P67 195. Cirugía del tromboembolismo pulmonar masivo en el enfermo crítico

La extracción de los trombos pulmonares en el tromboembolismo pulmonar masivo antes de 1953 (operación de Trendelenburg) cosechó fracaso tras fracaso. Desde el advenimiento de la circulación extracorpórea (CEC) el porcentaje de éxito de esta operación mejoró notablemente, no habiendo dejado de aumentar hasta la actualidad, existiendo series que reflejan porcentajes de hasta el 94% de supervivencia inmediata, con 86 y 83% de supervivencia actuarial a 1 y 3años.Presentamos un caso de paciente varón de 35años sin enfermedad previa ni antecedentes familiares de enfermedad tromboembólica. Consulta por insuficiencia respiratoria, siendo diagnosticado por tomografía computarizada de tromboembolismo en AP izquierda, la cual ocluye. El ECO-Doppler de MMII descarta trombosis venosa profunda (TVP). Una nueva tomografía computarizada informa de persistencia de la obstrucción de AP izquierda y sus ramas, que parece haber aumentado. En ecocardiografía transtorácica (ETT) dilatación de cavidades derechas con función de ventrículo derecho (VD) normal y presión sistólica de la arteria pulmonar (PSAP) de 70 mmHg. Los estudios para investigar trombofilia fueron negativos.Tras unos días empeora su situación, produciéndose dos paradas cardiorrespiratorias, de las que es reanimado y tratado inmediatamente con TNK. La tomografía computarizada muestra la existencia de nuevo episodio de tromboembolismo pulmonar que afecta a la AP derecha gravemente.Es intervenido quirúrgicamente bajo CEC sin parada circulatoria, extrayéndose molde trombótico de tronco y ambas ramas de la AP. La evolución postoperatoria fue favorable. En tomografía computarizada de control se observan limpios el tronco y las ramas de la AP, con cierto compromiso en ramas subsegmentarias de la AP izquierda.Se muestran imágenes de la intervención y tomografía computarizada pre y posquirúrgicas

Role of the employment status and education of mothers in the prevalence of intestinal parasitic infections in Mexican rural schoolchildren

<p><b>Background:</b> Intestinal parasitic infections are a public health problem in developing countries such as Mexico. As a result, two governmental programmes have been implemented: a) "National Deworming Campaign" and b) "Opportunities" aimed at maternal care. However, both programmes are developed separately and their impact is still unknown. We independently investigated whether a variety of socio-economic factors, including maternal education and employment levels, were associated with intestinal parasite infection in rural school children.</p> <p><b>Methods:</b> This cross-sectional study was conducted in 12 rural communities in two Mexican states. The study sites and populations were selected on the basis of the following traits: a) presence of activities by the national administration of albendazole, b) high rates of intestinal parasitism, c) little access to medical examination, and d) a population having less than 2,500 inhabitants. A total of 507 schoolchildren (mean age 8.2 years) were recruited and 1,521 stool samples collected (3 per child). Socio-economic information was obtained by an oral questionnaire. Regression modelling was used to determine the association of socio-economic indicators and intestinal parasitism.</p> <p><b>Results:</b> More than half of the schoolchildren showed poliparasitism (52%) and protozoan infections (65%). The prevalence of helminth infections was higher in children from Oaxaca (53%) than in those from Sinaloa (33%) (p < 0.0001). Giardia duodenalis and Hymenolepis nana showed a high prevalence in both states. Ascaris lumbricoides, Trichuris trichiura and Entamoeba hystolitica/dispar showed low prevalence. Children from lower-income families and with unemployed and less educated mothers showed higher risk of intestinal parasitism (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.6–22.6; OR 4.5, 95% CI 2.5–8.2; OR 3.3, 95% CI 1.5–7.4 respectively). Defecation in open areas was also a high risk factor for infection (OR 2.4, 95% CI 2.0–3.0).</p> <p><b>Conclusion:</b> Intestinal parasitism remains an important public health problem in Sinaloa (north-western Mexico) and Oaxaca (south-eastern Mexico). Lower income, defecation in open areas, employment status and a lower education level of mothers were the significant factors related to these infections. We conclude that mothers should be involved in health initiatives to control intestinal parasitism in Mexico.</p&gt

