Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis

Objective: Group training in communication skills [communication skills training (CST)] has become partly mandatory for oncology staff. However, so far, a comprehensive meta-analysis on the efficacy is lacking. Design: Included studies either compare the efficacy of a specific training with a control group or look at the additional effect of booster sessions on communication behaviour, attitudes or patient outcomes. Methods: Four electronic databases were searched up to July 2008 without language restriction, and reference lists of earlier reviews were screened. Effect sizes (ESs) were extracted and pooled in random effects meta-analyses. Results: We included 13 trials (three non-randomised), 10 with no specific intervention in the control group. Meta-analysis showed a moderate effect of CST on communication behaviour ES = 0.54. Three trials compared basic training courses with more extensive training courses and showed a small additional effect on communication skills ES = 0.37. Trials investigating participants' attitudes ES = 0.35 and patient outcomes ES = 0.13 (trend) confirmed this effect. Conclusions: Training health professionals by CST is a promising approach to change communication behaviour and attitudes. Patients might also benefit from specifically trained health professionals but strong studies are lacking. However, feasibility and economic aspects have to be kept in mind when considering providing a training of optimal lengt

Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis

Objective: Group training in communication skills [communication skills training (CST)] has become partly mandatory for oncology staff. However, so far, a comprehensive meta-analysis on the efficacy is lacking. Design: Included studies either compare the efficacy of a specific training with a control group or look at the additional effect of booster sessions on communication behaviour, attitudes or patient outcomes. Methods: Four electronic databases were searched up to July 2008 without language restriction, and reference lists of earlier reviews were screened. Effect sizes (ESs) were extracted and pooled in random effects meta-analyses. Results: We included 13 trials (three non-randomised), 10 with no specific intervention in the control group. Meta-analysis showed a moderate effect of CST on communication behaviour ES = 0.54. Three trials compared basic training courses with more extensive training courses and showed a small additional effect on communication skills ES = 0.37. Trials investigating participants' attitudes ES = 0.35 and patient outcomes ES = 0.13 (trend) confirmed this effect. Conclusions: Training health professionals by CST is a promising approach to change communication behaviour and attitudes. Patients might also benefit from specifically trained health professionals but strong studies are lacking. However, feasibility and economic aspects have to be kept in mind when considering providing a training of optimal length

Final Result of the MAJORANA DEMONSTRATOR's Search for Neutrinoless Double-β\beta Decay in 76^{76}Ge

The MAJORANA DEMONSTRATOR searched for neutrinoless double-$\beta$ decay ($0\nu\beta\beta$) of $^{76}$Ge using modular arrays of high-purity Ge detectors operated in vacuum cryostats in a low-background shield. The arrays operated with up to 40.4 kg of detectors (27.2 kg enriched to $\sim$88\% in $^{76}$Ge). From these measurements, the DEMONSTRATOR has accumulated 64.5 kg yr of enriched active exposure. With a world-leading energy resolution of 2.52 keV FWHM at the 2039 keV $Q_{\beta\beta}$ (0.12\%), we set a half-life limit of $0\nu\beta\beta$ in $^{76}$Ge at $T_{1/2}>8.3\times10^{25}$ yr (90\% C.L.). This provides a range of upper limits on $m_{\beta\beta}$ of $(113-269)$ meV (90\% C.L.), depending on the choice of nuclear matrix elements.Comment: 8 pages, 2 figure

Interpretable Boosted Decision Tree Analysis for the Majorana Demonstrator

The Majorana Demonstrator is a leading experiment searching for neutrinoless double-beta decay with high purity germanium detectors (HPGe). Machine learning provides a new way to maximize the amount of information provided by these detectors, but the data-driven nature makes it less interpretable compared to traditional analysis. An interpretability study reveals the machine's decision-making logic, allowing us to learn from the machine to feedback to the traditional analysis. In this work, we have presented the first machine learning analysis of the data from the Majorana Demonstrator; this is also the first interpretable machine learning analysis of any germanium detector experiment. Two gradient boosted decision tree models are trained to learn from the data, and a game-theory-based model interpretability study is conducted to understand the origin of the classification power. By learning from data, this analysis recognizes the correlations among reconstruction parameters to further enhance the background rejection performance. By learning from the machine, this analysis reveals the importance of new background categories to reciprocally benefit the standard Majorana analysis. This model is highly compatible with next-generation germanium detector experiments like LEGEND since it can be simultaneously trained on a large number of detectors.Comment: 13 pages, 9 figure

Modeling Backgrounds for the MAJORANA DEMONSTRATOR

The MAJORANA DEMONSTRATOR is a neutrinoless double-beta decay ($0\nu\beta\beta$) experiment containing $\sim$30 kg of p-type point contact germanium detectors enriched to 88% in 76Ge and $\sim$14 kg of natural germanium detectors. The detectors are housed in two electroformed copper cryostats and surrounded by a graded passive shield with active muon veto. An extensive radioassay campaign was performed prior to installation to insure the use of ultra-clean materials. The DEMONSTRATOR achieved one of the lowest background rates in the region of the $0\nu\beta\beta$ Q-value, 15.7 $\pm$ 1.4 cts/(FWHM t y) from the low-background configuration spanning most of the 64.5 kg-yr active exposure. Nevertheless this background rate is a factor of five higher than the projected background rate. This discrepancy arises from an excess of events from the 232Th decay chain. Background model fits aim to understand this deviation from assay-based projections, potentially determine the source(s) of observed backgrounds, and allow a precision measurement of the two-neutrino double-beta decay half-life. The fits agree with earlier simulation studies, which indicate the origin of the 232Th excess is not from a near-detector component and have informed design decisions for the next-generation LEGEND experiment. Recent findings have narrowed the suspected locations for the excess activity, motivating a final simulation and assay campaign to complete the background model.Comment: 8 pages, 6 figures, Proceedings from the Low Radioactivity Techniques Workshop 2022 in Rapid City, SD, US

