| 1. |
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| 2. |
- Adlarson, Patrik, et al.
(author)
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Search for C violation in the decay eta -> pi(0)e(+)e(-) with WASA-at-COSY
- 2018
-
In: Physics Letters B. - : ELSEVIER SCIENCE BV. - 0370-2693 .- 1873-2445. ; 784, s. 378-384
-
Journal article (peer-reviewed)abstract
- We report on the search for the rare decay eta -> pi(0)e(+)e(-) which is of interest to study C violation in the electromagnetic interaction which would indicate contributions from physics beyond the Standard Model, since the allowed decay via a two-photon intermediate state is strongly suppressed. The experiment has been performed using the WASA-at-COSY installation, located at the COSY accelerator of the Forschungszentrum Julich, Germany. In total 3 x 10(7) events of the reaction pd -> He-3 eta have been recorded at an excess energy of Q = 59.8MeV. Based on this data set the C parity violating decay eta -> pi(0)gamma* -> pi(0)e(+)e(-) via a single-photon intermediate state has been searched for, resulting in new upper limits of Gamma(eta -> pi(0)e(+) e(-))/Gamma(eta -> pi(+) pi(-) pi(0)) < 3.28 x 10(-5) and Gamma(eta -> pi(0)e(+) e(-))/Gamma(eta -> all)< 7.5 x 10(-6) (CL=90%), respectively.
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| 3. |
- Eversmann, D., et al.
(author)
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New Method for a Continuous Determination of the Spin Tune in Storage Rings and Implications for Precision Experiments
- 2015
-
In: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 115:9
-
Journal article (peer-reviewed)abstract
- A new method to determine the spin tune is described and tested. In an ideal planar magnetic ring, the spin tune-defined as the number of spin precessions per turn-is given by nu(s) = gamma G (gamma is the Lorentz factor, G the gyromagnetic anomaly). At 970 MeV/c, the deuteron spins coherently process at a frequency of approximate to 120 kHz in the Cooler Synchrotron COSY. The spin tune is deduced from the up-down asymmetry of deuteron-carbon scattering. In a time interval of 2.6 s, the spin tune was determined with a precision of the order 10(-8), and to 1 x 10(-10) for a continuous 100 s accelerator cycle. This renders the presented method a new precision tool for accelerator physics; controlling the spin motion of particles to high precision is mandatory, in particular, for the measurement of electric dipole moments of charged particles in a storage ring.
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| 4. |
- Guidoboni, G., et al.
(author)
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How to Reach a Thousand-Second in-Plane Polarization Lifetime with 0.97-GeV/c Deuterons in a Storage Ring
- 2016
-
In: Physical Review Letters. - : American Physical Society. - 0031-9007 .- 1079-7114. ; 117:5
-
Journal article (peer-reviewed)abstract
- We observe a deuteron beam polarization lifetime near 1000 s in the horizontal plane of a magnetic storage ring (COSY). This long spin coherence time is maintained through a combination of beam bunching, electron cooling, sextupole field corrections, and the suppression of collective effects through beam current limits. This record lifetime is required for a storage ring search for an intrinsic electric dipole moment on the deuteron at a statistical sensitivity level approaching 10(-29) e cm.
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| 5. |
- Adlarson, Patrik, et al.
(author)
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ABC effect and resonance structure in the double-pionic fusion to He-3
- 2015
-
In: Physical Review C. Nuclear Physics. - 0556-2813 .- 1089-490X. ; 91:1, s. 015201-
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Journal article (peer-reviewed)abstract
- Exclusive and kinematically complete measurements of the double pionic fusion to He-3 have been performed in the energy region of the so-called ABC effect, which denotes a pronounced low-mass enhancement in the pi pi-invariant mass spectrum. The experiments were carried out with the WASA detector setup at COSY (the cooler synchrotron at Forschungszentrum Julich). Similar to the observations in the basic pn -> d pi(0)pi(0) reaction and in the dd -> He-4 pi(0)pi(0) reaction, the data reveal a correlation between the ABC effect and a resonance-like energy dependence in the total cross section. Differential cross sections are well described by the hypothesis of d* resonance formation during the reaction process in addition to the conventional t-channel Delta Delta mechanism. The deduced d* resonance width can be understood from collision broadening due to Fermi motion of the nucleons in initial and final nuclei.