Reducing model bias in a deep learning classifier using domain adversarial neural networks in the MINERvA experiment

We present a simulation-based study using deep convolutional neural networks (DCNNs) to identify neutrino interaction vertices in the MINERvA passive targets region, and illustrate the application of domain adversarial neural networks (DANNs) in this context. DANNs are designed to be trained in one domain (simulated data) but tested in a second domain (physics data) and utilize unlabeled data from the second domain so that during training only features which are unable to discriminate between the domains are promoted. MINERvA is a neutrino-nucleus scattering experiment using the NuMI beamline at Fermilab. $A$-dependent cross sections are an important part of the physics program, and these measurements require vertex finding in complicated events. To illustrate the impact of the DANN we used a modified set of simulation in place of physics data during the training of the DANN and then used the label of the modified simulation during the evaluation of the DANN. We find that deep learning based methods offer significant advantages over our prior track-based reconstruction for the task of vertex finding, and that DANNs are able to improve the performance of deep networks by leveraging available unlabeled data and by mitigating network performance degradation rooted in biases in the physics models used for training.Comment: 41 page

Direct Measurement of Nuclear Dependence of Charged Current Quasielastic-like Neutrino Interactions using MINERvA

Charged-current $\nu_{\mu}$ interactions on carbon, iron, and lead with a final state hadronic system of one or more protons with zero mesons are used to investigate the influence of the nuclear environment on quasielastic-like interactions. The transfered four-momentum squared to the target nucleus, $Q^2$, is reconstructed based on the kinematics of the leading proton, and differential cross sections versus $Q^2$ and the cross-section ratios of iron, lead and carbon to scintillator are measured for the first time in a single experiment. The measurements show a dependence on atomic number. While the quasielastic-like scattering on carbon is compatible with predictions, the trends exhibited by scattering on iron and lead favor a prediction with intranuclear rescattering of hadrons accounted for by a conventional particle cascade treatment. These measurements help discriminate between different models of both initial state nucleons and final state interactions used in the neutrino oscillation experiments

Measurement of the muon anti-neutrino double-differential cross section for quasi-elastic scattering on hydrocarbon at~Eν∼3.5E_\nu \sim 3.5 GeV

We present double-differential measurements of anti-neutrino quasi-elastic scattering in the MINERvA detector. This study improves on a previous single differential measurement by using updated reconstruction algorithms and interaction models, and provides a complete description of observed muon kinematics in the form of a double-differential cross section with respect to muon transverse and longitudinal momentum. We include in our signal definition zero-meson final states arising from multi-nucleon interactions and from resonant pion production followed by pion absorption in the primary nucleus. We find that model agreement is considerably improved by a model tuned to MINERvA inclusive neutrino scattering data that incorporates nuclear effects such as weak nuclear screening and two-particle, two-hole enhancements.Comment: 47 pages, 31 figure

Single neutral pion production by charged-current νˉμ\bar{\nu}_\mu interactions on hydrocarbon at ⟨Eν⟩=\langle E_\nu \rangle = 3.6 GeV

Single neutral pion production via muon antineutrino charged-current interactions in plastic scintillator (CH) is studied using the \minerva detector exposed to the NuMI low-energy, wideband antineutrino beam at Fermilab. Measurement of this process constrains models of neutral pion production in nuclei, which is important because the neutral-current analog is a background for $\bar{\nu}_e$ appearance oscillation experiments. The differential cross sections for $\pi^0$ momentum and production angle, for events with a single observed $\pi^0$ and no charged pions, are presented and compared to model predictions. These results comprise the first measurement of the $\pi^0$ kinematics for this process.Comment: 6 pages, 5 figures, submitted to Physics Letters