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The sensitivity of direct searches for heavy neutral leptons (HNLs) in accelerator-based experiments depends strongly on the particles properties. Commonly used benchmark scenarios are important to ensure comparability and consistency between experimental searches, re-interpretations, and sensitivity studies for different facilities. In models where the HNLs are primarily produced and decay through the weak interaction, benchmarks are in particular defined by fixing the relative strengths of their mixing with SM neutrinos of different flavours, and the interpretation of experimental data is known to strongly depend on those ratios. The commonly used benchmarks in which a single HNL flavour exclusively interacts with one Standard Model generation do not reflect what is found in realistic neutrino mass models. We identify two additional benchmarks for accelerator-based direct HNL searches, which we primarily select based on the requirement to provide a better approximation for the phenomenology of realistic neutrino mass models in view of present and future neutrino oscillation data.

Particle physics today faces the challenge of explaining the mystery of dark matter, the origin of matter over anti-matter in the Universe, the origin of the neutrino masses, the apparent fine-tuning of the electro-weak scale, and many other aspects of fundamental physics. Perhaps the most striking frontier to emerge in the search for answers involves new physics at mass scales comparable to familiar matter, below the GeV-scale, or even radically below, down to sub-eV scales, and with very feeble interaction strength. New theoretical ideas to address dark matter and other fundamental questions predict such feebly interacting particles (FIPs) at these scales, and indeed, existing data provide numerous hints for such possibility. A vibrant experimental program to discover such physics is under way, guided by a systematic theoretical approach firmly grounded on the underlying principles of the Standard Model. This document represents the report of the FIPs 2022 workshop, held at CERN between the 17 and 21 October 2022 and aims to give an overview of these efforts, their motivations, and the decadal goals that animate the community involved in the search for FIPs.

With the establishment and maturation of the experimental programs searching for new physics with sizeable couplings at the LHC, there is an increasing interest in the broader particle and astrophysics community for exploring the physics of light and feebly-interacting particles as a paradigm complementary to a New Physics sector at the TeV scale and beyond. FIPs 2020 has been the first workshop fully dedicated to the physics of feebly-interacting particles and was held virtually from 31 August to 4 September 2020. The workshop has gathered together experts from collider, beam dump, fixed target experiments, as well as from astrophysics, axions/ALPs searches, current/future neutrino experiments, and dark matter direct detection communities to discuss progress in experimental searches and underlying theory models for FIPs physics, and to enhance the cross-fertilisation across different fields. FIPs 2020 has been complemented by the topical workshop “Physics Beyond Colliders meets theory”, held at CERN from 7 June to 9 June 2020. This document presents the summary of the talks presented at the workshops and the outcome of the subsequent discussions held immediately after. It aims to provide a clear picture of this blooming field and proposes a few recommendations for the next round of experimental results.

A bstract We consider a type-I seesaw framework endowed with a flavour symmetry, belonging to the series of non-abelian groups ∆(3 n 2 ) and ∆(6 n 2 ), and a CP symmetry. Breaking these symmetries in a non-trivial way results in the right-handed neutrinos being degenerate in mass up to possible (further symmetry-breaking) splittings κ and λ , while the neutrino Yukawa coupling matrix encodes the entire flavour structure in the neutrino sector. For a fixed combination of flavour and CP symmetry and residual groups, this matrix contains five real free parameters. Four of them are determined by the light neutrino mass spectrum and by accommodating experimental data on lepton mixing well, while the angle θ R is related to right-handed neutrinos. We scrutinise for all four lepton mixing patterns, grouped into Case 1) through Case 3 b.1), the potential to generate the baryon asymmetry of the Universe through low-scale leptogenesis numerically and analytically. The main results are: a ) the possible correlation of the baryon asymmetry and the Majorana phases, encoded in the Pontecorvo-Maki-Nakagawa-Sakata mixing matrix, in certain instances; b ) the possibility to generate the correct amount of baryon asymmetry for vanishing splittings κ and λ among the right-handed neutrinos as well as for large κ , depending on the case and the specific choice of group theory parameters; c ) the chance to produce sufficient baryon asymmetry for large active-sterile mixing angles, enabling direct experimental tests at current and future facilities, if θ R is close to a special value, potentially protected by an enhanced residual symmetry. We elucidate these results with representative examples of flavour and CP symmetries, which all lead to a good agreement with the measured values of the lepton mixing angles and, possibly, the current indication of the CP phase δ . We identify the CP-violating combinations relevant for low-scale leptogenesis, and show that the parametric dependence of the baryon asymmetry found in the numerical study can be understood well with their help.

