J. Anthony’s research while affiliated with University of Cambridge and other places

Background Multimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery. Methods This was a pre-planned analysis of a prospective, multicentre, international study investigating cardiovascular complications after major abdominal surgery conducted in 446 hospitals in 29 countries across Europe. The primary outcome was 30-day postoperative mortality. The secondary outcome measure was the incidence of complications within 30 days of surgery. Results Of 24,227 patients, 7006 (28.9%) had one long-term condition and 10,486 (43.9%) had multimorbidity (two or more long-term health conditions). The most common conditions were primary cancer (39.6%); hypertension (37.9%); chronic kidney disease (17.4%); and diabetes (15.4%). Patients with multimorbidity had a higher incidence of frailty compared with patients ≤ 1 long-term health condition. Mortality was higher in patients with one long-term health condition (adjusted odds ratio 1.93 (95%CI 1.16–3.23)) and multimorbidity (adjusted odds ratio 2.22 (95%CI 1.35–3.64)). Frailty and ASA physical status 3–5 mediated an estimated 31.7% of the 30-day mortality in patients with one long-term health condition (adjusted odds ratio 1.30 (95%CI 1.12– 1.51)) and an estimated 36.9% of the 30-day mortality in patients with multimorbidity (adjusted odds ratio 1.61 (95%CI 1.36–1.91)). There was no improvement in 30-day mortality in patients with multimorbidity who received pre-operative medical assessment. Conclusions Multimorbidity is common and outcomes are poor among surgical patients across Europe. Addressing multimorbidity in elective and emergency patients requires innovative strategies to account for frailty and disease control. The development of such strategies, that integrate care targeting whole surgical pathways to strengthen current systems, is urgently needed for multimorbid patients. Interventional trials are warranted to determine the effectiveness of targeted management for surgical patients with multimorbidity.

We present a measurement of η production from neutrino interactions on argon with the MicroBooNE detector. The modeling of resonant neutrino interactions on argon is a critical aspect of the neutrino oscillation physics program being carried out by the DUNE and Short Baseline Neutrino programs. η production in neutrino interactions provides a powerful new probe of resonant interactions, complementary to pion channels, and is particularly suited to the study of higher-order resonances beyond the Δ(1232). We measure a flux-integrated cross section for neutrino-induced η production on argon of 3.22±0.84(stat)±0.86(syst) 10−41 cm2/nucleon. By demonstrating the successful reconstruction of the two photons resulting from η production, this analysis enables a novel calibration technique for electromagnetic showers in GeV accelerator neutrino experiments.

Abstract Cardiovascular complications after major surgery are associated with increases in morbidity and mortality. There is confusion over definitions of cardiac injury or complications, and variability in the assessment and management of patients. This international prospective cohort study aimed to define the incidence and timing of these complications and to investigate their impact on 30-day all-cause mortality. We performed a prospective, international cohort study between January 2022 and May 2022. Data were collected on consecutive patients undergoing major abdominal surgery in 446 hospitals from 28 countries across Europe. The primary outcome measure was cardiovascular complications as defined by the Standardised Endpoints for Perioperative Medicine-Core Outcome Measures for Perioperative and Anaesthetic Care initiative up to 30 days after surgery. The secondary outcome was 30-day postoperative mortality. This study included 24,203 patients, of whom 611 (2.5%) developed cardiovascular complications. In total, 458 (1.9%) patients died within 30 days of surgery, of which 123 (26.9%) deaths were judged to be cardiac-related. Mortality rates were higher in patients who developed postoperative cardiovascular complications than in those who did not (19.8% vs. 1.4%), which persisted after risk adjustment (hazard ratio (95%CI) 4.15 (3.14-5.48)). We estimated an absolute risk reduction (95%CI) of 0.4 (0.3-0.5) in mortality in the absence of all cardiovascular complications. This would confer a relative risk reduction in mortality of 21.1% if all cardiovascular complications were prevented. Postoperative cardiovascular complications are relatively common and occur early after major abdominal surgery. However, over 1 in 5 postoperative deaths were attributable to these complications, highlighting an important area for future randomised trials.

MicroBooNE is a neutrino experiment located in the Booster Neutrino Beamline (BNB) at Fermilab, which collected data from 2015 to 2021. MicroBooNE’s liquid argon time projection chamber (LArTPC) is accompanied by a photon detection system consisting of 32 photomultiplier tubes used to measure the argon scintillation light and determine the timing of neutrino interactions. Analysis techniques combining light signals and reconstructed tracks are applied to achieve a neutrino interaction time resolution of O(1 ns). The result obtained allows MicroBooNE to access the nanosecond beam structure of the BNB for the first time. The timing resolution achieved will enable significant enhancement of cosmic background rejection for all neutrino analyses. Furthermore, the ns timing resolution opens new avenues to search for long-lived-particles such as heavy neutral leptons in MicroBooNE, as well as in future large LArTPC experiments, namely the SBN program and DUNE.