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| 6. |
- Adlarson, Patrik, et al.
(author)
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Measurement of the (n)over-right-arrowp -> d pi(0) pi(0) reaction with polarized beam in the region of the d(*)(2380) resonance
- 2016
-
In: European Physical Journal A. - : Springer Science and Business Media LLC. - 1434-6001 .- 1434-601X. ; 52:5, s. 1-7
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Journal article (peer-reviewed)abstract
- We report on a high-statistics measurement of the most basic double-pionic fusion reaction over the energy region of the d (*)(2380) resonance by use of a polarized deuteron beam and observing the double fusion reaction in the quasifree scattering mode. The measurements were performed with the WASA detector setup at COSY. The data reveal substantial analyzing powers and confirm conclusions about the d(*) resonance obtained from unpolarized measurements. We also confirm the previous unpolarized data obtained under complementary kinematic conditions.
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| 7. |
- Adlarson, Patrik, et al.
(author)
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Measurements of branching ratios for eta decays into charged particles
- 2016
-
In: PHYSICAL REVIEW C. - 2469-9985. ; 94:6
-
Journal article (peer-reviewed)abstract
- The WASA-at-COSY experiment has collected 3 x 10(7) events with eta mesons produced via the reaction pd -> He-3 eta at T = 1.0 GeV. Using this data set, we evaluate the branching ratios of the decays eta -> pi(+)pi(-)gamma, eta -> e(+)e(-)gamma, eta -> pi(+)pi(-)e(+)e(-), and eta -> e(+)e(-)e(+)e(-). The branching ratios are normalized to the eta -> pi(+)pi(-) pi(0) decay. In addition an upper limit on a CP-violating asymmetry in eta -> pi(+)pi(-)e(+)e(-) is extracted.
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| 8. |
- Adlarsona, Patrik, et al.
(author)
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Measurement of the np -> np pi(0)pi(0) reaction in search for the recently observed d* (2380) resonance
- 2015
-
In: Physics Letters B. - : Elsevier BV. - 0370-2693 .- 1873-2445. ; 743, s. 325-332
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Journal article (peer-reviewed)abstract
- Exclusive measurements of the quasi-free np --> np pi(0)pi(0) reaction have been performed by means of dp collisions at T-d = 2.27 GeV using the WASA detector setup at COSY. Total and differential cross sections have been obtained covering the energy region root s = (2.35-2.46) GeV, which includes the region of the ABC effect and its associated d* (2380) resonance. Adding the d* resonance amplitude to that for the conventional processes leads to a reasonable description of the data. The observed resonance effect in the total cross section is in agreement with the predictions of Faldt and Wilkin as well with those of Albadajedo and Oset. The ABC effect, i.e. the low-mass enhancement in the pi(0)pi(0)-invariant mass spectrum, is found to be very modest - if present at all, which might pose a problem to some of its interpretations.
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| 9. |
- Adlarson, Patrik, et al.
(author)
-
Isoscalar single-pion production in the region of Roper and d*(2380) resonances
- 2017
-
In: Physics Letters B. - : ELSEVIER SCIENCE BV. - 0370-2693 .- 1873-2445. ; 774, s. 599-607
-
Journal article (peer-reviewed)abstract
- Exclusive measurements of the quasi-free pn -> pp pi(-) and pp -> pp pi(0) reactions have been performed by means of pd collisions at T-p= 1.2 GeV using the WASA detector setup at COSY. Total and differential cross sections have been obtained covering the energy region T-p= 0.95-1.3 GeV (root s = 2.3-2.46 GeV), which includes the regions of triangle(1232), N*(1440) and d*(2380) resonance excitations. From these measurements the isoscalar single-pion production has been extracted, for which data existed so far only below T-p = 1 GeV. We observe a substantial increase of this cross section around 1 GeV, which can be related to the Roper resonance N*(1440), the strength of which shows up isolated from the triangle resonance in the isoscalar (N pi)(I=0) invariant-mass spectrum. No evidence for a decay of the dibaryon resonance d*(2380) into the isoscalar (NN pi)(I=0) channel is found. An upper limit of 180 mu b (90% CL.) corresponding to a branching ratio of 9% has been deduced.
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| 10. |
- Adlarson, Patrik, et al.