Variability in patients' postoperative pain experience and response to treatment challenges effective pain management. Variability in pain reflects individual differences in inhibitory pain modulation and psychological sensitivity, which in turn may be clinically relevant for the disposition to acquire pain. The aim of this study was to investigate the effects of conditioned pain modulation and situational pain catastrophizing on postoperative pain and pain persistency. Preoperatively, 42 healthy males undergoing funnel chest surgery completed the Spielberger's State-Trait Anxiety Inventory and Beck's Depression Inventory before undergoing a sequential conditioned pain modulation paradigm. Subsequently, the Pain Catastrophizing Scale was introduced and patients were instructed to reference the conditioning pain while answering. Ratings of movement-evoked pain and consumption of morphine equivalents were obtained during postoperative days 2-5. Pain was reevaluated at six months postoperatively. Patients reporting persistent pain at six months follow-up (n = 15) were not significantly different from pain-free patients (n = 16) concerning preoperative conditioned pain modulation response (Z = 1.0, P = 0.3) or level of catastrophizing (Z = 0.4, P = 1.0). In the acute postoperative phase, situational pain catastrophizing predicted movement-evoked pain, independently of anxiety and depression (β = 1.0, P = 0.007) whereas conditioned pain modulation predicted morphine consumption (β = -0.005, P = 0.001). Preoperative conditioned pain modulation and situational pain catastrophizing were not associated with the development of persistent postoperative pain following funnel chest repair. Secondary outcome analyses indicated that conditioned pain modulation predicted morphine consumption and situational pain catastrophizing predicted movement-evoked pain intensity in the acute postoperative phase. These findings may have important implications for developing strategies to treat or prevent acute postoperative pain in selected patients. Pain may be predicted and the malfunctioning pain inhibition mechanism as tested with CPM may be treated with suitable drugs augmenting descending inhibition.

A major problem in pain medicine is the lack of knowledge about which treatment suits a specific patient. We tested the ability of quantitative sensory testing to predict the analgesic effect of pregabalin and placebo in patients with chronic pancreatitis. Sixty-four patients with painful chronic pancreatitis received pregabalin (150-300 mg BID) or matching placebo for three consecutive weeks. Analgesic effect was documented in a pain diary based on a visual analogue scale. Responders were defined as patients with a reduction in clinical pain score of 30% or more after three weeks of study treatment compared to baseline recordings. Prior to study medication, pain thresholds to electric skin and pressure stimulation were measured in dermatomes T10 (pancreatic area) and C5 (control area). To eliminate inter-subject differences in absolute pain thresholds an index of sensitivity between stimulation areas was determined (ratio of pain detection thresholds in pancreatic versus control area, ePDT ratio). Pain modulation was recorded by a conditioned pain modulation paradigm. A support vector machine was used to screen sensory parameters for their predictive power of pregabalin efficacy. The pregabalin responders group was hypersensitive to electric tetanic stimulation of the pancreatic area (ePDT ratio 1.2 (0.9-1.3)) compared to non-responders group (ePDT ratio: 1.6 (1.5-2.0)) (P = 0.001). The electrical pain detection ratio was predictive for pregabalin effect with a classification accuracy of 83.9% (P = 0.007). The corresponding sensitivity was 87.5% and specificity was 80.0%. No other parameters were predictive of pregabalin or placebo efficacy. The present study provides first evidence that quantitative sensory testing predicts the analgesic effect of pregabalin in patients with painful chronic pancreatitis. The method can be used to tailor pain medication based on patient's individual sensory profile and thus comprises a significant step towards personalized pain medicine.

Background Visual impairment frequently occurs amongst older people. Therefore, the aim of this study was to investigate the predictive value of visual impairment on functioning, quality of life and mortality in people aged 85 years. Methods From the Leiden 85-plus Study, 548 people aged 85 years were eligible for this study. Visual acuity was measured at baseline by Early Treatment Diabetic Retinopathy Study charts (ETDRS). According to the visual acuity (VA) three groups were made, defined as no (VA > 0.7), moderate (0.5 ≤ VA ≤ 0.7) or severe visual impairment (VA < 0.5). Quality of life, physical, cognitive, psychological and social functioning were measured annually for 5 years. For mortality, participants were followed until the age of 95. Results At baseline, participants with visual impairment scored lower on physical, cognitive, psychological and social functioning and quality of life ( p  < 0.001). Compared to participants with no visual impairment, participants with moderate and severe visual impairment had an accelerated deterioration in basic activities of daily living (respectively 0.27-point ( p  = 0.017) and 0.35 point ( p  = 0.018)). In addition, compared to participants with no visual impairment, the mortality risk was 1.83 (95% CI 1.43, 2.35) for participants with severe visual impairment. Discussion In very older adults, visual impairment predicts accelerated deterioration in physical functioning. In addition, severely visually impaired adults had an increased mortality risk. A pro-active attitude, focussing on preventing and treating visual impairment could possibly contribute to the improvement of physical independence, wellbeing and successful aging in very old age.

