We report on studies of the viability and sensitivity of the Askaryan Radio Array (ARA), a new initiative to develop a Teraton-scale ultra-high energy neutrino detector in deep, radio-transparent ice ...near Amundsen-Scott station at the South Pole. An initial prototype ARA detector system was installed in January 2011, and has been operating continuously since then. We describe measurements of the background radio noise levels, the radio clarity of the ice, and the estimated sensitivity of the planned ARA array given these results, based on the first five months of operation. Anthropogenic radio interference in the vicinity of the South Pole currently leads to a few-percent loss of data, but no overall effect on the background noise levels, which are dominated by the thermal noise floor of the cold polar ice, and galactic noise at lower frequencies. We have also successfully detected signals originating from a 2.5km deep impulse generator at a distance of over 3 km from our prototype detector, confirming prior estimates of kilometer-scale attenuation lengths for cold polar ice. These are also the first such measurements for propagation over such large slant distances in ice. Based on these data, ARA-37, the ∼200km2 array now in its initial construction phase, will achieve the highest sensitivity of any planned or existing neutrino detector in the 1016–1019eV energy range.
The nationwide shortage of mental health resources often disproportionately affects rural areas. As innovative strategies are required to address mental health resource shortages in rural areas, ...telepsychiatry consultation (TPC) may represent a population health-oriented approach to bridge this gap. In this case report, we examine the use of TPC from an academic consultation-liaison psychiatry service to a rural community hospital.
We describe the case of a woman with Wernicke encephalopathy seeking to leave the hospital against medical advice and the role that the TPC service played in the patient's evaluation and management, including assessing decision-making capacity.
We then examine benefits and limitations of the service, including a narrative review of the relevant, but limited, available literature as well as suggestions for how the service may be improved and incorporated into psychiatry residency and fellowship training in the future.
Ultrahigh energy neutrinos are interesting messenger particles since, if detected, they can transmit exclusive information about ultrahigh energy processes in the Universe. These particles, with ...energies above 10 super(16)eV , interact very rarely. Therefore, detectors that instrument several gigatons of matter are needed to discover them. The ARA detector is currently being constructed at the South Pole. It is designed to use the Askaryan effect, the emission of radio waves from neutrino-induced cascades in the South Pole ice, to detect neutrino interactions at very high energies. With antennas distributed among 37 widely separated stations in the ice, such interactions can be observed in a volume of several hundred cubic kilometers. Currently three deep ARA stations are deployed in the ice, of which two have been taking data since the beginning of 2013. In this article, the ARA detector "as built" and calibrations are described. Data reduction methods used to distinguish the rare radio signals from overwhelming backgrounds of thermal and anthropogenic origin are presented. Using data from only two stations over a short exposure time of 10 months, a neutrino flux limit of 1.5x10 super(-6)GeV/cm super(2)/s/sr is calculated for a particle energy of 10 super(18)eV , which offers promise for the full ARA detector.
Ultra-high energy neutrinos are detectable through impulsive radio signals generated through interactions in dense media, such as ice. Subsurface in-ice radio arrays are a promising way to advance ...the observation and measurement of astrophysical high-energy neutrinos with energies above those discovered by the IceCube detector (≥ 1 PeV) as well as cosmogenic neutrinos created in the GZK process (≥ 100 PeV). Here we describe the NuPhase detector, which is a compact receiving array of low-gain antennas deployed 185 m deep in glacial ice near the South Pole. Signals from the antennas are digitized and coherently summed into multiple beams to form a low-threshold interferometric phased array trigger for radio impulses. The NuPhase detector was installed at an Askaryan Radio Array (ARA) station during the 2017/18 Austral summer season. In situ measurements with an impulsive, point-source calibration instrument show a 50% trigger efficiency on impulses with voltage signal-to-noise ratios (SNR) of ≤2.0, a factor of ∼1.8 improvement in SNR over the standard ARA combinatoric trigger. Hardware-level simulations, validated with in situ measurements, predict a trigger threshold of an SNR as low as 1.6 for neutrino interactions that are in the far field of the array. With the already-achieved NuPhase trigger performance included in ARASim, a detector simulation for the ARA experiment, we find the trigger-level effective detector volume is increased by a factor of 1.8 at neutrino energies between 10 and 100 PeV compared to the currently used ARA combinatoric trigger. We also discuss an achievable near term path toward lowering the trigger threshold further to an SNR of 1.0, which would increase the effective single-station volume by more than a factor of 3 in the same range of neutrino energies.
The Askaryan Radio Array (ARA) is an ultra-high energy (>1017eV) cosmic neutrino detector in phased construction near the south pole. ARA searches for radio Cherenkov emission from particle cascades ...induced by neutrino interactions in the ice using radio frequency antennas (∼150-800MHz) deployed at a design depth of 200m in the Antarctic ice. A prototype ARA Testbed station was deployed at ∼30m depth in the 2010–2011 season and the first three full ARA stations were deployed in the 2011–2012 and 2012–2013 seasons. We present the first neutrino search with ARA using data taken in 2011 and 2012 with the ARA Testbed and the resulting constraints on the neutrino flux from 1017-1021eV.
Background:
Hospitalizations for serious infections requiring long-term intravenous (IV) antimicrobials related to injection drug use have risen sharply over the last decade. At our rural tertiary ...care center, opportunities for treatment of underlying substance use disorders were often missed during these hospital admissions. Once medically stable, home IV antimicrobial therapy has not traditionally been offered to this patient population due to theoretical concerns about misuse of long-term IV catheters, leading to discharges with suboptimal treatment regimens, lengthy hospital stays, or care that is incongruent with patient goals and preferences.
Methods:
A multidisciplinary group of clinicians and patients set out to redesign and improve care for this patient population through a health care innovation process, with a focus on increasing the proportion of patients who may be discharged on home IV therapy. Baseline assessment of current experience was established through retrospective chart review and extensive stakeholder analysis. The innovation process was based in design thinking and facilitated by a health care delivery improvement incubator.
Results:
The components of the resulting intervention included early identification of hospitalized people who inject drugs with serious infections, a proactive psychiatry consultation service for addiction management for all patients, a multidisciplinary care conference to support decision making around treatment options for infection and substance use, and care coordination/navigation in the outpatient setting with a substance use peer recovery coach and infectious disease nurse for patients discharged on home IV antimicrobials. Patients discharged on home IV therapy followed routine outpatient parenteral antimicrobial therapy (OPAT) protocols and treatment protocols for addiction with their chosen provider.
Conclusion:
An intervention developed through a design-thinking-based health care redesign process improved patient-centered care for people with serious infections who inject drugs.
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