Study of the acoustic signature of UHE neutrino interactions in water and ice

The production of acoustic signals from the interactions of ultra-high energy (UHE) cosmic ray neutrinos in water and ice has been studied. A new computationally fast and efficient method of deriving the signal is presented. This method allows the implementation of up to date parameterisations of acoustic attenuation in sea water and ice that now includes the effects of complex attenuation, where appropriate. The methods presented here have been used to compute and study the properties of the acoustic signals which would be expected from such interactions. A matrix method of parameterising the signals, which includes the expected fluctuations, is also presented. These methods are used to generate the expected signals that would be detected in acoustic UHE neutrino telescopes.Comment: 21 pages and 13 figure

T2K ECAL Test–beam Proposal

The T2K experiment will search for the last unknown element of the neutrino mixing matrix. An crucial component of the near detector for this experiment is the electromagnetic calorimeter which is being built in the UK. Testbeam time is requested to test the full ECAL system, validate calibration techniques, and determine the hadronic and electromagnetic energy scale of the calorimeter

The electromagnetic calorimeter for the T2K near detector ND280

The T2K experiment studies oscillations of an off-axis muon neutrino beam between the J-PARC accelerator complex and the Super-Kamiokande detector. Special emphasis is placed on measuring the mixing angle θ 13 by observing ν e appearance via the sub-dominant νμ ν e oscillation and searching for CP violation in the lepton sector. The experiment includes a sophisticated, off-axis, near detector, the ND280, situated 280 m downstream of the neutrino production target in order to measure the properties of the neutrino beam and to understand better neutrino interactions at the energy scale below a few GeV. The data collected with the ND280 are used to study charged- and neutral-current neutrino interaction rates and kinematics prior to oscillation, in order to reduce uncertainties in the oscillation measurements by the far detector. A key element of the near detector is the ND280 electromagnetic calorimeter (ECal), consisting of active scintillator bars sandwiched between lead sheets and read out with multi-pixel photon counters (MPPCs). The ECal is vital to the reconstruction of neutral particles, and the identification of charged particle species. The ECal surrounds the Pi-0 detector (PØD) and the tracking region of the ND280, and is enclosed in the former UA1/NOMAD dipole magnet. This paper describes the design, construction and assembly of the ECal, as well as the materials from which it is composed. The electronic and data acquisition (DAQ) systems are discussed, and performance of the ECal modules, as deduced from measurements with particle beams, cosmic rays, the calibration system, and T2K data, is described.© 2013 IOP Publishing Ltd and Sissa Medialab srl.The ECal detector has been built and is operated using funds provided by the Science and Technology Facilities Council U.K. Important support was also provided by the collaborating institutions. Individual researchers have been supported by the Royal Society and the European Research Council

First muon-neutrino disappearance study with an off-axis beam

We report a measurement of muon-neutrino disappearance in the T2K experiment. The 295-km muon-neutrino beam from Tokai to Kamioka is the first implementation of the off-axis technique in a long-baseline neutrino oscillation experiment

Abstract MP05: Sex Differences In Mortality And 30-day All Cause Readmission Following Carotid Endarterectomy Following Acute Ischemic Stroke: A Nsqip Study (2014 - 2017)

Abstract only Background: Studies report that acute ischemic stroke (AIS) affects males and females differently. For example, the treatment outcomes of intra-arterial thrombolysis differ between males and females. In this study, we examined mortality and 30-day readmission differences by sex among AIS patients who had carotid endarterectomy (CEA). Methods: We used data from National Surgical Quality Improvement Program (NSQIP) registry (2014-2017). Patients ≥18 years of age, with CEA for AIS were included. AIS and CEA were identified using ICD-9 and ICD-10 diagnosis, and CPT codes, respectively. Using machine learning methods such as Hierarchical clustering, we grouped patients (low, medium, and high-risk clusters) based on their demographics, past medical history, and preoperative variables. Differences in means, and differences in proportions were calculated. Logistic regression was conducted for 30-day readmission and survival analysis for mortality, accounting for cluster groups and sex. Results: There were a total of 22,373 AIS patients who received CEA treatment. Mean (SD) age of the sample was 70.7 (9.4) years, and 61% were males while 39% were females. Mortality rates were 0.8% and 0.7% for men and women (p=0.113), respectively. Thirty-day readmission rates were 6.3% and 7.6% for men and women (p<0.0001), respectively. There were 56.3%, 34.4%, and 9.3% patients in Low, Medium, and High-Risk clusters, respectively. Females were 1.2 times (OR 95% CI: 1.1 - 1.3) as likely to be readmitted compared to males. Survival analysis showed that there was no significant difference in mortality between males and females (HR: 0.8; 95% CI: 0.6 - 1.2; p = 0.28). Conclusion: Our study found sex related disparities in short-term readmissions as it was higher among females. This could be because of underlaying sex specific pathophysiology of AIS. Healthcare providers should consider sex-specific management to improve post-stroke recovery for women and reduce their excess burden

Abstract P181: Machine Learning Methods For Predicting 30-day All Cause Readmission Following Carotid Endarterectomy Among Acute Ischemic Stoke Cases: A Nsqip Study (2014 - 2017)

