Increasing medical complexity, centrifugal forces of medical subspecialization and growing economic constraints are the key reasons for the introduction of quality management into routine care ...processes such as dialysis. Adequate quality assurance and improvement must be implemented in order to supply medical staff, care providers, and patients with the necessary information on critical issues of clinical management of dialysis patients. QiN (Quality in Nephrology), the quality management program of the largest German dialysis provider, is outlined here as a practicable example. The first of 2 parts provides information on the structure, implementation of QiN and achieved clinical improvement in routine care. The second part (quotation) analyzes longitudinal data in order to differentiate whether observed improvements during more than 5 years of QiN can be ascribed to the intervention (application of QiN) or whether they are due to other factors such as generally improved medical knowledge.
The IceCube Collaboration has observed a high-energy astrophysical neutrino flux and recently found evidence for neutrino emission from the blazar TXS 0506
+
056. These results open a new window into ...the high-energy universe. However, the source or sources of most of the observed flux of astrophysical neutrinos remains uncertain. Here, a search for steady point-like neutrino sources is performed using an unbinned likelihood analysis. The method searches for a spatial accumulation of muon-neutrino events using the very high-statistics sample of about 497,000 neutrinos recorded by IceCube between 2009 and 2017. The median angular resolution is
∼
1
∘
at 1 TeV and improves to
∼
0
.
3
∘
for neutrinos with an energy of 1 PeV. Compared to previous analyses, this search is optimized for point-like neutrino emission with the same flux-characteristics as the observed astrophysical muon-neutrino flux and introduces an improved event-reconstruction and parametrization of the background. The result is an improvement in sensitivity to the muon-neutrino flux compared to the previous analysis of
∼
35
%
assuming an
E
-
2
spectrum. The sensitivity on the muon-neutrino flux is at a level of
E
2
d
N
/
d
E
=
3
·
10
-
13
TeV
cm
-
2
s
-
1
. No new evidence for neutrino sources is found in a full sky scan and in an a priori candidate source list that is motivated by gamma-ray observations. Furthermore, no significant excesses above background are found from populations of sub-threshold sources. The implications of the non-observation for potential source classes are discussed.
We report a quasidifferential upper limit on the extremely-high-energy (EHE) neutrino flux above 5×106 GeV based on an analysis of nine years of IceCube data. The astrophysical neutrino flux ...measured by IceCube extends to PeV energies, and it is a background flux when searching for an independent signal flux at higher energies, such as the cosmogenic neutrino signal. We have developed a new method to place robust limits on the EHE neutrino flux in the presence of an astrophysical background, whose spectrum has yet to be understood with high precision at PeV energies. A distinct event with a deposited energy above 106 GeV was found in the new two-year sample, in addition to the one event previously found in the seven-year EHE neutrino search. These two events represent a neutrino flux that is incompatible with predictions for a cosmogenic neutrino flux and are considered to be an astrophysical background in the current study. The obtained limit is the most stringent to date in the energy range between 5×106 and 2×1010 GeV. This result constrains neutrino models predicting a three-flavor neutrino flux of Eν2ϕνe+νμ+ντ≃2×10−8 GeV/cm2 sec sr at 109 GeV. A significant part of the parameter space for EHE neutrino production scenarios assuming a proton-dominated composition of ultra-high-energy cosmic rays is disfavored independently of uncertain models of the extragalactic background light which previous IceCube constraints partially relied on.
We report on measurements of the all-particle cosmic ray energy spectrum and composition in the PeV to EeV energy range using 3 years of data from the IceCube Neutrino Observatory. The IceTop ...detector measures cosmic ray induced air showers on the surface of the ice, from which the energy spectrum of cosmic rays is determined by making additional assumptions about the mass composition. A separate measurement is performed when IceTop data are analyzed in coincidence with the high-energy muon energy loss information from the deep in-ice IceCube detector. In this measurement, both the spectrum and the mass composition of the primary cosmic rays are simultaneously reconstructed using a neural network trained on observables from both detectors. The performance and relative advantages of these two distinct analyses are discussed, including the systematic uncertainties and the dependence on the hadronic interaction models, and both all-particle spectra as well as individual spectra for elemental groups are presented.
Inelasticity, the fraction of a neutrino’s energy transferred to hadrons, is a quantity of interest in the study of astrophysical and atmospheric neutrino interactions at multi-TeV energies with ...IceCube. In this work, a sample of contained neutrino interactions in IceCube is obtained from five years of data and classified as 2650 tracks and 965 cascades. Tracks arise predominantly from charged-current νμ interactions, and we demonstrate that we can reconstruct their energy and inelasticity. The inelasticity distribution is found to be consistent with the calculation of Cooper-Sarkar et al. across the energy range from ∼1 to ∼100 TeV. Along with cascades from neutrinos of all flavors, we also perform a fit over the energy, zenith angle, and inelasticity distribution to characterize the flux of astrophysical and atmospheric neutrinos. The energy spectrum of diffuse astrophysical neutrinos is described well by a power law in both track and cascade samples, and a best-fit index γ=2.62±0.07 is found in the energy range from 3.5 TeV to 2.6 PeV. Limits are set on the astrophysical flavor composition and are compatible with a ratio of (13∶13∶13)⊕. Exploiting the distinct inelasticity distribution of νμ and ν¯μ interactions, the atmospheric νμ to ν¯μ flux ratio in the energy range from 770 GeV to 21 TeV is found to be 0.77−0.25+0.44 times the calculation by Honda et al. Lastly, the inelasticity distribution is also sensitive to neutrino charged-current charm production. The data are consistent with a leading-order calculation, with zero charm production excluded at 91% confidence level. Future analyses of inelasticity distributions may probe new physics that affects neutrino interactions both in and beyond the Standard Model.
The sources of the majority of the high-energy astrophysical neutrinos observed with the IceCube neutrino telescope at the South Pole are unknown. So far, only a flaring gamma-ray blazar was ...compellingly associated with the emission of high-energy neutrinos. However, several studies suggest that the neutrino emission from the gamma-ray blazar population only accounts for a small fraction of the total astrophysical neutrino flux. In this work we probe the production of high-energy neutrinos in the cores of active galactic nuclei (AGN), induced by accelerated cosmic rays in the accretion disk region. We present a likelihood analysis based on eight years of IceCube data, searching for a cumulative neutrino signal from three AGN samples created for this work. The neutrino emission is assumed to be proportional to the accretion disk luminosity estimated from the soft x-ray flux. Next to the observed soft x-ray flux, the objects for the three samples have been selected based on their radio emission and infrared color properties. For the largest sample in this search, an excess of high-energy neutrino events with respect to an isotropic background of atmospheric and astrophysical neutrinos is found, corresponding to a post-trial significance of 2.60σ. If interpreted as a genuine signal with the assumptions of a proportionality of x-ray and neutrino fluxes and a model for the subthreshold flux distribution, then this observation implies that at 100 TeV, 27%–100% of the observed neutrinos arise from particle acceleration in the core of AGN at 1σ confidence interval.
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