(author)
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Measurement of the ω → π+π−π0 Dalitz plot distribution : The WASA-at-COSY Collaboration
- 2017
-
In: Physics Letters B. - : Elsevier BV. - 0370-2693 .- 1873-2445. ; 770, s. 418-425
-
Journal article (peer-reviewed)abstract
- Using the production reactions pd -> He-3 omega and pp -> pp omega, the Dalitz plot distribution for the omega -> pi(+)pi(-)pi(0)decay is studied with the WASA detector at COSY, based on a combined data sample of (4.408 +/- 0.042) x 10(4) events. The Dalitz plot density is parametrised by a product of the P-wave phase space and a polynomial expansion in the normalised polar Dalitz plot variables Z and phi. For the first time, a deviation from pure P-wave phase space is observed with a significance of 4.1 sigma. The deviation is parametrised by a linear term 1+2 alpha Z, with alpha determined to be +0.147 +/- 0.036, consistent with the expectations of rho-meson-type final-state interactions of the P-wave pion pairs. (C) 2017 The Author. Published by Elsevier B.V.
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| 11. |
- Adlarson, Patrik, et al.
(author)
-
Search for an isospin I=3 dibaryon
- 2016
-
In: Physics Letters B. - : ELSEVIER SCIENCE BV. - 0370-2693 .- 1873-2445. ; 762, s. 455-461
-
Journal article (peer-reviewed)abstract
- Various theoretical calculations based on QCD or hadronic interactions predict that in addition to the recently observed dibaryon resonance d*(2380) with I(J(P)) = 3(0(+)) there should also exist a dibaryon resonance with mirrored quantum numbers I(J(P)) = 3(0(+)). We report here on a search for such a NN-decoupled state in data on the pp -> pp pi(+) pi(+) pi(-) pi(-) reaction. Since no clear-cut evidence has been found, we give upper limits for the production cross section of such a resonance in the mass range 2280-2500 MeV.
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| 12. |
- Adlarson, Patrik, et al.
(author)
-
Search for eta-mesic He-4 in the dd -> (3)Hen pi(0) and dd -> (3)Hep pi(-) reactions with the WASA-at-COSY facility
- 2017
-
In: Nuclear Physics A. - : ELSEVIER SCIENCE BV. - 0375-9474 .- 1873-1554. ; 959, s. 102-115
-
Journal article (peer-reviewed)abstract
- The search for He-4-eta bound states was performed with the WASA-at-COSY facility via the measurement of the excitation function for the dd -> (3)Hen pi(0) and dd -> (3)Hep pi(-) processes. The deuteron beam momentum was varied continuously between 2.127 GeV/c and 2.422 GeV/c, corresponding to the excess energy for the dd -> He-4 eta reaction ranging from Q = 70 MeV to Q = 30 MeV. The luminosity was determined based on the dd -> (3)Hen reaction and the quasi-free proton proton scattering via dd -> ppn(spectator)n(spectator) reactions. The excitation functions, determined independently for the measured reactions, do not reveal a structure which could be interpreted as a narrow mesic nucleus. Therefore, the upper limits of the total cross sections for the bound state production and decay in dd -> (4He-eta)(bound) -> (3)Hen pi(0) and dd -> (He-4-eta)(bound) -> (3)Hep pi(-) processes were determined taking into account the isospin relation between the both of the considered channels. The results of the analysis depend on the assumptions of the N* (1535) momentum distribution in the anticipated mesic-He-4. Assuming, as in the previous works, that this is identical with the distribution of nucleons bound with 20 MeV in He-4, we determined that (for the mesic bound state width in the range from 5 MeV to 50 MeV) the upper limits at 90% confidence level are about 3 nb and about 6 nb for n pi(0) and p pi(-) channels, respectively. However, based on the recent theoretical findings of the N*(1535) momentum distribution in the N*-He-3 nucleus bound by 3.6 MeV, we find that the WASA-at-COSY detector acceptance decreases and hence the corresponding upper limits are 5 nb and 10 nb for n pi(0) and p pi(-) channels respectively. (C) 2017 Elsevier B.V. All rights reserved.
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| 13. |
- Adlarson, Patrik, et al.