We report the first measurement of flux-integrated double-differential quasielasticlike neutrino-argon cross sections, which have been made using the Booster Neutrino Beam and the MicroBooNE detector at Fermi National Accelerator Laboratory. The data are presented as a function of kinematic imbalance variables which are sensitive to nuclear ground-state distributions and hadronic reinteraction processes. We find that the measured cross sections in different phase-space regions are sensitive to different nuclear effects. Therefore, they enable the impact of specific nuclear effects on the neutrino-nucleus interaction to be isolated more completely than was possible using previous single-differential cross section measurements. Our results provide precision data to help test and improve neutrino-nucleus interaction models. They further support ongoing neutrino-oscillation studies by establishing phase-space regions where precise reaction modeling has already been achieved.

We report on a flux-integrated multidifferential measurement of charged-current muon neutrino scattering on argon with one muon and one proton in the final state using the Booster Neutrino Beam and MicroBooNE detector at Fermi National Accelerator Laboratory. The data are studied as a function of various kinematic imbalance variables and of a neutrino energy estimator, and are compared to a number of event generator predictions. We find that the measured cross sections in different phase-space regions are sensitive to nuclear effects. Our results provide precision data to test and improve the neutrino-nucleus interaction models needed to perform high-accuracy oscillation analyses. Specific regions of phase space are identified where further model refinements are most needed.

We present the first measurement of the cross section of Cabibbo-suppressed Λ baryon production, using data collected with the MicroBooNE detector when exposed to the neutrinos from the main injector beam at the Fermi National Accelerator Laboratory. The data analyzed correspond to 2.2×1020 protons on target running in neutrino mode, and 4.9×1020 protons on target running in anti-neutrino mode. An automated selection is combined with hand scanning, with the former identifying five candidate Λ production events when the signal was unblinded, consistent with the GENIE prediction of 5.3±1.1 events. Several scanners were employed, selecting between three and five events, compared with a prediction from a blinded Monte Carlo simulation study of 3.7±1.0 events. Restricting the phase space to only include Λ baryons that decay above MicroBooNE’s detection thresholds, we obtain a flux averaged cross section of 2.0−1.7+2.2×10−40 cm2/Ar, where statistical and systematic uncertainties are combined.

We present a measurement of $\eta$ production from neutrino interactions on argon with the MicroBooNE detector. The modeling of resonant neutrino interactions on argon is a critical aspect of the neutrino oscillation physics program being carried out by the DUNE and Short Baseline Neutrino programs. $\eta$ production in neutrino interactions provides a powerful new probe of resonant interactions, complementary to pion channels, and is particularly suited to the study of higher-order resonances beyond the $\Delta(1232)$. We measure a flux-integrated cross section for neutrino-induced $\eta$ production on argon of $3.22 \pm 0.84 \; \textrm{(stat.)} \pm 0.86 \; \textrm{(syst.)}$ $10^{-41}{\textrm{cm}}^{2}$/nucleon. By demonstrating the successful reconstruction of the two photons resulting from $\eta$ production, this analysis enables a novel calibration technique for electromagnetic showers in GeV accelerator neutrino experiments.

MicroBooNE is a neutrino experiment located in the Booster Neutrino Beamline (BNB) at Fermilab, which collected data from 2015 to 2021. MicroBooNE's liquid argon time projection chamber (LArTPC) is accompanied by a photon detection system consisting of 32 photomultiplier tubes used to measure the argon scintillation light and determine the timing of neutrino interactions. Analysis techniques combining light signals and reconstructed tracks are applied to achieve a neutrino interaction time resolution of $\mathcal{O}(1\,\text{ns})$. The result obtained allows MicroBooNE to access the ns neutrino pulse structure of the BNB for the first time. The timing resolution achieved will enable significant enhancement of cosmic background rejection for all neutrino analyses. Furthermore, the ns timing resolution opens new avenues to search for long-lived-particles such as heavy neutral leptons in MicroBooNE, as well as in future large LArTPC experiments, namely the SBN program and DUNE.

We report the first measurement of π0 production in neutral current (NC) interactions on argon with average neutrino energy of ≲1 GeV. We use data from the MicroBooNE detector’s 85 metric tons active volume liquid argon time projection chamber situated in Fermilab’s Booster Neutrino Beam and exposed to 5.89×1020 protons on target for this measurement. Measurements of NC π0 events are reported for two exclusive event topologies without charged pions. Those include a topology with two photons from the decay of the π0 and one proton and a topology with two photons and zero protons. Flux-averaged cross sections for each exclusive topology and for their semi-inclusive combination are extracted (efficiency correcting for two-plus proton final states), and the results are compared to predictions from the genie, neut, and nuwro neutrino event generators. We measure cross sections of 1.243±0.185(syst)±0.076(stat), 0.444±0.098±0.047, and 0.624±0.131±0.075 [10−38 cm2/Ar] for the semi-inclusive NCπ0, exclusive NCπ0+1p, and exclusive NCπ0+0p processes, respectively.