A search for muon neutrino to electron neutrino oscillation mediated by sterile neutrinos in MINOS

The MINOS experiment made precision measurements of the neutrino oscillation parameters that are governed by the atmospheric mass-squared splitting. These measurements were made with data that were collected while the NuMI muon neutrino beam operated in a low energy mode that peaks around 3 GeV. Today the NuMI beam is running with a higher energy mode that produces a neutrino energy spectrum that peaks around 7 GeV, allowing the MINOS+ experiment to probe neutrino oscillation phenomena that could potentially be governed by a fourth mass-squared splitting. If observed, the presence of a fourth mass-squared splitting would be compelling evidence for a sterile neutrino state. In this analysis, we will present the results of a search for νµ → νe oscillation mediated by sterile neutrinos in MINOS+. The results will be contrasted against the measurements made by the LSND experiment

Essays on long-term care and health insurance

This thesis contributes to the literature on the impact of two individual options that may help to alleviate the financial pressure on the public sector with respect to health and long-term care expenditures. A particular focus is on the German health insurance and long-term care insurance (LTCI) system. The first option refers to the shifting of LTCI and health insurance coverage from a public system to markets for voluntary private health insurance (VPHI) and private LTCI. These private insurance markets may suffer from inefficiencies due to asymmetric information and selection effects, such as adverse selection. Hence, three papers in this thesis analyze selection effects in markets for VPHI and private LTCI. The first paper (chapter 2) reviews the empirical work on asymmetric information and related selection effects in markets for private LTCI and in the U.S. market for Medigap insurance. After providing an overview of the existence of selection effects in these markets, the review examines the evidence on several potential sources of selection. Regarding the latter, a focus is on the role of private information that individuals have on their risk type, on the role of the individuals risk preferences and of sociodemographic characteristics. Following the review, two empirical papers analyze selection effects in the German markets for complementary private LTCI (chapter 3) and for supplemental dental insurance (chapter 4). Both markets have in common that they provide voluntary private insurance coverage for residual out-of-pocket expenditure risks not covered by statutory LTCI or health insurance in Germany. In addition, the ex-ante premium differentiation is rather limited in these markets. This makes these markets prone to selection effects. Using a large dataset on more than 98,000 individuals from a German private insurance company, the findings in chapter 3 suggest that advantageous selection is the dominating type of selection in the German market for complementary private LTCI. Examining potential drivers for selection, the analysis indicates that the occupation as well as the residential location are observable characteristics that are not used for pricing, but that contribute to advantageous selection through the socioeconomic status. The holding of supplemental health insurance policies is another observable attribute that affects the selection behavior. Analyzing the selection behavior within a dynamic framework, the analysis shows that the uptake and the cancellation of LTCI policies are associated with changes in health insurance payouts. Moreover, individuals with financial problems and with a lower socioeconomic status are more likely to drop complementary LTCI coverage. Based on survey data from the Healthcare Monitor of the Bertelsmann Stiftung, the findings in chapter 4 do not reveal a significant correlation between insurance coverage and risk in the market for supplemental dental insurance in Germany. Since one possible explanation for this finding is heterogeneous selection leading to an offsetting of adverse and advantageous selection, a large set of potential sources of selection effects is tested. The results indicate that the holding of other supplemental health insurance policies is a main driver for advantageous selection in this market. The findings in this chapter provide solid evidence that this insurance market suffers from asymmetric information and selection effects even though the correlation between insurance coverage and risk is not statistically significant. Instead of shifting insurance coverage to a private insurance system, another option to alleviate the financial burden in a public health insurance system, which is analyzed in this thesis, refers to the promotion of preventive health care. Specifically, the fourth paper (chapter 5) empirically examines the effectiveness of a nationwide population-based skin cancer screening (SCS) program that was implemented in Germany in 2008. To this end, panel data from 2000 to 2013 of the Eurostat database on subregions in 22 European countries are exploited. Using fixed effects methods, the results show a positive and robust effect of the German SCS program