(author)
-
Backward single-pion production in the pd -> He-3 pi(0)reaction with WASA-at-COSY
- 2018
-
In: European Physical Journal A. - : SPRINGER. - 1434-6001 .- 1434-601X. ; 54:9
-
Journal article (peer-reviewed)abstract
- New data on the production of single neutral pions in the pd -> He-3 pi(0) reaction are presented. For fifteen proton beam momenta between p(p) = 1.60GeV/c and p(p) = 1.74 GeV/c, differential cross sections are determined over a large fraction of the backward hemisphere. Since the only previous systematic measurements of single-pion production at these energies were made in collinear kinematics, the present work constitutes a significant extension of the current knowledge on this reaction. Even this far above the production threshold, significant changes are found in the behaviour of the angular distributions over small intervals in beam momentum.
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| 14. |
- Adlarson, Patrik, et al.
(author)
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Examination of the production of an isotensor dibaryon in the pp -> pp pi(+)pi(-) reaction
- 2019
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In: Physical Review C. - : AMER PHYSICAL SOC. - 2469-9985 .- 2469-9993. ; 99:2
-
Journal article (peer-reviewed)abstract
- The quasifree pp -> pp pi(+)pi(-) reaction has been measured by means of pd collisions at T-p = 1.2 GeV using the WASA detector setup at COSY enabling exclusive and kinematically complete measurements. Total and differential cross sections have been extracted for the energy region T-p = 1.08-1.36 GeV (root s = 2.35-2.46 GeV) covering thus the regions of N* (1440 ) and Delta(1232)Delta(1232) resonance excitations. Calculations describing these excitations by t-channel meson exchange as well as isospin relations based on the pp -> pp pi(0)pi(0) data underpredict substantially the measured total cross section. The calculations are also at variance with specific experimental differential cross sections. An isotensor Delta N dibaryon resonance with I(J(P)) = 2(1(+) ) produced associatedly with a pion is able to overcome these deficiencies. Such a dibaryon was predicted by Dyson and Xuong [Phys. Rev. Lett. 13, 815 (1964)] and more recently calculated by A. Gal and H. Garcilazo [Nucl. Phys. A 928, 73 (2014)].
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| 15. |
- Adlarson, Patrik, et al.
(author)
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Importance of d-wave contributions in the charge symmetry breaking reaction dd -> He-4 pi(0)
- 2018
-
In: Physics Letters B. - : ELSEVIER SCIENCE BV. - 0370-2693 .- 1873-2445. ; 781, s. 645-650
-
Journal article (peer-reviewed)abstract
- This letter reports a first quantitative analysis of the contribution of higher partial waves in the charge symmetry breaking reaction dd -> He-4 pi(0) using the WASA-at-COSY detector setup at an excess energy of Q = 60 MeV. The determined differential cross section can be parametrized as d sigma/d Omega = a + b cos(2) theta*, where theta* is the production angle of the pion in the center-of-mass coordinate system, and the results for the parameters are a = (1.55 +/- 0.46(stat)(-0.8)(+0.32)(syst)) pb/sr and b = (13.1 +/- 2.1(stat)(-2.7)(+1.0)(syst)) pb/sr. The data are compatible with vanishing p-waves and a sizable d-wave contribution. This finding should strongly constrain the contribution of the A isobar to the dd -> He-4 pi(0) reaction and is, therefore, crucial for a quantitative understanding of quark mass effects in nuclear production reactions.
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| 16. |
- Adlarson, Patrik, et al.
(author)
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Isotensor Dibaryon in the pp -> pp pi(+)pi(-) Reaction?
- 2018
-
In: Physical Review Letters. - : AMER PHYSICAL SOC. - 0031-9007 .- 1079-7114. ; 121:5
-
Journal article (peer-reviewed)abstract
- Exclusive measurements of the quasifree pp -> pp pi(+)pi(-) reaction have been carried out at WASA@ COSY by means of pd collisions at T-p = 1.2 GeV. Total and differential cross sections have been extracted covering the energy region T-p = 1.08-1.36 GeV, which is the region of N* (1440) and Delta(123)Delta(1232) resonance excitations. Calculations describing these excitations by t-channel meson exchange are at variance with the measured differential cross sections and underpredict substantially the experimental total cross section. An isotensor Delta N dibaryon resonance with I(J(P)) = 2(1(+)) produced associatedly with a pion is able to overcome these deficiencies.
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| 17. |
- Adlarson, Patrik, et al.
