59 research outputs found
Impact of unstable housing on all-cause mortality among persons who inject drugs
BACKGROUND: Illicit drug injecting is a well-established risk factor for morbidity and mortality. However, a limited number of prospective studies have examined the independent effect of unstable housing on mortality among persons who inject drugs (PWIDs). In this study we sought to identify if a relationship exists between unstable housing and all-cause mortality among PWIDs living in Vancouver, Canada. METHODS: PWIDs participating in two prospective cohort studies in Vancouver, Canada were followed between May 1996 and December 2012. Cohort data were linked to the provincial vital statistics database to ascertain mortality rates and causes of death. We used multivariate Cox proportional hazards regression to determine factors associated with all-cause mortality and to investigate the independent relationship between unstable housing and time to all-cause mortality. RESULTS: During the study period, 2453 individuals were followed for a median of 69 months (Inter-quartile range [IQR]: 34 – 113). In total, there were 515 (21.0%) deaths for an incidence density of 3.1 (95% Confidence Interval [CI]: 2.8 – 3.4) deaths per 100 person years. In multivariate analyses, after adjusting for potential confounders including HIV infection and drug use patterns, unstable housing remained independently associated with all-cause mortality (adjusted hazard ratio [AHR] = 1.30, 95% CI: 1.08 – 1.56). CONCLUSIONS: These findings demonstrate that unstable housing is an important risk factor for mortality independent of known risk factors including HIV infection and patterns of drug use. This study highlights the urgent need to provide supportive housing interventions to address elevated levels of preventable mortality among this population
A combined maximum-likelihood analysis of the high-energy astrophysical neutrino flux measured with IceCube
Evidence for an extraterrestrial flux of high-energy neutrinos has now been
found in multiple searches with the IceCube detector. The first solid evidence
was provided by a search for neutrino events with deposited energies
TeV and interaction vertices inside the instrumented volume. Recent
analyses suggest that the extraterrestrial flux extends to lower energies and
is also visible with throughgoing, -induced tracks from the Northern
hemisphere. Here, we combine the results from six different IceCube searches
for astrophysical neutrinos in a maximum-likelihood analysis. The combined
event sample features high-statistics samples of shower-like and track-like
events. The data are fit in up to three observables: energy, zenith angle and
event topology. Assuming the astrophysical neutrino flux to be isotropic and to
consist of equal flavors at Earth, the all-flavor spectrum with neutrino
energies between 25 TeV and 2.8 PeV is well described by an unbroken power law
with best-fit spectral index and a flux at 100 TeV of
.
Under the same assumptions, an unbroken power law with index is disfavored
with a significance of 3.8 () with respect to the best
fit. This significance is reduced to 2.1 () if instead we
compare the best fit to a spectrum with index that has an exponential
cut-off at high energies. Allowing the electron neutrino flux to deviate from
the other two flavors, we find a fraction of at Earth.
The sole production of electron neutrinos, which would be characteristic of
neutron-decay dominated sources, is rejected with a significance of 3.6
().Comment: 16 pages, 10 figures; accepted for publication in The Astrophysical
Journal; updated one referenc
Flavor Ratio of Astrophysical Neutrinos above 35 TeV in IceCube
A diffuse flux of astrophysical neutrinos above has been
observed at the IceCube Neutrino Observatory. Here we extend this analysis to
probe the astrophysical flux down to and analyze its flavor
composition by classifying events as showers or tracks. Taking advantage of
lower atmospheric backgrounds for shower-like events, we obtain a shower-biased
sample containing 129 showers and 8 tracks collected in three years from 2010
to 2013. We demonstrate consistency with the
flavor ratio at Earth
commonly expected from the averaged oscillations of neutrinos produced by pion
decay in distant astrophysical sources. Limits are placed on non-standard
flavor compositions that cannot be produced by averaged neutrino oscillations
but could arise in exotic physics scenarios. A maximally track-like composition
of is excluded at , and a purely shower-like
composition of is excluded at .Comment: 8 pages, 3 figures. Submitted to PR
Measurement of the Atmospheric Spectrum with IceCube
We present a measurement of the atmospheric spectrum at energies
between 0.1 TeV and 100 TeV using data from the first year of the complete
IceCube detector. Atmospheric originate mainly from the decays of kaons
produced in cosmic-ray air showers. This analysis selects 1078 fully contained
events in 332 days of livetime, then identifies those consistent with particle
showers. A likelihood analysis with improved event selection extends our
previous measurement of the conventional fluxes to higher energies. The
data constrain the conventional flux to be times a
baseline prediction from a Honda's calculation, including the knee of the
cosmic-ray spectrum. A fit to the kaon contribution () to the neutrino
flux finds a kaon component that is times the baseline
value. The fitted/measured prompt neutrino flux from charmed hadron decays
strongly depends on the assumed astrophysical flux and shape. If the
astrophysical component follows a power law, the result for the prompt flux is
times a calculated flux based on the work by Enberg, Reno
and Sarcevic.Comment: PRD accepted versio
Characterization of the Atmospheric Muon Flux in IceCube
Muons produced in atmospheric cosmic ray showers account for the by far
dominant part of the event yield in large-volume underground particle
detectors. The IceCube detector, with an instrumented volume of about a cubic
kilometer, has the potential to conduct unique investigations on atmospheric
muons by exploiting the large collection area and the possibility to track
particles over a long distance. Through detailed reconstruction of energy
deposition along the tracks, the characteristics of muon bundles can be
quantified, and individual particles of exceptionally high energy identified.