Chronic inflammation is associated with diabetes and contributes to the development and progression of micro- and macrovascular complications. Transcutaneous vagus nerve stimulation (tVNS) has been proposed to reduce levels of circulating inflammatory cytokines in non-diabetics by activating the cholinergic anti-inflammatory pathway. We investigated the anti-inflammatory potential of tVNS as a secondary endpoint of a randomized controlled trial in people with diabetes (NCT04143269). 131 people with diabetes (type 1: n = 63; type 2: n = 68), gastrointestinal symptoms and various degrees of autonomic neuropathy were included and randomly assigned to self-administer active (n = 63) or sham (n = 68) tVNS over two successive study periods: (1) Seven days with four daily administrations and, (2) 56 days with two daily administrations. Levels of systemic inflammatory cytokines (IL-6, IL-8, IL-10, TNF-α, IFN-γ) were quantified from blood samples by multiplex technology. Information regarding age, sex, diabetes type, and the presence of cardiac autonomic neuropathy (CAN) was included in the analysis as possible confounders. No differences in either cytokine were seen after study period 1 and 2 between active and sham tVNS (all p-values > 0.08). Age, sex, diabetes type, presence of CAN, and baseline levels of inflammatory cytokines were not associated with changes after treatment (all p-values > 0.07). A tendency towards slight reductions in TNF-α levels after active treatment was observed in those with no CAN compared to those with early or manifest CAN (p = 0.052). In conclusion, tVNS did not influence the level of systemic inflammation in people with diabetes.

A bstract Heavy neutrinos with masses in the MeV range can in principle simultaneously explain the light neutrino masses and the origin of baryonic matter in the universe. The strongest constraints on their properties come from their potential impact on the formation of light elements in the early universe. Since these constraints rely on assumptions about the cosmic history, independent checks in the laboratory are highly desirable. In this paper, we discuss the opportunity to search for heavy neutrinos within the MeV mass range in short and medium baseline reactor neutrino experiments, using the SoLid, JUNO and TAO experiments as examples. These experiments can give the currently strongest upper bound on the mixing between the light electron neutrinos and the heavy neutrino in the 2–9 MeV mass range.

Intense abdominal pain is the dominant feature of chronic pancreatitis. During the disease changes in central pain processing, e.g. central sensitization manifest as spreading hyperalgesia, can result from ongoing nociceptive input. The aim of the present study is to evaluate the effect of pregabalin on pain processing in chronic pancreatitis as assessed by quantitative sensory testing (QST). This randomized, double-blind, placebo-controlled trial evaluated effects of pregabalin on pain processing. QST was used to quantify pain processing by measuring thresholds to painful electrical and pressure stimulation in six body dermatomes. Descending endogenous pain modulation was quantified using the conditioned pain modulation (CPM) paradigm to elicit a DNIC (diffuse noxious inhibitory controls) response. The main effect parameter was the change in the sum of all body pain threshold values after three weeks of study treatment versus baseline values between both treatment groups. 64 patients were analyzed. No differences in change in sum of pain thresholds were present for pregabalin vs. placebo after three weeks of treatment. For individual dermatomes, change vs. baseline pain thresholds was significantly greater in pregabalin vs. placebo patients for electric pain detection threshold in C5 (P = 0.005), electric pain tolerance threshold in C5 (P = 0.04) and L1 (P = 0.05), and pressure pain tolerance threshold in T4 (P = 0.004). No differences were observed between pregabalin and placebo regarding conditioned pain modulation. Our study provides first evidence that pregabalin has moderate inhibitory effects on central sensitization manifest as spreading hyperalgesia in chronic pancreatitis patients. These findings suggest that QST can be of clinical use for monitoring pain treatments in the context of chronic pain. ClinicalTrials.gov NCT00755573.