Precision Measurement of Reactor Antineutrino Oscillation at Kilometer-Scale Baselines by Daya Bay

We present a new determination of the smallest neutrino mixing angle θ_{13} and the mass-squared difference Δm_{32}^{2} using a final sample of 5.55×10^{6} inverse beta-decay (IBD) candidates with the final-state neutron captured on gadolinium. This sample is selected from the complete dataset obtained by the Daya Bay reactor neutrino experiment in 3158 days of operation. Compared to the previous Daya Bay results, selection of IBD candidates has been optimized, energy calibration refined, and treatment of backgrounds further improved. The resulting oscillation parameters are sin^{2}2θ_{13}=0.0851±0.0024, Δm_{32}^{2}=(2.466±0.060)×10^{-3}  eV^{2} for the normal mass ordering or Δm_{32}^{2}=-(2.571±0.060)×10^{-3}  eV^{2} for the inverted mass ordering.

University Coaching for Activity and Nutrition (UCAN): A weight-inclusive health coaching program

Background: Given the body image and disordered eating struggles prevalent in young adults, weight-inclusive anti-diet programs are needed on college campuses. Such programs replace weight loss advice with changes that center physical and mental well-being. Methods/Program Design: University health and wellness programs such as University Coaching for Activity and Nutrition (UCAN) is a novel weight-inclusive health and wellness coaching program designed to support university students and faculty/staff in their development and maintenance of self-care behaviors related to physical activity, nutrition, sleep, and stress management. Specifically, we describe the program's mechanisms for participant recruitment, health coach training, session protocol, program evaluation, and supervision so other campuses can replicate the program model at their respective universities. Discussion: This work can help campuses cultivate positive self-care habits that improve physical and mental health through the lens of a weight-inclusive paradigm while also creating research and service-learning experiences for pre-health professionals.

Measurement is the foundation of research and theory on children's eating behaviours: Current issues and directions for progress

Eating behaviours affect food intakes and are involved in the aetiology of obesity. There has been impetus to translate findings about children's eating behaviour into intervention and policy programs. However, measurement limitations have hindered our capacity to understand and influence children's eating behaviours. In the present paper we provide an overview of some of the key methodological and measurement issues facing the field of children's eating behaviours and highlight implications for research and health promotion. Drawing on insight from parallel issues that occur in the measurement of early social and emotional development, we examine two overlapping themes in children's (aged 0-∼12 years) eating behaviours (Somaraki et al., 2021) measurement issues related to validity and reliability, and (Steinsbekk & Wichstrøm, 2015) associated methodological challenges, such as contextual influences and the importance of designing studies that use multiple informants and multiple methods. We then suggest insights and strategies aimed at advancing approaches to measurement of children's eating behaviours. To progress our understanding of children's eating behaviours, we conclude that a range of psychometrically sound, fit-for-purpose measurement instruments and procedures are needed for use in multi-trait, multi-method, multi-informant studies in a range of populations and contexts.

Diagnostic radiography students' perspectives on cultural competence and safety

INTRODUCTION

Cultural competency and safety are essential components to consider in the provision of person-centred equitable healthcare. Therefore, student radiographers' learning should include the necessary knowledge, skill sets and competence to recognise the patient's unique characteristics to enable culturally competent and safe medical imaging services. Therefore, this study explored undergraduate and postgraduate diagnostic radiography students' perspectives on cultural competency and safety.

METHODS

A qualitative phenomenological design with a hermeneutic phenomenological approach was followed to explore student perspectives. Student radiographers (second and third-year undergraduate and first and second-year postgraduate) from the study site were purposively and conveniently recruited to participate in focus group interviews. Fifteen focus group interviews were conducted, recorded and transcribed verbatim before undergoing thematic analysis.

RESULTS

Thematic analysis identified two themes. Theme one centred around the cultural competence and safety learnt by student radiographers at university and the second theme cultural competence and safety learnt in workplace learning.

CONCLUSION

This study demonstrated the importance of cultural competence and safe practice in examining patients of different cultures. It highlights the importance of creating awareness among students of their own abilities and capabilities of cultural sensitivity and safe practice as part of their learning. Future health professionals should be empowered to address and respond to patients' unique needs in a competent, safe and professional manner to reduce health disparities.

IMPLICATIONS FOR PRACTICE

Cultural competence and safety are integral to person-centred care. Including these concepts in radiography education is therefore vital to ensure optimal patient outcomes.

A129 A RETROSPECTIVE ANALYSIS OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH PANCREATICODUODENECTOMY

Background

Surgically altered anatomy remains a challenge when performing advanced endoscopic procedures including endoscopic retrograde cholangiopancreatography (ERCP). Post-surgical anatomy frequently encountered in clinical practice that affects ERCP success includes Billroth II, roux-en-y gastric bypass, roux-en-y hepaticojejunostomy and pancreaticoduodenectomy (PD). While ERCP has a success rate of 90-95% in patients with native anatomy, the data is less robust in patients with PD anatomy. Advancement of the endoscope to the surgical anastomoses remains challenging as PD anatomy requires accurate identification of the afferent limb, and encourages acute bowel angulation and loop formation. In addition, navigation to the anastomosis may be more challenging with a sideviewing endoscope. Although forward viewing endoscopes may more readily reach the surgical anastomosis, cannulation may be difficult without an elevator or device-appropriate instruments. As a result, a retrospective analysis of technical and clinical success rates in ERCP was analyzed in post-PD patients.