on the diagnosis rate for malignant skin neoplasms, but no significant impact on the melanoma mortality rate. The former suggests that this program is effective in terms of an increased diagnosis rate for malignant skin neoplasms and may therefore contribute to an improved detection of skin cancer at an early stage.Diese Dissertation trägt zur Literatur zu Auswirkungen von zwei Möglichkeiten, die den öffentlichen Sektor bezüglich der Gesundheits- und Pflegeausgaben finanziell entlasten können, bei. Der Fokus liegt dabei auf dem deutschen Kranken- und Pflegeversicherungssystem. Die erste Möglichkeit bezieht sich auf die Verlagerung von Pflege- und Krankenversicherungsschutz von einem öffentlichen bzw. gesetzlichen System zu Märkten für freiwillige private Kranken- und Pflegeversicherung. In diesen privaten Versicherungsmärkten kann es zu Ineffizienzen aufgrund von asymmetrischen Informationen und Selektionseffekten, wie z. B. adverse Selektion, kommen. Vor diesem Hintergrund untersuchen drei wissenschaftliche Papiere Selektionseffekte in Märkten für freiwillige private Kranken- und Pflegeversicherung. Das erste Papier (Kapitel 2) ist ein Literaturüberblick zur empirischen Forschung von asymmetrischen Informationen und damit verbundenen Selektionseffekten in privaten Pflegeversicherungsmärkten und im Krankenzusatzversicherungsmarkt für Individuen mit Medicare-Versicherungsschutz in den USA (sog. Medigap-Versicherung). Neben einem Überblick über die Existenz von Selektionseffekten in diesen Märkten wird die empirische Evidenz zu verschiedenen potentiellen Ursachen von Selektionseffekten analysiert. In Bezug auf das Letztere liegt der Fokus auf der Rolle von privaten Informationen von Individuen über ihren Risikotyp, auf der Rolle von Risikopräferenzen und von soziodemographischen Merkmalen. Zwei empirische Papiere in dieser Dissertation befassen sich anschließend mit Selektionseffekten im deutschen Pflege- (Kapitel 3) und Zahnzusatzversicherungsmarkt (Kapitel 4). In diesen Märkten können sich Individuen in Deutschland gegen finanzielle Risiken, die nicht durch die gesetzliche Pflege- bzw. Krankenversicherung abgedeckt sind, zusätzlich privat versichern. Beide Märkte sind anfällig für Selektionseffekte, da die ex-ante Prämiendifferenzierung in diesen Märkten nicht sehr ausgeprägt ist. Basierend auf Daten von über 98.000 Versicherten eines deutschen privaten Versicherungsunternehmens deuten die Ergebnisse in Kapitel 3 darauf hin, dass eine aus Sicht der Versicherer vorteilhaften Selektion (sog. Advantageous Selection) der dominierende Selektionseffekt im Pflegezusatzversicherungsmarkt ist. Die weitere Analyse zeigt, dass der sozioökonomische Status basierend auf beobachtbaren Informationen über den Beruf und den Wohnort, die nicht zur Tarifierung herangezogen werden, zur Advantageous Selection beitragen. Der Besitz weiterer Krankenzusatzversicherungen ist ein weiteres beobachtbares Merkmal, das das Selektionsverhalten beeinflusst. Darüber hinaus zeigt die Analyse, dass es einen Zusammenhang zwischen Änderungen in den Krankenversicherungsleistungen und dem Abschluss bzw. der Kündigung von Pflegezusatzversicherungen gibt. Zudem kündigen Individuen mit finanziellen Problemen und einem niedrigeren sozioökonomischen Status mir höherer Wahrscheinlichkeit ihre Pflegezusatzversicherung. In der Analyse des deutschen Zahnzusatzversicherungsmarkts in Kapitel 4 wird basierend auf Daten des Gesundheitsmonitors der Bertelsmann Stiftung zunächst eine nicht signifikante Korrelation zwischen Versicherungsdeckung und dem Risiko gefunden. Da eine mögliche Erklärung hierfür eine Überlagerung von adverser Selektion und einer Advantageous Selection im Aggregat ist, werden in einem weiteren Schritt mögliche Treiber für Selektionseffekte untersucht. Die Ergebnisse deuten darauf hin, dass der Besitz weiterer Krankenzusatzversicherungen ein wesentlicher Treiber für Advantageous Selection in diesem Markt darstellt. Die Erkenntnisse in diesem Kapitel lassen den Schluss zu, dass in diesem Markt asymmetrische Informationen und Selektionseffekte trotz der nicht statistisch signifikanten Korrelation zwischen Versicherungsdeckung und Risiko vorliegen. Eine alternative Möglichkeit zur finanziellen Entlastung gesetzlicher bzw. öffentlich finanzierter Krankenversicherungssysteme, mit der sich diese Dissertation befasst, bezieht sich auf die Förderung von präventiven Gesundheitsmaßnahmen. In diesem Zusammenhang wird in Kapitel 5 die Effektivität eines bundesweiten populationsbasierten Hautkrebs-Screening Programms, das in Deutschland im Jahr 2008 implementiert wurde, analysiert. Hierzu werden Paneldaten der Eurostat-Datenbank zu Regionen in 22 europäischen Staaten aus den Jahren 2000-2013 verwendet. Mithilfe von Fixed-Effects-Schätzungen zeigen die Ergebnisse einen signifikant positiven Effekt des Hautkrebs-Screening Programms auf die Anzahl der Diagnosen für bösartige Neubildungen der Haut, aber keinen signifikanten Effekt auf die Mortalitätsrate für das bösartige Melanom der Haut. Die Ergebnisse deuten darauf hin, dass dieses Programm in Bezug auf eine gestiegene Diagnoserate für bösartige Neubildungen der Haut effektiv ist und somit zu einer verbesserten Früherkennung von Hautkrebs beitragen kann