Abstract only Background: Carotid endarterectomy (CEA) is associated with improved overall clinical outcomes in patients with acute ischemic stroke (AIS). However, studies on rates and factors associated with readmission following CEA for AIS are scarce. In this study, we used machine learning (ML) methods to identify the factors associated with readmission using a large-scale national database. Methods: We used National Surgical Quality Improvement Program (NSQIP) registry (2014-2017) and included patients 18 years or older, who underwent CEA for AIS. AIS and CEA were identified using ICD-9 and ICD-10 diagnosis and CPT procedure codes, respectively. We used Naïve Bayes, Boosted Decision Trees, and Bootstrapped Random Forest classification techniques to explore the predictors of 30-day readmission using demographics, past medical history, and preoperative variables. Results: There were a total of 22,373 AIS patients who underwent CEA. Mean (SD) age of the patients was 70.7 (9.4) years, and 61% were men. Majority were non-Hispanic White (80%), followed by non-Hispanic Black (4.6%). During the study period, 1 in 15 AIS patients who underwent CEA experienced 30-day readmission. Bootstrapped Random Forest classification performed best and Naïve Bayes worst with an AUROC of 92% and 59% respectively. The top 5 predictors of 30-day readmission after CEA were Hematocrit, BUN, Creatinine, WBC count, and Platelet count, all collected pre-operatively. Conclusion: Our study showed that ML techniques could accurately predict 30-day readmission using pre-operative risk factors. This ML model could be incorporated in EMR as a potential clinical decision support system. Implementing this system could help in early identification of patients who are at high risk for readmission following CEA. This could help physicians to plan and intervene effectively and prevent short-term readmissions; thereby improving quality of care and saving healthcare costs

Duration of Voriconazole Exposure: An Independent Risk Factor for Skin Cancer After Lung Transplantation

Objective To determine whether there is an association between duration of voriconazole therapy and number of nonmelanoma skin cancers (NMSC) after lung transplantation. Design A telephone-based survey and chart review were performed for all living patients who received a lung transplant at Emory University from 1993 to 2009. Setting Academic medical center. Participants Lung transplant recipients. Main Outcome Measured Number of NMSC after lung transplantation. Results Sixty of 91 (65.9%) subjects were exposed to voriconazole for at least 3 months (11.2 ± 8.7 months, range 3–58 months) after lung transplantation, of whom 16 developed NMSC, with a mean of 38 months to first NMSC. Of 31 patients not exposed to voriconazole, 12 developed NMSC, with a mean of 52 months to first NMSC . By univariate analysis, time since transplant (correlation coefficient (r) = 0.514), age (r = 0.101), and high lifetime sun exposure (r = 0.211) were correlated with number of skin cancers after transplantation. Skin types V and VI were protective (r = −0.353). In multivariate regression, time since transplantation (0.061 per month), age (0.151 per year), skin type I or II (4.939), and months of exposure to voriconazole (0.149) were found to be independent risk factors for number of skin cancers after lung transplantation. Conclusion Duration of voriconazole exposure correlates with number of NMSC after lung transplantation. All patients exposed to voriconazole should be educated about their increased risk of skin cancer and should have regular dermatologic follow-up for skin cancer screening. Physicians caring for lung-transplant recipients should consider alternatives to voriconazole in patients at risk for skin cancer

Abstract P137: Maternal Or Parental Outcomes During Delivery Related Hospitalizations Among Pregnant Individuals With Obesity In The United States

Abstract only Background: The prevalence of obesity among people of reproductive age has steadily increased. The rates of both maternal/parental and fetal adverse outcomes increased significantly with higher BMI. In this study, we examined the national estimates of adverse maternal/parental and fetal outcomes among pregnant individuals with pre-pregnancy obesity using a nationally representative database. Methods: This was a retrospective observational analysis of data retrieved from the Nationwide Inpatient Sample database (2010-2014). The primary outcomes of this study were various adverse maternal/parental and fetal outcomes. Delivery related hospitalizations and all outcomes were identified using the ICD-9 codes. Additionally, propensity-score matching analysis was conducted. Results: There were a total of 18,687,217 delivery-related hospitalizations, of which 1,048,323 were among people with obesity. The mean age of pregnant persons with obesity was 28.5 years while among those without obesity was 28.0 years. Between both groups, most pregnant persons were White, followed by Hispanic and Black. Pregnant persons with obesity were more likely to have labor inductions (AOR: 1.51; 95% CI: 1.42, 1.60), cesarean deliveries (1.70; 1.62, 1.79), and greater length of stay after both cesarean deliveries (1.14; 1.08, 1.36) and vaginal deliveries (1.48; 1.23, 1.77). They were also more likely to have risk factors for adverse obstetrical outcomes such as gestational hypertension (2.17; 2.06, 2.29), preeclampsia (2.06; 1.42, 2.99), gestational diabetes (2.75; 2.60, 2.90), premature rupture of membranes (1.17; 1.08, 1.27), chorioamnionitis (1.39; 1.25, 1.55), and venous thromboembolism (1.63; 1.34, 1.99). Additionally, pregnant persons with obesity were more likely to have adverse fetal outcomes such as excessive fetal growth (3.18; 2.96, 3.43) and fetal distress (1.28; 1.21, 1.35). Conclusion: Pregnant persons with obesity had significantly greater risk for adverse obstetrical outcomes. Risk stratification of pregnant individuals based on obesity can inform obstetrical providers’ clinical decision-making and potentially improve patient outcomes and decrease costs. There is an opportunity to address these risks with pre-conception interventions. Future studies could examine the effect of pre-conception interventions such as counseling on pre-pregnancy weight management, lifestyle modifications addressing nutrition and activity, and pre-pregnancy bariatric surgery