Purpose

The purpose of this study was to evaluate the technical and clinical success of ERCP in patients with post-PD anatomy.

Method

A retrospective analysis was conducted on all patients with post-PD anatomy referred to our institution between 2006 to 2021 for ERCP. Demographic and procedural details including gender, age, indications, primary malignancy, and anastomosis identification were collected. Major outcomes included technical success (TS) rate (successful biliary or pancreatic intervention) and clinical success (CS) rate (improvement in patient symptomatology or normalization of bilirubin level).

Result(s)

A total of 47 patients underwent 102 ERCPs for biliary (n = 98; 96.1%) and pancreatic (n = 4; 3.9%) indications. There were 31 (66.0%) male patients and 16 (34.0%) female patients. The average age of patients was 61.5 years. The most common primary malignancies included pancreatic adenocarcinoma (n = 26; 55.3%), pancreatic neuroendocrine tumour (n = 5; 10.6%), and ampullary adenocarcinoma (n = 4; 8.5%). The most common indications for ERCP included obstructive jaundice (n = 22; 21.6%), stent evaluation (n = 30; 29.4%), and cholangitis (n = 35; 34.3%). Surgical anastomosis was identified in 90 (88.2%) patients. The overall TS and CS rates were 82.4% and 75.5%, respectively. When adjusted for anastomosis identification, the overall TS and CS rates were 93.3% and 82.2%.

Conclusion(s)

Despite the challenges of conducting ERCP in patients with post-PD anatomy, this retrospective analysis demonstrates an adequate overall TS and CS rate. Although endoscope advancement to the surgical anastomoses may be challenging, TS and CS rates improved if the anastomosis was reached and identified. The advent of endoscopic enteroenterostomy formation, balloon-assisted enterscopy, and rigidizing overtubes may assist in reaching surgical anastomoses. As a result, consideration should be undertaken to attempt ERCP in post-PD patients.

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Disclosure of Interest

None Declared

A121 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH PANCREATICODUODENECTOMY USING DYNAMIC RIGIDIZING OVERTUBE

Background

Dynamic rigidizing overtubes have recently been described as a useful tool in challenging endoscopic procedures. These devices have the ability to dynamically rigidize, which stabilizes endoscope position, reduce loop formation and assist in the traversal of acute angulation. Its use has been best described in difficult colonoscopies by preventing loop formation and subsequently facilitating cecal intubation. However, the use of rigidizing overtubes for endoscopic retrograde cholangiopancreatography is sparsely described in the literature. In particular, rigidizing overtubes may be beneficial in patients with surgically-altered anatomy, including post-pancreaticoduodenectomy (PD) patients, as traversal to the surgical anastomosis is often challenging because of loop formation and acute angulation. In this study, a retrospective analysis was conducted on post-PD patients undergoing ERCP with dynamic rigidizing overtube.

Purpose

The purpose of this study was to evaluate the technical and clinical success of post-PD patients undergoing ERCP with rigidizing overtube.

Method

A retrospective analysis was conducted on all post-PD patients who underwent ERCP with rigidizing overtube between 2006 and 2021. Demographic information including age, gender and primary malignancy was collected. Pertinent procedure-related information including indication and anastomosis identification was obtained. The primary outcomes evaluated included technical and clinical success rate. Technical success (TS) was defined as the ability to perform an intended therapeutic intervention (stent insertion, cannulation, etc). Clinical success (CS) was operationalized as improvement in patient symptoms or normalization of bilirubin.

Result(s)

A total of 5 patients underwent 11 ERCPs with rigidizing overtube for biliary indications. There was a total of 3 (60.0%) male and 2 (40.0%) female patients. The average age of the patients was 62.5 years of age. There were 3 (60.0%) patients with pancreas cancer, 1 (20.0%) with metastatic renal cell carcinoma, and 1 (20.0%) with duodenal adenoma with high grade dysplasia. The indications for ERCP included stent evaluation (n = 6; 54.5%), obstructive jaundice (n =3; 27.3%), cholangitis (n = 1; 9.1%), and stricture evaluation (n = 1; 9.1%). The surgical anastomosis was identified in all patients (n = 11; 100%). The overall technical and clinical success rates were both 90.9%.

Conclusion(s)

The use of rigidizing overtubes in ERCP may be beneficial in patients with surgically altered anatomy. In this small sample, technical and clinical success rates were excellent in post-PD patients. However, additional studies need to be conducted to validate these findings further.

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Disclosure of Interest

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Evidence of Antineutrinos from Distant Reactors Using Pure Water at SNO

The SNO+ Collaboration reports the first evidence of reactor antineutrinos in a Cherenkov detector. The nearest nuclear reactors are located 240 km away in Ontario, Canada. This analysis uses events with energies lower than in any previous analysis with a large water Cherenkov detector. Two analytical methods are used to distinguish reactor antineutrinos from background events in 190 days of data and yield consistent evidence for antineutrinos with a combined significance of 3.5σ.