(author)
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Spin Dependence of eta Meson Production in Proton-Proton Collisions Close to Threshold
- 2018
-
In: Physical Review Letters. - 0031-9007 .- 1079-7114. ; 120:2
-
Journal article (peer-reviewed)abstract
- Taking advantage of the high acceptance and axial symmetry of the WASA-at-COSY detector, and the high polarization degree of the proton beam of COSY, the reaction →pp→ppη has been measured close to threshold to explore the analyzing power Ay. The angular distribution of Ay is determined with the precision improved by more than 1 order of magnitude with respect to previous results, allowing a first accurate comparison with theoretical predictions. The determined analyzing power is consistent with zero for an excess energy of Q=15 MeV, signaling s-wave production with no evidence for higher partial waves. At Q=72 MeV the data reveal strong interference of Ps and Pp partial waves and cancellation of (Pp)2 and Ss∗Sd contributions. These results rule out the presently available theoretical predictions for the production mechanism of the η meson.
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| 18. |
- Adlarson, Patrik, et al.
(author)
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Total and differential cross sections of η-production in proton–deuteron fusion for excess energies between Qη = 13 MeV and Qη = 81 MeV
- 2018
-
In: Physics Letters B. - : Elsevier BV. - 0370-2693 .- 1873-2445. ; 782, s. 297-304
-
Journal article (peer-reviewed)abstract
- New data on both total and differential cross sections of the production of eta mesons in proton-deuteron fusion to He-3 eta in the excess energy region 13.6 MeV <= Q(eta) <= 80.9 MeV are presented. These data have been obtained with the WASA-at-COSY detector setup located at the Forschungszentrum Julich, using a proton beam at 15 different beam momenta between p(p) = 1.60 GeV/c and p(p) = 1.74 GeV/c. While significant structure of the total cross section is observed in the energy region 20 MeV less than or similar to Q(eta) less than or similar to 60 MeV, a previously reported sharp variation around Q(eta) approximate to 50 MeV cannot be confirmed. Angular distributions show the typical forward- peaking that was noted earlier. For the first time, it is possible to study the development of these angular distributions with rising excess energy over a wide interval.
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| 19. |
- Goossens, K. V. Y., et al.
(author)
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Molecular Mechanism of Flocculation Self-Recognition in Yeast and Its Role in Mating and Survival
- 2015
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In: mBio. - 2150-7511 .- 2161-2129. ; 6:2, s. 1-16
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Journal article (peer-reviewed)abstract
- We studied the flocculation mechanism at the molecular level by determining the atomic structures of N-Flo1p and N-Lg-Flo1p in complex with their ligands. We show that they have similar ligand binding mechanisms but distinct carbohydrate specificities and affinities, which are determined by the compactness of the binding site. We characterized the glycans of Flo1p and their role in this binding process and demonstrate that glycan-glycan interactions significantly contribute to the cell-cell adhesion mechanism. Therefore, the extended flocculation mechanism is based on the self-interaction of Flo proteins and this interaction is established in two stages, involving both glycan-glycan and protein-glycan interactions. The crucial role of calcium in both types of interaction was demonstrated: Ca-2(+) takes part in the binding of the carbohydrate to the protein, and the glycans aggregate only in the presence of Ca-2(+). These results unify the generally accepted lectin hypothesis with the historically first-proposed "Ca-2(+)-bridge" hypothesis. Additionally, a new role of cell flocculation is demonstrated; i.e., flocculation is linked to cell conjugation and mating, and survival chances consequently increase significantly by spore formation and by introduction of genetic variability. The role of Flo1p in mating was demonstrated by showing that mating efficiency is increased when cells flocculate and by differential transcriptome analysis of flocculating versus nonflocculating cells in a low-shear environment (microgravity). The results show that a multicellular clump (floc) provides a uniquely organized multicellular ultrastructure that provides a suitable microenvironment to induce and perform cell conjugation and mating. IMPORTANCE Yeast cells can form multicellular clumps under adverse growth conditions that protect cells from harsh environmental stresses. The floc formation is based on the self-interaction of Flo proteins via an N-terminal PA14 lectin domain. We have focused on the flocculation mechanism and its role. We found that carbohydrate specificity and affinity are determined by the accessibility of the binding site of the Flo proteins where the external loops in the ligand-binding domains are involved in glycan recognition specificity. We demonstrated that, in addition to the Flo lectin-glycan interaction, glycan-glycan interactions also contribute significantly to cell-cell recognition and interaction. Additionally, we show that flocculation provides a uniquely organized multicellular ultrastructure that is suitable to induce and accomplish cell mating. Therefore, flocculation is an important mechanism to enhance long-term yeast survival.