Majorana Demonstrator Data Release for AI/ML Applications

The enclosed data release consists of a subset of the calibration data from the Majorana Demonstrator experiment. Each Majorana event is accompanied by raw Germanium detector waveforms, pulse shape discrimination cuts, and calibrated final energies, all shared in an HDF5 file format along with relevant metadata. This release is specifically designed to support the training and testing of Artificial Intelligence (AI) and Machine Learning (ML) algorithms upon our data. This document is structured as follows. Section I provides an overview of the dataset's content and format; Section II outlines the location of this dataset and the method for accessing it; Section III presents the NPML Machine Learning Challenge associated with this dataset; Section IV contains a disclaimer from the Majorana collaboration regarding the use of this dataset; Appendix A contains technical details of this data release. Please direct questions about the material provided within this release to [email protected] (A. Li).Comment: Zenodo DOI: https://doi.org/10.5281/zenodo.825702

Constraints on the decay of 180m^{180m}Ta

$^{180m}$Ta is a rare nuclear isomer whose decay has never been observed. Its remarkably long lifetime surpasses the half-lives of all other known $\beta$ and electron capture decays due to the large K-spin differences and small energy differences between the isomeric and lower energy states. Detecting its decay presents a significant experimental challenge but could shed light on neutrino-induced nucleosynthesis mechanisms, the nature of dark matter and K-spin violation. For this study, we repurposed the MAJORANA DEMONSTRATOR, an experimental search for the neutrinoless double-beta decay of $^{76}$Ge using an array of high-purity germanium detectors, to search for the decay of $^{180m}$Ta. More than 17 kilograms, the largest amount of tantalum metal ever used for such a search was installed within the ultra-low background detector array. In this paper we present results from the first year of Ta data taking and provide an updated limit for the $^{180m}$Ta half-life on the different decay channels. With new limits up to 1.5 x $10^{19}$ years, we improved existing limits by one to two orders of magnitude. This result is the most sensitive search for a single $\beta$ and electron capture decay ever achieved

Burden of child maltreatment in China:A systematic review

Objective To estimate the health and economic burdens of child maltreatment in China. Methods We did a systematic review for studies on child maltreatment in China using PubMed, Embase, PsycInfo, CINAHL-EBSCO, ERIC and the Chinese National Knowledge Infrastructure databases. We did meta-analyses of studies that met inclusion criteria to estimate the prevalence of child neglect and child physical, emotional and sexual abuse. We used data from the 2010 global burden of disease estimates to calculate disability-adjusted life-years (DALYs) lost as a result of child maltreatment. Findings From 68 studies we estimated that 26.6% of children under 18 years of age have suffered physical abuse, 19.6% emotional abuse, 8.7% sexual abuse and 26.0% neglect. We estimate that emotional abuse in childhood accounts for 26.3% of the DALYs lost because of mental disorders and 18.0% of those lost because of self-harm. Physical abuse in childhood accounts for 12.2% of DALYs lost because of depression, 17.0% of those lost to anxiety, 20.7% of those lost to problem drinking, 18.8% of those lost to illicit drug use and 18.3% of those lost to self-harm. The consequences of physical abuse of children costs China an estimated 0.84% of its gross domestic product – i.e. 50 billion United States dollars – in 2010. The corresponding losses attributable to emotional and sexual abuse in childhood were 0.47% and 0.39% of the gross domestic product, respectively. Conclusion In China, child maltreatment is common and associated with large economic losses because many maltreated children suffer substantial psychological distress and might adopt behaviours that increase their risk of chronic disease

Signatures of muonic activation in the Majorana Demonstrator

Experiments searching for very rare processes such as neutrinoless double-beta decay require a detailed understanding of all sources of background. Signals from radioactive impurities present in construction and detector materials can be suppressed using a number of well-understood techniques. Background from in situ cosmogenic interactions can be reduced by siting an experiment deep underground. However, the next generation of such experiments have unprecedented sensitivity goals of 1028 years half-life with background rates of 10-5cts/(keV kg yr) in the region of interest. To achieve these goals, the remaining cosmogenic background must be well understood. In the work presented here, Majorana Demonstrator data are used to search for decay signatures of metastable germanium isotopes. Contributions to the region of interest in energy and time are estimated using simulations and compared to Demonstrator data. Correlated time-delayed signals are used to identify decay signatures of isotopes produced in the germanium detectors. A good agreement between expected and measured rate is found and different simulation frameworks are used to estimate the uncertainties of the predictions. The simulation campaign is then extended to characterize the background for the LEGEND experiment, a proposed tonne-scale effort searching for neutrinoless double-beta decay in Ge76

Experimental study of C 13 (α,n) O 16 reactions in the Majorana Demonstrator calibration data

Neutron captures and delayed decays of reaction products are common sources of backgrounds in ultrarare event searches. In this work, we studied C13(α,n)O16 reactions induced by α particles emitted within the calibration sources of the Majorana Demonstrator. These sources are thorium-based calibration standards enclosed in carbon-rich materials. The reaction rate was estimated by using the 6129-keV γ rays emitted from the excited O16 states that are populated when the incoming α particles exceed the reaction Q value. Thanks to the excellent energy performance of the Demonstrator's germanium detectors, these characteristic photons can be clearly observed in the calibration data. Facilitated by Geant4 simulations, a comparison between the observed 6129-keV photon rates and predictions by a talys-based software was performed. The measurements and predictions were found to be consistent, albeit with large statistical uncertainties. This agreement provides support for background projections from (α,n) reactions in future double-beta decay search efforts