We present a conceptual design of a high-performance camera system with applications to neutrino detectors, deep sea exploration, and glaciology. The design combines ultra-sensitive cameras with a ...number of well-calibrated light sources enclosed in a pressure vessel. The instrument will be capable of withstanding extreme environments such as those encountered in Antarctica or the deep ocean, and be deployable as a standalone system that can be retrieved for deep-sea exploration or glaciology. The camera system is designed to be replicated and deployed in multiple detectors, requiring only modest modifications from one detector to another. The instrument combines a number of capabilities essential for neutrino detector calibrations, including characterization of the scattering and absorption properties of the optical medium, measurement of geometries via photogrammetry, and detector surveillance. The ability to deploy the instrument at different detector sites also offers opportunities for cross-calibration efforts. We present the conceptual design of the instrument and describe plans to produce a prototype.
In patients with atrial high-rate episodes, edoxaban did not significantly reduce the incidence of stroke and cardiovascular outcomes as compared with placebo, but it led to a higher incidence of ...bleeding.
Abstract
Background and Aims
Patients with long atrial high-rate episodes (AHREs) ≥24 h and stroke risk factors are often treated with anticoagulation for stroke prevention. Anticoagulation has never ...been compared with no anticoagulation in these patients.
Methods
This secondary pre-specified analysis of the Non-vitamin K antagonist Oral anticoagulants in patients with Atrial High-rate episodes (NOAH-AFNET 6) trial examined interactions between AHRE duration at baseline and anticoagulation with edoxaban compared with placebo in patients with AHRE and stroke risk factors. The primary efficacy outcome was a composite of stroke, systemic embolism, or cardiovascular death. The safety outcome was a composite of major bleeding and death. Key secondary outcomes were components of these outcomes and electrocardiogram (ECG)-diagnosed atrial fibrillation.
Results
Median follow-up of 2389 patients with core lab-verified AHRE was 1.8 years. AHRE ≥24 h were present at baseline in 259/2389 patients (11%, 78 ± 7 years old, 28% women, CHA2DS2-VASc 4). Clinical characteristics were not different from patients with shorter AHRE. The primary outcome occurred in 9/132 patients with AHRE ≥24 h (4.3%/patient-year, 2 strokes) treated with anticoagulation and in 14/127 patients treated with placebo (6.9%/patient-year, 2 strokes). Atrial high-rate episode duration did not interact with the efficacy (P-interaction = .65) or safety (P-interaction = .98) of anticoagulation. Analyses including AHRE as a continuous parameter confirmed this. Patients with AHRE ≥24 h developed more ECG-diagnosed atrial fibrillation (17.0%/patient-year) than patients with shorter AHRE (8.2%/patient-year; P < .001).
Conclusions
This hypothesis-generating analysis does not find an interaction between AHRE duration and anticoagulation therapy in patients with device-detected AHRE and stroke risk factors. Further research is needed to identify patients with long AHRE at high stroke risk.
Structured Graphical Abstract
Structured Graphical Abstract
Anticoagulation with edoxaban in patients with long AHRE ≥24 h. AHRE, atrial high-rate episodes; CI, confidence interval; ECG, electrocardiogram; HR, hazard ratio.