The data can then be used to constrain the cosmic ray primary flux and the
contribution to atmospheric lepton fluxes from prompt decays of short-lived
hadrons.
In this paper, techniques for the extraction of physical measurements from
atmospheric muon events are described and first results are presented. The
multiplicity spectrum of TeV muons in cosmic ray air showers for primaries in
the energy range from the knee to the ankle is derived and found to be
consistent with recent results from surface detectors. The single muon energy
spectrum is determined up to PeV energies and shows a clear indication for the
emergence of a distinct spectral component from prompt decays of short-lived
hadrons. The magnitude of the prompt flux, which should include a substantial
contribution from light vector meson di-muon decays, is consistent with current
theoretical predictions.Comment: 36 pages, 39 figure
Search for Dark Matter Annihilation in the Galactic Center with IceCube-79
The Milky Way is expected to be embedded in a halo of dark matter particles,
with the highest density in the central region, and decreasing density with the
halo-centric radius. Dark matter might be indirectly detectable at Earth
through a flux of stable particles generated in dark matter annihilations and
peaked in the direction of the Galactic Center. We present a search for an
excess flux of muon (anti-) neutrinos from dark matter annihilation in the
Galactic Center using the cubic-kilometer-sized IceCube neutrino detector at
the South Pole. There, the Galactic Center is always seen above the horizon.
Thus, new and dedicated veto techniques against atmospheric muons are required
to make the southern hemisphere accessible for IceCube. We used 319.7 live-days
of data from IceCube operating in its 79-string configuration during 2010 and
2011. No neutrino excess was found and the final result is compatible with the
background. We present upper limits on the self-annihilation cross-section,
\left, for WIMP masses ranging from 30 GeV up to
10 TeV, assuming cuspy (NFW) and flat-cored (Burkert) dark matter halo
profiles, reaching down to cm s, and
cm s for the
channel, respectively.Comment: 14 pages, 9 figures, Submitted to EPJ-C, added references, extended
limit overvie
Evidence for Astrophysical Muon Neutrinos from the Northern Sky with IceCube
Results from the IceCube Neutrino Observatory have recently provided
compelling evidence for the existence of a high energy astrophysical neutrino
flux utilizing a dominantly Southern Hemisphere dataset consisting primarily of
nu_e and nu_tau charged current and neutral current (cascade) neutrino
interactions. In the analysis presented here, a data sample of approximately
35,000 muon neutrinos from the Northern sky was extracted from data taken
during 659.5 days of livetime recorded between May 2010 and May 2012. While
this sample is composed primarily of neutrinos produced by cosmic ray
interactions in the Earth's atmosphere, the highest energy events are
inconsistent with a hypothesis of solely terrestrial origin at 3.7 sigma
significance. These neutrinos can, however, be explained by an astrophysical
flux per neutrino flavor at a level of Phi(E_nu) = 9.9^{+3.9}_{-3.4} times
10^{-19} GeV^{-1} cm^{-2} sr^{-1} s^{-1} ({E_nu / 100 TeV})^{-2}, consistent
with IceCube's Southern Hemisphere dominated result. Additionally, a fit for an
astrophysical flux with an arbitrary spectral index was performed. We find a
spectral index of 2.2^{+0.2}_{-0.2}, which is also in good agreement with the
Southern Hemisphere result.Comment: 4 figures, 2, tables, includes supplementary materia
Innovative strategies to support physical distancing among individuals with active addiction
Applied Science, Faculty ofMedicine, Faculty ofFamily Practice, Department ofMedicine, Department ofNursing, School ofReviewedFacultyResearche
The changing landscape of pharmaceutical alternatives to the unregulated drug supply during COVID-19
Background
The dual COVID-19 and overdose emergencies amplified strain on healthcare systems tasked with responding to both. One downstream consequence of the pandemic in the USA and Canada was a surge in drug overdoses resulting from public health-restricted access to services and an increasingly toxic unregulated drug supply. This study aimed to describe changes implemented by programs prescribing pharmaceutical alternatives to the drug supply during the early stages of the COVID-19 pandemic.
Methods
An environmental scan used surveys and qualitative interviews with service providers across Canada to examine pharmaceutical alternative prescribing practices and programs before and during the pandemic. This study summarized the nature, frequency, and reasons for pandemic-driven service delivery changes using directed content analysis, counts, and thematic analysis.
Results
Eighty-two of the 103 participating sites reported 1193 unique changes in physical space (368), client protocols (347), program operations (342), ancillary services (127), and staffing (90). Four qualitative themes describing the reasons for these changes emerged, namely (1) decreasing risk of COVID-19 infection; (2) decreasing risk of overdose; (3) prioritizing acute care of COVID-19 patients; and (4) improving client access to treatment.
Conclusions
While most changes were aimed at decreasing risk of COVID-19 infection, some were found to be at odds with the measures needed to combat the overdose crisis; others met dual objectives of decreased risk of both overdose and infection. Further research should examine which changes should be kept or reversed once COVID-19-related public health measures are lifted.Medicine, Faculty ofNon UBCMedicine, Department ofReviewedFacultyResearche
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