Draft Genome Sequence of Clinical Isolate Alcaligenaceae sp. Strain 429

Here, we present the 3.53-Mb genome for Alcaligenaceae sp. strain 429, isolated from a patient with unknown etiology. While the 16S rRNA gene most closely resembles Paenalcaligenes species, average amino acid identity (AAI) analysis did not meet the threshold to classify our strain as a species of this family

The Davis Strait crust - a transform margin between two oceanic basins

The Davis Strait is located between Canada and Greenland and connects the Labrador Sea and the Baffin Bay basins. Both basins formed in Cretaceous to Eocene time and were connected by a transform fault system in the Davis Strait. Whether the crust in the central Davis Strait is oceanic or continental has been disputed. This information is needed to understand the evolution of this transform margin during the separation of the North American plate and Greenland. We here present a 315-km-long east–west-oriented profile that crosses the Davis Strait and two major transform fault systems—the Ungava Fault Complex and the Hudson Fracture Zone. By forward modelling of data from 12 ocean bottom seismographs, we develop a P-wave velocity model.We compare thismodel with a density model from ship-borne gravity data. Seismic reflection and magnetic anomaly data support and complement the interpretation. Most of the crust is covered by basalt flows that indicate extensive volcanism in the Davis Strait. While the upper crust is uniform, the middle and lower crust are characterized by higher P-wave velocities and densities at the location of the Ungava Fault Complex. Here, P-wave velocities of the middle crust are 6.6 km s−1 and of the lower crust are 7.1 km s−1 compared to 6.3 and 6.8 km s−1 outside this area; densities are 2850 and 3050 kg m−3 compared to 2800 and 2900 kg m−3. We here interpret a 45-km-long section as stretched and intruded crust or as new igneous crust that correlates with oceanic crust in the southern Davis Strait. A high-velocity lower crust (6.9–7.3 km s−1) indicates a high content of mafic material. This mantle-derived material gradually intruded the lower crust of the adjacent continental crust and can be related to the Iceland mantle plume. With plate kinematic modelling, we can demonstrate the importance of two transform fault systems in the Davis Strait: the Ungava Fault Complex with transpression and the Hudson Fracture Zone with pure strike-slip motion. We show that with recent poles of rotation, most of the relative motion between the North American plate and Greenland took place along the Hudson Fracture Zone

Hypermetabolic Ipsilateral Supraclavicular and Axillary Lymphadenopathy: Optimal Time Point for Performing an 18F-FDG PET/CT after COVID-19 Vaccination.

BACKGROUND We aimed to evaluate the incidence of severe acute respiratory syndrome coronavirus type-2 (SARS-CoV2) vaccine-related hypermetabolic lymphadenopathy (HLA) and evaluate which time point produces the least number of false-positive findings in an 18F-2-Fluor-2-desoxy-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT). METHODS For this retrospective, multi-center imaging study, patients with any form of SARS-CoV2 vaccination prior to an 18F-FDG-PET/CT were included between January 2021 and December 2021. Patients were divided into six groups according to the time point of vaccination prior to their 18F-FDG-PET/CT imaging, e.g., group one (0-6 days) and group six (35-80 days). As the reference standards, the SUVmax of the mediastinal blood pool (MBP) and the SUVmax contralateral reference lymph node (RL) were determined. (A) The absolute SUVmax of HLA, (B) the ratio of SUVmaxHLA/SUVmax mediastinal blood pool (rHLA/MBP), (C) the ratio SUVmax HLA vs. SUVmax contralateral reference lymph node (rHLA/RL), (D) and the incidence of HLA defined as rHLA/MBP > 1.5 were assessed. RESULTS Group one (days 0-6) showed the highest incidence of HLA 16/23 (70%) and rHLA/MBP (2.58 ± 2.1). All three parameters for HLA reduced statistically significantly in the comparison of Groups 1-3 (days 0-20) versus Groups 4-6 (days 21-80) (p-values < 0.001). CONCLUSIONS If feasible, an FDG PET should be postponed by at least 3 weeks after SARS-CoV2 vaccination, especially if an accurate evaluation of axillary status is required