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| 20. |
- Hempelmann, N., et al.
(author)
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Locking the Spin Precession in a Storage Ring
- 2017
-
In: Physical Review Letters. - : American Physical Society. - 0031-9007 .- 1079-7114. ; 119:1
-
Journal article (peer-reviewed)abstract
- This Letter reports the successful use of feedback from a spin polarization measurement to the revolution frequency of a 0.97 GeV= c bunched and polarized deuteron beam in the Cooler Synchrotron (COSY) storage ring in order to control both the precession rate (approximate to 121 kHz) and the phase of the horizontal polarization component. Real time synchronization with a radio frequency (rf) solenoid made possible the rotation of the polarization out of the horizontal plane, yielding a demonstration of the feedback method to manipulate the polarization. In particular, the rotation rate shows a sinusoidal function of the horizontal polarization phase (relative to the rf solenoid), which was controlled to within a 1 standard deviation range of sigma= 0.21 rad. The minimum possible adjustment was 3.7 mHz out of a revolution frequency of 753 kHz, which changes the precession rate by 26 mrad/s. Such a capability meets a requirement for the use of storage rings to look for an intrinsic electric dipole moment of charged particles.
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| 21. |
- Hempelmann, N., et al.
(author)
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Phase measurement for driven spin oscillations in a storage ring
- 2018
-
In: Physical Review Accelerators and Beams. - : American Physical Society. - 2469-9888. ; 21:4
-
Journal article (peer-reviewed)abstract
- This paper reports the first simultaneous measurement of the horizontal and vertical components of the polarization vector in a storage ring under the influence of a radio frequency (rf) solenoid. The experiments were performed at the Cooler Synchrotron COSY in Julich using a vector polarized, bunched 0.97 GeV/c deuteron beam. Using the new spin feedback system, we set the initial phase difference between the solenoid field and the precession of the polarization vector to a predefined value. The feedback system was then switched off, allowing the phase difference to change over time, and the solenoid was switched on to rotate the polarization vector. We observed an oscillation of the vertical polarization component and the phase difference. The oscillations can be described using an analytical model. The results of this experiment also apply to other rf devices with horizontal magnetic fields, such as Wien filters. The precise manipulation of particle spins in storage rings is a prerequisite for measuring the electric dipole moment (EDM) of charged particles.
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| 22. |
- Saleev, A., et al.
(author)
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Spin tune mapping as a novel tool to probe the spin dynamics in storage rings
- 2017
-
In: Physical Review Accelerators and Beams. - : American Physical Society. - 2469-9888. ; 20:7
-
Journal article (peer-reviewed)abstract
- Precision experiments, such as the search for electric dipole moments of charged particles using storage rings, demand for an understanding of the spin dynamics with unprecedented accuracy. The ultimate aim is to measure the electric dipole moments with a sensitivity up to 15 orders in magnitude better than the magnetic dipole moment of the stored particles. This formidable task requires an understanding of the background to the signal of the electric dipole from rotations of the spins in the spurious magnetic fields of a storage ring. One of the observables, especially sensitive to the imperfection magnetic fields in the ring is the angular orientation of stable spin axis. Up to now, the stable spin axis has never been determined experimentally, and in addition, the JEDI collaboration for the first time succeeded to quantify the background signals that stem from false rotations of the magnetic dipole moments in the horizontal and longitudinal imperfection magnetic fields of the storage ring. To this end, we developed a new method based on the spin tune response of a machine to artificially applied longitudinal magnetic fields. This novel technique, called spin tune mapping, emerges as a very powerful tool to probe the spin dynamics in storage rings. The technique was experimentally tested in 2014 using polarized deuterons stored in the cooler synchrotron COSY, and for the first time, the angular orientation of the stable spin axis at two different locations in the ring has been determined to an unprecedented accuracy of better than 2.8 mu rad.
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| 23. |
- Ademuyiwa, Adesoji O., et al.
(author)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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In: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Journal article (peer-reviewed)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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