent ECT in 2011–2014 were identified from the Swedish National Quality Register for ECT. Remission was defined as self-rated Montgomery-Åsberg Depression Rating Scale scores of 0–10 after ECT. Other registers provided data on previous antidepressant use, comorbidities, and demographics. Results Of 1671 patients fulfilling the inclusion criteria, 42.8% achieved remission. Older age, education length over 9 years, psychotic symptoms, shorter duration of preceding antidepressant use, pulse width stimulus ≥ 0.50 ms, absence of substance use disorders, anxiety diagnosis, lamotrigine, and benzodiazepines, were associated with remission. Conclusions This study shows that psychotic subtype of depression and older age are clinically relevant predictors of a beneficial ECT effect. Additionally, ECT outcomes can be further improved by optimizing the treatment technique and concomitant medication. © 2017 The Author(s)
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19.
  • Brynolfsson, Patrik, et al. (författare)
  • Tensor-valued diffusion magnetic resonance imaging in a radiotherapy setting
  • 2022
  • Ingår i: Physics and imaging in radiation oncology. - : Elsevier BV. - 2405-6316. ; 24, s. 144-151
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and purposeDiagnostic information about cell density variations and microscopic tissue anisotropy can be gained from tensor-valued diffusion magnetic resonance imaging (MRI). These properties of tissue microstructure have the potential to become novel imaging biomarkers for radiotherapy response. However, tensor-valued diffusion encoding is more demanding than conventional encoding, and its compatibility with MR scanners that are dedicated to radiotherapy has not been established. Thus, our aim was to investigate the feasibility of tensor-valued diffusion MRI with radiotherapy dedicated MR equipment.Material and methodsA tensor-valued diffusion protocol was implemented, and five healthy volunteers were scanned with different resolutions using conventional head coil and radiotherapy coil setup with fixation masks. Signal-to-noise-ratio (SNR) was evaluated to assess the risk of signal bias due to rectified noise floor. We also evaluated the repeatability and reproducibility of the microstructure parameters. One patient with brain metastasis was scanned to investigate the image quality and the transferability of the setup to diseased tissue.ResultsA resolution of 3×3×3 mm3 provided images with SNR>3 for 93% of the voxels using radiotherapy coil setup. The parameter maps and repeatability characteristics were comparable to those observed with a conventional head coil. The patient evaluation demonstrated successful parameter analysis also in tumor tissue, with SNR>3 for 93% of the voxels.ConclusionWe demonstrate that tensor-valued diffusion MRI is compatible with radiotherapy fixation masks and coil setup for investigations of microstructure parameters. The reported reproducibility may be used to plan future investigations of imaging biomarkers in brain cancer radiotherapy.
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  • Calén, Hans, et al. (författare)
  • Measurement of η meson decays into lepton-antilepton pairs
  • 2007
  • Rapport (övrigt vetenskapligt/konstnärligt)abstract
    • A search for rare lepton decays of the η meson was performed using the WASA detector at CELSIUS. Two candidates for double Dalitz decay η→e+e−e+e− events are reported with a background of 1.3±0.2 events. This allows to set an upper limit to the branching ratio of 9.7×10−5 η(90% CL). The branching ratio for the decay η→e+e−γ is determined to (7.8±0.5stat ±0.8syst)×10−3 in agreement with world average value. An upper limit (90% CL) for the branching ratio for the η→e+e− decay is 2.7 × 10−5 and a limit for the sum of the η→μ+μ−μ+μ− and η→π+π−μ+μ− decays is 3.6 × 10−4.
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