Metabolic and amyloid PET network reorganization in Alzheimer's disease: differential patterns and partial volume effects

Alzheimer’s disease (AD) is a neurodegenerative disorder, considered a disconnection syndrome with regional molecular pattern abnormalities quantifiable by the aid of PET imaging. Solutions for accurate quantification of network dysfunction are scarce. We evaluate the extent to which PET molecular markers reflect quantifiable network metrics derived through the graph theory framework and how partial volume effects (PVE)-correction (PVEc) affects these PET-derived metrics 75 AD patients and 126 cognitively normal older subjects (CN). Therefore our goal is twofold: 1) to evaluate the differential patterns of [18F]FDG- and [18F]AV45-PET data to depict AD pathology; and ii) to analyse the effects of PVEc on global uptake measures of [18F]FDG- and [18F]AV45-PET data and their derived covariance network reconstructions for differentiating between patients and normal older subjects. Network organization patterns were assessed using graph theory in terms of “degree”, “modularity”, and “efficiency”. PVEc evidenced effects on global uptake measures that are specific to either [18F]FDG- or [18F]AV45-PET, leading to increased statistical differences between the groups. PVEc was further shown to influence the topological characterization of PET-derived covariance brain networks, leading to an optimised characterization of network efficiency and modularisation. Partial-volume effects correction improves the interpretability of PET data in AD and leads to optimised characterization of network properties for organisation or disconnection

Ventral and dorsal streams processing visual motion perception (FDG-PET study)

Background: Earlier functional imaging studies on visually induced self-motion perception (vection) disclosed a bilateral network of activations within primary and secondary visual cortex areas which was combined with signal decreases, i.e., deactivations, in multisensory vestibular cortex areas. This finding led to the concept of a reciprocal inhibitory interaction between the visual and vestibular systems. In order to define areas involved in special aspects of self-motion perception such as intensity and duration of the perceived circular vection (CV) or the amount of head tilt, correlation analyses of the regional cerebral glucose metabolism, rCGM (measured by fluorodeoxyglucose positron-emission tomography, FDG-PET) and these perceptual covariates were performed in 14 healthy volunteers. For analyses of the visual-vestibular interaction, the CV data were compared to a random dot motion stimulation condition (not inducing vection) and a control group at rest (no stimulation at all). Results: Group subtraction analyses showed that the visual-vestibular interaction was modified during CV, i.e., the activations within the cerebellar vermis and parieto-occipital areas were enhanced. The correlation analysis between the rCGM and the intensity of visually induced vection, experienced as body tilt, showed a relationship for areas of the multisensory vestibular cortical network (inferior parietal lobule bilaterally, anterior cingulate gyrus), the medial parieto-occipital cortex, the frontal eye fields and the cerebellar vermis. The "earlier" multisensory vestibular areas like the parieto-insular vestibular cortex and the superior temporal gyrus did not appear in the latter analysis. The duration of perceived vection after stimulus stop was positively correlated with rCGM in medial temporal lobe areas bilaterally, which included the (para-) hippocampus, known to be involved in various aspects of memory processing. The amount of head tilt was found to be positively correlated with the rCGM of bilateral basal ganglia regions responsible for the control of motor function of the head. Conclusions: Our data gave further insights into subfunctions within the complex cortical network involved in the processing of visual-vestibular interaction during CV. Specific areas of this cortical network could be attributed to the ventral stream ("what" pathway) responsible for the duration after stimulus stop and to the dorsal stream ("where/how" pathway) responsible for intensity aspects

Atypical Chryseobacterium meningosepticum and meningitis and sepsis in newborns and the immunocompromised, Taiwan.

From 1996 to 1999, 17 culture-documented systemic infections due to novel, atypical strains of Chryseobacterium meningosepticum occurred in two newborns and 15 immunocompromised patients in a medical center in Taiwan. All clinical isolates, which were initially misidentified as Aeromonas salmonicida by an automated bacterial identification system, were resistant to a number of antimicrobial agents. The isolates were characterized as atypical strains of C. meningosepticum by complete biochemical investigation, 16S rRNA gene sequence analysis, cellular fatty acid analysis, and random amplified polymorphic DNA fingerprinting (RAPD). This is the first report of a cluster of atypically variant strains of C. meningosepticum, which may be an emerging pathogen in newborns and the immunocompromised